Opinion ID: 77935
Heading Depth: 2
Heading Rank: 2

Heading: Awards Relating to Own Occupation Benefits

Text: (1) The Plan's Offset Provision According to section 4.1 of the Plan, an eligible participant will receive monthly benefits in an amount equal to 60% of her average compensation: The Participant who incurs a Disability will receive a monthly benefit in an amount equal to 60 percent of his Average Compensation, reduced to account for disability benefits payable from other sources, as required under Section 4.2. (R.15-216 at CC402.) Section 4.2(a) of the Plan, entitled Offset for Other Disability Benefits, provides: The monthly Disability benefit payable from this Plan to the Participant who receives disability benefits from any source described in Subsection (b) will be reduced as necessary so that the total of his monthly Disability Benefit from this Plan equals no more than the following amount: (1) 70 percent of his Average Compensation . . ., minus (2) the amount of his monthly disability benefits payable from all other sources; . . . provided further that the offset for other disability benefits will not serve to reduce the Disability Benefit under this Plan to an amount less than 60 percent of the Participant's Average Compensation as limited. (R.15-216 at CC402-03) (emphasis added). Byars argues that the italicized language creates a 60% floor below which an offset may not reduce benefits. According to her interpretation then, the district court erred in accepting the Coca-Cola Defendants' proposed judgment of own occupation benefits in an amount less than 60% of her average compensation. [10] The Coca-Cola Defendants respond with two points. First, they argue that Byars has failed to challenge a previous order of the district court barring her from raising this issue. Second, they argue that the issue is not ripe for review because Byars did not present the issue in her summary judgment papers and, consequently, the district court never considered it. We do not agree that Byars is barred from raising this issue. Byars raised it in her Second Amended Complaint where she requested a [d]eclaration of her right to benefits in an amount not less than at 60% of her salary. (R.9-131 at 69.) She also raised the issue in her memorandum in support of summary judgment (R.12-192 at 29), in her Proposed Judgment (R.16-225 at 4-10), and has thoroughly briefed the issue on appeal. Nor do we read the order of the district court cited by the Coca-Cola Defendants (R.8-115, Order Granting in Part Defendants' Motion to Dismiss Class Claims) as barring Byars from asserting her individual right to benefits that do not fall below 60% of her average compensation. Rather, the court in this order dismissed all class claims while preserving Byars' right to seek relief individually. Nowhere in the order does the court hold that Byars cannot raise the 60% argument in her individual claim. Therefore, Byars has preserved this issue. Nevertheless, we refuse to consider the merits of this issue. While the district court granted summary judgment and entered an order on the issue of liability, its summary judgment opinion did not discuss this issue, despite Byars specifically asking for past due LTD Plan benefits at a minimum floor of 60% of her pre-disability earnings in accord with the plan documents. . . . (R.12-192 at 29.) The district court only entered a final order awarding Byars an amount of benefits below 60% of her average compensation. If Byars is correct that the Plan does impose a 60% floor on benefits, then the court's final order is contrary to the terms of the Plan, and was entered without a finding by the court on the issue. Therefore, we vacate the judgment with respect to the amount of own occupation benefits awarded to permit the district court to address the issue in the first instance. (2) Attorney's Fees ERISA provides for an award of attorney's fees: In any action under this subchapter . . . by a participant, beneficiary, or fiduciary, the court in its discretion may allow a reasonable attorney's fee and costs of action to either party. 29 U.S.C. § 1132(g)(1). We have refused to interpret this provision as creating a presumption in favor of awarding fees. Freeman v. Cont'l Ins. Co., 996 F.2d 1116, 1119 (11th Cir.1993) (The law provides no presumption in favor of granting attorney's fees to a prevailing claimant in an ERISA action.); see also Florence Nightingale Nursing Serv., Inc. v. Blue Cross/Blue Shield of Ala., 41 F.3d 1476, 1485-86 (11th Cir.1995) (quoting Freeman and refusing to adopt presumption of awarding fees). District courts in our circuit should consider five factors in determining whether to award attorney's fees: (1) the degree of the opposing parties' culpability or bad faith; (2) the ability of the opposing parties to satisfy an award of attorney's fees; (3) whether an award of attorney's fees against the opposing parties would deter other persons acting under similar circumstances; (4) whether the parties requesting attorney's fees sought to benefit all participants and beneficiaries of an ERISA plan or to resolve a significant legal question regarding ERISA itself; [and] (5) the relative merits of the parties' positions. Freeman, 996 F.2d at 1119. Byars' main argument is that the court did not explain its reasons for denying fees. She argues that the court should have carefully analyzed the relevant factors showing how its findings are supported by the record, and set forth principled reasons for apparently concluding that the Coca-Cola defendants' conduct . . . did not merit attorneys' fees being awarded. (Byars