Opinion ID: 780581
Heading Depth: 2
Heading Rank: 2

Heading: watts' claim and administrative appeal

Text: 9 Gloria Watts, as a participant in the Plan, submitted a claim for disability benefits under it. On January 16, 2001, BellSouth notified Watts by letter that her claim had been denied. Watts timely filed what the parties call her first appeal, and BellSouth notified her by letter dated May 9, 2001, that it was denying her appeal and expressly informed her that she had 60 days to file a second and final administrative appeal. 1 10 Watts did not file the second and final administrative appeal. She consulted her union representative and was advised that it would not do any good, that she would not prevail in an administrative appeal. In an affidavit Watts filed in opposition to BellSouth's motion for summary judgment, she states that after consulting with the union representative, and while the 60 days for filing the second administrative appeal had not yet run, she consulted the summary plan description. She read in that document both the statement that she may use [the administrative appeal] procedure if a claim for benefits is denied, and also the statement that [i]f you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or federal court. According to Watts' affidavit, she understood from the summary plan description that she had the option of continuing to pursue her claim administratively (by taking her second appeal), or filing a lawsuit, or both. As she described it, the summary plan description caused her to believe that she could do either, both, or neither. 11 Because Watts was convinced she would not prevail administratively, she decided her best avenue for relief would be a federal lawsuit. She did not consult an attorney to discuss the possibility of a lawsuit until July 24, 2001, sixteen days after the deadline for filing her second administrative appeal had passed. On the same day that she met with her attorney, and presumably in compliance with legal advice, she sent a letter to BellSouth seeking to pick up and complete the administrative process by taking the second appeal from the denial of her claim for benefits. On August 1, 2001, BellSouth denied her second appeal because it, in the form of Watts' letter, had been filed seventy-six days after the denial of her first appeal, which was sixteen days too late. Watts then filed this suit in the district court.