United States Court of Appeals
FOR THE DISTRICT OF COLUMBIA CIRCUIT
Argued May 12, 2011 Decided July 15, 2011
No. 10-7062
SONYA PETTAWAY,
APPELLANT
v.
TEACHERS INSURANCE AND ANNUITY
ASSOCIATION OF AMERICA, ET AL.,
APPELLEES
Appeal from the United States District Court
for the District of Columbia
(No. 1:07-cv-01721)
Denise M. Clark argued the cause and filed the briefs for
appellant.
Andrew M. Altschul argued the cause and filed the brief for
appellees Teachers Insurance and Annuity Association and
Standard Benefit Administrators.
Karla Grossenbacher was on the brief for appellee National
Academy of Sciences Group Total Disability Insurance Plan.
Before: SENTELLE, Chief Judge, GINSBURG and GARLAND,
Circuit Judges.
2
Opinion for the Court filed by Chief Judge SENTELLE.
SENTELLE, Chief Judge: After injuring her back in a car
accident, Sonya Pettaway filed for and received long-term-
disability benefits from the insurance plan sponsored by her
employer. After providing benefits to Pettaway for several
years, the claims administrator of that plan determined that
Pettaway no longer qualified under the plan and terminated her
benefits. Pettaway brought suit pursuant to the Employee
Retirement Income Security Act of 1974 against her employer
and the administrators and underwriters of her employer-
sponsored long-term-benefit disability insurance policy.
Finding no violation of law, the district court granted the
defendants’ motion for summary judgment, and Pettaway
appealed. Because the district court properly granted summary
judgment, we affirm the district court’s decision.
I.
Plaintiff-appellant Sonya Pettaway was employed by the
National Academy of Sciences (“the Academy”) for seven years
and participated in the National Academy of Sciences Group
Total Disability Insurance Plan (“the Plan”), provided as a
benefit for employees by the Academy. The Academy Plan was
created pursuant to the Employee Retirement Income Security
Act of 1974 (“ERISA”), 29 U.S.C. §§ 1001 et seq., and was
governed by three separate documents. The first document was
the Academy Total Disability Insurance Plan description (the
“Plan Document”), a document created by the Academy which
outlined general aspects of the Academy Plan. The second
document was the Total Disability Insurance Plan Summary (the
“Summary Plan Description”), a plain language summary of the
participants’ rights and obligations under the Academy Plan.
The last document was the Group Total Disability Insurance
Certificate (the “Policy Document”), a document created by
3
Teachers Insurance and Annuity Association (“TIAA”), the
Academy Plan’s underwriter and claims administrator, which
described the main features of the insurance under the group
policy that TIAA issued to the Academy. At some time in or
around the year 2003 (the record is unclear as to the exact date),
Standard Benefit Administrators took over administration on
behalf of TIAA. As there appears to be no legal distinction
between the two entities relevant to this litigation, we will refer
to TIAA and Standard jointly and separately as “TIAA.”
The Academy Plan provided disability benefits to eligible
participants who qualified as “totally disabled” under the terms
of the plan. The plan employed two different definitions of
totally disabled, one concerning the first twenty-four months
during which a participant received benefits and a more rigorous
definition after that twenty-four month period. During the initial
two-year period, the Academy Plan defined totally disabled as
“being completely unable due to sickness, bodily injury, or
pregnancy to perform the material and substantial duties of [the
participant’s] Normal Occupation.” Policy Document at 8.1. To
continue to qualify as totally disabled after the initial period, the
Academy Plan required participants to be unable “to perform the
material and substantial duties of any occupation for which [the
participant is] reasonably qualified by education, training, or
experience.” Id. (emphasis added). During both periods, the
plan also required that participants be under the “Regular Care”
of a physician, defined as “regular in-person visits with [the
participant’s] Physician as frequently as required under standard
medical practice to effectively manage and treat [the
participant’s] disabling sickness or injury.” Id. “Regular Care”
also required participating in “a reasonable program of care and
treatment that is, in accordance with accepted medical practice,
expected to enhance your ability to work . . . .” Id. In
accordance with ERISA’s statutory requirements, the Academy
Plan provided participants with the opportunity for a “full and
4
fair” internal administrative review of any denial of participant
benefit claims.
