Ellis-Young v. The Prudential Insurance Company of America

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF TEXAS
HOUSTON DIVISION
SHERRI ELLIS-YOUNG,
Plaintiff,
v.
THE PRUDENTIAL INSURANCE
COMPANY OF AMERICA,
Defendant.
§
§
§
§
§ CIVIL ACTION NO. H-26-321
§
§
§
§
§
§
MEMORANDUM AND OPINION
This is an ERISA dispute over disability benefits. Sherri Ellis-Young had a disability
insurance policy through her employment at JPMorgan Chase. (Docket Entry No. 1 ¶¶ 9–11).
The Prudential Insurance Company of America was the claims administrator for that policy. (Id.).
Ellis-Young alleges that she “suffers from multiple medical conditions resulting in both exertional
and nonexertional impairments,” which cause “chronic pain and limitations,” and from “anxiety,
depression and visual impairments.” (Id. ¶¶ 56–59). Prudential approved long-term disability
benefits for Ellis-Young from May 12, 2022, to January 31, 2023. (Id. ¶ 36). Prudential stopped
providing her disability benefits on February 3, 2023. (Id. ¶ 38). Prudential’s termination letter
stated that Ellis-Young was no longer disabled under the policy and allowed her “180 days to
appeal this decision.” (Id. ¶ 39).
Prudential answered Ellis-Young’s complaint, (Docket Entry No. 11), and moved for
judgment on the pleadings, (Docket Entry No. 14), which this court construes as a motion for
summary judgment, see FED. R. CIV. P. 12(d),1 and, for the reasons below, grants.
1 At the initial conference, the parties did not identify any additional documents that the court needed to
review to consider fully whether Ellis-Young exhausted her administrative remedies.
United States District Court
Southern District of Texas
ENTERED
April 21, 2026
Nathan Ochsner, Clerk
Case 4:26-cv-00321 Document 19 Filed 04/21/26 in TXSD Page 1 of 7

2
Prudential argues that Ellis-Young did not exhaust her administrative remedies because
she did not timely appeal its denial of her long-term disability benefits. (Docket Entry No. 14 at
7–9). 	ERISA includes an administrative exhaustion requirement. 	See Gonzalez v. Aztex
Advantage, 547 F. App’x 424, 427–28 (5th Cir. 2013) (per curiam); Mem’l Hermann Health
System v. S.W. LTC, Ltd., Case No. 4:14-cv-02572, 2016 WL 3526137, at *6 (S.D. Tex. 2016),
aff’d, 683 F. App’x 274 (5th Cir. 2017). Failure to exhaust a plan’s internal appellate procedures
can result in dismissal of a plaintiff’s claim. 	See, e.g., Holmes v. Proctor & Gamble Disability
Benefit Plan, 228 F. App’x 377, 378–79 (5th Cir. 2007) (per curiam); Swanson v. Hearst Corp.
Long Term Disability Plan, 586 F.3d 1016, 1018–19 (5th Cir. 2009) (per curiam). A district court
reviews the plan administrator’s decisions de novo, unless a different standard is provided in the
plan documents. Metropolitan Life Ins. Co. v. Glenn, 554 U.S. 105, 111 (2008).
JPMorgan’s Long Term Disability Coverage Booklet-Certificate provides that “[i]f your
claim for benefits is denied, you or your representative may appeal your denied claim in writing
to Prudential within 180 days of the receipt of the written notice of denial or 180 days from the
date such claim is deemed denied.” (Docket Entry No. 11-2 at 46). It provides further that “[i]f
your claim for benefits is denied, in whole or in part, you or your authorized representative will
receive a written notice from Prudential of your denial,” which will include in part “a description
of Prudential’s appeals procedures and applicable time limits, including a statement of your right
to bring a civil action under section 502(a) of ERISA following your appeals.” (Id. at 45).
When Prudential denied Ellis-Young’s plan benefits, it enclosed a notice of her appellate
rights. 	(Docket Entry No. 11-1 at 3). 	The notice explained that the “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.) The notice stated that the appeal should include her control number,
Case 4:26-cv-00321 Document 19 Filed 04/21/26 in TXSD Page 2 of 7

