Theede v. United States
| Decision Date | 22 June 2011 |
| Docket Number | No. CIV S-11-1084 MCE DAD PS,CIV S-11-1084 MCE DAD PS |
| Parties | ROBERT L. THEEDE, Plaintiff, v. UNITED STATES OF AMERICA, et al., Defendants. |
| Court | U.S. District Court — Eastern District of California |
Plaintiff, Robert Theede, proceeding in this action pro se, has requested leave to proceed in forma pauperis pursuant to 28 U.S.C. § 1915. This matter was referred to the undersigned in accordance with Local Rule 72-302(c)(21) and 28 U.S.C. § 636(b)(1).
Plaintiff has submitted an in forma pauperis application that makes the showing required by 28 U.S.C. § 1915(a)(1). Plaintiff's request for leave to proceed in forma pauperis will therefore be granted.
The determination that plaintiff may proceed in forma pauperis does not complete the inquiry required by the statutes. Under 28 U.S.C. § 1915(e)(2), the court must dismiss the complaint at any time if the court determines that the pleading is frivolous or malicious, fails to state a claim on which relief may be granted, or seeks monetary relief against an immune defendant. A complaint is legally frivolous when it lacks an arguable basis in law or in fact.Neitzke v. Williams, 490 U.S. 319, 325 (1989); Franklin v. Murphy, 745 F.2d 1221, 1227-28 (9th Cir. 1984). Under this standard, a court must dismiss a complaint as frivolous where it is based on an indisputably meritless legal theory or where the factual contentions are clearly baseless. Neitzke, 490 U.S. at 327; 28 U.S.C. § 1915(e).
To state a claim on which relief may be granted, the plaintiff must allege "enough facts to state a claim to relief that is plausible on its face." Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007). In considering whether a complaint states a cognizable claim, the court accepts as true the material allegations in the complaint and construes the allegations in the light most favorable to the plaintiff. Hishon v. King & Spalding, 467 U.S. 69, 73 (1984); Hosp. Bldg. Co. v. Trustees of Rex Hosp., 425 U.S. 738, 740 (1976); Love v. United States, 915 F.2d 1242, 1245 (9th Cir. 1989). Pro se pleadings are held to a less stringent standard than those drafted by lawyers. Haines v. Kerner, 404 U.S. 519, 520 (1972). However, the court need not accept as true conclusory allegations, unreasonable inferences, or unwarranted deductions of fact. Western Mining Council v. Watt, 643 F.2d 618, 624 (9th Cir. 1981).
The minimum requirements for a civil complaint in federal court are as follows:
A pleading which sets forth a claim for relief . . . shall contain (1) a short and plain statement of the grounds upon which the court's jurisdiction depends . . . , (2) a short and plain statement of the claim showing that the pleader is entitled to relief, and (3) a demand for judgment for the relief the pleader seeks.
Here, plaintiff's complaint is deficient in several respects. First, plaintiff's complaint seeks "monetary relief" from the United States of America, the Mid-America Program Service Center, the U.S. Department of Labor and the Office of Workers' Compensation Programs. (Compl. (Doc. No.1) at 1.) "The basic rule of federal sovereign immunity is that the United States cannot be sued at all without the consent of Congress." Block v. North Dakota ex rel. Bd. of Univ. & Sch. Lands, 461 U.S. 273, 287 (1983). Similarly, no federal agency can be sued unless Congress has explicitly revoked that agency's immunity. Gerritsen v. ConsuladoGeneral de Mexico, 989 F.2d 340, 343 (9th Cir. 1993); City of Whittier v. U.S. Dep't of Justice, 598 F.2d 561, 562 (9th Cir. 1979). Put another way, no court has jurisdiction to award relief against the United States or a federal agency unless the requested relief is expressly and unequivocally authorized by federal statute. United States v. King, 395 U.S. 1, 4 (1969) (citing United States v. Sherwood, 312 U.S. 584, 586-87 (1941)).
"The question whether the United States has waived its sovereign immunity against suits for damages is, in the first instance, a question of subject matter jurisdiction." McCarthy, 850 F.2d at 560. Absent a waiver of sovereign immunity, a claim against the United States or a federal agency must be dismissed for lack of subject matter jurisdiction. See Gerritsen, 989 F.2d at 343; Gilbert v. DaGrossa, 756 F.2d 1455, 1458 (9th Cir. 1985). If conditions are attached to legislation that waives the sovereign immunity of the United States, the conditions must be strictly observed by the courts, and exceptions are not to be readily implied. Block, 461 U.S. at 287. See also Cato v. United States, 70 F.3d 1103, 1107 (9th Cir. 1995) (). Here, plaintiff does not allege in his complaint that the United States, or any of the federal agencies named as defendants above, has waived its immunity.
