Pearson v. Northwest Airlines, Inc.

659 F. Supp. 2d 1084, 2009 U.S. Dist. LEXIS 94999, 2009 WL 3164428
CourtDistrict Court, C.D. California
DecidedOctober 4, 2009
DocketCase EDCV 09-257(SGL)(RCx)
StatusPublished
Cited by8 cases

This text of 659 F. Supp. 2d 1084 (Pearson v. Northwest Airlines, Inc.) is published on Counsel Stack Legal Research, covering District Court, C.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pearson v. Northwest Airlines, Inc., 659 F. Supp. 2d 1084, 2009 U.S. Dist. LEXIS 94999, 2009 WL 3164428 (C.D. Cal. 2009).

Opinion

ORDER GRANTING DEFENDANTS’ MOTION TO DISMISS

STEPHEN G. LARSON, District Judge.

Plaintiff Veronica Pearson (“plaintiff’ or “Pearson”) filed this suit on February 6, 2009 against the Northwest Airlines, Inc. Long-Term Disability Income Plan (“the Plan”), American General Assurance Company (“AGAC”), and five unnamed Does (collectively “defendants”), alleging a breach of the Employee Retirement Income Security Act of 1974 (“ERISA”). Before the Court is defendants’ motion to dismiss, which forces the Court to examine the terms of the Plan contract, and the intersection of ERISA and the Railway Labor Act (“RLA”).

*1086 I. FACTUAL BACKGROUND

From 1994 through 2004, Pearson was employed by Northwest Airlines (“Northwest”) as a ramp worker at Los Angeles International Airport (LAX). Compl. ¶ 2. As an employee of Northwest and a member of the International Association of Machinists and Aerospace Workers (IAMAW) Union-District 143, Pearson participated in the Plan, an employee welfare benefit plan sponsored by Northwest, and created pursuant to a collective bargaining agreement (“the CBA”), paying premiums out of her paycheck. Compl. ¶3. The Plan is administered by Northwest Airlines, and claims are administered by AGAC. Compl. ¶¶ 3-4. Disability RMS Administrators (“Disability RMS”) appears to be a sub-administrator hired by AGAC to process claims. Compl. ¶¶ 4, 9.

Pearson alleges she became totally disabled on January 28, 2004 as a result of multiple workplace injuries to her back, arm, and hand. Compl. ¶ 8. She has been paid permanent disability benefits under Northwest’s worker’s compensation insurance policy pursuant to a compromise approved by an Administrative Law Judge on April 22, 2008. Compl. ¶ 8. 1

Pearson also filed a claim for long-term disability (“LTD”) benefits under the Plan on March 27, 2007. Compl. ¶ 9. Pearson claims she did not know she was eligible for LTD benefits under the Plan, offset by the amount of her worker’s compensation benefits, until told by a co-worker in or about March 2007. Id. Upon investigating Pearson’s claim and supporting documentation, on May 16, 2007, Disability RMS informed Pearson that it required further medical records from her physician, Dr. David L. Wood. Compl. ¶ 10. Pearson does not indicate these records were ever provided, but instead suggests that the Plan already “had all the evidence necessary to find plaintiff totally disabled under the terms of the LTD Plan.” Compl. ¶ 10.

On June 7, 2007, Disability RMS denied Pearson’s claim as untimely. Plaintiff appealed this denial on July 20, 2007. Compl. ¶¶ 12-13. Appeals Analyst Deborah Cole initially indicated Disability RMS needed more information to resolve the appeal. Compl. ¶ 12. However, Disability RMS then sent Pearson a letter on August 14, 2007, indicating it was upholding the decision that the claim was untimely, and noting that “This decision is based on the receipt of additional information, not known at the time of Deborah Cole’s initial appellate determination.” Compl. ¶ 13. Pearson’s subsequent request for a voluntary review on the basis that “other employees had filed claims beyond the ‘allowed time stated in the policy’ and she felt she was being treated unfairly” was denied on September 20, 2007. Compl. ¶ 14.

Pearson claims the denial of LTD benefits was wrongful, in that the Plan and AGAC “knew, or should have known, that Plaintiff was entitled to [ ] benefits under the terms of the LTD Plan;” “failed to provide a prompt and reasonable explanation of the basis relied on” in denying her claim;” “failed to adequately describe to Plaintiff any additional material or information necessary for Plaintiff to perfect her claim along with an explanation of why such material is or was necessary;” “concealed] and withheld] from Plaintiff the notice requirements [sic] American General and the LTD Plan were required to provide Plaintiff pursuant to ERISA”; failed “to properly and adequately investigate the merits of’ Pearson’s claim; failed to inform plaintiff of her right to file a claim; and failed to “apply the correct law to Plaintiffs claim.” Compl. ¶ 16.

*1087 Pearson seeks restitution of all past benefits due, unspecified damages, attorneys’ costs and fees, and declaratory and injunctive relief.

II. LEGAL STANDARD

Defendants bring this motion under Rules 12(b)(6) and 12(f).

A Rule 12(b)(6) motion tests the legal sufficiency of the claims asserted in a complaint. “While a complaint attacked by a Rule 12(b)(6) motion to dismiss does not need detailed factual allegations, a plaintiffs 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.” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 127 S.Ct. 1955, 1964-65, 167 L.Ed.2d 929 (2007). “[F]actual allegations must be enough to raise a right to relief above the speculative level.” Id at 1965.

However, since defendants move, in part, for dismissal on the basis of a lack of subject-matter jurisdiction, discussed below, the motion should also have been filed under Rule 12(b)(1). 2 As the Ninth Circuit has recently explained, a 12(b)(1) motion for dismissal for lack of subject-matter jurisdiction and a 12(b)(6) motion for dismissal for failure to state a claim are based on distinct concepts: “the former determines whether the plaintiff has a right to be in the particular court and the latter is an adjudication as to whether a cognizable legal claim has been stated.” Trustees of Screen Actors-Guild-Producers Pension & Health Plans v. NYCA Inc., 572 F.3d 771 (9th Cir.2009), quoting 5B Wright & Miller, Federal Prac. & Pro. § 1350 (3d ed. 2004). “Unless the jurisdictional issue is inextricable from the merits of a case, the court may determine jurisdiction on a motion to dismiss for lack of jurisdiction under Rule 12(b)(1) of the Federal Rules of Civil Procedure.” Kingman Reef Atoll Investments, L.L.C. v. United States, 541 F.3d 1189, 1195 (9th Cir.2008).

On a Rule 12(b)(1) motion, “the district court is free to hear evidence regarding jurisdiction and to rule on that issue prior to trial, resolving factual disputes where necessary. In such circumstances, no presumptive truthfulness attaches to plaintiffs allegations, and the existence of disputed material facts will not preclude the trial court from evaluating for itself the merits of jurisdictional claims.” Id, quoting Roberts v. Corrothers, 812 F.2d 1173, 1177 (9th Cir.1987).

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659 F. Supp. 2d 1084, 2009 U.S. Dist. LEXIS 94999, 2009 WL 3164428, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pearson-v-northwest-airlines-inc-cacd-2009.