Home > Blog > Blog > Long Term Disability > ERISA Watch – May 31, 2016

ERISA Watch – May 31, 2016

Welcome back from the 3-day weekend! Last week, I noted two district court decisions out of the Sixth Circuit which held that an aggrieved plaintiff cannot seek other “appropriate equitable relief” where he or she can pursue a claim for benefits for the same injury. This is based on what I believe is a misreading of Varity Corp. v. Howe. At the time of last week’s publication I had just missed the Ninth Circuit’s May 20th decision in Moyle v. Liberty Mut. Ret. Ben. Plan, No. 13-56330, __F.3d__, 2016 WL 2946271 (9th Cir. May 20, 2016). Moyle got the Varity issue right, and here’s why:

Moyle involves a claim by former Golden Eagle employees against Liberty Mutual for past service credit they alleged Liberty Mutual promised them when Liberty Mutual purchased Golden Eagle through a conservatorship sale and they became employees of Liberty Mutual. The former Golden Eagle employees brought four claims against Liberty Mutual, including a claim for entitlement to past service credit under the terms of the retirement plan under 29 U.S.C. § 1132(a)(1)(B) and a claim for equitable relief under 29 U.S.C. § 1132(a)(3) seeking reformation and surcharge.

The district court found that the terms of the retirement plan did not provide the benefits Appellants are seeking. The Ninth Circuit agreed that Liberty Mutual’s reading of the retirement plan was reasonable and Appellants’ do not prevail on the claim for benefits under § 1132(a)(1)(B). The district court dismissed the equitable relief claim, which the Ninth Circuit reversed, holding that Appellants may pursue simultaneous claims under 29 U.S.C. § 1132(a)(3) and 29 U.S.C. § 1132(a)(1)(B) in light of CIGNA Corp. v. Amara, 563 U.S. 421 (2011). In Amara, the Supreme Court held that § 1132(a)(3) authorized equitable relief in the form of plan reformation, even though plaintiffs also claimed relief under § 1132(a)(1)(B). “While Amara did not explicitly state that litigants may seek equitable remedies under § 1132(a)(3) if § 1132(a)(1)(B) provides adequate relief, Amara‘s holding in effect does precisely that.” Further, Amara’s conclusion that a plaintiff may seek relief under both § 1132(a)(1)(B) and § 1132(a)(3) does not contravene the ruling in Varity, where the key holding was that § 1132(a)(3) extends to other sections of the statute, even when § 1132 does not expressly provide a remedy for those sections. The Ninth Circuit explained that Varity did not explicitly prohibit a plaintiff from pursuing simultaneous claims under § 1132(a)(1)(B) and § 1132(a)(3). This approach also comports with the Federal Rules of Civil Procedure, which requires that “[a] pleading that states a claim for relief must contain … a demand for the relief sought, which may include relief in the alternative or different types of relief.” Fed.R.Civ.P. 8(a)(3). And to top it off, allowing plaintiffs to seek relief under both § 1132(a)(1)(B) and § 1132(a)(3) is consistent with ERISA’s intended purpose of protecting participants’ and beneficiaries’ interests.

The takeaway: Plaintiffs are allowed to plead alternate theories of relief without obtaining double recoveries.

Enjoy the rest of this past week’s cases!

Your reliable source for summaries of recent ERISA decisions

Below is Roberts Disability Law, P.C.’s summary of this past week’s notable ERISA decisions.

Select Slip Copy & Not Reported Decisions

Breach of Fiduciary Duty

Third Circuit

•· Denying motion to dismiss Plaintiffs’ First Amended Complaint for failure to state a claim and for lack of personal jurisdiction in matter seeking disgorgement of fees against Defendant Samuels, Yoelin Roberts Disability Law, P.C. (“SYK”), a law firm, where Plaintiffs allege that SYK represented John J. Koresko and others in ERISA litigation, that SYK knew the payment for its services improperly transferred ERISA-plan assets, and that SYK thereby committed malpractice and breach of fiduciary duty. Kalan v. Farmers & Merchants Trust Co. of Chambersburg, No. CV 15-1435, 2016 WL 2941041 (E.D. Pa. May 20, 2016)(Judge Wendy Beetlestone).

Disability Benefit Claims

Third Circuit

•· Denying Plaintiff’s motion to remand long term disability claim to Liberty Life based on SSDI award, and denying alternative motion to augment the Administrative Record with discovery as to alleged conflicts of interest in the Plan. O’Conner v. PNC Fin. Servs. Grp., Inc., No. CV 15-5051, 2016 WL 2941196 (E.D. Pa. May 20, 2016) (Judge Michael M. Baylson).

