2006 D e c i sion s O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit 2-22-2006 

# Hunt e r v . F ed Ex pres s C orp P r e c e de nt i al or N on-P r e c e de nt i al : N on-P r e c e de nt i al D ocke t N o . 04-3563

F o llow thi s and a dd it ion al work s at : http://d i git alc ommon s .l a w . vi ll anova . e du/thir dc ir c uit_2006

Thi s de c i sion i s br ou ght t o you for f r e e and ope n a c c e s s b y the O p inion s of the U nit e d S t at e s C our t of Appe al s for the Thir d C ir c uit at V i ll anova U nive r sity S choo l of L a

w Di git al Reposit ory

. It h as be e n a c c ept e d for inclusion in 2006 D e c i sion s b y an author i z e d a dmini s tr at or of V i ll anova U nive r sity S choo l of L a

w Di git al Reposit ory

. F or mor e inform at ion, p le as e c ont a ct Be n j amin . C arl s on@l a

w . vi ll anova . e du . Re c omme nde d C it at ion " Hunt e r v . F e d Expr e s s C orp " (2006). 2006 D e cisio n s . P ape r 1555. http://d i git alc ommon s .l a

w . vi ll anova . e du/thir dc ir c uit_2006/1555T h e H o n o r a b l e J o s e p h E . I r e n a s , S e n i o rD i s t r i c tJ u d g e f o rth e D i s t r i c to f

N e w J e r s e y, * s i t t i ng bydes i gnat i on. NOT P RE CE DE NT I AL

I N TH E UN I TED STATES CO UR T OF A PP EALS

F O R T H E T H IR D C IR C U IT C as e N o: 04- 3563 FLOREN CE H UN TER

v. F E DE RA L E XP RE S S CO RP OR AT I ON,

A ppel l ant O n A p p ea l from the U n it ed S tat es D istri ct C o u rt f o r th e E a ste rn D istric t o f P e n n sy lv a n ia D i s t r i ctC our tN o. : 03- C V - 06711 D istric t Ju d g e : T h e H o n o ra b le S tew a rt D a lze ll

A r gued J anuary26, 2006 B e f o re : R E N D E L L a n d S M IT H , C ir c u it J u d g e s , a n d IR E N A S , D is tr i ct

Judge * ( Fi l ed: February22, 2006 ) C ol byS. M or gan, J r . ( ar gued) J ohn M . O ehml er Feder al E xpr es s C orpor at i on 3620 H acks C r os s R oad B ui l di ng B , 3r d Fl oor M emphi s , T N 38125 C hr i s t opherJ . M or an D ar a P. N ew m an2

Si m on M or an 1600 M arketSt r eet Sui t e 2020 Phi l adel phi a, PA 19103 C ouns el f orAppel l ant G r egoryJ . B ol es ( ar gued) Fenner& B ol es 1515 M arketSt r eet Sui t e 1510 Phi l adel phi a, PA 19102 C ouns el f orAppel l ee
OP I NI ON S M IT H , C i r cui tJudge . Feder al E xpr es s C orpor at i on ( “FedEx”) appea l s fr om an or derof the U ni t ed St at es D istric t C o u rt f

o r th e E a ste rn D istric t o f P e n n sy lv a n ia g ra n tin g su m m a ryju d g m e n t in f a v o r o f F lo re n c e H u n ter o n h e r c laim u n d e r th e E m p lo y e e R e tirem e n t In c o m e S e c u rity A ct( “ER I SA ”) , 29 U . S. C . § 1132, forr es t or at i on of herl ong t erm di s abi l i t y( “LT D ”) ben efi t s. T he D i stri ctC ou rthad j uri sdi ct i on un der 28 U . S . C . § 13 31 . W e exerci se a p p e l l a t e j u r i s d i c t i o n p u r s u a n tt o 2 8 U. S . C. § 1 2 9 1 . F o rth e r e a s o n s s e tf o r t h b e l o w, we w ill re v e rse th e ju d g m e n t o f th e D istric t C o u rt.

I. In 1 9 9 4 , H u n ter w a s a m a n a g e r o f sta tio n o p e ra tio n s f

o r F e d E x a n d a p a rticip a n t in FedE x’ s L T D Pl an. I n J ul yof thaty ear , H unt ers t opped w or ki ng beca us e ofL T D b e n e f its w e re p a y a b le f

