Goodberry v. Northrop Grumman Long Term Disability Income Plan, 1999 U.S. App. LEXIS 29507 (9th Cir. November 4, 1999)(unpublished) - Evelyn Goodberry, who worked for Northrop Grumman as a trainer, appealed the denial by Metropolitan Life Insurance Company (MetLife) of her disability benefits claim. This court affirmed the district court’s conclusion that Goodberry was not "totally disabled" under the terms of the plan.
The
district court rightly followed a de novo standard of review because the plan
administrator failed to show that the benefit plan gave the administrator or
fiduciary discretionary authority to determine eligibility for benefits or to
construe the terms of the plan. The plan administrator argued that the summary
plan description conferred such discretion, but the court took issue with this
and further pointed out that regardless of the SPD’s terms, the failure to
disseminate the summary plan description to employees prevented it from being
controlling.
The
district court did not err by failing to require that MetLife consult a
vocational expert because under the "any occupation" standard, such
evidence is not necessarily required. The terms of Goodberry's disability policy
required that she be "unable to engage in any occupation or
employment." MetLife's denial letters, as well as several doctors,
suggested Goodberry could perform virtually any sedentary or light job.
The district court also did not err in failing to consider whether MetLife had met the requirements of "full and fair review." MetLife's denial letter cited the relevant plan provisions, made reference to the medical evidence, and informed Goodberry of the appropriate appeal process. Goodberry had an opportunity to comment on all the reports obtained by MetLife and the notice to her was sufficient.