[PUBLISH]
IN THE UNITED STATES COURT OF APPEALS
FOR THE ELEVENTH CIRCUIT
________________________ FILED
U.S. COURT OF APPEALS
No. 07-10348 ELEVENTH CIRCUIT
SEPT 18, 2008
________________________
THOMAS K. KAHN
CLERK
D.C. Docket No. 05-00133 CV-3-RV-EMT
ROBIN DOYLE,
Plaintiff-Appellant,
versus
LIBERTY LIFE ASSURANCE COMPANY OF BOSTON,
Defendant-Appellee.
________________________
Appeal from the United States District Court
for the Northern District of Florida
________________________
ON PETITION FOR REHEARING
(September 18, 2008)
Before BIRCH, BARKETT and COX, Circuit Judges.
COX, Circuit Judge:
Before the court is Liberty Life Assurance Company of Boston’s petition for
rehearing en banc of our opinion in Doyle v. Liberty Life Assurance Co. of Boston,
511 F.3d 1336 (11th Cir. 2008). About the time Liberty Life filed this petition, the
Supreme Court of the United States granted certiorari in a case from the United States
Court of Appeals for the Sixth Circuit involving an issue we admonished our court,
in our previous opinion, to consider en banc. See Glenn v. Metro. Life Ins. Co., 461
F.3d 660 (6th Cir. 2006), cert. granted 128 S. Ct. 1117 (Jan. 18, 2008). We postponed
ruling on the petition pending the Supreme Court’s decision. On June 19, 2008, the
Court issued its decision in Metro. Life Ins. Co. v. Glenn, __ U.S. __, 128 S. Ct. 2343
(2008).
We construe Liberty Life’s petition for rehearing en banc to include a petition
for panel rehearing, see 11th Cir. R. 35-5, and grant the petition for panel rehearing.
We withdraw our previous opinion and substitute the following opinion in its place:
The issue in this case is whether the district court correctly decided that the
administrator of an ERISA-governed long-term disability plan did not abuse its
discretion in refusing to award disability benefits to a plan participant. We affirm the
district court’s grant of summary judgment in favor of the administrator because the
court applied a proper standard of review and because the administrator did not abuse
its discretion in denying benefits to the plan participant.
2
I. Background
The Plaintiff, Robin Doyle, began working for ChoicePoint Services on
February 24, 2003, as a Registered Nurse/Clinical Information Line Specialist.
ChoicePoint sponsored for its eligible employees a long-term disability (“LTD”)
benefit plan governed by the Employee Retirement Income Security Act of 1974, 29
U.S.C. § 1001 et seq. The Defendant, Liberty Life Assurance Company of Boston,
insured the plan pursuant to a group policy, and administered the plan.
On January 30, 2004, Doyle filed a claim with ChoicePoint for disability
benefits under the plan, claiming that an anal fissure, enlarged internal hemorrhoids,
and external anal skin tags prevented her from working. On February 10, 2004, she
underwent a fissurotomy and sphincterotomy in an attempt to alleviate these
problems. Liberty Life granted Doyle short-term disability (“STD”) benefits through
the maximum date available, May 9, 2004.
While Doyle was receiving STD benefits, Liberty Life obtained her medical
records to determine whether she would qualify for LTD benefits, for which she had
applied, after her STD benefits expired. After receiving medical records from six of
Doyle’s treating physicians, Liberty Life retained an independent physician to review
her records. Liberty Life notified Doyle that she would not receive LTD benefits
because she was still able to perform the duties of her “Own Occupation.” Doyle
3
would qualify for LTD benefits for the initial 24 months only if she were unable to
perform the duties of her “Own Occupation.” Thereafter, she would qualify for LTD
benefits only if unable to perform the duties of “Any Occupation.” Specifically, the
policy provided:
For persons other than pilots, co-pilots, and crewmembers of an aircraft:
a. if the Covered Person is eligible for the 24 Month Own
Occupation benefit, “Disability” or “Disabled” means that during
the Elimination Period and the next 24 months of Disability the
Covered Person, as a result of Injury or Sickness, is unable to
perform the Material and Substantial Duties of his Own
Occupation; and
b. thereafter, the Covered Person is unable to perform, with
reasonable continuity, the Material and Substantial Duties of Any
Occupation.
(R.2-12 at 6.)
