Dickens v. Aetna Life Ins. Co., No. 11-1434

Decided: April 20, 2012

Aetna appealed the denial of its summary judgments request. Plaintiff, Dickens, filed suit in state court under ERISA after Aetna terminated his disability benefits. Aetna removed the case to the Southern District of West Virginia, and both parties moved for summary judgment. The District Court denied both motions and remanded to Aetna for further consideration, concluding that relevant evidence was not properly considered. While not addressed by either party, the Fourth Circuit Court of Appeals raised the issue of jurisdiction and dismissed the appeal for lack of jurisdiction.

In 2002, plaintiff was hired by Bristol-Meyers Squibb Company and participated in a long-term disability plan sponsored by the company. In 2004, plaintiff began suffering from clinical depression, anxiety, insomnia, and suicidal ideations and as a result applied for, and was granted, benefits under the long-term disability plan. Plaintiff also applied for, and was granted, Social Security benefits. Plaintiff received benefits until August of 2008 when Aetna, the successor claims administrator for the long-term disability plan, terminated his benefits finding that the plaintiff no longer suffered from a debilitating injury or illness. However, the Social Security Administration continued to consider the plaintiff disabled, and thus he continued to receive Social Security benefits.

Plaintiff filed two appeals with Aetna, but both were denied. Plaintiff then filed this suit in state court. Aetna removed the case to federal Court, invoking federal question jurisdiction pursuant to ERISA. The District Court denied both parties’ motions for summary judgment, but granted plaintiff motion to the extent that plaintiff requested the case be remanded to Aetna, finding that Aetna neglected to address relevant evidence regarding the Social Security Administration’s award of benefits to the plaintiff.

The District Court never entered final judgment, however, Aetna filed a notice of appeal on April 27, 2011. Neither party had raised the issue of appellate jurisdiction until oral arguments were heard. The appeal was deemed interlocutory as no final order of judgment was entered by the District Court. While the Fourth Circuit had not addressed the issue previously, the Court held that a District Court order remanding to an ERISA claims administrator for reconsideration does not constitute a final decision.

Aetna maintained that the Order satisfies each of the requirements of the collateral order doctrine. The Court conceded that the Order conclusively determined a disputed legal question, the first requirement of the collateral order doctrine, but pointed out that if the Order fails to satisfy any of the three requirements, the collateral order doctrine does not apply.

The Appellate Court then considered the second requirement of the collateral order doctrine and disagreed with Aetna’s argument that the Order did not reach the merits of plaintiff’s claim. The Court found that the lower Court’s decision was not “completely separate from the merits,” and that the threat of substantial duplication of judicial decision existed, and as such was enough to preclude the application of the collateral order doctrine in this case as failing under the second requirement.

The appellate Court also pointed out that even if the District Court’s order was not as entangled with the merits of the case, the third requirement of the collateral order doctrine – that the Order itself would be effectively unreviewable – would not be met in this case. The Order merely directs Aetna to reconsider the evidence, but does not direct it to find the existence of a disability and grant plaintiff the disputed benefits. Furthermore, even if Aetna’s reconsideration of the evidence pursuant to the Order results in it awarding the benefits to plaintiff, Aetna would still be entitled to appeal the final judgment despite that fact that it would appear that Aetna would be appealing it’s own eligibility determination. In dealing with this “perceived dilemma” the appellate Court held that it would adopt the rationale of the First, Sixth, and Eleventh Circuits construing the Order as retaining jurisdiction in the Southern District of West Virginia for appropriate further proceedings following disposition of the Court’s remand to Aetna. As such, the decision would be reviewable precluding the application of the collateral order doctrine as failing the third requirement.

In conclusion, the Court found that the collateral order doctrine did not apply, thus the Court lacked jurisdiction and dismissed the appeal.

Full Opinion

– Kassandra Moore

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