Opinion ID: 1767685
Heading Depth: 2
Heading Rank: 3

Heading: MetLife's internal policies and procedures

Text: Selmon next alleges that MetLife abused its discretion by failing to comply with some of its own internal policies and procedures. First, he contends that MetLife was required to consult his attending physicians when the results reached by the independent reviewing physician were inconsistent with those of his attending physicians. He also claims that MetLife did not even attempt to contact his treating physicians. These statements are simply not supported by the record. First, the conclusion of Dr. Pujarathat Selmon could return to workwas not completely inconsistent with the views of Selmon's attending physicians. In fact, his attending physicians had noted improvement in Selmon's recent test results and had never concluded that he could not perform any occupation. Moreover, MetLife was in contact with Selmon's attending physicians well after his benefits were terminated in June 2001. Secondly, Selmon argues that MetLife acted in contravention of its own Summary Plan Description by not awarding Selmon benefits once the Social Security Administration (SSA) found him disabled. He contends that the Summary Plan Description implies that once the SSA determines that a claimant qualifies for social security disability benefits, the plan automatically pays benefits. The Summary Plan Description explains that a claimant must qualify for disability benefits and states that if the claimant qualifies for disability benefits from Social Security or other group plans those other sources pay first and the company plan makes up the difference until you have sixty percent of your pay. A plain reading of the Summary Plan Description does not indicate that a claimant will automatically receive benefits once he qualifies for Social Security benefits. Instead, the plan simply states a claimant's other income sources must pay benefits before the plan will pay. Thus, we find no merit in Selmon's arguments concerning MetLife's compliance with its own policies and procedures.