Adam Ruessler v. Boilermaker-Blacksmith National Pension Trust ( 2023 )

United States Court of Appeals
For the Eighth Circuit
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No. 21-3876
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Adam Ruessler
Plaintiff - Appellant
v.
Boilermaker-Blacksmith National Pension Trust Board of Trustees
Defendant - Appellee
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Appeal from United States District Court
for the Eastern District of Missouri
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Submitted: September 20, 2022
Filed: April 3, 2023
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Before SHEPHERD, KELLY, and GRASZ, Circuit Judges.
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GRASZ, Circuit Judge.
The Boilermaker-Blacksmith National Pension Trust Board of Trustees
(“Board”) denied Adam Ruessler’s application for disability pension benefits under
a plan governed by the Employee Retirement Income Security Act (“ERISA”),
codified at 29 U.S.C. §§ 1001–1461. Ruessler argues the Board’s stated reason for
denying his application was unreasonable, and the Board violated its fiduciary
duties. The district court 1 granted the Board’s motion for summary judgment.
Ruessler appeals, and we affirm.
I. Background
The Board administers the Boilermaker-Blacksmith National Pension Trust
(“Pension Trust”). The parties agree that benefits under the Pension Trust are
governed by the Thirteenth Restatement of the Pension Plan Document (“Plan”).
The relevant provisions of the Plan relate to how the Board determines who is
eligible for benefits, the Board’s timeline for making an initial decision on an
application, and the applicant’s rights if his or her application is denied.
Section 4.09 of the Plan provides a disability pension to certain participants
who become totally and permanently disabled before reaching age sixty-five. To be
eligible, there are multiple requirements, two of which are that the applicant “[h]as
been awarded a Social Security Disability Benefit” and the applicant “[h]as filed a
written application for benefits . . . together with a notice of award of disability
benefits from the Social Security Administration . . . .” In this way, the Plan does
not permit participants to independently establish disability.
The Board has interpreted the Plan to require it to decide claims within 180
days from the time the Pension Trust receives the application. For this rule, it cites
section 10.01(c), which states:
Approval or denial of the claim will normally be made within ninety
(90) days after the claim has been received by the Plan. If additional
time is required in special cases, the claimant will be notified in writing
of the special circumstances requiring an extension of time and of the
date by which the Plan expects to render the final decision, which will
be not more than ninety (90) days from the end of the initial time
1
The Honorable Stephen N. Limbaugh, Jr., United States District Judge for
the Eastern District of Missouri.
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period. . . . If additional information is required, the claimant will be
notified and requested to furnish the necessary data within the 180-day
time period specified by this provision.
If the Board denies a claim, section 10.01(d) of the Plan requires the Board to
notify the participant in writing. In addition to citing the specific reason for the
denial along with references to the Plan, the notice is to provide “a description of the
additional material or information necessary for the claimant to perfect his claim and
an explanation of why such material or information is necessary.” The notice must
also include a statement about the right to sue under ERISA after the claimant
exhausts the review procedures.
If a claim is denied, section 10.03(e) provides that the claimant may appeal
and “request[] review of the denial” by the Board. During the appeal, Plan section
10.01(g)(1) specifies that a claimant is “entitled to submit” documents related to the
claim; section 10.01(g)(4) provides the Board is to review those documents,
“regardless of whether such information was submitted or considered in the initial
benefit determination”; and section 10.01(g)(5) states the Board is to “decide the
claim anew” without giving deference to the initial decision.
The relevant facts of this case are not in dispute. Ruessler became disabled
and unable to work in 2015. He applied for Social Security Disability benefits the
same year. Ruessler applied for disability pension benefits under the Plan in July
2017. His application followed on the heels of an amendment to the Plan. In early
2017, the Board adopted Amendment 4, which drastically reduced benefits under
the disability pension for annuity start dates on or after October 1, 2017. The parties
agree that, for purposes relevant to this case, an applicant’s annuity start date is
determined by when he applied for benefits. Based on Ruessler’s July 2017
application date, Ruessler’s projected annuity start date was September 2017—
which would avoid the reduction of benefits for annuities that began on or after
October 1.
