United States District Court, S.D. New York
OPINION & ORDER
KATHERINE B. FORREST, District Judge.
On November 16, 2012, plaintiff Francy Ocampo ("plaintiff' or "Ocampo") filed this action against defendants Building Service 32B-J Pension Fund ("the Pension Fund") and the Board of Trustees for the Building Service 32B-J Pension Fund ("the Board of Trustees") (together, "defendants"), alleging under the Employee Retirement Income and Security Act of 1974 ("ERISA"), 29 U.S.C. §§ 1132(a)(1)(B), that defendants improperly denied her certain disability benefits. (Compl., Nov. 16, 2012, ECF No. 1.) On December 19, 2012, defendants answered (see ECF No.3) and on July 10, 2013, plaintiff filed a motion for summary judgment. (See ECF No.7.) Two days later, on July 12, 2013, defendants filed a cross-motion for summary judgment. (See ECF No. 11.)
For the reasons set forth below, the Court finds that defendants have acted neither arbitrarily nor capriciously and GRANTS defendants' motion for summary judgment.
1. FACTUAL BACKGROUND
For more than 20 years, plaintiff worked as an office cleaner and was a member of the Local 32B-J union (or its predecessors in interest). (Compl. ¶ 4.) On March 22, 2005, plaintiff stopped working because of back problems. (Peggy Napier Affidavit in Support of Motion for Summary Judgment ("Napier Aff."), Ex. A at 1, July 12, 2013, ECF No. 12 (stating March 22, 2005 was plaintiff's last day of work and the first day of her disability).)
On July 29, 2005, plaintiff submitted an application to the Social Security Administration ("SSA") for disability benefits, and on December 7, 2006, the SSA issued a bench decision approving plaintiff's application. ( Id., Ex. B at 2.) The SSA determined plaintiff was disabled and unable to sustain full-time employment because of "herniated disks at L4-5 and L5-S1 with S1 nerve root compression and L5 radiculopathy and peripheral polyneurepathy." (Id.) The SSA stated that she would be receiving additional information regarding her benefits at a later date. (Id.) On March 26, 2007, the SSA issued plaintiff a Notice of Award, which stated plaintiff was entitled to monthly disability benefits beginning September 2005 because she had become disabled under the SSA's rules on March 22, 2005. ( Id., Ex. I at 27.) Specficially, the Notice of Award said: "Doctors and other trained staff decided that you are disabled under our rules. But, this decision must be reviewed at least once every 3 years." (Id. at 35.)
On September 14, 2011, plaintiff submitted a claim for a Disability Pension under her Pension Plan ("the Plan"). ( Id., Ex. A.) On her application, plaintiff indicated that her last day of work was March 22, 2005 and that her disability began that day. (Id. at 1.) Plaintiff provided as an attachment a "Physician Attestation Statement of Disability, " which stated that plaintiff had lumbar radiculopathy. (Id. at 2.) Plaintiff's physician verified that plaintiff's symptoms began on March 22, 2005, noted that plaintiff's symptoms had stayed the same since March 22, 2005, and circled that that the disability was "permanent." (Id.)
In order to be eligible for a Disability Pension, the Plan provides that a participant's disability must be permanent. Section 4.10 of the Plan states that a participant "shall be deemed totally and permanently disabled only under the following circumstances:"
(i) the Participant presents to the Trustees a certification of a permanent disability benefit award from the [SSA] showing that the Participant's disability was found to have commenced on a date on which the Trustees determine the Participant was working in Covered Employment;
(ii) the Trustees or their authorized delegate(s) determine, in their sole and absolute discretion as provided in Section 7.06, based upon information submitted, that the Participant became totally and permanently disabled within the meaning of Section 4.10(a) before August 1, 2010 while working in Covered Employment (taking into account the presumption described in that subsection); or
(iii) in the case of a Participant who cannot satisfy one or more of the requirements to receive a disability benefit award from the [SSA] for reasons unrelated to the Participant's medical or mental condition, the Trustees or their authorized delegate(s) determine, in their sole and absolute discretion as provided in Section 7.06, based upon information submitted, that the Participant became totally and permanently disabled within the meaning of Section 4.10(a) while working in Covered Employment (taking into account the presumption described in that subsection).
( Id., Ex. Fat 11.) Section 7.06 outlines the powers of the Trustees and states that they "shall have the exclusive right, power, and authority, in their sole and absolute discretion, to administer, apply and interpret the Plan and any other plan documents and to decide all matters arising in connection with the operation or administration of the Plan." (Id. at 25.)
On October 19, 2011, plaintiff's request for a Disability Pension under the Plan was denied in full; specifically, the Trustees deemed plaintiff ineligible for Extended Health Care Coverage (Fund-Paid COBRA), Long Term Disability ("LTD") $250 monthly benefits, and a Disability Pension. (Napier Aff., Ex. I at 8.) The Trustees denied plaintiff's request because she failed to submit her SSA Notice of Award. (Id.) In response, plaintiff submitted her Notice of Award, which the Trustees received on or before December 15, 2011. (Id. at 23.)
On January 17, 2012, the Trustees issued a new determination based on the additional documentation provided by plaintiff; the Trustees found plaintiff eligible for LTD, but still ineligible for Extended Health Care Coverage and a Disability Pension. (Id. at 5.) The Trustees ...