o r e ith e r a n o c c u p a tio n a l d is a b ility o r a to ta l d is a b ility. 1 A n o c c u p a tio n a l d isa b ili tym e a n t an in a b ili ty“ b e c a u se o f a m e d ica lly -d e ter m in a b le phy s i cal i m pai r m entorm ent al i m pai r m ent. . . t o per form the dut i es of hi s r egul ar occupa t i on. ” A t ot al di s abi l i t yw as defi ned bythe LT D Pl an as an “i nabi l i t y. . . beca us e of a 2 m edi cal l y - det erm i nabl e phy s i cal i m pai r m ent. . . t o engage i n anys ubs t ant i al l ygai nful act i vi t yforw hi ch he i s r eas onabl yqual i fi ed ( orcoul d r eas onabl ybecome qual i fi ed) on t he bas i s of hi s educa t i on, t r ai ni ng orexper i ence . ” The t erm “s ubs t ant i al l ygai nful ac ti v ity ” w as n o t def

ined b ythe P lan. T h e e m p loy ee b en ef it s h an d b o o k , h o w ev er, p rov ided that “[ t] o tal d isab il itym ea n s y o u ca n n o t, fo r ph y sical reaso n s o n ly , d o an yw o rk on ei t hera part - t i m e orful l - t i m e bas i s forw hi ch y ou have tr ai ni ng, educa t i on, or exper i ence orforw hi ch y ou can obt ai n t he educ at i on ortr ai ni ng. ” 3 c o m p lic a tio n s w ith h e r p re g n a n c ya n d s h e b e g a n re c e iv in g s h o rt te rm d is a b ility b e n e f its . I n O ct ober , dur i ng chi l dbi r t h, s he s uffe r ed a l eftocci pi t al hemorrhage i nfar ctand another in tra c ra n ial h e m o rrh a g e in th e sa m e lo c a tio n tw o w e e k s la ter . S h o rt ter m d isa b ili ty b e n e f i t s c o n t i n u e d u n t i l J a n u a r y 2 6 , 1 9 9 5 . L T D b e n e f i t s f o ra n “ o c c u p a t i o n a l d i s a b i l i ty” comm ence d t he fol l ow i ng day . O n D ece m ber11, 1996, H unt er ’ s appl i cat i on forSoci al 1 S e c u rityd isa b ili tyb e n e f its w a s a p p ro v e d . L T D b e n e f its b a se d o n a to tal d isa b ili ty comm ence d on J anuary27, 1997. 2 FedE x’ s L T D pl an pr ovi ded thatFedE x w as the admi ni s t r at orof the Pl an. T he i ni t i al r evi ew and pr oces s i ng of di s abi l i t ycl ai m s , how ever , w as per form ed pur s uantt o a contr actbyK emperI ns ur ance . O nce be nefi t s w er e aw ar ded, an empl oy ee w as obl i gat ed to p ro v id e “ [ a ]d d itio n a l u p d a te d s u b s ta n tia tio n ” o r r is k e d th e s u s p e n s io n o f b e n e f its . C o n sist en t w ith the a b o v e, K em p er o cc asio n all yco n tacted H u n ter’s prim aryca re phy s i ci an, D r . Per l s on, r egar di ng herm edi cal s t atus . I n A ugus tof 1998, i n r es pons e t o an4

i nqui r yfr om K emper , D r . Per l s on i ndi cat ed thatH unt erw as “bl i nd - dy s l exi c” a nd he opi ned thats he w as notabl e t o w or k w i t h r es t r i ct i ons . I n a form ent i t l ed “Eval uat i on of Phy s i cal A bi l i t i es , ” D r . Per l s on not ed thatH unt ercoul d notdr i ve form or e than thr ee hour s orl i ftm or e than tw entypounds . H ervi s ual cl ar i t yand col orw er e uni m pai r ed, but h e r v is u a l d e p th p e rc e p tio n w a s lim ite d . Per i odi c updat es w er e obt ai ned ther eaf t er . O n Sept ember18, 2002, H unt ers poke w i t h a cl ai m s r epr es ent at i ve and c onfi r m ed thats he w as i ndepende ntr egar di ng her act i vi t i es of dai l yl i vi ng and thats he w as abl e t o dr i ve s hor tdi s t ance s . H unt eradvi s ed th a t D r. P e rl s o n w a s h e r o n ly tre a tin g p h y s ic ia n . O n Sept ember19, 2002, D r . Per l s on compl et ed a LT D Phy s i ci an R epor ts ubm i t t ed byK emper . H e document ed thatH unt erhad hyper t ens i on and ds y l exi a s econda r yt o t he o c c ip ital in f

a rc tio n sh e su sta in e d in 1 9 9 4 . In re sp o n se to a n in q u irya s to H u n ter ’s a b ili ty t o w or k ful l dut y , D r . Per l s on chec ked the “no” box. A l t hough the box r egar di ng H u n ter’s ab il ityto w o rk p art-t im e w as n o t com p let ed , D r. P erlson o p ined that H u n ter’s onl yw or k r es t r i ct i on w as t hats he w as notperm i t t ed “t o r ead - anyt hi ng. ” A comput er l og entr ydat ed Sept ember27, 2002 i ndi cat ed thatD r . Per l s on advi s ed a K emper r epr es ent at i ve thatH unt er ’ s cogni t i ve func t i on w as “good” a nd thats he “pr obabl ycan w or k fora mi ni m um of 25 hr s /w eek a nyj ob as l ong as ther e i s no r eadi ng i nvol ved. ” I n O ct oberof 2002, K empers ubm i t t ed the document at i on i thad fr om D r . Per l s on t o D r . C ohan, a neur ol ogi s t , fort he purpos e of c onduct i ng a pee rr evi ew . D r . C ohan5

