Achtel v. Connecticut Mutual Life Insur. Co., 2000 U.S. App. LEXIS 5228 (9^th Cir. Mar. 24, 2000) (unpublished)-Achtel sued in district court seeking disability benefits after Mass Mutual denied his claim.  Mass Mutual denied the claim because Achtel’s back pain was pre-existing, and because he failed to satisfy the requirement of 20% loss of income for partial disability benefits.

Achtel was correct in asserting that the district court should have used a de novo standard of review rather than abuse of discretion.  An ERISA plan administrator has discretion only if the administrator "unambiguously retained" such discretion.  In this case, the plan administrator did not do so.  Therefore, ERISA required the use of the default standard of de novo.  Simply requiring "proof of Disability and proof of any Loss of Income or any other proof required to substantiate the claim" does not imply discretion on the part of the plan administrator.  See Kearney v. Standard Insurance Company, 175 F.3d 1084, 1088 (9^th Cir. 1999) (en banc). [See detailed analysis.}

In spite of de novo review, this court affirmed the district court's holding for Mass Mutual. Achtel's doctors' reports supported Mass Mutual's conclusion that Achtel's back disability was a long-standing ailment.  There was no evidence that a golf injury caused his back pain, as he had claimed.