The opinion of the court was delivered by: G. Patrick Murphy United States District Judge
Ralph Lilley filed this case under 29 U.S.C. § 1132 (ERISA) because he was denied permanent disability benefits. Lilley has worked as a member of the United Automobile, Aerospace, and Agricultural Implement Workers of America ("UAW") for Chrysler's truck plant since 1976, and, during the course of his employment, he sustained several back injuries resulting in at least partial disability. He is a member of the pension plan ("Plan") administered jointly by the Union and the Corporation through the DaimlerChrysler-UAW Pension Board of Administration ("Pension Board").
Lilley filed for permanent disability with the Pension Board; his claim was denied on January 28, 2003. He filed again on May 3, 2003; that claim was denied on August 25, 2003. His appeal of that decision was denied on February 6, 2004.
Lilley then commenced this action against DaimlerChrysler Corporation -- UAW Pension Plan, DaimlerChrysler Corporation -- UAW Pension Board of Administration, Chrysler Corporation, LLC, Chrysler Holding, LLC, and DaimlerChrysler AG on January 29, 2008, in Madison County, Illinois. Defendants removed to this Court on March 24, 2008.
Lilley seeks a reversal of the Pension Board determination that he was not eligible for permanent disability. In his second amended complaint (Doc. 48), he adds the claim that the Pension Board did not comply with the procedural requirements of ERISA. Lilley prays for the decision to be vacated and this issue to be remanded to the Pension Board for a rehearing following the appropriate procedures, or, in the alternative, for this Court to review his claim de novo.
Defendants have filed a motion for summary judgment (Doc. 36) claiming that the Pension Board's decision is subject to deferential review, only to be overturned if its decision was "arbitrary or capricious."*fn1 Lilley responded to Defendant's motion, but he did not file a dispositive motion of his own.
The relevant facts are not in dispute. Lilley first injured his back in 1994 and again in 1996, finally stopping work for a period in 2001. He returned to work in October 2001 with permanent job restrictions, and, while he has chronic back problems, including degenerative disc disease, according to Defendant, at least two jobs have been available at the plant that meet his physical limitations since his first job restrictions.
Several doctors have examined Lilley throughout the administrative process. The first doctor was Dr. Gornet, Lilley's treating physician. The initial Pension Board determination of this claim ruled that Lilley was not permanently disabled. The next doctor to examine Lilley was Dr. Pinada, who determined that Lilley was, in fact, permanently disabled. As discussed below, however, there are problems with Dr. Pinada's conclusions.
During the Pension Board review process, Dr. Malak (employed by DaimlerChrysler as plant physician) and Dr. Tate (employed by the Pension Board) both determined that Lilley was not permanently disabled because there were two or three jobs at the plant that Lilley could work at with the permanent restrictions agreed upon by all doctors. The Pension Board denied Lilley's last claim for permanent disability based on these opinions. He appealed this latest claim for permanent disability through a lawyer, but failed to submit any further medical information and, therefore, his appeal was denied by the Pension Board on February 6, 2004.
The standard of review for analyzing a decision by a pension board varies depending on the language of the plan. The Court may give an "informed and independent judgment" of an employee's claim for benefits, making its own interpretation of the language of the plan, analyzing any evidence presented to the administrator, and allowing new evidence to be admitted at its discretion. Patton v. MFS/SunLife Financial Distributors, Inc., 480 F.3d 478, 485-6 (7th Cir. 2007) (internal citations omitted). However, clear language in the plan itself that gives the administrator "discretionary authority to determine eligibility for benefits" restricts the standard of review. Such language must give the administrator the ability assess compliance, interpret the rules, implement the rules, and even to change them entirely. Diaz v. Prudential Ins. Co. of Am., 424 F.3d 635, 639 (7th Cir. 2005). If this language exists, the Court must give due deference to the determination of the pension board.
In the present case, the Plan grants discretionary authority to the Pension Board to interpret the plan and to determine eligibility and the amount of benefits to which an employee is entitled (see Administrative Record, p. 0114). Under this language, this Court must use a deferential standard of review when analyzing the actions of the Pension Board. Only if a decision reached ...