Court Rules in Favor of Injured Stuntwoman; SAG Benefit Plan Board Remains in Denial

If someone claimed severe trauma after decades of falling down stairs, getting into car crashes, getting dropped to the floor head first, and leaping from rigged explosions, one would tend to believe that person. Yet the Screen Actors Guild Pension and Health Plan believes that Leslie Hoffman, a retired Hollywood stuntwoman who did these things and more, has no right to make such a claim. Trustees of the plan, in fact, have spent over a decade in court for the purpose of blocking her attempt to receive benefits. But a U.S. Court of Appeals, Ninth Circuit, now has told the Plan that the charade is over. On March 18, a three-judge panel ruled that Ms. Hoffman, who hasn’t done any stunts in nearly 20 years and who has been diagnosed multiple times with traumatic brain injury, deserves full compensation. But the circuit court, and not for the first time, has remanded the case to a lower court.

Union Corruption Update has described this saga twice, in 2015 and in 2018. The situation appears no closer to resolution. Leslie Hoffman, a native of Saranac Lake, N.Y., had performed stunts for movies and television shows for at least 25 years before retiring in 2002. She took a pummeling in the process. In 2003 she was admitted for psychiatric treatment on three separate occasions and was diagnosed with “severe major depression.” The following year she was awarded disability benefits from the Social Security Administration, which had determined Hoffman had suffered “severe” and “degenerative” back injury. Her personal physician, Dr. Jeffrey Salberg, eventually diagnosed her with “traumatic brain injury” and “severe back, neck, knee and shoulder injuries…due to continuous traumas throughout her stunt career.”

Hoffman also was a longtime dues-paying member of the Screen Actors Guild. Indeed, for a while she had served on the SAG’s board of directors, and later on the board of directors of the American Federation of Television and Radio Artists (AFTRA) prior to the merger of the two unions in 2012. One would think that the SAG-AFTRA Pension and Health Plan, which is legally separate from the union, would have approved her request for occupational disability payments. But Plan administrators rejected the request in 2004, authorizing only limited coverage for psychiatric depression. Five years later, she appealed to Plan administrators to convert her status to “occupational disability.” The union once again rejected her request.

In 2010, Hoffman tried another approach: She sued the SAG plan in federal district court. The court dismissed her case. Hoffman appealed to the U.S. Ninth Circuit Court and won. “We conclude,” wrote the higher court, “that the district court erred in dismissing Hoffman’s claim on summary judgment because she is entitled to a second medical opinion and a fully developed record resulting therefrom.” The court remanded the case to the lower court for a new determination of eligibility.

To make her case, Ms. Hoffman presented the SAG health plan with the results of two separate SPECT (Single-Photon Emission Computed Tomography) scan tests revealing clear evidence of traumatic brain injury. It was to no avail. Plan administrators continued to deny her health benefits, claiming that her trauma was not job-related. The ruling purportedly was based on separate evaluations by two doctors. Yet these evaluations contained no test information. And SAG pension and health plan managers refused to identify the doctors. The administrators based their decision on a very thin reed. Hoffman, well into retirement, had worked as a stunt coordinator on a Star Trek fan web-based short film and as a fight coordinator for a 12-minute University of Southern California student-produced short film. In neither instance did she perform stunts or receive pay. Her only SAG-related income since retirement was from residuals.

Rather than admit to error, plan administrators became punitive. Not only was Ms. Hoffman ineligible for disability benefits, they claimed, but she falsely had claimed clinical depression. They demanded that she return $123,827.50 in accumulated depression coverage payouts, plus interest. If she did not pay, the Plan would deduct the money from any future benefits. Several attendees at a SAG Pension and Health trustees meeting on June 18, 2010, the minutes of which had been leaked to the industry blog Deadline Hollywood, inadvertently let down their guard. If Hoffman won her disability claim, certain trustees admitted, that might open the door to a deluge of stunt performer claims. SAG Plan Chief Operating Officer Chris Dowdell had expressed a similar concern via email two weeks earlier. Despite this smoking gun, a district court granted summary judgment in favor of the SAG-AFTRA plan in 2012. A circuit court subsequently denied her a petition for review. That cleared the way for a June 2015 decision by benefit plan managers to claw back her pension payouts.

This case was beginning to resemble a Hollywood dark comedy. In 2016, U.S. District Judge Manuel Real granted the SAG-AFTRA benefits plan a motion for summary dismissal. But Hoffman, now broke, had some fight left in her. She appealed to the Ninth Circuit Court. And the effort paid off. In January 2019, the court reversed Judge Real’s ruling and remanded her case back to a lower court. It also admonished the SAG-AFTRA Pension and Health Plan. “Although the Plans repeatedly requested that Hoffman provide all of her tax records to the board of trustees, the Plans later claimed that they only reviewed a ‘summary’ of these records, and retroactively denied Hoffman’s benefits in part on the basis that Hoffman was holding herself out to be available to work,” wrote the Circuit Court. “In contrast, Hoffman provided voluminous tax records to the Plans to show she had not been paid for work since her disability began. The Plans acknowledged receiving these, but did not include them in the administrative record, suggesting that the Plans did not review them.”

Hoffman, for a change, prevailed at the lower level as well. In October 2019, U.S. District Judge Gary Klausner determined that plan administrators and trustees had not given her a full and fair review of her disability claim. While stopping short of concluding that malice was at work, Judge Klausner did say that the Plan “abused its discretion” and that its ruling contained “procedural irregularities combined with the existence of conflicting evidence and the omission of other evidence from the Plan’s review.” He remanded the case to the union benefit plans “for consideration.”

As could have been predicted, the union plan once again denied her pension benefits. Leslie Hoffman, having split her case into separate pension and disability lawsuits, went back to court. In 2020, a district court judge ruled in her favor in the pension case, and ordered all benefits reinstated. She then went back to the original disability suit. A new district judge, Cormac Carney, dismissed the case, arguing she had taken too long the first time around. But Hoffman appealed. And this past March 18, U.S. Circuit Judges Andrew Kleinfeld, Richard Tallman and John Owens overturned the district court ruling:

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 ERISA 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 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.

That’s where it stands now. Once again, a lower court will review the case.

The reader by now might be asking: When will this game of legal ping-pong end? Why have circuit court judges repeatedly tossed this case back to a lower court instead of ruling definitively? There are two plausible answers. First, our legal system is set up to maximize the possibilities for negotiation in monetary disputes. The downside is that if two sides are far apart, and at least one is unwilling to compromise, a settlement is next to impossible. The Ninth Circuit Court seems to believe that after years of stonewalling Hoffman, SAG-AFTRA benefit plan trustees and administrators one day will become a model of flexibility. Second, the Employee Retirement Income Security Act (ERISA) gives plan management in any industry almost complete discretion in determining participant eligibility. SAG-AFTRA trustees and administrators, knowing they hold the upper hand, have every incentive to wear down a plaintiff lacking deep pockets. Courts generally avoid legislating from the bench in cases like these. But Leslie Hoffman is not about to blink. If she wins, it will be an overdue victory for the stunt community.