Shniper, that Scarinci was not totally disabled as of her termination on February 20, 1991.
59. The entire AT&T Benefit Claim & Appeal Committee File was reviewed by the AT&T Benefit Claim & Appeal Committee.
60. After reviewing the entire file, the AT&T Benefit Claim & Appeal Committee rejected Scarinci's appeal.
61. The AT&T Benefit Claim & Appeal Committee was not subject to any quota or other requirements setting the amount of appeals it should sustain or overrule. The AT&T Benefit Claim & Appeal Committee has never been pressured by AT&T management to keep costs down by denying claims.
62. Approximately twenty percent of the cases reviewed by the AT&T Benefit Claim & Appeal Committee reverse the denial of claims by Health Affairs.
63. The decision of the AT&T Benefit Claim Committee in rejecting plaintiff's appeal was under all the evidence before it was reasonable.
CONCLUSIONS OF LAW
1. This Court has jurisdiction over the subject matter of all claims in this matter pursuant to Sections 502(e) and (f) of ERISA, 29 U.S.C. §§ 1132(e) and (f).
2. Venue is proper in this judicial district because a substantial portion of the actions complained of herein occurred and had their intended effects within this judicial district and defendant regularly transacts business in this judicial district. 28 U.S.C. § 1991(b).
3. The AT&T SADB is a plan governed under the terms of ERISA.
4. Where an ERISA plan gives the plan administrator discretionary authority to determine eligibility for benefits or to construe the terms of the plan, review under the "arbitrary and capricious" standard, rather than the more stringent de novo standard, is mandated. Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115, 103 L. Ed. 2d 80, 109 S. Ct. 948 (1989).
5. Where an ERISA plan grants it administrator the power to interpret and construe the plan and decide questions as to eligibility, the arbitrary and capricious standard applies. See Abnathya v. Hoffman-LaRoche, Inc., 2 F.3d 40, 45 (3d Cir. 1993) (discretion found where plan gave benefit committee "'power to interpret and construe and Plan . . . and to determine all questions relating to eligibility . . . for disability income benefit'"); Nazay v. Miller, 949 F.2d 1323, 1335 (3d Cir. 1991) (discretionary authority found based on authority to "interpret and construe provisions . . . determine eligibility . . . make and enforce rules . . . decide questions"); Stoetzner v. United States Steel Corp., 897 F.2d 115, 119 n.5 (3d Cir. 1990) (discretion found based on authority to "administer . . . decide all questions," interpret and apply terms).
6. The arbitrary and capricious standard applies to the decision of the AT&T Benefit Claim & Appeal Committee to deny Scarinci benefits. AT&T administers the AT&T SADB through the AT&T Benefit Claim & Appeal Committee. To qualify for benefits, an employee must furnish the Benefit Claim & Appeal committee "satisfactory" evidence of disability. Finally, the AT&T Benefit Claim & Appeal Committee has the discretionary authority "to . . . determine conclusively for all parties all questions arising in the administration of the Plan."
7. Where the plaintiff has established the existence of sufficient facts to prove that the administrator of an ERISA plan had a conflict of interest, a modified arbitrary and capricious standard may be applied by the Court. See Kotrosits v. GATX Corp. Non-Contributory Pension Plan for Salaried Employees, 970 F.2d 1165, 1173 (3d Cir.), cert. denied, 121 L. Ed. 2d 583, 113 S. Ct. 657 (1992).
8. Plaintiff offered no evidence justifying the application of a modified arbitrary and capricious standard in the present case.
