John Doe v. Blue Cross & Blue Shield United of Wisconsin and Aurora Health Care, Inc.

112 F.3d 869, 20 Employee Benefits Cas. (BNA) 2889, 38 Fed. R. Serv. 3d 292, 1997 U.S. App. LEXIS 9087, 1997 WL 212545
CourtCourt of Appeals for the Seventh Circuit
DecidedApril 29, 1997
Docket96-3275
StatusPublished
Cited by425 cases

This text of 112 F.3d 869 (John Doe v. Blue Cross & Blue Shield United of Wisconsin and Aurora Health Care, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
John Doe v. Blue Cross & Blue Shield United of Wisconsin and Aurora Health Care, Inc., 112 F.3d 869, 20 Employee Benefits Cas. (BNA) 2889, 38 Fed. R. Serv. 3d 292, 1997 U.S. App. LEXIS 9087, 1997 WL 212545 (7th Cir. 1997).

Opinion

POSNER, Chief Judge.

The plaintiff was enrolled in an employee welfare benefit plan offered and funded by his employer (Aurora), administered by a health insurer (Blue Cross), and governed by ERISA. In 1989 he underwent psychiatric treatment for which the plan initially paid, but it stopped paying early in 1990 and later that year formally denied coverage. On September 27, 1994, he brought this suit against the employer and the insurer under 29 U.S.C. § 1132(a)(1)(B) to recover benefits allegedly due him under the plan. The district judge granted summary judgment for the defendants on the ground that the suit was brought too late.

The plaintiff is proceeding under a fictitious name because of fear that the litigation might result in the disclosure of his psychiatric records. The motion to proceed in this way was not opposed, and the district judge granted it without comment. The judge’s action was entirely understandable given the absence of objection and the sensitivity of psychiatric records, but we would be remiss if we failed to point out that the privilege of suing or defending under a fictitious name should not be granted automatically even if the opposing party does not object. The use of fictitious names is disfavored, and the judge has an independent duty to determine whether exceptional circumstances justify such a departure from the normal method of proceeding in federal courts. See United States v. Microsoft Corp., 56 F.3d 1448, 1463-64 (D.C.Cir.1995) (per curiam), and cases cited there, and our recent dictum in K.F.P. v. Dane County, 110 F.3d 516, 518-19 (7th Cir.1997). Rule 10(a) of the Federal Rules of Civil Procedure, in providing that the complaint shall give the names of all the parties to the suit (and our plaintiffs name is not “John Doe”), instantiates the principle that judicial proceedings, civil as well as criminal, are to be conducted in public. See Richmond Newspapers, Inc. v. Virginia, 448 U.S. 555, 580 and n. 17, 100 S.Ct. 2814, 2821 and n. 17, 65 L.Ed.2d 973 (1980); Gannett Co. v. DePasquale, 443 U.S. 368, 386 n. 15, 99 S.Ct. 2898, 2908 n. 15, 61 L.Ed.2d 608 (1979). Identifying the parties to the proceeding is an important dimension of publicness. The people have a right to know who is using their courts.

There are exceptions. Records or parts of records are sometimes sealed for good reasons, including the protection of state secrets, trade secrets, and informers; and fictitious names are allowed when necessary to protect the privacy of children, rape victims, and other particularly vulnerable parties or witnesses. But the fact that a case involves a medical issue is not a sufficient reason for allowing the use of a fictitious name, even though many people are understandably secretive about their medical problems. “John Doe” suffers, or at least from 1989 to 1991 suffered, from a psychiatric disorder — obsessive-compulsive syndrome. This is a common enough disorder— some would say that most lawyers and judges suffer from it to a degree — and not such a badge of infamy or humiliation in the modern world that its presence should be an automatic ground for concealing the identity of a party to a federal suit. To make it such would be to propagate the view that mental illness is shameful. Should “John Doe’”s psychiatric records contain material that would be highly embarrassing to the average person yet somehow pertinent to this suit and so an appropriate part of the judicial record, the judge could require that this material be placed under seal.

On August 17, 1990, Blue Cross informed the plaintiff that it would not pay for his psychiatric treatment rendered after December 1, 1989. The suit seeks benefits, in excess of $30,000, for the period between December 1989 and May 31, 1991. The employee benefit plan provides, however, that “no legal action may be commenced ... later than three (3) years from the time written *873 proof of loss was required to be filed. Written proof of loss must be filed within ninety (90) days of the date of service. ■ This means that any legal action must be commenced within thirty-nine (39) months of the first date of services on which the action is based.” The district judge concluded that the last day on which the plaintiff could sue for the full benefits that he was seeking to recover was March 1993, 39 months after the first date (sometime in December 1989) on which the services for which he is seeking benefits were rendered, and that the last day on which he could sue for anything was August 29, 1994, 39 months after the final date (May 31, 1991) on which services for which he is seeking benefits were rendered.

The plan also contains a provision, however, that no suit may be brought until the “completion of the ERISA claim appeal process,” which is to say until the exhaustion of the plaintiffs internal remedies. Even without this provision, the plaintiff, as a matter of the federal common law of ERISA, would be required to exhaust his ERISArequired internal remedies, 29 U.S.C. § 1133(2); 29 C.F.R. § 2560.503-l(g), before being allowed to sue. Wilczynski v. Lumbermens Mutual Casualty Co., 93 F.3d 397, 401-02 (7th Cir.1996); Powell v. A.T. & .T Communications, Inc., 938 F.2d 823, 825-26 (7th Cir.1991); Communications Workers of America v. American Tel. & Tel. Co., 40 F.3d 426, 431-32 (D.C.Cir.1994); Makar v. Health Care Corp., 872 F.2d 80, 82-83 (4th Cir.1989); John H. Langbein & Bruce A. Wolk, Pension and Employee Benefit Law 732-34 (2d ed.1995). So if the internal appeals process took more than 39 months, the plaintiff would be barred-from suing even though the plan forbade him to sue earlier. Less dramatically, if the internal appeals process is at all protracted, the plaintiffs time for suing may be substantially compressed. The process was protracted in this case, not winding up until September 25, 1991. But that still left 17 months within which the plaintiff could sue yet his entire claim still be within the 39-month limitation.

The plaintiff points out correctly that ERISA does not contain a statute of limitations for suits to recover benefits and that the practice of the federal courts when a federal statute contains no limitations period is to borrow the limitations period in the most nearly analogous state or federal statute of limitations.

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Bluebook (online)
112 F.3d 869, 20 Employee Benefits Cas. (BNA) 2889, 38 Fed. R. Serv. 3d 292, 1997 U.S. App. LEXIS 9087, 1997 WL 212545, Counsel Stack Legal Research, https://law.counselstack.com/opinion/john-doe-v-blue-cross-blue-shield-united-of-wisconsin-and-aurora-health-ca7-1997.