Monday, June 1, 2015

LTD ERISA: 9th Circuit Excludes Weekends from 180 Day Appeal Deadline

Once an insurance company denies or terminates a long term disability claim, a claimant has 180 days to file an administrative appeal.  Last week, the 9th Circuit Court of Appeals ruled that weekends should not be counted in the 180th day computation when the deadline falls on a Saturday or a Sunday.     
In Legras v. Aetna Life Insurance Company, (Click Here for a Copy of the Opinion) Aetna cancelled Andre LeGras' long term disability benefits because he, allegedly, was no longer disabled under the terms of the plan.  The the 180 time frame for LeGras to file the appeal ended on a Saturday. However, he did not mail his appeal until the following Monday.  Aetna automatically turned down his appeal because it was untimely.  Subsequently, the the District Court entered a judgement in Aetna's favor and ruled that LeGras had failed to submit his appeal within the 180 time period. 
On appeal, Judge Richard Paez from the 9th Circuit Court of Appeals determined that Aetna should have allowed LeGras' appeal based on the "widespread understanding that a deadline falling on a Saturday, Sunday or a holiday extends to the next business day".  It is important to note that ERISA does not specify a method for computing time for appeals.  There has always been a great deal of uncertainty as to how this time period is computed.  Fortunately, this Circuit Court decision provides some guidance on this issue.  
Judge Paez wrote on behalf of the majority: "There is nothing novel about the principle we adopt here",,,  Incorporating this time-computation method into ERISA's federal common law protects the interests of insureds, thereby effectuating the policy goals of ERISA.  
A dissenting opinion was written by Judge N. Randy Smith who maintained that the case dealt with "simple contract interpretation" and that the ruling expanded "Federal Common Law" without any precedent.