United States District Court, W.D. Pennsylvania
LONIE M. McDONALD, Plaintiff,
APPLETON PAPERS INC. RETIREMENT PLAN, and KERRY ARENT, PLAN ADMINISTRATOR, Defendants.
KIM R. GIBSON, District Judge.
Currently pending in this case are cross-motions for summary judgment (ECF Nos. 25, 28). The parties' motions present a single issue for this Court to decide: whether the Defendants, Appleton Papers Inc. Retirement Plan and the Plan Administrator, Kerry Arent, abused their discretion in denying Plaintiff Lonie McDonald's claim for total and permanent disability under the Retirement Plan. The Court finds that Defendants did not abuse their discretion. Accordingly, and for the reasons stated below, the Court will DENY Plaintiff's motion for summary judgment (ECF No. 25) and will GRANT Defendants' motion for summary judgment (ECF No. 28).
II. Jurisdiction and Venue
The Court has jurisdiction over this matter pursuant to 29 U.S.C. §§ 1132(a)(1)(B) and (e)(1). Venue is proper under 29 U.S.C. § 1132(e)(2).
This case involves the denial of Plaintiff's claim for benefits for total and permanent disability under the Appleton Papers Inc. Retirement Plan, which is governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§ 1001, et seq. ("ERISA"). The following facts are not in dispute.
Plaintiff was an employee with Appleton Papers Inc. for 29 years, working as a machine room worker in Appleton Papers' Roaring Spring production facility. (ECF No. 31 at 124). Plaintiff's employment with Appleton Papers ended in June 2010, after Plaintiff and Appleton Papers entered a compromise and release agreement related to Plaintiff's claim for workers' compensation benefits. ( Id. ).
Appleton Papers maintains a Retirement Plan, subject to ERISA, for eligible, former employees. ( Id. at 333-472). Based on Plaintiff's employment with Appleton Papers, she became a Plan participant, pursuant to the special provisions supplement applicable to the employees of the Appleton Papers' Roaring Spring facility. ( Id. at 438-47). As a Plan participant, Plaintiff is eligible to receive vested pension benefits under the terms of the Plan. ( Id. at 438-47). Among other benefits, the Plan provides a benefit for "Total and Permanent Disability, " subject to certain eligibility requirements. ( Id. at 445).
Under the Plan, the Vice President of Human Resources-Kerry Arent-serves as the Administrative Named Fiduciary and is thus the Plan Administrator. ( Id. at 382). The Plan provides the Plan Administrator with "the power (and... discretion with respect to such power)... to construe all terms, provisions, conditions and limitations of the Plan;... [and] to determine all questions arising out of or in connection with the provisions of the Plan or its administration in any and all cases." ( Id. at 382-83). Likewise, the Plan Administrator has the authority to "control and manage the operation and administration of the Plan, " and the Plan Administrator's decisions and actions are "conclusive and binding upon all parties concerned." ( Id. at 382).
In May 2005, Plaintiff began losing her voice, which developed into a persistent voice impairment that continues to inhibit her ability to speak. ( Id. at 58, 78-80, 127-28). Plaintiff sought various courses of treatment and was diagnosed with dysphonia. ( Id. at 127-28, 179). Plaintiff continued to work at Appleton Papers following the onset of her impairment. ( Id. at 326).
On June 8, 2006, while working at the Appleton Papers' Roaring Spring facility, Plaintiff fell from a six-foot high catwalk and sustained a laceration on her forehead and a right shoulder injury. ( Id. at 128, 244). X-rays taken immediately after the fall showed that Plaintiff had not suffered any fractures. ( Id. at 89, 244). Following her fall, Plaintiff stopped working for several months and underwent physical therapy. ( Id. at 128, 244). Plaintiff returned to work in April 2007, but continued to suffer pain and a decreased range of motion. ( Id. at 128). Following an MRI in May 2008, Plaintiff was diagnosed with a right shoulder subacromial impingement, rotator cuff tear, and bicep tendon tear, requiring arthroscopic surgery. ( Id. at 128, 151). In connection with her surgery, Plaintiff again stopped working and underwent physical therapy. ( Id. at 155). Eventually, Plaintiff filed a workers' compensation claim related to her shoulder injury. ( Id. at 12-30). The parties reached a settlement and entered a compromise and release agreement, ending Plaintiff's employment with Appleton Papers in June 2010. ( Id. at 12-30).
In March 2009, Plaintiff applied for social security disability benefits. After Plaintiff provided relevant documentation ( Id. at 206-17), the Social Security Administration granted Plaintiff's application for disability benefits in September 2009. ( Id. at 221-24).
Plaintiff then applied for total and permanent disability benefits under the Appleton Papers Retirement Plan. Plaintiff's claim was denied, as explained in a letter from Defendant Kerry Arent, the Plan Administrator, on October 25, 2010. ( Id. at 37). According to the letter, based on a review of Plaintiff's medical records by Dr. Harrison- Appleton Paper's Corporate Medical Director-Plaintiff had not provided sufficient evidence to establish that she was both wholly and permanently prevented from engaging in any occupation or employment as required by the Plan, and thus was not entitled to the requested benefits. ( Id. at 37). Plaintiff appealed Defendants' decision to deny the disability benefits on December 3, 2010. ( Id. at 38). On December 22, 2010, the Plan Administrator confirmed the denial of the disability benefits, explaining that, based on a review of the medical records provided, Plaintiff was not "wholly" disabled within the meaning of the Plan. ( Id. at 41).
On August 15, 2011, in a letter to Plaintiff's attorney, the Plan Administrator stated that Plaintiff had exhausted all of her appeal opportunities under the Plan, and that the decision to deny the requested benefits was final. ( Id. at 43). Nevertheless, the Retirement Plan's Benefit Finance Committee agreed to again review Plaintiff's request for disability benefits. ( Id. at 323). After reviewing the evidence submitted, the Committee upheld the denial of Plaintiff's claim in a letter dated September 26, 2012. ( Id. at 323-27).
Having fully exhausted her appeal rights under the Plan, Plaintiff filed a complaint (ECF No. 1) in this Court on August 14, 2013. Defendants filed an answer (ECF No. 16) on October 22, 2013. On February 21, 2014, the parties filed cross-motions for summary judgment (ECF Nos. 25, 28), along with briefs in support (ECF Nos. 26, 29), concise statements of material facts (ECF Nos. 27, 30), and a joint appendix of documents (ECF No. 31). Thereafter, the ...