Black & Decker Disability Plan v. Nord
Nord, an employee of a subsidiary of the Black & Decker Corporation, was enrolled in the Black & Decker Disability Benefits Plan. When he was diagnosed with sciatica, Nord applied for disability benefits. The Plan Manager denied his benefits despite the written support of two treating physicians. As part of a review of denial of benefits, Nord was examined by a doctor chosen by the insurance plan, who disputed the conclusion of the treating physicians, and a Black & Decker human resources manager, who confirmed the conclusion. Nord appealed his final denial of benefits to the district court under the Employee Retirement Income Security Act (ERISA), which held that the Plan Manager did not abuse its discretion in denying Nord's claim. The Ninth Circuit Court of Appeals reversed, holding (1) that the district court erred in reviewing the disability determination for an abuse of discretion because the Plan was operating under a conflict of interest and a less deferential standard of review must be applied; (2) Nord supplied material, probative evidence tending to show that the Plan’s self-interest caused a breach of its fiduciary obligations to the beneficiary; (3) the Plan failed to rebut the presumption that the conflict of interest did not affect its decision to deny benefits to Nord.
Question Presented:
Whether the Ninth Circuit erred in holding that an ERISA disability plan administrator's determination of disability is subject to the "treating physician rule" and, therefore, that the plan
administrator is required to accept a treating physician's opinion of disability as controlling unless the plan administrator rebuts that opinion in writing based upon substantial evidence on the
record.
