Ngapey v. Granite Bay Care

• Docket Number: Civil Action CV-2023-0208
• Decision Date: 10 October 2023
• Parties: LIONEL NGAPEY, Plaintiff, v. GRANITE BAY CARE and MAINE EMPLOYER MUTUAL INSURANCE COMPANY, Defendants.
• Court: Maine Superior Court

1

LIONEL NGAPEY, Plaintiff, v. GRANITE BAY CARE and MAINE EMPLOYER MUTUAL INSURANCE COMPANY, Defendants.

Civil Action No. CV-2023-0208

Superior Court of Maine, Cumberland

October 10, 2023

ORDER ON DEFENDANT MAINE EMPLOYER MUTUAL INSURANCE COMPANY'S MOTION TO DISMISS

JOHN O' NEIL, JR. JUSTICE.

Before the Court is Defendant Maine Employer Mutual Insurance Company's ("MEMIC")motion to dismiss PlaintiffLionel Ngapey's complaint pursuant to M.R. Civ. P 12(b)(6).For the following reasons, MEMIC's motion is GRANTED.

FACTUAL BACKGROUND

The following facts are distilled from Plaintiff's complaint and exhibits.SeeMoody v. State Liquor & Lottery Comm'n,2004 ME 20, ¶ 10, 843 A.2d 43(noting that while a motion to dismiss is typically based on review of the complaint alone, a "narrow exception allows a court to consider official public documents, documents that are central to the plaintiff's claim, and documents referred to in the complaint, without converting a motion to dismiss into a motion for summary judgment[,] when the authenticity of such documents is not challenged").

Plaintiff began working for Granite Bay Care ("GBC") in May 2016, and he was promoted to House Manager in the summer of 2020.From June 2020 to January 2022, Plaintiff worked 168 hours per week.During his tenure with GBC, Plaintiff contracted CO VID several times.On the first two occasions GMC required him to keep working without rest.In January 2022, during his third bout of CO VID, Plaintiff notified his supervisor that he needed treatment for post-traumatic stress disorder ("PTSD"), severe anxiety, and insomnia.Plaintiff was later terminated.^[1]

On February 27, 2022, Plaintiff filed a Notice of Injury with GBC and requested a leave of absence from March to September 2022 to seek treatment for persistent insomnia, severe PTSD, attention deficit disorder, panic attacks, general anxiety disorder, and mood swings caused by nearly two years of work injuries, neglect, and unrest.^[2] In March 2022 and March 2023, MEMIC denied Plaintiff's workers' compensation claim arising from an injury on January 29,2022, termed "malaise and fatigue."^[3] On that same date, MEMIC issued Plaintiff a one-time payment of $40,000 to cure its earlier procedural violation of the Workers' Compensation Act(the "Act").

On May 30, 2023, Plaintiff filed a complaint alleging that MEMIC (i) discriminated against him under the Act; (ii) unlawfully and fraudulently denied his workers' compensation claims; and (iii) conspired with GBC to commit the Class D crime of failing to secure workers' compensation payments under the Act.On August 30, 2023, MEMIC timely filed the instant motion to dismiss.

DISCUSSION

I.Standard of Review

A court reviewing a M.R. Civ. P. 12(b)(6) motion to dismiss treats the facts alleged in the complaint as admitted.Berounskyv.Oceanside Rubbish Inc., 2022 ME 3, ¶ 7, 266 A.3d 284(citation omitted).The complaint itself is viewed "in the light most favorable to the plaintiff to determine whether it sets forth elements of a cause of action or alleges facts that would entitle the plaintiff to relief pursuant to some legal theory."Nadeem v.Frydrych, 2014 ME 154, ¶ 5,108 A.3d 1254;see alsoSaundersv.Fisher, 2006 ME 94, ¶ 8, 902 A.2d 830(examining whether any cause of action "may reasonably be inferred from the complaint");Howev. MMG Ins. Co., 2014 ME 78, ¶ 9, 95 A.3d 79(stating that the M.R. Civ. P. 8(a) notice standard requires only that the complaint "give fair notice of the cause of action by providing a short and plain statement of the claim showing that the pleader is entitled to relief")."Dismissal is warranted when it appears beyond a doubt that plaintiff is not entitled to relief under any set of facts that [they] might prove in support of [their] claim."Johansonv. Dunnington, 2001 ME 169, ¶ 5, 785 A.2d 1244.