In January of 2000, while employed by the Academy and
while participating in the Academy Plan, Pettaway suffered a
back injury in an automobile accident. The injury, which
required back surgery, prevented Pettaway from performing her
usual duties, so Pettaway filed the total disability claim
underlying the present litigation. Agreeing that Pettaway
qualified as “totally disabled” as defined by the Academy Plan
for the first twenty-four months, TIAA approved Pettaway’s
claim and began providing disability benefits effective August
1, 2000. In September 2001, in preparation for the end of the
initial two-year benefits period, TIAA began reviewing
Pettaway’s file and requesting additional medical information
from Pettaway to determine if she would qualify for benefits
under the Academy Plan’s more rigorous definition of total
disability. After performing an independent medical
examination and assessing Pettaway’s medical record, TIAA
concluded that Pettaway did not qualify for benefits beyond the
initial twenty-four month period and notified her that it would
cease paying benefits after December 2002.
Pursuant to the Academy Plan’s administrative review
provisions, Pettaway requested an internal review of TIAA’s
decision to terminate her benefits. Pettaway failed, however, to
provide TIAA with any new evidence to support her total
disability claim. Noting that it had “no diagnostics or physical
exam findings on file” to support Pettaway’s complaint, TIAA
affirmed its decision to cease paying benefits after December
2002. Letter from Iserdai Burston, Group Benefits Analyst,
TIAA, to Sonya Pettaway (Jan. 14, 2003). TIAA notified
Pettaway of the results of the administrative review, informed
her that she still had 180 days to submit another written request
for further review, and recommended that any future request
5
should be accompanied by relevant medical documentation that
would support her disability claim.
Over the course of the next six months, a series of events
caused TIAA to reconsider its decision to cancel Pettaway’s
benefits. First, Pettaway returned to the “Regular Care” of her
back surgeon, whom she had not seen for over two years. This
was significant because, as discussed above, by resuming
medical treatment and monitoring of her disability by her
physician, Pettaway satisfied a significant condition of her long-
term-disability policy. Furthermore, Pettaway aggravated her
back injury twice, once during a slip-and-fall accident in January
2003 and again during a second car accident in April 2003. As
a result of the additional injuries, Pettaway’s back surgeon
recommended that Pettaway undergo a second back surgery. In
light of Pettaway’s new injuries, her pending back surgery, and
her return to the “Regular Care” of her surgeon, TIAA reinstated
Pettaway’s long term disability benefits in August 2003,
requesting that she provide TIAA with an update of her medical
condition after her back surgery.
Beginning in November 2003, TIAA began requesting from
Pettaway updates on her medical status. In January 2004,
Pettaway’s back surgeon sent TIAA a brief letter stating his
opinion that Pettaway could not “return to any type of gainful
employment.” Letter from Bernard Stopak to Whom It May
Concern (Jan. 23, 2004). In June 2004, Pettaway’s surgeon,
Doctor Stopak, sent a brief report to TIAA in which he
explained that Pettaway had not yet undergone her second back
surgery and that she was unable to “return to any type of work
whatsoever at [that] time.” Bernard Stopak, Supplemental
Neurological Report (June 24, 2004). The surgeon did not
provide TIAA with any medical data or test results with either
the letter or the report. Hoping to obtain objective medical data,
TIAA scheduled an independent medical examination and a
6
functional capacity examination for Pettaway, but she did not
attend either test. On August 12, 2004, lacking “objective
medical documentation to support [Pettaway’s] inability to
perform any occupation,” TIAA terminated Pettaway’s benefits
effective August 31, 2004. Letter from Carmen Lourensz,
Senior Disability Benefits Analyst, Standard Benefit
Administrators, to Sonya Pettaway (Aug. 12, 2004). As before,
TIAA informed Pettaway that she had 180 days to request an
internal administrative review of the termination decision and
suggested that she include any new medical evidence with her
request for review.