After Liberty Life denied her claim for LTD benefits, Doyle visited a
rheumatologist who diagnosed her with fibromyalgia. In light of this new diagnosis,
Doyle appealed the denial of her claim. Liberty Life reviewed her additional medical
records and received further peer review from a specialist in internal medicine.
Liberty Life upheld its decision denying Doyle benefits, stating that she could still
perform the duties of her “Own Occupation,” and so did not qualify for LTD benefits
under the policy.
4
Invoking ERISA jurisdiction, 29 U.S.C. §§ 1132(a)(1)(B), (e)(1), Doyle filed
this action against Liberty Life seeking judicial review of its decision. Liberty Life
filed a motion for summary judgment, which the district court granted. Doyle
appeals.
II. Pre-Glenn ERISA Framework and the District Court Proceeding
ERISA does not set out standards under which district courts must review an
administrator’s decision to deny benefits. Firestone Tire & Rubber Co. v. Bruch, 489
U.S. 101, 109, 109 S. Ct. 948, 953 (1989). In order to fill this void, the Supreme
Court held in Firestone that district courts should review de novo benefit decisions
made by an administrator who is without discretion to determine eligibility or
construe the terms of an ERISA-governed plan. Id. at 115, 109 S. Ct. at 956. On the
other hand, the Court said that where the administrator exercises discretion,
deferential (i.e., arbitrary and capricious1 ) review is appropriate according to trust
principles, which guide review of decisions affecting ERISA-governed plans. Id. at
111, 109 S. Ct. at 954. Finally, the Court observed that when an administrator with
discretion operates under a conflict of interest, “that conflict must be weighed as a
1
Cases in our circuit equate the arbitrary and capricious standard with the abuse of discretion
standard. See Jett v. Blue Cross & Blue Shield of Ala., Inc., 890 F.2d 1137, 1139 (11th Cir. 1989).
We use the terms interchangeably.
5
‘facto[r] in determining whether there is an abuse of discretion.’” Id. at 115, 109 S.
Ct. at 957 (quoting Restatement (Second) of Trusts § 187 cmt. d (1959)).
Following Firestone, we undertook the “task [of] develop[ing] a coherent
method for integrating factors such as self-interest into the legal standard for
reviewing benefits determinations.” Brown v. Blue Cross & Blue Shield of Ala., Inc.,
898 F.2d 1556, 1561 (11th Cir. 1990). In Brown, we reasoned that trust principles
mandated that some deferential level of review applies to benefits decisions, id. at
1568, but refused to apply “highly deferential” review when the administrator
operated under a conflict of interest, id. at 1562. We settled on what came to be
known as the “heightened arbitrary and capricious standard” (hereinafter the
“heightened standard”), the hallmark of which is its burden-shifting requirement.
Under this standard, “the burden shifts to the fiduciary to prove that its interpretation
of plan provisions committed to its discretion was not tainted by self-interest.” Id. at
1566. We said that an administrator’s plan interpretation that “advances the
conflicting interest of the fiduciary at the expense of the affected beneficiary” was
arbitrary and capricious, unless the administrator “justifies the interpretation on the
ground of its benefit to the class of all participants and beneficiaries.” Id. at 1567.
Our more recent cases condense the holdings of Firestone and Brown into a six
step analysis to guide district courts in reviewing an administrator’s benefits decision:
6
(1) Apply the de novo standard to determine whether the claim
administrator’s benefits-denial decision is “wrong” (i.e., the court
disagrees with the administrator’s decision); if it is not, then end the
inquiry and affirm the decision.
(2) If the administrator’s decision in fact is “de novo wrong,” then
determine whether he was vested with discretion in reviewing claims;
if not, end judicial inquiry and reverse the decision.
(3) If the administrator’s decision is “de novo wrong” and he was vested
with discretion in reviewing claims, then determine whether
“reasonable” grounds supported it (hence, review his decision under the
more deferential arbitrary and capricious standard).
(4) If no reasonable grounds exist, then end the inquiry and reverse the
administrator's decision; if reasonable grounds do exist, then determine
if he operated under a conflict of interest.
(5) If there is no conflict, then end the inquiry and affirm the decision.
(6) If there is a conflict of interest, then apply heightened arbitrary and
capricious review to the decision to affirm or deny it.
