Opinion ID: 3003254
Heading Depth: 2
Heading Rank: 2

Heading: Applying the Abuse-of-Discretion Standard of

Text: Review After Glenn Under the arbitrary-and-capricious standard—which, at least for ERISA purposes, is synonymous with abuse of discretion—this court will overturn an admin- istrator’s denial of benefits only if it lacks any rational support in the record. See Jenkins v. Price Waterhouse Long Term Disability Plan, 564 F.3d 856, 861 & n.8 (7th Cir. 2009). In other words, this court’s role is not to decide whether it would reach the same decision as the administrator, Davis v. Unum Life Ins. Co. of Am., 444 F.3d 569, 576 (7th Cir. 2006); rather, as long as specific reasons for the denial are communicated to the claimant and supported by record evidence, this court will uphold the administrator’s decision, see Leger v. Tribune Co. Long Term Disability Ben. Plan, 557 F.3d 823, 831 (7th Cir. 2009). Raybourne’s strongest argument on appeal is that the district court insufficiently engaged the Supreme Court’s 10 No. 08-2754 recent decision in Metropolitan Life Insurance Company v. Glenn, 128 S.Ct. 2343 (2008)—which issued just five days before Cigna won summary judgment—in assessing whether Cigna’s inherent conflict of interest (as a plan administrator that both adjudicates claims and pays awarded benefits) rendered its decision arbitrary and capricious. In Glenn, the Supreme Court clarified that courts should be aware of structural conflicts of interest in reviewing plan decisions for abuse of discretion. Id. at 2348. A structural conflict is one factor among many that are relevant in the abuse-of-discretion analysis— including whether the administrator overemphasized medical reports that favored its decision and whether it gave its medical examiners all of the relevant evidence—and will “act as a tiebreaker when the other factors are closely balanced.” Id. at 2351-52. Glenn emphasizes that courts should give additional weight to a structural conflict where the administrator has a history of biased claim administration or helped a claimant obtain a social security award it then disregarded. Id. The conflict may be “less important (perhaps to the vanishing point) where the administrator has taken active steps to reduce potential bias and to promote accuracy.” Id. at 2351. Although the Court stressed that there is no “precise set of instructions” for weighing the relevant factors, it emphasized that a structural conflict may not be ignored. Id. at 2351-52. Raybourne correctly points out that it is unclear whether the district court properly accounted for Cigna’s structural conflict of interest. In its opinion awarding Cigna summary judgment, the district court included a No. 08-2754 11 short footnote recognizing that Glenn issued “[a]fter this opinion was prepared,” and stating summarily that “nothing in [Glenn] has altered” its analysis. The district court then denied, without explanation, Raybourne’s motion for reconsideration in light of Glenn. Given the district court’s cursory treatment of Glenn, we cannot determine whether it engaged in the balancing analysis that Glenn requires with respect to a plan administrator’s conflict of interest. For instance, the district court did not mention Cigna’s structural conflict in evaluating and paying for claims, or explain how the conflict weighed in the abuse-of-discretion balance. Moreover, the court had little to say beyond acknowledging that it was “disturbed” by the discrepancy it saw between Cigna’s hiring of a consultant group to advocate on Raybourne’s behalf before the SSA, and Cigna’s subsequent denial of his claim for benefits despite the SSA’s finding of disability. The court ultimately disregarded the discrepancy because it concluded that Cigna’s decision was supported by the record. But after Glenn, Cigna’s advocacy of a disability finding before the SSA should have been treated as a “serious concern” for the court to consider in weighing whether Cigna’s structural conflict rendered its denial of benefits arbitrary. See DeLisle v. Sun Life Assurance Co. Of Canada, 558 F.3d 440, 446 (6th Cir. 2009). In the wake of Glenn, other circuits have not hesitated to remand cases so that district courts may consider the impact of a structural conflict in the first instance. See, e.g., Denmark v. Liberty Life Assurance Co. of Boston, 566 12 No. 08-2754 F.3d 1, 9 (1st Cir. 2009); Hackett v. Standard Ins. Co., 559 F.3d 825, 830 (8th Cir. 2009); Burke v. Pitney Bowes Inc. LongTerm Disability Plan, 544 F.3d 1016, 1027 (9th Cir. 2008). A remand is similarly appropriate here because the district court’s cursory reference to Glenn casts doubt on whether it properly analyzed Cigna’s structural conflict. A remand will ensure that the court conducts in the first instance the balancing analysis that Glenn requires. We recognize that ultimately Cigna’s conflict will tip the balance only if the district court concludes that this is a borderline case, see Glenn, 128 S.Ct. at 2351; Jenkins, 564 F.3d at 861-62, but after weighing Cigna’s conflict together with factors such as its pursuit of the social security award and its willingness to discount Raybourne’s subjective pain complaints, the court might view Raybourne’s case as borderline. We thus follow the lead of our sister circuits and remand to allow the district court, in the first instance, to consider how heavily Cigna’s conflict weighs in the abuse-of-discretion balance. The judgment of the district court is V ACATED and the case is R EMANDED for further proceedings. 8-6-09