United States District Court, W.D. Kentucky, Louisville Division
BONNIE E. DECOLA, Plaintiff,
PRUDENTIAL INSURANCE COMPANY OF AMERICA, Defendant.
MEMORANDUM OPINION AND ORDER
J. Hale, Judge.
Plaintiff Bonnie Decola became disabled and could no longer
work, she received benefits through her employer's
disability plans, administered by Defendant Prudential
Insurance. (Docket No. 12, PageID # 140) After paying
benefits for several years, Prudential terminated
Decola's claim and informed her on May 26, 2015, that she
had 180 days to appeal Prudential's decision. (D.N. 8-1,
PageID # 31) Two months later, Decola's counsel sent a
letter informing Prudential that Decola was appealing and
would be sending Decola's medical records as she received
them. (D.N. 8-4, PageID # 99) Shortly thereafter,
Decola's counsel sent another letter that reiterated her
intention to appeal the termination and included some medical
records from one of Decola's doctors but indicated that
additional records would be submitted. (D.N. 8-5, PageID #
100) Prudential wrote back to say that Decola must inform
Prudential when her appeal was complete. (D.N. 8-6, PageID #
126) Until Decola notified Prudential that her appeal was
complete, Prudential would not review Decola's claim.
(Id.) Decola's counsel failed to provide any
further response or information until after the 180-day
deadline had lapsed. (D.N. 8-7, PageID # 127)
refused to consider Decola's appeal on the ground that
Decola failed to submit a timely appeal. (D.N. 8-10, PageID #
130) Decola filed suit against Prudential, alleging that
Prudential violated the Employee Retirement Income Security
Act (ERISA) by wrongfully denying her disability benefits.
(D.N. 1-1, PageID # 8) Prudential has moved to dismiss on the
ground that Decola failed to exhaust her administrative
remedies. (D.N. 8) Because the Court finds that Decola failed
to exhaust her administrative remedies, the Court will grant
Prudential's motion to dismiss.
Bonnie Decola worked as a truck driver for Penske Truck
Leasing. (D.N. 1-1, PageID # 7; D.N. 12, PageID # 140) In
2008, Decola became disabled and could no longer work. (D.N.
12, PageID # 140) She applied for disability benefits under
Penske's long-term disability (LTD) and short-term
disability (STD) plans. (D.N. 1-1, PageID # 7; D.N. 8-1,
PageID # 31) Defendant Prudential Insurance is the claims
administrator of Penske's STD and LTD plan. (D.N. 8-1,
PageID # 31)
began paying Decola benefits under the STD and LTD plans.
(Id.) Then, on May 26, 2015, Prudential terminated
Decola's LTD claim. (D.N. 8-1, PageID # 31) The May 26
termination letter stated:
You have a right to appeal this decision. If you choose to do
so, your appeal must be made in writing by you or your
authorized representative, and submitted within 180 days of
the date of receipt of this letter.
(Id., PageID # 32) Prudential added:
appeal should contain:
• Your name, control number, and Social Security number
(or claim number)
• The reasons that you disagree with our determination
• Medical evidence or information to support your
position such as:
o Copies of therapy treatment notes o Any additional
treatment records from physicians
o Actual test results (e.g., EMG, MRI)
(D.N. 8-3, PageID # 97-98) “Factoring in 14 days for
receipt” of the termination letter, Decola had until
December 6, 2015, to file an appeal. (D.N. 8-1, PageID # 31)
On August 26, 2015, Plaintiff's then-counsel wrote a
letter to Prudential, stating:
We are representing Ms. Decola in this matter and we are
appealing the decision from the letter that was sent.
I am currently requesting medical records from Ms.
Decola's doctors that she is currently seeing to show all
updated records about her disabilities to show that there is
no relief and wellness in her condition. I will be sending
these records as I receive them. Again take this letter as an
appeal, please allow time for the medical records to be
(D.N. 8-4, PageID # 99) Prudential did not respond to this
letter. On September 2, 2015, her counsel sent another letter
As I have written before I have requested medical records
from Ms. Decola's doctors. I am enclosing records from
one of the doctors. It clearly shows her struggle with her
gastro problems. I will ...