found no obj ect i ve evi dence t o s uppor tthe w or k r es t r i ct i on out l i ned byD r . Per l s on, but n o te d th a t a n e u ro -o p h th a lm o lo g ic re p o rt w o u ld b e u s e f u l. K emperfol l ow ed thi s s ugges t i on and arr anged f oran i ndepende ntm edi cal e x a m in a tio n o n N o v e m b e r 1 9 , 2 0 0 2 b yD r. L iu , w h o w a s a ss o c iate d w ith th e U n iv e rsity of Penns y l vani a’ s D epart m entof N eur ol ogyand O phthal m ol ogy . D r . L i u not ed thathe w as pr ovi ded l i m i t ed medi cal r ecor ds , no di agnos t i c s tudi es orr epor t s , and thathe w as r el y i ng on H unt er ’ s hi s t or yand hi s exami nat i on. D r . L i u document ed that“[o] verthe y ear s s he s t at es s he has had s om e r ecove r y , buts he s t at es thats he ca n r ead f ortw o or t h r e e m i n u t e s a tb e s ta n d t h e n s h e c a n n o l o n g e rr e a d . S h e s t a t e s s h e c a n r e a d s e l e c t i v e l y, butcannotr ead w hol e pas s ages orm emos. ” D r . L i u’ s phy s i cal exami nat i on of H unt err evea l ed thathervi s i on as corr ect ed w as “20/ 20 w i t h t he r i ghtey e and 20/ 25 w i t h t he l eft . A tnears he s aw 20/ 50+2 w i t h t he r i ght ey e pi nhol i ng t o 20/ 30 and w i t h t he l efts he w as 20/ 40+3. She s aw 12 of 12 col orpl at es w i t h bot h ey es . Fi el ds w er e ful l t o confr ont at i on t echni ques . For m al fi el ds w er e notdone t oday . ” A di l at ed fundus copi c exa m i nat i on w as nor m al . D r . L i u al s o per form ed a “det ai l ed l anguage exami nat i on. She can r ead, w r i t e, name, r epea t , compre hend, and her s peec h i s fl uent . T her efor e, w e found no a phas i a. ” I d. H i s r epor tal s o i ndi cat ed that H un t er di d n ot exhi bitanym otoror sensorydefici t s. Be f o r e s t a t i n g h i s o p i n i o n , Dr . L i u r e p e a t e d th e l i mi t a t i o n s o f h i s r e p o r t . He o p in e d th a t h e “ f

o u n d th a t sh e w a s a b le to re a d a n d h a d n o v isu a l f ield d e f icits o r a c u ity6

defi ci t s r el at ed t o w hatr epor t edl yoccurr ed i n 1994. I have no obj ect i ve evi dence for v i s u a l r e a d i n g p r o b l e ms a tt h i s t i me a n d I h a v e o n l yh e rs u b j e c t i v e c o mp l a i n t s . ” He fur t hers t at ed that“[f

] r om w hatI w as abl e t o s ee on myexami nat i on t oday , I do nots ee herhavi ng anypr obl ems w or ki ng ata r egul arj ob. ” D r . L i u’ s r epor tw as pr ovi ded t o D r . C ohan. I n a s uppl ement al r epor tdat ed D ec em b er 3 , 2 0 0 2 , D r. C o h an ad h ere d to h is i n it ial o p inion that the d ata f ail ed to su p p o rt a f u n c tio n a l im p a irm e n t th a t w o u ld re n d e r H u n ter u n a b le to e n g a g e in a n yc o m p e n sa b le empl oym entfor25 hour s . O n D ece m ber6, 2002, K empernot i fi ed H unt eri n a l et t ert hat it h a d re v iew e d h e r L T D b e n e f its c laim a n d “ d e ter m in e d th a t n o b e n e f its a re p a y a b le to y o u fo r th is cl aim b ey o n d 1 1 /30 /02 . ” K em p er e x p lai n ed that ith ad rev iew ed D r. P erlson ’s do cu m en tat ion an d h is w o rk re str ict ion p rec lud ing rea d ing , tog ethe r w ith D r. L i u’ s r epor tt hatH unt erhad “e s s ent i al l ynor m al fi ndi ngs , ” and thatther e w as “no s i gni fi cantobj ect i ve evi dence forvi s ual r eadi ng pr obl ems. ” The not i ce a dvi s ed thats he had the r i ghtt o appea l and thats he s houl d s ubm i tm edi cal document at i on t o s uppor ther c la im o f a to ta l d is a b ility. H u n ter ob tai n ed co u n sel an d ap p ea led th e term ination o f b en ef it s to F ed E x ’s B enef i t s R evi ew C om m i t t ee ( “B R C ”) . Shor t l yther eaf t er , on D ece m ber28, 2002, H unt er wa s e x a mi n e d b yP a u l S u s c a v a g e , OD. He o p i n e d th a ts h e “ ma n a g e d S n e l l e n c h a r tOK” a n d h a d “ g o o d c e n tra l v isio n w ith c u rre n t u se o f sp e c tac les .” T h e re su lts o f a v isu a l f

