Employee Benefits

Dist. Ct. erred in granting defendant-plan's motion for summary judgment in ERISA action challenging defendant's denial of plaintiff's request for long-term disability benefits based on plaintiff's fibromyalgia, where defendant relied upon self-reported symptoms limitation clause in plan that required discontinuance of disability benefits where, according to defendant, plaintiff's disability was based on self-reported symptoms of pain and fatigue that could not be verified using objective tests. Record showed that plaintiff's fibromyalgia was not primarily based on self-reported symptoms, but rather was based on verifiable evidence of its manifestations, so as to preclude defendant from relying on self-reported symptoms limitation to deny instant application.

Dist. Ct. did not err in finding in favor of defendant-pension plan in ERISA action alleging that defendant wrongfully withheld pension benefits from plaintiff-widow after finding that plaintiff's un-witnessed signed consent was sufficient to give effect to deceased husband/plan participant's prior designation of plaintiff's three children as beneficiaries of pension plan benefits. While plan participant may elect to waive spousal-survivor annuity and designate someone other that surviving spouse to be beneficiary of plan benefits under section 1055(c)(2)(A) of ERISA, where spouse of plan participant gives written consent that is witnessed by plan representative or notary, defendant could properly find that section 1055(c)(2)(A) had been satisfied in spite of lack of witness signature on plaintiff's consent form where: (1) husband was instant plan representative; (2) plaintiff conceded that she had signed consent; and (3) record suggested that husband had witnessed plaintiff's consent where said consent was located in plan's files.

Dist. Ct. did not err in dismissing plaintiffs' action alleging that defendant-defined-contribution pension plan offered too expensive mutual fund options in said plan in terms of ratios of expenses to assets that plaintiffs claimed violated requirements set forth in section 1104(a) of ERISA. Record showed that defendant offered plan participants 32 investment options, with various expense ratios that included 24 "no load" mutual funds that were also open to general public, and that included high expense/high-risk funds that had potential for high reward returns, as well as low expense/low risk funds with modest returns. Ct. found that nothing in ERISA required plan fiduciaries to scour market to find and offer cheapest possible funds as long as plan offered instant wide variety of options. Ct. also rejected plaintiffs' claims that defendant could not offer retail mutual funds that charged same expenses as those charged to general public, and that defendant should have covered administrative costs of all mutual funds contained in plan.

Dist. Ct. erred in granting plaintiff's motion for summary judgment in ERISA action alleging that defendant-pension plan improperly denied plaintiff pension benefits where it offset said benefits by amounts plaintiff had previously received from his employer in settlement of two Ill. workers' compensation permanent partial disability claims. Defendant had discretion to interpret language of instant benefit plan, and said defendant could rationally find that plaintiff's permanent partial disability was subject to said offset. Fact that one interpretation of plan language might favor plaintiff's argument that offset did not apply does not require different result in light of discretion given to defendant to resolve any ambiguity in plan language, as well as plaintiff's failure to show any inconsistency in defendant's interpretation of said plan.

Dist. Ct. did not err in dismissing plaintiff-welfare benefit plan's ERISA claim seeking to recover amounts it paid to defendants on behalf of dependent of covered person where plaintiff subsequently determined that child was not covered under said plan. Terms of plan permitted recovery only for payments made on behalf of covered persons, and plaintiff insisted that child was not covered under plan. As such, plaintiff pleaded itself out of any recovery under section 502(a)(3) of ERISA and also could not prevail under any federal common law theory under ERISA. However, Dist. Ct. erred in finding that plaintiff's state-law breach of contract claims were preempted by ERISA where resolution of claims did not require review of plan.

Dist. Ct. did not err in granting defendant-pension plan’s motion for summary judgment in ERISA action alleging that defendant miscalculated some of plaintiff’s projected pension benefits, that said miscalculations induced plaintiff to settle his potential age discrimination claim with his employer, and that defendant’s actions estopped it from providing plaintiff with reduced benefits once defendant’s error in its calculations had been discovered. Plaintiff’s proffered evidence established only that defendant’s error was inadvertent mistake, as opposed to intentional misrepresentation that was required to establish estoppel claim. Moreover, plaintiff had failed to provide evidence of detrimental reliance where there was no showing that he would have done any better in his negotiations than deal he ultimately signed.

In action alleging that defendant violated ERISA by failing to give timely COBRA notices to departing employees, Dist. Ct. did not err in denying motion for class certification, after finding that proposed class attorney was inadequate to represent class. Dist. Ct. could properly base denial on counsel's competency and attitude by looking to prior identical case, where another Dist. Ct. judge had denied similar motion filed by same attorney due to said attorney's failure to abide by discovery orders and where same attorney had failed to appeal denial of class certification motion in prior case. Dist. Ct. also did not err in denying plaintiffs' request for statutory damages on their individual claims where: (1) defendant had oversight system that attempted to determine existence of any untimely COBRA notices; (2) plaintiffs failed to establish any prejudice upon receiving untimely COBRA notice; and (3) defendant took immediate corrective measures once it became aware of untimely COBRA notices.

Dist. Ct. did not err in granting defendant-pension plan's motion for summary judgment in ERISA action alleging that defendant violated ERISA's and plan's anti-cutback provisions by denying plaintiffs-current employees' claims for annuity payments under terms of pension plan, even though plaintiffs asserted that they were entitled to said payments once defendant had taken steps to terminate pension plan. Record showed that while defendant took steps to terminate pension plan, it withdrew from said process before termination became final, so as to appropriately preclude plaintiffs from receiving said payments. Moreover, plaintiffs' right to said annuity payments while still employed is not protected by ERISA, and thus defendant's refusal to make said payments did not violated ERISA's anti-cutback provision.

Record contained sufficient evidence to support ALJ's denial of claimant's application for SSI benefits after ALJ determined existence of certain sedentary jobs that claimant could do in spite of his condition. Ct. rejected claimant's contention that ALJ did not adequately inquire into whether vocational expert's (VE) testimony was consistent with Dictionary of Occupational Titles (DOT) and further found that there was no apparent conflict between VE's testimony and DOT.