Opinion ID: 183519
Heading Depth: 4
Heading Rank: 1

Heading: Reversal of Position

Text: An administrator's reversal of its decision to award a claimant benefits without receiving any new medical information to support this change in position is an irregularity that counsels towards finding an abuse of discretion. See, e.g., Post, 501 F.3d at 164-65; Pinto v. Reliance Standard Life Ins. Co., 214 F.3d 377, 393 (3d Cir.2000). Miller claims that American abruptly terminated his benefits in 2006 upon evaluating the same information that it had previously found to support an award of benefits. The District Court found that our decision in Foley v. International Brotherhood of Electrical Workers Local Union 98 Pension Fund, 271 F.3d 551 (3d Cir.2001), dictates that American should not be prevented from terminating Miller's benefits, despite the fact that it previously awarded them. See Miller, 2010 WL 890016, at . In any event, the District Court further concluded, American did not unjustifiably reverse its position as to Miller's eligibility because American received reports from Dr. Gonzalez that Miller was asymptomatic in 2005 and 2006 to support the conclusion that he was no longer disabled. See id. Our review of the decision in Foley leads us to conclude that it is not controlling in this situation. In Foley, the claimant argued that it was arbitrary and capricious for the employer to refuse to apply an exception for calculating credited service when it had previously interpreted the pension plan to allow the exception for other employees. See 271 F.3d at 554. We rejected that argument, reasoning that it would be improper to effectively foreclose an employer from correcting a previous erroneous interpretation of a plan. See id. at 558-59. Thus, Foley deals with an employer's reversal of a previous interpretation of a plan's language. It does not address the significance of an employer's inconsistent treatment of medical evidence used to determine whether a claimant is disabled. In fact, we made clear in Post, decided after Foley, that an employer's reversal of position as to whether a claimant is disabled is a significant factor to be weighed on arbitrary and capricious review. See Post, 501 F.3d at 164-65. Turning to the District Court's alternative conclusion that American did not reverse its position, we disagree that the documentation from Dr. Gonzalez provided new information regarding Miller's eligibility for benefits. The records that American received from Dr. Gonzalez in 2005 and 2006 stating that Miller was asymptomatic do not differ in any material aspect from the records submitted in 2003 that American determined supported a disability finding. For example, Dr. Gonzalez reported in 2003 that Miller was diagnosed with anxiety and brief reactive psychosis, but that he was currently asymptomatic. Later, in 2005, Dr. Gonzalez stated that Miller was asymptomatic and was working toward preventing manifestations of stress. Similarly, in 2006, Dr. Gonzalez reported that Miller's diagnoses remained the same and that he was asymptomatic. Each report mirrors the next and identifies Miller as asymptomatic. Thus, the more recent records were only new to the extent that they had not been received before; they did not provide any new information. Moreover, American admitted that it could not determine whether there was any change that occurred in Miller's psychiatric condition between January 2003 and May 2007. As a result, the information that American relied upon to terminate Miller's benefits in 2006 was the same type of documentation that American interpreted to support a disability finding in 1999 and again in 2003 through 2006. We recognize that American's initial payment of Miller's benefits does not operate as an estoppel such that they can never terminate benefits. But, in the absence of any meaningful evidence to support a change in position, American's abrupt reversal is cause for concern that weighs in favor of finding that its termination decision was arbitrary and capricious. See id.; see also McOsker v. Paul Revere Life Ins. Co., 279 F.3d 586, 589 (8th Cir.2002) (reversal of position supported arbitrary and capricious finding where information used to terminate benefits did not vary significantly from the [previous] opinions).