In the

United States Court of Appeals

For the Seventh Circuit

Nos. 07-1022 & 07-1116

JO ANN TATE,

Plaintiff-Appellee,

Cross-Appellant,

v.

LONG TERM DISABILITY PLAN FOR SALARIED EMPLOYEES

OF CHAMPION INTERNATIONAL CORPORATION #506,

Defendant-Appellant,

Cross-Appellee.

Appeals from the United States District Court for the 

Northern District of Illinois, Eastern Division.

No. 04 C 8204—Blanche M. Manning, Judge.

ARGUED JANUARY 14, 2008—DECIDED SEPTEMBER 19, 2008

Before POSNER, KANNE, and WILLIAMS, Circuit Judges.

WILLIAMS, Circuit Judge. Jo Ann Tate claims that the

administrator of her employer’s long-term disability plan

(the “Plan”) violated the Employment Retirement Income

Security Act (“ERISA”), 29 U.S.C. §§ 1001 et seq., when,

after four years, it terminated her long-term disability

benefits. The Plan’s determination was based on its con-
2 Nos. 07-1022 & 07-1116

clusion that despite Tate’s long history of psychiatric

difficulties, including a major depressive disorder and

bipolar disease, she is able to perform an occupation for

which she is qualified. Yet the Plan did not determine

what occupation that might be, or explain why, after years

of concluding that Tate was disabled, it found Tate (a

former sales employee who has not left her house in

many years except to see her treating physicians) suddenly

able to work. Tate filed suit to recover benefits after

exhausting her administrative appeals. On cross-motions

for summary judgment, the district court determined

that the Plan administrator had acted arbitrarily and

capriciously in denying Tate’s benefits and remanded the

case so that the Plan could conclusively establish whether

Tate is entitled to benefits. The district court also denied

Tate’s motion for attorney’s fees.

We affirm the district court’s decisions. Because the

record does not suggest the Plan’s decision to terminate

Tate’s long-term disability benefits was the result of an

informed reasoning process, we conclude that the decision was arbitrary and capricious. But we cannot say

that Tate was entitled to continued long-term disability

benefits at the time her benefits were terminated, so we

affirm the district court’s decision to remand the case

for further proceedings. Additionally, because it is too

early to tell if Tate is the “prevailing party” in this case, we

affirm the district court’s denial of Tate’s motion for

attorney’s fees.
Nos. 07-1022 & 07-1116 3

When Tate first applied for disability benefits, CORE, Inc. 1

served as the third-party claims administrator. It was replaced on January 1, 2001 by Wausau Benefits, Inc. 

I. BACKGROUND

Tate was employed as a sales representative at Nationwide Papers, a subsidiary of Champion International

Corporation, until June 30, 1998, when she left work due to

problems with severe anxiety and depression. As an

employee of Champion, Tate was eligible for short-term

and long-term disability benefits. Champion’s benefits

plan is governed by ERISA, 29 U.S.C. §§1001 et seq.

1

After receiving short-term disability benefits for six

months, Tate applied for long-term disability in 1999. The

Plan determines an employee’s eligibility for long-term

disability benefits in two stages. For the first twenty-four

months after an employee receives short-term disability

benefits, the employee must be found unable to perform

the duties of her employment with the company. To

qualify for benefits after that time, the employee must

be found unable to engage in “any occupation” for which

she “is or may become reasonably qualified by training,

education, or experience.” The Plan refers to these different standards of eligibility as the “own occupation”

standard and the “any occupation” standard. Tate was

approved for long-term disability on March 8, 1999. The

“own occupation” stage ended in 2001 and Tate continued to receive benefits for another two years, during

which time she submitted reports by her physicians

regarding her condition.
4 Nos. 07-1022 & 07-1116

Pursuant to the administrative services agreements

between the Plan administrators and Champion, the Plan

relied on consulting physicians to review the files of

employees receiving benefits. In the four years that Tate

received benefits, at least twelve physicians evaluated

her condition. Among those physicians are Tate’s own

physicians, Dr. Sharon Greenburg and Dr. Lawrence

Kayton, both of whom treated Tate, as well as a multitude

of physicians retained by the Plan to evaluate Tate’s

disability.

