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Dapron v. Spire Inc.

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

May 7, 2019

HARRY DAPRON, [1] Plaintiff,
v.
SPIRE, INC. RETIREMENT PLANS COMMITTEE, Defendant.

          MEMORANDUM AND ORDER

          John M. Bodenhausen, United States Magistrate Judge.

         This is an action under § 502(a)(1)(B) of the Employee Retirement Income Security Act (“ERISA”), 29 U.S.C. §1132(a)(1)(B), for judicial review of a decision by the Defendant Spire, Inc. Retirement Plans Committee's (“Committee”) to deny Plaintiff Harry DaPron's (“DaPron”) claim for payment of disability pension benefits. Presently pending before the Court are the parties' cross-motions for summary judgment (ECF Nos. 35 and 47). The motions are fully briefed and ready for disposition. All matters are pending before the undersigned United States Magistrate Judge with the consent of the parties, pursuant to 28 U.S.C. § 636(c). Based upon a review of the file, record and proceedings herein, and for the reasons stated, the Court grants the Committee's motion for summary judgment and denies DaPron's cross motion for summary judgment.

         In the First Amended Complaint (“FAC”), DaPron alleges a wrongful denial of disability benefits claim under ERISA (Count I), arguing that the Committee wrongfully denied him disability benefits because he did not “apply for Disability Retirement benefits in connection with [his] termination.” (ECF No. 32, FAC at ¶ 35) DaPron also alleges a breach of fiduciary duty claim stemming from when the Committee adjudicated his claim for benefits in 2016. (Count II). (Id. at ¶ 50) In particular, DaPron alleges that his employer was aware that his mental condition impaired his judgment, insight and capacity, and prevented him from applying for benefits until 2016. (Id. at ¶ ¶ 47-48) DaPron further alleges that the Committee breached its fiduciary duty by refusing “to consider the medical evidence documenting his incapacity to apply for benefits at the time of his separation from his employment; not investigating whether the plan administrator received notice of his disability and his incapacity to apply for benefits at the time of his separation from his employment; and using an unfair and biased process designed to create evidence to support a denial of benefits.” (Id. at ¶ 50(a)-(c)) DaPron seeks an order of remand with instructions for the Committee to conduct a full and fair review and an award of attorney's fees and costs.

         Fundamental to this Court's function in reviewing the decision of the plan administrator regarding a claim for benefits is the necessity that the Court has a full and complete administrative record. Gentile v. John Hancock Mut. Life Ins. Co., 951 F.Supp. 284, 287 (D.Mass. 1997). DaPron attached two letters, one dated January 27, 2017, and the other dated February 9, 2017 (ECF No. 48-1), as evidence in support of his assertion that the full and complete administrative record has not been filed with the Court. However, to the extent that DaPron presents evidence that was not raised prior to the conclusion of the administrative claims process and the close of the administrative record on January 19, 2017, these letters may not be considered because the Court can consider only the evidence that was before the administrator when the claim was denied. See Brown v. Seitz Foods, Inc. Disability Benefit Plan, 140 F.3d 1198, 1200 (8th Cir. 1998) (“Such additional evidence gathering is ruled out on deferential review, and discouraged on de novo review to ensure expeditious judicial review of ERISA benefit decisions and to keep district courts from becoming substitute plan administrators.”) (internal quotations omitted); Sandoval v. Aetna Life and Cas. Ins. Co., 967 F.2d 377, 381 (10th Cir. 1992) (“In effect, a curtain falls when the fiduciary completes its review, and for purposes of determining if there is substantial evidence supported the decision, the district court must evaluate the record as it was at the time of the decision.”). Accordingly, the undersigned finds that the full and complete Administrative Record has been filed with the Court, and DaPron's assertion denying otherwise is not supported by the record.

         I. Factual Background

         The facts are taken from the Committee's Statement of Uncontroverted Facts (ECF No. 37) and DaPron's Statement of Uncontroverted Material Facts (ECF No. 49). The Committee filed its Response to Plaintiff's Statement of Uncontroverted Material Facts (ECF No. 51); however, DaPron filed a Response to only five of the eighteen paragraphs of the Committee's Statements of Uncontroverted Facts. See ¶¶ 1, 11, 12, 13, and 14.[2] Local Rule 4.01(E) provides with respect to summary judgment motions:

A memorandum in support of a motion for summary judgment shall have attached a statement of uncontroverted material facts, set forth in a separately numbered paragraph for each fact, indicating whether each fact is established by the record, and, if so, the appropriate citations. Every memorandum in opposition shall include a statement of material facts as to which the party contends a genuine dispute exists. Those matters in dispute shall be set forth with specific references to portions of the record, where available, upon which the opposing party relies. The opposing party also shall note for all the disputed facts the paragraph number from movant's listing of facts. All matters set forth in the statement of the movant shall be deemed admitted for purposes of summary judgment unless specifically controverted by the opposing party.

E.D. Mo. L.R. 4.01(E) (“Local Rule 4.01(E). As a result of DaPron's failure to submit responses to ¶¶ 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 16, 17, and 18, DaPron has not met the requirements of Local Rule 4.01(E), and is deemed to have admitted the facts set forth in those paragraphs in the Committee's statements of uncontroverted facts. Turner v. Shinseki, 2010 WL 2555114, at *2 (E.D.Mo. June 22, 2010)(citing Deichmann v. Boeing Co., 36 F.Supp.2d 1166, 1168 (E.D.Mo. 1999), aff'd 232 F.3d 907 (8th Cir. 2000), cert. denied, 531 U.S. 877.

