Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-4_18-cv-03741/USCOURTS-cand-4_18-cv-03741-0/pdf.json

Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 29:1132 E.R.I.S.A.: Employee Benefits

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

EDMUNDO CUEVAS,

Plaintiff,

v.

RESILIENT FLOOR COVERING 

PENSION TRUST FUND,

Defendant.

Case No. 18-cv-03741-PJH 

ORDER GRANTING PLAINTIFF'S 

MOTION FOR SUMMARY 

JUDGMENT, DENYING 

DEFENDANT'S MOTION FOR 

SUMMARY JUDGMENT, AND 

REMANDING CASE

Re: Dkt. Nos. 16, 17

Plaintiff Edmundo Cuevas’s and defendant Resilient Floor Covering Pension Trust 

Fund’s (the “Trust”) cross-motions for summary judgment came on for hearing before this 

court on April 17, 2019. Plaintiff appeared through his counsel, Jim Keenley. Defendant 

appeared through its counsel, Michael Korda and Jessica Melgar. Having read the 

papers filed by the parties and carefully considered their arguments and the relevant 

legal authority, and good cause appearing, the court hereby DENIES defendant’s motion, 

GRANTS plaintiff’s motion, and REMANDS the action for the following reasons.

DISCUSSION

A. Legal Standard

Summary judgment is proper where the pleadings, discovery, and affidavits show 

that there is “no genuine dispute as to any material fact and the movant is entitled to 

judgment as a matter of law.” Fed. R. Civ. P. 56(a). Material facts are those which may 

affect the outcome of the case. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 

(1986). A dispute as to a material fact is genuine if there is sufficient evidence for a 

reasonable jury to return a verdict for the nonmoving party. Id.

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The moving party for summary judgment bears the initial burden of identifying 

those portions of the pleadings, discovery, and affidavits which demonstrate the absence 

of a genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986); 

Nissan Fire & Marine Ins. Co. v. Fritz Cos., 210 F.3d 1099, 1102 (9th Cir. 2000). When 

the moving party has met this burden of production, the nonmoving party must go beyond 

the pleadings and, by its own affidavits or discovery, set forth specific facts showing that 

there is a genuine issue for trial. Id. If the nonmoving party fails to produce enough 

evidence to show a genuine issue of material fact, the moving party wins. Id

At summary judgment, the court must view the evidence in the light most favorable 

to the nonmoving party: if evidence produced by the moving party conflicts with evidence 

produced by the nonmoving party, the judge must assume the truth of the evidence set 

forth by the nonmoving party with respect to that fact. See Tolan v. Cotton, 134 S. Ct. 

1861, 1865 (2014); Leslie v. Grupo ICA, 198 F.3d 1152, 1158 (9th Cir. 1999).

Under the abuse of discretion standard, “a plan administrator’s decision ‘will not be 

disturbed if reasonable.’” Stephan v. Unum Life Ins. Co. of Am., 697 F.3d 917, 929 (9th 

Cir. 2012) (quoting Conkright v. Frommert, 559 U.S. 506, 512 (2010)). “[A]n 

administrator’s denial of benefits must be upheld if it is based upon a reasonable 

interpretation of the plan’s terms and if it was made in good faith.” Moyle v. Liberty Mut. 

Ret. Ben. Plan, 823 F.3d 948, 957–58 (9th Cir. 2016) (internal quotation marks omitted). 

A plan administrator’s decision is unreasonable if it is “(1) illogical, (2) implausible, 

or (3) without support in inferences that may be drawn from the facts in the record.” 

Salomaa v. Honda Long Term Disability Plan, 642 F.3d 666, 676 (9th Cir. 2011). 

Administrators “abuse their discretion if they render decisions without any explanation, or 

construe provisions of the plan in a way that clearly conflicts with the plain language of 

the plan,” or rely on clearly erroneous findings of fact. Johnson v. Tr.s of W. Conf. of 

Teamsters Pension Trust Fund, 879 F.2d 651, 654 (9th Cir. 1989); Boyd v. Bert Bell/Pete 

Rozelle NFL Players Retirement Plan, 410 F.3d 1173, 1178 (9th Cir. 2005). A finding is 

“clearly erroneous” when even though there is evidence to support it, the reviewing court 

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“on the entire evidence is left with the definite and firm conviction that a mistake has been 

committed.” Boyd, 410 F.3d at 1178. 

