Opinion ID: 1201548
Heading Depth: 2
Heading Rank: 1

Heading: Excessive Levels of Review

Text: Menz appeals the district court's grant of judgment on the administrative record, which we treat as a form of summary judgment and review de novo. See Riddell v. Unum Life Ins. Co. of Am., 457 F.3d 861, 864 (8th Cir.2006). We also review de novo the district court's determination of the appropriate standard of review to apply to a denial of benefits under ERISA. See Barham v. Reliance Standard. Life Ins. Co., 441 F.3d 581, 584 (8th Cir.2006). When a plan grants the administrator discretionary authority to determine eligibility for benefits or to construe the terms of the plan, a denial of benefits is reviewed under an abuse of discretion standard. See Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989). In the present case, it is undisputed that the Plan grants discretionary authority to its administrator (Procter & Gamble) to determine eligibility and to interpret the terms of the plan. However, even where the administrator has discretionary authority, a less deferential standard of review may be warranted if a plaintiff shows that a serious procedural irregularity existed which caused a serious breach of the plan trustee's fiduciary duty to the plan beneficiary. Buttram v. Cent. States, Se. & Sw. Areas Health & Welfare Fund, 76 F.3d 896, 900 (8th Cir. 1996). Menz believes that a serious procedural irregularity occurred because his claim was subjected to excessive levels of review. An employee benefits plan has an obligation to establish and maintain reasonable claims procedures. See 29 C.F.R. § 2560.503-1(b) (2007). Claims procedures are reasonable if they, inter alia, do not contain any provision, and are not administered in a way, that requires a claimant to file more than two appeals of an adverse benefit determination prior to bringing a civil action under section 502(a) of [ERISA.] Id. § 2560.503-1(c)(2). It appears that Menz did participate in more than two appeals of his denial of benefits, [7] but the mere presence of a procedural irregularity is not enough to strip a plan administrator of the deferential standard of review. McGarrah v. Hartford Life Ins. Co., 234 F.3d 1026, 1031 (8th Cir.2000). A less deferential standard is only warranted when a beneficiary shows that the plan administrator, in the exercise of its power, acted dishonestly, acted from an improper motive, or failed to use judgment in reaching its decision. Neumann v. AT & T Commc'ns, Inc., 376 F.3d 773, 781 (8th Cir.2004). Additionally, the irregularity must have some connection to the substantive decision reached. . . . Buttram, 76 F.3d at 901. The Plan admits that certain procedural mistakes were made during the processing of Menz's claim, and that there was some confusion as to which entity was responsible for handling the claim  Healthlink or EPOCH. See Appellee Procter & Gamble's Br. 33. The Plan attempted to remedy any errors or confusion by allowing him a new appeal process to give him the opportunity to demonstrate the validity of his request for benefits. Menz fails to demonstrate how permitting an additional appeal had any connection to the substantive decision reached or that the Plan acted with an improper motive. On the contrary, Menz had further opportunity to supplement the record in support of his claim. Menz has not raised serious doubts as to whether the result reached was the product of an arbitrary decision or the plan administrator's whim, and he has not demonstrated that the actual decision was reached without reflection and judgment. . . . Buttram, 76 F.3d at 900-01. Accordingly, the district court did not err when it reviewed the Plan's decision for abuse of discretion, despite the fact that Menz's claim was subject to more than two appeals.