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LeGras v. AETNA Life Insurance Co.

United States Court of Appeals, Ninth Circuit

May 28, 2015

ANDRE LEGRAS, Plaintiff-Appellant,
v.
AETNA LIFE INSURANCE COMPANY; FEDERAL EXPRESS CORPORATION LONG TERM DISABILITY PLAN, Defendants-Appellees

Argued and Submitted, Pasadena, California: March 7, 2014.

Page 1234

Appeal from the United States District Court for the Central District of California. D.C. No. 2:12-cv-02128-R-JCG. Manuel L. Real, District Judge, Presiding.

SUMMARY[*]

ERISA

The panel reversed the district court's dismissal of an action challenging the denial of an application for continued long-term disability benefits under the Employee Retirement Income Security Act.

The panel held that the district court erred in dismissing the action for failure to exhaust administrative remedies. The plaintiff's internal appeal from the denial of his benefits application was denied as untimely under a 180-day appeal period. The panel held that the plaintiffs' notice of internal appeal was timely because it was filed on the Monday after the Saturday on which the 180-day period ended. The panel adopted this method of counting time as part of ERISA's federal common law.

Dissenting, Judge N.R. Smith wrote that as a matter of contract interpretation, the plaintiff's administrative appeal was untimely.

Peter S. Sessions (argued) and Glenn R. Kantor, Kantor & Kantor LLP, Northridge, California, for Plaintiff-Appellant.

David P. Knox (argued), Federal Express Corporation, Memphis, Tennessee, for Defendants-Appellees.

Before: Harry Pregerson, Richard A. Paez, and N. Randy Smith, Circuit Judges. Opinion by Judge Paez; Dissent by Judge N.R. Smith.

OPINION

Page 1235

PAEZ, Circuit Judge:

Andre LeGras appeals the district court's judgment in favor of Defendants Federal Express Corporation Long Term Disability Plan and AETNA Life Insurance Company (collectively, " AETNA" ). In a letter denying LeGras's application for continued long-term disability benefits, AETNA informed LeGras that he could file an internal appeal of the decision within 180 days. The 180-day period ended on a Saturday. Although LeGras mailed his appeal the following Monday, AETNA denied it as untimely. The district court dismissed LeGras's action for failure to exhaust administrative remedies. We reverse. We hold that because the last day of the appeal period fell on a Saturday, neither that day nor Sunday count in the computation of the 180 days. As LeGras mailed his notice of appeal on Monday, it was timely. This method of counting time is widely recognized and furthers the goals and purposes of the Employee Retirement Income Security Act (" ERISA" ), 29 U.S.C. § 1001 et seq. We therefore adopt it as part of ERISA's federal common law.

I.

In October 2008, LeGras seriously injured himself while working as a ramp transport driver for Federal Express Corporation (" FedEx" ), a job he had held for twenty-three years. LeGras suffered a serious back injury that caused severe and sustained pain. Subsequent surgeries did not correct the problem. As an employee of FedEx, LeGras was a participant and beneficiary of FedEx's Long Term Disability Plan (" LTD Plan" or " Plan" ). In May 2009, he began receiving disability benefits under the Plan. Subsequently, AETNA, the Plan's Claims Paying Administrator, informed LeGras that his benefits would terminate on May 24, 2011, unless he could establish that his disability qualified as a " total disability" under the LTD Plan.

After LeGras attempted to make the required showing, AETNA sent LeGras a letter explaining that the evidence he submitted did not establish that he suffered from a total disability. Of concern to AETNA was LeGras's alleged failure to prove that he could not " sit or use [his] upper extremities for sedentary work." LeGras received the letter at 1:23 p.m. on April 18, 2011. The letter stated, " [i]f you disagree with the above determination, in whole or in part, you may file a request to appeal this decision within 180 days of receipt of this notice."

The parties agree that the 180-day appeal period expired on October 15, 2011, a Saturday. LeGras mailed his appeal the following Monday. On January 17, 2012, AETNA denied LeGras's appeal as untimely. LeGras filed an action in the district court pursuant to 29 U.S.C. § 1132, the civil enforcement provision of ERISA. After answering the complaint, AETNA filed a motion for judgment on the pleadings under Federal Rule of Civil Procedure 12(c). AETNA argued that LeGras failed to exhaust his administrative remedies because he mailed his appeal after the 180-day period specified in the April 18, 2011 denial letter lapsed. The district

Page 1236

court granted the motion and entered judgment in ...


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