Williams v. BellSouth Telecomms., Inc., 373 F.3d 1132, 1138 (11th Cir. 2004)
(summarizing analysis set forth in HCA Health Servs. of Ga., Inc. v. Employers
Health Ins. Co., 240 F.3d 982, 993-95 (11th Cir. 2001)) (footnotes omitted).
The district court began its discussion in this case by noting that ChoicePoint’s
plan vested Liberty Life with discretion in making claims decisions (step 2). The
court next found that genuine issues of material fact precluded a determination of
whether Liberty Life’s decision was right or wrong; so, for purposes of summary
judgment, the court assumed that Liberty Life’s decision was wrong (step 1). Next,
the court recited the measures taken by Liberty Life in reviewing Doyle’s claim for
7
benefits and concluded that Liberty Life’s denial of her claim was reasonable (step
3).
Finally, the court found that Liberty Life operated under a conflict of interest
since it was responsible for both determining eligibility and paying benefits under the
plan (step 4). But, instead of applying the heightened arbitrary and capricious
standard, as required under step 6, it applied a “modified” heightened arbitrary and
capricious standard. The court “modified” the heightened standard in the following
way: instead of requiring Liberty Life to prove that its decision was not influenced
by the conflict—as the heightened standard requires—the court reviewed the record
and concluded that “there does not appear to be any evidence that Liberty in any way
manipulated or improperly influenced Doyle’s LTD benefits process in order to
achieve a financially beneficial result.” (R.2-18 at 13.) The court said that “given the
lack of any indication to the contrary, . . . Liberty would have reached the same
conclusion in this case even if it had not been operating under a conflict of interest."
Id.
The court offered two justifications for not applying the heightened standard.
First, the court thought that the question of whether the heightened standard applied
to an administrator’s factual determinations “remains open in this circuit,” although
it acknowledged that the heightened standard applies in plan interpretation cases. Id.
8
Second, the court reasoned that a modified standard was more in line with Firestone
and principles of trust law than was our heightened standard. Id. at 11-12.
III. Issues on Appeal and Standard of Review
Doyle initially raised two arguments on appeal. First, she argued that the
district court erred in finding that Liberty Life’s decision was reasonable. Second,
she argued that the district court erred in applying a modified, rather than heightened,
standard of review.
After the Supreme Court decided Glenn, we ordered Doyle and Liberty Life to
brief the impact of Glenn on this petition for rehearing.2 While Doyle now concedes
that, post-Glenn, the heightened standard of review is inappropriate, she does argue
that the district court did not place as much weight on the conflict of interest in this
case as Glenn requires.
Liberty Life responds that the district court did not err in finding that its
decision was reasonable, even if, as the court assumed, its decision was wrong.
Liberty Life agrees that, post-Glenn, the heightened standard of review is
inappropriate and that the district court’s use of a modified standard was correct.
2
Doyle and Liberty Life also briefed the issue of whether the petition for rehearing should be heard
by the panel or by the court en banc. As discussed above, we agree with both parties that the petition
for rehearing should be heard by this panel.
9
While Liberty Life admits that a conflict existed, it argues that Glenn does not compel
the district court to give greater weight to the conflict than it did.
We review the district court’s grant of summary judgment de novo and apply
the same legal standards that governed the district court’s decision. Williams, 373
F.3d at 1134.
IV. Discussion
A. Reasonableness Finding
Doyle argues that the district court erred in finding that Liberty Life’s denial
of her claim for disability benefits was reasonable. Specifically, she argues that it
was unreasonable for Liberty Life not to consider her subjective claims of pain and
suffering, which she argues are substantiated by her fibromylagia diagnosis.
Liberty Life considered Doyle’s medical records and employed the services of
two independent physicians to review those records. It concluded that she was still
able to perform the duties of her “Own Occupation,” and so did not satisfy the
prerequisite for obtaining LTD benefits under the ChoicePoint policy. We conclude
that it was not unreasonable for Liberty Life to disregard Doyle’s complaints of
intangible pain and suffering. Under ChoicePoint’s policy, a plan beneficiary must
provide proof that she is disabled in order to obtain LTD benefits. The policy defines
“proof” as including “chart notes, lab findings, test results, x-rays and/or other forms
10
of objective medical evidence in support of a claim for benefits.” (R.2-12 at 9)
(emphasis added). Therefore, it was reasonable for Liberty Life to rely only on
objective medical evidence supporting Doyle’s claim, evidence which Liberty Life’s
reviewing physicians found lacking. See, e.g., R.1-12 at 279 (statement of Liberty
Life’s reviewing physician, Dr. Silver, that Doyle’s complaints “are unsubstantiated
by objective clinical orthopedic findings”); R.2-12 at 104 (statement of Liberty Life’s
reviewing physician, Dr. Truchelut, that Doyle’s “subjective reports are
disproportionate to the physical, radiological, laboratory, and neurodiagnostic”
records).
