### INTHE UNI TED S TATESCOU RT OFAPPEALS FORTHE FIFTH CIRCU IT

N o. 09- 20159

D E B R AS W A N S O N , P l a i n ti ff - A p p ell a n t v. H E A R S T C O R P O R A T IO N L O N G T E R M D IS A B IL IT YP L A N , D efen da n t- A pp el l ee .

A p p ea lf

rom the U n i tedS tates D i stri ct C ou rt f or t h e Sou t h ern D i st ri ctof T exas
B ef ore C L E M E N T , P R A D O , an d E L R O D , C i rcui tJu dg es . P E R C U R I A M: A pp ell an tD ebra S w an son ch a ll e n g e s th e d istr ict co u rt’s g ra n t of s u m m ary j u dg m en tt o A pp el l ee H earstC orp. L on g T erm D i sabi l i t y P l an ( “ t h e P l an ” ) , on th e g rou n d s th a t Sw a n son fa i l ed to exh a u st ad m i n i strative re m ed i es p ri or to b r i n g i n gs u i t
. W e AF FI RM
. T h rough her em pl oym en t w ith th e H o u sto n C h ro n icle, A p p e ll a n t S w a n son o bt ai ne d c o ve r ag e unde ra l o ng- t e r m di s ab i l i t y be ne f i t s po l i c y unde r w r i t t e n a nd
a d m in is te r e db yH a r tfo r dL ife In s u r a n c e C o . ( “ H a r t fo r d ”). T h e p o lic yfa lls
w i thi n the P l a n , w h i ch i s go ve rn ed bythe E m p l oy ee R eti rem en t I n com e S ecu ri ty Act(E R ISA ) , 2 9 U
. S. C. § § 1 00 1– 14 61
. Swans o n r e c e ive d b e ne f i t s und e rt he pol i cy begi n n i n g i n Jan u ary 200 2, bu ton A pri l4, 200 3, H art f ord noti f

i ed h er United States Court of App eals

Fifth Circuit 

### F I L E D November

3, 2009 Cha rl es R. F ulb ru g e II I ClerkN o. 09- 20159

2 t hatb e ne f

i t s w o ul d t e r m i nat e b e c au se sh e w as c l e ar e d t o r e t ur n t o w o r k o n a fu ll-tim e b a s is
. T h e te r m s o f th e P la n a llo w e d S w a n s o n 1 8 0 d a y s to a p p e a l th is det er m i nat i on, af

t erw hi c h H ar t f

or d w oul d have f

or t y- f ive days

— orni net y days in ce r ta in cir c u m s ta n c e s — to ru le o n th e a p p e a l. O n A u gu st25, 2 003 , 1 44 da ys lat er, S w an son’ s cou n selsu bm i t t ed a l et t er to H a rtf

ord
. Iti n d i ca ted tha t c o u n sel rep rese n tedS w a n son “i n h er efforts t o r e in s ta te h e ru n la w fu llyte r m in a te dd is a b ilitya n dh e a lth in s u r a n c e b e n e fits .” I tf ur t he ri ndi c at e d: P l ea se a ccep t t h i s l etter a s n o tice of D eb ra S w a n son ’ s i n ten ti on to appealyo ur de c i si on t er m i nat i ng herbe nef i t s und ert he abo ve r e fe r e nc e d p o l i c y. Onc e w e ha ve ha d a de qua t e t i m e t o r e vi e w a nd su p p l em en t t h e rec ord , w e w i l ln oti fy y ou in w ri ti n g to p roce ed w i th D e br a Sw ans o n’ s a dm i ni s t r at ive ap pe alund e rt he t e r m s o f t he Pl an. T h e lett er re q u ested va ri ou s d ocu m en ts f rom the P l a n , an dask ed H a rtf ord to provi de coun selw i t h noti ce of f u rt h er dead l i n es. H art f ord d i d n otconsi der t h i s t o be an app eal
. H art f ord personn el
reco rd ed re ceipt of t h e lett er in S w a n son ’ s f i l e, a n dad d ed the f

oll ow i n g e n try to t h e f i l e : “ I n t e n tt o a p p e a ll e t t e rr e c ’ dn o ta n a p p e a l–wi l ls e n do u ta c k n o w. le tt e r .” H a r tfo r d fo r w a r d e d th e file , in c lu d in g th is e n tr y , to S w a n s o n ’ s co u n s e l. W h en t h e 180

