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URBANIA v. CENTRAL STATES

October 14, 2004.

MATTHEW MARK URBANIA, Plaintiff,
v.
CENTRAL STATES, SOUTHEAST AND SOUTHWEST AREA PENSION FUND, and THE BOARD OF TRUSTEES OF THE CENTRAL STATES SOUTHEAST AND SOUTHWEST AREAS PENSION FUND, Defendants.



The opinion of the court was delivered by: GEORGE MAROVICH, Senior District Judge

MEMORANDUM OPINION AND ORDER

Plaintiff Matthew Urbania, Jr. ("Urbania") filed a one-count complaint against Central States Southeast and Southwest Areas Pension Fund ("Central States" or the "Fund") and the Board of Trustees of the Central States Southeast and Southwest Areas Pension Fund (the "Trustees"), alleging denial of disability benefits under the Employee Retirement Income Security Act ("ERISA") § 502 (a) (1) (B), 29 U.S.C. § 1132 (a) (1) (B).

The parties have filed cross-motions for summary judgment pursuant to Federal Rule of Civil Procedure 56, and the plaintiff has filed a motion to amend the complaint. For the reasons set forth below, the Court grants plaintiff's motion to amend the complaint, grants defendants' motion for summary judgment and denies plaintiff's motion for summary judgment.

  BACKGROUND

  The trustees administer the Fund and the Central States Southeast and Southwest Areas Pension Plan (the "Plan"). The Plan is a multi-employer pension fund covered by ERISA. Central States provides pension and disability benefits to covered participants who meet the requirements outlined in the Plan.*fn1

  With respect to the disability benefits Urbania seeks in this case, the Plan provides, in relevant part:
(a) A Participant who sustains a total and permanent disability as hereinafter defined
(1) Prior to his 62nd birthday; and
(2) after completion of 10 years of Credited Service (as defined in Section 3.03) if at least 35 weeks of contributions to the Pension Fund have been made or were required to have been made on behalf of the Participant during each of 5 calendar years of Covered Employment, or at least 225 weeks of contributions have been made or were required to have been to the Pension Fund on his behalf, subject to the Break in Service provisions of Section 3.05; and
(3) after contributions by his last Employer on his behalf under a Collective Bargaining Agreement providing for contributions in amounts at least equivalent to those required for Contribution Class 4 or above;
shall be eligible for a Disability Pension Benefit under this Plan if he is entitled to disability benefits payable under Title II of the Social Security Act (as evidenced by a Certificate of Social Insurance Award) or if said Participant has sustained a disability which would satisfy the medical and physical requirements for such Certificate of Social Insurance Award where the Participant did not receive such Certificate for reasons unrelated to his medical and physical condition.
* * *
(c) Disability, as used herein, shall be deemed to be total and permanent, for purposes of this section, whenever the Participant is wholly disabled by bodily injury or disease, and will as a result be permanently, continuously and wholly prevented for life from engaging in any occupation and performing any work for wage or profit. The6 Trustees will recognize as total and permanent Disability the entire and irrevocable loss of sight in both eyes, or the severance of both hands above the wrist, or both feet above the ankle, or one hand above the wrist and one foot above the ankle.
(d) A Participant shall be eligible for a Disability Pension Benefit if he sustains a total and permanent disability while still in Covered Employment or before sustaining 3 consecutive One-Year Breaks in Service (as defined in Section 3.05(c)).
(Plan at Sect. 4.06). Section 3.05 of the Plan describes Breaks in Service. Specifically, the Plan provides:
(c) On and after January 1, 1976, a Participant shall sustain a One-Year Break in Service at the end of any calendar year in which he receives less than 10 Vesting ServicWeeks. * * *
(g) On and after January 1, 1976, solely for the purposes of determining whether a One-Year Break in Service shall be sustained, a Participant shall be deemed to have received 1 Vesting Service Week for each week in which he was not in Covered Employment as a result of sickness, injury, vacation or disability.
(Plan at Sect. 3.05). The Plan also provides that a Participant receives one Vesting Service Week for "each contribution which is made or is required to be made to the Pension Fund on his behalf". (Plan at Sect. 3.04(b)).

  Urbania became a participant of the Central States Pension Fund due to his employment with various Teamster-industry employers, who made contributions on his behalf to the Fund. Urbania established 9.825 years of contributory service credit with Central States during his industry employment between 1965 and 1981.

  Urbania's Central States-covered employment ended in 1981. After that, Urbania worked for employers not covered by the Plan. For example, in 1982 and 1983, Urbania worked for Page Avjet Corporation in Florida, earning approximately $7,800.00. On June 21, 1982, Urbania injured his back while working in the cockpit of an airplane during his employment with Page Avjet. Urbania filed a workers' compensation claim, which he settled in December 1983.

  Urbania's next position was at Lodge No. 1851, of the Loyal Order of Moose in Sanford, Florida. In 1984, Urbania earned $2457.06 working for the Loyal Order of Moose. In 1985, Urbania earned $2,548.64 working for Alexander-Seewald, Co., Inc. in Georgia and $180.00 working at Eagle Pools in Washington.

  Urbania was injured again on October 16, 1986 while hanging drywall for D.J.'s Drywall, Inc. in Florida. Urbania again filed a workers' compensation claim, which he settled in June 1989.

  In addition to workers' compensation, Urbania also received disability benefits from the Social Security Administration. Urbania received Social Security benefits from June 1982 through December 1983, from November 1986 through May 1988, and from June 1988 through at least October 1999.

  In February 1998, Central States received from Urbania an application for disability benefits. In his application, Urbania stated that he suffered a job-related injury on June 21, 1982. Urbania stated that he was totally disabled, that it was necessary for him to give up all of his duties as of June 21, 1982 and that he had not done any type of work since June 21, 1982.

  In support of Urbania's claim, his union submitted copies of Urbania's workers' compensation claims, Social Security awards and medical records. Among the documents submitted to the Plan was the Administrative Law Judge's October 1990 decision granting Urbania Social Security disability benefits. In the decision, the Administrati Law Judge ("ALJ") noted that Urbania had credibly testified that he became unable to work on June 1, 1988. The ALJ also found that Urbania had suffered an earlier back injury in 1982 but that he had been able to return to work. Urbania was represented by an attorney in connection with the Social Security proceedings.

  Attached to the ALJ's decision were Urbania's medical records, including records from Seminole Orthopaedics. A February 25, 1983 Seminole Orthopaedics medical entry stated, ". . . this man can return to work that does not require him to lift objects weighing more than 25 lbs. next to the axis of the body and objects weighing more than 10 lbs. at arms length from the body." In April 1983, Seminole Orthopaedics encouraged Urbania to return ...


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