After reviewing the record, we find no error in the district court’s determination
that Liberty Life’s decision was reasonable. We express no opinion on whether it was
right or wrong.
B. Standard of Review in the District Court
Doyle’s initial argument was that the district court erred in applying a
modified, rather than heightened, standard of review. But, in light of Glenn, both
Doyle and Liberty Life agree that an application of the heightened standard of review
would have been inappropriate. We agree that the district court did not err in refusing
to apply the heightened standard.
11
Doyle now argues, however, that the same facts which led the Glenn Court to
give greater weight to the existence of a conflict in that case are also present in this
case. Accordingly, Doyle argues that under Glenn, the district court should have
placed greater weight on the existence of a conflict than it did.
In Glenn, the administrator of Sears, Roebuck & Company’s long-term
disability plan, MetLife, which also served as the plan’s insurer, denied LTD benefits
to the plaintiff. The plan vested MetLife with discretion to determine eligibility and
provided that a participant incapable of performing “the material duties of any gainful
occupation for which she was reasonably qualified” was entitled to LTD benefits. __
U.S. __, 128 S. Ct. at 2347. MetLife denied benefits to the plaintiff because she was
“capable of performing full time sedentary work.” Id. The plaintiff appealed.
The district court denied relief, but the Sixth Circuit, applying a deferential
standard of review, set aside MetLife’s decision. It treated as a relevant factor
MetLife’s conflict arising from its dual role as administrator and insurer. The court
considered the conflict, but relied more heavily on other factors, including
questionable actions taken by MetLife, to conclude that MetLife abused its discretion
in denying the plaintiff benefits.
The Supreme Court granted certiorari on two issues: whether an entity’s dual
role of administrator and insurer creates a conflict of interest, and if a conflict exists,
12
how to account for that conflict in judicial review of benefits decisions. With respect
to the first issue, the Court, relying on principles of trust law, held that the dual role
does create a conflict of interest. It explained that an entity that “determines whether
an employee is eligible for benefits and pays benefits out of its own pocket,” such as
an employer or insurance company, operates under a conflict of interest. __ U.S. at__,
128 S. Ct. at 2346.
The Court then turned to the question of how a conflict, once identified, affects
judicial review of an administrator’s decision. The Court held that “a conflict should
be weighed as a factor in determining whether there is an abuse of discretion.” Id. at
__, 128 S. Ct. at 2350 (quoting Firestone, 489 U.S. at 115, 109 S. Ct. at 957) (internal
quotation marks omitted). The Court emphasized that “the word ‘factor’ implies,
namely, that when judges review the lawfulness of benefit denials, they will often
take account of several different considerations of which a conflict of interest is one.”
Id. at __, 128 S. Ct. at 2351. The Court approved the Sixth Circuit’s treatment of the
conflict as a relevant factor, and affirmed its decision because the conflict, along with
other factors, showed that MetLife’s decision was arbitrary. Id. at __, 128 S. Ct. at
2351-52.
As we now show, Glenn implicitly overrules and conflicts with our precedent
requiring courts to review under the heightened standard a conflicted administrator’s
13
benefits decision. Our prior opinion in this case identified three troubling aspects of
the heightened standard, Doyle, 536 F.3d at 1344-46, two of which3 the Glenn Court
denounced as contrary to Firestone. First, our heightened standard conflicts with the
adoption in Firestone of two standards under which an administrator’s decision
should be reviewed, de novo and abuse of discretion. The heightened standard, which
essentially imposes greater than de novo review, is not required by, and more
importantly is contrary to, Firestone’s reliance on two standards of review. See
Chambers v. Family Health Plan Corp., 100 F.3d 818, 826 (10th Cir. 1996) (rejecting
Brown’s heightened standard “as inconsistent with . . . the Supreme Court’s dictum
in Firestone.”). The Glenn Court criticized the heightened standard for conflicted
administrators, approving Firestone’s reliance on trust law, which still applies “a
deferential standard of review to the discretionary decisionmaking of a conflicted
trustee . . . .” Glenn, __ U.S. at __, 128 S. Ct. at 2350.
