Court Opinion

ID: 9744533
Source: CourtListenerOpinion
Date Created: 2023-08-26 22:05:26.836969+00
Date Added: 2024-06-11T12:24:59.895269
License: Public Domain

KIRSCH, Judge,
dissenting.
I respectfully dissent. I commend the majority for research and analysis, but I nevertheless reach a different conclusion and believe that allowing the admission of additional evidence in a de novo review proceeding is better law and better policy.
The United States Supreme Court has directed that because ERISA is intended to further the protection of covered workers a trial court reviewing an administrator’s decision is to conduct such review de novo unless the fiduciary has discretionary authority to construe the terms of the plan or make eligibility determinations. Firestone Tire and Rubber Co. v. Bruch, 489 U.S. 101, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989). In conducting the de novo review, the trial court is to make an informed and independent judgment. Casey v. Uddeholm Corp., 32 F.3d 1094, 1099 (7th Cir.1994).
Here, Wheatley sought to introduce expert testimony that he met the standard of total disability, to testify why his bowel movements subsided on the third day he was hospitalized to rebut contrary evidence, and to present the testimony of a physician as to the severity of his condition. All of this evidence is relevant to an informed and independent judgment.
I also believe allowing such evidence is better policy. The rule announced by the majority which allows additional evidence “only when it is necessary to conduct an adequate de novo review of the administrator’s determination, and this discretion should only be exercised when good cause exists,” Opinion, p. 931, will significantly increase the cost of making claims. Looking only at the case before us, I believe it was reasonable and prudent for Wheatley to present only the opinion of his treating physician as to the nature and extent of his disability coupled with the disability determination made by the Social Security Administration. Only in the event that the administrator denies the claim, should a claimant have to go to the expense of hiring expert witnesses, taking depositions and so forth. Under the rule set out in this case, a claimant now faces a Hobson’s choice: Either incur the expenses inherent in presenting such evidence—expenses and evidence which may not be necessary to the administrator’s determination—or save the expenses but face the risk that such evidence may not be later admitted should an appeal of an adverse decision be required.
I also believe that making the admission of such evidence discretionary with the trial courts places a very difficult burden on the trial court and will inevitably lead to inconsistent rulings. What are the limits of the trial court’s discretion? How does a trial court determine whether additional evidence is necessary to conduct an adequate de novo review unless it hears the additional evidence?
I would reverse the decision of the trial court, order the admission of the additional evidence, and remand for further proceedings.