Filed: Jan. 14, 2008
Latest Update: Feb. 12, 2020
Summary: UNPUBLISHED UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 06-2112 In Re: WILBER BUDDYHIA MARSHALL, Debtor. - JANET M. MEIBURGER, Trustee; WILBER BUDDYHIA MARSHALL, Plaintiffs - Appellants, versus THE BERT BELL/PETE ROZELLE NFL PLAYER RETIREMENT PLAN, Defendant - Appellee. Appeal from the United States District Court for the Eastern District of Virginia, at Alexandria. Gerald Bruce Lee, District Judge. (1:06-cv-00075; 02-80496; 04-1020-RGM) Argued: October 31, 2007 Decided: January 14
Summary: UNPUBLISHED UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 06-2112 In Re: WILBER BUDDYHIA MARSHALL, Debtor. - JANET M. MEIBURGER, Trustee; WILBER BUDDYHIA MARSHALL, Plaintiffs - Appellants, versus THE BERT BELL/PETE ROZELLE NFL PLAYER RETIREMENT PLAN, Defendant - Appellee. Appeal from the United States District Court for the Eastern District of Virginia, at Alexandria. Gerald Bruce Lee, District Judge. (1:06-cv-00075; 02-80496; 04-1020-RGM) Argued: October 31, 2007 Decided: January 14,..
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UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 06-2112
In Re: WILBER BUDDYHIA MARSHALL,
Debtor.
------------------------
JANET M. MEIBURGER, Trustee; WILBER BUDDYHIA
MARSHALL,
Plaintiffs - Appellants,
versus
THE BERT BELL/PETE ROZELLE NFL PLAYER
RETIREMENT PLAN,
Defendant - Appellee.
Appeal from the United States District Court for the Eastern
District of Virginia, at Alexandria. Gerald Bruce Lee, District
Judge. (1:06-cv-00075; 02-80496; 04-1020-RGM)
Argued: October 31, 2007 Decided: January 14, 2008
Before MICHAEL, KING, and DUNCAN, Circuit Judges.
Reversed and remanded by unpublished per curiam opinion.
ARGUED: William Daniel Sullivan, TIGHE, PATTON, ARMSTRONG &
TEASDALE, P.L.L.C., Washington, D.C., for Appellants. Lonie Anne
Hassel, GROOM LAW GROUP, CHARTERED, Washington, D.C., for Appellee.
ON BRIEF: Janet M. Meiburger, THE MEIBURGER LAW FIRM, P.C., McLean,
Virginia, for Appellant Janet M. Meiburger. Douglas W. Ell, GROOM
LAW GROUP, CHARTERED, Washington, D.C., for Appellee.
Unpublished opinions are not binding precedent in this circuit.
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PER CURIAM:
Wilber B. Marshall, Jr., and his trustee in bankruptcy
sued the Bert Bell/Pete Rozelle NFL Player Retirement Plan and the
NFL Player Supplemental Disability Plan (together, the Plan) under
the Employee Retirement Income Security Act (ERISA), 29 U.S.C.
§ 1132(a)(1)(B). Marshall and the trustee sought a determination
that (1) the Plan’s Retirement Board (the Board) erred in
determining the onset date of Marshall’s total and permanent
disability, and that (2) he was entitled to retroactive benefits
for an additional eight-month period. The Board arbitrarily
selected the date of a doctor’s examination as the onset date. The
record, however, contained evidence establishing an earlier onset
date, and the bankruptcy court entered judgment in favor of
Marshall and the trustee. The district court reversed. Because we
conclude that the bankruptcy court’s ultimate determination was
correct, its judgment will be reinstated.
I.
A.
The Plan provides disability benefits to a vested
inactive (or retired) football player who qualifies as “totally and
permanently disabled.” J.A. 39. According to the terms of the
Plan, an applicant for benefits is considered to be totally and
permanently disabled if he is “totally disabled to the extent that
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he is substantially prevented from or substantially unable to
engage in any occupation or employment for remuneration or profit.”
J.A. 41. A benefits recipient may be required to submit to
periodic physical examinations for the purpose of reevaluating his
condition; if total and permanent disability ends, benefits are
terminated. In the event of termination, a beneficiary may reapply
for benefits. The Plan provides that benefits are awarded
“retroactive to . . . the first of the month following the date of
the total and permanent disability,” but not more than forty-two
months prior to the date the Board receives the application for
benefits. J.A. 39.
