Copeland v. American Postal Workers Accident Benefit Association
Filing
53
Memorandum Opinion and Order granting Defendants motion for judgment on the pleadings (Doc. # 33 ). All other pending motions are denied (Docs. # 34 , # 36 , # 41 , # 46 , # 48 , # 50 , and # 51 ). This matter is hereby dismissed. The Court certifies that an appeal from this decision could not be taken in good faith. Judge John R. Adams on 3/19/14. (K,C)
UNITED STATES DISTRICT COURT
NORTHERN DISTRICT OF OHIO
EASTERN DIVISION
CHARLES D. COPELAND,
Plaintiffs,
v.
AMERICAN POSTAL WORKERS
ACCIDENT BENEFIT ASSOCIATION, et
al.,
) CASE NO. 5:13 CV 0912
)
)
) JUDGE JOHN R. ADAMS
)
) ORDER
)
)
)
)
Defendants.
This matter is before the Court on Defendant American Postal Workers Accident Benefit
Association’s (“Defendant”) Motion for Judgment on the Pleadings or in the Alternative for
Summary Judgment (Doc. 33). Plaintiff Charles D. Copeland (“Plaintiff”) responded in
opposition to the motion (Doc. 42).
I.
Standard of Review
Fed.R. Civ.P. 12(c) provides that “[a]fter the pleadings are closed -- but early enough not
to delay trial -- a party may move for judgment on the pleadings.” The standard for evaluating a
motion for judgment on the pleadings is the same as that applicable to a motion to dismiss under
Rule 12(b)(6) for failure to state a claim. Ziegler v. IBP Hog Market, Inc., 249 F.3d 509, 511-12
(6th Cir. 2001). The Sixth Circuit stated the standard for reviewing such a motion to dismiss in
Assn. of Cleveland Fire Fighters v. Cleveland, 502 F.3d 545 (6th Cir. 2007) as follows:
The Supreme Court has recently clarified the law with respect to what a plaintiff
must plead in order to survive a Rule 12(b)(6) motion. Bell Atl. Corp. v.
Twombly, 550 U.S. 544 (2007). The Court stated that “a plaintiff’s obligation to
provide the grounds of his entitlement to relief requires more than labels and
conclusions, and a formulaic recitation of the elements of a cause of action will
not do.” Id. at 1964-65 (citations and quotation marks omitted). Additionally, the
Court emphasized that even though a complaint need not contain “detailed”
factual allegations, its “[f]actual allegations must be enough to raise a right to
relief above the speculative level on the assumption that all the allegations in the
complaint are true.” Id. (internal citation and quotation marks omitted). In so
holding, the Court disavowed the oft-quoted Rule 12(b)(6) standard of Conley v.
Gibson, 355 U.S. 41, 45-46 (1957) (recognizing “the accepted rule that a
complaint should not be dismissed for failure to state a claim unless it appears
beyond doubt that the plaintiff can prove no set of facts in support of his claim
which would entitle him to relief”), characterizing that rule as one “best forgotten
as an incomplete, negative gloss on an accepted pleading standard.” Twombly,
550 U.S. at 563.
Id. at 548.
If an allegation is capable of more than one inference, this Court must construe it in the
plaintiff’s favor. Columbia Natural Res., Inc. v. Tatum, 58 F.3d 1101, 1109 (6th Cir. 1995)
(citing Allard v. Weitzman, 991 F.2d 1236, 1240 (6th Cir. 1993)). This Court may not grant a
Rule 12(b)(6) motion merely because it may not believe the plaintiff’s factual allegations. Id.
Although this is a liberal standard of review, the plaintiff still must do more than merely assert
bare legal conclusions. Id. Specifically, the complaint must contain “either direct or inferential
allegations respecting all the material elements to sustain a recovery under some viable legal
theory.”
Scheid v. Fanny Farmer Candy Shops, Inc., 859 F.2d 434, 436 (6th Cir. 1988)
(quotations and emphasis omitted).
II. Facts
For the purpose of analyzing Defendant’s motions, the Court accepts as true the
following facts:
Plaintiff previously worked for the United States Postal Service for over 30 years. During
his employment, Plaintiff entered into an insurance agreement for medical and disability
coverage. On several occasions, Plaintiff suffered injuries at work. These injuries included lower
back strain, chest strain, strained leg, neck injuries and eye injuries. Additional, throughout his
employment, Plaintiff suffered numerous stress related injuries. Specifically, Plaintiff reported
his stress related injuries to the insurance company on an array of dates ranging from the mid1970s to 2010. Each of Plaintiff’s stress related injury claims was denied by the company.
Eventually, Plaintiff’s injuries required him to retire from the USPO. Plaintiff filed for
disability retirement and requested Defendant to pay him under the agreement.
Without
conducting an in-person physical exam of Plaintiff, Defendant denied him disability under the
insurance agreement.
III. Procedural History
Following Defendant’s denial of his benefits, Plaintiff filed a pro se Complaint in the
Stark County Court of Common Pleas alleging that Defendant breached the insurance agreement
by refusing to pay the benefits to him. Defendant removed the matter to this Court on April 23,
2013. On August 22, 2013, Defendant moved for judgment on the pleadings, asserting that
Plaintiff’s claims were preempted and that he had failed to exhaust his administrative remedies.
Copeland responded in opposition on October 1, 2013, appearing to assert that Defendant had
committed fraud and that the motion was untimely. The Court now resolves the motion.