ield anal y zerdemonstr at ed “mar ked fi el d l os s , ” gr eat eri n t he r i ghtey e than the l eftey e, and7

“s t er eo vi s i on r educe d t o 25% . ” A n M R I of the br ai n per form ed on D ece m ber31, 2002 sh o w e d a n “ a re a o f

c h ro n ic h e m o rrh a g ic in f a rc tio n . . . in th e lef

t o c c ip ital lo b e . M u lti p le s m al l r ound foci of hi gh s i gnal i nt ens i t yw er e not ed i n t he s ubcort i cal w hi t e mat t er . ” T h e re w a s n o e v id e n c e o f a n ya c u te o r s u b a c u te c o n d itio n . H unt erw as al s o exami ned byD r . K l azmer , a neur ol ogi s t , and Ps y chol ogi s tJ os eph T racy , P h. D . D r. T racycon cl ud ed thatH un t er had several neu ropsy cho l og i cal defici t s, t he “mosts i gni fi cantdefi ci t s ar e i n vi s ual per ceptual and vi s uos pat i al r eas oni ng cons i s t entw i t h herocci pi t al s t r oke. ” D efi ci t s w er e al s o not ed w i t h r egar d t o exec ut i ve funct i on and s om e ps y chomot ors ki l l s . D r . T r acyal s o not ed thatH unt erdi s pl ay ed “a cl i ni cal l ys i gni fi cantl evel of depr es s i on. ” H e s t at ed thathe “c ons i der [ed] M s . H unt er di s abl ed” a nd opi ned thathe di d notbel i eve thatH unt erw as “capabl e of w or ki ng ather p re v io u s le v e ls w h ich a p p a re n tlyin v o lv e m a n a g e ria l w o rk h a n d lin g c u sto m e r c o m p lain ts atFeder al E xpr es s . Speeded a nd det ai l ed comput erw or k w i t h a hi gh r el i ance on vi s uoper ceptual and vi s uos pat i al s ki l l s w oul d be t oo di ffi cul tforher . ” D r . T r acy ’ s r epor tand the M R I w er e both pr ovi ded t o D r . K l azmer . I n a l ett er dat ed J anuary23, 2003, D r . K l azmerdocument ed thatneur ol ogi c exa m i nat i on “s how ed e v i d e n c e o f

s u b j e c t i v e r i g h ts u p e r i o rq u a d r a n tv i s u a l f i e l d l o s s i n b o t h e y e s . ” He i ndi cat ed thatt he M R I s how ed “a n ar ea of abnorm al s i gnal i n t he l eftocci pi t al l obe c o n sis ten t w ith a c h ro n ic in f a rc tio n ” a n d su b c o rtica l w h ite m a tter h yp e rin ten sities . W ith r egar d t o D r . T r acy ’ s r epor t , D r . K l azmerr el at ed thathe had s poken t o D r . T r acy , w ho8

co n v ey ed that H u n ter s how s vi s ual pr oces s i ng i m pai r m ental ong w i t h s ubt l e di ffi cul t i es us i ng her r i g h th a n d , me mo r yp r o b l e ms a n d f i n d i n g s s u g g e s t i v e o f

