Middlebrooks v. United States

• Decision Date: 20 March 2014
• Docket Number: Civ. No. 13–4033–KES.
• Citation: Middlebrooks v. United States, 8 F.Supp.3d 1169 (D. S.D. 2014)
• Parties: Stefan Mark MIDDLEBROOKS, Plaintiff, v. UNITED STATES of America, Defendant.
• Court: U.S. District Court — District of South Dakota

8 F.Supp.3d 1169

Stefan Mark MIDDLEBROOKS, Plaintiff

v.UNITED STATES of America, Defendant.

Civ. No. 13–4033–KES.

United States District Court, D. South Dakota, Southern Division.

Signed March 20, 2014.

Eric C. Schulte, Elizabeth S. Hertz, Davenport, Evans, Hurwitz & Smith, LLP, Sioux Falls, SD, for Plaintiff.

Camela C. Theeler, U.S. Attorney's Office, Sioux Falls, SD, for Defendant.

ORDER DENYING DEFENDANT'S MOTION TO DISMISS

KAREN E. SCHREIER, District Judge.

Plaintiff, Stefan Mark Middlebrooks, seeks review of an agency action under the Administrative Procedure Act.Defendant, United States of America, moves the court to dismiss the amended complaint.For the reasons stated below, the court denies the motion to dismiss.

BACKGROUND

The facts, according to the amended complaint, are as follows:

Middlebrooks was born on October 26, 1993.His father, Gary Middlebrooks, is a retired member of the South Dakota Air National Guard.Middlebrooks suffers from a rare genetic condition known as tricho-dento-osseous syndrome (TDO), which affects a person's hair, teeth, and bones.¹Middlebrooks suffers from taurodontism,² enamel hypoplasia,³ and a malformation of his jaw.As a result, Middlebrooks's medical providers recommend full mouth crowns to protect his teeth.

The TRICARE program provides certain medical benefits for active duty uniformed services members, retirees, and their dependents.⁴As a result of his father's military service, Middlebrooks is eligible for medical benefits through TRICARE.Middlebrooks sought approval of the recommended dental procedure from TRICARE, which was denied.Subsequently, Middlebrooks requested reconsideration, but his benefits were denied again.Middlebrooks again appealed, and the office of the Assistant Secretary of Defense issued a final denial.Docket 18–1.Middlebrooks then filed this action.Docket 1.The United States moved to dismiss the original complaint.Docket 8.Middlebrooks timely filed an amended complaint.⁵The United States moved to dismiss the amended complaint, which is the subject of this motion to dismiss.Docket 12.

LEGAL STANDARD

The motion to dismiss before the court is brought pursuant to Federal Rule of Civil Procedure 12(b)(1), for lack of subject matter jurisdiction, and Rule 12(b)(6), for failure to state a claim upon which relief can be granted.A party challenging subject matter jurisdiction under Rule 12(b)(1) must attack either the facial or factual basis for jurisdiction.SeeOsborn v. United States,918 F.2d 724, 729 n. 6(8th Cir.1990).A facial challenge requires the court to examine the complaint and determine if the plaintiff has sufficiently alleged a basis for subject matter jurisdiction, and the nonmoving party receives the same protections as it would if defending a motion to dismiss under Rule 12(b)(6).Id.A factual attack challenges the factual basis for subject matter jurisdiction, and the court considers matters outside the pleadings without giving the nonmoving party the benefit of the Rule 12(b)(6) safeguards.Id.The party seeking to establish jurisdiction has the burden of proof that jurisdiction exists.Id. at 730(quotingMortensen v. First Fed. Sav. & Loan Ass'n,549 F.2d 884, 891(3d Cir.1977) ).

When reviewing a motion to dismiss under Rule 12(b)(6), the court accepts as true all factual allegations in the complaint and draws all reasonable inferences in favor of the nonmoving party.Freitas v. Wells Fargo Home Mortg., Inc.,703 F.3d 436, 438(8th Cir.2013)(quotingRichter v. Advance Auto Parts, Inc.,686 F.3d 847, 850(8th Cir.2012) ).The court may consider the complaint, some materials that are part of the public record, and materials embraced by the complaint.Porous Media Corp. v. Pall Corp.,186 F.3d 1077, 1079(8th Cir.1999).“To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, ‘to state a claim to relief that is plausible on its face.’ ”Ashcroft v. Iqbal,556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868(2009)(quotingBell Atlantic Corp. v. Twombly,550 U.S. 544, 570, 127 S.Ct. 1955, 167 L.Ed.2d 929(2007) ).“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.”Id.

DISCUSSION

I.Subject Matter Jurisdiction

A.Money Damages or Equitable Relief

The United States argues that this court does not have subject matter jurisdiction because this court cannot grant the relief Middlebrooks requests due to the doctrine of sovereign immunity.Under the doctrine of sovereign immunity, the United States cannot be sued without its consent.United States v. Mitchell,463 U.S. 206, 212, 103 S.Ct. 2961, 77 L.Ed.2d 580(1983).“When the United States consents to be sued, the terms of its waiver of sovereign immunity define the extent of the court's jurisdiction.”

