Carrow v. Standard Insurance
664 F.3d 1254
8th Cir.2012Background
- Carrow, a Jager Industries employee, was eligible for long-term disability benefits under the Plan administered by Standard.
- The Plan defines disability as own occupation for 24 months, then any occupation reasonably fitted by education, training, and experience, with Standard retaining discretionary interpretation power.
- Carrow developed avascular necrosis and underwent hip surgery in 2005, receiving STD then LTD benefits through mid-2006.
- After a 2006 hip replacement and later knee/spine issues, Carrow returned to work briefly in March–June 2006 but remained disabled due to ongoing pain.
- Standard relied on both treating and consulting physicians, including Dr. Mullen and Dr. Carlson, to evaluate Carrow’s ability to work and ultimately denied LTD on December 12, 2007.
- Carrow appeals the denial, arguing Standard abused its discretion in determining an inability to perform any occupations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Plan administrator abused discretion in any-occupation denial. | Carrow argues conflict of interest and improper weighting of evidence. | Standard contends its determinations were supported by substantial evidence and credible medical reviews. | No abuse of discretion; substantial evidence supports denial. |
| Whether consulting physicians' reports can carry more weight than treating physicians. | Carrow asserts treating doctors should be preferred for disability determinations. | Standard may rely on non-examining reports and compare credibility among sources. | Plan acted within discretion by considering consulting opinions alongside treating physicians. |
| Whether SSA disability findings bind ERISA plan decisions. | SSA findings should be controlling if consistent with plan goals. | SSA findings are not binding on ERISA plan determinations. | SSA findings are not controlling; plan properly independent. |
| Whether there was any inconsistency in Standard's handling of Dr. Mullen's disabling assessments. | Dr. Mullen repeatedly asserted total disability with broad limitations. | Standard sought corroboration from other physicians and evaluated credibility. | No inconsistency; Standard conducted inquiries and weighed multiple sources. |
Key Cases Cited
- Weidner v. Federal Express Corp., 492 F.3d 925 (8th Cir. 2007) (administrative deference to consultant reports over treating physicians)
- Rutledge v. Liberty Life Assurance Co. of Boston, 481 F.3d 655 (8th Cir. 2007) (credibility and comparative evaluation of medical reports in denial of benefits)
- Manning v. Am. Republic Ins. Co., 604 F.3d 1030 (8th Cir. 2010) (practice of reviewing ERISA plan decisions under abuse-of-discretion standard with conflict consideration)
- Jones v. ReliaStar Life Ins. Co., 615 F.3d 941 (8th Cir. 2010) (conflicts of interest weight in abuse-of-discretion review)