d e p r e s s i o n . He fe els th e n eu rop sy ch o log ical i m p airm en ts no ti ce d o n h er rec en t t esti n g are i n parand es s ent i al l yunchange d fr om heri ni t i al neur ops y chol ogi cal ev alua ti o n that w as p erf o rm ed o n Ju ly1 , 1 9 9 6 b yD r. R o d erick H af er. D r. K laz m e r o p in e d th a t Fl or ence H unt er , i n s um m ary , i s s t atus pos ta l eftocci pi t al hemorrhage, pr obabl yfr om ecl ampsi a w i t h r es i dual cogni t i ve i m pai r m entthathas not i m pr oved. I n m yopi ni on, t hi s pr ecl udes herfr om r eturni ng t o w or k i n her form ercapa ci t yand w i l l i m pai rherabi l i t yt o obt ai n anytype of c o m m e n s u ra b le e m p lo ym e n t f o r w h ic h s h e w a s re a s o n a b ly q u a lif ie d . K em p er h ad p ee r rev iew s co n d u cted af ter H u n ter fil ed h er a p p ea l byD r. Super fi ne, an i nt erni s t , D r . G ol dber g, a neur ol ogi s t , D r . E ps t ei n, an ophthal m ol ogi s t , and Dr . Ca rp e n t e r , a p s y c h o l o g i s t . Ne i t h e rOp t o me t r i s tS u s c a v a g e ’ s r e p o r tn o rth e M RI r epor tw er e pr ovi ded t o K emperunt i l M ayof 2003. A s a r es ul t , the pee rr evi ew phy s i ci ans di d nothave the oppor tuni t yt o r evi ew thatevi dence . B uttheydi d r evi ew t he re p o rts o f

D r. L iu , D r. K laz m e r, an d D r. T ra c y . T h e p e e r re v iew p h y sic ian s g e n e ra lly opi ned thatt he dat a s ubm i t t ed fa i l ed t o s ubs t ant i at e a f unct i onal i m pai r m entpr ecl udi ng H u n te r f ro m w o rk in g e ith e r p a rt o r f u ll- tim e . A f ter O p to m e trist S u sc a v a g e ’s r e c o rd s a n d th e M R I w e re su b m itt e d to K e m p e r, it p rov ided the d o cu m en ts t o D r. G o ldb erg to su p p lem en t his pe er rev iew rep o rt . D r. G ol dber g di d notal t erhi s concl us i on. H e ac know l edged the new evi dence thatH unt er had a vi s ual fi el d defe ctfr om 1995, butpoi nt ed outthatD r . L i u had conduc t ed a9

th o ro u g h e y e e x a m in a tio n a n d c o n c lu d e d th a t th e re w a s n o th in g to su p p o rt v isu a l f ield d e f e c ts . D r. E p ste in a lso su b m itt e d a su p p lem e n tal p e e r re v iew re p o rt a f ter re v iew in g th is addi t i onal evi dence . H e opi ned that“[f ] r om an ophthal m ol ogi c s t andpoi nt , I fee l that th e re is n o o b

jec tiv e e v id e n c e to su b sta n tiate d isa b ili ty , h o w e v e r, th e v isu a l f ield a b n o rm a lity h a s n o t b e e n a d d re s s e d .” A ft ercons i der at i on of al l of thi s m edi cal document at i on, the B R C deni ed H u n ter’s ap p ea l. T h e B R C cit ed the P lan’s d ef init ion o f to tal d isab il ityan d the P lan’s pr ovi s i on w hi ch al l ow s an aw ar d of bene fi t s onl yw hen the “A dm i ni s t r at orhas r ece i ved .

. . in f o rm a tio n su f

f icie n t . . . to d e ter m in e in its so le a n d e x c lu siv e d isc re tio n th a t a D i s abi l i t yexi s t s . ” The B R C expl ai ned thati tuphel d t he deni al bas ed “on a l l the i n f o r ma t i o n s u b mi t t e d , i n c l u d i n g Ke mp e r ’ s p e e rp h y s i c i a n r e v i e ws . ” Th e BRC emphasi zed thati thad t o as s es s w hetherH unt erw as di s abl ed as t o “al l occupa t i ons begi nni ng on 12/ 01/ 02. ” The B R C expr es s ed i t s r egr etthatthe dec i s i on w as unfavor abl e, buti tr ei t er at ed thatt he Pl an i s “s peci fi c r egar di ng the r equi r ementof s i gni fi cant obj ect i ve fi ndi ngs t hata func t i onal i m pai r m entexi s t s thatw oul d pr ecl ude a c over ed e m p lo y e e f

ro m e n g a g in g in a n ys u b s ta n tia lly g a in f u l a c tiv ity, p a rt -t im e o r f u ll- tim e . . . and thi s r equi r ementw as notm eti n t hi s cas e. ” T hi s E R I SA act i on fol l ow ed. C r os s - m ot i ons fors um m aryj udgm entw er e fi l ed a f t e rd i s c o v e r yc l o s e d . T h e Di s t r i c tCo u r ta p p l i e d a h e i g h t e n e d s t a n d a r d o f r e v i e w,10

co n clud ed the B R C ’s de cisi o n w as a rbitraryan d ca p ri ciou s, an d g ran ted s u m m ary ju d g m e n t in f

