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Gallion v. Medco Health Solutions, Inc.

United States District Court, E.D. Washington

April 2, 2014

MEDCO HEALTH SOLUTIONS, INC., et al., Defendants.


THOMAS O. RICE, District Judge.

BEFORE THE COURT is Defendant Medco Health Solutions, Inc.'s Motion for Judgment on the Pleadings (ECF No. 13). This matter was heard with oral argument on April 2, 2014. Bradley E. Smith appeared on behalf of the Plaintiff. Deidra Nguyen appeared on behalf of Defendant Medco Health Solutions. The Court has reviewed the briefing and the record and files herein, and is fully informed.


Plaintiff asserts a variety of state law claims arising from an allegedly wrongful denial of short-term and long-term disability benefits by her former employer, Defendant Medco Health Solutions. Medco now moves to dismiss Plaintiff's claims as barred by a one-year limitations period in the subject disability insurance policy. For the reasons discussed below, the Court will grant the motion.


Plaintiff Karen Gallion ("Plaintiff") was employed by Defendant Medco Health Solutions, Inc. ("Medco") from September 1995 to December 2010 as a data entry operator. On or about November 11, 2010, Plaintiff was forced to stop working due to symptoms attendant to post-traumatic stress disorder ("PTSD"). Plaintiff asserts that her PTSD resulted from working under an abusive supervisor.

Unable to work, Plaintiff submitted a claim for short-term disability ("STD") benefits under a disability insurance policy sponsored by Medco and provided to all Medco employees. The administrator of the STD policy, Defendant Disability Management Alternatives, LLC, denied the claim on or about December 2, 2010. Plaintiff returned to work on December 13, 2010, despite the fact that her PTSD symptoms had not improved.

Plaintiff's return to work was not successful. On December 17, 2010, as a "direct result of the work environment, " Plaintiff attempted to commit suicide. At some point thereafter, Plaintiff submitted a second claim for STD benefits under the same policy. This claim was also denied by Defendant Disability Management Alternatives. Plaintiff did not thereafter return to work at Medco.

Plaintiff subsequently appealed the denials of her claims pursuant to the appeal procedures set forth in the Summary Plan Description ("SPD" or "Plan"). These appeals were ultimately denied on April 22, 2011, and August 2, 2011.

Plaintiff filed the instant action in the Spokane County Superior Court on December 24, 2012. She subsequently filed an amended complaint on March 5, 2013, which was served on Medco on March 6, 2013. Medco removed the action to this Court on April 4, 2013, on diversity jurisdiction and federal question grounds. Medco now moves to dismiss Plaintiff's claims as time-barred under the one-year limitations period in the Plan.


Motions for judgment on the pleadings are governed by Federal Rule of Civil Procedure 12(c). Rule 12(c) provides that a party may move for judgment on the pleadings "[a]fter the pleadings are closed[, ] but early enough not to delay trial." Fed.R.Civ.P. 12(c). To prevail on such a motion, the moving party must "clearly establish[] on the face of the pleadings that no material issue of fact remains to be resolved and that it is entitled to judgment as a matter of law." Hal Roach Studios, Inc. v. Richard Feiner and Co., Inc., 896 F.2d 1542, 1550 (9th Cir. 1989). This standard is "functionally identical" to the standard applicable to a Rule 12(b)(6) motion. Cafasso, U.S. ex rel. v. Gen. Dynamics C4 Sys., Inc., 637 F.3d 1047, 1055 n.4 (9th Cir. 2011).

To withstand dismissal under Rule 12(b)(6), a complaint must contain "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). "Naked assertion[s], " "labels and conclusions, " or "formulaic recitation[s] of the elements of a cause of action will not do." Id. at 555, 557. "A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). While a plaintiff need not establish a probability of success on the merits, he or she must demonstrate "more than a sheer possibility that a defendant has acted unlawfully." Id.

A complaint must also contain a "short and plain statement of the claim showing that the pleader is entitled to relief." Fed.R.Civ.P. 8(a)(2). This standard "does not require detailed factual allegations, but it demands more than an unadorned, the defendant-unlawfully-harmed-me accusation." Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 555). In assessing whether Rule 8(a)(2) has been satisfied, a court must first identify the elements of the plaintiff's claim(s) and then determine whether those elements could be proven on the facts pled. The court should generally draw all reasonable inferences in the plaintiff's favor, see Sheppard v. David Evans and Assocs., 694 F.3d ...

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