UNITED STATES DISTRICT COURT
MIDDLE DISTRICT OF LOUISIANA
KELVIN J. SCHEXNAYDER
CF INDUSTRIES LONG TERM DISABILITY
PLAN FOR IT’S EMPLOYEES, ET AL.
RULING ON SUMMARY JUDGMENT
This matter is before the court on cross motions for summary judgment by the
Defendant, Hartford Life and Accident Insurance Company (doc. 20) and the
Plaintiff, Kelvin J. Schexnayder (doc. 23). Both parties have filed opposition briefs
(docs. 27, 29), and Mr. Schexnayder has filed a reply brief (doc. 31). Jurisdiction
exists pursuant to 28 U.S.C. § 1331. Oral argument is not necessary.
CF Industries, Inc. sponsored a Long Term Disability Insurance Program (“the
Plan”) for its eligible employees, and the Plan was funded by a policy of group long
term disability insurance (the “Policy”) issued by Continental Casualty Company.2
Pursuant to an Endorsement, the name of the underwriting company for the Policy
1 Hartford is the only remaining defendant in this case. The Plaintiff dismissed
his claims against the Plan because it was fully insured by Hartford. See Plaintiff’s
Memorandum in Support of Summary Judgment (doc. 24) at 3. The Plaintiff dismissed
his wrongful termination claims against CF Industries after contracting with CF to
reinstate his status to active employment if this court reverses Hartford’s denial of
disability benefits. Id.
2 Hartford’s Statement of Uncontested Material Facts (doc. 21) at ¶ 1.
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was changed to Hartford Life Group Insurance Company.3 The parties have
stipulated that ERISA governs the long term disability benefit Plan at issue.4
The Plaintiff worked for CF Industries as a “chemical operator” from February
1981 until he became injured in May of 2003.5 The Plaintiff claimed that back and
leg pain prevented him from returning to work.6 On May 29, 2003, when the Plaintiff
became disabled, he was an eligible participant under the Plan.7 In addition, the
Social Security Administration found that Plaintiff “became disabled under [SSA]
rules on June 7, 2003" which entitled him to monthly disability benefits beginning in
After receiving benefits for two years under the Plan, Hartford Life decided to
terminate payment of benefits to the Plaintiff under the Plan.9 At the time of
termination, Hartford had sole discretionary authority to determine eligibility for
benefits and to interpret the terms and provisions of the Plan and Policy.10
3 Id. at ¶ 2.
4 Stipulation of Parties in Response to ERISA Case Order (doc. 9) at 1.
5 Hartford’s Response to Plaintiff’s Statement of Uncontested Facts (doc. 28) at ¶
1; Hartford’s Statement of Uncontested Material Facts (doc. 21) at ¶ 3.
6 Hartford’s Statement of Uncontested Material Facts (doc. 21) at ¶ 6.
7 Id. at ¶ 3.
8 Id. at ¶ 19.
9 Plaintiff’s Statement of Uncontested Facts (doc. 25) at ¶ 11; Hartford’s
Response to Plaintiff’s Statement of Uncontested Facts (doc. 28) at ¶ 11.
10 Hartford’s Statement of Uncontested Material Facts (doc. 21) at ¶ 4.
Case 3:07-cv-00084-JJB-CN Document 33 04/02/08 Page 2 of 20
Under the language of the policy, “disability” means “injury or sickness causes
physical or mental impairment to such a degree of severity that You are: (1)
continuously unable to perform the Material and Substantial Duties of your Regular
occupation; and (2) not working for wages in any occupation for which You are or
become qualified by education, training, or experience.”11 After the monthly benefit
has been payable under the policy for twenty-four months, “disability” means injury
or sickness of such a severity that You are: “(1) continuously unable to engage in
any occupation for which You are or become qualified by education, training, or
experience; and (2) not working for wages in any occupation for which You are or
become qualified by education, training or experience.”12
On October 19, 2004, Hartford’s Medical Advisory Group physician concluded
that the plaintiff could be “employed full-time at Light demand work as defined by the
US Department of Labor Dictionary of Occupational Titles.”13 By letter dated
November 2, 2004, Hartford informed the Plaintiff that his 24 month occupation
period would end on November 25, 2005, and the current medical and vocational
documentation did not support that he remained disabled from any occupation at
that time.14 In November of 2005, Hartford decided to extend the Plaintiff’s benefits