The second flaw in our heightened standard is its burden-shifting feature, under
which the administrator bears the burden of proving that its decision was not
influenced by a conflict. As the Second Circuit noted, our burden-shifting standard
3
The third flawed feature of our heightened review standard that our prior decision identified was
the remarkably difficult burden it imposes upon the administrator to prove that its decision was not
tainted by a conflict. This flaw was a natural consequence of the burden-shifting feature, which the
Glenn Court disapproves.
14
is “contrary to the traditional burden of proof in a civil case.” Whitney v. Empire Blue
Cross & Blue Shield, 106 F.3d 475, 477 (2d Cir. 1997) (quoting Sullivan v. LTV
Aerospace & Def. Co., 82 F.3d 1251, 1259 (2d Cir. 1996)) (internal quotation marks
omitted). The traditional burden of proof requires the plaintiff to prove that the
decision was tainted by self-interest, whereas our standard requires the defendant to
prove that its decision was not tainted. The Glenn Court thought that shifting the
burden of proof is unnecessary to adequately account for the conflict: “Neither do we
believe it necessary or desirable for courts to create special burden-of-proof rules, or
other special procedural or evidentiary rules, focused narrowly on the evaluator/payor
conflict.” __ U.S. at __, 128 S. Ct. at 2351.
We continue to adhere to Firestone’s mandate that reviewing courts must
consider an administrator’s conflict of interest in deciding whether the decision to
deny benefits was arbitrary. But we hold that Glenn implicitly overrules our
precedent to the extent it requires district courts to review benefit determinations by
a conflicted administrator under the heightened standard. We hold that the existence
of a conflict of interest should merely be a factor for the district court to take into
account when determining whether an administrator’s decision was arbitrary and
capricious. And we hold that, while the reviewing court must take into account an
administrative conflict when determining whether an administrator’s decision was
15
arbitrary and capricious, the burden remains on the plaintiff to show the decision was
arbitrary; it is not the defendant’s burden to prove its decision was not tainted by self-
interest.
We now consider whether the district court, in light of Glenn, applied the
correct standard of review, and if so, whether it properly granted summary judgment
in favor of Liberty Life. The district court, following the Williams steps, found that
Liberty Life was vested with discretion, that its decision was reasonable, and that it
operated under a conflict of interest. Thus, at this point the court had concluded that
Liberty Life did not abuse its discretion in denying benefits. See Glazer v. Reliance
Standard Life Ins. Co., 524 F.3d 1241, 1246 (11th Cir. 2008) (“When conducting a
review of an ERISA benefits denial under an arbitrary and capricious standard
(sometimes used interchangeably with an abuse of discretion standard), the function
of the court is to determine whether there was a reasonable basis for the decision,
based upon the facts as known to the administrator at the time the decision was
made.” (quoting Jett v. Blue Cross & Blue Shield of Ala., 890 F.2d 1137, 1139 (11th
Cir.1989)) (internal quotation marks omitted)). The only remaining step in the
Williams analysis was to determine whether Liberty Life’s conflict of interest tainted
its decision, thereby rendering its otherwise reasonable decision unreasonable. The
district court considered the conflict and concluded that Liberty Life was not
16
influenced by it. We conclude that the court’s treatment of a conflict of interest is
consistent with Firestone and Glenn, and that it did not err in granting summary
judgment to Liberty Life.
In its summary judgment brief, Liberty Life argued that two aspects of its
benefits determination process proved that it was not influenced by the conflict. First,
Liberty Life argued that its approval of STD benefits “demonstrates that Liberty
Life’s decision making processes were not biased.” (R.1-11 at 16 n.1.) Second,
Liberty Life argued that its decision to employ an independent physician to review
Doyle’s benefits-denial appeal “demonstrate[s] that its decision-making process was
free from bias.” (R.1-11 at 19 n.2.)
In her opposition to Liberty Life’s motion for summary judgment, Doyle
offered alternative explanations for Liberty Life’s actions. Doyle argued that Liberty
Life’s approval of 90 days of STD benefits—which it characterized as
“charitable”—could be viewed as an arbitrary decision to terminate benefits on the
91st day “without any explanation as to how Ms. Doyle’s condition had changed on
the 90th day.” (R.2-14 at 9.) Further, Doyle explained that Liberty Life’s retention
of an independent physician to review her benefits-denial appeal did not demonstrate
its lack of bias because Liberty Life was required by federal regulations to “obtain a
17
report from an unrelated physician consultant as part of [her] appeal under 29 C.F.R.
§ 2560.503-1(h)(3)(iii) & (v) and 29 C.F.R. § 2560.503-1(h)(4).”4 (R.2-14 at 9.)
Doyle’s explanations for Liberty Life’s actions do not create an issue of fact
as to whether Liberty Life was influenced by the conflict. The regulations cited by
Doyle require Liberty Life to employ an independent physician on appeal following
an adverse benefits determination; Liberty Life did so. But, Liberty Life went beyond
4
29 C.F.R. § 2560.503-1(h) provides:
Appeal of adverse benefit determinations.
***
(3) Group health plans. The claims procedures of a group health plan will not be
deemed to provide a claimant with a reasonable opportunity for a full and fair review
of a claim and adverse benefit determination unless, in addition to complying with
the requirements of paragraphs (h)(2)(ii) through (iv) of this section, the claims
procedures–
***
(iii) Provide that, in deciding an appeal of any adverse benefit determination
that is based in whole or in part on a medical judgment, including determinations
with regard to whether a particular treatment, drug, or other item is experimental,
investigational, or not medically necessary or appropriate, the appropriate named
fiduciary shall consult with a health care professional who has appropriate training
and experience in the field of medicine involved in the medical judgment;
***
(v) Provide that the health care professional engaged for purposes of a
consultation under paragraph (h)(3)(iii) of this section shall be an individual who is
neither an individual who was consulted in connection with the adverse benefit
determination that is the subject of the appeal, nor the subordinate of any such
individual. . . .
***
(4) Plans providing disability benefits. The claims procedures of a plan providing
disability benefits will not, with respect to claims for such benefits, be deemed to
provide a claimant with a reasonable opportunity for a full and fair review of a claim
and adverse benefit determination unless the claims procedures comply with the
requirements of paragraphs (h)(2)(ii) through (iv) and (h)(3)(i) through (v) of this
section.
18
what the regulations require by employing an independent physician to review
Doyle’s medical records during its initial determination of her entitlement to benefits.
Moreover, the fact that Liberty Life terminated Doyle’s benefits on the 91st day does
not show Liberty Life’s decision was arbitrary. The plan permits Liberty Life to
terminate benefits unless the plan participant proves that she satisfies the LTD
definition. Liberty Life had no obligation to explain, as Doyle maintains, “how Ms.
Doyle’s condition had changed on the 90th day.” (R.2-14 at 9.) The burden fell on
Doyle to establish that she was entitled to LTD benefits. Finally, Liberty Life took
it upon itself to obtain Doyle’s updated medical records, even though it was Doyle’s
responsibility to provide medical evidence substantiating her claim.
Doyle argues that, post-Glenn, a court must give greater weight to the existence
of a conflict if there is no evidence that the administrator put in place procedures to
assure accurate claims assessment. Doyle argues Glenn places the burden on a
conflicted administrator to offer evidence of its efforts to assure accurate claims
assessment. If an administrator does not, reasons Doyle, then the absence of any
procedures becomes a factor counseling a reviewing court to find its decision
unreasonable. We agree with Liberty Life that this is precisely the kind of burden-
shifting rule which Glenn rejects. The Glenn Court held that the presence of a
conflict of interest might be of little significance if the administrator can show what
19
steps it has taken to promote accurate claim assessment, but if the record is silent on
this point, it is proper to focus on other factors. __ U.S. at __, 128 S.Ct. at 2351-2.
