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Walter v. Std. Ins. Co.

United States District Court, W.D. Missouri, Western Division

September 25, 2015

CHRISTOPHER S. WALTER, Plaintiff,
v.
STANDARD INSURANCE COMPANY, Defendant

         Decided September 24, 2015

          For Christopher S. Walter, Plaintiff: Roger M. Driskill, Burnett & Driskill, Liberty, MO.

         For Standard Insurance Company, Defendant: Richard J Pautler, LEAD ATTORNEY, Thompson Coburn LLP-3500, St. Louis, MO.

Page 955

         ORDER GRANTING MOTION FOR SUMMARY JUDGMENT

         ROBERT E. LARSEN, United States Magistrate Judge.

         Before the court is Defendant Standard Insurance Company's motion for summary judgment. For the following reasons, the motion will be granted.

         I. BACKGROUND

         On October 22, 2014, Plaintiff Christopher Walter filed a complaint against Defendant Standard Insurance Company for recovery of employment disability benefits (Doc. No. 1). Defendant filed a motion for summary judgment and suggestions in support (Doc. Nos. 13, 14). Plaintiff filed suggestions in opposition (Doc. No. 19) and Defendant filed a reply (Doc. No. 20).

         II. STANDARD OF REVIEW UNDER ERISA

         When a disability plan gives discretion to the administrator, the administrator's decision is reviewed for abuse of discretion. Green v. Union Sec. Ins. Co., 646 F.3d 1042, 1050 (8th Cir. 2011). " In reviewing for an abuse of discretion, the administrator's decision should be reversed 'only if it is arbitrary and capricious.'" Id. (quoting Midgett v. Washington Grp. Int'l Long Term Disability Plan, 561 F.3d 887, 896 (8th Cir. 2009)). " The administrator's decision should be affirmed if it is reasonable, meaning it is supported by substantial evidence." Green, 646 F.3d at 1050. " Substantial evidence is more than a scintilla but less than a preponderance." Id. " 'The requirement that the plan administrator's decision be reasonable should be read to mean that a decision is reasonable if a reasonable person could have reached a similar decision, given the evidence before him, not that a reasonable person would have reached that decision." Id. (quoting Midgett, 561 F.3d at 897)(quoting Jackson v. Metro. Life Ins. Co., 303 F.3d 884, 887 (8th Cir. 2002))(emphasis in original).

         III. UNCONTROVERTED FACTS

         Below, typed in bold, are the facts offered by Defendant that I find to be uncontroverted by the record before me.

         1. Plaintiff, Christopher S. Walter (" Walter" ) is a former employee of Graham Ship By Truck Company (" Graham" ).

         Plaintiff does not dispute this fact.

         2. While an employee of Graham, Walter was a participant in an employee welfare benefit plan sponsored by Graham that provided disability benefits to eligible, qualifying participants (hereinafter " LTD Plan" ).

         Plaintiff does not dispute this fact.

         3. The LTD Plan was insured by Group Long Term Disability Insurance Policy No. 143812-B issued by Standard (" Policy" ).

         Plaintiff does not dispute this fact.

         4. Walter's W-2 from Graham for 2007 showed wages, tips and other compensation of $50, 270.

         Plaintiff does not dispute this fact.

         5. Walter was injured in a motor vehicle accident on January 17, 2008.

         Plaintiff does not dispute this fact.

         6. Walter's W-2 from Graham for 2008 showed wages, tips and other compensation of 2 $53, 790.

         Plaintiff does not dispute this fact.

         7. Graham advised Standard that during 2008, Walter earned $1, 020/week until late in the year when he earned a raise to $1, 040/week.

         Plaintiff does not dispute this fact.

         8. Graham advised Standard that Walter earned a standard Christmas bonus of $750 in 2008.

Page 956

          Plaintiff does not dispute this fact.

         9. Graham advised Standard that Walter had been involved in a motor vehicle accident on January 17, 2008, that he missed work the following Friday and Monday, that he worked Tuesday and then worked half-days Wednesday, Thursday and Friday before returning full-time on Monday, January 28, 2008.

         Plaintiff does not dispute this fact.

         10. Walter did not submit any evidence that he had missed any work at Graham after January 28, 2008 because of any medical condition.

Plaintiff disputes this proposed fact, citing evidence that he had doctors' appointments on September 29, 2008, October 27, 2008, December 2, 2008 and December 23, 2008. This fact is remains controverted.

         11. According to the terms of the Policy, an individual was " Disabled" from his Own Occupation:

If as a result of Physical Disease, Injury, Pregnancy or Mental Disorder:
1. You are unable to perform with reasonable continuity the Material Duties of your Own Occupation; and
2. You suffer a loss of at least 20% in your Indexed Pre disability Earnings when working in your Own Occupation.

         Plaintiff does not dispute this fact.

         12. The LTD Plan includes a 90-day Benefit Waiting Period.

         Plaintiff does not dispute this fact.

         13. The Benefit Waiting Period " means the period you [i.e. the participant] must be continuously Disabled before LTD Benefits become payable. No LTD Benefits are payable for the Benefit Waiting Period."

         Plaintiff does not dispute this fact.

         14. Under the terms of the LTD Plan, a participant's insurance ended automatically on the date his employment terminated.

         Plaintiff does not dispute this fact.

         15. Walter submitted a claim to Standard for LTD Plan benefits in July 2011.

         Plaintiff does not dispute this fact.

         16. In its Employer's Statement submitted as a part of Walter's claim, Graham reported that Walter " was layed (sic) off in 1-2009 and was not disabled" and that Walter's employment terminated because " Layed off -- economic reasons 1-2009."

         Plaintiff does not dispute this fact.

         17. In an email, Graham advised Standard that Walter's employment with Graham (along with that of another employee) terminated January ...


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