11 Id. at ¶ 11.
12 Id. (emphasis added).
13 Id. at ¶ 24.
14 Id. at ¶ 26.
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as they continued to investigate his alleged disability.15 In December 2005, Hartford
conducted an employability assessment which identified three occupations which
would match the plaintiff’s “education, training, work history, and physical
capabilities.16” Hartford then notified the Plaintiff that as of January 31, 2006, no
further benefits would be paid under the Policy because “medical and vocational
documentation in Plaintiff’s file [did] not support that he remains disabled from any
occupation.”17 The Plaintiff appealed this finding,18 and Hartford upheld the
termination of his long term disability benefits because the Plaintiff was “functionally
capable of performing the occupations identified on the employability analysis, each
of which requires only a sedentary level of exertion.”19
The Plaintiff contends that he suffers from degenerative disc disease, epidural
lipoma, disc herniation, carpal tunnel syndrome, bilateral ulnar neuropathy, and
extreme hyperesthesias.20 The Plaintiff claims that his physical condition limits his
activities in terms of “lifting, sitting, walking, or standing.”21 The Plaintiff asserts that
15 Id. at ¶ 30.
16 Id. at ¶ 35.
17 Id. at ¶ 35.
18 Id. at ¶ 36.
19 Id. at ¶ 39.
20 Plaintiff’s Statement of Uncontested Facts (doc. 25) at ¶ 7.
21 Id. at ¶ 22.
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his physical condition prevents him from working, and he claims evidence from his
doctors supports this conclusion.22
The Plaintiff seeks reinstatement of his long-term disability benefits from
Hartford Life and Accident Insurance Company. Mr. Schexnayder contends that
Hartford’s termination of benefits was based on factual conclusions contrary to the
evidence. Mr. Schexnayder asserts that the reports and medical records from
treating physicians show that he is unable to work full time at any job, and as a
result, he meets the definition of disability under the Hartford Plan. The Plaintiff
argues that Hartford has abused its discretion by terminating his benefits under the
Hartford Insurance Company contends that the termination of benefits was
supported by substantial evidence in the administrative record, and as a result, the
administrator’s decision was not an abuse of discretion. The Defendant argues it is
entitled to summary judgment and attorney fees because it did not abuse its
discretion in finding that Plaintiff was not disabled under the terms of the Plan.
22 Id. at ¶ 17.
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Summary Judgment Standard
Summary judgment is appropriate “if the pleadings, depositions, answers to
interrogatories, and admissions on file, together with the affidavits, if any, show that
there is no genuine issue as to any material fact and that the moving party is entitled
to a judgment as a matter of law.” Fed. Rule Civ. P. 56(c). The party seeking
summary judgment carries the burden of demonstrating that there is an absence of
evidence to support the non-moving party’s case. Celotex Corp. v. Catrett, 477 U.S.
317, 325 (1986). When the burden at trial rests on the non-moving party, as it does
here, the moving party need only demonstrate that the record lacks sufficient
evidentiary support for the non-moving party’s case. Id. The moving party may do
this by showing that the evidence is insufficient to prove the existence of one or
more essential elements of the non-moving party’s case. Id.
Although this Court considers the evidence in a light most favorable to the
non-moving party, the non-moving party must show that there is a genuine issue for
trial. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248-49 (1986). Conclusory
allegations and unsubstantiated assertions will not satisfy the non-moving party’s
burden. Grimes v. Tex. Dep’t of Mental Health, 102 F.3d 137, 139-40 (5th Cir. 1996).
Similarly, “[u]nsworn pleadings, memoranda or the like are not, of course, competent
summary judgment evidence.” Larry v. White, 929 F.2d 206, 211 n.12 (5th Cir.
