Andre Lesgras v. Aetna Life Insurance

FOR PUBLICATION

UNITED STATES COURT OF APPEALS

FOR THE NINTH CIRCUIT

ANDRE LEGRAS, No. 12-56541 Plaintiff-Appellant, D.C. No. v. 2:12-cv-02128-

R-JCG

AETNA LIFE INSURANCE COMPANY;

FEDERAL EXPRESS CORPORATION

LONG TERM DISABILITY PLAN, OPINION

Defendants-Appellees.

Appeal from the United States District Court for the Central District of California Manuel L. Real, District Judge, Presiding

Argued and Submitted March 7, 2014—Pasadena, California

Filed May 28, 2015

Before: Harry Pregerson, Richard A. Paez, and N. Randy Smith, Circuit Judges.

Opinion by Judge Paez; Dissent by Judge N.R. Smith 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’…

Opinion by Judge PAEZ; Dissent by Judge N.R. SMITH.

OPINION

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…

dissenting:

Mr. LeGras had 180 days to appeal an adverse decision from AETNA Life Insurance Company (“AETNA”), denying him long-term disability benefits under a Long Term Disability Plan (“Plan”) provided by his employer, Federal Express (“FedEx”). He lost his opportunity to appeal as a result of his own conduct; he sent his appeal to AETNA two days after the appeal period expired. Even LeGras agrees that he sent his appeal two days late. To excuse LeGras’s untimeliness, the majority turns a simple case of contract interpretation into an opportunity to (without precedent) expand federal common law surrounding the Employee Retirement Income Security Act (“ERISA”) to rewrite private contracts. I cannot go along with them in “bailing LeGras out.”

“An ERISA plan is a contract that we interpret in an ordinary and popular sense as would a person of average intelligence and experience. We look first to the explicit language of the agreement to determine, if possible, the clear intent of the parties.... ” Harlick v. Blue Shield of Cal., 686 F.3d 699, 708 (9th Cir.2012) (internal quotation marks, citations, and alterations omitted). In general, “[cjontraet terms are to be given their…