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Hatton v. Ingersoll Rand Company Limited Benefit Administration Committee

United States District Court, W.D. Arkansas, Fort Smith Division

May 31, 2019




         Before the Court is an action under the Employee Retirement Income Security Act of 1974 (“ERISA”), initiated by Plaintiff Ronnie Hatton's complaint (Doc. 1). Defendant Ingersoll Rand Company Limited Benefits Administration Committee (“Ingersoll”) filed an answer (Doc. 6), and the parties submitted a stipulated administrative record (Doc. 9). Hatton then filed a motion for summary judgment (Doc. 12), statement of facts (Doc. 14), and a brief in support (Doc. 13). Defendant filed a response in opposition (Doc. 16), and a response to Hatton's statement of facts (Doc. 15). For the following reasons, Hatton's motion for summary judgment will be DENIED and summary judgment will be entered in favor of Defendant Ingersoll.[1]

         I. Background

         Mr. Hatton's employment with Trane U.S. Inc. (“Trane”) began in February of 1990 at its Fort Smith facility. (Doc. 9, p. 926). Hatton worked as a machine operator for Trane until May 15, 2014. Id. In this role, Hatton was making $28, 800.49 as a base salary and his annual compensation was $40, 553.24 when benefits and overtime were included. (Doc. 14, p. 1). On December 9, 2014, Hatton applied for disability benefits under the Trane Merged Hourly Pension Plan. (Doc. 9, p. 1309). Hatton's physician, Dr. Donna Shipley, noted that his diagnosis was “knee pain from [osteoarthritis]” and back pain from degenerative disc disease of the spine. (Doc. 9, p. 1311). Shipley identified Hatton as having a “severe limitation of functional capacity: incapable of minimal (sedentary) activity.” Id. In response to this claim, the Ingersoll-Rand Company Benefits Administration Committee (“BAC”) reviewed Hatton's claim.[2](Doc. 9, p. 1307). The BAC initiated a medical records review by Dr. William C. Andrews. (Doc. 9, p. 1329). Dr. Andrews determined based on a conversation with Dr. Shipley and a review of Hatton's medical records that Hatton “would be capable of working eight hours per day, 40 hours per week” in a sedentary capacity. (Doc. 9, p. 1330). At the time, the BAC defined disability under the pension plan as “disabled from performing further work for any occupation for remuneration or profit prior to his Severance Date, and in the Company's opinion is likely to remain so disabled continuously and permanently.” (Doc. 9, p. 1331). Based on Dr. Andrews's report, the committee denied Hatton's claim for disability benefits. (Doc. 9, p. 1307). On June 29, 2015, Hatton appealed the BAC's decision. (Doc. 9, p. 1334). The BAC had Hatton undergo an Independent Medical Examination (“IME”) by Kevin Trangle, a board-certified internist. (Doc. 9, p. 889). Dr. Trangle completed a thorough review of Hatton's medical history and concluded that he likely had “physical and functional limitations, ” but “is not precluded . . . from working in a sedentary occupation.” (Doc. 9, p. 905). Thus, Dr. Trangle concluded that Hatton's medical history did not establish that the claimant was totally disabled from performing further work by the definition of “any occupation for remuneration or profit.” (Doc. 9, p. 906). On August 25, 2015, the BAC denied Hatton's appeal and concluded that documentation from Hatton's medical providers as well as the reports from independent medical specialists demonstrated a lack of evidence that his medical conditions precluded him from working in any occupation. (Doc. 9, p. 892). On November 9, 2015, Hatton's attorney reached out to Ingersoll seeking Hatton's records from the administrative appeal. (Doc. 9, p. 886). In response, Ingersoll sent Hatton's attorney the records and shared with him that Ingersoll was reopening Hatton's claim for disability benefits in light of this Court's order in Betnar v. Ingersoll Rand Company Limited, Case 2:14-cv-02032, that directed Ingersoll to conduct a vocational review in its determination of disability pension claims.[3]

         On January 21, 2016, BAC scheduled a functional capacity evaluation for Hatton with Mike Williams, a physical therapist at WorkStrategies. Williams concluded that Hatton demonstrated the ability to function in “Light Physical Demand Category for an 8 hour day . . . based on his material handling capabilities.” (Doc. 9, p. 838). Williams noted that the results of his evaluation “cannot be considered an accurate representation of Mr. Hatton's maximal functional capacity” due to inconsistency during testing. Id. Williams notes in his report that he believed Hatton did not put forth maximum effort while completing the tests. Id. The committee also had a vocational employability assessment completed for Hatton. (Doc. 9, p. 830). The assessment determined that based on Hatton's functional capacity allowing for sedentary to light physical work, there were 49 occupational titles that matched his skills. (Doc. 9, p. 832). Of those titles, 2 were considered good matches, 14 were considered fair matches and 33 were considered potential matches. Id. Wage data for those occupations averaged $28, 360 annually. (Doc. 9, p. 833).

