Opinion · Supreme Court of the United States

Black & Decker Disability Plan v. Nord

538 U.S. 822

Type
Opinion
Court
Supreme Court of the United States
Jurisdiction
Federal
Date
2003-05-27
Topic
general

How later courts describe this case

  • holding that plan administrators do not owe special deference to the opinion of a treating physician
  • holding that while ERISA administrators may not arbitrarily ignore a treating physician’s opinion, that opinion also is not entitled to any “special deference”
  • holding that the “treating physician” rule does not apply to disability determinations under employee benefits plans covered by ERISA
  • holding that the “treating physician rule” does not apply to disability determinations under employee benefit plans covered by ERISA
  • holding that courts may not impose on plan administrators a “discrete burden of explanation when they credit reliable evidence that conflicts with a treating physician’s evaluation”
  • holding that ERISA does not require plan administrators to accord special deference to the opinions of treating physicians
  • holding that ERISA requirements “do not command plan administrators to credit the opinions of treating physicians over other evidence relevant to the claimant’s medical condition.”
  • holding that ERISA does not require plan administrators to give special deference to treating physicians’ opinions, although administrators may not arbitrarily refuse to credit them

Citator

UpLaw has not yet analyzed Black & Decker Disability Plan v. Nord. The absence of a flag is not a finding that it is good law.

Cited by
1367 opinions

Headnotes

  1. Employee Benefits & Exec Comp — Disability Benefit Determinations — Weight of Treating Physician Opinions ERISA does not require plan administrators to accord special deference to the opinions of a claimant's treating physicians, and neither the Act nor the Secretary of Labor's regulations impose a heightened burden of explanation on administrators when they reject a treating physician's opinion. 538 U.S. at 825
  2. Employee Benefits & Exec Comp — Claim Procedures — Full and Fair Review ERISA and the Secretary of Labor's regulations require a "full and fair" assessment of claims and clear communication to the claimant of the specific reasons for benefit denials, but these measures do not command plan administrators to credit the opinions of treating physicians over other evidence relevant to the claimant's medical condition. 538 U.S. at 825
  3. Administrative Law — ERISA — Agency Deference Where the Secretary of Labor has not adopted a treating physician rule by regulation for ERISA disability determinations and the Department of Labor opposes such a rule, courts have no warrant to impose one; had the Secretary chosen to adopt such a rule, courts would examine that determination with appropriate deference under Chevron. 538 U.S. at 831
  4. Employee Benefits & Exec Comp — Disability Determinations — Accuracy of Benefit Determinations Whether a treating physician rule would increase the accuracy of ERISA disability determinations is a question best addressed by the Legislature or the superintending administrative agency, particularly because the assumption that a treating physician's opinion warrants greater credit than a plan consultant's may make scant sense where the treating relationship was of short duration or the plan's specialist has expertise the treating physician lacks. 538 U.S. at 832
  5. Employee Benefits & Exec Comp — Disability Determinations — Distinction from Social Security Program Critical differences between the Social Security disability program and ERISA benefit plans caution against importing a treating physician rule from the former into the latter: the Social Security program is an obligatory, nationwide benefits program administered under uniform federal criteria, whereas ERISA does not require employers to establish benefit plans or mandate what benefits they must provide, and the validity of an ERISA claim generally turns on the interpretation of the terms of the particular plan at issue. 538 U.S. at 833
  6. Employee Benefits & Exec Comp — Disability Determinations — Evidence Plan administrators may not arbitrarily refuse to credit a claimant's reliable evidence, including the opinions of a treating physician, but courts may not require administrators automatically to accord special weight to the opinions of a claimant's physician, nor impose on administrators a discrete burden of explanation when they credit reliable evidence that conflicts with a treating physician's evaluation. 538 U.S. at 834