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Gresham v. State, State Benefits Office

United States District Court, D. Delaware

February 5, 2018




         The plaintiff, Elisha L. Gresham ("Gresham"), who proceeds pro se, commenced this action on October 24, 2016. (D.I. 2.) The defendant State of Delaware State Benefits Office, Office of Management & Budget ("SBO") moves to dismiss pursuant to Fed.R.Civ.P. 12(b)(1) and 12(b)(6). (D.I. 13.) Gresham opposes and moves for leave to amend. (D.I. 16.) She also seeks injunctive relief. (D.I. 15, 17.)


         Gresham was employed by the Delaware Department of Health and Human Social Services ("DHSS") until her employment was terminated effective November 18, 2015. Gresham sues the SBO for short and long term disability payments. (D.I. 2 at 2, 7.)

         Prior to her termination, Gresham was out on a medical leave and been awarded short term disability benefits by the State of Delaware's disability insurance carrier, The Hartford. (Id. at 3-4.) The short term disability benefits were discontinued on September 18, 2015, and Gresham went through several dissatisfying appeals.[1] (Id. at 4.) On September 13, 2016, the SBO advised Gresham that the State Employee Benefits Committee had denied Gresham's appeal for an extension of short term disability benefits for the period beyond September 20, 2015. (D.I. 12 at 14.) In the same letter, Gresham was advised of her right to appeal to the Delaware Superior Court within thirty days of the postmark of the decision. (Id.) The letter referred Gresham to a web-site explaining the appeals process. (Id.) Gresham received the letter on or about September 16 or 17, 2016. (D.I. 2 at 5.)

         Gresham alleges that the SBO knew she had no money to proceed with the appeal and knew that her chances of succeeding were unlikely. (Id.) Gresham spoke to the Superior Court's Prothonotary's office on four different occasions from September 16, 2016 through October 18, 2016, for guidance on how to file an appeal, but she did not file an appeal. (Id. at 4.)

         Gresham alleges that she was denied disability benefits despite medical recommendations and advice from credible medical experts. (Id. at 6.) Gresham alleges that her "condition is still medically diagnosed as being permanent, " and she has been released by her physician to attempt to perform part-time work with limitations, accommodations, and restrictions. (Id.) Gresham seeks disability payments from October 2015 through November 2017. (Id. at 10.)

         The State moves for dismissal pursuant to Fed.R.Civ.P. 12(b)(1) and 12(b)(6). Gresham opposes and seeks leave to amend.


         A. Fed.R.Civ.P. 12(b)(1)

         Rule 12(b)(1) of the Federal Rules of Civil Procedure permits the dismissal of an action for "lack of subject matter jurisdiction." A Rule 12(b)(1) motion may be treated as either a facial or factual challenge to the court's subject matter jurisdiction. See Davis v. Wells Fargo, 824 F.3d 333, 346 (3d Cir. 2016). A facial attack contests the sufficiency of the pleadings, whereas a factual attack contests the sufficiency of jurisdictional facts. See Lincoln Ben. Life Co. v. AEI Life, LLC, 800 F.3d 99, 105 (3d Cir. 2015). When considering a facial attack, the court accepts the plaintiffs well-pleaded factual allegations as true and draws all reasonable inferences from those allegations in the plaintiffs favor. See In re Horizon Healthcare Services Inc. Data Breach Litigation, 846 F.3d 625, 633 (3d Cir. 2017). When reviewing a factual attack, the court may weigh and consider evidence outside the pleadings. See Gould Elecs. Inc. v. United States, 220 F.3d 169, 176 (3d Cir. 2000).

         B. Fed.R.Civ.P. 12(b)(6)

         Because Gresham proceeds pro se, her pleading is liberally construed and her complaint, "however inartfully pleaded, must be held to less stringent standards than formal pleadings drafted by lawyers." Erickson v. Pardus, 551 U.S. 89, 94 (2007) (internal quotation marks omitted). Evaluating a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6) requires the court to accept as true all material allegations of the complaint. See Spruill v. Gillis, 372 F.3d 218, 223 (3d Cir. 2004). "The issue is not whether a plaintiff will ultimately prevail but whether the claimant is entitled to offer evidence to support the claims." In re Burlington Coat Factory Sec. Litig., 114 F.3d 1410, 1420 (3d Cir. 1997) (internal quotation marks omitted). Thus, the court may grant such a motion to dismiss only if, after "accepting all well-pleaded allegations in the complaint as true, and viewing them in the light most favorable to plaintiff, plaintiff is not entitled to relief." Maio v. Aetna, Inc., 221 F.3d 472, 481-82 (3d Cir. 2000) (internal quotation marks omitted).

         A well-pleaded complaint must contain more than mere labels and conclusions. See Ashcroft v. Iqbal,556 U.S. 662 (2009); BellAtl Corp. v. Twombly,550 U.S. 544 (2007). A plaintiff must plead facts sufficient to show that a claim has substantive plausibility. See Johnson v. City of Shelby, __ U.S. __, 135 S.Ct. 346, 347 (2014). A complaint may not dismissed, ...

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