Ninth Circuit

•· Finding that MetLife’s failure to issue a timely denial violated ERISA, and has both prejudiced Plaintiff and disrupted the litigation. Exercising authority under Pannebecker v. Liberty Life Assur. Co. of Boston, 542 F.3d 1213 (9th Cir. 2008) and ordering MetLife to bring Plaintiff current on his benefits and pay back benefits, with interest, to Plaintiff from the beginning of the “any occupation” period on February 11, 2013, to the present, with interest accruing at the applicable U.S. Treasury bill rate on February 11, 2013. Remanding to MetLife for a determination that complies with ERISA of Plaintiff’s benefits under the “any occupation” provision of the Plan and ordering MetLife to continue paying benefits so long as they continue to remain due under the Plan, unless and until MetLife issues a denial that fully complies with ERISA.Tash v. Metro. Life Ins. Co., No. SACV1401914AGRNBX, 2016 WL 2944074 (C.D. Cal. May 19, 2016) (Judge Andrew Guilford).

Eleventh Circuit

•· Granting summary judgment in favor of Aetna on Plaintiff’s long term disability claim, where Aetna’s decision was supported by an independent medical examination performed by Dr. Leonard Cosmo and a peer review performed by Dr. Wendy Weinsten that found that Plaintiff did not have a Total Disability and was able to work twenty-five hours a week. Street v. Aetna Life Ins. Co., No. 8:15-CV-388-T-24 MAP, 2016 WL 2961556 (M.D. Fla. May 23, 2016)(Judge Susan C. Bucklew).


Fourth Circuit

•· In suit by a health care service provider against Aetna Health and Life Insurance Company for underpayment of a claim made on behalf of an individual who received services from Upper Bay, finding that Upper Bay fails to justify its request for discovery of matters extrinsic to the administrative record and denying its motion for limited discovery. Upper Bay Surgery Ctr., LLC v. Aetna Health & Life INS. Co., No. JKB-15-2992, 2016 WL 2939739 (D. Md. May 20, 2016) (Judge James K. Bredar).

ERISA Preemption

Sixth Circuit

•· In matter where disability claimant brought Kentucky state-court action against two nurses who worked for ERISA plan administrator and provided their opinions regarding claimant’s eligibility, alleging negligence per se by giving medical advice without being licensed under state’s medical-licensure laws, holding that: (1) negligence per se claims fell within ERISA’s complete preemption provision; (2) nurses were not proper defendants after recasting claim as ERISA claim to recover benefits; (3) allegations merely recited ERISA statutory language barring “interference” with obtaining benefits; and (4) imposing appellate sanctions against claimant’s counsel based on frivolousness was unwarranted. Hogan v. Jacobson, No. 15-5572, __F.3d__, 2016 WL 2957153 (6th Cir. May 23, 2016) (Before MOORE, GIBBONS, and DAVIS, Circuit Judges).

Medical Benefit Claims

Third Circuit

•· Granting Defendants’ Motions to Dismiss as they pertain to Count I (Breach of Contract), Count III (Breach of Fiduciary Duty and Co-Fiduciary Duty under 29 U.S.C. § 1132(a)(3), 29 U.S.C. § 1104(a)(1) and 29 U.S.C. § 1105(a)), and Count IV (Failure to Establish/Maintain Reasonable Claim Procedures under 29 C.F.R. 2560.503-1), but denying Motion to Dismiss as to Count II (Failure to Make all Payments Pursuant to Member’s Plan under 29 U.S.C. § 1132(a)(1)(B)) without prejudice. Drzala v. Horizon Blue Cross Blue Shield, No. CV 15-8392, 2016 WL 2932545 (D.N.J. May 18, 2016) (Judge John Michael Vazquez).

Pension Benefit Claims

Second Circuit

•· Affirming grant of summary judgment in favor of defendant-appellee PepsiCo Hourly Employees Retirement Plan in this action challenging the denial of Plaintiff’s application for pension benefits (where he sought benefits more than six months after his entitlement to LTD benefits), and the district court’s subsequent order denying reconsideration of that decision. Preville v. PepsiCo Hourly Employees Ret. Plan, No. 15-2553, __F.App’x__, 2016 WL 2942612 (2d Cir. May 20, 2016) (Present JOSÉ A. CABRANES, CHESTER J. STRAUB, RAYMOND J. LOHIER, JR., Circuit Judges).

