The opinion of the court was delivered by: WILLIAM SCHWARZER, Senior District Judge
FINDINGS OF FACT AND CONCLUSIONS OF LAW
Plaintiff Richard H. Aguilar brings this action, arising under
the Employee Retirement Income Security Act of 1974 ("ERISA"),
29 U.S.C. § 1132, against Defendant New United Motor Manufacturing,
Inc. Disability Insurance Income Plan ("the Plan"), challenging
the denial of his claim for short-term and long-term disability
benefits that he alleges are due to him under the terms of the
A pretrial conference was held on October 25, 2004, at which
the Court (White, J.) appropriately determined and the parties
conceded that Plaintiff's claim would be reviewed de novo
because the Plan contains no language delegating authority to the
Plan Administrator to interpret the terms of the Plan. See
Kearney v. Standard Ins. Co., 175 F.3d 1084, 1089 (9th Cir.
1999) (citing Firestone Tire & Rubber Co. v. Bruch,
489 U.S. 101, 109 (1989)). The Court additionally held that it would not exercise its discretion to
admit evidence outside of the administrative record in its
evaluation of the Plan Administrator's decision. See id. at
The parties submitted trial briefs and proposed findings of
fact and conclusions of law, and made arguments at a bench trial
hearing on February 4, 2005. The case was reassigned to the
undersigned on June 27, 2005.
The Court, having reviewed the administrative record, the
hearing transcripts, and the papers submitted by the parties, now
finds for Defendant and against Plaintiff.
The action arises under ERISA, 29 U.S.C. § 1132, and this Court
has jurisdiction over Plaintiff's claim pursuant to
29 U.S.C. § 1132(e) .
The following facts are taken from the administrative record
("PLAN") submitted by the parties, which contains the only
relevant and admissible evidence in the trial of this matter.
See Kearney, 175 F.3d at 1090-91.
Plaintiff was employed by New United Motor Manufacturing, Inc.
("NUMMI") from February 1985 to December 2000, as a production
line inspector. PLAN 0284-85. As an employee of NUMMI, Plaintiff
was a participant in NUMMI's employee welfare benefit Plan, which
was funded through the purchase of a group insurance policy
issued by the Life Insurance Company of North America ("LINA").
A. The NUMMI Disability Income Insurance Plan
The Plan provides for disability benefits if, because of injury
or sickness, an employee is unable to perform all the material
duties of any occupation available at the Plant for which he is
or may reasonably become qualified based on his education,
training or experience. PLAN 0005, 0309.
Under the Plan, short-term disability benefits are payable for
a maximum of 52 weeks after a seven-day benefit waiting period
during which the participant must be continuously and totally
disabled. PLAN 0027. Long-term disability benefits are payable
after 52 weeks of continuous disability. PLAN 0009. If a
participant is 50 or older when the disability began, long-term benefits are payable until the earlier of ...