Pettaway wrote to TIAA in October 2004 requesting an
administrative review of its decision to terminate her disability
benefits. In response to TIAA’s statement that it lacked
independent medical evidence to support Pettaway’s disability
claim, Pettaway included with her request two additional
medical reports from her surgeon. TIAA forwarded Pettaway’s
file and the new medical reports to its Quality Assurance Unit,
a separate in-house group that, according to TIAA, exists
specifically to assure that each claim receives a fair and
objective review by individuals who were not involved in the
original determination. In addition to reviewing Pettaway’s
existing file, the Quality Assurance Unit took several actions to
develop its own evidence. First, it offered Pettaway another
opportunity to attend the previously requested independent
medical and functional capacity examinations. Although it
made three attempts to contact Pettaway to schedule the
examinations, Pettaway never responded and the tests were not
performed. The Quality Assurance Unit also hired a consulting
physician to review all of the medical records in Pettaway’s file.
The reviewing physician disagreed with Pettaway’s back
surgeon’s conclusions regarding Pettaway’s disability, stating
“the medical information provided does not support that the
claimant has limitations and restrictions due to her back
7
condition that would preclude her from performing any gainful
employment.” Mary Lindquist, Physician Consultant Memo
(Mar. 2, 2005). Finally, based on the reviewing physician’s
assessment of Pettaway’s ability to work, the Quality
Assessment Unit performed a “transferable skills assessment” to
determine whether Pettaway would be able to find comparable
work in her labor market. That assessment indicated that
positions were available in six different comparable occupations
in sufficient numbers to allow Pettaway to reenter the
workforce. In March 2005, based on the consulting physician’s
review of Pettaway’s medical file, the results of the transferable
skills assessment, and the lack of objective medical data to
support Pettaway’s claim, the Quality Assurance Unit upheld the
termination of Pettaway’s long-term-disability benefits.
While the administrative appeal process was ongoing,
Pettaway had also filed a complaint with the District of
Columbia Department of Insurance and Securities Regulations
(“DOI”). In May 2005, two months after the close of the TIAA
administrative process, the DOI contacted TIAA to inform them
that Pettaway was attempting to schedule the previously
requested independent medical and functional capacity
examinations at her own expense and asked if TIAA would be
willing to pay for the examinations. TIAA agreed to reopen the
Quality Assurance Unit’s review and to arrange and pay for
Pettaway’s examinations. The examinations were finally
conducted in June and July of 2005.
The physical therapist who performed the functional
capacity examination concluded that Pettaway was capable of
sedentary work. The therapist noted, however, that “[d]ue to the
extent of self-limiting on the endurance tasks of the test, it is
difficult to predict whether [Pettaway] can sustain the Sedentary
level of work for the 8 hour day.” Christian Wheeler, Physical
Work Performance Evaluation Summary (July 5, 2005). The
8
therapist observed inconsistencies in Pettaway’s performance,
which combined with Pettaway’s self-limiting behavior, heavily
influenced the outcome of the functional capacity examination.
The doctor who performed the independent medical
examination also observed inconsistencies in Pettaway’s
capabilities and limitations. He stated that “there are gross
inadequacies between what the claimant can perform when she’s
not on the exam table versus what she does on the exam table,”
and that his “objective findings do not correlate with the
claimant’s stated diagnosis and findings.” Letter from John
Hennessey, Associated Neurologist, P.C., to Laura Mizner,
MedReps (July 21, 2005). The doctor concluded that Pettaway
“is ready for sedentary activity” and recommended that she
begin with four-hour days and then transition into full-time work
“within a month or two of starting half a day work cycles.” Id.
After the completion of the independent medical and
functional capacity examinations, the Quality Assurance Unit
obtained another independent medical review from a new
consulting physician. That physician diagnosed Pettaway with
mechanical back pain and concluded that Pettaway’s record
indicates that “she cannot perform full-time sedentary level
work.” Ronald Fraback, Physician Consultant Memo (Aug. 25,
2005). The physician offered to consult directly with the doctor
who performed the July independent medical examination, but
he doubted that the consultation would result in that doctor
changing his conclusion.
Based on the results of the independent medical and
functional capacity examinations, the results from the
transferable skills assessment, and the independent medical
review of Pettaway’s file, the Quality Assurance Unit concluded
that Pettaway was capable of returning to part-time employment.
