Opinion ID: 1037472
Heading Depth: 3
Heading Rank: 2

Heading: Timely Exhaustion of Administrative Remedies

Text: Because the termination letter substantially complied with the relevant regulation, McGowan had 180 days from receipt of the letter to file a written request for review. As the Plan clearly states, a determination “that is not timely appealed[] will be conclusive, final and binding on all persons.” In order to challenge the Fund’s determination in court, McGowan must show that he timely exhausted the administrative remedies available. McGowan concedes that he did not file a written request for review within the 180-day period provided by the Plan. He claims instead that he orally notified Daniel of his intent to appeal the termination in a phone call that took place a few days after he received the letter. As the Plan makes abundantly clear, however, oral notification does not suffice. Beneficiaries seeking review of a determination must make “a written request for review to the Board” within 180 days of receiving the adverse benefit determination. Since McGowan failed to do so, his termination of benefits became final and binding. 6 Case: 13-30051 Document: 00512338134 Page: 7 Date Filed: 08/12/2013 No. 13-30051 In an attempt to salvage his claim, McGowan contends that the hearing held in 2012, prior to the district court’s summary judgment determination, remedied his failure to timely exhaust administrative remedies because the merits of his claim were considered. McGowan, however, provides no argumentation or authority in support of this proposition. Furthermore, the Fund’s decision to evaluate the timeliness of McGowan’s appeal at a hearing where McGowan’s employment history was also discussed does not remedy McGowan’s failure to exhaust. The hearing was held in response to McGowan’s February 9, 2012 letter, a written request for review that was submitted ten months after McGowan received the termination letter; and the primary purpose of the hearing was to evaluate the timeliness of McGowan’s appeal. As the Fund stated in its final determination: “No written appeal was filed by Mr. McGowan or his counsel within the 180-day period established by the plan.” McGowan thus did not appeal the termination of benefits within the time allotted; the subsequent hearing did not remedy McGowan’s default. Therefore, we affirm the district court’s grant of summary judgment for failure to timely exhaust administrative remedies.