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Cooper v. Metropolitan Life Insurance Co.

United States Court of Appeals, Eighth Circuit

July 5, 2017

Michelle E. Cooper Plaintiff- Appellant
v.
Metropolitan Life Insurance Company Defendant-Appellee MetLife, Inc. Defendant

          Submitted: April 6, 2017

         Appeal from United States District Court for the Eastern District of Missouri - St. Louis

          Before WOLLMAN and LOKEN, Circuit Judges, and NELSON, [1] District Judge.

          NELSON, District Judge.

         Michelle Cooper brought this action pursuant to the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1132(a)(1)(B), claiming that Metropolitan Life Insurance Company ("MetLife") improperly denied her long term disability ("LTD") benefits under a group insurance plan sponsored by her former employer, Anheuser-Busch Companies, LLC ("Anheuser-Busch"). The district court[2]entered summary judgment in favor of MetLife, finding that there was no abuse of discretion. Cooper now appeals from that decision, arguing that the court erred in applying an abuse of discretion standard of review to MetLife's decision, and that it improperly excluded two affidavits from the record. Alternatively, Cooper contends that MetLife abused its discretion in denying LTD benefits. Finding no error, we affirm.

         I.

         From August 2008 until May 2012, Cooper worked at Anheuser-Busch as a business-to-business coordinator. Her responsibilities in that position consisted primarily of acting as a point of contact for customers, which she accomplished through use of the phone, email, and social networks. Through her employment, Cooper was a participant in the Group Insurance Plan for Certain Employees of Anheuser-Busch Companies, LLC and its Subsidiaries (the "Plan"). Disability benefits under the Plan are funded by MetLife, which, as the Plan's claim fiduciary, is also responsible for adjudicating claims for those benefits. For purposes of LTD benefits, the Plan defines the terms "disabled" and "disability" as follows:

Disabled or Disability means that, due to Sickness or as a direct result of accidental injury:
You are receiving Appropriate Care and Treatment determined by Your Physician as necessary to treat the Sickness or injury;
You are complying with the requirements of such treatment; and
You are unable to earn:
during the Elimination Period and the next 24 months of Sickness or accidental injury, more than 80% of Your Predisability Earnings or adjusted Predisability Earnings at Your Regular Occupation from any employer in Your Local Economy; and
after such period, more than 80% of Your Predisability Earnings from any employer in Your Local Economy at any gainful occupation for which you are reasonably qualified taking into account Your training, education and experience.

         Due to illness, Cooper ceased working at Anheuser-Busch in October 2011. On November 4, 2011, she submitted an initial claim with MetLife for short term disability ("STD") benefits. To support her claim, Cooper provided a Supplemental Attending Physician Statement ("APS") completed by her physician, Dr. Varsha Rathod, which listed Cooper's primary diagnosis as "Sjogren's syndrome/SLE [systemic lupus erythematosus], " and her secondary diagnosis as migraine headaches. Dr. Rathod subsequently determined that Cooper could return ...


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