B. Analysis

On June 22, 2018, Cuevas filed this action against the Trust. Dkt. 1. The 

complaint has a single claim for relief under ERISA § 502(a)(1)(B), 29 U.S.C. 

§ 1132(a)(1)(B). Plaintiff alleges that he was wrongfully denied benefits under the terms 

of the Resilient Floor Covering Pension Fund Pension Plan. Dkt. 17-1, Ex. 2 at ECF 

p. 90 (the “Plan”). 

In short, plaintiff challenges the Trust’s Board of Trustees’ (the “Board”) decision to 

not credit time he worked early in his career as qualifying hours for his pension

calculation. Cuevas argues that he worked as an “apprentice” during that time, and the 

hours he worked in that position would qualify him for additional pension benefits. 

However, he now argues that he was misclassified as a “floor covering handler,” and 

hours worked in that occupation do not count toward pension eligibility. 

Defendant seeks summary judgment that it did not abuse its discretion in denying 

benefits based on plaintiff’s misclassification because plaintiff did not timely raise an 

argument that he was misclassified. Plaintiff seeks only a finding that defendant abused 

its discretion in handling his claims and appeals, and he seeks an order remanding the 

case for consideration of his misclassification claim in the first instance. An explanation 

from defendant addressing the merits of plaintiff’s misclassification claim would make its 

conclusion clearer and more amenable to review.

The issues presented by the parties’ cross motions center around a series of 

exchanges between plaintiff and the Board. The exchanges reveal that plaintiff’s pension 

application was not pursued by plaintiff or handled by the Board even remotely in 

accordance with the procedures required by the Plan. 

As an initial matter, Cuevas’s1 original December 5, 2016 application for a Regular 

 

1 Cuevas sent certain communications to the Board himself, and he was later

represented by two different counsel. This order describes communications sent by both 

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Pension2 was handled directly by the Board rather than being processed by the thirdparty administrator, as would have been the normal procedure. Dkt. 17-1 at ECF p. 6 

(application). The application did not raise the argument Cuevas now relies upon, which 

is that he was misclassified. The parties agree that Cuevas’s claim was denied, however

no written denial was issued. The Board apparently told Cuevas that he likely qualified 

for an “Early Retirement Pension,” and he was supposedly provided with documents to 

elect that type of pension. The primary evidence of the oral denial is a document 

prepared by the Board following its May 12, 2017 meeting. Dkt. 17-1 at ECF p. 4. 

The Plan requires a written denial setting forth, in a manner calculated to be 

understood by the applicant, the “specific reason(s) for the adverse determination;” 

“[r]eference to the specific Plan provision(s) on which the denial is based;” a “description 

of any additional material or information necessary for the applicant to perfect the claim 

and an explanation of why such material or information is necessary;” and a “description 

of the Plan’s review procedures and the time limits applicable to such procedures, 

including a statement of the applicant’s right to bring a civil action under Section 502(a) of 

ERISA following an adverse benefit determination on review.” Plan § 10.04(a). The 

Board did not issue a written denial, and the evidence indicates that the oral denial also 

failed to comply with the other requirements. 

Moreover, the Plan was required to issue a written denial within 90 days from the 

date the application was filed. Id. The Plan did not provide a written denial—or a written 

notice of an extension—to plaintiff’s December 5 application within 90 days, as was 

required. The first writing from defendant in the record came on May 22, 2017, which 

purported to deny plaintiff’s “appeal.” Dkt. 17-1 at ECF p. 35. 

Deficient from the very beginning, the parties’ procedural failures only 

compounded with time.

 

Cuevas and his representatives as communications from Cuevas.

2 The Plan offers several different types of pensions, including a “Regular Pension,” an 

“Early Retirement Pension,” and a “Service Penson.” See Plan §§ 3.02, 3.04, 3.12.

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On April 26, 2017, Cuevas sent a letter to the Board stating that he was told he did 

not qualify for a “Regular Service Pension” and requested that the Board “reconsider and 

credit the hours worked” earlier in his career so he can “retire with a Regular Service 

Pension without penalties.” Dkt. 17-1 at ECF p. 60. It is unclear whether Cuevas was 

requesting a “Regular Pension” (for which he applied in December), or submitting a new 

application for a “Service Pension.” Again, he did not argue that he was misclassified.

