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Leirer v. The Proctor & Gamble Disability Benefit Plan

United States District Court, E.D. Missouri, Eastern Division

September 29, 2017

GARY LEIRER, Plaintiff,
v.
THE PROCTOR & GAMBLE DISABILITY BENEFIT PLAN, et al., Defendants.

          MEMORANDUM AND ORDER

          AUDREY G. FLEISSIG, UNITED STATES DISTRICT JUDGE.

         This is an action under Section 502(a)(1)(B) of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. § 1132(a)(1)(B), for disability benefits under an employer sponsored disability benefit plan. The matter is before the Court on the cross motions for summary judgment filed by Plaintiff Gary Leirer, and by Defendants The Proctor & Gamble Disability Benefit Plan and related entities. For the reasons set forth below, Plaintiff's motion for summary judgment will be denied, and Defendants' motion for summary judgment will be granted.

         BACKGROUND

         Plaintiff, who was born on August 3, 1955, was employed by The Proctor & Gamble Company, beginning on May 30, 1989, as a line operator and was a member of its Disability Benefit Plan (“DBP”), Long-Term Disability Allowance Policy Plan (“LTDP”), and Optional Disability Insurance Plan (”ODIP”). The DBP (effective January 1, 2008), defines “Total Disability” as follows:

[A] mental or physical condition resulting from an illness or injury which is generally considered totally disabling by the medical profession and for which the Participant is receiving regular recognized treatment by a qualified medical professional. Usually, Total Disability involves a condition of such severity as to require care in a hospital or restriction to the immediate confines of the home. The Trustees reserve the right to determine what is considered as “regular” and “recognized treatment.”

ECF No. 52-22 at 43.

         “Partial Disability” is defined as:

[A] mental or physical condition resulting from an illness or injury because of which the Participant is receiving medical treatment and cannot perform the regular duties of his or her job but can perform other roles at the same site or other jobs outside the Company. Thus, a condition of Partial Disability does not necessarily prevent that Participant from performing useful tasks, utilizing public or private transportation, or taking part in social or business activities outside the home.

Id. at 42. Partial Disability payments are limited to 52 weeks.

         Determination of eligibility is vested with the relevant Trustees under all three Plans. The DBP states:

[The] Trustees have the discretionary authority to interpret the terms of this Plan, to determine the facts underlying any benefits claims, and to determine eligibility for and entitlement to Plan benefits in accordance with the terms of the Plan. Determination by the Trustees as to the interpretations and application of this Plan in any particular case shall be conclusive on all interested parties and their action shall not be subject to any review.

ECF No. 52-23 at 3. The ODIP (effective January 1, 2009) states:

The Trustees of the Plan, in carrying out their responsibilities under the Plan, shall have discretionary authority to interpret the Plan and to determine eligibility for and entitlement to any Plan benefits in accordance with the terms of the Plan. Any interpretation or determination made ...

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