1991), cert. denied, 507 U.S. 1051. If, once the non-moving party has been given
the opportunity to raise a genuine fact issue, no reasonable juror could find for the
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non-moving party, summary judgment will be granted for the non-moving party.
Celotex, 477 U.S. at 322; see also, Fed. Rule Civ. P. 56(c).
Standard of Review
If a benefit plan gives discretion to an administrator or fiduciary, the “abuse of
discretion” standard is appropriate in determining if the administrator was correct in
denying benefits under the plan. Pierre v. Connecticut General Life Ins. Comp., 932
F.2d 1552, 1562 (5th Cir. 1991). In this case, Hartford Life Group Insurance was
delegated sole discretionary authority to determine the Plaintiff’s eligibility for
In the ERISA context, the “abuse of discretion” standard is synonymous with
an “arbitrary and capricious” standard. Meditrust Fin. Servs. Corp. v. Sterling
Chems., Inc., 168 F.3d 211, 214 (5th Cir. 1999). An arbitrary decision is one “without
a rational connection between the known facts and the decision or between the found
facts and the evidence.” Bellaire Gen. Hosp. v. Blue Cross Blue Shield of Michigan,
97 F.3d 822, 828 (5th Cir. 1996). Despite the synonymity of the two standards, the
Fifth Circuit has continuously applied the abuse of discretion standard in the ERISA
context. Pierre, 932 F.2d 1552, 1562; Vega v. Nat’l Life Ins. Servs., Inc., 188 F.3d
23 Memorandum in Support of Motion for Summary Judgment of Hartford (doc.
22) at 11, n. 5.
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287, 296 (5th Cir. 1999); Gothard v. Metropolitan Life Ins. Co., 491 F.3d 246, 249 (5th
The law requires substantial evidence to support the decision of an
administrator to terminate disability benefits. Meditrust Fin. Servs. Corp, 168 F.3dat
215. Substantial evidence is “more than a scintilla, less than a preponderance, and
is such relevant evidence as a reasonable mind might accept as adequate to support
a conclusion.” Deters v. Sec’y of Health, Educ. and Welfare, 789 F.2d 1181, 1185
(5th Cir. 1986). When reviewing the administrator’s decision, the court may only
consider the evidence made available to the administrator before the lawsuit was
filed. Vega, 188 F.3d at 300. Thus, in this case, the Court will only analyze that
evidence available to the Defendant at the time the Plaintiff’s benefits were
B. Conflicts of Interest
At least a minimal conflict of interest exists when the plan fiduciary serves as
both the administrator and insurer of the plan. Robinson v. Aetna Life Ins. Co., 443
F.3d 389, 395 (5th Cir. 2006). ERISA defines a fiduciary as one who “exercises
discretionary authority or discretionary control respecting management of a plan or
exercises any authority or control respecting management or disposition of its
assets.” 29 U.S.C. §1002(21)(A)(I). Where a conflict of interest exists, the court will
give less deference to the administrator’s decision. Vega, 188 F.3d at 297. The
abuse of discretion standard does not change, but the court will apply a “sliding
Case 3:07-cv-00084-JJB-CN Document 33 04/02/08 Page 8 of 20
scale” standard which gives less deference to the conflicted administrator’s decision.
Id. at 298-299. Under the “sliding scale” standard, the administrator’s decision is
entitled to some deference, but this deference is lessened to the degree necessary
to neutralize any untoward influence from the conflict. Id. at 296.
C. Application of the Standard
Plaintiff has alleged a conflict of interest exists because the Defendant is both
the administrator and insurer of the Plan and, therefore, benefits from denying the
claim.24 Hartford acknowledges it has “sole discretionary authority to determine
Plaintiff’s eligibility for benefits and to interpret the terms and provisions of the plan.”25
A conflict of interest exists because Hartford, as administrator and insurer of the
disability plan, potentially benefits from every denied claim. Thus, the Court will
evaluate Hartford’s decision to terminate Mr. Shexnayder’s benefits under an abuse
of discretion standard, but will give less deference to that decision because a conflict
exists pursuant to the sliding scale.
Did Hartford Abuse Its Discretion?
