IN THE UNITED STATES COURT OF APPEALS

FOR THE FIFTH CIRCUIT

No. 14-31200

Summary Calendar

ANGEL DIX, 

 Plaintiff - Appellant

v.

BLUE CROSS AND BLUE SHIELD ASSOCIATION LONG TERM 

DISABILITY PROGRAM, 

 Defendant - Appellee

Appeal from the United States District Court 

for the Middle District of Louisiana

USDC No. 3:12-CV-319

Before HIGGINBOTHAM, JONES, and HIGGINSON, Circuit Judges.

PER CURIAM:*

This is an appeal from the district court’s grant of summary judgment in 

favor of Blue Cross and Blue Shield Association Long Term Disability Program 

(“the Program”). The district court correctly held that the plan administrator’s

decision to deny disability payments to Angel Dix was not an abuse of 

discretion. However, because the district court named the incorrect defendant

 

* Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not 

be published and is not precedent except under the limited circumstances set forth in 5TH 

CIR. R. 47.5.4.

United States Court of Appeals

Fifth Circuit

FILED

May 29, 2015

Lyle W. Cayce

Clerk

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(“Blue Cross/Blue Shield of Louisiana”) in its order, we AFFIRM the

judgment, but REMAND with instructions to correct the name of the 

defendant. 

I. Factual Background 

This case arose out of the termination of disability benefits to Dix under

the Blue Cross Blue Shield of Louisiana’s (“BCBSL”) long-term disability 

program, which is governed by ERISA. Dix’s employer, BCBSL, and other 

independent Blue Cross and Blue shield organizations participate in the 

Program by paying into a trust which in turn funds the Program. The Blue 

Cross and Blue Shield Association (“the Association”) is an Illinois not-forprofit corporation which provides fiduciary administrative services to BCBSL 

and other Blue Cross and Blue Shield Organizations through its National 

Employees Benefits Committee (“NEBC”) and National Employees Benefits 

Administration (“NEBA”). NEBA and NEBC (the “Administrator”) administer 

the Program at issue in this case. The parties agree that the Administrator 

has discretionary authority to approve or deny benefits. 

Dix was an employee of BCBSL from 2006 to 2007. In 2007, Dix began 

experiencing back pain and applied for disability benefits on June 13, 2007. 

Dix was deemed disabled following examination and began receiving disability

benefits. On July 7, 2010, Dix was notified that she would no longer be 

receiving disability payments, as the Administrator had found that the medical 

evidence no longer supported a finding of disability. Dix appealed the decision

to deny benefits to the Assistant Secretary of NEBC, Barbara Grant, who 

affirmed the denial.

In reviewing Dix’s claim, Grant considered the medical opinions of

numerous treating and reviewing physicians, and the findings of an 

independent medical evaluation and a vocational expert’s report. Reviewing 

physician Dr. Scott Kale found Dix not disabled and capable of work with 

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accommodations. Dix claims that Dr. Kale lied about speaking with her 

treating physicians, Dr. Kevin McCarthy and Dr. Elizabeth Russo-Stringer. 

On January 27, 2012, Dix submitted to the Administrator medical 

records, X-rays, and MRIs from Dr. McCarthy, affidavits from Dr. McCarthy 

and Dr. Russo-Stringer stating that they do not recall speaking with Dr. Kale, 

and the first page of a favorable Social Security Administration (“SSA”) 

decision. The Administrator declined to add the documents to the 

administrative record on the basis that they were either cumulative or not 

available at the time Dix exhausted her administrative remedies. Dix filed 

suit and the district court granted summary judgment in favor of the Program. 

II. Standard of Review

This court reviews summary judgments de novo in ERISA cases, 

applying the same standards as the district court. Robinson v. Aetna Life Ins. 

Co., 443 F.3d 389, 392 (5th Cir. 2006). 

When, in an ERISA case, the language of the plan grants discretion to 

an administrator to interpret the plan and determine eligibility for benefits, a 

court will reverse the administrator’s decision only for abuse of discretion. 

McCorkle v. Metropolitan Life Ins. Co., 757 F.3d 452, 457 (5th Cir. 2014). Here, 

the parties do not dispute that the plan grants discretionary authority to the 

plan administrator. “A plan administrator abuses its discretion where the 

decision is not based on evidence, even if disputable, that clearly supports the 

basis for its denial.” Id. (quoting Holland v. Int’l Paper Co. Ret. Plan, 576 F.3d 

240, 246 (5th Cir. 2009), (internal quotation marks omitted). We reach a 

finding of abuse of discretion only when the plan administrator acted 

arbitrarily or capriciously. Id. A decision is arbitrary or capricious if made 

without a rational connection between the known facts and the decision. Id.

The administrator's decision to deny benefits must be supported by 

substantial evidence. Holland, 576 F.3d at 246. Substantial evidence is 

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merely “more than a scintilla, less than a preponderance, and is such relevant 

evidence as a reasonable mind might accept as adequate to support a 

conclusion.” McCorkle, 757 F.3d at 457 (quoting Ellis v. Liberty Life Assurance 

Co. of Boston, 394 F.3d 262, 273 (5th Cir. 2004)) (internal quotation marks 

omitted). A court’s “review of the administrator’s decision need not be 

particularly complex or technical; it need only assure that the administrator's 

decision falls somewhere on a continuum of reasonableness—even if on the low 

end.” Holland, 576 F.3d at 247. 