- da y dea dl i n e p assed, a n d H art f ord concl u ded n o a pp ealha d been received , H art f

ord cl osed S w an son’ s f i l e. T h ree and a ha l f

years l ater , on F ebru ary 23, 200 7, t h e sam e coun self or S w a n son su b m i tted to H a rtf ord w h a t sh e n ow de scribe s a s “ h er b ri ef w i th
a c c o m p a n y in ge v id e n c e , in c lu d in gm e d ic a l r e c o r d s a n da v o c a t io n a l e x p e r t ’s
r e p o r t
. ” T h e c o v e rl e t t e rs t a t e dt h a t“ [t ] h i s f i r m r e p r e s e nt s D e b o r a h [ s i c ] C. S w a n s o n i n h e r o n g o in ga p p e a l o f t h e H a r t fo r dL ife I n s u r a n c e C o m p a n y ’s
u n l aw f u ldeci si on . . . t o cl ose M s. Sw an son’ s c l ai m f or c on tin u e d l on g- t erm di sabi l i t y ( “ L T D ” ) ben ef i t s. ” H art f

ord di d n ott reatt h i s as an ap pea lor rul e onN o. 09- 20159

3 i t s m eri t s. R ather, on A pri l2 1, 2 007 , H art f ord w rot e S w an son, rej ect i n g t h e new sub m i ssi on as an a pp ealf i l ed aft er t h e 180

- da y dea dl i n e. S w a n s o n t h e n fi l e ds u itin th e d is t r ic tc o u r t , w h ic h g r a n t e dth e P la n ’s
m o tio n fo rs u m m a r yju d g m e n t. S w a n so n v. Hea rs t Co rp . L o ngT er m D isa b ili ty Plan , N o. H

- 08-213, 200 9 W L 361 469 ( S
. D
. T ex. Feb
. 11, 200 9)

. Th e di st ri ct court h el d that Sw an son’ s A u gu st25, 200 3 l et t er m erel y exp ress ed an i n t en t i on t o a p p e a l in th e fu t u r e , b u td i d n o tc o n s t it u t e a n a p p e a l, a n dth a tS w a n s o n ’s fai l u re t o f

i l e an act u al ap pea l bef ore t h e 180

- da y dea dl i n e am ou n t ed to a fai l u re to e x h a u s t a d m in is tr a tiv e re m e d ie s p r io rto b r in g in gs u it. Id
. a t* 4

– 5
. I n t he al t erna t ive, t h e courthel d that i f t h e A u gu st25, 200 3 l et t er w as an app eal , t h en t h e st atute of

l i m i t ati on s f

or Sw an son’ s 2007 sui tbegan run n i n g at t h e l atest
w hen H ar t f

or d fai l ed t o r ul e o n t he appea lw i t hi n n i n ety d a ys, and t hat S w a n s o n ’ s s u it w a s tim e -b a r r e dw h e n s h e file dit m o r e th a n fo u ry e a r s la te r . I d. at*5 n. 13. The c our tal so r ej ec t ed Sw anso n’ s ar gum entt hatt he Pl an sho ul d be
e s to p p e dfr o m a s s e r tin gfa ilu r e to e x h a u s t a d m in is tr a tiv e re m e d ie s . Id
. at *6 &
n. 15. T h i s C ou rtrevi ew s s u m m ary j u dg m en t s d e novo i n E RI SA c as e s , a pplyi ng th e s a m e s ta n d a r d s a s th e d is tr ic t c o u r t. Pe a c ev . A m . G e n . L ifeIn s . Co ., 462 F
. 3d 4 37, 439 ( 5t h Ci r . 2 00 6)