3
social security number, the basis of her disagreement with the determination, and the medical
evidence in support of her position. 	(Id.). 	The notice provided that the “written claim appeal
should be submitted to Appeals Review Unit at the address listed” in the notice. (Id.). The notice
also stated that, due to the COVID-19 pandemic, the 180-day appeal period would begin to run on
the earlier of (a) the first day following the sixty (60)-day period after the announced end of the
presidentially declared National Emergency due to COVID-19 or (b) one (1) year from the date of
the Denial Letter. (See id.).
The presidentially declared National Emergency due to COVID-19 ended on May 11,
2023. 	United States v. Leon, No. 9:10-CR-29(1), 2025 WL 3496919, at *9 (E.D. Tex. Dec. 4,
2025). Ellis-Young’s appeal deadline was Saturday, January 6, 2024 (or January 8, 2024, if tolled
to Monday).
On February 13, 2023, Ellis-Young sent a letter to Prudential stating:
Please note that I will be fling an appeal in regards to my denial of Long term
Disability Benefits based on the fact that I am unable to read the computer due
to blurred/loss of vision which effect my mental state and I have been having
difficulty in coping with everyday task. Previously I sent a request to give my
daughter Charrisse Y. Marsh all access to my information and she will be in
contact with your office and my doctors during the appeal. Charrisse’s contact
telephone number is [REDACTED].
In order to file the appeal please send my complete file from claim #13101811
so that I can reach out to doctors to clarify paperwork. After denial I did reach
out to my doctors. All three doctors feel that your office is misreading the
documents submitted. The forms sent to them is period form which mean that
there was no change to my conditions as previously reported to you guys from
previous months and that is why indication of no change. When I receive my
complete file, I will review these forms with my doctor. Please also send to me
any instructions on how to complete or any forms needed.
(Docket Entry No. 17-1).
On February 21, 2023, Prudential sent an SMS notification to Ellis-Young in response to
the letter with the following notation: “Prudential Claim # 13101811: Courtesy Notification - A
Case 4:26-cv-00321 Document 19 Filed 04/21/26 in TXSD Page 3 of 7

4
new document - Appeal Request has been received. We will review the document, and if needed,
contact you with any questions or next steps.” (Docket Entry No. 16 at 3).
On February 22, 2023, Ellis-Young’s counsel sent a letter to Prudential. The letter stated
in part:
Please accept this letter as legal notice of Mrs. Sherri Ellis-Young’s intent to
appeal your decision denying benefits under the above referenced policy. This
letter is tendered to comply with the notice deadline specified in your last denial
letter transmitted to the claimant.
We hereby ask for 180 days from the date of your denial letter to complete
development of the administrative record. Further, we reserve the right to
request additional time if so needed.
(Id.).
On February 24, 2023, Prudential sent a letter to Ellis-Young’s counsel stating that it
“received a letter from your office advising us of the intent to appeal and request for a copy of Ms.
Ellis-Young’s claim file.” (Docket Entry No. 11-4 at 2). Prudential sent the claim file to Ellis-
Young’s counsel on February 27, 2023. (Docket Entry No. 16 at 3–4; Docket Entry No. 11-4 at
2). Ellis-Young’s counsel called Prudential in June 2023, advising that it did not receive the claim
file. (Docket Entry No. 11-4 at 2). Although Prudential confirmed it had sent the file on a flash
drive in February 2023, it sent another copy to Ellis-Young on June 27, 2023. (Id.).
On January 5, 2024, Ellis-Young’s counsel requested an update on the appeal. 	(Id.).
Prudential called back and “left a message confirming that, to date, [it] had not received any appeal
request from [their] office.” (Id.). Ellis-Young’s counsel requested another update on September
10, 2025. (Id. at 3). Prudential sent a letter the next day advising him of the case’s chronology
and explaining that it never received an appeal for the claim. (Id.). On September 16, 2025, Ellis-
Young’s counsel sent a letter “brief” with attached medical records disputing Prudential’s decision
denying Ellis-Young benefits. (Docket Entry No. 11-3 at 1).
Case 4:26-cv-00321 Document 19 Filed 04/21/26 in TXSD Page 4 of 7

