Opinion ID: 70646
Heading Depth: 3
Heading Rank: 1

Heading: Supplementation of Administrative Record

Text: McDonald argues that the district court abused its discretion by declining to permit McDonald to enter her SSA award into the administrative record. The SSA award was issued October 23, 2007, more than one year after Hartford issued its final decision in April 2006. McDonald argues that the district court’s 10 Case: 09-30381 Document: 00511007186 Page: 11 Date Filed: 01/19/2010 No. 09-30381 remand for further investigation re-opened the administrative process, making it proper to supplement the administrative record with the SSA award. Hartford argues that, given the limited purpose of the remand, there was no obligation for Hartford to consider new evidence outside of the district court’s instructions and the district court acted within its discretion in declining to consider the SSA award. The determination of whether evidence should be included in the administrative record is an evidentiary decision, and we review for abuse of discretion. Corry v. Liberty Life Assurance Co. of Boston, 499 F.3d 389, 398 n.12 (5th Cir. 2007). When conducting abuse of discretion review of a denial of benefits based on an administrative record, we have generally required that the scope of review be limited to facts known to the plan administrator at the time of the benefits decision. S. Farm Bureau Life Ins. Co. v. Moore, 993 F.2d 98, 102 (5th Cir. 1993). However, we have recognized certain limited exceptions to this rule. See Vega v. Nat’l Life Ins. Servs., Inc., 188 F.3d 287, 299 (5th Cir. 1999) (en banc) (“To date, th[e] exceptions have been related to either interpreting the plan or explaining medical terms and procedures relating to the claim.”).7 These exceptions have been judged on a case-by-case basis, and we have declined to adopt any per se rules in this area. Cf. Duhon v. Texaco, Inc., 15 F.3d 1302, 1309 (5th Cir. 1994). When compiling the administrative record, the plan administrator must identify what evidence constitutes the administrative record, and the claimant 7 Metropolitan Life Insurance Co. v. Glenn, — U.S. —, 128 S.Ct. 2343, 2350 (2008), abrogated Vega to the extent that Vega adopted a “sliding-scale” methodology of weighing conflicts of interest. See Holland v. Int’l Paper Co. Ret. Plan, 576 F.3d 240, 247 n.3 (5th Cir. 2009). However, we have maintained that “much of our ‘sliding scale’ precedent is compatible with the Supreme Court’s newly clarified ‘factor’ methodology, and Glenn does not supercede that precedent to the extent it reflects the use of a conflict as a factor that would alter the relative weight of other factors.” Id. Therefore, Vega continues to be good law for propositions unrelated to the “sliding scale” method of reviewing alleged conflicts of interest. 11 Case: 09-30381 Document: 00511007186 Page: 12 Date Filed: 01/19/2010 No. 09-30381 must have “a reasonable opportunity to contest whether that record is complete.” Estate of Bratton v. Nat’l Union Fire Ins. Co. of Pittsburgh, 215 F.3d 516, 521 (5th Cir. 2000). While the administrative record is generally limited to “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,” we have attempted to avoid abuse or mistake by allowing “the claimant’s lawyer [to] add additional evidence to the administrative record simply by submitting it to the administrator in a manner that gives the administrator a fair opportunity to consider it.” Id. at 521 & n.5. We have been clear, however, that “the district court is precluded from receiving evidence to resolve disputed material facts—i.e., a fact the administrator relied on to resolve the merits of the claim itself.” Vega, 188 F.3d at 299. Had the district court not remanded to Hartford for further investigation of Dr. Steck’s opinion, the question of whether the SSA award should be included in the administrative record would be clear: the administrative record closed when McDonald filed suit in June 2006. Cf. Moore, 993 F.2d at 102. The SSA award does not fall into the two acknowledged exceptions: evidence interpreting the plan or explaining medical terms and procedures. The timing of the remand order complicates the analysis somewhat, for Estate of Bratton suggests that McDonald had the opportunity to offer additional information to Hartford, so long as the submission of new information was conducted “in a manner that gives the administrator a fair opportunity to consider it.” Estate of Bratton, 215 F.3d at 521 n.5. Assuming without deciding that McDonald could have supplemented the record on remand, she missed her opportunity. The SSA award was issued on October 23, 2007, five months before the district court remanded the case to Hartford on March 28, 2008. Yet McDonald did not bring the SSA award to the district court’s attention until after the conclusion of the remand period, despite at least one opportunity to do 12 Case: 09-30381 Document: 00511007186 Page: 13 Date Filed: 01/19/2010 No. 09-30381 so. For example, Hartford moved for reconsideration of the remand order, which McDonald opposed in writing—without mention of the SSA award. McDonald was aware of the district court’s specific instructions on remand but did not ask the district court to expand the scope of the remand to include consideration of the award. The first mention of the SSA award in McDonald’s filings is in her January 23, 2009, reurged motion for summary judgment. In light of the district court’s very specific instructions limiting the scope of the remand and McDonald’s failure to submit the award for consideration at an appropriate time, the district court did not abuse its discretion in refusing to consider the SSA award and in approving Hartford’s decision not to consider the award.