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Burke v. PricewaterhouseCoopers LLP Long Term Disability Plan

July 9, 2009

PATRICIA A. BURKE, PLAINTIFF-APPELLANT,
v.
PRICEWATERHOUSECOOPERS LLP LONG TERM DISABILITY PLAN, THE HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY, DEFENDANTS-APPELLEES.



SYLLABUS BY THE COURT

Appeal from the judgment of the United States District Court for the Southern District of New York (Chin, J.) entered on March 6, 2008, dismissing plaintiff's complaint brought pursuant to 29 U.S.C. § 1132, finding the claim time-barred.

Affirmed.

Per curiam.

Argued: April 30, 2009

Before: B.D. PARKER, WESLEY, Circuit Judges, and MURTHA, District Judge.*fn1

Plaintiff-Appellant Patricia Burke appeals from a Judgment entered March 6, 2008 in the United States District Court for the Southern District of New York (Chin, J.), dismissing with prejudice her ERISA claim against PricewaterhouseCoopers LLP ("PwC") Long Term Disability Plan and the Hartford Life and Accident Insurance Company ("Hartford") (collectively, "Defendants"). For the reasons stated below, we affirm the district court's dismissal of Burke's 29 U.S.C. § 1132 claim because it is time-barred under the written terms of the plan.

In June 2002, following knee surgery, Burke, a former PwC employee, applied for short-term disability benefits under the PwC Health and Welfare Benefits Plan (the "Plan"). She was granted and received benefits until they were exhausted. On September 17, 2002, Burke applied for long-term disability ("LTD") benefits which were approved to commence at the expiration of her short-term benefits on October 20, 2002.

On March 28, 2003, Hartford, the Plan administrator, requested Proof of Loss, including an evaluation to be completed by her doctor. The Plan required Proof of Loss be provided within thirty days of the request. Burke's doctor submitted the evaluation on April 25, 2003. Hartford requested further information be submitted by May 5, 2003, because it viewed the doctor's conclusions that Burke was permanently disabled, but that she could work for eight hours per day as contradictory. When Hartford did not receive a response by May 12, 2003, it notified Burke her LTD benefits were terminated as of April 30, 2003 because "the weight of medical evidence" did not support continuing the benefits. On June 10, 2003, Burke appealed the termination and submitted additional information. Hartford denied the appeal on October 1, 2003 and informed Burke she could bring a civil action.

On September 25, 2006, Burke filed a suit in federal court challenging the termination of her LTD benefits. 29 U.S.C. § 1132(a)(1)(B) (creating a cause of action for a plan beneficiary to recover benefits due under an employee benefit plan). The district court held a summary trial on a stipulated administrative record. Judge Chin dismissed Burke's claim as time-barred under the Plan in a well-reasoned Memorandum Decision dated February 29, 2008. Burke v. PricewaterhouseCoopers LLP, Long Term Disability Plan, 537 F. Supp. 2d 546 (S.D.N.Y. 2008).

We review the district court's judgment de novo because the sole issue on appeal is a question of law; the facts are undisputed. Grace v. Corbis-Sygma, 487 F.3d 113, 118 (2d Cir. 2007) (stating that conclusions of law are reviewed de novo). Burke's appeal hinges on whether the applicable limitations period began to run before she could bring a § 1132 claim. If yes, her appeal is untimely; if no, her appeal is timely.

The starting point is the applicable limitations period. The Employee Retirement Income Security Act of 1974 (ERISA), codified at 29 U.S.C. §§ 1001-1461, does not prescribe a limitations period for 29 U.S.C. § 1132 actions, the section under which Burke brought her claim. See Miles v. N.Y. State Teamsters Conference Pension & Ret. Fund Employee Pension Benefit Plan, 698 F.2d 593, 598 (2d Cir. 1983). Therefore, the applicable limitations period is "that specified in the most nearly analogous state limitations statute." Id. Here, New York's six-year limitations period for contract actions, N.Y. C.P.L.R. 213, applies as it is most analogous to § 1132 actions. Miles, 698 F.2d at 598. New York permits contracting parties to shorten a limitations period, however, if the agreement is memorialized in writing. N.Y. C.P.L.R. 201. In this case, the three-year limitations period in the Plan controls, a conclusion the parties do not dispute.*fn2

District courts in this Circuit have used two methods to determine when an ERISA § 1132 claim accrues when the policy contract contains a limitations provision*fn3: (1) when benefits are initially denied, Patterson-Priori v. Unum Life Ins. Co. of Am., 846 F. Supp. 1102, 1108 (E.D.N.Y. 1994), or (2) when administrative remedies have been exhausted, Mitchell v. Shearson Lehman Bros., No. 97 CIV. 0526, 1997 WL 277381, at *3 (S.D.N.Y. May 27, 1997). Under Patterson-Priori, Burke's claim "accrued" on May 12, 2003. Since she filed this action on September 25, 2006, her suit is untimely under this standard. If we were to apply the Mitchell standard, by contrast, we would deem Burke's claim to have "accrued" on October 1, 2003 --when her appeal was denied -- and her suit would be timely. Judge Chin did not reach the issue of the unresolved accrual date for § 1132 actions, Burke, 537 F. Supp. 2d at 549 n.2, and we have previously declined to do so as well, see Veltri v. Bldg. Serv. 32B-J Pension Fund, 393 F.3d 318, 325 (2d Cir. 2004).

Here, without reference to an accrual date, the Plan's limitations period prohibits a claimant from bringing legal action more than "three years after the time written Proof of Loss is required to be furnished." Burke, 537 F. Supp. 2d. at 547 (internal quotation marks omitted). New York law permits the Plan to begin the limitations period before a plan beneficiary can bring suit by permitting parties to alter "the time within which an action must be commenced." N.Y. C.P.L.R. 203(a). The rule further provides: "The time within which an action must be commenced, except as otherwise expressly prescribed, shall be computed from the time the cause of action accrued to the time the claim is interposed." Id. (emphasis added).

The Supreme Court has stated "it is theoretically possible for a statute to create a cause of action that accrues at one time for the purpose of calculating when the statute of limitations begins to run, but at another time for the purpose of bringing suit." Reiter v. Cooper, 507 U.S. 258, 267 (1993). Though in that case the Court did not "infer such an odd result in the absence of any such indication in the statute," id., here, as allowed under New York law, the Plan specifies the limitations period will begin to run at a different time than when a claimant could bring a federal action. Therefore, there is reason to "infer the odd result" that the limitations period began to run prior to the time Burke could file suit in federal court. Because an ERISA action may not be brought in federal court until administrative ...


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