Although Tate’s entire medical history need not be

cataloged here, a brief synopsis provides context for this

case. Tate suffered from depression, panic disorder, and

bipolar disorder. In 1999, she was diagnosed by Dr.

Greenburg as having a major depressive disorder that

caused her to feel hopeless, fatigued, irritable, and uninterested in people. Dr. Kayton (who conferred with Dr.

Greenburg about Tate’s condition) diagnosed Tate with

bipolar disorder. Tate’s physicians attempted to improve

her condition with medication which had varying results. In November 2000, Tate reported she was able to

perform some activities of daily living but that she did not

leave her house except to see her doctor. She continued to

suffer from severe mood swings and had difficulty maintaining concentration, engaging in social interactions, and

completing tasks. Although her mood swings appear to

have ceased in late 2001 and early 2002, they returned by

June 2002, when her overall condition worsened. Her

depression never subsided. In February 2003, she was

struggling with activities of daily living other than

eating and cleaning.
Nos. 07-1022 & 07-1116 5

On May 30, 2003, the Plan informed Tate she was no

longer eligible for disability benefits because she did not

meet the definition of “totally disabled” under the “any

occupation” standard. The Plan terminated her benefits

based on a report by Dr. Gail Tasch, who stated that

although Tate exhibited signs of major depressive disorder, she “did not manifest significant measurable

impairment which would prevent her from performing her

occupation or any occupation.” Dr. Tasch noted that Tate,

who had difficulty concentrating and establishing a daily

routine, was nonetheless able to care for her “affairs” and

herself and her pets. Dr. Tasch did not examine Tate; her

analysis was based on a review of Tate’s file, which

included case manager notes, an employee questionnaire,

a discussion with Dr. Kayton, psychotherapy progress

notes, and the review of another physician’s report dated

April 17, 1999.

Tate appealed the Plan’s decision to terminate her

benefits, arguing that Dr. Tasch’s opinion was based on

outdated medical records. Tate submitted a report from

Dr. Kayton dated November 20, 2003, which stated that

Tate suffered from moderately severe bipolar disorder

that, despite intensive treatment, had not sufficiently

stabilized to permit her to work in a job commensurate

with her abilities, experience, and previous levels of

employment. In support of his conclusion, Dr. Kayton

noted that Tate was hypomaniac, inefficient in completing tasks, and that she suffered from concentration

problems and episodic rages.

In response to Tate’s appeal, the Plan had Tate’s medical

record reviewed by Dr. Barbara H. Center. Dr. Center, like
6 Nos. 07-1022 & 07-1116

Dr. Tasch, did not examine Tate, but spoke to both of her

treating physicians and reviewed, among other things,

Tate’s job description and résumé. Dr. Center concluded

that Tate did not manifest significant measurable impairment that would render her unable to do any job for

which she was qualified. Dr. Center based this conclusion on the fact that Tate was able to maintain her

own home, complied with treatment, and had experienced

benefit from medication. The Plan notified Tate that

based on Dr. Center’s review, she no longer qualified for

long-term disability benefits.

Tate brought suit challenging the termination in the

Northern District of Illinois. The parties filed cross-motions

for summary judgment. The district court granted Tate’s

motion for summary judgment, holding that the Plan’s

decision to terminate Tate’s benefits was arbitrary and

capricious because the reviewing physicians’ opinions

were comprised of conclusory assertions unsupported

by facts. Specifically, the court noted that the Plan failed

to identify the types of positions Tate could undertake,

conduct an employability review, or conduct a transferable skills analysis (TSA). The Plan appeals this decision.

The district court remanded the case so that the Plan

could conclusively determine whether Tate is entitled to

disability benefits. The court also denied Tate’s request

for attorney’s fees, holding Tate was not yet a prevailing

party and that the record did not suggest the Plan had

terminated Tate’s benefits in bad faith. Tate filed a

motion to alter or amend the court’s judgment pursuant

to Rule 59(e) of the Federal Rules of Civil Procedure,
Nos. 07-1022 & 07-1116 7

arguing that the court should have reinstated her benefits rather than remanding the case for further disposition.

