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PIETRO v. PRUDENTIAL INSURANCE COMPANY OF AMERICA

United States District Court, N.D. Illinois


May 4, 2004.

FRANK DIPIETRO, Plaintiff,
v.
THE PRUDENTIAL INSURANCE COMPANY OF AMERICA, Defendant

The opinion of the court was delivered by: JAMES MORAN, Senior District Judge

MEMORANDUM OPINION AND ORDER

Plaintiff Frank DiPietro brought this ERISA action against defendant Prudential Insurance Company of America, challenging its denial of disability benefits under his employee benefits plan. On March 25, 2004, this court issued a memorandum opinion and order granting plaintiffs motion for summary judgment and denying defendant's cross-motion for summary judgment. Defendant now brings a motion for reconsideration pursuant to Rule 59(e) of the Federal Rules of Civil Procedure. The motion is denied.

A party can bring a motion for reconsideration to correct errors of law or fact, or present newly discovered evidence. See Bordelon v. Chicago School Reform Board of Trustees, 233 F.3d 524, 529 (7th Cir. 2000)(citing LB Credit Corp. v. Resolution Trust Corp., 49 F.3d 1263 (7th Cir. 1995)). Defendant argues that the court committed two legal errors in reaching its decision. First, that after finding the plan administrator's denial of benefits to be "arbitrary and capricious" the court awarded benefits to plaintiff instead of remanding the claim to the plan administrator. Second, that the court misapplied the summary judgment standard in finding for plaintiff. We disagree.

  Defendant argues that when reviewing a plan administrator's initial denial of a claimant's benefits, it is not the district court's place to determine the claimant's eligibility. It maintains that after finding the plan administrator's decision to be arbitrary and capricious, the court must return the plaintiff to the same position he was in before the arbitrary decision and remand the case to the plan administrator to determine whether or not the plaintiff is disabled. Indeed, the Seventh Circuit states in Hackett v. Xerox Corporation Long-Term Disability Income Plan, 315 F.3d 771, 776 (7th Cir. 2003): "In a case where the plan administrator did not afford adequate procedures in its initial denial of benefits, the appropriate remedy respecting the status quo and correcting for the defective procedures is to provide the claimant with the procedures that she sought in the first place." However, we did not simply find that the process was inadequate.

  In the opinion granting summary judgment for plaintiff, we discussed the defendant's three proffered reasons for denying plaintiff's claim: lack of evidence to support his claim;, failure to work to the greatest extent possible; and failure to follow treatment recommendations. While discussing defendant's first argument, we highlighted the deficiencies in its decision — improper assumptions, discrediting of evidence without justification, and selective review of the evidence. We also recited the evidence on record that supported plaintiff's claim of disability, including the medical opinion of Dr. Sliwa, a post-polio specialist; the recommendations of Maureen Ziegler, an occupational therapist; the report of Thomas Grzesik, a rehabilitation consultant; the Social Security Administration's finding of disability; plaintiff's statements; and the letters of his friends and co-workers. In our opinion we noted the dearth of evidence to support the determination that plaintiff was not disabled. Finally, we concluded not just that the plan administrator's opinion contained procedural deficiencies but that, given this record, it was unreasonable not to find plaintiff disabled. As we stated, "The record is clear that plaintiff is entitled to disability benefits," As defendant acknowledges in its own motion, an outright award of benefits is proper when the decision is "so clear cut that it would be unreasonable for the plan administrator to deny the application for benefits on any ground." Gallo v. Amoco. Corp., 102 F.3d 918, 923 (7th Cir. 1996)(citing Weaver v. Phoenix Home Life Mutual Ins. Co., 990 F.2d 154, 159 (4th Cir. 1993)). This record provides a clear-cut case, thus remand is unnecessary. After arbitrarily denying plaintiffs claim, defendant is not entitled to develop a new record to evaluate plaintiff's initial eligibility while plaintiff waits without benefits. Defendant may certainly conduct new tests and exams to determine whether plaintiff should continue to receive benefits, but the present record establishes his initial eligibility.

  Defendant also argues that the court misapplied the summary judgment standard by granting plaintiff's motion merely because it found that the plan administrator's decision was arbitrary and capricious. Defendant reminds the court that it must consider the merits of each cross-motion separately. As explained above, we reviewed the evidence that supported denying defendant's motion and the evidence that supported granting summary judgment for plaintiff. We did not find for plaintiff merely because the plan administrator's decision was arbitrary and capricious, but because the record supports only one reasonable outcome — an award of disability benefits to plaintiff.

  CONCLUSION

  For the foregoing reasons, defendant's motion to reconsider is denied.

20040504

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