Social Security Administration’s Finding of Disability
The Social Security Administration found Mr. Shexnayder disabled under the
24 Memorandum in Support of Plaintiff’s Motion for Summary Judgment (doc. 24)
25 Memorandum in Support of Motion for Summary Judgment of Hartford Life
(doc. 22) at 2.
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SSA rules on June 7, 2003.26 Plaintiff argues the importance of this evidence
because the SSA is an impartial federal government agency which uses a similar
standard to determine eligibility for disability benefits.27 Conversely, Defendant
claims to be unbound by the SSA determination because the analysis of entitlement
for Social Security benefits is different than the entitlement analysis under an ERISA
The Court agrees with Plaintiff that the SSA determination is relevant, but does
not consider the determination binding. Although Social Security determinations are
not binding upon plan administrators, they are “relevant and instructive” in a Court’s
determination of whether a plan administrator acted arbitrarily or capriciously.
Gellerman v. Jefferson Pilot Fin. Ins. Co., 376 F.Supp.2d 724, 735 (S.D. Tex. 2005)
(noting that “no court has held that an SSA determination is completely irrelevant”).
26 Hartford’s Statement of Uncontested Material Facts (doc. 21) at ¶ 19.
27 Disability Benefits Plan standard: “After the Monthly Benefit had been payable
for 24 months, “Disability” means that injury or Sickness causes physical or mental
impairment to such a degree of severity that You are:
1. continuously unable to engage in any occupation for which You are or
become qualified by education, training or experience; and
2. not working for wages in any occupation for which You are or become
qualified by education, training or experience .
See Memorandum in Support of Motion for Summary Judgment of Hartford Life (doc.
22) at 5.
The Social Security Administration’s standard for disability is a five step process,
the fifth step stating: “We consider our assessment of your residual functional capacity
and your age, education, and work experience to see if you can make an adjustment to
other work. If you can make an adjustment to other work, we will find that you are not
disabled. If you cannot make an adjustment to other work, we will find that you are
disabled.” 20 C.F.R. § 404.1520.
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Using a standard similar to the Hartford Plan, the SSA found Mr. Shexnayder
incapable of performing other work; whereas, the Defendant found Plaintiff capable
of performing three other jobs. The Court also considers the fact that the Defendant
requested overpayment refunds from the Mr. Shexnayder after the SSA found him
incapable of performing any job, and he repaid those funds without hesitation.
Although the SSA determination is not binding, the Court finds this independent
determination relevant in determining whether Hartford’s denial of long-term disability
benefits was arbitrary and capricious.
The Defendant argues its decision to terminate Mr. Shexnayder’s disability
benefits was based on substantial evidence in its possession at the time the decision
was made.28 Particularly, Hartford based its decision on the results of a Functional
Capacity Evaluation (FCE), performed by a physical therapist who was hired by
Hartford. The results of that test yielded an opinion that Mr. Shexnayder “would
likely” be able to work full-time. Hartford further based its decision to terminate
Plaintiff’s benefits on the opinion of Dr. Marion. Dr. Marion opined that Mr.
Shexnayder “is currently capable of performing full time work that is primarily seated
in nature with the flexibility to reposition as needed and may require occasional lifting
28 Memorandum in Support of Motion for Summary Judgment of Hartford (doc.
22) at 13.
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up to 10 pounds.”29 Dr. Marion did not physically examine Mr. Shexnayder, but
formed an opinion by speaking with his examining physicians and reviewing the
results of their medical records.30
Hartford also hired Dr. Mattin to form an opinion as to Mr. Shexnayder’s ability
to perform any job. Dr. Mattin opined that Plaintiff “retains the capacity to be
employed full-time at light demand work as defined by the US Department of Labor
Dictionary of Occupational Titles.”31 Dr. Mattin did not examine Plaintiff, but
formulated his opinion by reviewing medical records of Plaintiff’s examining
physicians, Dr. Landreneau and Dr. Cavalier, and speaking with those physicians.32
Following the receipt of Dr. Mattin’s report, Hartford’s rehabilitation case
manager conducted a “Vocational Any Occupancy Assessment,” identifying three
alternative occupations that Mr. Shexnayder could perform, given his “age, current
level of education, work history and level of function ability.”33 Hartford asserts that
the evidence is substantial to support a decision to terminate Mr. Shexnayder’s
disability benefits, and it argues that the decision must be upheld even if the record
29 Memorandum in Support of Plaintiff’s Motion for Summary Judgment (doc. 24)
at Exh. L.