Because the Academy Plan covered only total disability, and not
9
partial disability, the Quality Assurance Unit concluded that
Pettaway did not qualify under the terms of the plan and again
upheld TIAA’s decision to terminate Pettaway’s long-term-
disability benefits. In a September 2005 letter notifying
Pettaway of the results of the administrative review, TIAA
informed Pettaway that her right to an administrative review had
been satisfied and that, therefore, TIAA was closing her claim.
In March 2006, Pettaway sent additional documents to
TIAA in an attempt to supplement her claim for long-term-
disability benefits. TIAA returned the materials stating that
Pettaway’s administrative review had been completed and that
her claim was closed. In September 2007, Pettaway filed suit in
the district court, claiming that the Academy and TIAA violated
ERISA by wrongfully terminating her benefits and by failing to
follow the proper procedures while administering her claim.
The parties cross-moved for summary judgment and the district
court granted TIAA’s motion, upholding TIAA’s termination of
Pettaway’s benefits. Pettaway v. Teachers Ins. & Annuity Ass’n
of Am., 699 F. Supp. 2d 185, 209 (D.D.C. 2010).
II.
We review the district court’s grant of summary judgment
in an ERISA denial-of-benefits case de novo. Heller v. Fortis
Benefits Ins. Co., 142 F.3d 487, 491-92 (D.C. Cir. 1998).
Pettaway challenges three aspects of the district court’s opinion.
First, she argues that the district court applied the wrong
standard of review when it considered whether TIAA
wrongfully terminated her benefits. Second, Pettaway argues
that the district court misapplied the requirement, contained in
ERISA and Department of Labor regulations promulgated
thereunder, that she receive “full and fair review” of her appeal
of TIAA’s termination of her benefits. Finally, Pettaway argues
that the district court violated its local rules by failing to require
10
the filing of the entire administrative record in connection with
the defendants’ motion for summary judgment.
A.
Pettaway argues that the district court erred when it applied
a deferential standard of review to the court’s review of TIAA’s
decision to terminate her benefits. See Pettaway, 699 F. Supp.
2d at 201 (holding that the district court “must employ a
discretionary, or ‘reasonableness’ review to the eligibility
determination”). Pettaway asserts that a de novo standard
should have been applied for two reasons: because the Policy
Document did not grant discretionary authority to TIAA to
interpret the terms of the group policy; and because the
Academy, as fiduciary of the Academy Plan, limited its own
fiduciary duties to determining eligibility and therefore had no
discretion to delegate interpretation authority to TIAA.
We review a denial of benefits challenged under 29 U.S.C.
§ 1132(a)(1)(B), under a de novo standard, rather than under the
more deferential arbitrary and capricious standard, “unless the
benefit plan gives the administrator or fiduciary discretionary
authority to determine eligibility for benefits or to construe the
terms of the plan.’” Firestone Tire & Rubber Co. v. Bruch, 489
U.S. 101, 115 (1989); Fitts v. Fed. Nat’l Mortgage Ass’n, 236
F.3d 1, 5 (D.C. Cir. 2001). The key dispute between the parties
in this appeal is to which of the three Academy Plan
documents—the Plan Document, the Summary Plan
Description, or the Policy Document—the court may look to
determine whether “the benefit plan gives the administrator or
fiduciary discretionary authority to determine eligibility for
benefits or to construe the terms of the plan.” Pettaway argues
that only the Policy Document is legally relevant. TIAA and the
Academy argue that all three documents must be considered
together. Although the question is one of first impression in this
11
circuit, we agree with the district court that in this case all three
documents should be examined to determine the appropriate
standard of review.
Our decision to look at all of the Academy Plan documents
is supported both by the text of ERISA and by the weight of
authority from the other circuits that have considered this
question. First, ERISA’s statutory text suggests that multiple
plan documents can be legally relevant. ERISA requires that a
“summary plan description of any employee benefit plan shall
be furnished to participants and beneficiaries” and specifies that
it “shall be written in a manner calculated to be understood by
the average plan participant, and shall be sufficiently accurate
and comprehensive to reasonably apprise such participants and
beneficiaries of their rights and obligations under the plan.” 29
U.S.C. § 1022(a). The statute further requires that the summary
plan description contain, inter alia, “the plan’s requirements
respecting eligibility for participation and benefits” and the
“circumstances which may result in disqualification,
ineligibility, or denial or loss of benefits.” 29 U.S.C. § 1022(b).