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When Ruessler submitted his application under the Plan, he did not include
documentation from the Social Security Administration because he had not yet been
awarded Social Security Disability benefits. While Ruessler’s application for
pension benefits was pending, the Board contacted him at least four times to notify
him that he needed to provide the Board with a notice of award. In a letter dated
September 12, 2017, the Board stated that if the notice of award was not received
within 180 days from when the application was filed, the application would be
denied and it would “be necessary . . . to complete a new Pension Application.” The
Board made similar statements in 2017 letters dated September 29, November 16,
and December 15. The Board again communicated Ruessler’s right to reapply if his
application was denied in a letter dated December 20.
As indicated in the letters, after approximately 180 days from the July 2017
application date, the Board denied Ruessler’s claim in January 2018. The Board’s
denial letter explained that Ruessler “[did] not qualify for a Disability Pension
because [he] failed to provide a copy of [his] Social Security Disability Notice of
Award.” The letter cited section 4.09(a) of the Plan, which required that the
applicant “ha[ve] been awarded a Social Security Disability Benefit” to be eligible
for the Disability Pension.
Ruessler appealed the denial to the Board in either late February or early
March 2018. In February, a Social Security Administrative Law Judge issued a
written “Notice of Decision – Fully Favorable” on Ruessler’s application for Social
Security Disability benefits. By March 2, Ruessler submitted the “Notice of
Decision” to be considered with his appeal of the Board’s initial denial.
While the appeal was pending, there were several communications between
the Board and Ruessler. First, the Board provided Ruessler an unsolicited pension
application packet near the end of April 2018. A few days later, Ruessler contacted
the Board by phone. The parties dispute whether one of Ruessler’s purposes in
making the call was to ask about the purpose of the unsolicited packet; however,
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during the call Ruessler asked what his pension would be if he waited to apply until
a later time, and he requested estimates for different retirement ages.
In June 2018, the Board denied Ruessler’s appeal. The Board explained it
denied the appeal because Ruessler “applied for a Disability Pension with a filing
date of July 17, 2017 and failed to provide a copy of [his] Social Security Disability
Notice of Award within the 180-day time period allowed of January 13, 2018.”
When the Board denied Ruessler’s appeal, it cited: section 4.09(a), making eligibility
under the Plan contingent on whether the claimant “[h]as been awarded a Social
Security Disability Benefit”; section 4.09(d), stating the written application for
benefits is required “together with a notice of award”; and section 10.01(c), requiring
the initial benefit determination to be made within 180-days of when the claim is
filed.
Ruessler filed his first lawsuit in September 2019. A couple weeks later, the
Board’s counsel emailed Ruessler’s counsel. The Board’s counsel had observed that
Ruessler had not reapplied for a pension. The email stated that Ruessler could
reapply for pension benefits and doing so would not prevent him from litigating the
decision on his 2017 application. Ultimately, Ruessler dismissed the first case
without prejudice, reapplied for benefits in 2020, and began receiving an early
retirement pension, albeit one reduced under Amendment 4.
Ruessler then filed this lawsuit, alleging he has suffered damages as a result
of the Board’s denial of his July 2017 application for benefits. Ruessler brought two
claims: (1) wrongful denial of benefits, see 29 U.S.C. § 1132(a)(1)(B), and (2)
breach of fiduciary duties, see 29 U.S.C. § 1132(a)(3). Eventually the parties filed
cross-motions for summary judgment. The district court denied Ruessler’s motion
and granted the Board’s motion. Ruessler appeals.
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II. Analysis
A. Standard of Review
Our review of a district court’s grant of summary judgment is de novo,
“viewing the evidence in the light most favorable to . . . the nonmoving party and
drawing all reasonable inferences in [his or] her favor.” Roebuck v. USAble Life,
992 F.3d 732, 735 (8th Cir. 2021). “We review the district court’s adjudication of
this [ERISA] claim de novo, applying the same standard of review to the [Board’s]
decision as the district court.” McClelland v. Life Ins. Co. of N. Am., 679 F.3d 755,
759 (8th Cir. 2012).
