United States Tenth Circuit

In an action challenging defendant-plan administrator's denial of a request for long-term disability benefits, summary judgment for administrator is reversed and remanded as: 1) the district court erred in interpreting the plan according to New Mexico law as ERISA governs the terms of defendant's master-group insurance policy; and 2) applying the proper standard, the plan was ambiguous because a reasonable plan participant could easily conclude that a Title XVI award coupled with a finding of physical disability would constitute a "Social Security Disability Award" for purposes of the benefits sought.

Appellate Information

• Decided 09/25/2007
• Published 09/26/2007

Judges

• HENRY, Circuit Judge., Before HENRY, McWILLIAMS, and TYMKOVICH, Circuit Judges.

Court

• United States Tenth Circuit

Counsel

• For Appellant:
  
• James Rawley, Albuquerque, NM, for Plaintiff-Appellant.


• For Appellees:
  
• Bernie E. Hauder, Adkerson, Hauder & Bezney, Dallas, TX (Bruce S. McDonald and Lucinda Siembieda, Law Offices of Bruce S. McDonald, Albuquerque, NM, with him on the briefs), for Defendants-Appellees.