Lupo v. Daimlerchrysler Corp.

NOT RECOMMENDED FOR FULL-TEXT PUBLICATION
File Name: 08a0363n.06
Filed: June 24, 2008
No. 06-1921
UNITED STATES COURT OF APPEALS
FOR THE SIXTH CIRCUIT
MICHAEL J. LUPO, )
)
Plaintiff-Appellant, )
) ON APPEAL FROM THE UNITED
v. ) STATES DISTRICT COURT FOR THE
) EASTERN DISTRICT OF MICHIGAN
DAIMLERCHRYSLER CORPORATION, )
)
Defendant-Appellee. )
Before: MARTIN and BATCHELDER, Circuit Judges: JORDAN, District Judge.*
LEON JORDAN, District Judge. Michael J. Lupo appeals the district court’s
grant of judgment for defendant in this action filed under the Employee Retirement Income
Security Act (“ERISA”), 29 U.S.C. §§ 1001-1461. For the reasons that follow, we AFFIRM
the district court.
Lupo filed his complaint in the district court by counsel, alleging that his
employer, defendant DaimlerChrysler Corporation, improperly denied his application for
long-term disability benefits and breached its fiduciary duty to him. After defendant
submitted the administrative record, Lupo moved for summary judgment and defendant
*
The Honorable R. Leon Jordan, United States District Judge for the Eastern District
of Tennessee, sitting by designation.
moved for judgment on the administrative record. Following a brief hearing, the district court
denied Lupo’s motion, granted defendant’s motion, and entered judgment accordingly. Lupo
filed a timely notice of appeal.
On appeal, Lupo is proceeding pro se and contends: (1) that his former attorney failed
to submit medical evidence; and (2) that his medical problems render him disabled.
Defendant responds that the district court’s judgment was proper. Upon consideration, we
affirm the judgment for reasons other than those stated by the district court. See Thomas v.
Miller, 489 F.3d 293, 297 n.5 (6 th Cir. 2007); Russ’ Kwik Car Wash, Inc. v. Marathon
Petroleum Co., 772 F.2d 214, 216 (6 th Cir. 1985).
This Court reviews de novo a district court’s judgment based upon the administrative
record in an ERISA action for disability benefits. See Wenner v. Sun Life Assurance Co. of
Can., 482 F.3d 878, 881 (6 th Cir. 2007). Where an ERISA plan affords an administrator
discretion to determine whether benefits are due, federal courts review the administrator’s
determination under an arbitrary and capricious standard. See Firestone Tire & Rubber Co.
v. Bruch, 489 U.S. 101, 115 (1989); Wenner, 482 F.3d at 881. However, where an ERISA
plan affords an administrator no discretionary authority to construe plan terms, courts review
an administrator’s determination de novo. Pollett v. Rinker Materials Corp., 477 F.3d 376,
377 (6 th Cir. 2007) (citing Bruch, 489 U.S. at 115). Although the district court applied the
deferential arbitrary and capricious standard of review in this case, de novo review is
appropriate because the ERISA plan at issue required defendant to deny Lupo’s application
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for disability benefits.
Review of the administrative record reveals that the permanent total disability
provisions of defendant’s pension plan provide:
The medical opinions of the physician or physicians shall resolve
the issue as to the individual’s condition. Provided they are
consistent, such opinions shall be binding upon the Employee
Benefits Committee which, following receipt thereof, shall
render its findings in accordance with such opinions. If the
physicians shall disagree over the issue of whether the Employee
is Permanently and Totally Disabled or as to the duration of such
condition, the matter shall be submitted to an independent
medical examiner. Such independent medical examiner shall
render his opinion which shall be binding upon the Employee
Benefits Committee. Following its receipt thereof, the Employee
Benefits Committee shall render its findings in accordance with
such opinion.
Although Lupo’s physician opined that Lupo is permanently and totally disabled due to
significant medical problems which have rendered him disabled for purposes of social
security, defendant’s physician did not agree. Pursuant to the terms of defendant’s pension
plan, Lupo was examined by an independent physician. While the independent physician
noted that Lupo “is likely suffering from a severe persistent mental illness, which does render
him incapacitated and unable to work” and which “prevent[s] him from taking medications
and seeking treatment,” the physician recommended that Lupo “not be permanently and totally
disabled as he has not sufficiently attempted to get full treatment necessary to determine that.”
Although the independent physician’s opinion might be disputed or challenged, the opinion
nonetheless is binding on the administrator under the terms of defendant’s pension plan.
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Lupo’s contention on appeal that counsel failed to submit medical evidence is of no moment
because judicial review is confined to the administrative record that was before the
administrator. See Wilkins v. Baptist Healthcare Sys., Inc., 150 F.3d 609, 615 (6 th Cir. 1998);
Perry v. Simplicity Eng’g, 900 F.2d 963, 966 (6 th Cir. 1990). Under these circumstances,
defendant properly denied Lupo’s application for long-term disability benefits.
For the foregoing reasons, the district court’s judgment is AFFIRMED.
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