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GRUMBINE v. TEAMSTERS PENSION TRUST FUND OF PHILAD

July 18, 1986

PATSY LOU GRUMBINE
v.
THE TEAMSTERS PENSION TRUST FUND OF PHILADELPHIA & VICINITY



The opinion of the court was delivered by: LUONGO

 In this action, plaintiff Patsy L. Grumbine seeks to recover disability retirement benefits allegedly due to her as beneficiary of her deceased husband Richard Grumbine. Plaintiff avers that Richard Grumbine qualified for benefits as a participant in defendant Teamsters Pension Trust Fund of Philadelphia & Vicinity. The Fund has moved to dismiss the complaint or, in the alternative, for summary judgment on the ground that plaintiff has not exhausted her right to appeal within the Fund. Plaintiff has responded that the exhaustion requirement should not apply in her case and has filed a cross-motion for summary judgment, contending that she is entitled to benefits as a matter of law. Because I conclude that plaintiff must avail herself of the Fund's internal appeal procedures before resorting to the federal courts, I will grant defendant's motion for summary judgment *fn1" and deny plaintiff's cross-motion.

 Certain facts are not in dispute. The Fund is a multi-employer plan established to furnish pension benefits to participants. A written pension plan provides for the payment of disability retirement benefits to eligible participants who are totally and permanently disabled. Richard Grumbine was a Fund participant by virtue of employer contributions made to the Fund on his behalf through the end of 1971. On April 25, 1980 he filed an application for retirement benefits, stating that he was disabled and had been receiving Social Security disability benefits since February of 1975. In a letter dated January 26, 1981, Fund Administrator Charles J. Schaffer, Jr. denied the application, explaining that Mr. Grumbine had incurred a break in service which made him ineligible for pension benefits. The letter stated that Mr. Grumbine could appeal the decision by following the procedures outlined in an enclosed summary plan description. Under the pension plan, a participant who is denied benefits has the right to request a hearing from a panel of Fund trustees. If dissatisfied with the trustees' decision, the participant may submit the matter to arbitration. Mr. Grumbine did not appeal.

 In a letter dated September 20, 1983 plaintiff inquired as to her right to receive benefits on behalf of her husband, who died in 1982. Mr. Schaffer replied in a letter dated September 26, 1983, stating that Mr. Grumbine had been found ineligible for benefits and informing plaintiff of the appeal procedures set forth in the pension plan. Mrs. Grumbine also did not appeal. Instead, she retained an attorney who began to correspond with the Fund on March 5, 1985. The Fund responded to the attorney's requests for information and explained again why the Grumbines' applications for benefits had been denied. On May 20, 1985, plaintiff's counsel wrote a letter to Mr. Schaffer outlining his belief that Mr. Grumbine qualified for a disability retirement pension. Apparently receiving no response, plaintiff filed the instant lawsuit on February 27, 1986.

 Defendant's motion for summary judgment is based upon the Grumbines' failure to exhaust their right to appeal within the Fund. Plaintiff argues that she should be excused from the exhaustion requirement because defendant did not provide her with the plan documents in effect when Richard Grumbine first became disabled. She also asserts that, although defendant rejected applications for pension benefits, defendant has refused to take action on her request for disability benefits.

 Section 502(a) of the Employee Retirement Income Security Act (ERISA), 29 U.S.C. ยง 1132(a), provides that a participant or beneficiary of an employee benefit plan may bring a civil action to recover benefits due under the plan. Before bringing such an action, however, a claimant must normally exhaust internal remedies provided by the plan. E.g., Denton v. First National Bank, 765 F.2d 1295 (5th Cir. 1985); Wolf v. National Shopmen Pension Fund, 728 F.2d 182, 185 (3d Cir. 1984); Tomczyscyn v. Teamsters, Local 115 Health & Welfare Fund, 590 F. Supp. 211, 213 (E.D.Pa. 1984). In general, courts will excuse a failure to exhaust "only if the claimant is threatened with irreparable harm, if resort to administrative remedies would be futile, or if the claimant has been denied meaningful access to the plan's administrative procedures." Id.

 Plaintiff has not alleged that she bypassed the Fund's appeal procedures because she is threatened with irreparable harm, nor that resort to those procedures would be futile. Although her position is not entirely clear, she appears to be arguing that she was denied meaningful access to Fund remedies. According to plaintiff, the Fund did not give her copies of the plan documents in effect when Richard Grumbine became disabled and she was therefore deprived of information which could have served as the basis of an appeal.

 The Secretary of Labor has promulgated regulations governing the information which must be provided to a plan participant who has been denied benefits. The regulations state, in pertinent part:

 
A plan administrator . . . shall provide to every claimant who is denied a claim for benefits written notice setting forth in a manner calculated to be understood by the claimant:
 
(1) The specific reason or reasons for the denial;
 
(2) Specific reference to pertinent plan provisions on which the denial is based;
 
(3) A description of any additional material or information necessary for the claimant to perfect the claim and an explanation of why such material or information is necessary; and
 
(4) Appropriate information as to the steps to be taken if the participant or beneficiary wishes to submit ...

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