Plaintiff also seeks monetary compensation from the Social Security Administration. Plaintiff alleges that the Social Security Administration falsely claimed that plaintiff was overpaid Social Security benefits and, in response, terminated those benefits. (Compl. (Doc. No. 1) at 3.)
Section 405(g) of the Social Security Act provides a waiver of sovereign immunity as to final decisions of the Commissioner of Social Security. See 42 U.S.C. § 405(g); Califano v. Sanders, 430 U.S. 99, 108 (1977). Section 405(g) provides, in relevant part, that:
Any individual, after any final decision of the Commissioner of Social Security made after a hearing to which he was a party, irrespective of the amount in controversy, may obtain a review of such decision by a civil action commenced within sixty days after the mailing to him of notice of such decision or within such furthertime as the Commissioner of Social Security may allow. Such action shall be brought in the district court of the United States for the judicial district in which the plaintiff resides . . .
Except as provided by statute, "[n]o findings of fact or decision of the Commissioner shall be reviewed by any person, tribunal, or governmental agency." 42 U.S.C. § 405(h). These regulations "operate as a statute of limitations setting the time period in which a claimant may appeal a final decision of the Commissioner." Berrigan v. Astrue, No. 1:10-cv-000165-GSA, 2010 WL 4392941, *2 (E.D. Cal. Oct. 29, 2010) (citing Bowen v. City of New York, 476 U.S. 467, 479 (1986). See also Matthews v. Eldridge, 424 U.S. 319, 328 n. 9 (1976). This time limit for commencing a civil action under § 405(g) is a condition on the waiver of sovereign immunity, and it must be strictly construed. Bowen, 476 U.S. at 479. Here, plaintiff does not allege in his complaint when his Social Security benefits were allegedly terminated nor does he state that he filed this action within sixty days of receiving a final decision of the Commissioner of Social Security after a hearing to which he was a party.
Second, plaintiff alleges in his complaint that "the defendants have a proclivity to approve benefits monetary pay and medical Medicare Part A and B, and then cancel such benefits awarded." (Compl. (Doc. No. 1) at 2-3.) Specifically, plaintiff alleges that the Social Security Administration and the Mid-American Program Service Center falsely claimed that plaintiff was overpaid Social Security benefits and, in response, terminated plaintiff's Medicare Part B coverage. (Id. at 3.) In this regard, plaintiff alleges that in April of 2011 he learned from the Social Security Administration that he no longer had Medicare Part B coverage. (Id. at 4.)
Title XVIII of the Social Security Act of 1935, commonly referred to as the Medicare Act, "establishe[d] a federally subsidized health insurance program for elderly and disabled persons." Ass'n of Am. Med. Colls. v. United States, 217 F.3d 770, 774 (9th Cir. 2000) (citing 42 U.S.C. § 1395). The Medicare Act contains multiple parts, including Part B, 42 U.S.C. §§ 1395j-1395w-4, which covers medical services provided directly to individuals on a fee-for-service basis, including physician services, medical supplies, and laboratory tests.
Medicare programs are administered by the Department of Health and Human Services through the Centers for Medicare and Medicaid Services and the latter contracts with private contractors to administer payments and make coverage determinations for Medicare and Medicaid beneficiaries. 42 U.S.C. §§ 1395h, 1395u(a). An individual dissatisfied with a decision regarding Medicare benefits is entitled to administrative review at several levels and may be entitled to judicial review of the Secretary's final decision. 42 U.S.C. §§ 1395ff(b)(1), 1395w-22(g)(5).
Judicial review, however, is contingent upon a final decision, which incorporates two elements: (1) presentment of a claim to the Secretary and (2) exhaustion of administrative remedies. Heckler v. Ringer, 466 U.S. 602, 615-17 (1984); Mathews, 424 U.S. at 328-30; Weinberger v. Salfi, 422 U.S. 749, 763-64 (1975); Kaiser v. Blue Cross of Calif., 347 F.3d 1107, 1115-16 (9th Cir. 2003); Linoz v. Heckler, 800 F.2d 871, 876 n. 5 (9th Cir. 1986). Here, plaintiff's does not allege in his complaint that he presented any claim to the Secretary of the Department of Health and Human Services or that he exhausted his administrative remedies.
Finally, plaintiff, a former dentist and oral surgeon for the U.S. Department of Veterans Affairs, alleges in his complaint that the U.S. Department of Labor and the Office of Workers' Compensation Program "took from 1986 to 1991" to grant his disability benefits. (Compl. (Doc. No. 1) at 3.) Plaintiff also alleges that on June 1, 1996, the U.S. Department of Labor and the Office of Workers' Compensation Program "withdrew such approved benefits guaranteed for life" causing plaintiff financial harm. (Id.)
The Federal Employees' Compensation Act ("FECA"), 5 U.S.C. § 8101 et seq., "establishes a comprehensive and exclusive workers' compensation scheme for federal employees."1...
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