Barboza v. CAL. ASS'N OF PROFESSIONAL FIREFIGHTERS
651 F.3d 1073
| 9th Cir. | 2011Background
- Barboza sued the Plan for failing to pay long-term disability benefits under ERISA.
- Parties agreed Barboza is entitled to benefits, but dispute over offset for other state-law payments.
- District court dismissed Barboza's claims without prejudice for failure to exhaust administrative remedies.
- The district court did not reach exhaustion issues; focus on whether ERISA regulations render exhaustion automatic.
- This appeal concerns whether Barboza's claims should be deemed exhausted under 29 C.F.R. § 2560.503-1(l) and (i).
- The Ninth Circuit reverses and remands, holding Barboza's claims should be deemed exhausted.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether exhaustion should be deemed under §2560.503-1(l). | Barboza contends timely resolution failures trigger exhaustion. | Plan argues exceptions do not apply; must exhaust. | Exhaustion deemed; plan's delay violated rules. |
| Whether district court's dismissal without prejudice affected appellate jurisdiction. | Dismissal with prejudice might bar appeal; here finality allows appeal. | No final appealable judgment; need dismissal with prejudice. | District court dismissal constituted a final, appealable judgment. |
| Whether quarterly meeting rule applies to disability claims in non-multiemployer plans. | Disability claims may use quarterly meetings to resolve determinations. | Quarterly rule limited to multiemployer plans. | Quarterly rule limited to multiemployer plans; not applicable here. |
| What standard of review governs interpretation of §2560.503-1(i). | Regulation should be construed to favor exhaustion. | Chevron deference to agency interpretation; deference to Secretary. | Deference to Secretary's interpretation controls; deference warranted. |
| What is the final result for Barboza on exhaustion and benefits. | Should be deemed exhausted and benefits awarded. | Plan authorized to decide under its interpretation; not exhausted. | Barboza's claims deemed exhausted; reversed and remanded for benefits. |
Key Cases Cited
- Griffin v. Arpaio, 557 F.3d 1117 (9th Cir.2009) (finality when dismissal without prejudice leaves no pending remedies)
- Eastman Kodak Co. v. STWB, Inc., 452 F.3d 215 (2d Cir.2006) (ERISA exhaustion finality doctrine for dismissal without prejudice)
- Pension Benefit Guar. Corp. v. Carter & Tillery Enters., 133 F.3d 1183 (9th Cir.1998) (final decision mechanics in exhaustion context)
- Diaz v. United Agricultural Employee Welfare Benefit Plan & Trust, 50 F.3d 1478 (9th Cir.1995) (exhaustion is a question of law)
- Boeing Co. v. United States, 258 F.3d 958 (9th Cir.2001) (prefer specific over general regulatory provisions)
- Chevron U.S.A., Inc. v. Nat. Res. Def. Council, Inc., 467 U.S. 837 (1984) (agency deference to interpretations of statutes/regulations)
- Riegel v. Medtronic, Inc., 552 U.S. 312 (2008) (deference to agency interpretation of its regulations)
- Thomas Jefferson Univ. v. Shalala, 512 U.S. 504 (1994) (agency intent and regulatory interpretation permissible with deference)
- Bassiri v. Xerox Corp., 463 F.3d 927 (9th Cir.2006) (deference to agency's stated purpose in regulatory preamble)