Appellate court upholds disability ruling in favor of ex-MFPD captain

By MIKE ANTHONY

A lower court’s ruling in favor of a former Mehlville Fire Protection District employee’s claim for disability benefits has been affirmed by the Eastern District of the Missouri Court of Appeals.

A three-judge panel — Robert G. Dowd, Clifford H. Ahrens and Sherri B. Sullivan — of the Eastern District of the Missouri Court of Appeals last week issued a per curiam order affirming an August ruling by St. Louis County Circuit Court Judge Colleen Dolan in favor of former Capt. Don Hoskins’ claim for disability benefits.

Hoskins filed the lawsuit against the Mehlville Fire Protection District in May 2007 after the Board of Directors voted to deny the claim he filed in November 2006 for disability benefits.

The district’s Pension Committee voted March 6, 2007, to grant Hoskins’ claim for disability benefits. However, the district’s Board of Directors voted 2-1 to overrule the Pension Committee’s decision with board Chairman Aaron Hilmer and board Treasurer Bonnie Stegman in favor and then-board Secretary Dan Ottoline opposed.

Hoskins, who had been employed by the fire district since April 1980, then filed suit. His attorney, Gary Growe, contended the Pension Committee’s decision was not subject to review by the Board of Directors, and the fire district and board breached their fiduciary duties by failing to follow the provisions of the disability plan.

Mathew Hoffman, the fire district’s legal counsel, responded the Board of Directors had voted Hoskins was not disabled under the terms of the disability plan, contending Hoskins’ condition was not the result of an identifiable, objective recent incident as required by the plan. Under the plan, three doctors were required to evaluate Hoskins’ condition and they concluded Hoskins suffered from a pre-existing injury, according to Hoffman.

The fire district’s attorney also noted that Hoskins had filed a report of a work-related injury on Sept. 27, 2006, stating the injury occurred Sept. 19, 2006, yet worked overtime hours after Sept. 19, 2006.

Dolan granted Hoskins’ motion for partial summary judgment on April 16, 2008, and issued an amended final judgment on Aug. 6, 2008.

In her amended final judgment, she wrote, “Judgment is hereby entered the sum of $28,856.83 for payment of past-due disability benefits as set forth in the amended stipulation of parties with respect to damages.

“In addition, a judgment is hereby entered in favor of plaintiff granting to plaintiff the right to elect a lump-sum payment at normal retirement age or earlier should defendant choose that option for payment.”

The amended final judgment was appealed by the Board of Directors. Before Hoskins filed his claim, the board had voted to change to the district’s self-funded employee disability plan to an insurance policy with the Standard Insurance Co.

However, Local 1889 of the International Association of Fire Fighters filed a lawsuit in June 2005 asking the court to prohibit the board from implementing the disability benefit contract with Standard Insurance. The lawsuit was dismissed in February 2006 and the dismissal was affirmed by the appellate court in January 2007.

The state Supreme Court in May 2007 declined to hear the suit and the self-funded disability plan later was terminated.

During oral arguments June 10 before the appellate-court panel, Growe contended Hoskins’ medical condition was irrelevant because the Pension Committee approved his claim for disability benefits.

In his appellate brief, Growe wrote, “… Defendants claim that they reviewed certain medical records and reports on plaintiff and decided to veto the decision of the Pension Committee … The answer to defendants’ position is quite simple. IT IS NOT THEIR DECISION TO MAKE! The language of the retirement plan and summary plan description vest full and sole authority to the Pension Committee … The plan does not provide for an appeal or review by the Board of Directors. In fact, the only review which is authorized under the terms of the plan is a review or reversal by the Pension Committee …”

Growe also wrote, “… The issue is not the nature and extent of plaintiff’s injury and whether he qualified for disability … The issue is simply that the question of Capt. Hoskins’ entitlement to disability benefits was decided by the final arbiter of the question — the Pension Committee. The Board of Directors had delegated all authority to that committee for decision-making.”

Hoffman countered Hoskins previously had applied for disability benefits in April 1998 “for his prior back condition, but later withdrew his application … At that time, Mr. Hoskins also cited persistent back problems as a reason for his disability in 1998, which is consistent with the relevant medical reports received by the district regarding his 2006 disability application … Clearly, Mr. Hoskins did not suffer ‘a recent, identifiable event’ as required by the terms of the disability policy.

“It is curious that Mr. Hoskins did not want the lower court to review any of the medical issues with regard to his application for disability with the Mehlville Fire Protection District. Rather, Mr. Hoskins contends that it is irrelevant whether he is actually disabled … Further, Mr. Hoskins states that his medical condition is irrelevant to the disability determination …”

Hoffman also contended the self-funded disability plan was administered “subject to the ultimate authority” of the board under state statute while Growe countered the board had the ultimate authority to establish the plan, but not the authority to overrule the Pension Committee.

Of the appellate court’s decision, Growe told the Call, “… The court accepted the proposition that it was the Pension Committee’s sole job to determine eligibility and the plan document actually says that there shall be no appeals from the decision of the Pension Committee. The only appeal available is to bring it back to the Pension Committee …”

Hilmer told the Call he wasn’t surprised by the court’s decision, but noted Hoskins will be the last employee to receive disability benefits under the old disability plan.

“… This is exactly why Bonnie and I terminated this plan because it enabled employees to get put on lifetime disability regardless of their medical condition,” he said. “This also makes it crystal clear why we were sued by Local 1889 so we couldn’t get rid off this fraud-ridden plan. But the good news is that this never can happen again. This is the last vestige of the old Mehlville. The new Mehlville is what we’re focused on. After years of ripping off the taxpayers, this is the final poke in the eye by the employees on the now-defunct Pension Committee …”

Hilmer also said he personally believes the board will not appeal the appellate court’s decision, but noted the board has not made a decision. A closed session to discuss the matter was scheduled Tuesday — after the Call went to press.