United States District Court, N.D. Illinois, Eastern Division
MEMORANDUM OPINION AND ORDER
ELAINE E. BUCKLO, District Judge.
Kirk Meyers ("Meyers") has sued the Sheet M Workers' Local No. 73 Pension Fund ("Fund") under the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1132(a)(1)(B), to recover benefits allegedly owed to him under a disability pension plan.
The parties have filed cross motions for summary judgment. I grant Meyers's motion and deny the Fund's cross motion for the reasons stated below.
At all relevant times, Meyers was a member of the Sheet M Workers' International Association, Local Union No. 73 ("Union"). Since 1985, Meyers has performed sheet m work for several employers who were contractually required to contribute to the Fund based on the number of hours he worked. The Fund, in turn, administers the Sheet M Workers Local No. 73 Pension Plan ("Plan"). Among other benefits, the Plan provides disability pensions to participants who have earned a sufficient number of credits. Meyers could earn up to one pension credit each calendar year if he worked at least 1, 200 hours for contributing employers. He could also receive up to two pension credits for any disability arising in covered employment for which he received workers' compensation benefits.
On September 14, 2005, while working for a contributing employer, Meyers's right foot was crushed by a 4, 000 pound lift driven by another employee. After the injury, Meyers continued to work for contributing employers until December 2005. R. 558-59. He stopped working in December 2005 and remained off work until April 2006 because of his injury. R. 559. Meyers received workers' compensation benefits during this four to five month period, for which he received 760 hours or seven-twelfths of a pension credit. Id.
Meyers resumed working for contributing employers in April 2006 and earned a full pension credit in 2006 and 2007. R. 558-59. In 2008, however, Meyers earned no pension credit because he worked only 70.5 hours for contributing employers. R. 559. His only other period of covered employment was in February 2009 when he worked 107.5 hours, which was enough to earn one-twelfth of a pension credit. Id.
In July 2008, as his hours of covered employment were dwindling, Meyers applied for a disability pension based on the injuries he sustained in September 2005. Section 3.9 of the Plan provides that:
(a) A Participant shall be eligible for a Disability Pension if he meets the following requirements:
(i) He becomes Totally and Permanently Disabled;
(ii) He has at least 10 Pension Credits of which at least 4 were earned during the Contribution Period;
(iii) He earned at least 1/2 Pension Credit in Covered Employment during the Contribution Period within the twelve-month period immediately preceding the time he became Totally and Permanently Disabled; [and]
(iv) After January 1, 1990, he has not at any time performed any employment in the Sheet M Industry at a position not covered by a Collective Bargaining Agreement between the Union and the Employee.
R. 627. Only the first and third requirements are at issue in this case.
In order to determine whether a pension applicant is "totally and permanently disabled, " the Plan requires applicants to "submit to an examination by a competent physician or physicians selected by the Trustees." R. 629. The Fund selected Dr. Steven DeAngeles, M.D., to examine Meyers in July 2008. After acknowledging Meyers's complaints about persistent pain in his right foot, Dr. DeAngeles stated, "I don't doubt the patient's description of his pain but I was unable to objectively identify a cause for this pain." Pl.'s Ex. D. Therefore, in Dr. DeAngeles's opinion, Meyers was not totally and permanently disabled. Id.
An initial review committee denied Meyers's pension application in August 2008. Meyers appealed the committee's decision to the Fund's Board of Trustees ("Trustees"), which was comprised of three Union representatives and three employer representatives. The Trustees rejected Meyers's appeal in November 2008 because a recent functional assessment showed that he could perform work at the medium to heavy physical demand level, which included sheet m work. See Pl.'s Ex. C. Meyers declined to seek judicial review of the Trustees' decision.
In April 2011, over two years after he last performed sheet m work, Meyers reapplied for a disability pension. Meyers identified September 2005 as the date when he first became disabled with complex regional pain syndrome ("CRPS"). R. 555. In support of his application, Meyers submitted his work history and the six medical records:
1. a May 27, 2008 letter from Dr. Tariq Malik, M.D., of the University of Chicago Hospitals in which he diagnosed Meyers with "right foot neuropathic pain versus RSD" and "right foot neuropathic pain versus CRPS" (R. 562);
2. a July 23, 2009 report from Dr. Rodney Stuck, D.P.M., of Loyola University in which he reached the same ...