Former stuntwoman Leslie Hoffman has won another ruling before the U.S. Ninth Circuit of Appeals in her decade-long battle with the SAG Pension Plan and the SAG-AFTRA Health Plan over whether she is entitled to receive an occupational disability pension, which would give her lifetime health coverage because of the injuries she suffered over her long career.
The case has bounced back and forth between the lower district court and the appellate court since she first filed suit in 2010 — when the Plans denied her occupational disability pension and health – and then again in 2015, when the Plans took away her pension, which she’d been receiving since 2002, saying that she wasn’t disabled anymore and could return to work.
In their ruling, Circuit Court judges Andrew Kleinfeld, Richard Tallman and John Owens repeatedly cited the “curious facts in the case” and “the unusual posture of this case.” The litigation over her entitlement to benefits “has a tortured history and is now on its fourth district judge and its third panel of circuit judges,” they wrote in a ruling handed down today.
Hoffman once was among Hollywood’s top stuntwomen and the first ever elected to the SAG Hollywood board of directors, and later to AFTRA’s Hollywood board and national boards of directors. She’s been twice diagnosed with a traumatic brain injury that she says was the result of one too many concussions sustained during her many years of stunt work. She hasn’t been able to work since 2002, but the Plans, while acknowledging that she’s disabled, have insisted that it’s the result of emotional problems unrelated to her years of stunt work.
After she became disabled in 2002, she began collecting SAG disability pension benefits. But after a slipshod investigation, the Plan trustees determined that she had worked and held herself out for work while collecting those benefits and ordered her to repay $123,827.50 in benefits she’d received over a 13-year period, plus another $8,457.72 in interest on those payments.
Hoffman filed suit, and her case has been rattling around in the courts ever since. It turns out, however, that the trustees and the Plans’ attorneys have known all along that she never worked under SAG’s jurisdiction while disabled. In fact, the Plans’ own records, obtained by Deadline, show that she has had no SAG earnings at all, except residuals, since 2001.
And yet, despite knowing that she had no earnings under the union’s contract as a stunt performer or coordinator during all those years, the Plans’ trustees accused her of having “been engaged on certain projects as a stunt coordinator during the course of your claimed disability.”
In its third ruling in her favor, the Circuit Court now has directed the district court to reopen the first of her two cases (known as Hoffman I), or to reopen the second case (Hoffman II) and consolidate them and then decide whether she is entitled to continuing health benefits. As the result of an earlier partial settlement, the parties stipulated that the Plans would pay her an additional $54,516.67 in arrears, pending re-adjudication of whether she was “totally disabled” under the Plans’ definitions.
Hoffman has sought benefits from the Plans since 2004. In 2010, the Plans denied her 2008 request to modify her existing $952 monthly Disability Pension into an Occupational Disability Pension – and the lifetime health care coverage it provides – after determining her disability from severe major depression was not linked to her stunt work. Following an unsuccessful administrative appeal, she sued in 2010, challenging the Plan’s conclusion that her ‘total disability’ was not caused by her work.
The district court granted summary judgment in favor of the Plans in 2012, but the Circuit Court reversed that ruling after concluding that the Plans had “denied Hoffman a full and fair review of her claim of entitlement to coverage” under its Occupational Disability Plan.
The district court then issued its remand order to the Plans, but expanded the scope of review to encompass all information that bore on her disability claim. On remand, the Plans confirmed their earlier determination that her disability was not work-related, while also informing Hoffman that they were retroactively reviewing her entitlement to the $952 monthly Disability Pension she had been receiving for years.
“Although the Plans had denied the claim on grounds that her disability was not work-related,” the Circuit Court judges said in their latest ruling, “the district court subsequently denied Hoffman’s first motion to reopen Hoffman I on January 20, 2015, reasoning that “the case is not presently closed, and the Plan has apparently not completed administrative review of whether she is disabled.” The Circuit Court denied her petition to compel the district court to review the disability issue in February 2015.
In June 2015, the Pension Plan retroactively terminated her Disability Pension, determining she had not actually met the Plans’ definition of “totally disabled” since at least December 31, 2004. It sought restitution for all disability payments previously paid, plus interest. Hoffman unsuccessfully administratively appealed that decision, and then filed her second lawsuit, which challenged that retroactive decision. “The district court again granted summary judgment for the Pension Plan, but we again reversed,” the Circuit Court judges noted.
On remand, the district court found that the Pension Plan abused its discretion in terminating Hoffman’s disability benefits and further remanded the matter to the Pension Plan in October 2019. Several months later, however, the district court entered the parties’ stipulated judgment in Hoffman’s favor and later awarded Hoffman attorney fees for Hoffman II.
In April 2020, Hoffman filed her second motion to reopen Hoffman I so she could pursue her claim for lifetime medical benefits, “which for some reason was not resolved in the earlier litigation,” the Circuit Court judges wrote. They added:
“The district court entered the Order now before us on May 1, 2020, limited solely to allowing Hoffman’s attorney fees motion to proceed for the work in Hoffman I, but rejecting Hoffman’s request to reopen the case to adjudicate her entitlement for future health benefits under the Occupational Disability Pension.
“We were informed at oral argument that on remand the Pension Plan has done nothing because it has paid out all Disability Pension monetary benefits to which it believes Hoffman would be entitled and that the Plans no longer seek restitution of the benefits paid. The briefs tell us that the Health Plan has done nothing further to adjudicate Hoffman’s claim for continuing health insurance because it considers the case closed. We now hold that in light of this odd procedural history we have jurisdiction to review the Order.
“The district court’s fundamental assumption that the Plans will someday decide whether Hoffman is totally disabled based on her work as a stunt actress, and therefore entitled to future health benefits, is inconsistent with the expedited timeline within which the Plans must act under the Employee Retirement Income Security Act regulations. It was therefore an abuse of discretion to deny her motion to reopen based on that assumption. The Plans have done nothing to adjudicate Hoffman’s outstanding claim for medical coverage under the Health Plan and will do no more because they believe there is nothing left to be decided.
“By not finding the Plans had constructively denied Hoffman’s claim as to the Occupational Disability Pension continuing health care obligations Hoffman seeks, the district court erred. Accordingly, we direct the district court to reopen Hoffman I, or to reopen Hoffman II and consolidate the cases below if necessary, and then decide de novo whether Hoffman is entitled to continuing health benefits.”
In reversing, vacating and remanding with instructions, the judges awarded costs to Hoffman, who has been represented by attorney Chuck Fleishman.