a v o r o f H u n ter . F e d E x f

iled a tim e lya p p e a l. II. B e c a u s e w e a re re v ie w in g a g ra n t o f s u m m a ry ju d g m e n t, o u r r e v ie w is p le n a ry. Sm athers v. Mul t i - ToolI nc , 2 9 8 F .3 d 1 9 1 , 1 9 4 (3 d C ir. 2 0 0 2 ). In a d d iti o n , b e c a u se th is is a n E R IS A c laim , w e m u st d e ter m in e th e lev e l o f sc ru tin ya p p ro p ria telye m p lo y e d in r evi ew i ng FedE x’ s deci s i on t o t erm i nat e H unt er ’ s L T D benef i t s . FedE x cont ends thatt he D i s t r i ctC our terr ed i n appl y i ng t he hei ght ened a rbi t r aryand capr i ci ous s t andar d of r evi ew . W e agr ee. I n F i r es t one Ti r e & R ubberC om pany v. B r uch , 489 U . S. 101, 115 ( 1989) , the Supr eme C our ti ns t ruct ed thatt he def er ent i al arbi t r aryand capr i ci ous s t andar d of r evi ew appl i es i f an ER I SA pl an gi ves t he admi ni s t r at ordi s cr et i onaryauthor i t yt o det erm i ne the e lig ib ility f

o r b e n e f its o r t o c o n s tru e th e te rm s o f th e p la n . I

d. T he B r uch C o u rt o b se rv e d th a t “if

a b e n e f it p lan g iv e s d isc re tio n to a n a d m in istra to r o r f id u c iar yw h o is o p e ra tin g u n d e r a c o n f

lict o f in ter e st, th a t co n f

lict m u st b e w e ig h e d a s a f a c to r in det erm i ni ng w hethert her e i s an abus e of di s cr et i on. ” I d. I n P i nt o v. R el i ance Standar d Li f e I ns ur ance Com

pany , 2 1 4 F . 3 d 3 7 7 (3d C ir . 2000) , w e hel d t hatan i ns ur erw ho both funded a nd admi ni s t er ed an ER I SA pl an had a confl i ctof i nt er es tt hat“w arr ant [ed] a hei ght ened f or m of the arbi t r aryand ca pr i ci ous s t andar d of r evi ew . ” I

d. a t 3 7 8 . P in to di s t i ngui s hed betw een i ns ur ance compani es that11

bot h fund and a dm i ni s t era pl an, and empl oy er s thatboth fund and a dm i ni s t era pl an, re c o g n izin g th a t th e h e ig h ten e d sta n d a rd n e e d n o t b e a p p lied to a n e m p lo y e r w h o b o th fu n d s an d ad m inist ers a p lan u n less the e m p loy ee d em o n str ates tha t th e e m p loy er’s e x e rc is e o f

d is c re tio n m a yh a v e b e e n ta in te d . P in to , 214 F. 3d at387- 388. I n P in to ’ s w ake, w e have notbeen he s i t antt o appl ya hei ght ened s t andar d of r evi ew t o an empl oy erw ho bot h funds and admi ni s t er s i t s E R I SA pl an w her e the e v id e n c e d e m o n stra tes a re a so n to q u e stio n th e e m p lo y e r’s im p a rtiality . F o r e x a m p le, in Sm athers v. Mul t i - Tool

, I nc. , 298 F. 3d 191, 198 ( 3d C i r . 2002) , w e conc l uded thatthe hei ght ened a rbi t r aryand ca pr i ci ous s t andar d s houl d have be en appl i ed bec aus e the empl oy erw oul d s us t ai n di r ectfi nanci al harm i f the cl ai m w as pai d. I n Kos i ba v. Mer ck & C om pany , 38 4 F . 3d 58 (3d C i r. 20 04 ), w e recogn i zed thata fi nan ci al con fl i ctof int eres t w as not the o nlycause fo r hei gh t ened revi ew . W e exp l ai ned that our precedents al so es t abl i s hed thats uch r evi ew m aybe w arr ant ed i f ther e i s a “de m ons t r at ed pr ocedur al i r r egul ar i t y , bi as orunfai r nes s i n t he r evi ew of the cl ai m ant ’ s appl i cat i on forbenef i t s . ” I d. at66. T her e, t he evi dence unequi vocal l ydemonstr at ed thatthe empl oy ee ha d t ot al di s abi l i t y , y ett he empl oy eri nt ervened i n t he appe al bys eeki ng an i ndepende ntm edi cal e x a m in a tio n , ev e n th o u g h its in su ra n c e a d m in istra to r h a d n o t. W e c o n c lu d e d th a t th is pr ocedur al i r r egul ar i t yw arr ant ed more s t r i ngents crut i nythan the def er ent i al arbi t r aryand c a p ri c io u s s ta n d a rd o f

re v ie w . I

d. at 68 . In th e a b sen ce o f a fin an cial co n fli ct or a pr ocedur al i r r egul ar i t y , how ever , w e have found thati tw as err ort o empl oythe12