On May 12, 2017, the Board held a meeting during which it considered Cuevas’s 

April 26, 2017 letter. The Board treated Cuevas’s April 16, 2017 letter as an “appeal” of 

an adverse benefit determination. Dkt. 17-1 at ECF p. 4.

On May 22, 2017, the Board sent a letter to Cuevas regarding its May 12, 2017 

meeting. Dkt. 17-1 at ECF p. 35. The letter states that the Board reviewed Cuevas’s 

appeal and “made the decision to deny your appeal in which you requested that hours 

worked as a Floor Covering Handler for the years 1990-1997 be recognized towards 

qualification for a Service Pension.” Id. The letter further states that “This decision was 

made on the fact that during your employment as Floor Covering Handler . . . [employers] 

were not required to make any pension contributions on your behalf.” Id. The letter then 

describes Cuevas’s right under ERISA to bring an action in District Court within two years 

of the denial of his appeal. Id. 

It appears that the Board considered Cuevas’s April 26, 2017 letter to be an 

appeal of his December 5, 2016 application for a Regular Pension. Yet, the Board also 

appears to have treated Cuevas’s April 26, 2017 letter as an application for a Service 

Pension, which it was denying. Even if the Board’s May 22, 2017 letter is considered the 

written denial (of either Cuevas’s December application for a Regular Pension or his April 

application for a Service Pension), the letter did not comply with the substantive 

requirements of a denial because it failed to reference the specific plan provisions at 

issue, describe additional information necessary to perfect the claim, and explain the 

Plan’s review procedures. Plan § 10.04(a); see also 29 C.F.R. § 2560.503-1(g)(1); 29 

U.S.C. § 1133. 

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Defendant concedes that the Board failed to provide required information in its 

denials. Dkt. 20 at 11–13. Defendant argues that those “technical” errors were not 

problematic because plaintiff generally understood that his claim was denied because his 

employment was not counted as credited service. Defendant further argues that plaintiff 

“was not harmed by the Plan’s failure to include a description of the review procedures 

since he subsequently submitted an appeal through a legal representative in June 2017 

and the Board heard that appeal at its August 2017 meeting.” Dkt. 20 at 12. First, it is 

not clear that plaintiff’s June 2017 appeal shows he understood the review procedures, 

because the Board later made clear that its May 2017 decision was “final and binding”

and could “not be reconsidered for appeal.” Dkt. 17-1 at ECF p. 226. Second, although 

defendant is right that the parties continued to exchange correspondence, the 

fundamental problems underlying this dispute stem from the fact that neither party

followed the Plan’s review procedures. As they veered further from the Plan’s procedural 

requirements, the parties’ exchanges continued to leave each other uncertain of their 

decisions, arguments, and reasoning. 

After receiving the May 22, 2017 letter, Cuevas obtained legal assistance and sent 

a letter to the Board on June 23, 2017. Dkt. 17-1 at ECF p. 36. The June 23, 2017 letter 

was styled as an appeal of the May 22, 2017 decision, arguing that the Board should 

credit Cuevas’s time working as a “Floor Covering Handler” with service credits under 

Section 6.02 of the Plan. Id. at 37. (The parties now agree that Section 6.02 of the Plan 

does not qualify Cuevas for a Service Pension.) Again, Cuevas did not argue that he 

was misclassified. Instead, he raised only arguments that he now agrees were rightly 

rejected by the Board.

Cuevas then engaged in a written exchange with Katherine McDonough, outside 

counsel for the Board, about his time as an apprentice or floor covering handler. It is 

omitted from this recounting of the parties’ exchanges, although a review of plaintiff’s 

exchange with McDonough shows that it did not clarify the parties’ positions, but served 

mostly to further confuse each party as to the other’s position. It appears that 

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McDonough introduced Cuevas for the first time to the idea that he may have been 

misclassified.

On August 11, 2017, the Board met and reconsidered their May 2017 denial. 

Dkt. 17-1 at ECF p. 34. On August 16, 2017, the Board sent a letter to Cuevas stating 

that the appeal was “thoroughly reviewed by the Board of Trustees and was denied in 

accordance with the rules of the Plan.” Dkt. 17-1 at ECF p. 88. The letter also provided: 

“At this time, only if you have further documentation to submit which may help your case 

may you submit another appeal. If you have no further evidence you may file a civil action 

pursuant to Section 502(a) of ERISA.” Id.