The court denied Tate’s motion on the ground that the

Plan’s denial of Tate’s benefits was an “initial denial”

rather than a termination of benefits for which Tate had

previously been determined eligible. Tate appeals these

decisions and seeks attorney’s fees. 

II. ANALYSIS

We review a district court’s grant of summary judgment

de novo. Schneider v. Sentry Group Long Term Disability

Plan, 422 F.3d 621, 626 (7th Cir. 2005). In reviewing crossmotions for summary judgment, we view all facts and

draw all reasonable inferences in a light most favorable

to the party against whom the motion is made. Gazarkiewicz

v. Town of Kingsford Heights, Ind., 359 F.3d 933, 939 (7th

Cir. 2004).

 

A. Termination of Tate’s benefits was arbitrary and

capricious.

Where, as is the case here, the benefit plan gives the

administrator discretionary authority to determine eligibility for benefits or to construe the terms of the plan, we

review a denial of benefits under the arbitrary and capricious standard. Firestone Tire & Rubber Co. v. Bruch, 489 U.S.

101, 115 (1989); Hackett v. Xerox Corp. Long-Term Disability

Income Plan, 315 F.3d 771, 773 (7th Cir. 2003). The parties

do not dispute that the Plan’s administrator has discretionary authority and that the district court used the
8 Nos. 07-1022 & 07-1116

correct standard when it reviewed Tate’s denial of benefits under the arbitrary and capricious standard.

Notwithstanding the highly deferential nature of this

standard, we have held that termination procedures must

substantially comply with the ERISA requirement “that

specific reasons for denial be communicated to the claimant and that the claimant be afforded an opportunity

for ‘full and fair review’ by the administrator.” Halpin v.

W.W. Grainger, Inc., 962 F.2d 685, 688-89 (7th Cir. 1992).

“[W]e will not uphold a termination when there is an

absence of reasoning in the record to support it.” Hackett,

315 F.3d at 774-75 (standard of review is not a “rubber

stamp”); Halpin, 962 F.2d at 695 (“[T]he administrator

must weigh the evidence for and against [the denial or

termination of benefits], and within reasonable limits, the

reasons for rejecting evidence must be articulated if there

is to be meaningful appellate review.”) (internal quotation

marks omitted).

The issue in this case is whether the Plan offered a

reasonable explanation, based on the evidence, for its

determination that Tate was not “totally disabled” as

defined by the terms of the plan. In determining Tate’s

eligibility for long-term disability benefits, the Plan had

to determine whether Tate was “incapable of performing

any occupation or employment for which [she was]

qualified by education, training, or experience.” So as a

matter of logic, this means the Plan needed to consider (at

minimum) Tate’s qualifications in determining whether

her impairment affects her ability to work.

We agree with the district court that the Plan’s decision

to terminate Tate’s benefits was arbitrary and capricious
Nos. 07-1022 & 07-1116 9

because the Plan’s conclusion that Tate’s disability did

not render her unable to do any job for which she was

qualified was not based on any explanation or reasoning.

The Plan twice informed Tate of its decision to terminate

her benefits, first based on a report by Dr. Tasch, and then

based on a report by Dr. Center in response to Tate’s

appeal. Both determinations are at issue here.

Dr. Tasch first reviewed Tate’s file and issued the

report that provided the basis for the Plan’s May 30, 2003

determination that Tate did not qualify for benefits. As an

initial matter, the record does not demonstrate that Dr.

Tasch even reviewed Tate’s employment file so it is not

clear how she could have come to any reasonable conclusion about Tate’s qualifications. See Quinn v. Blue Cross

& Blue Shield Ass’n, 161 F.3d 472, 476-77 (7th Cir. 1998)

(finding that plan administrator’s review was arbitrary

and capricious when the reviewer failed to adequately

investigate the requirements of the claimant’s previous

occupation). In her report, Dr. Tasch states that though

Tate “appears to meet the criteria for a diagnosis of Major

Depressive Disorder,” she is not unable to perform any

occupation. In lieu of an explanation for this conclusion,

Dr. Tasch states (and this is the full extent of her analysis)

that because Tate was “working in a high stress position

previously [she] may benefit from a job that is not so

intense.” We do not know what she means by jobs that are

not “intense” or whether Tate is qualified for those jobs.