30 Id. at 6, Exh. L.
31 Memorandum in Support of Motion for Summary Judgment of Hartford (doc.
22) at 7.
33 Id. at 7.
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contains conflicting evidence.34 Where conflicting medical evidence exists in the
record, Hartford claims the administrator has the authority to choose between the
evidence without giving more weight to the claimant’s treating physician than its own
Plaintiff provides conflicting medical evidence and claims the administrative
record contains overwhelming evidence that he suffers from degenerative disc
disease, carpal tunnel, and other conditions, all of which cause debilitating pain. Mr.
Shexnayder was examined by Dr. Morris and found to be “totally medically
disabled.”36 Dr. Cavalier also examined Mr. Shexnayder and opined that [he] was
“totally disabled because of his back, neck, and peripheral nerve issues” and not
allowed to work.37 Finally, Dr. Landreneau examined Mr. Shexnayder and found him
to be “completely disabled from his back, neck, and peripheral nerve issue” and
unable to work due to risk of further injury.38 Based on this medical evidence, Plaintiff
asserts that Hartford arbitrarily ignored the reliable medical evidence of plaintiff’s
disability, particularly the evidence from his treating physicians.
34 Id. at 13, citing Vega, 188 F.3d at 299; Meditrust Fin. Servs. Corp. v. Sterling
Chems., Inc., 168 F.3d 211, 215 (5th Cir. 1999); Sweatman, 39 F.3d 601-603.
35 Id. at 14, citing Black & Decker v. Nord, 123 S.Ct. 1965 (2003).
36 Memorandum in Support of Plaintiff’s Motion for Summary Judgment (doc. 24)
at 4, Exh. C.
37 Id. at 4, Exh. D.
38 Id. at 5, Exh. G.
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The Court acknowledges that an administrator can choose between conflicting
medical evidence in the record. However, although there is no treating physician
preference in the ERISA context, an administrator “may not arbitrarily refuse to credit
a claimant’s reliable evidence, including the opinions of treating physicians.” Black
& Decker Disability Plan v. Nord, 538 U.S. 822, 834 (2003). Mr. Shexnayder’s
treating physicians found him disabled with chronic degenerative disc disease, carpal
tunnel syndrome, and spinal stenosis.39 In addition to these objective medical
findings, Mr. Shexnayder suffers from chronic pain in his back and anterior thighs that
is increased by movements and activities.40 Hartford found Mr. Shexnayder’s
complaints of pain to be subjective and “not consistent” with the objective findings.
However, Dr. Feinberg conducted an MRI on Plaintiff and found evidence of
laminectomary and significant stenosis in the lumbar spin,41 which corroborates Mr.
Shexnayder’s complaints of pain. Dr. Morris, Plaintiff’s treating physician, found
evidence of elevated spinal fluid protein after conducting a spinal fluid examination.
In addition to physically examining Mr. Shexnayder, his physicians also
completed Functional Assessment evaluations provided by Hartford. The Functional
Assessment Tools asked the physicians if they felt that Mr. Shexnayder was “capable
39 Memorandum in Support of Plaintiff’s Motion for Summary Judgment (doc 24)
at Exhs. C, G and L.
40 Id. at Exhs. A, J and L.
41 Id. at Exh. A.
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of performing full time work, which involves primarily seated work with flexibility to
sit/stand when needed and does not require lifting over 0-30 pounds.” Both Drs.
Freiburg and Morris indicated that Mr. Shexnayder was not capable of working with
the flexibility to stand and the limitation of lifting less than thirty pounds. Dr. Cavalier
also responded to the Functional Assessment Tool provided by Hartford, noting that
Mr. Shexnayder was capable fo performing full time seated work with flexibility to sit
or stand when needed. However, as noted by Dr. Cavalier, he only examined Mr.
