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In re Disability Application of
[JRG], Claimant.
________________________/
not governed by the collective bargaining agreement dated October 6, 1979 [Jt
[Claimant]'s application for a disability pension under the terms of the collective
Factual Background
The claimant, [JRG], was employed by the Company, Huron Forge and
Machine Company, on July 13, 1965. During the course of his employment,
[Claimant] was a member of and represented by the Union, West Side Local
Workers of America ("UAW"). [Claimant]'s last day worked was June 15,
1977, at which time he went on sick leave for hypertension. [Claimant] was not
in good health, having taken sick leave for hypertension some two years earlier.
[Claimant] has not worked at all since his last day with the Company in 1977.
Huron Forge and Machine Company - UAW Retirement Income Plan ("Plan")
[Jt Ex 1, §2.3, p 4]. [Claimant]'s original application for Social Security benefits
was denied in a decision dated August 14, 1978 [Jt Ex 11, p 4]. However, his
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Workers' Compensation claim was redeemed by order dated August 30, 1979
[Claimant] executed a Release and Waiver of Seniority dated June 28, 1979 [Jt
Ex 4]. On that same date, [Claimant] filled out an application for a Disability
Retirement Benefit from the Plan [Jt Ex 3]. It is from a denial of this application
[Claimant]'s application. From the minutes of that meeting [Co Ex 1], it appears
that the Committee reviewed the provisions of the Plan document pertaining to
Dash, [Claimant]'s physician [Un Ex 7A-B]. Although Dr. Dash opined that
[Claimant] was disabled1, the Committee was aware that the Social Security
Plan §4.2(c)(l), p 12, referred [Claimant] to Dr. Sonia Ramirez for examination
[Jt Ex 6-7].
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condition of such disabled Employee," Dr. Ramirez* report [Jt Ex 8] was
nothing in that paragraph or in the rest of the report gives Dr. Ramirez' opinion
Following receipt of Dr. Ramirez' report, the Committee met on April 30,
1980 and voted unanimously to deny [Claimant]'s application [Co Ex 2]. The
letter informing [Claimant] of the Committee's decision also apprised him of his
appeal rights under Plan §8.4, p 19 [Jt Ex 9]. In response, on May 27, 1980,
[Claimant] wrote the Committee, asking that his application be put on hold
pending a new hearing on his application for Social Security disability benefits
[Jt Ex 10].
Judge Arthur Yim on February 25, 1982 [Jt Ex 11]. Upon learning of the award,
the Company members of the Committee sought advice from the Plan actuary
The Committee met April 26, 1982 and split along organizational lines
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In view of the split vote, it was the unanimous decision of the Committee
that letters be sent to John Hancock requesting *** information on ***
their proof of disability and Dr. Sonia Ramirez, M.D., examining
physician for specific medical opinion of his case.
Although a letter to John Hancock was drafted [Un Ex 6], it was never sent, nor
was one sent to Dr. Ramirez. A letter dated April 27, 1982 [Un Ex 11] was sent
to [Claimant] informing him that a hearing was to be held in his case, although
August 24, 1982 and continued into 1983. The Union filed a grievance, to
pursuant to Plan §8.1, p 18 and §8.6, p 19. This procedure finally was agreed
upon.
and continued on December 2, 1983. Present were the claimant and his counsel.
Also present were the three Company Committee members and the three Union
Committee members. The case for the claimant and Union was presented by an
International Representative from the UAW. The case for the Company was
stated that he was satisfied with the representation afforded him by his Union
and agreed that he had received a full and fair hearing. Counsel for the claimant
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and Company filed post-hearing briefs on January 23, 1984, while the Union
Discussion
dated October 6, 1979 [Jt Ex 15] ("1979 Agreement") and the Plan as amended
The 1979 Agreement covers all Company "employees" except office workers,
the salaried and supervisors [1979 Agreement, Art I, §1, p 1 and §4, p 2].
Although there is some debate as to whether the effective date of the claimant's
Release and Waiver of Seniority [Jt Ex 4] ought to be June 28, 1979 or the
August 30, 1979 date of the Redemption Order [Jt Ex 5], in either case the
the express terms of the release, he "voluntarily quit his employment with the
*** Company."
Although the 1979 Agreement did make some what might be called
"retroactive" changes in the Plan [1979 Agreement, pp 76-78], the parties were
careful to delineate which changes applied to past retirees and which applied
the 1979 Agreement is to be given effect to anyone who was not an "employee"
at the time. The language of the Second Amendment to the Plan [Un Ex 1],
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signed by the Union and the Company in implementation of the 1979
NOW, THEREFORE, the Parties Hereby Agree that the Plan shall be
amended effective as of October 6, 1979, which amendment for all
purposes shall be effective as of October 6, 1979, except as provided
specifically herein, with respect only to Employees represented by the
Union in active employment with the Company on or after October 6,
1979.
The Union urges that the disability provisions of ¶C.l, p 76 of the 1979
there may be some merit to this point, it is irrelevant to the issue of the effective
disability pension only under the terms of the Plan as it existed prior to the 1979
Agreement.