Defendant argues that any harm from its earlier deficient denials was cured by

plaintiff’s June 23, 2017 appeal and the Board’s August 16, 2017 denial. Dkt. 20 at 12. 

But plaintiff submitted his June appeal without the benefit of a written denial, which would 

have explained what Plan provisions the Board believed supported its denial and what 

information could have cured the deficiency. The initial denial is required to provide such

information so the parties can have a meaningful exchange and so the applicant can 

attempt to correct problems on appeal. Here, the Board only issued a completelydeficient oral denial followed by summary written denials of “appeals”.

Moreover, the Board informed plaintiff that his April 26 appeal and their May 12

denial was the “final and binding” decision. Dkt. 17-1 at ECF p. 226. Given that 

representation, it is hard to credit defendant’s argument that the parties continued to have 

a meaningful back-and-forth through ongoing “appeals” during June and August.

Finally, on November 28, 2017, Cuevas sent the Board a packet of information he 

hoped they would consider at their December 1 meeting. Dkt. 17-1 at ECF p. 190. 

(Cuevas had also sent some materials on August 18, 2017. Dkt. 17-1 at ECF p. 208) 

After the drawn-out, iterative application and appeals process described above, this was

the first time Cuevas presented the Board with any argument or evidence attempting to 

show that he was misclassified.

On December 5, 2017, the Board sent a letter to Cuevas—the final communication 

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in the record. Dkt. 17-1 at ECF p. 226. The Board wrote that it “reviewed” the 

“documentation” Cuevas submitted in his August 18 and November 28 communications. 

However, “the issues raised in the November 28, 2017 letter and August 18, 2017 email 

have not been considered by the Trustees and your appeal stands as rejected.” Id. The 

Board also stated that the Board’s decision at its May 12, 2017 meeting to deny Cuevas’s 

claim was an “appeal denial decision [that] was final and binding on all parties. Thus this 

matter has been resolved and may not be reconsidered for appeal.” Id.

Plaintiff’s November 28, 2017 appeal and the Board’s December 5, 2017 denial 

did not cure the procedural morass explained above. First, the deficiencies infecting the 

earlier “appeals” also apply to the December 5 denial. But more importantly, the Board 

did not treat plaintiff’s submission as an appeal under the Plan. The Board explained in 

clear terms that “the issues raised in the November 28, 2017 letter and August 18, 2017 

email have not been considered by the Trustees and your appeal stands as rejected.” 

Dkt. 17-1 at ECF p. 226. Although the Board apparently looked over the materials 

plaintiff submitted, the Board clearly did not treat plaintiff’s correspondence as an appeal 

under Section 10.04(b) of the Plan, which requires the Board to “take into account all 

comments, documents, records and other information submitted by the claimant relating 

to the claim without regard to whether such information was submitted or considered in 

the initial benefit determination.” Plan § 10.04(b). The Board cannot decline to 

“consider” “issues” raised by the claimant on appeal. Compare Plan § 10.04(b) ¶ 4, with

Dkt. 17-1 at ECF p. 226.

Both parties to this action veered substantially from the Plan’s procedural 

requirements. Cuevas raised his misclassification argument, which is the only argument

he relies on today, for the first time in August 2017 after a number of rejected applications 

or appeals. The Board never issued a denial in writing explaining the specific reasons for 

its adverse determination, referring to the specific Plan provisions on which the denial 

was based, or explaining what information was necessary for plaintiff to perfect the claim

and why it was necessary. Under these circumstances, the Board’s denial of benefits 

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was an abuse of its discretion. As a result—and unsurprisingly—the record is insufficient 

for this court to review.

CONCLUSION

For the reasons stated above, defendant’s motion for summary judgment is 

DENIED based on the court’s finding that defendant abused its discretion by not 

complying with the terms of the Plan when reviewing plaintiff’s claims and appeals. 

Plaintiff’s motion for summary judgment is GRANTED, and the action is REMANDED to 

the Board for consideration of plaintiff’s application de novo, which must be conducted in 

compliance with the Plan’s requirements. The court expresses no opinion on whether 

plaintiff’s claim should be granted or denied upon review. The application plaintiff 

submits to the Board following this court’s decision, explained on April 23, 2019 and in 

this order, shall be considered his initial application under the Plan’s procedures.

IT IS SO ORDERED.

Dated: May 8, 2019

PHYLLIS J. HAMILTON

United States District Judge

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