5
On this record, Ellis-Young did not exhaust her administrative remedies because she failed
to appeal timely Prudential’s denial of her disability benefits. Fifth Circuit cases have repeatedly
held that an intention to appeal an ERISA administrator’s denial of benefits is not an appeal of a
denial of benefits. In Holmes, the Fifth Circuit held that the plaintiff did not substantially comply
with the plan’s appellate procedures because the plaintiff “stated only his intent to appeal the Plan’s
decision at some time in the future.” Holmes, 228 F. App’x at 379 (emphasis omitted). The Fifth
Circuit emphasized that the plaintiff’s letter expressing an intent to appeal was not an actual appeal
because “Holmes’ attorney requested Holmes’ personnel file in order to prepare an appeal.” Id.
The Fifth Circuit added that the Plan “contacted Holmes’ attorney” and “gave clear indication that
his April 2004 letter was not an appeal,” a fact that Holmes’ attorney acknowledged when he later
asked “for an extension to the 180–day appeal deadline.” Id. The Fifth Circuit reached the same
result in Swanson, where the plaintiff’s letter to the plan administrator “merely expressed an
‘intention to appeal’”; “included no factual or substantive arguments, and no evidence” in the
intent-to-appeal letter; and, as a result, provided “no basis to require” the plan administrator to
issue a decision within 45 days after it received the plaintiff’s letter. 586 F.3d at 1018–19 (quoting
Holmes, 228 Fed. App’x at 379).
This case is not distinguishable from Holmes and Swanson. 	First, each letter sent to
Prudential clearly expresses a mere intent to appeal. The February 13, 2023, letter stated that Ellis-
Young “will be [filing] an appeal,” (Docket Entry No. 17-1), and the February 22, 2023, letter
provided “legal notice of Mrs. Sherri Ellis-Young’s intent to appeal,” (Docket Entry No. 16 at 3).
Second, Ellis-Young repeatedly requested additional information so that she could file a proper
appeal. (Docket Entry No. 17-1; Docket Entry No. 16 at 3). Third, Prudential told Ellis-Young
that she did not appeal but filed “intent to appeal and request for a copy of Ms. Ellis-Young’s claim
Case 4:26-cv-00321 Document 19 Filed 04/21/26 in TXSD Page 5 of 7

6
file.” (Docket Entry No. 11-4 at 2). It did the same when Ellis-Young’s counsel inquired about
the case in January 2024. (Id.). Fourth, Ellis-Young did not submit to Prudential any factual or
substantive arguments or evidence explaining her disagreement with its denial until September
2025, (Docket Entry No. 11-3), even though the notice of Ellis-Young’s appellate rights stated that
the appeal should contain “the reasons” she disagreed and the “[m]edical evidence or information
to support” her “position,” (Docket Entry No. 11-1 at 5). This case has all the material facts that
led to dismissal in Holmes and Swanson.
The court does not find persuasive Ellis-Young’s fallback argument that the administrative-
exhaustion requirement should be excused. 	(Docket Entry No. 16 at 8–9). 	The Fifth Circuit
rejected such an argument in Swanson. The Fifth Circuit explained that a plan administrator should
be estopped from enforcing the exhaustion requirement where “various officials” lead the plaintiff
“on a wild goose chase, effectively extinguishing his time to apply for benefits.” Swanson, 586
F.3d at 1019 (quoting Bourgeois v. Pension Plan for Emps. of Santa Fe Int’l Corps., 215 F.3d 475,
481 (5th Cir. 2000)). 	But the Swanson court found its facts materially different. 	The court
“ascribe[d] no fault to” the Plan “for failing to rule on the merits of the appeal” because “there was
no valid appeal on which to rule.” Id. The plan administrator “notified” the plaintiff “of the Plan’s
180–day appeal deadline at the outset” and “forwarded her file to counsel within that time period,
including notations indicating that” the plan administrator “did not consider the” plaintiff’s letters
to constitute appeals. 	Id. 	There was “no provision of the Plan or any other source of law that
would obligate [the plan administrator] to send further notices or reminders before concluding that
[the plaintiff] failed to timely appeal.” Id. As discussed, the facts of Ellis-Young’s case are no
different. This is not a case “where the ERISA plan affirmatively misled the applicant.” Id. There
is no basis to excuse Ellis-Young’s exhaustion obligations.
Case 4:26-cv-00321 Document 19 Filed 04/21/26 in TXSD Page 6 of 7

7
For these reasons, the court grants Prudential’s motion for judgment on the pleadings,
(Docket Entry No. 14), which it construes as a motion for summary judgment, see FED. R. CIV. P.
12(d). A final judgment is entered separately.
SIGNED on April 21, 2026, at Houston, Texas.
________________________________
Lee H. Rosenthal
Senior United States District Judge
Case 4:26-cv-00321 Document 19 Filed 04/21/26 in TXSD Page 7 of 7