•· Entering judgment in favor of Plaintiff in his 29 U.S.C. § 1132(a)(1)(B) claim that the Committee was arbitrary and capricious in denying his benefits under the Supplemental Retirement Plan by unreasonably interpreting “total compensation” in Appendix D-1 of the Pension Plan to exclude Option Proceeds; entering judgment in favor of the Committee on Plaintiff’s Benefit Equalization Plan-related claims and on his claims that the ERISA’s anti-cutback provision, 29 U.S.C. § 1054(g)(1) as well as ERISA’s notice provision, 29 U.S.C. § 1054(h) were violated by the Committee; denying attorney’s fees to Plaintiff. Kelly v. Retirement Plan Committee, No. 3:11-CV-01890 (WGY), 2016 WL 2963417 (D. Conn. May 20, 2016) (Judge William G. Young).

Ninth Circuit

•· In putative class action lawsuit brought by Plan participants against a retirement benefit plan, plan administrator, and employer for their alleged violations of ERISA, in which participants sought payment of benefits under plan or, in alternative, equitable relief, holding that: (1) Plaintiffs failed to establish existence of any structural conflict of interest on part of administrator of ERISA employee retirement plan, that was so serious as to warrant de novo review of the plan administrator’s denial of benefits; (2) the plan administrator reasonably interpreted plan terms defining accrued retirement benefits when it denied claims that calculation of their benefits should have included Plaintiffs’ past service with company whose assets were acquired by employer; (3) Plaintiffs could simultaneously pursue, as alternate remedies under ERISA, both a claim for benefits and equitable claim for surcharge, estoppel, and restitution; (4) Plaintiffs were not entitled to reformation of plan on fraud theory; and (5) district court did not abuse its discretion in certifying plaintiff class. Affirmed in part, reversed in part, and remanded. Moyle v. Liberty Mut. Ret. Ben. Plan, No. 13-56330, __F.3d__, 2016 WL 2946271 (9th Cir. May 20, 2016) (Before: HARRY PREGERSON and CONSUELO M. CALLAHAN, Circuit Judges and STANLEY ALLEN BASTIAN,* District Judge).

Plan Status

Ninth Circuit

•· Noting that what qualifies under 29 U.S.C. § 1002(2)(A) is matter of first impression in this circuit, and agreeing with sister circuits that have determined that the paramount consideration is whether the primary purpose of the plan is to provide deferred compensation or other retirement benefits. Here, the Stock Rights Plan’s main purpose was not to provide retirement or systematically deferred income and, thus, is not covered by ERISA. Rich v. Shrader, No. 14-55484, __F.3d__, 2016 WL 2994736 (9th Cir. May 24, 2016)(Before: Richard R. Clifton and Sandra S. Ikuta, Circuit Judges, and Frederic Block, District Judge).

Pleading Issues & Procedure

Third Circuit

•· Affirming district court’s decision that there is no private right of action under § 503 of ERISA and finding no § 503 claim where Plaintiff alleges that he was denied an opportunity to review the plan itself but did not file a claim and so no decision was ever rendered denying any claim. Finding that district court correctly dismissed Plaintiff’s § 502(a)(1)(B) claim where Plaintiff did not provide any details concerning his standing to sue as a beneficiary, the plan, or any provision showing that he is entitled to retirement benefits. Piscopo v. Public Service Electric and Gas Company, No. 15-2819, __F.App’x__, 2016 WL 3000342 (3d Cir. May 25, 2016) (Before: FISHER, RENDELL and BARRY, Circuit Judges).

Eighth Circuit

•· Finding that Plaintiffs have not pled administrative exhaustion as required for ERISA claims in this circuit and granting Defendant’s motion to dismiss, but giving Plaintiffs leave to replead and allege in their amended complaint any facts they believe to be relevant to the administrative exhaustion requirement.Lacy v. Valmont Indus., Inc., No. 8:15-CV-3070, 2016 WL 3014656 (D. Neb. May 24, 2016) (Judge John M. Gerrard).

Retaliation Claims

Third Circuit

•· In matter where Plaintiff alleges that he was discriminatorily discharged from his employment in violation of ERISA, and where Defendant filed a motion to dismiss on the basis that Plaintiff failed to plausibly plead an employer-employee relationship between Integrative Staffing and himself, denying the motion because it is premature at this stage to determine the employer-employee relationship as a matter of law, and the applicable law appears to weigh in favor of finding that Integrative Staffing and Allegheny Plywood were joint employers. Dunkel v. Integrative Staffing Grp., No. 15-1632, 2016 WL 2958269 (W.D. Pa. May 23, 2016) (Judge Maurice B. Cohill, Jr.).

Fifth Circuit

•· Dismissing Plaintiff’s ERISA interference claim because although Plaintiff can establish a prima facie case of ERISA retaliation in light of the close proximity between his inquiry regarding short term disability benefits and his termination, he cannot overcome Defendant’s legitimate, non-discriminatory reason for his termination-a reduction in force. Crain v. Schlumberger Technology Co., No. CV 15-1777, 2016 WL 2942417 (E.D. La. May 20, 2016) (Judge Jane Triche Milazzo).