Far from being an irrelevant piece of human resources material,
the Summary Plan Description is the ERISA-mandated, plain-
language document upon which plan participants may rely to
understand their benefits.
Furthermore, the ERISA sections on fiduciary
responsibilities imply that there will be multiple legally
important plan documents. The section defining “fiduciary
duties” states that the plan fiduciary—in this case the
Academy—“shall discharge his duties with respect to a plan . . .
in accordance with the documents and instruments governing the
plan.” 29 U.S.C. § 1104(a)(1)(D) (emphasis added). The
ERISA section governing reporting and disclosure also
references multiple documents. It requires the administrator of
a benefits plan to “furnish to the Secretary [of the Department of
12
Labor], upon request, any documents relating to the employee
benefit plan, including but not limited to, the latest summary
plan description (including any summaries of plan changes not
contained in the summary plan description), and the bargaining
agreement, trust agreement, contract, or other instrument under
which the plan is established or operated.” 29 U.S.C.
§ 1024(a)(6). Far from suggesting that one plan document must
contain all the legally relevant terms and language, the statutory
text clearly contemplates multiple relevant documents.
Other circuit courts that have considered this question have
also generally concluded that multiple plan documents are
legally relevant. For example, in Young v. Verizon’s Bell Atl.
Cash Balance Plan, the Seventh Circuit held that because both
a “summary plan description” and a “summary of any material
modification” are ERISA-required writings, each should be
given primary effect and strictly enforced. 615 F.3d 808, 817-
18 (7th Cir. 2010). Relying on the text of 29 U.S.C.
§ 1024(a)(6), the Eleventh Circuit recognized that many
documents control the operation of a benefits plan under ERISA,
including the summary plan description, the bargaining
agreement, the trust agreement, the contract, and other
instruments. Heffner v. Blue Cross and Blue Shield of Ala., Inc.,
443 F.3d 1330, 1342-43 (11th Cir. 2006). The Sixth Circuit
recognized the importance of the summary plan description,
concluding that “statements in a summary plan are binding and
if the statements conflict with those in the plan itself, the
summary shall govern.” Yolton v. El Paso Tennessee Pipeline
Co., 435 F.3d 571, 582 n.10 (6th Cir. 2006) (citation omitted).
Similarly, many circuits have recognized the legal significance
of summary plan descriptions. See, e.g., Bergt v. Retirement
Plan for Pilots Employed by MarkAir, Inc., 293 F.3d 1139, 1143
(9th Cir. 2002) (“[T]he SPD is a plan document and should be
considered when interpreting an ERISA plan.”); Hughes v. 3M
Retiree Medical Plan, 281 F.3d 786,790 (8th Cir. 2002) (same);
13
Fallo v. Piccadilly Cafeterias, Inc., 141 F.3d 580, 583-84 (5th
Cir. 1998) (same); Chiles v. Ceridian Corp., 95 F.3d 1505, 1511
(10th Cir. 1996) (same).
Based on the text of ERISA we hold, consistent with the
decisions of the other circuits, that the district court properly
considered the Plan Document, the Summary Plan Description,
and the Policy Document to determine the appropriate standard
of review to apply in this case.
Having so concluded, the remaining analysis is
straightforward. As stated in the Plan Document, the “Academy
shall be the Plan Administrator and the ‘Named Fiduciary’” with
the “absolute power, authority and discretion to administer the
[Academy] Plan.” Plan Document at 3.1, 3.2. “All
interpretations of the Plan, and questions concerning its
administration and application, shall be determined” by the
Academy, which has the authority to “appoint such accountants,
counsel, specialists, and other persons as it deems necessary or
desirable in connection with the administration of the Plan.” Id.
at 3.2. Furthermore, the Summary Plan Description grants
TIAA “full power and discretionary authority under the group
policy to control and manage the operation and administration
of the group policy, subject only to the participant’s rights of
review and appeal under the group policy.” Summary Plan
Description at 8. The Summary Plan Description further
explains:
TIAA has all powers necessary to accomplish these
purposes in accordance with the terms of the group policy
including, but not limited to, the following: (1) determining
the benefits and amounts payable therefor to any
participant or beneficiary; (2) establishing and
administering a claims review and appeal process; and (3)
interpreting, applying, and administering the provisions of
14
the group policy.
