Source: https://www.lexisnexis.com/community/case-opinion/b/case-old/posts/black-decker-disability-plan-v-nord
Timestamp: 2020-04-06 10:07:54
Document Index: 739775242

Matched Legal Cases: ['§ 404', '§ 1001', '§ 1001', '§ 1133', '§ 1133', '§ 2560']

LEdHN[1A][] [1A] HN1[] Under HN2[] a rule adopted by the Commissioner of Social Security, in determining whether a claimant is entitled to Social Security disability benefits, special weight is accorded opinions of the claimant's treating physician. See 20 CFR §§ 404.1527(d)(2), 416.927(d)(2) (2002). This case presents the question whether a similar "treating physician rule" applies to disability determinations under employee benefits plans covered by the Employee Retirement Income Security Act of 1974 (ERISA or Act), 88 Stat 832, as amended, 29 U.S.C. § 1001 et seq [29 USCS §§ 1001 et seq.] We hold that HN3[] plan administrators are not obliged to accord special deference to the opinions of treating physicians.
HN4[] ERISA and the Secretary of Labor's regulations under the Act require "full and fair" assessment of claims and clear communication to the claimant of the "specific reasons" for benefit denials. See 29 USC § 1133 [29 USCS § 1133]; 29 CFR § 2560.503-1 (2002). But these measures do not command plan administrators to credit the opinions of treating physicians over other evidence [****7] relevant to the claimant's medical condition. Because the Court of Appeals for the Ninth Circuit erroneously applied a "treating physician rule" to a disability plan governed by ERISA, we vacate that court's judgment and remand for further proceedings.