III. Discussion

On appeal, Dix reasserts that the Administrator had a conflict of 

interest; that the administrative record should have included documents, 

including a favorable SSA disability award, that Dix failed to submit to the 

Administrator for over a year after its final decision; and that the termination 

of benefits was an abuse of discretion and unsupported by substantial evidence. 

We consider each issue in turn.

A. Conflict of Interest 

The parties disagree about whether the Administrator operated under 

a structural conflict of interest when it terminated Dix’s disability payments. 

The district court found that the Administrator had a conflict of interest when 

it evaluated Dix’s claim because it both funded the disability program and 

made benefits eligibility decisions. This was incorrect.

A conflict of interest exists when a plan administrator both evaluates 

claims for benefits and pays benefits claims. Metro. Life Ins. Co. v. Glenn, 

554 U.S. 105, 112 (2008). “If the administrator has a conflict of interest, we 

weigh the conflict of interest as a factor in determining whether there is an 

abuse of discretion in the benefits denial, meaning we take account of several 

different considerations of which conflict of interest is one.” Holland, 576 F.3d 

at 247.

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Here, Dix’s employer, BCBSL, paid into a trust which in turn funded the 

payment of benefits under the Program. The Association determined eligibility 

for benefits through NEBA and NEBC. Although the district court found that 

“BCBS’s Board of Directors comprised the committee charged with 

administering the disability plan,” the record shows that it was the 

Association’s board of directors which comprised the eligibility committee, not 

the board of directors of the Program or of BCBSL. These facts show that a 

structural conflict of interest did not exist because the Association, through 

NEBA and NEBC, made benefits eligibility decisions, while the Program paid 

benefits claims,1 and BCBSL had no financial interest in individual disability 

determinations.

B. Supplementing the Administrative Record

Dix argues that the district court should have allowed her to supplement 

the administrative record with additional medical records, affidavits from 

Dr. McCarthy and Dr. Russo-Stringer, and a favorable Social Security 

Administration decision. In Vega, the Fifth Circuit held that “[t]he 

administrative record consists of relevant information made available to the 

[plan] administrator prior to the complainant’s filing of a lawsuit and in a 

manner that gives the administrator a fair opportunity to consider it.” Vega v. 

Nat’l Life Ins. Servs., Inc., 188 F.3d 287, 300 (5th Cir. 1999). 

Here, the Administrator gave Dix ample opportunity to supplement the 

administrative record prior to making a final decision on Dix’s benefits 

eligibility appeal. Grant asked Dix whether she would like to submit 

additional documentation, and even gave Dix an extension on the deadline for 

 

1 Assuming arguendo that the district court correctly found that a structural conflict 

of interest exists, the court nevertheless found that the decision to deny Dix’s benefits was 

not arbitrary and capricious, even when factoring the conflict of interest into its analysis. We 

agree with the district court, that, even if a conflict of interest exists, it does not change the 

outcome reached here. 

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submitting documentation. Dix failed to submit any of the documentation she 

now seeks to include in the administrative record before the administrator 

made the final decision. Dix only sent the additional documents to Grant after 

Dix had exhausted her administrative remedies, approximately one year and 

three months after the Administrator issued its final decision in her appeal. 

Given this history, Dix did not make the documents she now seeks to introduce 

into the record available in a manner that gave the plan administrator a fair 

opportunity to consider them. See Hamburg v. Life Ins. Co. of North America, 

470 F. App’x 382 (5th Cir. 2012) (upholding the district court’s refusal to 

remand a case to the plan administrator to supplement the administrative 

record where the benefits claimant failed to submit documentation to the plan 

administrator during the 18 months in which he was pursuing an appeal). Dix 

argues that it was arbitrary and capricious for the Administrator not to 

consider a SSA decision (made after the plan administrator upheld denial of 

her claim) finding Dix disabled. Because the SSA decision was properly 

excluded from the administrative record, we do not consider it in determining 

whether the Administrator’s denial was arbitrary and capricious. 

C. The Administrator’s Decision 

The district court very thoroughly analyzed whether the Administrator’s

decision was arbitrary and capricious. “The job of weighing valid, conflicting 

professional medical opinions is not the job of the courts; that job has been 

given to the administrators of ERISA plan administrators.” Corry v. Liberty 

Life Assurance Co. of Boston, 499 F.3d 389, 401 (5th Cir. 2007). Here, the 

Administrator based its decision on the medical opinions of several physicians

and an independent medical evaluation finding Dix capable of sedentary 

employment. Although Dix disputes the accuracy and completeness of these 

medical findings, she cannot meet her burden to show that the Administrator’s 

decision was not based on substantial evidence. Accordingly, the 

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Administrator’s decision was not arbitrary and capricious, and there was no 

abuse of discretion in denying Dix’s claim. 

Although the district court’s judgment is correct, the court named the 

wrong party in its order granting summary judgment. For this reason, we 

AFFIRM the judgment, but REMAND with instructions to name as the 

defendant Blue Cross and Blue Shield Association Long Term Disability 

Program. 

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