Shexnayder on one occasion in 2004. Drs. Freiberg, Landreneau and Morris
evaluated Mr. Shexnayder on many occasions and in 2005, found him incapable of
performing full seated work with flexibility to sit or stand when needed.42
Hartford hired two doctors, Dr. Mattin and Dr. Marion to analyze the medical
records provided by Plaintiff’s examining physicians. Based on the medical evidence,
Drs. Mattin and Marion found Plaintiff capable of performing sedentary work. The
Functional Capacity Evaluation suggested by Dr. Freiburg and performed by a
physical therapist found Mr. Schexnayder capable of performing “medium work” with
a physical demand of moving objects 10 lbs. to 20 lbs. constantly.43 Despite this
finding, the test administrator noted as an “additional comment” that:
Patient vocalized pain and burning sensation in bilateral hands and
forearms, left elbow, left lumbar spine, and bilateral anterior thighs
during all testing procedures. His pain levels rose from initial rating of
42 Id. at Exhs. B, E and J.
43 See H-0319.
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8 of 10 (on a 0 to 10 point scale) to 9 3/4 of 10 by completion of all
Hartford consistently reiterates the importance of the FCE test results and the
fact that it was suggested by Mr. Shexnayder’s physician. However, Hartford failed
to consider the fact that Mr. Shexnayder was in considerable pain during the
examination. Accounts of pain cannot be ignored. Audino v. Raytheon Co. v. Short
Term Disability Plan, 129 Fed. Appx. 882, 885 (5th Cir. 2005).
Taking into consideration that Hartford is the administrator and insurer of the
disability benefits plan, the Court finds Hartford abused its discretion in denying Mr.
Shexnayder disability benefits. Mr. Shexnayder’s pain is a subjective disability which
is substantiated by the objective medical evidence of his examining physicians.
Although pain cannot always be objectively quantified, Mr. Shexnayder’s pain is
corroborated by medical evidence finding degenerative disc disease and spinal
stenosis and notations of pain in the results of the FCE. The Defendant abused its
discretion in discounting the subjective evidence of Plaintiff’s pain and the objective
evidence corroborating the disability. Hartford’s reliance on the FCE and opinions of
physicians who did not examine Plaintiff is an abuse of its discretion.
In sum, the Court reviewed the administrative record for an abuse of discretion
under the Fifth Circuit’s sliding scale. Hartford chose to conduct only file reviews of
Mr. Shexnayder’s medical evidence until his examining physician suggested an FCE.
44 See H-0324.
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That FCE found Mr. Shexnayder capable of performing “medium exertion work.”
However, the medical evidence and opinions of Mr. Shexnayder’s examining
physicians and his subjective complaints before, during and after testing indicate
otherwise. This Court finds that Hartford abused its discretion in terminating
Plaintiff’s disability benefits.
Both Plaintiff and Defendant seek an award of attorneys’ fees and costs. The
Plaintiff argues that Hartford acted in bad faith by denying his claim when
overwhelming evidence supported a finding of eligibility. Furthermore, Mr.
Shexnayder seeks to deter Hartford from future terminations of long-term disability
benefits under an ERISA plan by requiring it to pay fees and costs. Conversely,
Hartford argues that the Plaintiff is capable of paying the fees because he did not file
the action in forma pauperis. In addition to Mr. Shexnayder’s ability to pay the costs
and fees, Defendant argues awarding such costs will deter frivilous cases in the
Under ERISA, “the court in its discretion may allow a reasonable attorneys’ fee
and costs of action to either party.” 29 U.S.C. §1132(g)(1). An award of attorneys
fees in an ERISA action is purely discretionary. The Court generally considers five
factors in deciding whether to award attorneys’ fees and costs:
(1) the degree of the opposing parties’ culpability or bad faith; (2) the
ability of the opposing parties to satisfy an award of attorneys’ fees; (3)
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whether an award of attorneys’ fees against the opposing party would
deter other persons acting under similar circumstances; (4) whether the
parties requesting attorneys’ fees sought to benefit all participants and
beneficiaries of an ERISA plan or to resolve a significant legal question
regarding ERISA itself; and (5) the relative merits of the parties’
Applying the first Bowen factor, the Court finds that Hartford acted arbitrarily
and capriciously in denying the Plaintiff’s disability benefits, and as a result, the first
factor weighs in favor of the Plaintiff. The evidence clearly establishes that Plaintiff
is completely disabled due to degenerative disc disease and spinal stenosis and
debilitating pain. Hartford ignored the medical evidence of Mr. Shexnayder’s
examining physicians and scoured the record for evidence consistent with the
outcome which was most financially beneficial for itself. Acknowledging the fact that
Hartford is the administrator and insurer of the disability benefit plan, this Court hopes
that awarding attorneys’ fees and costs will have a deterrent effect in future decisions
made by Hartford.