The parties disagree about what standard the district court should have
applied—and, therefore, what standard we should apply—to review the Board’s
decision. Ruessler argues the appropriate standard is a less deferential, “modified”
abuse of discretion standard. The Board argues the traditional abuse of discretion
standard governs. Our review of “the district court’s determination of the
appropriate standard of review under ERISA” is de novo. McIntyre v. Reliance
Standard Life Ins. Co., 972 F.3d 955, 958 (8th Cir. 2020).
The general rule is that challenges under § 1132(a)(1)(B) are reviewed de
novo. See id. at 958. There is an exception to the general rule if “the benefit plan
gives the administrator or fiduciary discretionary authority to determine eligibility
for benefits or to construe the terms of the plan.” Id. at 958–59 (quoting Firestone
Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989)). Under those circumstances,
the decision is reviewed for an abuse of discretion. See id. at 959.
Ruessler admits the Plan gives the Board the necessary discretionary authority
to trigger abuse of discretion review, but he argues there is an additional wrinkle in
his case. In Ruessler’s view, a “modified” abuse of discretion review is triggered if
the Board has a conflict of interest—i.e., if it decides who should receive benefits
and makes the payments. Ruessler cites primarily two cases in support of this
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argument: McIntyre, 972 F.3d 955, and Woo v. Deluxe Corp., 144 F.3d 1157 (8th
Cir. 1998).
Woo is the source of the standard for which Ruessler argues. In Woo, we
stated a plaintiff could “obtain a less deferential review” if he or she “present[ed]
material, probative evidence demonstrating that (1) a palpable conflict of interest or
a serious procedural irregularity existed, which (2) caused a serious breach of the
plan administrator’s fiduciary duty to [him or] her.” 144 F.3d at 1160. Ruessler
rests his argument for a less deferential review on the conflict-of-interest prong of
Woo. Herein lies the problem.
The conflict-of-interest prong of Woo is no longer good law. That part of Woo
was abrogated by the Supreme Court in Metropolitan Life Insurance Co. v. Glenn,
554 U.S. 105 (2008). See McIntyre, 972 F.3d at 959 (acknowledging we have
“repeatedly recognized” that Glenn “abrogated at least the conflict-of-interest
component of Woo”). Now, under Glenn, any conflict of interest is just a factor to
be weighed in the abuse of discretion analysis. See Roebuck, 992 F.3d at 737 (citing
Glenn, 554 U.S. at 111–12); Johnston v. Prudential Ins. Co. of Am., 916 F.3d 712,
714 (8th Cir. 2019). Therefore, we conclude the appropriate standard of review of
the Board’s decision is for an abuse of discretion, taking into consideration a conflict
of interest as a factor in the analysis.
Now, we arrive at another sticking point. The parties disagree on whether the
Board has the kind of conflict of interest that must be considered under Glenn. The
Board focuses on its structure—a union-affiliated benefit fund, equally controlled
by employer and employee representatives, and financed by employer contributions,
not the trustees—and argues that consideration of an alleged conflict of interest is
not required under these circumstances. The Board refers to these as Taft-Hartley
funds. We have recognized that Taft-Hartley funds are those in “a trust fund set up
pursuant to the terms of the Labor Management Relations Act of 1947” and meet the
requirements of 29 U.S.C. § 186, Lickteig v. Bus. Men’s Assur. Co. of Am., 61 F.3d
579, 581 n.3 (8th Cir. 1995), including that “employees and employers are equally
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represented in the administration of such fund,” among other things. 29 U.S.C.
§ 186(c)(5)(B). Ruessler argues the Board has an inherent conflict of interest as both
the decider and payer of benefits, i.e., it has a conflict between the Board’s duty to
preserve the long-term financial health of the Plan and its duty to Ruessler
individually. He maintains this conflict of interest is embodied in Amendment 4.
Although he admits Amendment 4 was aimed at improving the long-term financial
health of the Plan, he says it was adopted at the expense of individuals like Ruessler.