. Sum m ar y j udg m e nti s pr o pe ri f t he r e i s no gen u i n e i s s ue o f m at e r i al fac t and t he m o va nt i s e nt i t l e d t o a j udg m e nt as a m at t e ro f

l aw. Fe d. R. Ci v. P. 5 6(c )

. “W e r e s o lve do ubt s i n fav o ro f t he
n o n m o v in gp a r tya n dm a k e a ll re a s o n a b le in fe r e n c e s in fa v o ro f th a t p a r ty .” D ean v. C i ty of

S h reve port , 438 F
. 3d448 , 454 ( 5t h C i r . 200 6)

. N o g e nui ne i s s ue o f m at e r i alfac te xi s t s i f t he e vi de nc e i s s uc h t hatno r e as o nab l e j ur o rc o ul d f i nd fo rth e n o n m o v a n t. W he e le rv . BL D e v . Cor p. , 4 1 5 F .3d 3 9 9 , 4 0 2 (5t h C ir. 2 0 0 5 ).
A s Sw an so n c on cedes, exh au st i on of adm i n i st rat ive rem edi es i s a p r e r e q u is ite to a n E R IS Aa c tio n in fe d e r a l co u r t. Se eB o urge o i s v. Pe ns i o n PlanN o. 09- 20159

Wehave reco gniz edaf utilityexceptionto the exh au stionrequirem ent, see Bou rgeo is , 1 215F .3d at 4 79, whichSwanson invokes in passing
. But there is no indication in therecord that Hartford would not h ave properly consi dered Swanson’s argu ments and evidence if she had submitted them withinthe 1 80-day perio d. As discu ssed below, she di d not. Although Holmesis not precedential, we consi der its analysis of the point in que stion 2 to b e persuasive . 4 f o rt heEmploy e e s of

Sant a FeI

nt ’lCor ps ., 2 1 5 F .3d 4 7 5 , 4 7 9 (5t h C ir. 2 0 0 0 ). 1 T h ere i s l i kew i se no di spu t e t h at i n order t o exh au st rem edi es, Sw an son n eeded t o a ppealt he t er m i nat i on o f be nef i t s w i t hi n 180 days of A pril4, 2003. Sw ans o n c hal l e nge s t he di s t r i c tc o ur t ’ s e xha us t i o n r ul i ng ba s e d o n t he
as s e r t i o n t hat s he i nde e d f i l e d he r ap pe al w i t hi n 18 0 da ys . She a r gue s t hats he

“ preserved h er r i gh tto a pp ealb y send i n g a l et t er on A u gu st2 5, 2 003 t o H art f ord as noti ce of

her ap pea lw el l w i t h i n t h e 180 da y t i m e l i m i t , ” an d that “ H art f ord
w as requir ed to i ssue i t s d eci si on in w ri t i n g 45 d ays aft er i trec eived t h e w ri t t en r e q u e s t .” W e a g r e e w it h t h e d is t r ic t c o u r tth a tth is a r g u m e n tfa il s . S w a n s o n ’s A u g u s t 2 5 le tt e r w a s n o t a n a p p e a l; it m e r e ly e x p r e s s e da n “in te n tio n to a p p e a l.” Cf

. Ho l m e s v . Pr o c t o r& G am bleD i s ab i l i ty Be nef i tPlan , N o . 0 6

- 3 0 9 5 6 , 228 F. A p p ’ x 3 77, 379 ( 5th C i r. 200 7) (u n pu bl i shed ) (h ol di n g, i n t h e contextof
m at e r i al l y s i m i l arER I SA app e alp roce dur e s , t hatt he pl ai nt i f f “ di d n ot
s u b s ta n tia llyco m p lyw ith th e P la n ’ s a p p e a l p r o c e d u r e s [b e c a u s e h e ] s ta te do n ly h i s in ten t t o a p p e a l t h e P la n ’s d e c is io n a ts o m e ti m e in th e fu t u r e .” ). S w a n s o n ’s 2 l et t eri ncl uded n o fac t ualor subs t ant ive ar gum ent s, an d n o evi denc e. There w as accordi n gl y n ot h i n g f or H art f

ord t o consi der on a pp eal , an d n o b asi s to r equ i re H art f ord t o “ i ssue i t s deci si on i n w ri t i n g 45 d ays aft er i tre ce ive d the w ri t t en r e q u e s t ,” a s S w a n s o n p r o p o s e s . T h e a p p r o p r ia t e m a t e r ia ls m a k in gS w a n s o n ’s
case— h er act u alapp eal

