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Jose Marmol v. Division 1181 A.T.U. - New York

August 7, 2012

JOSE MARMOL, PLAINTIFF,
v.
DIVISION 1181 A.T.U. - NEW YORK EMPLOYEES PENSION FUND & PLAN, DEFENDANT.



The opinion of the court was delivered by: John Gleeson, United States District Judge:

MEMORANDUM AND ORDER

Jose Marmol brings this suit against the Division 1181 A.T.U. - New York Employees Pension Fund (the "Fund"), for disability benefits under the Fund's employee benefits plan, the Division 1181 A.T.U. - New York Employees Pension Plan (the "Plan"). Marmol contends that he has been totally disabled since 2006, rendering him eligible for disability benefits under the Plan. The Fund moves for summary judgment on the grounds that Marmol has failed to exhaust administrative remedies, and, in any event, he does not qualify for benefits under the express terms of the Plan. Because the uncontested Plan documents substantiate the Fund's arguments, I grant summary judgment in full and direct that judgment be entered denying Marmol's claim.

BACKGROUND

A. Undisputed Facts

Marmol is a Participant in the Plan by virtue of his prior employment as a driver with Pioneer Transportation Corp. from October 2000 until March 2007. See Plan § 1.22, at 4,*fn1 § 2.1, at 5*fn2 (D'Ulisse Dec., Ex. 1, ECF No. 16-1); see also Marmol Calc. Analysis (D'Ulisse Dec., Ex. 3, ECF No. 16-3); Marmol Pay Stubs (Opp., Ex. 5, ECF No. 26-1). As a Participant, Marmol may receive a Full Disability Pension*fn3 under the Plan if he:

(1) [is] forty- five years of age or older;

(2) has completed at least ten (10) years of consecutive Credited Service and has worked not less than 1,000 Hours of Service in each of the ten (10) consecutive Plan Years preceding the date he sustained the disability;

(3) . . . becomes Totally and Permanently Disabled;

(4) . . . is actively employed by an Employer in Employment in the Industry at the time he sustains the disability that is or becomes a Total and Permanent Disability; and

(5) files an application for a disability pension.

Plan § 4.2(a), at 11;*fn4 accord Summary Plan Description § 8, at 15 (D'Ulisse Dec., Ex. 2, ECF No. 16-2).*fn5 The Plan defines "[a] year of Credited Service" as "any Plan Year during which a Participant has completed at least 1,000 Hours of Service in Employment." Plan § 1.9, at 2.*fn6 A "Plan Year is the consecutive twelve month period from September 1 through and including August 31." Id. § 1.25, at 5. addiction to narcotics or as a result of an injury sustained in military service." Plan § 4.3, at 12; accord Summary Plan Description § 8, at 15.

"Totally and Permanently Disabled" means a "total disability as a result of bodily injury or disease such that the Participant is prevented thereby from engaging in any occupation or employment and with respect to which it appears probable that such disability will be permanent and continuous during the remainder of the Participant's lifetime." Plan § 4.3, at 12. The determination is based solely on whether the Participant qualifies for a disability benefit under the Federal Social Security Act, except it does not include any disability that "was suffered as the result of [the Participant's] criminal activity, habitual drunkenness, self-inflicted injury,

The Summary Plan Description instructs Participants on how to apply for benefits under the Plan:

In order to receive benefits from the Pension Fund, you must complete an application form and submit it with requested documents to the Fund Office. Your application will not be considered complete until all required documents are received by the Pension Fund. The application forms will explain what documents are required as well as the benefit options available to you. The Fund Office is available ...


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