Our sister-circuits have approached this issue in different ways. Compare
Anderson v. Suburban Teamsters of N. Ill. Pension Fund Bd. of Trs., 588 F.3d 641,
648 (9th Cir. 2009) (holding that a plan maintained under the Taft-Hartley Act did
not have a conflict of interest because the plan did not meet the standard laid out in
Glenn), with Durakovic v. Bldg. Serv. 32 BJ Pension Fund, 609 F.3d 133, 138–39
(2d Cir. 2010) (concluding that funds maintained under the Taft-Hartley Act had a
conflict of interest that needed to be weighed under Glenn). We find it unnecessary
to resolve this issue for our circuit today. Even if we assume a conflict exists and
give it an appropriate amount of weight, it does not change the outcome of this case.
B. Denial of Benefits
Ruessler argues the Board abused its discretion by adopting an unreasonable
interpretation of the Plan. The district court did not address whether the Board’s
interpretation was reasonable because the district court found Ruessler’s arguments
could not overcome the fact he never submitted a notice of award. Ruessler argues
this is an impermissible post-hoc rationale under King v. Hartford Life & Accident
Insurance Co., 414 F.3d 994 (8th Cir. 2005) (en banc). Although we are skeptical
of Ruessler’s characterization of the district court’s rationale, we recognize it is our
practice, with limited exceptions, to review only the administrative record when
considering a plan administrator’s discretionary denial of a benefits application. See
Ingram v. Terminal R.R. Ass’n of St. Louis Pension Plan for Nonschedule Emps.,
812 F.3d 628, 634 (8th Cir. 2016). We opt to address the Board’s interpretation of
the Plan directly, and ultimately affirm on alternative “grounds supported in the
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record,” rather than on the grounds relied on by the district court. See Catipovic v.
Peoples Cmty. Health Clinic, Inc., 401 F.3d 952, 957 (8th Cir. 2005).
The question we ask in this context is whether the Board’s decision was
“reasonable.” See Roehr v. Sun Life Assurance Co. of Can., 21 F.4th 519, 525 (8th
Cir. 2021). “Under the abuse of discretion standard of review, ‘we must uphold [a
plan administrator’s] decision so long as it is based on a reasonable interpretation of
the Plan and is supported by substantial evidence.’” Ingram, 812 F.3d at 634(quoting Hampton v. Reliance Standard Life Ins. Co., 769 F.3d 597, 600 (8th Cir.
2014)).
The Board denied Ruessler’s claim because Ruessler did not provide the
notice of award within 180 days from his application date. Under its interpretation
of the Plan, if an applicant fails to comply with the 180-day timeline, he or she must
reapply to receive benefits. The new application would then establish a new Annuity
Starting Date. 2 The Board based this interpretation on section 4.09(a), which makes
eligibility for a disability pension contingent on having been awarded Social
Security Disability benefits; section 4.09(d), which states the application must be
submitted “together with a notice of award”; and section 10.01(c), which lays out
the 180-day timeline for the initial benefit determination.
We use a factor-based analysis to assess whether a Plan interpretation is
reasonable. See King, 414 F.3d at 999. The factors are:
2
The concurring opinion expresses the view that it is speculative to conclude
the Board has taken this position. We disagree. The statement of denial fairly
encompasses this interpretation of the Plan because it put Ruessler on notice that his
failure to comply with the 180-day time period was at least one of the fatal flaws in
his application. See Hall v. Metropolitan Life Ins. Co., 750 F.3d 995, 999 (8th Cir.
2014) (concluding rationale was not post-hoc when the denial letter “implicitly
rejected” one of the appellant’s arguments). And the Board has defended its denial
of Ruessler’s claim on these very grounds throughout each stage of the litigation.
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whether their interpretation is consistent with the goals of the Plan,
whether their interpretation renders any language of the Plan
meaningless or internally inconsistent, whether their interpretation
conflicts with the substantive or procedural requirements of the ERISA
statute, whether they have interpreted the words at issue consistently,
and whether their interpretation is contrary to the clear language of the
Plan.
