Frank Regula v. Delta Family-Care Disability Survivorship Plan

266 F.3d 1130 (9th Cir. 2001) FRANK REGULA, PLAINTIFF-APPELLANT, v. DELTA FAMILY-CARE DISABILITY SURVIVORSHIP PLAN, DEFENDANT-APPELLEE. No. 98-55853 UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT Argued and Submitted October 6, 1999 Filed September 24, 2001 [Copyrighted Material Omitted] Lawrence D. Rohlfing, Santa Fe Springs, California, for the plaintiff-appellant. Hunter B. Hughes, Atlanta, Georgia, for the defendant-appellee. Appeal from the United States District Court for the Central District of California Ronald S.W. Lew, District Judge, Presiding D.C. No. CV-96-07304-RSWLBefore: Betty B. Fletcher, Dorothy W. Nelson, and Melvin Brunetti, Circuit Judges. Opinion by Judge B. Fletcher; Dissent by Judge Brunetti BETTY B. FLETCHER, Circuit Judge: 1 Frank Regula appeals the district court's denial of his motion for summary judgment on his claim that the Delta Family-Care Disability Survivorship Plan ("Delta Plan" or "Plan") abused its discretion in terminating his disability benefits. Specifically, Regula contends that the Delta Plan should have accorded deference to the opinions of his treating physicians and considered vocational evidence in making its benefits…

Opinion by Judge BETTY B. FLETCHER; Dissent by Judge BRUNETTI.

Frank Regula appeals the district court’s denial of his motion for summary judgment on his claim that the Delta Family-Care Disability Survivorship Plan (“Delta Plan” or “Plan”) abused its discretion in terminating his disability benefits. Specifically, Regula contends that the Delta Plan should have accorded deference to the opinions of his treating physicians and considered vocational evidence in making its benefits determination. Regula also sought summary judgment on the ground that the Delta Plan failed to provide him with a full and fair review of his disability claim. The district court denied Regula’s summary judgment motion in its entirety and entered judgment in the Plan’s favor pursuant to a stipulation signed by the parties. We vacate the judgment of the district court and remand for a determination as to whether the Delta Plan may have been acting under a conflict of interest, and thus whether the court should have applied a less deferential standard of review to the Plan’s decision to discontinue Regula’s benefits.

I.

The Delta Plan is a non-contributory employee welfare benefit plan governed by the…

dissenting:

I dissent from part III of the majority’s opinion.

I.

In this case, the district court reviewed the decision terminating Regula’s disability benefits, by Delta’s ERISA Plan Administrator, for an abuse of discretion. The abuse of discretion standard was applied for good reason — the parties stipulated to this standard of review. Nowhere in the briefs- does either party argue that a different standard should apply. In fact, Re- *1148 gula’s opening brief states that “Plaintiff conceded in the District Court that it reviews factual determinations for abuse of discretion.” Opening Brief at 11. The parties’ stipulation is in complete accord with the Plan’s language, which states that:

The Administrative Committee is also granted “the exclusive power to interpret” the Plan, its interpretation and decisions being “final and conclusive.” However, the majority now holds that before applying this standard of review in accordance with the stipulation, the district court should have determined whether the Plan was operating under a conflict of interest.

There is no doubt that where a conflict of interest is found to exist, the plan administrator’s decision is afforded less…