Doyle argues next that, under Glenn, a court should give greater weight to the
existence of a conflict when there is evidence of procedural unreasonableness. Here,
Doyle argues that Liberty Life demonstrated procedural unreasonableness in
awarding Doyle STD benefits, which required Doyle to show she was unable to
perform the duties of her “Own Occupation” while denying her LTD benefits, which
required the exact same showing. Liberty Life responds that it did not complete its
evaluation of Doyle’s ability to perform the duties of her “Own Occupation” until
after she had received her STD benefits. In this case, once all relevant medical
records were received and the investigation complete, Liberty Life determined that
Doyle was able to perform the duties of her “Own Occupation.” Liberty Life
contends that the award of STD benefits before the investigation was complete is not
evidence of procedural unfairness but rather of Liberty Life’s willingness to
overcompensate claimants while investigations are pending. We agree with Liberty
Life that its actions here do not compel a district court to give greater weight to the
presence of a conflict than the district court did.
Finally, Doyle contends that, post-Glenn, a district court should place greater
weight on the existence of a conflict when the administrator emphasizes medical
20
records favoring a denial of benefits. Doyle argues that Liberty Life placed greater
emphasis on medical reports suggesting Doyle could perform the duties of her “Own
Occupation” than those which suggested she could not. Accordingly, argues Doyle,
the district court erred in not placing greater weight on the existence of the conflict.
Liberty Life responds that the medical reports suggesting Doyle was unable to
perform the duties of her “Own Occupation” were not based on objective medical
evidence. Liberty Life placed greater emphasis on the medical reports based on
objective medical evidence, which, coincidentally, also suggested Doyle could
perform the duties of her “Own Occupation.” We do not believe, as discussed above,
that Liberty Life’s preference for medical opinions grounded on objective medical
evidence is somehow indicative that its decision was unreasonable or that the
presence of a conflict should be given greater weight than the district court gave it.
There is no evidence showing that Liberty Life was influenced by the conflict.
Furthermore, there is no evidence which should have prompted the district court to
accord more weight to the conflict. Glenn’s holding that a conflict must be taken into
account during review of benefit denials applies in all cases where a conflict is
present, regardless of whether the administrator was influenced by the conflict. In
other words, the existence of a conflict of interest alone is sufficient to trigger the
obligation to weigh it on judicial review. See Glenn, __ U.S. at __, 128 S. Ct. at 2352-
21
53 (Roberts, C.J., concurring in part and concurring in the judgment) (“The majority’s
approach would allow the bare existence of a conflict to enhance the significance of
other factors already considered by reviewing courts, even if the conflict is not shown
to have played any role in the denial of benefits.”); id. at __, 128 S. Ct. at 2357
(Scalia, J., dissenting) (criticizing the majority opinion as inconsistent with the
principle of trust law that “a fiduciary with a conflict does not abuse its discretion
unless the conflict actually and improperly motivates the decision”). There is no
evidence in the record suggesting “a higher likelihood that [the conflict] affected
[Liberty Life’s] benefits decision,” such as “a history of biased claims
administration.” Id. at __, 128 S. Ct. at 2351 (majority opinion). Consequently, the
conflict should have had little weight in the district court’s analysis.
The evidence shows that Doyle had substantial medical problems. Some of the
experts opined that she could not perform the material duties of her “Own
Occupation.” Other experts opined that objective medical evidence did not
substantiate her claims and that she could perform the material duties of her “Own
Occupation.” Liberty Life is vested with discretion to determine eligibility under
ChoicePoint’s plan; thus we owe deference to its determination. Glenn, __ U.S. at __,
128 S. Ct. at 2350 (“Trust law continues to apply a deferential standard of review to
the discretionary decisionmaking of a conflicted trustee . . . .”). Because the evidence
22
is close, we cannot say, even accounting for the conflict, that Liberty Life abused its
discretion in denying Doyle benefits.
V. Conclusion
Liberty Life did not abuse its discretion in denying Doyle’s claim for LTD
benefits. We therefore affirm the district court’s judgment in favor of Liberty
Life.5
AFFIRMED.
5
Liberty Life’s motion for summary judgment, and Doyle’s response, presented no procedural
issues. And, the case for both parties was bottomed on the administrative record. It seems preferable
in a case like this for the district court to determine by conference or stipulation whether either party
desires to present evidence beyond the administrative record, and if not, take the case under
submission and enter findings of fact and conclusions of law. Rule 56 practice seems to be an extra
and unnecessary step—and one that can result in two appeals rather than one.
23