Debra Shaw v. The McFarland Clinic, P.C.

RILEY, Circuit Judge,

dissenting.

Because the majority opinion misreads Iowa law and fails to follow circuit precedent, I respectfully dissent.

First, Shaw’s complaint clearly alleges jurisdiction under 29 U.S..C. § 1132(e), and states Shaw is bringing “this cause of action pursuant to 29 U.S.C. § 1132(a)(1)(B) (2001).”9 In the district court and on appeal, Shaw argues her employer, acting as plan administrator, (1) abused its discretion under the ERISA plan, and (2) breached its fiduciary duty with respect to ERISA. Shaw clearly has not alleged or argued an ordinary breach of contract action.

Second, the majority contends Shaw’s action resembles an insured’s claim against her insurer for denial of coverage and breach of contract. Shaw obviously did not bring a claim as an insured against an insurer, and, as explained above, did not sue for an ordinary breach of contract. Shaw filed an ERISA lawsuit as an employee covered by an employer’s ERISA plan, arguing abuse of discretion and breach of fiduciary duty. The resemblance falls short.

I will discuss first the statute of limitations for Shaw’s.abuse of discretion claim, and then address the statute of limitations for Shawls breach of fiduciary duty claim.

A. Statute of Limitations-Abuse of Discretion

Shaw first argues her employer, acting in its capacity as plan administrator, abused its discretion in denying her health benefits under the employer’s ERISA plan. ERISA does not have an express statute of limitations for a cause of action based on abuse of discretion by the plan administrator. As the. majority recognizes, we must look to, and borrow from, the most analogous Iowa statute of limitations. See Johnson v. State Mutual Life Assurance Co. of Am., 942 F.2d 1260, 1262 (8th Cir.1991). The majority concludes Shaw’s action is most analogous to a general cause of action for breach of contract, rather than the specific Iowa Wage Payment Collection Act (IWPCA). However, *752the IWPCA expressly applies to the employee and employer relationship, including (1) payments for health benefits due an employee, and (2) expenses incurred and recoverable under a health benefit plan. Iowa Code § 91A.2(7)(c) & (d). The IWP-CA seems obviously the most analogous statute of limitations, more analogous than a general statute of limitations for breach of contract actions.

Iowa Code section 91A.2 defines wages as “[a]ny payments to the employee or to a fund for the benefit of the employee, including ... payments for medical, health, hospital, ... which are due an employee under an agreement with the employer or under a policy of the employer,” Iowa Code § 91A.2(7)(c), and “[ejxpenses incurred and recoverable under a health benefit plan,” id. § 91A.2(7)(d). The unmistakable language of these sections establishes the IWPCA covers Shaw’s claim.

The majority attempts to distinguish section 91A.2(7)(d) by stating the IWPCA only treats as wages those expenses of the employee that are preauthorized by the employer and incurred by the employee. Because McFarland did not authorize payment of the expenses in this case, the majority opines the expenses cannot constitute wages. Such a strained interpretation of the IWPCA would allow the statute to apply only when the plan administrator authorizes payment. This view would result in real anomalies in future cases.

It is undisputed the expenses here were “incurred.” Based on Shaw’s reading of the health benefit plan, as well as her doctor’s reading of the plan, Shaw contends her expenses are “recoverable,” which is precisely the issue for resolution. The terms “incurred and recoverable” in this context mean the expenses are authorized by the plan documents, not authorized by the employer on a case-by-case basis, as the majority contends. The majority opinion is completely contradictory in finding the benefit was not “incurred and recoverable” within the meaning of the IWP-CA, and then in awarding Shaw recovery under the plan for the very expenses incurred (i.e., by ultimately finding the expenses were actually incurred and recoverable).

The majority cites Iowa Code section 91A.3(6), stating it “believe[s] the IWPCA only treats as wages those ‘[ejxpenses by the employee which are authorized by the employer and incurred by the employee.’ ” Supra at 9. Section 91A.3(6), however, is entitled “Mode of payment.” Iowa Code § 91A.3(6). This section does not contain a definition of “wages” and covers the procedures for payment of wages, including expenses. Section 91A.2, on the other hand, is entitled “Definitions,” and contains a specific definition of “wages.” Iowa Code § 91A.2(7)(d). The IWPCA clearly does not treat as wages only those expenses authorized by the employer and incurred by the employee. The IWPCA treats as wages, inter alia, “[ejxpenses incurred and recoverable under a health benefit plan.” Id. The “authorized” and “incurred” language the majority uses to define “wages” has no place in the analysis of Shaw’s claims.

The majority opinion’s logic minimizes the IWPCA’s actual reach and renders section 91A.2(7)(d) virtually meaningless. An employer could avoid the IWPCA, whether inside or outside the ERISA context, by denying authorization under a health benefit plan, making benefits nonrecoverable. Thus, even after an employer’s bad faith refusal to authorize an expense incurred by the employee and recoverable under the plan documents, section 91A.2(7)(d) would not apply under any circumstances.