h e ig h te n e d s ta n d a rd o f

re v ie w to a n e m p lo y e r’ s d e c is io n . V i tal e v. Lat r obe Area H os p. , 4 2 0 F .3 d 2 7 8 , 2 8 3 (3 d C ir . 2 0 0 5 ). T hus , w e mustdet erm i ne w hetherthe D i s t r i ctC our t ’ s appl i cat i on of the hei ght ened s t andar d of r evi ew w as w arr ant ed i n l i ghtof the fa ctthatFedE x i s an em p loy er a n d n o t an in su ran ce co m p an y . W e c o n clud e a fter ca ref u l r ev iew o f th e re co rd t hatFedE x, even though i tbot h funds and admi ni s t er s i t s Pl an, di d nothave a fi nanci al confl i ctof i nt er es ti nas m uch as i tqual i fi ed as the “typi cal empl oy er ” des cr i bed i n P in to . 2 1 4 F .3 d a t 3 8 8 . Its c o n trib u tio n s to th e P lan w e re a c tu a ria llyg ro u n d e d a n d irre v o c a b ly m ade t o t he Trus tFund. T he as s et s of the Trus tw er e us ed exc l us i vel yforthe paym entof benef i t s undert he Pl an and a dm i ni s t r at i ve cos t s . I n t he eve ntthe Trus tw as unabl e t o pay b e n e f its d u e u n d e r t h e P la n , F e d E x w a s u n d e r n o o b lig a tio n to m a k e u p th e s h o rt f a ll. P in to , 21 4 F . 3d 38 8. M oreove r, F edE x h ad co ntr act ed w i t h K em per t o ini t i al l yprocess its c la im s . Kos i ba , 384 F. 3d at61. I ndeed, H unt erdi d notcont end thata fi nanci al confl i ctof i nt er es texi s t ed. I ns t ead, H unt eras s er t ed thathei ght ened r evi ew w as w arr ant ed bec aus e of pr ocedur al anomal i es . W e fi nd no bas i s forconcl udi ng thatther e w as a pr ocedur al i r r egul ar i t y , as i n Kos i ba, w hi ch w oul d j us t i fyappl i cat i on of the hei ght ened a rbi t r aryand c a p r i c i o u s s t a n d a r d o f

r e v i e w. As t h e Di s t r i c tCo u r tp o i n t e d o u ti n i t s me mo r a n d u m, H unt erdi d not“al l ege thatFedE x fai l ed t o compl yw i t h Pl an pr ocedur es . ” A ccor di ngl y , i n t he abs ence of a f i nanci al confl i ctof i nt er es tora pr ocedur al13

i r r egul ar i t y , FedE x’ s deci s i on t o t erm i nat e H unt er ’ s L T D benef i t s s houl d have be en r e v i e we d u n d e rt h e d e f

e r e n t i a l a rb i t r a r ya n d c a p r i c i o u s s t a n d a r d . F o rth a tr e a s o n , we concl ude thatt he D i s t r i ctC our terr ed byappl y i ng the hei ght ened a rbi t r aryand capr i ci ous s ta n d a rd o f

re v ie w . III . O r di nar i l y , w e w oul d r emand t o al l ow the D i s t r i ctC our tt o appl ythe corr ect stan d ard o f re v iew . R em an d is un n ec essa ry , h o w ev er, be ca u se th e D istri ct C o u rt concl uded thatt he B R C ’ s deci s i on w as “s o fl aw ed thati tcoul d nots t and eve n i f w e had appl i ed the hi ghl ydefe r ent i al ‘ arbi t r aryand capr i ci ous ’ s t andar d. ” “U ndert he arbi t r aryand ca pr i ci ous ( orabus e of di s cr et i on) s t andar d of r evi ew , t he di s t r i ctcour tm ayover tur n a dec i s i on of the Pl an admi ni s t r at oronl yi f i ti s ‘ w i t hout r eas on, uns uppor t ed bys ubs t ant i al evi dence orerr oneous as a mat t erof l aw . ’ ” A bnathya v. H of f m an- La R oche, I

nc. , 2 F. 3d 40, 45 ( 3d C i r . 1993) ( quot i ng A dam o v. A nchor H ocki ng C or

p. , 7 2 0 F . S u p p . 4 9 1 , 5 0 0 ( W. D. P a . 1 9 8 9 ) ) . “ T h i s s c o p e o f r e v i e w i s n a rr o w, a n d ‘th e c o u rt is n o t f

re e to su b stitu te its o w n ju d g m e n t f o r th a t o f th e d e f e n d a n ts in det erm i ni ng el i gi bi l i t yforpl an bene fi t s . ’ ” A bnathya , 2 F. 3d at45 ( quot i ng Lucas h v. Str i ck Corp. , 6 0 2 F . S u p p . 4 3 0 , 4 3 4 (E . D . P a. 19 8 4 )). W e conc l ude thatt he D i s t r i ctC our tal s o err ed i n appl y i ng, i n t he al t ernat i ve, the d ef ere n ti al arb itraryan d ca p ri ciou s stan d ard o f re v iew . T h e B R C term inated H u n ter’s L T D benef