Id. (emphasis added).
This language establishes that, under the Academy Plan,
denial-of-benefits determinations by TIAA qualify for
deferential review under the Supreme Court’s test in Firestone
Tire & Rubber. See Fitts, 236 F.3d at 5 (quoting 489 U.S. at
115). The Academy Plan reserved for the Academy “absolute
power, authority and discretion to administer the Plan” and also
the ability to delegate specific powers to TIAA as the plan
administrator. The Academy Plan entrusted TIAA with “full
power and discretionary authority” to both determine eligibility
for benefits and to construe the terms of the plan. We conclude,
therefore, that the district court did not err by employing a
deferential standard of review to TIAA’s eligibility
determination.
“This court has defined the Firestone deferential standard
as one of ‘reasonableness,’” Wagener v. SBC Pension Benefit
Plan-Non Bargained Program, 407 F.3d 395, 402 (D.C. Cir.
2005) (quoting Block v. Pitney Bowes, Inc., 952 F.2d 1450, 1452
(D.C. Cir. 1992)), so we must decide whether TIAA acted
reasonably when it denied Pettaway’s benefits claim.
Pettaway’s case presented TIAA with conflicting evidence.
Pettaway’s back surgeon determined that Pettaway was unfit to
work, but TIAA’s own doctors found that Pettaway could return
to part-time employment. TIAA’s doctors also disagreed with
Pettaway’s surgeon on his interpretation of Pettaway’s medical
records. The Supreme Court has held that in the ERISA context,
“courts have no warrant to require administrators automatically
to accord special weight to the opinions of a claimant’s
physician; nor may courts impose on plan administrators a
discrete burden of explanation when they credit reliable
evidence that conflicts with a treating physician's evaluation.”
15
Black & Decker Disability Plan v. Nord, 538 U.S. 822, 834
(2003). Faced with contradicting opinions and with no
requirement to prefer one opinion over another, we cannot
conclude that TIAA acted unreasonably when it valued the
opinion of its own personnel over that of Pettaway’s surgeon.
TIAA offered a rational explanation for its decision, which was
reasonably derived from the medical evidence in the
administrative record. TIAA did not “arbitrarily refuse to
credit” Pettaway’s evidence, see id., but credited one medical
opinion over conflicting evidence. Because TIAA acted
reasonably, we conclude that TIAA’s termination of Pettaway’s
benefits complied with federal law.
B.
Pettaway next argues that the district court erred when it
held that the TIAA’s administrative review of her claim satisfied
ERISA’s “full and fair review” requirement. Pettaway asserts
that TIAA’s appeal process was unlawful due to a variety of
procedural flaws, the most serious of which was TIAA’s alleged
failure to give Pettaway the opportunity to challenge TIAA’s
September 2005 decision to uphold its August 2004 termination-
of-benefits determination. Although Pettaway contends that the
September 2005 decision was a second “adverse determination”
from which she should have had the opportunity to appeal, we
disagree.
Under ERISA, the Department of Labor requires every
employee benefit plan to “establish and maintain a procedure by
which a claimant shall have a reasonable opportunity to appeal
an adverse benefit determination to an appropriate named
fiduciary of the plan, and under which there will be a full and
fair review of the claim and the adverse benefit determination.”
29 C.F.R. § 2560.503-1(h) (emphasis added). Beyond specific
procedural requirements specified in the regulations, see 29
16
C.F.R. §§ 2560.503-1(h)(1) to (4), none of which is alleged to
have been violated in this case, the administrative review
process need only be reasonable and afford the participant a
“full and fair review.”