Id. (quoting Finley v. Special Agents Mut. Benefit Assoc., Inc., 957 F.2d 617, 621
(8th Cir. 1992)). These have come to be known as the “Finley factors.” See id. The
touchstone of the analysis remains whether the interpretation of the provision is
“reasonable.” See id.Although Ruessler suggests the Board’s interpretation implicates all five of
the Finley factors, his argument hinges almost entirely on one factor: “whether their
interpretation renders any language of the Plan meaningless or internally
inconsistent . . . .” Id. (quoting Finley, 957 F.2d at 621). He points to section 10.01
of the Plan that governs appeals, including subsections (d), (g)(1), and (g)(4)–(5).
Subsection (d) indicates the Board must state in the notice of denial “a description
of the additional material or information necessary for the claimant to perfect his
claim and an explanation of why such material or information is necessary . . . .” In
addition, the appeal procedures provide that an appellant has the right to submit
documents not previously considered, 10.01(g)(1); that the Trustees are to review
those documents, 10.01(g)(4); and that the Trustees have a duty to “decide the claim
anew,” 10.01(g)(5).
In Ruessler’s view, these provisions make it clear a Plan participant has the
right to submit a notice of award during the appeal process and that doing so would
cure the defect and preserve the annuity starting date associated with that
application. And Ruessler maintains the Board’s interpretation of the Plan “ignores
this right” and “creates an inherent inconsistency.” Therefore, he urges us to
conclude the Board’s interpretation of the Plan requiring the notice of award to be
submitted within the 180-day timeframe is unreasonable.
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We disagree with Ruessler’s characterization of the appeal provisions as
meaningless under the Board’s interpretation of the Plan. Contrary to Ruessler’s
claims, the right to be given notice of how to “perfect his claim” on appeal does not
necessarily mean notice of how to cure any defect. See Brehmer v. Inland Steel
Indus. Pension Plan, 114 F.3d 656, 661 (7th Cir. 1997) (holding the requirement
that the written denial describe “additional material or information necessary for the
claimant to perfect his claim” only applied when a plan administrator needed more
information “to review the denial of a claim”). Subsection (g)(1), which gives the
appellant the right to submit documents is not rendered meaningless because it still
provides the appellant with the opportunity to submit documents showing he or she
had provided the Board with the required document in the 180-day time period.
Subsection (g)(4), requiring the Board to review submitted documents, is likewise
not meaningless. The Board would review submitted documents that indicate
whether the initial decision was correct. As for the Board’s duty to “decide the claim
anew” under subsection (g)(5), interpreting this as deciding the claim without
deference to the initial decision, rather than as a do-over or an extended opportunity
to submit the notice of award, does not render the provision meaningless. An
applicant could still submit documentation showing timely submission of the
required documents, and he could obtain a different result when the claim is decided
“anew.”
The remainder of the Finley factors do not help Ruessler. Ruessler argues the
Plan’s goal is to provide benefits to members who become disabled before the age
of sixty-five. Even if we assume this is a Plan goal, the Board’s interpretation is not
inconsistent with the assumed goal because Ruessler was able to reapply and has
been receiving an early retirement pension. Ruessler has not identified any specific
substantive or procedural ERISA requirements that were violated, nor has he
provided evidence the Board has interpreted this provision differently in other
circumstances.
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Lastly, assuming there is a conflict of interest that must be weighed as a factor
under Glenn, the conflict does not tip the scales for Ruessler. The weight given to a
conflict of interest is determined case-by-case. Roebuck, 992 F.3d at 737. Ruessler
has not provided evidence to suggest the alleged conflict he emphasizes—the
Board’s duty to preserve the long-term financial health of the Plan and its duty to
Ruessler—warrants special weight because it is the kind of tension all trustees who
decide claims and pay benefits must balance. The mere existence of a conflict of
interest does not alter “the dispositive principle . . . that where plan fiduciaries have
offered a ‘reasonable interpretation’ of disputed provisions, courts may not replace
it with an interpretation of their own—and therefore cannot disturb as an ‘abuse of
discretion’ the challenged benefits determination.” Mitchell v. Blue Cross Blue
Shield of N.D., 953 F.3d 529, 538 (8th Cir. 2020) (quoting Darvell v. Life Ins. Co.
of N. Am., 597 F.3d 929, 935 (8th Cir. 2010)). We see no compelling reason to
disturb the Board’s interpretation of the Plan as an abuse of discretion.