IV. Law and Analysis
Initially, the Court would note that Defendant is correct that Plaintiff’s claims, as pled,
are preempted by ERISA. The Sixth Circuit has “long interpreted ERISA as broadly preempting
most state law claims that relate to an employee-benefit plan, particularly where - as here - those
claims explicitly refer to such a plan.” Werner v. Primax Recoveries, Inc., 2010 WL 565447, at
*2 (6th Cir. Feb. 19, 2010) (citing and quoting Zuniga v. Blue Cross & Blue Shield of Mich., 52
F.3d 1395, 1401 (6th Cir. 1995)).
It is also well-established that such state law tort claims are preempted by the Act.
See Pilot Life Ins. Co., 481 U.S. at 57 (state law bad-faith claim preempted);
Tolton v. Am. Biodyne, Inc., 48 F.3d 937, 942 (6th Cir. 1995) (finding state-law
claims for wrongful death, improper denial of benefits, medical malpractice, and
insurance bad faith were preempted because defendants “were determining what
benefits were available to [plaintiff] under the plan”); Cromwell, 944 F.2d at 1276
(holding state-law claims of promissory estoppel, breach of contract, negligent
misrepresentation, and breach of good faith based on denial of benefits “are at the
very heart of issues within the scope of ERISA’s exclusive regulation”).
Ramsey v. Formica Corp., 398 F.3d 421, 425 (6th Cir. 2005).
While recognizing that the above law would preempt Plaintiff’s claims as they are
currently pled, the Court is also cognizant of the fact that the matter was removed here from state
court. Accordingly, the Court would ordinarily simply order Plaintiff to amend his complaint to
assert ERISA claims, rather than state law claims. However, because the ERISA claims would
also be futile, the Court declines to order an amendment. Crawford v. Roane, 53 F.3d 750, 753
(6th Cir. 1995) (noting that a Court may deny leave to amend if the amendment would be futile).
The Sixth Circuit has held that “[t]he administrative scheme of ERISA requires a
participant to exhaust his or her administrative remedies prior to commencing suit in federal
court.” Miller v. Metropolitan Life Ins. Co., 925 F.2d 979, 986 (6th Cir. 1991). “This is the law
in most circuits despite the fact that ERISA does not explicitly command exhaustion.”
Ravencraft v. UNUM Life Ins. Co. of Am., 212 F.3d 341, 343 (6th Cir. 2000). See also Fallick v.
Nationwide Mut. Ins. Co., 162 F.3d 410, 418 n. 4 (6th Cir. 1998) (citing cases that have read an
exhaustion of administrative remedies requirement into the statute). The exhaustion requirement
“enables plan fiduciaries to efficiently manage their funds; correct their errors; interpret plan
provisions; and assemble a factual record which will assist a court in reviewing the fiduciaries'
actions.” Ravencraft, 212 F.3d at 343 (quoting Makar v. Health Care Corp., 872 F.2d 80, 83 (4th
Cir. 1989)).
The Court would note that both parties acknowledge that this matter is dependent upon
the written agreement between the parties. Accordingly, the Court may properly consider that
agreement in resolving the motion for judgment on the pleadings. The agreement requires
Plaintiff to first appeal his denial to the National Director, an action that Copeland successfully
completed. The plan then requires a “Second Appeal to the Committee” which is the Committee
on Claims of the Board of Directors. Doc. 33-3 at 9. Copeland did not take this appeal.
Moreover, in his response, Copeland makes no argument that he in fact exhausted his
administrative remedies or that it would have been futile for him to attempt to do so.
Instead, Copeland makes numerous arguments about Defendant being in default,
committing perjury, and failing to properly pay him benefits. None of these arguments are
responsive to the legal issues raised by Defendant in its motion for judgment on the pleadings.
While the Court is cognizant of Copeland’s pro se status, such status does not provide a basis to
excuse him from the requirement that he exhaust his administrative remedies. Accordingly, the
motion for judgment on the pleadings is GRANTED and the complaint is hereby DISMISSED.
The Court would also note that Copeland has filed numerous other motions that remain
pending at this time: 1) “motion to strike filing of defendant based upon perjury by their witness
and exhibits of contract” (Doc. 34), 2) “Motion to strike filing of defendants due to fraud and
issue of res judicata” (Doc. 36), 3) “motion to strike all filings of defendant based upon default”
(Doc. 41), 4) “Motion to strike pleading of defendant due to Fed R 11 and Fed R 55 Default
(Doc. 46), 5) “Request to clerk of courts to place cause on trial cause calander” (Doc. 48), 6)
“request for mandatory amount as required for restitution based on default (Doc. 50), and 7)
“Motion to remand due to lack of venue” (Doc. 51) (sic throughout).
These motions are
DENIED. While Copeland appears to contend throughout that there have misstatements made
by Defendants, the ERISA agreement is clear and it demonstrates beyond dispute that Copeland
has failed to exhaust his administrative remedies.
V. Conclusion
Defendant’s motion for judgment on the pleadings is GRANTED. All other pending
motions are DENIED. This matter is hereby DISMISSED. The Court certifies, pursuant to 28
U.S.C. § 1915(a)(3), that an appeal from this decision could not be taken in good faith.
IT IS SO ORDERED.
March 19, 2014
Date
____/s/ Judge John R. Adams_______
JUDGE JOHN R. ADAMS
UNITED STATES DISTRICT COURT
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