         After receiving the functional capacity analysis and the vocational employability assessment, the BAC determined that Hatton's claim should be denied again. (Doc. 9, p. 816). In its letter of denial, the BAC notes that because the base salaries of the occupations identified as matches for Hatton's functional capacity were equal to or greater than his base salary when he left Trane, he was not disabled under the Plan because “there were jobs that permit [Hatton] to earn a reasonably substantial income from [his] employment, rising to the dignity of an income or livelihood.” (Doc. 9, p. 817). Hatton appealed the decision of the BAC. In his appeal, Hatton argued that the BAC's denial of his claim was based on “cherry picked information” and supplemented Hatton's claim file with a functional capacity assessment completed by Velvet Medlock, a physical therapist. Medlock determined from her tests that Hatton's functional capacity was “below sedentary secondary to his inability to tolerate any prolonged posture of more than 20 minutes.” (Doc. 9, p. 48). After receiving Hatton's second appeal, Ingersoll had Hatton's entire claim file reviewed again by Dr. Josette Boukhalil-Laklak, another independent physician procured through Trangle & Associates.[4] Dr. Laklak determined that although Hatton has “a complex medical history with multiple chronic medical conditions . . . Hatton is able to stand and walk for 3 hours, lift up to 10 pounds, and push and pull up to 20 pounds. There are no limitations regarding sitting. However, none of these conditions are severe enough to preclude him from performing any occupation.” (Doc. 9, p. 21).

         On August 8, 2017, the BAC denied Hatton's appeal. In its decision letter, the BAC noted that it credited the functional capacity evaluation of Williams over the evaluation by Medlock because Williams's evaluation was more thorough due to the “detailed and well supported testing” conducted by Williams. (Doc. 9, p. 22). The BAC noted that Hatton's decline noted in Medlock's evaluation may also have been the result of Hatton's cardiac condition, which presented after Hatton filed his disability claim in 2014. Id. The BAC also found that Williams's testing appeared in line with the findings of two reviewing physicians. Id. The BAC also considered the vocational employability assessment and explained that Hatton was not disabled under the plan because the base salaries of the occupations found to be suitable for Hatton's skills and functional capacity were equal to or greater than Hatton's base wages when he left Trane. Id. On July 16, 2018, Hatton filed this action asking the Court to overturn the BAC's decision. (Doc. 1).

         II. Legal Standard

         Once a plaintiff in an ERISA action has exhausted his administrative remedies under a benefits plan, a reviewing court's function is to examine the record that was before the administrator of the plan at the time the claim was denied. Farfalla v. Mut. of Omaha Ins. Co., 324 F.3d 971, 974-75 (8th Cir. 2003); Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989). When a plan gives the administrator discretionary authority to determine a participant's eligibility for benefits, the Court reviews the decision for abuse of discretion, and will defer to the determination made by the administrator or fiduciary unless such determination is arbitrary and capricious. Firestone, 489 U.S. at 115; McGee v. Reliance Standard Life Ins. Co., 360 F.3d 921, 924 (8th Cir. 2004); Schatz v. Mut. of Omaha Ins. Co., 220 F.3d 944, 946 n.4 (8th Cir. 2000) (“[R]eview for an ‘abuse of discretion' or for being ‘arbitrary and capricious' is a distinction without a difference . . . .”). The Court considers five factors to determine whether the decision was supported by a reasonable explanation or was instead an abuse of discretion:

(1) whether the administrator's interpretation is consistent with the goals of the Plan;
(2) whether the interpretation renders any language in the plan meaningless or internally inconsistent;
(3) whether the administrator's interpretation conflicts with the substantive or procedural requirements of the ERISA statute;
(4) whether the administrator interpreted the relevant terms ...

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