United States District Court, S.D. New York
HONORABLE LORNA G. SCHOFIELD, United States District Judge.
OPINION, REPORT AND RECOMMENDATION
KATHARINE H. PARKER United States Magistrate Judge.
Agnes Xie, proceeding pro se, brings this action under
Section 502(a)(1)(B) of the Employee Retirement Income
Security Act of 1974 (“ERISA”), 29 U.S.C. §
1132(a)(1)(B), to recover short-term disability
(“STD”) benefits pursuant to a short-term
disability plan offered by her former employer, JPMorgan
Chase Bank, N.A. (“JPMC”).
has moved for leave to file a Second Amended Complaint
(“SAC”) pursuant to Federal Rule of Civil
Procedure 15. (Doc. No. 52.) Plaintiff also requests
permission to file certain medical records under seal. (Doc.
No. 64.) For the reasons set forth below, this Court
recommends that Plaintiff's motion for leave to amend be
denied insofar as it seeks to add claims under Sections
502(a)(3) and 510 of ERISA and to the extent it seeks to add
claims under Section 502(c) of ERISA premised upon plan
document requests made orally and to nonadministrators. This
Court grants Plaintiff's motion for leave to amend
insofar as it seeks to add a claim under Section 502(c) of
ERISA premised upon Plaintiff's written request for plan
documents made to the Plan Administrator. Finally, this Court
denies Plaintiff's motion to seal (Doc. No. 64) as moot.
September 12, 2013, JPMC offered Plaintiff a full-time
position as an Executive Director in the Model Risk &
Development Group in JPMC's New York office. JPMC set out
the terms of its offer in an agreement of the same date.
Plaintiff accepted the offer and commenced work on September
the terms of her employment agreement, Plaintiff was eligible
to participate in JPMC's Short-Term Disability Plan (the
“STD Plan”) and other benefit plans included as
part of JPMC's “Wrap Plan” in accordance with
the terms and conditions of such plans. The STD Plan
designates JPMorgan Chase Employee Relations Executive as the
condition of her hire, Plaintiff also entered into an
Arbitration Agreement (the “Agreement”), in which
Plaintiff agreed to submit “Covered Claims” to
final and binding arbitration before the American Arbitration
Association (“AAA”) in accordance with the terms
of the Agreement. The Agreement defines “Covered
Claims” as all legally protected employment-related
claims (subject to certain specifically identified
exceptions) against JPMC, including, but not limited to,
“claims of employment discrimination or harassment if
protected by applicable federal, state or local law, and
retaliation for raising discrimination or harassment claims,
failure to pay wages, bonuses or other compensation, tortious
acts, wrongful, retaliatory and/or constructive discharge . .
. .” (Doc. No. 60-5, ¶ 2.) Certain claims,
including “claims for benefits under a plan that is
governed by Employee Retirement Income Security Act of 1974
("ERISA"), ” among others, are specifically
excluded from arbitration under the Agreement. (Doc. No.
60-5, ¶ 3.)
two weeks of her start date and continuing through December
10, 2013, Plaintiff complained of certain defects in her
workstation that caused an injury to her shoulder, as well as
pain in her shoulder, neck and back, and severe headaches.
The SAC alleges that Plaintiff's supervisor knew of and
acknowledged her complaints.
designated “Access HR” as the channel for JPMC
employees to report leaves of absence and make inquiries
about leave of absence benefits. Between November 2013 and
December 2013, Plaintiff called Access HR at least three
times and spoke to two different Human Resources
(“HR”) representatives to inquire how to file STD
and workers' compensation claims and to request plan
documents and company policies. According to Plaintiff,
Access HR told Plaintiff that she was not eligible for
short-term disability or workers' compensation benefits,
refused to provide Plaintiff with information, denied
Plaintiff access to Plan documents, and refused to disclose
the identity of the STD Plan Administrator.
states that she “commenced a leave of absence from work
. . . due to [a] psychological condition . . . triggered by
physical injuries that she was enduring” on December
29, 2013. (SAC ¶ 12.) While on leave, Plaintiff
contacted Access HR again and was again informed that she
could not file a claim for short-term disability benefits or
workers' compensation because she had not completed a
90-day “Introductory Period.” (SAC ¶ 12.)
