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Obaid v. Building Service 32Bj Pension Fund

United States District Court, S.D. New York

December 2, 2014

ABDO OBAID, Plaintiff,
v.
BUILDING SERVICE 32BJ PENSION FUND ET AL., Defendants.

MEMORANDUM OPINION AND ORDER

JOHN G. KOELTL, District Judge.

Plaintiff Abdo Obaid commenced this action under the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1132(a)(1)(B). He alleges that defendants Building Service 32BJ Pension Fund (the "Pension Fund") and the Board of Trustees of Building Service 32BJ Pension Fund (the "Trustees") wrongfully denied him disability benefits. The parties agreed to try this action as a non-jury trial based on a stipulated Administrative Record ("AR") and their trial briefs. Endorsed Letter, May 28, 2013, ECF No. 13; Endorsed Letter, Mar. 26, 2013, ECF No. 7. Based on that procedure, and pursuant to Rule 52(a) of the Federal Rules of Civil Procedure, the Court makes the following findings of fact and conclusions of law.

FINDINGS OF FACT

1. From 1975 to 2009, Obaid worked as a custodian in office buildings in New York City. AR 356. He was a member of the Service Employees International Union, Local 32BJ (or its predecessor in interest) during that time and was a participant in the Pension Fund. See AR 272, 374. He has a third grade education. AR 343. Obaid's last date of covered employment was on or about September 19, 2009. AR 401. In March 2010, Obaid submitted a claim for disability benefits to the Pension Fund. AR 272, 329.

2. The Pension Fund is a multi-employer benefit fund established pursuant to the Taft-Hartley Act, 29 U.S.C. § 186(c)(5). AR 5-6. The Fund is jointly administered by an equal number of management and union trustees and is governed by an Agreement and Declaration of Trust. AR 12.

3. The Pension Plan provides that to be eligible for a permanent disability pension, a participant must be "permanently and totality disabled, " must have at least 120 months of service credits, and must have become disabled while working in covered employment. AR 66.[1]

4. Under the Pension Plan, a participant is "permanently and totality disabled" if he is found "totally and permanently unable, as a result of bodily injury or disease, to engage in any further employment or gainful pursuit." AR 66; see also AR 167. The Pension Plan affords the "Trustees or their authorized delegate(s)... sole and absolute discretion" to determine whether a participant is totally and permanently disabled. AR 66; see also AR 16, 81.

5. At the time that Obaid submitted his application, the Pension Fund had delegated to MetLife the authority to make clinical determinations related to disability pension applications and appeals. AR 256, 259B-60.

6. In support of his disability pension application, Obaid submitted a letter from his primary physician, Dr. Iraj Akhavan. The letter identified a number of conditions that Obaid suffered from, including hip joint arthritis and cartilage loss. Dr. Akhavan considered Obaid "totally disable[d] and unable to do any type of job related activities." AR 277. Obaid also submitted MRI results, blood test results, x-rays, prescriptions, and notes from Dr. Akhavan. AR 278-98.

7. In a letter dated July 12, 2010, MetLife informed Obaid that his application for disability pension benefits had been denied. In relevant part, the denial letter stated:

The medical records submitted do support your inability to function in any capacity at the present time. However, they do not support a permanent condition.... Based on the information provided by Dr. Iraj Akhavan, you may require hip surgery in the future. As a result, you will have limitations and restrictions that would preclude your abilities [sic] to return to work as a [c]ustodian.
In conclusion, based on the restrictions and limitations identified, you may not be able to return to your job as a [c]ustodian, but you may have sedentary work capacity in the future. Therefore, you do not meet the definition of totally disabled... and it is recommended that your claim be denied. AR 312-13.

8. The denial letter does not identify what "sedentary work" that Obaid was qualified to perform.

9. In a letter also dated July 12, 2010, MetLife approved Obaid's "claim for long Term Disability (LTD) Benefits from the Building Service 32BJ Health Fund." AR 309. This benefit is provided to covered employees who become "totally disabled ...


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