Huntsberry v. Life Ins Co N Americ ( 1999 )

IN THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
No. 98-31146
Summary Calendar
ELDRIDGE HUNTSBERRY,
Plaintiff-Appellant,
versus
LIFE INSURANCE COMPANY OF NORTH AMERICA,
Defendant-Appellee.
Appeal from the United States District Court
for the Western District of Louisiana
USDC No. 97-CV-1777
June 14, 1999
Before POLITZ, BARKSDALE, and STEWART, Circuit Judges.
PER CURIAM:*
Eldridge Huntsberry, a retired Uno cal employee, brought a claim for long-term disability
against Life Insurance Company of North America (“LINA”), the claim fiduciary for the long-term
disability plan. The district court granted LINA’s motion for summary judgment which Huntsberry
now appeals. We affirm.
*
Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not be
published and is not precedent except under the limited circumstances set forth in 5TH CIR. R. 47.5.4.
FACTUAL AND PROCEDURAL BACKGROUND
From 1977 until his retirement in May 1997, Unocal employed Hunt sberry as a mechanic.
In April 1994, Huntsberry suffered an injury to his back which led him to request placement in a
position which did not require heavy lifting. Nevertheless, Huntsberry continued working in the same
capacity until August 17, 1995 at which time he informed Unocal that he would retire effective
September 1, 1995. On September 21, 1995, Huntsberry informed Unocal that he was not going to
retire. Unocal then placed him on leave with pay until October 3, 1995.
Beginning in January 1995, Huntsberyy received medical attention from three physicians and
a therapist who performed a Functional Capacities Evaluation (“FCE”). Dr. Donald M. Molenaar
performed a physical examination on Huntsberry and found that Huntsberry experienced leg pain,
fatigue and elevated blood pressure with exercise. Dr. Molenaar temporarily certified Huntsberry for
work and referred him to an orthopedic surgeon, Dr. Michael J. Duval, for further examination. Dr.
Duval’s examination led him to conclude that years of heavy mechanical labor was slowly causing
Huntsberry to develop degenerative discs in his back. Although Dr. Duval found that a lumbosacral
corset would permit Huntsberry to continue to work, he indicated that he did not think Huntsberry
was ready to return to work. Dr. Duval’s subsequent examinations of Huntsberry on October 10 and
October 26, 1995 revealed that Huntsberry’s physical therapy regimen was not producing positive
results thereby reducing the likelihood of Huntsberry returning to his previous job. Unocal placed
Huntsberry on sick leave with pay from October 3, 1995 through April 24, 1996, when it expired.
Huntsberry saw a third physician after he filed his claim for long term disability benefits. On
April 1, 1996, Dr. Gregory Gidman examined Huntsberry upon LINA’s referral. Huntsberry
underwent a series of examinations including an MRI, EMG, nerve condition studies and a bone scan.
The results of the EMG and the nerve condition examinations were normal but the MRI and bone
scan results indicated a small focal disc protrusion. Overall, Dr. Gidman concluded that Huntsberry
had reached maximum medical improvement and had no indication of any permanent physical
impairment. Dr. Gidman further explained that a FCE would offer some validation of Huntsberry’s
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subjective complaints.
Huntsberry met Duane Lege, a physical therapist, who performed the FCE on August 14 and
15, 1996. Lege observed that Huntsberry was uncooperative, unnecessarily limiting himself and not
expending full maximum effort. The therapist further described Huntsberry as demonstrating
inappropriate pain behavior and engaging in extremely excessive behavior such as flailing his upper
extremities; lying on the floor on several occasions; and excessive shaking and trembling of the body.
Throughout the entire test, the polar heart rate monitor did not show the customary rise in heart rate
associated with maximal efforts. According to the therapist, Huntsberry’s sub-maximal efforts
throughout the examination undermined his ability to make a recommendation on whether
Huntsberry’s physical abilities matched the job description of mechanic.
