FILED
NOT FOR PUBLICATION
APR 14 2016
UNITED STATES COURT OF APPEALS MOLLY C. DWYER, CLERK
U.S. COURT OF APPEALS
FOR THE NINTH CIRCUIT
NERSES MEGUERDITCHIAN, No. 14-55468
Plaintiff - Appellee, D.C. No. 2:12-cv-10999-ODW-JC
v. MEMORANDUM*
AETNA LIFE INSURANCE
COMPANY and FEDERAL
EXPRESS CORPORATION SHORT
TERM DISABILITY PLAN,
Defendants - Appellants.
Appeal from the United States District Court
for the Central District of California
Otis D. Wright, II, District Judge, Presiding
Argued and Submitted March 10, 2016
Pasadena, California
Before: MURPHY, ** PAEZ, and NGUYEN, Circuit Judges.
Aetna Life Insurance Company (“Aetna”) and Federal Express
Corporation Short Term Disability Plan (the “Plan”) appeal the district
*
This disposition is not appropriate for publication and is not
precedent except as provided by 9th Cir. R. 36-3.
**
The Honorable Michael R. Murphy, Senior Circuit Judge for the
U.S. Court of Appeals, Tenth Circuit, sitting by designation.
court’s ruling that Aetna1 abused its discretion when it denied as untimely
Nerses Meguerditchian’s claim for short-term disability benefits. We
affirm the district court’s ruling.
During the relevant period, Meguerditchian was employed by Federal
Express Corporation (“FedEx”) and was covered by the Plan. In addition to
the Plan, FedEx has a Temporary Return to Work Program (“TRW
Program”) for employees injured on the job. Meguerditchian injured his
back, participated in the TRW Program for the maximum ninety-day period,
and then filed a claim for short-term disability (“STD”) benefits. Aetna
denied his claim as untimely.
After his administrative appeal was denied, Meguerditchian brought
this civil action challenging Aetna’s decision. See 29 U.S.C. § 1132(a)
(permitting a plan participant to bring a civil action to recover benefits or
enjoin any practice which violates ERISA or the terms of the plan). The
district court concluded the summary plan description (“SPD”) did not
adequately inform Meguerditchian that he was required to submit his claim
to Aetna within sixty days of his injury as opposed to sixty days after he
ceased participating in the TRW Program. See 29 U.S.C. § 1022(a)
1
Aetna is the claims-paying administrator of the Plan.
-2-
(requiring SPDs to contain specific information and be “written in a manner
calculated to be understood by the average plan participant”). The court
remanded the matter to Aetna for a decision on the merits of
Meguerditchian’s STD claim.
Having reviewed the administrative record2 and considered the
arguments of the parties, this court finds no reversible error in the district
court’s analysis. The SPD provided to Meguerditchian states that an
employee is considered disabled if a physical or mental illness prevents him
from “doing [his] job.” The SPD does not inform an employee that his
“job” is his “regular occupation.” A plan participant could reasonably
believe he is continuing to do his job while he participates in FedEx’s TRW
Program. Because the SPD does not adequately inform plan participants of
the time limit for filing an STD claim, Aetna abused its discretion when it
denied Meguerditchian’s claim as untimely.
2
The district court did not abuse its discretion by refusing to
consider documents outside the administrative record. “[I]n general, a
district court may review only the administrative record when considering
whether the plan administrator abused its discretion . . . .” Abatie v. Alta
Health & Life Ins. Co., 458 F.3d 955, 970 (9th Cir. 2006) (en banc).
Meguerditchian’s claim involves a substantive violation of ERISA, not a
procedural violation. Thus, the exception permitting a district court to
consider evidence outside the administrative record “[w]hen a plan
administrator has failed to follow a procedural requirement of ERISA” is
not applicable. Id. at 972-73.
-3-
AFFIRMED.
-4-