The Plan’s letter informing Tate that her benefits were

being denied contains no reasons for the denial other

than stating that a physician found that Tate was not

totally disabled from any occupation so there is nothing

further in the initial denial letter for the court to review.
10 Nos. 07-1022 & 07-1116

Dr. Center’s report also states that Tate has a “long history of 2

psychiatric difficulties” and that she “is likely to have ongoing

psychiatric mental health symptoms for an extended period

of time.” The report notes that Tate has ongoing difficulties

with hypomania, is inefficient in completing tasks, and suffers

from mood swings.

In response to Tate’s appeal the Plan had her file reviewed by Dr. Center, whose report indicates that she

considered Tate’s résumé and job description, in addition to her medical files. But what Dr. Center did with

that additional information is less than clear. For example, Dr. Center’s report states that “Interpersonal

relationship difficulties characterized by the patient

becoming ‘enraged’ if she feels she is being patronized or

if others are incompetent may be limiting in terms of

future vocational options.” Nevertheless, Dr. Center

concludes that Tate (who was employed in sales) is not

totally disabled from any occupation at this time because

she is able to maintain her own home, complies with

treatment, and there is no documentation of suicidal

ideation, homicidal ideation, or psychosis. Dr. Center

also states that the addition of Adderall to her medication regimen in September 2002 provided her “significant benefit.”2

Dr. Center’s report is just as defective as Dr. Tasch’s

because nowhere in the report does Dr. Center connect

her conclusion that Tate is not totally disabled to something that is relevant to Tate’s ability to work. Similarly,

Dr. Center’s general conclusion that medication has

provided “significant benefit” to Tate does not prove
Nos. 07-1022 & 07-1116 11

anything unless the improvement is shown to be connected in some rational way to her ability to work. See

Elliott v. Metropolitan Life Ins. Co., 473 F.3d 613, 620 (6th Cir.

2006) (“ ‘Getting better,’ without more, does not equal ‘able

to work.’ ”).

The Plan’s second letter to Tate informing her that its

decision to deny her benefits would remain the same

echoes Dr. Center’s non-sequitur analysis. The letter states:

It is the opinion of the reviewer that you are able to

maintain your own home and care for your animals. There is no documentation of suicidal

ideation, homicidal ideation or psychosis. You

have been compliant with Outpatient psychotherapy and multiple medication trials. You are able to

understand and participate in the process regarding disability determinations. It appears that you

have had an exacerbation of mood symptoms

following the determination regarding disability.

However, no specific measurable impairments

rendering you unable to do “any job” for which

you are qualified by reason of training, education,

and/or experience were noted.

That Tate can clean her home and care for her pets after

years of treatment and medication does not support a

conclusion that she is capable of employment unless the

Plan believes she is qualified to care for animals as a

living. That she has not contemplated killing herself or

others is even less probative of her ability to work. These

reasons are not relevant to a conclusion that Tate, a former

sales employee, is able to do a job for which she is qualified.
12 Nos. 07-1022 & 07-1116

The Plan protests that it should not be required to

review vocational evidence in making disability determinations. But logically, the Plan could have made a

reasoned determination that Tate was not “totally disabled” only if it relied on evidence that assessed her

ability to perform a job for which she is qualified by

education, training, or experience. This means the Plan

must have made a reasonable inquiry into Tate’s medical

condition as well as her vocational skills and qualifications

for its decision denying benefits to be upheld. Quinn, 161

F.3d at 476. In so holding, we express no opinion as to

whether ERISA plan administrators as a rule must hire

vocational experts or perform a transferrable skills analysis. But it is the Plan’s burden to make sure its determination—that Tate could perform a job for which she

was qualified despite her medical condition—is reached

in a manner that substantially complies with ERISA, see

Halpin, 962 F.2d 688-90. That did not happen here.

Although the record shows Dr. Center was given Tate’s

résumé and job description as part of her materials to

consider, nothing in Dr. Center’s report or the Plan’s

specific reasons for denial relates to Tate’s job qualifications. Unless the Plan provides a reasonable explanation

for its conclusion that Tate was capable of performing

another job for which she was qualified, we have no basis

to uphold the Plan’s decision. “Conclusions without

explanation do not provide the requisite reasoning and do

not allow for effective review.” Hackett, 315 F.3d at 775; see

also Halpin, 962 F.2d at 695 (rejecting plan administrator’s

denial of benefits as too conclusory to permit appellate

review where administrator did not weigh the evidence
Nos. 07-1022 & 07-1116 13

The Plan contends in its briefs that Tate’s medical records and

3

submissions contain conflicting information and therefore

Dr. Tasch and Dr. Center were justified in questioning the

objectivity of Dr. Kayton and Dr. Greenburg. Even if this were

true, the credibility of Tate’s physicians is not discussed anywhere in the record or in the reports of Dr. Tasch and Dr. Center.

Post hoc rationalizations for the denial of benefits on appeal

(continued...)

for and against a determination that a claimant is ready

to return to work).

The Plan contends that Tate bears the burden of demonstrating through a vocational expert that she is unable to

perform any job for which she is qualified. We disagree.

Although she certainly could have provided the affidavit

of a vocational expert, there is nothing in our case law

that requires her to do so as long as she provides evidence that she has an impairment that affects her ability to

work. Tate presented evidence, in the form of her physician’s report, that she was not capable of performing any

job. In his November 2003 letter to the Plan, Dr. Kayton

wrote that Tate is hypomaniac, inefficient in completing

tasks, and suffers from pronounced concentration problems, emotional volatility, episodic rages, and an inability

to handle even her activities of daily living. Dr. Kayton

reported that Tate had not been free from mood swings

since 1998, and that because of her unpredictable temper,

she had severely limited her interpersonal contacts.

Accordingly, Dr. Kayton wrote, her illness did not permit

her to work in a job commensurate with her abilities,

experience, and previous levels of employment.3
14 Nos. 07-1022 & 07-1116

(...continued) 3

are not sufficient. Halpin, 962 F.2d at 696. 

Without refuting this report or the assertions contained within, the Plan responded with the bare conclusion that Tate could do another job. This does not suffice

under the arbitrary and capricious standard of review

because there is no reason for this conclusion. It is well

within the power of the Plan to reject Dr. Kayton’s and

Dr. Greenburg’s conclusions but it must do so with some

explanation, especially in light of the fact that Tate was

awarded disability benefits for nearly four years on the

basis of those doctors’ opinions. See Hackett, 315 F.3d at

775 (termination procedures were arbitrary and capricious

when administrator did not explain departure from

opinions of previous doctors).

For the Plan to make a reasonable determination that

Tate was able to work in an occupation for which she

was qualified despite her impairments, the Plan was

required, at minimum, to assess her qualifications and

how they comport with jobs that Tate might be able to

perform in spite of her impairments. By not performing

this assessment before determining that Tate was not

totally disabled, the Plan acted arbitrarily and capriciously.

B. Remand, not reinstatement, is the appropriate

remedy.

Having found the Plan’s determination to be arbitrary

and capricious, we turn to Tate’s cross-appeal, which
Nos. 07-1022 & 07-1116 15

raises the issue of whether remand is the proper remedy.

We review the district court’s decision for an abuse of

discretion. Halpin, 962 F.2d at 697. 

Courts that find a plan administrator’s denial of benefits

to be arbitrary and capricious may either remand the

case for further proceedings or reinstate benefits. Generally, “when a court or agency fails to make adequate

findings or fails to provide an adequate reasoning, the

proper remedy in an ERISA case, as well as a conventional case, is to remand for further findings or explanations, unless it is ‘so clear cut that it would be unreasonable for the plan administrator to deny the application

for benefits on any ground.’ ” Quinn, 161 F.3d at 477

(quoting Gallo v. Amoco Corp., 102 F.3d 918, 923 (7th Cir.

