providing that an administrator’s finding constitutes an abuse of discretion when, “although there is evidence to support it, the reviewing [body] on the entire evidence is left with the definite and firm conviction that a mistake has been committed.” (quoting Concrete Pipe & Prods. of Cal., Inc. v. Constr. Laborers Pension Trust for S. Cal., 508 U.S. 602, 622, 113 S.Ct. 2264, 124 L.Ed.2d 539 (1993)) (alteration in original)
How later courts described this case
- providing that an administrator’s finding constitutes an abuse of discretion when, “although there is evidence to support it, the reviewing [body] on the entire evidence is left with the definite and firm conviction that a mistake has been committed.” (quoting Concrete Pipe & Prods. of Cal., Inc. v. Constr. Laborers Pension Trust for S. Cal., 508 U.S. 602, 622, 113 S.Ct. 2264, 124 L.Ed.2d 539 (1993)) (alteration in original)
- holding that ERISA fiduciary decisions in claim for disability benefits were reviewed under deferential standard
- holding that fiduciaries of benefit plans are “obligated to guard the assets of the Plan from improper claims”
- holding that 24 an “ERISA administrator abuses its discretion [if it] renders a decision without explanation”
Written by the judges who cited it.
The opinion
WARDLAW, Circuit Judge,
concurring in part and concurring in the result:
I part company with the majority’s inclusion of the dictum on pages 7026-27, *1180 where the opinion states: “An ERISA administrator’s exercise of its discretion to adjudicate claims is not a mere exercise in expert poll-taking. We hold that a mere tally of experts is insufficient to demonstrate that an ERISA fiduciary has abused its discretion.” The opinion reaches the correct result solely because the standard of review is “significantly deferential” to the Board; we may not hold the Board’s factfinding to be erroneous unless the “entire evidence” leaves us with “the definite and firm conviction that a mistake has been committed.” Concrete Pipe & Prods., Inc. v. Constr. Laborers Pension Trust, 508 U.S. 602 , 113 S.Ct. 2264 , 124 L.Ed.2d 539 (1993). Moreover, “that the plan administrator’s decision is directly contrary to some evidence in the record does not show that the decision is clearly erroneous.” Snow v. Standard Ins. Co., 87 F.3d 327, 331 (9th Cir.1996). My conclusion that the Board did not abuse its discretion under this standard is based on the fact that Boyd’s head injury was not contemporaneously diagnosed, and therefore it was not unreasonable for the Board to rely upon Dr. Gordon’s opinion that Boyd’s head injury did not arise from his football activities. Because the opinion’s conclusion is based on the deferential nature of the abuse of discretion standard of review applicable to this case, both the tone and substance of the quoted sentences are unnecessary.