Initial Br. at 40.) Precedent in this circuit does not support such a requirement. Although it would be helpful if district courts specifically referred to each of [these] factors in their analysis, Plumbers & Steamfitters Local 150 Pension Fund v. Vertex Constr. Co., Inc., 932 F.2d 1443, 1453 (11th Cir.1991), we have said that so long as a court's analysis takes these guidelines into account, it does not abuse its discretion by not enumerating each and every one. Id. In fact, the case originally setting forth these factors, Iron Workers Local 272 v. Bowen, 624 F.2d 1255 (5th Cir.1980), [11] understood them to operate only as a guideline[ ] to assist [district courts] in exercising their discretion and as a nuclei of concerns that a court should address in applying section [1132(g)]. Id. at 1266. The district court's analysis satisfies our test. The court listed the five factors and concluded that [h]ere, these factors do not weigh in favor of an award of attorney's fees against the Defendants or against the Plaintiff. (R.15-221 at 20.) We hesitate to require the district court to do more than it did, that is, list the factors and conclude that they do not favor an award of fees. We also conclude that the district court did not abuse its discretion in denying fees. Our cases have not infrequently affirmed denial of attorney's fees where the ERISA beneficiary prevails in the district court on a claim for benefits. For example, in Florence Nightingale, a healthcare provider sued a plan administrator for denying its claim for reimbursement of benefits provided to a plan participant. The district court reversed the administrator's decision, but denied the provider's petition for attorney's fees. The court considered only the first factor, bad faith, and concluded that the plan administrator had an arguable basis for denying the healthcare provider's claim. We affirmed denial of fees recognizing that the district court is in the best position to judge the propriety of awarding fees. 41 F.3d at 1485; see also Dixon v. Seafarers' Welfare Plan, 878 F.2d 1411, 1413 (11th Cir.1989) (affirming denial of attorney's fees to successful ERISA claimant in part because the administrator had a reasonable basis for denying benefits). The district court did not abuse its discretion here. (3) Reinstatement and Retroactive Other Employee Benefits Byars argues that she is entitled to be reinstated in other employee benefit plans, at least for the first twenty-four months that the court awarded her own occupation benefits. Byars more specifically asks us for a declaration that she is eligible for reimbursement of any would-be-covered expenses had they occurred. She bases her entitlement to reinstatement (and consequently, reimbursement) on the Summary Plan Descriptions and the 1999 Total Compensation Perspective (TCP), which together essentially provide that an employee who is determined to be disabled under the Plan is eligible to continue her participation in other employee benefit plans. The TCP also states that an approved LTD beneficiary is entitled to automatic vesting of stock options. The Coca-Cola Defendants argue two points in response. First, they argue that the remedies that Byars seeks are external to the Plan and not recoverable under § 1132(a)(1)(B), which limits recovery to benefits due . . . under the terms of [the] plan. Second, they argue that Byars never submitted claims to the administrators of these other employee plans. Although Byars has from the inception of this litigation requested reinstatement in and reimbursement from other benefit plans, nowhere has Byars claimed that she actually incurred expenses related to these other plans that would have been covered had the Committee approved her claim for LTD benefits. The Smith Report, upon which Byars based her proposed final judgment, calculates the value of past medical and retirement benefits for the first twenty-four months at either $8,792 or $9,587 (R.16-225, Ex. F at 4, ¶ II(A)), but nowhere does Byars specify to which amount she is entitled, nor does she explain why she is entitled to the value of the benefits of other employee plans that she never utilized. The district court did not err in not awarding Byars relief related to other employee benefit plans. (4) Prejudgment Interest Byars argues that the district court abused its discretion in refusing to award prejudgment interest at a statutory rate of 12% on her award of own occupation benefits. See Ga.Code Ann. § 7-4-12 (establishing Georgia's post-judgment interest rate). We cannot say on this record that the district court abused its discretion in refusing to award prejudgment interest. In her proposed final judgment, which the district court refused to accept as untimely, Byars requested interest on own occupation benefits at a rate of 12%, totaling $59,765.41. This amount is greater than her award of own occupation benefits, $52,423.68. Furthermore, Byars bears some fault for the extended period of time required to litigate this case to judgment. She filed several amended complaints, a class action complaint, requested two discovery extensions, filed six motions to extend various deadlines, three motions to file various briefs as nunc pro tunc, and a motion to disqualify the district judge. As the Coca-Cola Defendants point out in their brief here, a similar case involving the same Plan and Defendants was resolved on summary judgment within six months. (Coca-Cola Defendants Br. at 14 n. 4.) This case has been ongoing for years. The district court did not abuse its discretion in denying Byars prejudgment interest on these facts.