The Plan is administered by the Board, whose voting
membership consists of three representatives of the NFL Management
Council and three representatives of the National Football League
Players Association (NFLPA). The Plan grants the Board “full and
absolute discretion, authority and power” to decide claims for
benefits and to interpret the terms of the Plan. J.A. 49-50. If
the Board deadlocks on whether a retired player qualifies as
totally and permanently disabled, it may by a three-member vote
request that the player be examined by a medical advisory physician
(MAP), a board-certified orthopedic physician jointly designated by
the NFL Management Council and the NFLPA. MAP decisions are final
and binding upon the Board.
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B.
Marshall played NFL football for twelve seasons, retiring
in 1995. As a result of injuries sustained during his playing
career, Marshall has degenerative arthritis in both knees, his
right elbow, his left shoulder, both ankles, his spine, and his
hands. As a vested inactive player under the Plan, he qualifies
for disability benefits if he is determined to be totally and
permanently disabled.
Marshall first applied for disability benefits in 1997.
Based on a finding by neutral physician Dr. Royer Collins on March
6, 1997, that Marshall could do sedentary work, the Board denied
the application. Marshall appealed in November of 1997 and was
referred to a MAP, Dr. James E. Tibone, who examined Marshall on
February 5, 1998, and determined that he was totally and
permanently disabled. The Board awarded Marshall benefits
retroactive to April 1, 1997. In 1999 Marshall was again examined
by Dr. Collins who found that he remained totally and permanently
disabled.
In February of 2000 the Board received two unsolicited
physicians’ reports: one from Dr. Collins, who opined that
Marshall was still totally and permanently disabled; and one from
Dr. Richard Zipnick, who, in the course of treating Marshall for an
unrelated condition, opined that he was capable of doing desk work.
The Board consulted Dr. Collins, who then agreed with Dr. Zipnick’s
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conclusion that Marshall could work. The Board next referred
Marshall to a MAP, Dr. Bernard Bach, who reported on September 11,
2000, that Marshall did not meet the criteria for total and
permanent disability and that he could work in a sedentary
position. At its meeting on April 12, 2001, the Board terminated
Marshall’s benefits effective April 27, 2001. Marshall’s June 5,
2001, appeal to the Board was denied on August 2, 2001.
On November 13, 2001, Marshall reapplied for disability
benefits. The Board referred him to a neutral physician, Dr.
Walter Doren, who examined him on December 7, 2001. Dr. Doren
reported on January 3, 2002, that Marshall was unable to work and
that based on a review of Marshall’s medical records, his symptoms
had remained consistent since his initial evaluation in 1997. The
Board then referred Marshall to a MAP, Dr. Alfred Tria, who
reported on February 21, 2002, that Marshall was totally and
permanently disabled. Based on Dr. Tria’s report, the Board
renewed Marshall’s benefits, to commence on March 1, 2002 (the
first of the month after the examination by Dr. Tria). Marshall
then sent the Board two letters, the first requesting that the
effective date for the benefits be changed to December 2001 and the
second requesting that it be changed to February 8, 2002. The
Board changed the effective date to January 1, 2002, the first day
of the month after Marshall was examined by Dr. Doren.
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In the meantime, on February 5, 2002, Marshall filed a
voluntary petition under chapter 11 of the bankruptcy code. In
early 2004 Marshall’s bankruptcy trustee initiated an adversary
proceeding, filing a complaint (later joined by Marshall) against
the Plan. The complaint, brought under ERISA, sought benefits
(approximately $72,000) that were denied to Marshall for an eight-
month period, May 2001 through December 2001. The parties cross-
moved for summary judgment based on the administrative record.
After a hearing in the summary judgment proceedings, the bankruptcy
court (1) noted that the Plan requires benefits to be awarded
retroactively to the first of the month following the onset of
disability, and (2) that it was an abuse of discretion in this case
for the Board to use the date of Dr. Doren’s medical examination as
the onset date. The bankruptcy court asked the parties for
memoranda on whether the question of the actual onset date should
be remanded to the Board or whether the court should decide it,
either on the administrative record or by taking additional
evidence. In its supplemental memorandum the Plan argued against
either a remand to the Board or an evidentiary hearing in
bankruptcy court and asked the court to decide the case based on
the administrative record. After requesting additional briefing on
the merits and considering the record, including Dr. Doren’s report
concluding that Marshall’s symptoms had remained consistent since
his first disability award, effective April 1997, the bankruptcy
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court determined that Marshall should receive benefits retroactive
to May 1, 2001. The court also assessed attorney fees and costs
against the Plan.
