District Court Judge Invites the 11th Circuit Court of Appeals to Reverse Him
The Honorable William Acker, sitting in the United States District Court for the Northern District of Alabama, was not shy in letting his opinion be known, when he lambasted the entire ERISA benefits review process – from the fiduciary’s administrative claims handling to the 11th Circuit’s unique six-step methodology in reviewing the fiduciary’s decision – even while ruling in favor of the defendants.
The case itself, May v.AT&T et al. 2013 U.S. Dist. LEXIS 105023 (N.D. Ala., July26, 2013), was ordinary in the ERISA benefit case sense. In fact, Judge Acker observed that the employee benefits at issue involved only a portion of the short-term disability period, and he questioned why the fiduciary was fighting with such “vigor and adversarial zeal” in a dispute involving “chump change.” Judge Acker then took the opportunity to editorialize on the dichotomy contained in the teachings of MetLife v. Glenn: Certain conflicts-of-interest, says Glenn, are indisputable, yet the “mere existence of a conflict” is one factor, among many. Judge Acker mused that “the word ‘mere’ rhymes with ‘sneer,’” which is “like saying ‘she had a mere case of terminal cancer.‘”
Next, Judge Acker took issue with the “sacrosanct” limit on the scope of admissible evidence to the administrative record. He found irony in the defendants’ emphasis during original briefing to the magistrate judge on the SSA’s denial of Plaintiff’s SSD benefits as support for defendants’ own denial, yet later filing a motion to strike Plaintiff’s proffer of the SSA’s subsequent approval, on the grounds that the SSA’s decision was outside of the administrative record. Judge Acker conceded that he would have to grant the motion to strike, unless he chose instead to remand to the fiduciary for consideration of the SSA’s benefit approval. As to the latter option, he predicted that a remand would be a waste of time and expense for the claimant “in light of the virtually universal experience by ERISA claimants that reconsideration by an inherently conflicted plan administrator is rarely if ever worthwhile.”
In ultimately ruling in defendant’s favor, Judge Acker found that the fiduciary’s decision was de novo wrong (reversing the magistrate judge’s finding), but he nevertheless conceded that he could not hold that the fiduciary’s determination was arbitrary and capricious without being reversed under controlling Eleventh Circuit authority. He ruled with a sarcastic undertone that “it was not ‘unreasonable’ for Sedgwick to prefer the opinion of its own hired physicians over the findings of Ms. May’s treating physicians, … [and] because Sedgwick’s obvious conflict-of-interest is a “mere” factor that can be discounted into virtual oblivion, this court defers to Sedgwick’s discretion.”
In concluding, Judge Acker gave Plaintiff the “unsolicited advice” to forego an appeal, citing insurmountable odds. Nevertheless, Judge Acker made it known that, in the event Plaintiff appealed, “his feelings would not be hurt” if he were reversed.
The case itself, May v.AT&T et al. 2013 U.S. Dist. LEXIS 105023 (N.D. Ala., July26, 2013), was ordinary in the ERISA benefit case sense. In fact, Judge Acker observed that the employee benefits at issue involved only a portion of the short-term disability period, and he questioned why the fiduciary was fighting with such “vigor and adversarial zeal” in a dispute involving “chump change.” Judge Acker then took the opportunity to editorialize on the dichotomy contained in the teachings of MetLife v. Glenn: Certain conflicts-of-interest, says Glenn, are indisputable, yet the “mere existence of a conflict” is one factor, among many. Judge Acker mused that “the word ‘mere’ rhymes with ‘sneer,’” which is “like saying ‘she had a mere case of terminal cancer.‘”
Next, Judge Acker took issue with the “sacrosanct” limit on the scope of admissible evidence to the administrative record. He found irony in the defendants’ emphasis during original briefing to the magistrate judge on the SSA’s denial of Plaintiff’s SSD benefits as support for defendants’ own denial, yet later filing a motion to strike Plaintiff’s proffer of the SSA’s subsequent approval, on the grounds that the SSA’s decision was outside of the administrative record. Judge Acker conceded that he would have to grant the motion to strike, unless he chose instead to remand to the fiduciary for consideration of the SSA’s benefit approval. As to the latter option, he predicted that a remand would be a waste of time and expense for the claimant “in light of the virtually universal experience by ERISA claimants that reconsideration by an inherently conflicted plan administrator is rarely if ever worthwhile.”
In ultimately ruling in defendant’s favor, Judge Acker found that the fiduciary’s decision was de novo wrong (reversing the magistrate judge’s finding), but he nevertheless conceded that he could not hold that the fiduciary’s determination was arbitrary and capricious without being reversed under controlling Eleventh Circuit authority. He ruled with a sarcastic undertone that “it was not ‘unreasonable’ for Sedgwick to prefer the opinion of its own hired physicians over the findings of Ms. May’s treating physicians, … [and] because Sedgwick’s obvious conflict-of-interest is a “mere” factor that can be discounted into virtual oblivion, this court defers to Sedgwick’s discretion.”
In concluding, Judge Acker gave Plaintiff the “unsolicited advice” to forego an appeal, citing insurmountable odds. Nevertheless, Judge Acker made it known that, in the event Plaintiff appealed, “his feelings would not be hurt” if he were reversed.
1 Comments:
The Honorable William Acker again provides a commentary on ERISA jurisprudence in Criss v. Union Security Ins. Co., 2014 U.S Dist. Lexis 79300, 2014 WL 2707774 (June 11, 2014). In a case he ultimately remands, Judge Acker laments that the "fundamental jurisprudential principle" coined by Chief Justice Coke in 1610 - "No man should be a judge in his own case" - is institutionally violated by the plan administrators and insurers who are given the authority (via Firestone v. Bruch) to rule on whether they have to pay benefits.
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