United States v. Mottaz,476 U.S. 834, 841, 106 S.Ct. 2224, 90 L.Ed.2d 841(1986).The plaintiff has the burden of showing both a waiver of sovereign immunity and a grant of subject matter jurisdiction.V S Ltd. P'ship v. Dep't of Hous. & Urban Dev.,235 F.3d 1109, 1112(8th Cir.2000).Two separate waivers of sovereign immunity are at issue in this case: the Tucker Act, 28 U.S.C. § 1491, and the Administrative Procedure Act (APA),5 U.S.C. §§ 701 –706.

The APA waives sovereign immunity for actions against the United States for review of administrative actions that do not seek money damages and provides for judicial review in the federal district courts.SeeSuburban Mortg. Assocs., Inc. v. U.S. Dep't of Hous. & Urban Dev.,480 F.3d 1116, 1122(Fed.Cir.2007).The Tucker Act waives the United States's sovereign immunity as to certain suits for money damages, but vests exclusive jurisdiction over all such suits seeking money damages exceeding $10,000⁶ in the Court of Federal Claims.Id. at 1122 n. 10(explaining that the Court of Federal Claims has exclusive jurisdiction because Congress has not granted the authority to hear such claims to any other court).The Tucker Act is only a waiver of sovereign immunity and does not create a substantive right enforceable against the government.United States v. White Mountain Apache Tribe,537 U.S. 465, 472, 123 S.Ct. 1126, 155 L.Ed.2d 40(2003).Additionally, the Tucker Act does not give the Court of Federal Claims the ability to grant any equitable relief, with certain limited exceptions not relevant here.Bowen v. Massachusetts,487 U.S. 879, 905, 108 S.Ct. 2722, 101 L.Ed.2d 749(1988).

The United States takes the position that the relief requested by Middlebrooks is essentially a claim for money damages, which would require his claim to be heard in the Court of Federal Claims pursuant to the Tucker Act.Middlebrooks argues that his claim is for equitable relief under the APA, which would require his claim to be heard in federal district court.

As an initial matter, the United States appears to contend that its Rule 12(b)(1) challenge is a factual challenge rather than a facial challenge.SeeDocket 17at 6–7(reciting the standards for a factual challenge under Rule 12(b)(1)).But there are no disputed facts raised by the parties.Instead, the parties dispute the legal classification of Middlebrooks's requested relief.Because there are no factual disputes for the court to resolve at this point, and the Rule 12(b)(1) argument turns on whether Middlebrooks's complaint on its face falls within this court's jurisdiction, the court considers it as a facial challenge to the court's subject matter jurisdiction.

To determine whether a claim is for money damages or equitable relief, a court“must look beyond the form of the pleadings to the substance of the claim....[D]ressing up a claim for money as one for equitable relief will not remove the claim from Tucker Act jurisdiction and make it an APA case.”Suburban Mortg. Assocs.,480 F.3d at 1124;accordSellers v. Brown,633 F.2d 106, 108(8th Cir.1980)(“We must look beyond the facial allegations of the complaint to determine the true nature of this suit.”).Money damages “are intended to provide a victim with monetary compensation for an injury to his person, property, or reputation....”Bowen,487 U.S. at 893, 108 S.Ct. 2722.An equitable action for specific relief may include “ ‘the recovery of specific property or monies, ejectment from land, or injunction either directing or restraining the defendant officer's actions.’ ”Id.(emphasis in original)(quotingLarson v. Domestic & Foreign Commerce Corp.,337 U.S. 682, 688, 69 S.Ct. 1457, 93 L.Ed. 1628(1949) ).

The mere fact that a remedy may require one party to pay money to another does not automatically classify the relief as money damages.Id. at 893–94, 108 S.Ct. 2722.To classify a claim as equitable relief, the relief sought must have some significant effect or value beyond fixing the amount of money the government must pay.SeeState of Minn. v. Heckler,718 F.2d 852, 858(8th Cir.1983).“Damages are given to the plaintiff to substitute for a suffered loss, whereas specific remedies ‘are not substitute remedies at all, but attempt to give the plaintiff the very thing to which he was entitled.’ ”Bowen,487 U.S. at 895, 108 S.Ct. 2722(emphasis in original)(quoting D. Dobbs, Handbook on the Law of Remedies 135 (1973)).

The amended complaint requests a declaration that the recommended procedure is covered and an injunction prohibiting the United States from denying payment for the recommended procedure.Docket 12at 4.The relief requested by Middlebrooks in the amended complaint is similar to the example the Supreme Court cited in Bowen as equitable relief, stating “ ‘the Town repeatedly characterized reimbursement as “damages,” but that simply is not the case.Reimbursement merely requires the Town to belatedly pay expenses that it should have paid all along and would have borne in the first instance ....’ ”Bowen,487 U.S. at 894, 108 S.Ct. 2722(quoting...