The Plan appealed this decision to the district court.
The district court reversed, concluding that the Board’s decision
to award benefits retroactive only to January 1, 2002, was
supported by substantial evidence and was reasonable. Marshall now
appeals the district court’s decision to this court.
II.
A.
We review the decision of a district court sitting in
review of a bankruptcy court de novo, applying the same standards
of review that were applied in the district court; specifically, we
review the bankruptcy court’s findings of fact for clear error and
its conclusions of law de novo. Logan v. JKV Real Estate Servs.
(In re Bogdan),
414 F.3d 507, 510 (4th Cir. 2005). In an ERISA
case a reviewing court first determines de novo whether a benefits
plan confers discretionary authority on the administrator or
fiduciary. If it does, the court reviews the decision of the
administrator or fiduciary for abuse of discretion. Ellis v.
Metropolitan Life Ins. Co.,
126 F.3d 228, 232-33 (4th Cir. 1997).
Under the abuse of discretion standard, a decision is reasonable if
it is the result of a deliberate, principled reasoning process and
8
is supported by substantial evidence. Bernstein v. CapitalCare,
Inc.,
70 F.3d 783, 788 (4th Cir. 1995). Because the Plan here
grants the Board the discretion to decide claims for benefits and
to interpret the terms of the Plan, we review the Board’s decision
for abuse of discretion.
The central question here is whether the Board abused its
discretion by using as the disability onset date the date of Dr.
Doren’s examination (December 7, 2001) that revealed Marshall was
totally and permanently disabled. The Plan provides that benefits
must be awarded retroactively to the first of the month after the
onset of total and permanent disability. The bankruptcy court
concluded that the Plan therefore requires the Board to determine
when the onset of total and permanent disability occurred and that
the Board abused its discretion by not making a reasonable effort
to fulfill its duty in this case.
At oral argument counsel for the Plan stated that the
Board does not automatically award benefits on the first of the
month after the first doctor’s report finding total and permanent
disability. For example, when the record contains social security
disability records or tax returns reflecting that an applicant is
unable to work, the Board has awarded benefits retroactively to the
time when employment ended. Counsel asserted, however, that in
Marshall’s case Dr. Doren’s December 2001 examination was the
9
earliest evidence of total and permanent disability in the record
after Dr. Bach’s September 2000 report that Marshall could work.
We appreciate the difficulty of determining an exact date
of total and permanent disability in the case of a degenerative
illness, such as Marshall’s, where the severity of symptoms may
vary from time to time. In some cases the date of a doctor’s
examination may be the only information available as to the onset
date of total and permanent disability, especially when the
examining doctor is unable or unwilling to provide an opinion
regarding onset. Here, however, the bankruptcy court rejected the
Board’s arbitrary use of the date of the doctor’s examination to
reinstate benefits. The bankruptcy court reviewed the record and
found sufficient evidence in Dr. Doren’s report to indicate that
Marshall’s total and permanent disability extended back at least to
May 1, 2001. Indeed, Dr. Doren’s opinion was that Marshall’s
symptoms had been consistent since 1997. Thus, in Marshall’s case
the simple date of Dr. Doren’s examination was not the only
information available to the Board from which to determine an onset
date. In that situation the Board’s exclusive reliance on the date
of the doctor’s examination did not result in an onset
determination that was “the result of a deliberate, principled
reasoning process.” See
Bernstein, 70 F.3d at 788 (internal
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quotation marks and citation omitted).* As a result, we agree with
the bankruptcy court that the Board abused its discretion in
selecting the onset date.
For these reasons, we reverse the order of the district
court, which had reversed the bankruptcy court, and remand for
reinstatement of the judgment of the bankruptcy court.
REVERSED AND REMANDED
*
We are not unsympathetic to the Plan’s argument that allowing
benefits to be paid retroactively to May 1, 2001, would create
tension with the “final and binding” decision of Dr. Bach on
September 11, 2000, that Marshall was not totally and permanently
disabled at that time. We simply conclude here that the Board
could not escape this tension by ignoring Dr. Doren’s finding on
January 3, 2002, that Marshall was totally and permanently disabled
and that his symptoms had remained consistent since his initial
medical evaluation in 1997.
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