Rivera v. Sedgwick Claims Management Services

Background

Rivera alleged that he was injured while working at Nestle’s production facility in Wisconsin. He claimed that Nestle, Ace, and Sedgwick conspired to deny or delay benefits and medical care related to that injury. The complaint asserted seven claims under the Employee Retirement Income Security Act (ERISA), the Americans with Disabilities Act (ADA), and Title VII of the Civil Rights Act of 1964.

Rivera alleged one ERISA claim based on the refusal to cover knee surgery and the ending of medical treatment. He asserted two Title VII retaliation claims against Nestle, involving his termination and the refusal to pay for surgeries. He also asserted four claims under the ADA or both the ADA and ERISA, involving delayed workers’ compensation benefits and several medical examinations or ratings.

Ace and Sedgwick moved to dismiss under Federal Rule of Civil Procedure 12(b)(6), which addresses failure to state a legally sufficient claim, and Nestle moved for judgment on the pleadings under Rule 12(c). The defendants argued that Rivera had not stated a claim and that Minnesota was not a proper venue. Rivera also filed motions to strike, for permission to file a later reply, for sanctions, and for entry of default judgment.

ERISA Claims

The court dismissed Rivera’s ERISA-based claims because he did not allege that an ERISA-governed employee-benefit plan existed. The court explained that an ERISA claim requires allegations establishing an employee-benefit plan, including information showing the intended benefits, the beneficiaries, the financing source, and the procedures for receiving benefits.

The court found that Rivera instead made general statements that he was entitled to benefits and that the defendants had delayed or denied benefits. The court also rejected Rivera’s position that discovery was needed to determine whether the benefits fell within ERISA. Because the complaint did not plausibly allege the existence of an ERISA plan, the court concluded that the ERISA claims failed to state a claim.

Venue for the ADA and Title VII Claims

The court held that the District of Minnesota was not a proper venue for Rivera’s remaining ADA and Title VII claims. It applied the special venue rules for those statutes, which generally allow a case where the alleged unlawful employment practice occurred, where relevant employment records are kept, or where the claimant would have worked absent the alleged unlawful practice.

The court noted that Rivera worked for and was terminated from a Nestle facility in Wisconsin. It found that Rivera provided no allegations connecting the alleged employment practices, relevant employment records, or expected workplace to Minnesota. The court also rejected Rivera’s argument that Sedgwick’s alleged Minnesota office or business operations established venue there, explaining that Sedgwick was not Rivera’s employer and that the general venue statute did not control these ADA and Title VII claims.

The court considered whether to transfer the case to another district rather than dismiss it. It declined to transfer, citing the pleading defects and Rivera’s two earlier federal lawsuits in the Eastern District of Wisconsin, both of which had been dismissed. The court therefore dismissed the action instead of transferring it.

Other Motions and Disposition

The court dismissed as moot Rivera’s two motions to strike Nestle’s answer and his motion for leave to file a later reply. It denied Rivera’s motion for sanctions, finding it meritless, and denied his application for entry of default judgment against Nestle.

The order granted Ace’s motion to dismiss, granted Sedgwick’s motion to dismiss, and granted Nestle’s motion for judgment on the pleadings. It denied Rivera’s motion for sanctions and application for entry of default judgment, dismissed the motions to strike and motion for leave to file a later reply as moot, and dismissed Rivera’s complaint without prejudice.