Our ruling in Mead v. Intermec Technologies Corp., 271 F.3d 715 (8th Cir.2001), is *753indistinguishable from Shaw’s case. The benefits at issue in both Mead and this ease were included within the definition of wages in the IWPCA. In Mead, Intermee was sued as a plan administrator, just as McFarland is in this case. Intermee concluded Mead was not eligible for the benefits he sought under a short-term disability plan. Id. at 716-17. In the present case, McFarland denied Shaw’s request for preauthorization for the surgery, because McFarland concluded Shaw was not eligible for these benefits under the health benefit plan. The Mead court interpreted the IWPCA and found Mead’s claim for short-term disability benefits fell within the IWPCA and was barred by its two-year statute of limitations. Id. The majority in this case states the benefits at issue in Mead “fit easily within the definition of wages provided in § 91A.2(7)(c).” The benefits Shaw seeks fit just as easily within this statutory. definition of wages contained in section 91A.2(7)(c), and fit even more clearly within section 91A.2(7)(d): “[ejxpenses incurred and recoverable under a health benefit .plan.” Accordingly, Mead should control our statute of limitations determination.

The majority’s opinion also runs afoul of this court’s ruling in Adamson v. Armco, Inc., 44 F.3d 650 (8th Cir.1995). In Adamson, we analyzed the Minnesota law governing claims for recovery of wages and other compensation. Id. at 652-54. Four hundred eighty-seven former employees sued to recover benefits under unfunded welfare benefit plans. Like Iowa, Minnesota has both a general contract statute of limitations (six years) and a specific statute of limitations for the recovery of wages (two years). Id. at 652 (citing Minn.Stat. §§ 541.05(1), 541.07(5)). Also like Iowa, Minnesota’s wage law was meant to be broadly construed and applied. Compare id. (citing Stowman v. Carlson Cos., 430 N.W.2d 490, 493 (Minn. Ct.App.1988)) (observing Minnesota courts have broadly applied Minnesota’s wage claims • statute), with Kartheiser v. Am. Nat’l Can Co., 271 F.3d 1135, 1136 (8th Cir.2001) (observing the IWPCA “is remedial in nature and is meant to be liberally construed”). In Adamson, we decided the wage claims statute covered the welfare benefits sought' and -applied the two-year statute of limitations. Adamson, 44 F.3d at 652-53. Adamson and its reasoning should also govern our decision here.

The Third Circuit, citing Adamson, ruled a Delaware one-year statute of limitations for contracts within the employer-employee relationship was analogous to the ERISA case before it. Syed v. Hercules, Inc., 214 F.3d 155, 159-60 (3d Cir.2000). The statutes at issue in Syed were Delaware’s three-year statute regarding “general actions on a promise,” and a specific one-year statuté that c'overed employment disputes, particularly actions to recover “upon a cláim of wages ... or for any other benefits arising from such work, labor or personal services ^performed.” Id. at 159 (quoting Del.Code Ann. tit. 10, § 8111). In rejecting a similar general contract argument as the majority adopts here, and concluding the one-year statute applied, the Third Circuit noted that, although the Delaware Wage Payment Collection Act did not provide a statutory remedy for the denial of benefits, its definition of benefits clearly encompassed the benefits the plaintiff had sued to recover. Id. at 161 n. 5. The Third Circuit recognized the one-year statute was short, but the court could not say a one-year statute of limitations was inconsistent with ERISA’s policy. Id. at 161.

Likewise, the IWPCA two-year statute of limitations is reasonable, permitting a claimant enough time to. file, a claim and also protecting the corpus of the ERISA plan for other employees in the group. *754See Adamson, 44 F.3d at 653 (concluding “a two-year statute of limitations for [ERISA] benefit claims is not fundamentally unfair or at odds with federal policy”).

B. Statute of Limitations-Breach of Fiduciary Duty

Finally, the majority notes Shaw cannot recover monetary damages based on the plan administrator’s breach of fiduciary duty. See supra at 11. While I agree with the majority, due to my opinion that Shaw’s abuse of discretion claim for recovery of benefits is barred by the statute of limitations, a ruling is necessary as to whether Shaw may bring an action individually to recover monetary damages for a breach of fiduciary duty. She cannot. 29 U.S.C. § 1109 does not permit an individual beneficiary to recover compensatory damages based on breach of fiduciary duties. See Mass. Mut. Life Ins. Co. v. Russell, 473 U.S. 134, 144, 105 S.Ct. 3085, 87 L.Ed.2d 96 (1985) (stating “the entire text of § [1109] persuades us that Congress did not intend that section to authorize any relief except for the plan itself. In short ..., we do not find in § [1109] express authority for an award of extracon-tractual damages to a beneficiary.”); Slice v. Sons of Norway, 34 F.3d 630, 632 n. 6 (8th Cir.1994) (“In Massachusetts Mutual ..., the Supreme Court held that, under 29 U.S.C. § 1109(a), an individual could not recover extra-contractual damages caused by a breach of a fiduciary’s duties.”).

Furthermore, even if Shaw could bring an individual breach of fiduciary duty claim to recover compensatory damages, she commenced her lawsuit outside the ERISA three-year statute of limitations for actions arising under section 1109. 29 U.S.C. § 1113 (“after ... plaintiff had actual knowledge of the breach or violation”).

C. Conclusion

Because the applicable two and three year statutes of limitations expired before Shaw filed suit, I would reverse the district court’s grant of summary judgment in Shaw’s favor.

. Section 1132(a)(1)(B) provides

A civil action may be brought-
(1) by a participant or beneficiary-(B) to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan ....