Opinion ID: 175293
Heading Depth: 2
Heading Rank: 2

Heading: Additional evidence submitted after the final appeal

Text: The parties dispute whether information Anderson mailed to Cytec's third-party benefits administrator in 2007treatment notes that begin in July 2006, after the denial of his final appeal, and two doctor's letters written in January 2007should have been included in the administrative record. Anderson argues that the additional material buttresses his benefits claim. Cytec argues that it should not be included in the record and that, in any event, the additional information is irrelevant. In ERISA cases, courts generally cannot consider evidence outside the administrative record. [8] Robinson v. Aetna Life Ins. Co., 443 F.3d 389, 395 n. 3 (5th Cir.2006). In Vega v. National Life Insurance Services, Inc., this court, sitting en banc, stated that if a claimant submits additional information to the administrator. . . and requests the administrator to reconsider his decision, that additional information should be treated as part of the administrative record. 188 F.3d at 300. The Vega court summarized its holding as follows: the administrative record consists of relevant information made available to the administrator prior to the complainant's filing of a lawsuit and in a manner that gives the administrator a fair opportunity to consider it. Id. Subsequent panels of this court and several district courts within the circuit have wrestled with this language from Vega, which could be read to allow claimants to add material to the administrative record long after exhausting their final administrative appeal, even without a showing that the evidence was unavailable to them while their administrative appeal was pending or that they made a good-faith effort to discover or submit the information during the administrative process. [9] Because the late-submitted information is either cumulative of the earlier evidence or largely irrelevant to Anderson's claim for STDP benefits, we need not address the thorny timing issues posed by Vega. Assuming arguendo that the materials submitted in 2007 could have been part of the administrative record, we do not deviate from our holding that the administrator's decision was not an abuse of discretion. First, the clinicians' notes and progress reports on Anderson's mental health after his final appeal was denied are weakly relevant, at best, to his mental health during the time period at issue from September 2005, when Anderson first sought treatment, to May 2006, when he was terminated by Cytec, which made him ineligible for STDP benefits. Reports about Anderson's mental health after his eligibility for STDP benefits expiredreports that were not before the independent experts or the plan administrator while they considered his appealscould not have factored into Cytec's decision to deny benefits, and therefore are not directly relevant to the question whether Cytec abused its discretion by denying Anderson's claim. [10] Second, the two doctors' letters that Anderson submittedboth dated January 17, 2007do not change the analysis. One, from a psychiatry resident who the record does not show treated Anderson during any part of the relevant time period, contains little more than the conclusory statements that Anderson is completely unable to perform work because of his disability since Sept. 2005 and is totally disabled and will be unable to work indefinitely. The second letter is from a psychiatrist who is not shown as treating Anderson elsewhere in the record. It lists his symptoms and states that they prevent him from performing salient duties of his job as panel board operator or any similar occupation and that they are severe enough to warrant complete disability and intensive treatment in our specialized PTSD clinic. The second letter does not aver that Anderson was unable to perform his job during the relevant period, and it appears to misstate one of Anderson's symptoms as homicidal ideationa symptom the record shows that he exhibited for, at most, several days in July 2006. The relevance and probative value of both letters is questionable. Only the first and most conclusory letter asserts that Anderson was disabled in 2005 and 2006, and a doctor's statement that an individual is `totally disabled' does not suffice to establish disability under the language of the [STDP], a determination which is a legal conclusion left to the Plan administrator. Cooper v. Hewlett-Packard Co., 592 F.3d 645, 656 (5th Cir.2009). Even if the letters were more clearly relevant to the issue before the court, they would not serve as anything more than additional expert opinions. And as established above, Cytec was not obliged to accept the opinions of Anderson's treating physicians. See Corry, 499 F.3d at 401. Thus, while we do not endorse Cytec's decision to deny benefits as obviously correct, we cannot say that it was an abuse of discretion. See Gothard v. Metro. Life Ins. Co., 491 F.3d 246, 250 (5th Cir.2007). The circumstances of this case are sad and unfortunate. Dennis Anderson served this nation in two wars and undoubtedly faces a difficult disability as a result of that service. But Cytec was entitled to require some evidence of the functional impact of his disability; it did not abuse its discretion by denying further benefits in the absence of such evidence.