Statute of Limitations

Second Circuit

•· Affirming the district court’s determination that Appellants’ action is barred by the three-year statute of limitations because they had “actual knowledge” of a breach before December 2008, where Appellants repeatedly alleged in their complaint that, prior to December 2008, there were widely publicized warnings about Citigroup’s exposure to subprime mortgages. (Per 29 U.S.C. § 1113(2), ERISA claims alleging a breach of fiduciary duty must be brought within three years after the earliest date on which the plaintiff had actual knowledge of the breach or violation). Muehlgay v. Citigroup Inc., No. 15-2461-CV, __F.App’x__, 2016 WL 2956958 (2d Cir. May 23, 2016) (Present RALPH K. WINTER, PETER W. HALL and CHRISTOPHER F. DRONEY, Circuit Judges).

Withdrawal Liability & Unpaid Contributions

Third Circuit

•· Granting Plaintiffs’ motion for default judgment against Defendant Phillips Enterprise, Inc. (“Phillips”) seeking damages and equitable relief under ERISA and the LMRA for Phillips’s alleged failure to timely pay certain contributions, reports and deductions due pursuant to the parties’ Collective Bargaining Agreement. Bd. of Trustees of the Laborers Dist. Council Constr. Indus. Pension Fund v. Phillips Enter., Inc., No. CV 15-06490, 2016 WL 2939509 (E.D. Pa. May 20, 2016) (Judge Gerald J. Pappert).

•· Granting Plaintiffs’ motion for default judgment against Defendant in the following amounts: (1) $14,065.98 in unpaid contributions; (2) $1,513.31 in accrued interest on the unpaid contributions; (3) $1,513.31 in “double interest” as provided by ERISA Section 1132(g)(2)(C)(i); (4) $1,625.10 in accrued interest on late contribution payments; (5) $3,243.50 in attorneys’ fees and costs; and (6) $1,800 in audit fees. Bd. of Trustees of the Laborers Dist. Council Constr. Indus. Pension Fund v. Phillips Enter., Inc., No. CV 15-06490, 2016 WL 2939510 (E.D. Pa. May 20, 2016) (Judge Gerald J. Pappert).

Seventh Circuit

•· Directing the Clerk to enter judgment in favor of Plaintiffs and against Defendants John Kny Painting & Decorating, Inc. and Fine Finishes & Restoration, Inc. on alter ego claim, and in favor of Defendant John H. Kny and against Plaintiffs on the piercing the corporate veil claim. On the alter ego claim, awarding Plaintiffs damages against John Kny Painting & Decorating, Inc. and Fine Finishes & Restoration, Inc., jointly and severally, in the amount of $3,126,133.66. Trustees of the Chicago Painters & Decorators Pension Fund v. John Kny Painting & Decorating, Inc., No. 14 C 6507, 2016 WL 2958372 (N.D. Ill. May 23, 2016) (Judge Matthew F. Kennelly).

Tenth Circuit

•· Granting Plaintiffs’ Motion for Default Judgment and directing clerk to enter default judgment against Defendant in the following amounts: Contributions: $12,857.28, Liquidated Damages: $1,542.88, Interest: $400.40, Attorney’s Fees: $1,700.00, Costs: $556.25 (TOTAL: $17,056.81). Boilermaker-Blacksmith National Pension Fund, et al. v. South Buffalo Electric, Inc., No. 15-9937-CM, 2016 WL 2989291 (D. Kan. May 24, 2016) (Judge Carlos Murguia).

* Please note that these are only case summaries of decisions as they are reported and do not constitute legal advice. These summaries are not updated to note any subsequent change in status, including whether a decision is reconsidered or vacated. The cases reported above were handled by other law firms but if you have questions about how the developing law impacts your ERISA benefit claim, the attorneys at Roberts Disability Law, P.C. may be able to advise you so please contact us. Case summaries authored by Michelle L. Roberts, Partner, Roberts Disability Law, P.C., 1050 Marina Village Pkwy., Ste. 105, Alameda, CA 94501; Tel: 510-230-2090.


facebook twitter shop

*Please note that this blog is a summary of a reported legal decision and does not constitute legal advice. This blog has not been updated to note any subsequent change in status, including whether a decision is reconsidered or vacated. The case above was handled by other law firms, but if you have questions about how the developing law impacts your ERISA benefit claim, the attorneys at Roberts Disability Law, P.C. may be able to advise you so please contact us.

Get The Help You Need Today

Inner form image


Contact Us

We know how to get your insurance claim paid. Call today at:
(510) 230-2090

Close Popup