IL Analysis

a. Discrimination

Plaintiff summarily alleges that MEMIC unlawfully discriminated against him pursuant to 39-A M.R.S.A, § 353(2023) of the Act.MEMIC argues that this claim should be dismissed because Plaintiff has failed to exhaust his available administrative remedies-the Court agrees.

The doctrine of exhaustion of administrative remedies requires a party to "proceed in the administrative/municipal arena until all possible administrative remedies are exhausted before initiating action in the courts."Bryant v. Town of Camden,2016 ME 27, ¶ 10, 132 A.3d 1183(quotingCushingv. Smith, 457 A,2d 816, 821(Me.1983)).Here, the Act expressly provides that employees who are discriminated against by an employer "for testifying or asserting any claim" under the Act may file a petition with the Workers' Compensation Commission, and the matter is then referred to an administrative law judge for a formal hearing.39-A M.R.S.A. § 353.

Plaintiff's complaint contains no factual allegations that the above-described administrative remedy has been exhausted.Consequently, this claim is not properly before the Court and must be dismissed.

b. Workers' Compensation Benefits

Plaintiff contends that MEMIC wrongfully and fraudulently denied his claims for workers' compensation benefit.MEMIC makes the off-base argument that this claim must be dismissed because the Act immunizes workers' compensation insurers from civil liability arising from employee personal injuries.The Court nonetheless grants dismissal of this claim for lack of subject matter jurisdiction.SeeMonteith v. Monteith,2021 ME 40, ¶ 29 n. 10, 255 A,3d 1030("[S]ubject matter jurisdiction may be raised at any time, including sua sponte by the court.").

"The rights of a party under the Workers' Compensation Act are purely statutory."Lavoie v. Gervais,1998 ME 158, ¶ 11, 713 A.2d 335.The Act expressly requires claims resting on the "basic contention" that the plaintiff was wrongfully denied workers' compensation benefits to "first be addressed by a hearing offer and, if appropriate, reviewed by the board, and finally, appealed to [the Law Court]."Id.¶ 13;see also39-AM.R.S.A. § 322.

Because the Act provides no mechanism for the Court's review of such denials, Plaintiff's claim is barred in this forum and must be dismissed for lack of subject matter jurisdiction.

c. Criminal Conspiracy

Plaintiff finally seeks to hold MEMIC guilty of conspiring with GBC to commit the Class D crime of failing to secure workers' compensation payments in violation of 39-AM.R.S.A. § 324.MEMIC argues that this claim must be dismissed because Maine law does not permit private citizens to initiate criminal complaints.The Court grants dismissal on a more nuanced ground.

Common law dictates "that in the absence of statutory requirement to the contrary, all [criminal] complaints may be made by any person who can legally be a witness and who has knowledge or information of any violation of the criminal law."Statev. Giles, 101 Me. 349, 353, 64 A. 619, 620(1906).However, while private citizens may initiate criminal proceedings, such as by informing public officials of criminal conduct, they may not file criminal complaints to commence prosecution.SeeSlate v.Maynard, 2007 ME 79, ¶¶ 19-21, 926 A.2d 172(analyzing what constitutes initiating criminal proceedings versus commencing prosecution in the context of an obstruction of justice conviction).Maine law permits non-law enforcement persons to initiate criminal complaints so long as the complaint itself is prepared and approved for prosecution by the district attorney, the Attorney General, or their respective designees.15 M.R.S.A. § 708(2023);see alsoUnited States v. Nixon,418 U.S. 683, 693(1974)("[T]he Executive Branch has exclusive authority and absolute discretion to decide whether to prosecute a case.").

In the instant case, Plaintiff has...