C. Fiduciary Duty
Ruessler argues the Board breached its fiduciary duty to him by failing to
provide him with certain information. ERISA contains the express requirement that
fiduciaries “discharge [their] duties . . . with care, skill, prudence, and diligence
under the circumstances then prevailing that a prudent man acting in a like capacity
and familiar with such matters would use . . . .” 29 U.S.C. § 1104(a)(1)(B). That
requirement is further supplemented by the common law of trusts, including the duty
of prudence and the duty of loyalty. See Skelton v. Radisson Hotel Bloomington, 33
F.4th 968, 976–77 (8th Cir. 2022).
Ruessler focuses his arguments on the duty of loyalty. This duty “includes
the obligation to deal fairly with all plan members.” Id. at 977 (quoting Shea v.
Esensten, 107 F.3d 625, 628 (8th Cir. 1997)). One way a fiduciary can breach the
duty of loyalty is by making an affirmative and materially misleading statement. See
Braden v. Wal-Mart Stores, Inc., 588 F.3d 585, 598 (8th Cir. 2009) (stating, “it is a
breach of this duty affirmatively to mislead a participant or beneficiary”); Kalda v.
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Sioux Valley Physician Partners, Inc., 481 F.3d 639, 644 (8th Cir. 2007) (stating, “a
fiduciary may not affirmatively miscommunicate or mislead plan participants about
material matters regarding their ERISA plan” (quotation omitted)).
There are no allegations in this case that the Board made inaccurate statements
to Ruessler about his rights under the Plan. Instead, Ruessler argues the Board’s
statements in the January 2018 denial letter were inexcusably incomplete. Ruessler
maintains that the Board’s failure to specify he could reapply for benefits was a
material misrepresentation because it “presented the appeal as the only path towards
benefits.” In Ruessler’s view, the Board needed to also expressly state that he could
reapply for benefits while his appeal was pending. And lastly, Ruessler argues the
Board had a duty to inform him the Notice of Decision he submitted during the
appeal was insufficient.
Ruessler is right that the duty of loyalty “impose[s] additional obligations of
communication and disclosure under certain circumstances” beyond those expressly
required by ERISA and its regulations. Braden, 588 F.3d at 598. And the duty also
goes further than prohibiting affirmative misrepresentations. See Delker v.
MasterCard Int’l, Inc., 21 F.4th 1019, 1025 (8th Cir. 2022). This duty may include
“disclos[ing] any material information that could adversely affect a participant’s
interests,” Braden, 588 F.3d at 598 (quoting Kalda, 481 F.3d at 644), and disclosing
material information “when it knows that silence may be harmful” or the beneficiary
“is laboring under a material misunderstanding of plan benefits.” Kalda, 481 F.3d
at 644. Still, “we are not quick to infer specific duties of disclosure under § 1104
because of the extent of the statutory and regulatory scheme.” Braden, 588 F.3d at
598.
Even with these more expansive principles in mind, we discern no breach of
the duty of loyalty here. Although the January 2018 denial letter did not specify that
Ruessler could reapply, the Board had already told Ruessler he could reapply if his
application was denied. In the September 12, 2017 letter, the Board stated that if the
notice of award was not received, the application would be denied and it would “be
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necessary . . . to complete a new Pension Application.” Similar statements were
made in four additional letters. The absence of the information in the denial letter is
not enough to establish a violation of a fiduciary duty when such disclosure was not
required by ERISA, and the Board had previously communicated Ruessler’s right to
reapply if his application was denied no less than five times. Cf. Vercellino v. Optum
Insight, Inc., 26 F.4th 464, 469 (8th Cir.), cert. denied, 142 S. Ct. 2819 (2022)(finding no violation of fiduciary duty when information the beneficiary said ought
to have been disclosed was in the plan documents).