Breach of Fiduciary Duty
Defendant urges dismissal of Plaintiff’s claim that Hartford breached its
fiduciary duty under 29 U.S.C. §1132(a)(3).46 The Defendant asserts that 29 U.S.C.
§1104 does not provide a cause of action for a breach of fiduciary duty as
administrator of a disability benefits plan, and 29 U.S.C. §1132(a)(3) is an
45 Iron Workers Local No. 272 v. Bowen, 624 F.2d 1255, 1266 (5th Cir. 1980).
46 Memorandum in Support of Motion for Summary Judgment of Hartford (doc.
22) at 17.
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inappropriate provision to seek personal recovery because other equitable relief is
available.47 Hartford continues by arguing that relief is available through
§1131(a)(1)(B), thus relief under §1132(a)(3) is inappropriate.
A plaintiff cannot bring a suit for breach of a fiduciary duty when the civil
enforcement provision of ERISA provides a possible remedy. Estate of Bratton v.
Nat’l Union Fire Ins. Co., 215 F.3d 516, 526 (5th Cir. 2000). The Supreme Court has
interpreted § 1132(a)(3) to allow plaintiffs to sue for breach of fiduciary duty only
when no other relief is available. Tolson v. Avondale Indus., 141 F.3d 604, 610 (5th
Cir. 1998), citing Variety Corp. v. Howe, 516 U.S. 489 (1996). Because the Plaintiff
has adequate relief in his claim for the improper termination of benefits under
§1132(a)(1), relief through § 1132(a)(3) would be inappropriate. Id. Accordingly, the
Plaintiff’s breach of fiduciary duty claim will be dismissed.
For the reasons set forth above, the Court finds for Plaintiff, Kevin
Schexnayder, and against Defendant, Hartford Life and Accident Insurance
Company. Accordingly, the Plaintiff’s motion for summary judgment (doc. 24) is
hereby GRANTED, and the Defendant’s motion for summary judgment (doc. 22) is
DENIED IN PART. The Plaintiff’s claim for breach of fiduciary duty is hereby
47 Id. citing Varity Corp. v. Howe, 516 U.S. 489 (1996).
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Hartford is ordered to pay past long term disability benefits retroactive to
January 31, 2006 to the present in the monthly amount specified in the Plan and
subject to such offsets as are permitted in the Plan, plus pre-judgment interest.
Hartford is further ordered to continue to make future long term disability benefits in
the monthly amount specified in the Plan and subject to such offsets as are permitted
in the Plan until such time as Hartford makes an adverse determination of long-term
disability consistent with ERISA and the Plaintiff’s entitlements under the Plan.
The Plaintiff is entitled attorneys’ fees. The Plaintiff shall file a request for
attorneys’ fees with supporting documentation within 14 days from the date of this
order. The Defendant shall have 7 days after the Plaintiff’s filing to reply to the
Plaintiff’s request for attorneys’ fees. Costs other than attorneys’ fees will be
awarded to the Plaintiff according to law. See Fed. R. Civ. Pro. 54(d).
It is so ORDERED.
Baton Rouge, Louisiana, April 1, 2008.
JAMES J. BRADY, JUDGE
MIDDLE DISTRICT OF LOUISIANA
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