United States District Court, N.D. Alabama, Southern Division
E. OTT, Chief United States Magistrate Judge.
case arises out of the denial of Plaintiff Antonio
Campbell's claims for short-term disability
(“STD”) and long-term disability
(“LTD”) benefits under group disability insurance
policies issued by United of Omaha Life Insurance Company
(“United of Omaha”) to Campbell's employer,
J&B Importers, Inc. (“J&B”) (collectively
“the Defendants”). Campbell brought his various
claims in this action under the Employee Retirement Income
Security Act of 1974, 29 U.S.C. § 1001 et seq.
(“ERISA”). Those claims included a request for
reinstatement and payment of benefits, breach of fiduciary
duty, and failure to provide required documents.
(Doc. 1). Following motion practice, the court
found that the Defendants improperly denied his claim for STD
benefits through February 16, 2012 and for LTD benefits until
the end of October 2014. (Docs. 47 & 48). Accordingly,
the court required the parties to calculate the short-term
and long-term benefits and interest that accrued to
Campbell's benefit premised on the court's findings.
(Id. at 48). The court also informed Plaintiff's
counsel of his right to make application for reasonable
attorney's fees and costs. (Doc. 49).
filed a “Request for Reconsideration of the Court's
Order, ” which is presently before the court. (Doc.
72). He asserts that the court erred in (1) applying a
deferential review standard to the denial of his claims and
(2) “crafting a new denial” that his LTD benefits
should terminate as of October 2012. (Id. at 2,
21-33). The court set the motion for oral argument. At the
argument, Plaintiff's counsel further argued as to the
second claim that the court prejudiced Campbell by limiting
his ability to respond to the decision. (Doc. 78 at 9).
Counsel argues that if the court had remanded the matter to
the administrator, he (Campbell) would have been permitted to
submit new evidence. (Id. at 9-10). By way of
example, he states that because of the court's
determination, he was denied the opportunity to offer
additional evidence or place in context the progress note of
Dr. Camilo Gomez, which this court relied upon in reaching
its determination of Campbell's benefits. (Id.
at 11-12). Counsel for the Defendants argues that the
determination of the court is not a “new decision,
” but a review of the entire administrative process
through the June 17, 2013 affirmance by United of Omaha of
the denial of Campbell's STD and LTD benefits.
(Id. at 17).
court is not impressed with Campbell's first argument
concerning the determination of the appropriate standard. The
court remains convinced in the reasoning detailed in the
lengthy memorandum opinion previously entered in this case.
As to the second matter, the court finds that Campbell's
argument is well-founded to the extent the court determined
his LTD benefits properly terminated as of October 2012.
Despite its prior ruling, the court now believes the proper
and prudent recourse is to remand this matter to the Plan
administrator for further proceedings premised on the finding
that the administrator improperly denied him benefits when
his LTD policy became effective. While the administrator will
be required to award Campbell the STD and LTD benefits
erroneously denied because the decisions were arbitrary and
capricious, nothing in this order precludes the administrator
from further evaluating the length and duration of
Campbell's disability for the purpose of awarding LTD
benefits. The administrator is not limited, however, by the
court's previous determination concerning the duration or
scope of his LTD benefits. Similarly, Campbell should not be
precluded from presenting additional evidence and/or argument
concerning his condition, particularly as it relates to the
opinions of Dr. Gomez.
the court finds this matter is due to be remanded to the Plan
administrator for further proceedings. The court retains
jurisdiction over the claim for attorneys' fees pursuant
to Federal Rule of Civil Procedure 54(d)(2)(B). (See
Doc. 59 at 2, n.3). The parties will be afforded until April
26, 2017, to resolve this aspect of the case. If they do not,
Plaintiffs counsel's claim for attorney's fees and
costs shall be filed by April 26, 2017. Any response from
Defendants concerning the fees and costs will be due on May
appropriate order in accordance with this memorandum opinion
will be entered.
References to “Doc. (s)_ ”
are to the document numbers assigned by the Clerk of the
Court to the pleadings, motions, and other materials in the
court file, as reflected on the docket sheet in the
court's Case Management/Electronic Case Files (CM/ECF)
The court notes that the parties are in
agreement as to the amount due under the STD plan, including
interest, as of November 25, 2015. (See Doc. ...