October Term 2002 · Docket 02-469
Must ERISA plans accept treating physician opinions over other medical evidence?
the sides that brought the case argue the Ninth Circuit wrongly forces plans to accept treating physician views. the opposing sides claim this rule protects disabled workers from biased denials.
Verified source milestones
- — An official oral-argument transcript was verified.
- — An official oral-argument transcript was verified.
The arguments, in order
This case may have been argued more than once. Each entry below uses that session's official transcript. Later arguments do not erase earlier ones.
Argument 1 ·
What happened at the argument
Mr. Rohlfing argued lower courts confused conflict of interest with actual bias. He stated this confusion occurred after the Firestone decision. He claimed this misinterpretation harms plan administrators.
Mr. Paterson argued the Ninth Circuit rule is categorical. He stated it assumes treating physician opinions are superior. He claimed this assumption lacks support in the record.
Ms. Blatt stated the Secretary did not impose a treating physician requirement. She argued the Secretary did not constrain plan administrators. She maintained the Secretary considered alternatives to this rule.
Read the official transcript for this argument · Official argument details
Sources used for this argument breakdown
- Official Supreme Court Transcript — file page 18, lines 35-45 — Transcript, file page 18, lines 35-45
- Official Supreme Court Transcript — file page 25, lines 9-7 — Transcript, file page 25, lines 9-7
- Official Supreme Court Transcript — file page 3, lines 17-5 — Transcript, file page 3, lines 17-5
- Official Supreme Court Transcript — file page 3, lines 5-15 — Transcript, file page 3, lines 5-15
- Official Supreme Court Transcript — file page 50, lines 43-31 — Transcript, file page 50, lines 43-31
- Official Supreme Court Transcript — file page 53, lines 33-37 — Transcript, file page 53, lines 33-37
A citizen's guide to the whole case
What this case is about
This case tests whether federal disability plans must prioritize treating physician opinions. The Ninth Circuit created a rule requiring plans to accept these views or provide specific reasons for rejection. the sides that brought the case argue this rule misinterprets federal law. the opposing sides argue it prevents arbitrary denials of benefits.
Official sources for this section
- Official Supreme Court Transcript — file page 18, lines 35-45 — Transcript, file page 18, lines 35-45
- Official Supreme Court Transcript — file page 25, lines 9-7 — Transcript, file page 25, lines 9-7
- Official Supreme Court Transcript — file page 3, lines 17-5 — Transcript, file page 3, lines 17-5
- Official Supreme Court Transcript — file page 50, lines 43-31 — Transcript, file page 50, lines 43-31
How the case got here
The Supreme Court heard oral argument in this case on April 28, 2003.
Official sources for this section
- Official Supreme Court Transcript — file page 3, lines 5-15 — Transcript, file page 3, lines 5-15
- Official Supreme Court Transcript — file page 53, lines 33-37 — Transcript, file page 53, lines 33-37
What each side wants
the sides that brought the case want the Court to strike down the treating physician rule. They argue this rule wrongly constrains plan administrators. They seek a standard that allows flexible review of medical evidence.
the opposing sides want the Court to keep the treating physician rule. They argue this rule protects disabled workers. They seek a standard that prevents arbitrary benefit denials.
Official sources for this section
- Official Supreme Court Transcript — file page 18, lines 35-45 — Transcript, file page 18, lines 35-45
- Official Supreme Court Transcript — file page 25, lines 9-7 — Transcript, file page 25, lines 9-7
- Official Supreme Court Transcript — file page 3, lines 17-5 — Transcript, file page 3, lines 17-5
- Official Supreme Court Transcript — file page 50, lines 43-31 — Transcript, file page 50, lines 43-31
What each side says
the sides that brought the case argue the Ninth Circuit rule creates a categorical presumption. They claim this presumes treating physician opinions are superior. They argue this conflicts with federal law principles.
the opposing sides argue the rule requires specific legitimate reasons for rejection. They claim this prevents arbitrary denials of benefits. They argue this protects workers from biased plan administrators.
Official sources for this section
- Official Supreme Court Transcript — file page 18, lines 35-45 — Transcript, file page 18, lines 35-45
- Official Supreme Court Transcript — file page 25, lines 9-7 — Transcript, file page 25, lines 9-7
- Official Supreme Court Transcript — file page 3, lines 17-5 — Transcript, file page 3, lines 17-5
- Official Supreme Court Transcript — file page 50, lines 43-31 — Transcript, file page 50, lines 43-31
What the justices asked
Justice Scalia asked about conflict of interest. He questioned if lower courts confused conflict with actual bias. the sides that brought the case argued lower courts grossly confused these concepts.
Justice O'Connor asked if the Secretary considered alternatives. She questioned if the Secretary imposed a treating physician requirement. the opposing sides stated the Secretary did not impose such a requirement.
Official sources for this section
- Official Supreme Court Transcript — file page 53, lines 33-37 — Transcript, file page 53, lines 33-37
Why it matters
This case defines how disability plans review medical evidence. It determines whether plans must prioritize treating physician opinions. It affects the rights of workers seeking disability benefits. It shapes the balance between plan flexibility and worker protection.
Official sources for this section
- Official Supreme Court Transcript — file page 18, lines 35-45 — Transcript, file page 18, lines 35-45
- Official Supreme Court Transcript — file page 25, lines 9-7 — Transcript, file page 25, lines 9-7
- Official Supreme Court Transcript — file page 3, lines 17-5 — Transcript, file page 3, lines 17-5
- Official Supreme Court Transcript — file page 50, lines 43-31 — Transcript, file page 50, lines 43-31
What happens next
This article currently covers the argument record. Use the official docket link for later case activity.
Official sources for this section
- Official Supreme Court Transcript — file page 3, lines 5-15 — Transcript, file page 3, lines 5-15
- Official Supreme Court Transcript — file page 53, lines 33-37 — Transcript, file page 53, lines 33-37
Official Court provenance
Official docket and case history · Official Supreme Court oral-argument detail page
Title and summary sources
- Official Supreme Court Transcript — file page 18, lines 35-45 — Transcript, file page 18, lines 35-45
- Official Supreme Court Transcript — file page 25, lines 9-7 — Transcript, file page 25, lines 9-7
- Official Supreme Court Transcript — file page 3, lines 17-5 — Transcript, file page 3, lines 17-5
- Official Supreme Court Transcript — file page 50, lines 43-31 — Transcript, file page 50, lines 43-31
- Official Supreme Court Transcript — file page 18, lines 35-45 — Transcript, file page 18, lines 35-45
- Official Supreme Court Transcript — file page 25, lines 9-7 — Transcript, file page 25, lines 9-7
- Official Supreme Court Transcript — file page 3, lines 17-5 — Transcript, file page 3, lines 17-5
- Official Supreme Court Transcript — file page 50, lines 43-31 — Transcript, file page 50, lines 43-31
Revision history
- Revision 1 · Official Transcript ·
Correction: Rewritten to the concise citizen-facing editorial standard.
- Revision 2 · Official Transcript ·
Correction: Migrated to the dated official Court activity contract without model use.