We conclude the Board did not breach its fiduciary duty when it did not notify
Ruessler the Notice of Decision he submitted on appeal was insufficient. The initial
letter the Board sent to Ruessler noting the absence of the document clearly stated
Ruessler needed to submit a “Notice of Award.” When the plain language of the
Plan and the Board’s other communications are consistent, there is no obvious
unfairness to Ruessler if his claim is denied because he submitted the wrong
document. See id. (“[T]he information Vercellino claims the Insurer should have
disclosed . . . was laid out in the plan documents, and Vercellino does not point to
any false or misleading statement made by the Insurer.”).
As for Ruessler’s contention that the Board had a duty to specify he could
reapply for pension benefits while his appeal was pending, we are also unpersuaded.
The Board had accurately communicated both Ruessler’s right to reapply if his
application was denied, as described above, and his right to appeal. There is no
evidence the Board knew silence would harm Ruessler because in the May 2018
phone call, Ruessler himself asked about how waiting to receive the pension would
affect the annuity amount and ultimately requested estimates for retirement at later
ages. Moreover, Ruessler has not identified anything that should have caused the
Board to know he misunderstood his rights. Under these circumstances, Ruessler
fails to establish a violation of the duty of loyalty.
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III. Conclusion
For the reasons above, the judgment of the district court is affirmed.
KELLY, Circuit Judge, concurring.
I concur in the court’s opinion except as to section II.B, because I disagree
with the court’s understanding of the Board’s interpretation of the Plan.
I agree that the Board denied Ruessler’s claim because Ruessler did not
“provide a copy of [his] Social Security Disability Notice of Award within the 180-
day time period allowed.” Ruessler argues that this rationale ignores subsection
10.01(g) of the Plan, which provided Ruessler the opportunity to submit additional
documentation during the appeal process. According to Ruessler, he could have
cured the defect in his application by submitting a notice of award as an additional
document, which the Board would have had to consider “anew.” And he contends
that any interpretation of the Plan that would not have permitted him to cure his
earlier failure to submit such a notice, would render subsection 10.01(g)
“meaningless.” This is Ruessler’s primary argument for why the Board’s
interpretation of the Plan was not reasonable. See Finley, 957 F.2d at 621.
But Ruessler misstates the Board’s interpretation of the Plan. Whether the
Plan permitted Ruessler to submit a notice of award during the appeal process was
not a question before the Board because Ruessler—undisputedly—did not submit a
notice of award while his appeal was pending. See Hall, 750 F.3d at 997–99
(concluding insurance company’s litigation position—that it reasonably denied
benefits for failure to timely submit a change-of-beneficiary form—was not a “post
hoc” rationale where applicant submitted the form during the appeal, and “[a]fter
considering this information,” the company issued a denial letter basing its benefits
determination on a form already on file, thus “implicitly reject[ing]” the validity of
the newly submitted form); cf. King, 414 F.3d at 1003 (rejecting plan administrator’s
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attempt to “offer[] a post hoc rationale during litigation to justify a decision reached
on different grounds during the administrative process.”)
Both counsel for the Board and the Board’s designated representative under
Federal Rule of Civil Procedure 30(b)(6), stated that it would be up to the Board to
decide whether to consider an untimely notice of award. But here, the Board was
not presented with one to consider. It would be speculative to conclude that the
Board would have refused to consider a notice of award had Ruessler in fact
submitted one or that the Board would have required Ruessler to reapply for benefits
regardless of his untimely submission. The Board’s interpretation of the Plan as
stated in its decision denying Ruessler’s claim for benefits does not render
subsections (g)(1), (g)(4), or (g)(5) of section 10 of the Plan meaningless.
Ruessler does not meaningfully address how any of the remaining Finley
factors support his position, and I agree with the court’s conclusion that there are no
grounds to disturb the Board’s decision.
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