Plaintiff's employment was terminated on December 30,
her termination from employment, Plaintiff contacted Access
HR on at least three more occasions about filing claims for
STD and workers' compensation benefits. According to the
SAC, the HR representatives repeated what they previously
communicated-that Plaintiff was not eligible for these
benefits because she had not worked for 90 days-and continued
to refuse to provide Plaintiff with Plan documents and
contact information for filing a claim.
effort to get information from another source, Plaintiff then
contacted the New York State Workers' Compensation Board
and its Disability Benefits Bureau (collectively, the
“WCB”), which allegedly informed her that
JPMC's policies violated state laws. Thereafter, on March
20, 2014, Plaintiff called Access HR again regarding filing
an STD benefits claim and to again request documentation
regarding workers' compensation benefits. On this call,
Plaintiff informed the HR representative that she had filed a
claim with the WCB. The HR representative again refused to
send Plaintiff the requested documentation.
on March 25, 2014, Plaintiff filed a claim for STD benefits
under the STD Plan by fax to JPMorgan Chase Disability
Management Services (“DMS”), the claims
administrator for the STD Plan. The SAC is silent as to how
Plaintiff learned how and where to file her STD claim.
Plaintiff alleges that she also made telephonic requests for
STD Plan documents to DMS, but these requests were ignored.
April 9, 2014, DMS denied Plaintiff's claims for New York
State short-term disability benefits and for supplemental STD
benefits under the STD Plan because her claim was untimely.
Plaintiff contends she was never advised of any deadline for
filing a benefits claim. Plaintiff filed an administrative
appeal on April 28, 2014, which DMS denied on June 10, 2014.
14, 2014, the WCB determined that Plaintiff was entitled to
New York State short-term disability benefits for the period
running from December 2013 to June 2014. On July 24, 2014,
DMS reversed its prior denial of New York State short-term
disability benefits, but continued to deny Plaintiff's
claim for supplemental STD benefits under the STD Plan.
Plaintiff subsequently filed two additional administrative
appeals from the denial of STD benefits to DMS, both of which
December 28, 2014, Plaintiff made a written request for STD
Plan documents to the named Plan Administrator. She received
the STD Plan documents from JPMC's Legal Department by
email in January 2015.
commenced this action on June 8, 2015, seeking to recover
unpaid STD benefits under the STD Plan pursuant to Section
502(a)(1)(B) of ERISA, 29 U.S.C. § 1132(a)(1)(B). On
November 5, 2015, Plaintiff filed an Amended Complaint, which
asserted the same cause of action as the initial Complaint
but modified the factual allegations recited therein.
Defendants subsequently filed a motion to dismiss pursuant to
Rule 12(b)(6) of the Federal Rules of Civil Procedure. On
July 20, 2016, the Honorable Lorna G. Schofield denied
Defendants' motion to dismiss.
about August 9, 2016, Plaintiff requested permission to
further amend her pleading, but indicated that, because of
disability, she needed an extension of time to do so as an
accommodation. Judge Schofield granted Plaintiff's
request, stayed this case for six months, and ordered
Plaintiff to file either a motion to amend or a letter
stating that she no longer sought an amendment by no later
than February 10, 2017. Judge Schofield further ordered that
Plaintiff's failure to file such a motion or letter by
February 10, 2017 would result in the case being dismissed
February 21, 2017, Judge Schofield dismissed this case
without prejudice because Plaintiff had not filed a motion or
letter regarding her proposed amendments. Plaintiff
subsequently moved to reopen the case. Judge Schofield
granted Plaintiff's request to reopen and ordered her to
file a motion for leave to amend her complaint by March 15,
March 11, 2017, Plaintiff filed the instant motion for leave
to amend and on May 4, 2017, filed her request for permission
to file certain medical records ...