To qualify for a disability pension under Plan §2.3, p 4, the claimant must
The claimant in his brief urges that the "occupation or employment" must be
with the Company but this narrow interpretation does not comport readily with
the broad language which the parties chose to express their intent. Thus the
ultimate issue is whether the claimant was or was not able to engage in any
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regular full time occupation or employment for remuneration or profit as of the
layman almost 5 years later in 1984, is far from satisfactory. It is all the more
unsatisfactory when one considers that the sad state of the evidence is due to the
report [Jt Ex 8] which, according to the express terms of the Plan document, is
for it without hesitation except for the fact that [Claimant]'s application has been
pending for almost 5 years. This dispute simply must come to an end. The
4
The explanation offered is that these Committee members became convinced that the 1979 Agreement had
some retroactive effect or that it codified past practice of awarding disability pensions on the basis of Social
Security awards. As has been discussed, the language of both the 1979 Agreement and the Second Amendment
implementing it negate any suggestion of retroactivity. As to past practice of granting disability pensions on the
basis of Social Security awards, the testimony was highly conflicting. Some of the very Committee members who
were alleged to have voted to award disability pensions on the basis of Social Security awards flatly denied doing
so. Documented evidence of past practice was offered only in the form of the complete files of previous claimants
without any summary, synopsis or digest from which the Committee's decision-making process could be
reviewed. Nothing short of retrials of earlier cases could have established the basis for the Committee's decisions.
If the Committee wants its decisions to be helpful as precedents, it should consider embodying them in a useful,
written form. There was a suggestion that some Committee members led the claimant to believe that a favorable
decision from Social Security automatically would entitle him to a disability pension under the Plan. A Committee
member's authority to make such a representation is clearly restricted by Plan §8.9, p 20 and a member does so at
his own legal peril.
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signed by [Claimant]'s personal physician, Dr. Dash [Un Ex 7A-B]. The
Company contends that the definition of disability used by Dr. Dash is different
Atherosclerosis. Syncope. Cephalgia" and opined (a) that [Claimant] was totally
disabled for his regular occupation and for any occupation, and (b) that
[Claimant] would never be able to resume any work in his regular occupation or
in any occupation. Not a perfect match with the Plan definition, but really very
close. In Un Ex 7B, Dr. Dash basically reiterated his earlier diagnosis and
opinion.
Administrative Law Judge Yim [Jt Ex 11]. It is unclear if Judge Yim had before
him Dr. Dash's February 15, 1978 report [Un Ex 7A], either at the original
hearing in 1978 or at the subsequent one in 1982. It is important to note that the
Committee, consisting of legal laymen, did not seek the advice of counsel in
given.
concluded that [Claimant] “‘still has the residual functional capacity to perform
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sedentary work.’” However, a close reading of Judge Yim's opinion indicates
[T]he Administrative Law Judge concludes and finds that the claimant
still has the residual functional capacity for no more than sedentary work.
(Emphasis supplied)
See also Claimant's Brief, p 1. This choice of language reveals a change from
In a decision dated August 14, 1978, it was determined that the claimant
*** had the residual functional capacity to perform sedentary work and
was, therefore, not disabled ***.
To say that a car was going no more than 60 miles per hour is not to say
that the driver necessarily was speeding. He may have been driving 55, yet the
affirmatively found that [Claimant] had the capacity to perform sedentary work,
in 1982 he weakened that finding to no more than sedentary work; that is,
[Claimant] may not have had the capacity to do sedentary work, just as the
driver may not have been speeding. If Judge Yim had meant only that
When one considers the task before a decision-maker like Judge Yim, it
is not difficult to understand why he may have phrased his opinion as he did.
What Judge Yim may have done is decided [Claimant]'s case by taking the easy
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way out. Judge Yim could have reviewed all of the detailed, complicated
medical evidence in the case and found [Claimant] to be disabled and thus
entitled to disability benefits or he could have found for [Claimant] based upon
resolved readily and easily on the basis of a technicality, there was no incentive
for Judge Yim to undertake the more difficult, time-consuming task of delving
deeply into medical evidence and reaching the real merits on [Claimant]'s
physical condition.5 We shall never know for sure, because Judge Yim did not
that too much weight has been given to Judge Yim's opinion [Jt Ex 11].
more tends to be read out of them than is written into them. With the foregoing
discussion freshly in mind, the absence of a definitive opinion from Dr. Ramirez
becomes all the more distressing. She does not say that [Claimant] is disabled
within the meaning of the Plan; on the other hand, she does not say that he is
not. Like Judge Yim's opinion, Dr. Ramirez' report compels no conclusion one
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In summary, the evidence before me is as follows:
9. Undisputed fact that claimant has not worked at all since 6/15/77, i.e., in
over 6 years.
I conclude that the claimant has, by the narrowest of margins, established that he
In so deciding, I am not unmindful of the fact that the minutes6 reflect the
6
Minutes of Committee meetings were received over objections that they were incomplete, inaccurate or had not
been approved by Committee members; see, e.g., Jt Ex 16. There is no reason to doubt the integrity of the
Committee secretary who wrote the minutes nor is there any reason to attribute to him any sinister motive. This
being the case, minutes written contemporaneously with the events described therein are as good or better
evidence than witnesses' memories of the same events long past. If the Committee wants its minutes to have
precedential value, and especially if the Committee expects to rely on the minutes to prove that it acted prudently,
then procedures might be adopted for circulating and approving minutes as soon as they are prepared.
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application because members felt he did not meet the Plan's criteria for a
disability pension. If the regular members of the Committee have doubts about
the status of the claimant's health, they can exercise their discretion under Plan
§4.2(b)(2), (3) and (c)(l) to require that the claimant submit to a new physical
examination.
retroactive to the date of his application, June 28, 1979 (unless the Committee
sets an earlier effective date pursuant to Plan §4.3, p 12). His pension is, of
course, subject to the offsets described in Plan §3.3, p 7. Interest need not be
added to any net amount found owing because the delay was due in part to the
claimant's own request and because a bona fide dispute existed over his
entitlement.
____________________________
E. Frank Cornelius, J.D., Ph.D.
Impartial Chairman
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