9. The mere fact that an employer acts as the administrator of its own ERISA plan is not significant enough to warrant a heightened standard of review. Abnathya, 2 F.3d at 45, n.5; Jordan v. Retirement Committee of Rensselaer Polytechnic Institute, 46 F.3d 1264, 1995 U.S. App. LEXIS 1533, 1995 WL 30897, at *11 (2d Cir. 1995). In view of the fact that ERISA specifically contemplates that employers may act as the fiduciaries and administrators of ERISA plans, finding a conflict of interest merely because the AT&T Benefit Claim Appeal Committee is part of AT&T would be anomalous. See 29 U.S.C. § 1003(a); Phillips v. Amoco Oil Co., 799 F.2d 1464, 1471 (11th Cir. 1986), cert. denied, 481 U.S. 1016, 95 L. Ed. 2d 500, 107 S. Ct. 1893 (1987). ("the ERISA scheme envisions that employers will act in a dual capacity as both fiduciary to the plan and employer").
10. There is no evidence of bad faith on the part of the AT&T Benefit Claim & Appeal Committee. See Abnathya, 2 F.3d at 45, n.5; Nazay, 949 F.2d at 1335.
11. There is also no evidence that the decision of the AT&T Benefit Claim & Appeal Committee was based on any considerations outside those mandated by the SADB Plan.
12. There is no evidence of record establishing that the decision of the AT&T Benefit Claim & Appeal Committee was clear error or not rational, i.e., arbitrary and capricious.
13. Plaintiff's argument that the AT&T Benefit Claim & Appeal Committee acted arbitrarily and capriciously because the Social Security Administration awarded her Social Security Disability Insurance Benefits is rejected.
14. Even under a modified arbitrary and capricious standard, the award of Social Security Disability Benefits does not establish that the plan administrator acted arbitrarily and capriciously. See Pokratz v. Jones Dairy Farm, 771 F.2d 206, 209 (7th Cir. 1985) (rejecting similar argument Court held: "The arbitrary or capricious standard calls for less searching inquiry than the substantial evidence standard that applies to the social security disability cases"); Freeman v. Sickness & Accident Disability Plan of AT&T Technologies, Inc., 823 F. Supp. 404, 415-16 (S.D. Miss. 1993).
15. The AT&T SADB Plan only provides for the award of benefits to AT&T employees based on events that occurred while they were employed by AT&T.
16. a. This interpretation of the AT&T SADB Plan was fully in accord with the plan's purpose which is "the payment of definite amounts to employees when they are disabled by accident or sickness."
17. The AT&T SADB Plan did not give the AT&T Benefit Claim & Appeal Committee the authority to rehire Scarinci, terminate her or consider the reasons for her termination when making a benefits decision.
18. Significantly, "in a case involving the interpretation of a provision of [an ERISA] plan . . . under the arbitrary and capricious standard, the [defendant's] interpretation 'should be upheld even if the court disagrees with it, so long as the interpretation is rationally related to a valid plan purpose and not contrary to the plain language of the plan.'" Moats v. United Mine Workers of America Health & Retirement Funds, 981 F.2d 685, 688 (3d Cir. 1992) (citation omitted).
19. Plaintiff has offered no evidence showing that the AT&T Benefit Claim & Appeal Committee acted arbitrarily or capriciously by deciding not to award her benefits based on her condition after February 20, 1991.
20. Scarinci appealed the denial of her claim for benefits to the AT&T Benefit Claim & Appeal Committee in December, 1992. By February 1991, Scarinci and her attorney certainly knew that AT&T had concluded that: (1) she had agreed to be voluntarily terminated under the AT&T Facility Closing Plan and (2) she was not disabled as of February 19, 1991 and denied her claim for benefits based, in part, on Dr. Glueck's finding that she was fit for sitting work.
21. For all of the foregoing reasons, I hereby find in favor of defendant Vince J. Ciccia, Secretary AT&T Benefit Claim & Appeal Committee and against plaintiff, Nancy M. Scarinci.
AND NOW, this 1st day of March, 1995, in consideration of the foregoing Findings of Fact and Conclusions of Law, it is ORDERED that Judgment is ENTERED in favor of defendants, Vince J. Ciccia, Secretary, AT&T Benefit Claim and Appeal Committee, and Equicor, Inc., and AGAINST plaintiff, Nancy M. Scarinci.
BY THE COURT:
JAMES McGIRR KELLY, J.
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