Upon its review of the administrative record, LINA denied Huntsberry’s claim for long-term
disability benefits. Huntsberry brought an act ion for denial of benefits under the Employment
Retirement Income Security Act (“ERISA”), 29 U.S.C. §§ 1001, et seq. (1997) in state court. On
September 5, 1997, the case was removed to federal district court where the court adjudicated
LINA’s motion for summary judgment. Finding no genuine issues of material fact, the district court
granted LINA’s motion for summary judgment on July 24, 1998. The court also denied Huntsberry’s
subsequent motion to reconsider judgment in light of this court’s decision in Vega v. Life Ins.
Services, Inc., 145 F.3d 673 (5th Cir. 1998). Huntsberry timely filed his notice of appeal.
DISCUSSION
We review the district court’s grant of summary judgment de novo. See Guillory v. Domtar
Industries, Inc., 95 F.3d 1320, 1326 (5th Cir. 1996). This review requires the same analysis
employed by the district court. See id. (citing Turnage v. General Elec. Co. 953 F.2d 206, 212 (5th
Cir. 1992)). Summary judgment is appropriate when “the pleadings, depositions, answers to
interrogatories, and admissions on file along with the affidavits filed in support of the motion, if any,
indicate that there is no genuine issue o f material fact and that the moving party is entitled to
judgment as a matter of law.” Fed. R. Civ. P. 56.; see also, Celotex Corp. v. Catrett, 477 U.S. 317,
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322 (1986). The essence of our review rests on “whether the evidence presents a sufficient
disagreement to require submission to the jury or whether it is so one-sided that one party must
prevail as a matter of law.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 251-52 (1986).
In Firestone Tire and Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989), the Supreme Court
established that courts must apply a de novo standard of review in actions brought by ERISA plan
participants who challenge the denial of benefits. However, if the plan vests the plan administrator
with discretionary authority to make eligibility determinations or construe the plan's terms, we are to
review for abuse of discretion. See id. We agree with the district court and find that the Unocal plan
grants LINA discretionary authority to determine a plan participant’s eligibility for long-term
disability benefits. Accordingly, we review the LINA’s denial of Huntsberry’s request for benefits
for abuse of discretion.
In our review for abuse of discretion, we seek to determine whether LINA acted arbitrarily
or capriciously in denying benefits. See Sweatman v. Commercial Union, Ins. Co., 39 F.3d 594, 601
(5th Cir. 1994). Nothing in the record indicates arbitrary and capricious conduct on the part of LINA.
On the contrary, LINA considered all of the available medical information and the FCE. Combined
this information leaves no genuine issues of material fact. Despite Huntsberry’s subjective
complaints, which remain medically unsupported, there is no indication that he is disabled or that he
otherwise qualifies for long-term disability benefits. Most telling in this regard is Dr. Gidman’s
observation that Huntsberry suffered no physical impairment of the whole person or exhibited
objective evidence of any permanent impairment or functional limitation.
As in the court below, Huntsberry significantly relies on this court’s decision in Vega. The
case has been scheduled for rehearing en banc, see Vega v. Life Ins. Services, Inc., 167 F.3d 197 (5th
Cir. 1999); consequently, the prior opinion is without precedential effect. See, 5TH CIR. R.35 ("[T]he
effect of granting a rehearing en banc is to vacate the previous opinion and judgment of the Court and
to stay the mandate."); see also, de Aguilar v. Boeing Co., 47 F.3d 1404, 1411 (5th Cir.), cert.
denied, 516 U.S. 865, 116 S. Ct. 180 (1995). Nevertheless, unlike the court in Vega, we cannot find
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that LINA conducted an unreasonably lax or bad faith investigation. Therefore, Vega is inapplicable
and we need not delay our adjudication of this matter pending en banc resolution of Vega.
Additionally, we summarily reject Huntsberry’s argument that a conflict of interest exists which
requires this court to (1) find an abuse of discretion; and (2) consider information outside the
administrative record. The possible existence of a conflict of interest does not mandate a finding of
abuse or consideration of additional information. Instead, it would require us to examine closely the
actions of LINA. Yet, even a close examination of LINA’s actions fails to reveal conduct which
would support the continued prosecution of this case.
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CONCLUSION
For the ascribed reasons as well as those articulated by the district court, we AFFIRM the
judgment below.
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