— di d n otarrive u n t i lm ore t h an t h ree years l ater
. S w a n s o n a ls o fa il s to p e r s u a d e u s o f a n ye r r o rin th e d is t r ic tc o u r t ’s concl u si on t h at H art f ord w as n ot est opp ed f rom i n vok i n g fai l u re t o ex h au st ad m i ni s t r at ive r e m e di e s as an af f i r m at ive de fe ns e . I n B o u rg eo is , w e he l d t hatN o. 09- 20159

5 an E R ISAp l an w as estopped fr om enfor ci n g t h e exh au st i on requi rem en t , w h ere “v a r io u s o ffic ia ls o f th e c o m p a n yle dB o u r g e o is o n aw ildg o o s e ch a s e , e ffe c tiv e ly exti n gu i shi n g h i s t i m e t o ap pl y f or ben ef i t s. ” 215 F
. 3d at 481
. C i t i n g t h at c ase, S w an son argu es t h at H art f ord shou l d be estopped f rom asser t i ng t he exh au st i on d e fe n s e b e c a u s e “n o d e c is io n w a s e v e ris s u e d , in w r itin go ro th e r w is e ,” in
r e s po ns e t o he rAugus t2 5, 2 00 3 l e t t e ro rt h e Fe br uar y 23 , 2 00 7 f i l i ng, a nd bec ause H ar t f

or d di d notf

or m al l y s t at e i t s pos i t i on t hatheri ni t i all et t erw as i n ad equ ate un t i l af

t er t h e dea dl i n e h ad passed. W e ascr ibe n o fau l tt o H art f ord f o rfai l i ng t o r ul e o n t h e m eri t s o f t he a ppe al , b e c aus e w e ha ve a f f i r m e d t he d i s t r i c tc o u r t ’ s c o n c l u s i o n t h a tt h e r e wa s n o v a l i da p p e a lo n wh i c h t o r u l e . As t o t h e am ou n tof

noti ce Sw an son received , she does n otdi spu t e t h at H art f ord
n ot i f i ed h er of

t h e P l an ’ s 180-day ap pea ldead l i n e at t h e outset , or t h at H art f ord f o r w ar de d he rf

i l e t o cou n se lw i t hi n t hatt i m e pe r i o d, i nc l udi ng no t at i o ns i ndi c at i ng t hatH ar t f or d di d notc ons i dert he A ugust25, 2003 l et t er to b e an appeal
. Sw anso n cit es no pr ovi si on o f t he Pl an orany o t hers our c e o f l aw t hat
w o ul d o bl i ga t e H ar t f o r d t o s e nd f

ur t he rnot i c e s orr e m i nde r s b e f o r e c o nc l udi ng t hatSw ans o n fai l e d t o t i m e l y ap pea l
. H e rc i r c um s t anc e s a r e c e r t ai nl y unl i ke t ho s e i n B o u rg eo is , w h ere the E R IS Aplan aff i rm a tive l y m is le d t h e a p p l i ca n t. S ee 2 1 5 F .3 da t 4 8 1
. Bec aus e w e ha ve r ej e c t e d Swans o n’ s c hal l e nge t o t he di s t r i c tc o ur t ’ s r ul i ng t h at H art f

ord w as en tit l ed to an af f i rm ative defense of

fai l u re t o exh au st
a d m in is t r a t iv e r e m e d ie s , itis n o t n e c e s s a r yfo ru s to c o n s id e rth e d is t r ic tc o u r t ’s al t erna t ive groun d f or s u m m ary j u dg m en t b a sed on the st atute of l i m i t ati on s. T h e r u l i n go f

t h e d i s t r i c tc o u r ti s A F F I RMED.