Sun Sun Lin v. Mellon Long Term Disability Plan, an ERISA plan

This disposition is not appropriate for publication and is not precedent*
except as provided by 9th Cir. R. 36-3.
NOT FOR PUBLICATION
UNITED STATES COURT OF APPEALS
FOR THE NINTH CIRCUIT
SUN SUN LIN,
Plaintiff - Appellant,
v.
MELLON LONG TERM DISABILITY
PLAN, an ERISA plan,
Defendant - Appellee.
No. 09-55434
D.C. No. 8:08-cv-00107-DOC-AN
MEMORANDUM*
Appeal from the United States District Court
for the Central District of California
David O. Carter, District Judge, Presiding
Argued and Submitted May 5, 2010
Pasadena, California
Before: NOONAN, CLIFTON and BYBEE, Circuit Judges.
Plaintiff-appellant Sun Sun Lin (“Lin”) appeals the district court’s grant of
summary judgment in favor of defendant-appellee Mellon Long Term Disability
Plan (“the Plan”). Because the Plan Administrator—the Corporate Benefits
FILED
MAY 13 2010
MOLLY C. DWYER, CLERK
U .S. C OU R T OF APPE ALS

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Section 6.5(a)(2) mirrors the language of 29 C.F.R. § 2560.503-1(h)(2),1
which states that “the claims procedures of a plan will not be deemed to provide a
claimant with a reasonable opportunity for a full and fair review of a claim and
adverse benefit determination unless the claims procedures . . . (iv) Provide for a
review that takes into account all comments, documents, records, and other
information submitted by the claimant relating to the claim, without regard to
whether such information was submitted or considered in the initial benefit
determination.”
In 2004, the Plan found Lin to be totally disabled from performing the2
essential duties of her own occupation. Under the terms of the Plan, after two
years of benefits under the “own occupation” definition of total disability, benefits
are provided only if the claimant is determined to be totally disabled under the
more exacting “any occupation” standard.
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Committee (“CBC”)—neither interpreted the Plan unreasonably nor abused its
discretion in determining that Lin was not totally disabled, we affirm.
Lin argues that the CBC failed to provide her with a full and fair review of
the denial of her claim for long term disability benefits. Lin points to § 6.5(a)(2) of
the Plan, which provides that the CBC “shall take into account all comments,
documents, records, and other information submitted by the participant relating to
the Claim, without regard to whether such information was submitted or
considered in the initial benefit determination.” According to Lin, the CBC ran1
afoul of § 6.5(a)(2) because it did not directly consider certain documents relating
to an earlier determination that Lin was totally disabled under a less stringent
definition of total disability. Lin relies on a statement by the Plan’s attorneys “that2

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the CBC did not directly consider those documents in making its determination to
deny [Lin’s] claim,” but did “‘indirectly’ consider[] these documents to the extent
they were reviewed and considered by” an independent medical examiner retained
by the CBC in its review of Lin’s appeal.
The Plan does not, by its terms, contain any “direct[] consider[ation]”
requirement. Rather, § 6.5(a)(2) of the Plan requires the CBC to “take into account
all comments, documents, records, and other information submitted by the
participant relating to the Claim.” The CBC fully complied with this requirement:
in its letter of October 29, 2007, advising Lin that it was rejecting her appeal, the
CBC stated that “[i]n making [its] determination, the CBC considered [Lin’s]
entire administrative record, including information [Lin] submitted on appeal and
the report of an independent medical professional.” Moreover, § 6.5(a)(3)
provides that the CBC “shall, in the event of an appeal of any Adverse Benefit
Determination that is based in whole or in part on medical judgment, consult with a
Health Care Professional who has appropriate training and experience in the field
of medicine involved in the medical judgment.” Here, the CBC designated an
independent medical expert to review all documents submitted by Lin, and then
directly reviewed the medical expert’s report as well as other documents. The

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CBC did not interpret § 6.5(a)(2) as requiring it to directly review each and every
document considered by the independent medical expert.
The Plan unambiguously delegates discretion to the CBC, so we review the
CBC’s interpretation of the Plan and its determination that Lin was not totally
disabled for abuse of discretion. Kearney v. Standard Ins. Co., 175 F.3d 1084,
1090 (9th Cir. 1999) (en banc). We must defer to the CBC’s decisionmaking
“unless it [wa]s not grounded on any reasonable basis.” Sznewajs v. United States
Bancorp Amended & Restated Supplemental Benefits Plan, 572 F.3d 727, 734-35
(9th Cir. 2009). In light of the plain language of the Plan, which provides that the
CBC need only “take into account,” not “directly consider,” all documentation, and
which actually requires that the CBC consult an independent expert on questions
of medical judgment, the CBC did not abuse its discretion in “indirectly
consider[ing]” certain medical documents relating to an earlier benefits
determination under a different disability standard. Moreover, the record makes
clear that the CBC had a reasonable basis for determining that Lin was not totally
disabled under the Plan’s “any occupation” standard.
AFFIRMED.

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