Justia U.S. 7th Circuit Court of Appeals Opinion Summaries

Aschermann suffers from degenerating discs and spondylolisthesis and had lumbar fusion operations in 2002 and 2004. Until 2003 she worked as a sales representative. Back pain left her unable to perform its duties. Between 2003 and 2009 she received disability payments under the employer’s disability plan, a welfare-benefit plan governed by the Employee Retirement Income Security Act. The policy provides that after the first two years of benefits, the question becomes whether the recipient can perform any job in the economy as a whole. Lumbermens stopped paying disability benefits to Aschermann in fall 2009, concluding that she could do sedentary work. The district court held that the decision to end her disability benefits was not arbitrary. The Seventh Circuit affirmed. Aschermann does not deny that her education B.S. in psychology and master’s degree in social work and experience suit her for many desk-bound positions, but claimed inability to work more than four hours a day. The insurer gave notice complying with ERISA, (29 U.S.C. §1133(1), that it wanted new diagnostic test results and other recent information; she was given a “reasonable opportunity” to supplement the file and receive a “full and fair review.” View "Aschermann v. Aetna Life Ins. Co." on Justia Law

In a class action under ERISA, the district court partially decertified the class, 3000 to 3500 members (57 to 71 percent). Plaintiffs appealed under Rule 23(f), which authorizes a court of appeals to “permit an appeal from an order granting or denying class-action certification.” After holding that an order materially altering a previous order granting or denying class certification is within the scope of Rule 23(f), the Seventh Circuit denied the appeal for failure to satisfy the criteria for a Rule 23(f) appeal. View "Matz v. Household Int'l Tax Reduction Inv. Plan" on Justia Law

Marantz practiced pulmonary and critical care medicine. In 1997 she underwent surgery for a herniated disc and degenerative disc disease. The surgery did not eliminate her pain. In 1999, she stopped working full time. Through her employment with she received disability coverage from LINA. LINA approved her claim. Additional surgery did not resolve the problem. MRIs revealed degenerative disc disease and spinal stenosis. In 2000 LINA provided funding for Marantz to enroll in an online Masters of Public Health program, for retraining for less-demanding work. In 2001, Marantz began working approximately 20 hours per week for the Illinois Department of Public Health. LINA offset disability benefits and reduced its monthly payment from $7,616 to $5,000 per month. LINA paid benefits for 60 months. In 2004, LINA investigated whether Marantz satisfied the policy’s more stringent definition of disability relevant after the first 60 months: “unable to perform all the material duties of any occupation for which [that worker] may reasonably become qualified based on education, training or experience.” In 2005 LINA terminated benefits, based on a functional capacity evaluation, doctors’ assessments, and surveillance. Marantz sued under the ERISA, 29 U.S.C. 113. The district court entered judgment in the defendants’ favor. The Seventh Circuit affirmed. View "Marantz v. Permanente Med. Grp., Inc." on Justia Law

At age 56, plaintiff left his position as a partner in a law firm and enrolled in school. Employees who depart at age 55 or older may withdraw money from the employer's retirement plan. They must pay income tax, but a 10 percent additional tax imposed on most withdrawals before age 59½ does not apply to distributions "made to an employee after separation from service after attainment of age 55," 26 U.S.C. 72(t)(1), (2)(A)(v). Plaintiff moved the funds from the plan to an individual retirement account then withdrew about $240,000. A rollover is not taxable 26 U.S.C. 402(c). Plaintiff paid income tax. The IRS claimed he owed the 10 percent additional tax, plus a penalty for substantial underpayment of taxes. The Tax Court held that he owed the tax on money not used for tuition. The Seventh Circuit affirmed; the distribution was made to an IRA, not to the employee. Section 6662 excuses the taxpayer if there was substantial authority for the tax return's treatment, but there was no authority for plaintiff's position.

Plaintiffs brought a putative class action under the Employee Retirement Income Security Act, 29 U.S.C. 1001, to recover benefits under long-term disability benefit plans maintained by their former employers. The plans provide for reduction of benefits if the disabled employee also receives benefits under the Social Security Act, as both plaintiffs do. They dispute calculation of the reduction, claiming that the plans do not authorize inclusion in the offset of benefits paid to dependent children. Both plans require offsets for "loss of time disability" benefits. The district court dismissed. The Seventh Circuit affirmed, holding that children's Social Security disability benefits paid based on a parent's disability are "loss of time disability" benefits under the language of the plans.

The employer sought an early withdrawal from its obligation to make pension contributions to a multiemployer pension fund; it entered into a new collective bargaining agreement, six weeks before expiration of the existing agreement, that abrogated its obligation to make payments to the fund. The fund sued under the Employee Retirement Income Security Act of 1974, 29 U.S.C. 1145. The district court entered summary judgment in favor of the fund. The Seventh Circuit affirmed, rejecting an argument that the agreement was ambiguous in providing that the employer could not “prospectively” change its obligation.

Abbott created Hospira for its Hospital Products Division. Before the spin-off, HPD employees had access to Abbott's pension plan. Hospira did not offer a pension plan. The spin-off included reciprocal two-year no-hire policies. When HPD employees became Hospira employees, non-vested pension rights in the Abbott plan were eliminated. Retirement-eligible HPD employees were effectively prevented from retiring from Abbott then joining Hospira. A certified class of Hospira employees alleged that violation of the Employee Retirement Income Security Act, 29 U.S.C. 1140, by using the spin and no-hire policy to get rid of pension liability and deter HPD employees from exercising pension benefits before the spin. They alleged that Abbott breached its fiduciary duty by failing to disclose that Hospira would not offer pension benefits. The district court entered judgment for Abbott and Hospira on all counts. The Seventh Circuit affirmed. ERISA claims failed because Abbott and Hospira did not act with the requisite intent to interfere with plaintiffs' pension benefits. The breach-of-fiduciary-duty claim failed because Abbott had nothing to do with the Hospira benefits plan and because Abbott reported truthfully to HPD employees that benefits might change after the spin.

Under the Multiemployer Pension Plan Amendments Act of 1980, all "trades or businesses" under "common control" are treated as a single employer for purposes of determining withdrawal liability. 29 U.S.C. 1301(b)(1). SCOFBP incurred withdrawal liability for unfunded pension benefits in 2001 when it ceased operations and paying into a union pension fund. The district court held that the solvent MCRI and MCOF, which were part of a complex set of entities and trusts under control of a single businessman (who went through personal bankruptcy in 1999), were both trades or businesses that were under common control with insolvent SCOFBP at the relevant times, so that both are liable for SCOFBP's withdrawal liability. The Seventh Circuit affirmed, rejecting arguments that MCRI and MCOF were only passive investment vehicles rather than trades or businesses and that the businessman's personal bankruptcy disrupted what had been common control of the three entities.

After being diagnosed with fibromyalgia, chronic pain, anxiety, and depression, plaintiff was awarded long-term disability benefits under an employee benefit plan issued and administered by defendant. Benefits were discontinued a little more than 24 months later, when defendant determined that plaintiff had received all to which she was entitled under the plan’s self-reported symptoms limitation. Because plaintiff had retroactively received social security benefits, defendant also sought to recoup equivalent overpayments as provided by the plan. On rehearing, the Seventh Circuit reversed the district court ruling in favor of defendant. The application of the self-reported symptoms clause was unreasonable under ERISA, 29 U.S.C. 1001; the disabling illness, fibromyalgia, is not primarily based on self-reported symptoms, but rather can be based on the verifiable evidence of its manifestations. The Social Security Act, 42 U.S.C. 407(a), does not preclude recovery of any overpayment that resulted from receipt of social security benefits.

Before his death, the orthodontist designated his sons as beneficiaries of a pension plan he had established for his business. Because the Employee Retirement Income Security Act, 29 U.S.C. 1001. The Plan moved for summary judgment.guarantees surviving spouses certain benefits, his wife signed a written consent form. After her husband died, wife claimed her consent was invalid because it was not witnessed, as required by ERISA. The pension plan denied her claim for benefits. The district court upheld that decision, invoking the substantial-compliance doctrine. The Seventh Circuit affirmed, but held that the substantial-compliance doctrine did not apply because ERISA is not silent on the issue of witnessing. The plan was within its discretion to deny the claim. Although no witness signed the consent form as a witness, it is clear that the orthodontist, then the plan representative, witnessed his wife's written consent to the waiver, as required by ERISA.