Javery v. Lucent Technologies, Inc. Long Term Disability Plan for Management or LBA Employees
741 F.3d 686
| 6th Cir. | 2014Background
- Javery, a Lucent software engineer whose job required prolonged sitting and high cognitive functioning, stopped working May 19, 2005 for severe back pain and related complaints and applied for long‑term disability (LTD) benefits starting Nov. 25, 2005 under Lucent’s ERISA plan administered by CIGNA.
- Treating physicians (Drs. Seymour, Holtzmeier, Saguil and others) and therapists reported severe physical and mental limitations (inability to sit, concentration problems, severe pain); MRIs and later EMG/CT scans showed degenerative disc disease and radiculopathy. Javery was hospitalized for psychiatric illness in Sept. 2006.
- CIGNA denied LTD initially (Feb. 17, 2006) and on appeal (June 7, 2006; Jan. 4, 2007), relying on in‑house file reviews and a 2005 IME finding no neurologic involvement and suggesting psychogenic input. Later independent file reviewers (2011) also concluded Javery could perform sedentary work.
- Javery obtained Social Security disability benefits (ALJ found him disabled, Nov. 28, 2008) and pursued ERISA litigation; the district court remanded for further review of the psychological component, then the plan again denied benefits and the district court granted CIGNA judgment; Javery appealed to the Sixth Circuit.
- The Sixth Circuit reviewed de novo whether Javery was "disabled" under the Plan for the relevant period (Nov. 25, 2005–Nov. 24, 2006) and whether judicial estoppel barred his claim due to a bankruptcy nondisclosure.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Javery is judicially estopped from pursuing the ERISA claim because he failed to disclose it in Chapter 13 bankruptcy | Omission was inadvertent; claim was disclosed to bankruptcy counsel; no bad faith or motive to conceal | Nondisclosure is an inconsistent position that should bar the claim | Not estopped: district court properly found omission inadvertent and no basis to infer intentional concealment |
| Proper remedy after district court found incomplete record — remand vs. decision on merits | District court should adjudicate de novo when record suffices; remand only if further fact‑finding needed | Remand appropriate because administrative record lacked necessary factual findings | Remand was not an abuse of discretion: district court intended remand to develop facts, which is permissible even on de novo review |
| Whether Javery met his burden to prove he was "disabled" under the Plan for Nov. 25, 2005–Nov. 24, 2006 | Medical and psychiatric treating‑source opinions, objective imaging, hospitalization, and SSA award establish inability to perform his Lucent software‑engineer duties | File‑review opinions and an earlier IME showed no neurologic basis and questioned psychiatric evidence; plan administrator found insufficient objective support | Reversed district court: on de novo review, the Sixth Circuit concluded Javery proved by a preponderance that he was disabled for the relevant period and is entitled to LTD benefits |
| Weight to give file‑review opinions by doctors who never examined claimant | Treating‑source opinions and objective findings should be given greater weight; file reviews are weak, especially for psychiatric issues | File reviewers are qualified and may rely on records to rebut treating opinions | File‑review opinions were given little weight: Sixth Circuit found them inadequate to overcome treating doctors, IME context, and hospitalization evidence |
Key Cases Cited
- New Hampshire v. Maine, 532 U.S. 742 (2001) (judicial estoppel is equitable and discretionary)
- Salve Regina College v. Russell, 499 U.S. 225 (1991) (de novo review precludes appellate deference)
- Wilkins v. Baptist Healthcare Sys., Inc., 150 F.3d 609 (6th Cir. 1998) (de novo review of plan administrator decisions absent discretionary authority)
- Williams v. Int’l Paper Co., 227 F.3d 706 (6th Cir. 2000) (remand is appropriate when further fact‑finding is necessary)
- Hoover v. Provident Life & Acc. Ins. Co., 290 F.3d 801 (6th Cir. 2002) (no deference to administrator under de novo review)
- Calvert v. Firstar Finance, Inc., 409 F.3d 286 (6th Cir. 2005) (file reviews by qualified physicians are permissible but have limits)