         Moreover, DaPron failed to cite to specific portions of the record to support his objections to ¶¶ 11, 12, 13, and 14 of the Committee's statement of uncontroverted facts. (ECF No. 48 at 1-2) In support of his objections, DaPron asserts that “the citation to particular parts of materials in the record do not support this contention.” (ECF No. 48 at 2) “Those matters in dispute shall be set forth with specific references to portions of the record, where available, upon which the opposing party relies. The opposing party shall also note for all disputed facts the paragraph number from movant's listing of facts. All matters set forth in the statement shall be deemed admitted for the purposes unless specifically controverted by the opposing party.” Local Rule 4.01(E). These objections DaPron has raised that do not cite to the record and are ineffective for purposes of establishing a genuine factual dispute. Accordingly, for purposes of the Committee's motion for summary judgment, DaPron is deemed to have admitted the facts set forth in those paragraphs in the Committee's statements of uncontroverted facts. See Roe v. St. Louis Univ., 746 F.3d 881, (8th Cir. 2014) (If the opposing party does not raise objections to a movant's statement of facts as required by Local Rule 4.01(E), “ a district court will not abuse its discretion by admitting the movant's facts.”); Ridpath v. Pederson, 407 F.3d 934, 936 (8th Cir. 2005) (where plaintiff did not controvert defendant's statement of material fact, it was deemed admitted under Local Rule 4.01(E)).

         With this in mind, the Court accepts the following facts as true for purposes of resolving the cross motions for summary judgment. In March 2010, DaPron was a participant in the Laclede Gas Company Employees' Retirement Plan (“Plan”). (FAC at ¶¶ 1, 32-33 (ECF No. 32)) DaPron voluntarily resigned from his employment on March 2, 2010. (Id. at ¶ 13; Answer to First Amended Complaint at ¶ 13 (ECF No. 34))

         The Plan includes the following disability section:

         ARTICLE VII - DISABILITY

7.1 Disability Date. Any Participant who, at a time when he is employed in Covered Employment, has fifteen or more Years of Credited Service and has then attained the age forty but not age sixty-five, and in the judgment of the Retirement Board, based on competent medical evidence, is unable by reason of any medically determinable physical or mental impairment to perform the duties required by his job, shall be deemed Totally and Permanently Disabled (“Disability”) if there is no work that he is able to perform available to him within the Company.
Such Participant may be retired by the Retirement Board not less than thirty days and not more than ninety days following written application therefore filed with the Retirement Board by such Participant, or in the event such Participant is unable to make such application, then by a member of such Participant's immediate family or his legal representative.

(AR 27 (2009 Restatement) and AR 167 (2014 Restatement))[3]

         Under the Plan, Section 16.3 of the Plan delineates how to file a claim for benefits:

16.3 Filing Claim for Benefits. An Employee or Beneficiary, or the Company acting in his behalf, shall notify the Retirement Board in writing of a claim for benefits under the Plan. Such request shall be in any form acceptable to the Retirement Board, shall set forth the basis of such claim, and shall authorize the Retirement Board to conduct such examinations as may be necessary to determine the validity of the claim. The Retirement Board will take steps necessary to facilitate the payment of any benefits to which the Employee or Beneficiary may be entitled.

(AR 61 (2009 Restatement) and AR 200 (2014 Restatement))

         The Plan provides in Section 7.7, Review of Claim Denial by Retirement Board, the process for reviewing of a decision: “If a review of a decision is requested, such review shall be made by the Retirement Board, which shall review all comments, documents, records, and other information submitted by the claimant relating to the disability claim, without regard to whether such information was submitted or considered in the initial benefit determination.” (AR 30)

         Under the Plan, to file an appeal from the decision of the Retirement Board concerning disability, the following must take place:

         7.8 Appeals from Decisions of Retirement Board Concerning Disability.

(a) In the event any Participant shall object to a decision of the Retirement Board involving a determination of whether the Participant is Totally Disabled so as to be eligible for Retirement under the Article, such appeal shall be submitted to a Medical Appeals Board consisting of one medical doctor selected by the Participant or, if the Participant is a Contract Employee, selected by his duly elected bargaining representative, and one medical doctor selected by the Company. The expense for the Medical Appeals Board shall be borne by the parties as outlined in subsection (b), below. If the two doctors so selected shall be in disagreement with respect to such Participant's disability, a third medical doctor selected by the Dean of the School of Medicine of Washington University, St. Louis, Missouri, shall be appointed as a third member of such Medical Appeals Board. The Participant involved shall be required to provide all medical records requested by the respective doctors and submit to examinations requested by members of such Medical Appeals Board, which Board shall thereafter submit its report in writing to the Retirement Board. A decision on the question of disability, concurred in by a majority of said Medical Appeals Board, shall be final and binding on both the Retirement Board and the Participant or his duly elected bargaining representative.

(AR 31 (2009 Restatement) and AR 171 (2014 Restatement))

         With respect to the standard of review, § 16.7 provides in relevant part:

In particular, the interpretation of all Plan provisions, and the determination of whether a Participant or Beneficiary is entitled to any benefit pursuant to the terms of the Plan, shall be exercised by the Retirement Board in its sole discretion. Any construction of the terms of the Plan for which there is a rational basis that is adopted by the Retirement Board shall be final and legally binding on all parties.

(AR 62-63 (2009 Restatement) and 201-02 (2014 Restatement))

         The 2010 Summary Plan Description (“SPD”)[4] outlined the retirement process as follows:

         RETIREMENT PROCEDURE

You must apply for retirement by submitting a written statement to the Retirement Board of your intention to retire and the date chosen; and apply at least 30 days and no more than 90 days before your intended retirement date. Employee Benefits will provide a form suitable for this if you request it. Retirement dates are limited to the first day of a month.
For Disability Retirement, you must also submit competent medical evidence of total and permanent disability with your application. Totally and Permanently Disabled is defined in the Plan. If you are unable to apply for yourself, a member of your immediate ...

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