Pettaway suffered an adverse determination in August 2004
when TIAA determined that she was no longer eligible for long-
term-disability benefits. This adverse determination triggered
her right under ERISA to a full and fair administrative review,
which TIAA initially conducted between October 2004 and
March 2005. TIAA then voluntarily reopened its review in May
2005 to permit Pettaway to undergo the independent medical
and functional capacity examinations that she had previously
failed to attend. In September 2005, after both of those
examinations and an independent physician review, TIAA
issued its final decision upholding the August 2004 denial of
long-term-disability benefits. We conclude that TIAA satisfied
its obligation to provide Pettaway with “a reasonable
opportunity to appeal an adverse benefit determination.” 29
C.F.R. § 2560.503-1(h).
We draw this conclusion for several reasons. First,
contrary to Pettaway’s assertion, TIAA’s September 2005
decision was merely confirmatory of its early determination that
Pettaway did not qualify for long-term-disability benefits.
Although TIAA had new information to consider during the
administrative review—the results of the independent medical
and functional capacity examinations, the results from the
transferable skills assessment, and the independent medical
review of Pettaway’s file—its conclusion was the same: that
Pettaway did not qualify as totally disabled under the Academy
Plan. The results of the additional tests and reviews did not
provide a new basis for terminating Pettaway’s benefits, but
merely supplemented its initial reasoning. Second, we will not
punish TIAA for voluntarily reopening its administrative review
17
process. As Pettaway conceded at oral argument, “there was no
reason for [TIAA] to reopen it” and nothing in ERISA
compelled TIAA to do so. Or. Arg. at 24:56–25:04. TIAA
reopened Pettaway’s review solely to give her an additional
opportunity to prove her claim. We cannot hold that this
benevolent act made Pettaway’s review any less reasonable, full,
or fair. Finally, as other circuits have noted, even though new
medical reports were generated during TIAA’s administrative
review, the regulations provide for the “opportunity to appeal an
adverse benefit determination,” 29 C.F.R. § 2560.503-1(h)(1),
and not for the opportunity to engage in a continuous cycle of
appeals from appeals. See, e.g., Midgett v. Washington Group
Intern. Long Term Disability Plan, 561 F.3d 887, 895 (8th Cir.
2009) (“[R]equiring a plan administrator to grant a claimant the
opportunity to review and rebut medical opinions generated on
administrative appeal ‘would set up an unnecessary cycle of
submission, review, re-submission, and re-review.’”) (quoting
Metzger v. UNUM Life Ins. Co. of Am., 476 F.3d 1161, 1166
(10th Cir. 2007)); Glazer v. Reliance Standard Life Ins. Co., 524
F.3d 1241, 1245-46 (11t h Cir. 2008) (same). Limiting Pettaway
to a single administrative review of the original adverse benefit
determination when the review upheld the denial on the same
basis as the initial decision does not violate the requirement that
the review be “full and fair.”
Finding none of Pettaway’s procedural claims persuasive,
we conclude that the district court did not err when it held that
the TIAA did not violate Pettaway’s right to a full and fair
review of her adverse eligibility determination.
C.
Finally, Pettaway argues that the district court violated the
district court’s local rule 7(h) by failing to require the filing of
the entire administrative record in connection with the appellees’
18
motion for summary judgment. Because Pettaway failed to
make this argument before the district court, we would normally
reject it now. See Ramirez de Arellano v. Weinberger, 745 F.2d
1500, 1537 (D.C. Cir. 1984) (“Ordinarily, in reviewing motions
for summary judgment, the appellate court considers only those
matters presented to the district court, disregarding additional
allegations raised for the first time on appeal.”), vacated on
other grounds, 471 U.S. 1113 (1985); District of Columbia v.
Air Florida, Inc., 750 F.2d 1077, 1084 (D.C. Cir. 1984); Tarpley
v. Greene, 684 F.2d 1, 7 n.17 (D.C. Cir. 1982). Pettaway offers
no compelling reason why we should deviate from our normal
policy in this case. Finding none ourselves, we will not do so.
III.
For the foregoing reasons, the district court properly granted
the Academy and TIAA’s motion for summary judgment. We
affirm the decision of the district court.
So ordered.