i t s beca us e the obj ect i ve evi dence s he s ubm i t t ed di d notdemonstr at e thats he14

had a phy s i cal i m pai r m entt hatpr ecl uded herfr om engagi ng i n anys ubs t ant i al l ygai nful act i vi t yon ei t hera part - t i m e orful l - t i m e bas i s . T he D i s t r i ctC our tconcl uded thatthe B R C ’ s det erm i nat i on w as nots uppor t ed bys ubs t ant i al evi dence beca us e H unt erhad s ubm i t t ed obj ect i ve evi dence , namel yD r . Susc avage ’ s 2002 pr ogr es s not es , the 2002 M R I t es tr es ul t , and D r . T r acy ’ s r epor t . Y etnei t herD r . Susc avage ’ s not es , i ncl udi ng t he v isua l fi eld test resu lt , n o r th e M R I, ex p lai n ed h o w their find ing s af fe cted H u n ter’s cu rren t abili tyto f

u n cti o n an d en g ag e in s u b stan ti al ga inf u l acti v ity . A lth o u g h D r. T r acy ’ s r epor texpl ai ned thatH unt erw as l i m i t ed i n herabi l i t yt o funct i on, he opi ned that sh e w as u n ab le t o p erf

o rm h er p rev iou s m an ag erial po sit ion w ith F ed E x . H u n ter’s i nabi l i t yt o per form herpr evi ous w or k w i t h FedE x, how ever , di d notes t abl i s h t hats he had a t ot al di s abi l i t yas defi ned byt he Pl an. I n addi t i on, t he D i s t r i ctC our tfur t herexpl ai ned thatthe B R C ’ s deci s i on w as defi ci entbeca us e i tr el i ed on the opi ni ons of i t s peerr evi ew phy s i ci ans , w ho acc or ded m or e w ei ghtt o D r . L i u’ s r epor tt han t o t he M R I t es tr es ul tand D r . Susc avage ’ s vi s ual f ield tes t. A lth o u g h th e D istric t C o u rt m a yh a v e c o n c lu d e d th a t th e v isu a l f ield tes t re su lt s houl d t rum p t he opi ni on of D r . L i u, a r evi ew i ng courtm aynots ubs t i tut e i t s j udgm ent f o r t h a t o f th e B R C . A bnathya , 2 F . 3 d at 45 . R athe r, itm u st de term ine if th e B R C ’s deci s i on w as w i t houtr eas on oruns uppor t ed bys ubs t ant i al evi dence . I n ourvi ew , i tw as n o t un rea so n ab le fo r th e B R C to ac co rd m o re w eigh t t o the o p inion o f a m ed ical do ctor, w ho s peci al i zes i n neur ol ogyand ophthal m ol ogyata maj oruni ver s i t yhos pi t al and w ho15

bas ed hi s opi ni on on hi s phy s i cal exami nat i on of the pat i ent , than t o a t es tr es ul tobt ai ned b yan o p tom etri st th at i s u n ac co m p an ied b yan yex p lana ti o n reg ard ing h o w the test’s f in d in g s lim it th a t p a tie n t’ s a b ility to f u n c tio n . N ordo w e fi nd t he dec i s i on t o t erm i nat e bene fi t s s us pectbeca us e i toccurr ed se v e ra l y e a rs a f

ter b e n e f its h a d b e e n a w a rd e d . It i s n o t u n c o m m o n f o r b e n e f it p lan s to p eriod icall yrev iew a b en ef ici ary ’s st atus . H ere , the in it ial step s to inv esti g ate H u n ter’s con t i nu ed eli gibi l i t yoccu rr ed o nlyaft er D r. P erl son o pined t hat s he co uld w ork on a l ess th a n f u ll tim e b a s is a s lo n g a s s h e w a s n o t r e q u ir e d to re a d . I n s um , t he D i s t r i ctC our tdi d engage i n a thor ough r evi ew of the medi cal evi dence . A ppl i cat i on of the def er ent i al s t andar d of r evi ew , how ever , es t abl i s hes thatt he B R C ’ s d e c i s i o n t o t e r m i n a t e H u n t e r ’ s L T D b e n e f i t s w a s n o ta rb i t r a r ya n d c a p r i c i o u s . We w i l l r ever s e the j udgm entof the D i s t r i ctC our t . W e w i l l r emand t o t he D i s t r i ctC our tw i th t he di r ect i on t hati tvaca t e the j udgm enti n favorof H unt erand ent erj udgm enti n favorof FedE x.