1996)). Here, our finding that the Plan’s determination

was arbitrary and capricious is based on the fact that

the Plan did not provide adequate reasoning for its conclusion, so remand is appropriate. We express no opinion

regarding the merits of Tate’s claim as the record does

not make clear either way whether Tate is “totally disabled.”

Tate argues that she is entitled to reinstatement of

benefits because her claim involves the denial of benefits

for which she had initially been deemed eligible. In Hackett,

we noted a distinction “between a case dealing with a

plan administrator’s initial denial of benefits and a case

where the plan administrator terminated benefits to

which the administrator had previously determined the

claimant was entitled.” 315 F.3d at 775. Tate contends that

her case fits into the latter category because the “own
16 Nos. 07-1022 & 07-1116

occupation” period for disability benefits ended in

May 2001 and she received long-term disability benefits

for two years after that time. According to Tate, this

means she must have been approved for disability under

the “any occupation” standard.

We agree that if Tate could prove she had been entitled

to continued benefits at the time of the Plan’s decision,

reinstatement would be the proper remedy. See Schneider,

422 F.3d at 629 (“In fashioning relief for a plaintiff who

has sued to enforce her rights under ERISA, see 29 U.S.C.

§ 1132(a)(1)(B), we have focused ‘on what is required in

each case to fully remedy the defective procedures given

the status quo prior to the denial or termination’ of benefits.” (quoting Hackett 315 F.3d at 776)). But the fact that

the Plan continued to provide Tate long-term disability

benefits after the initial twenty-four months does not

prove that the Plan ever determined she was eligible for

benefits under the “any occupation” standard that Tate

must meet for continued benefits. Although it is odd that

the Plan would continue to award benefits to Tate for

two years without holding her to the more stringent “any

occupation” standard, this fact alone does not necessarily

mean Tate was entitled to continue receiving benefits

under the terms of the plan.

Like the district court, we cannot determine on this

record whether Tate is totally disabled from any occupation. See Quinn, 161 F.3d at 478 (reversing district court’s

award of reinstatement where it was not clear claimant

was disabled under the terms of the benefits program).

Therefore, we view this situation to be closer to an initial
Nos. 07-1022 & 07-1116 17

denial of benefits for which remand is appropriate rather

than a termination of benefits for which reinstatement

is appropriate.

Because we are not reinstating Tate’s benefits, we do not

reach the issue of whether Tate is entitled to prejudgment interest on the award.

C. Tate’s claim for attorney’s fees is premature.

Tate seeks attorney’s fees if we reinstate her benefits, an

argument that is mooted by our holding that Tate is not

entitled to reinstatement. Tate also argues that she

should be awarded attorney’s fees even if we affirm the

district court’s decision to remand the case. We disagree.

We review a district court’s decision to deny attorney’s

fees for an abuse of discretion. Herman v. Central States,

Southeast and Southwest Areas Pension Fund, 423 F.3d 684,

695 (7th Cir. 2005). In analyzing whether attorney’s fees

should be awarded to a “prevailing party” in an ERISA

case, a court should consider whether the losing party’s

position was justified and taken in good faith. Quinn, 161

F.3d at 478. However, we have held that a claimant who

is awarded a remand in an ERISA case generally is not a

“prevailing party” in the “truest sense of the term,” id. at

478-79. The district court first considered this question

and relied on Quinn to hold that Tate was not yet a prevailing party. Then the district court found that the record did

not suggest that Tate’s benefits were terminated in bad

faith or that the Plan’s position was not substantially

justified. 
18 Nos. 07-1022 & 07-1116

Tate urges us to reconsider our holding in Quinn but

cites cases that predate Quinn, see Miller v. United Welfare

Fund, 72 F.3d 1066, 1074 (2d Cir. 1995) and White v. Jacobs

Engineering Group Long Term Disability Benefit Plan, 896 F.2d

344 (9th Cir. 1990). These cases do not persuade us to

depart from Quinn. The district court considered the

proper test, and its conclusion was not an abuse of discretion. Tate is not entitled to attorney’s fees at this juncture.

III. CONCLUSION

The judgment of the district court is AFFIRMED.

9-19-08