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RUMPH v. STATE WORKMEN'S INS. FUND

May 8, 1997

NATHANIEL RUMPH,
v.
STATE WORKMEN'S INSURANCE FUND, ET AL.



The opinion of the court was delivered by: BRODERICK

 Broderick, J.

 May 8, 1997

 Presently before the Court in this civil rights action for denial of workmen's compensation benefits is Defendants' motion for summary judgment. Defendants argue that the Plaintiff's claims are barred by the Eleventh Amendment, by the exclusivity provisions of the state workmen's compensation act, and by the Plaintiff's inability to prevail as a matter of law under 42 U.S.C. § 1983 (1993). Because the Court finds that Defendants qualify for Eleventh Amendment immunity and because Plaintiff has failed to establish any element necessary to prove his due process claim, the Court will grant Defendants' motion for summary judgment and enter judgment in their favor.

 I. BACKGROUND

 Plaintiff Nathaniel Rumph commenced this action on February 27, 1996, against the State Workmen's Insurance Fund ("SWIF"), the statutorily created and state-operated insurance carrier which provided workmen's compensation insurance to his employer. Plaintiff also named as defendants Charles R. Fleming and R. Alvin Bensley, Jr., two SWIF employees who were involved in processing his claim; the State Workmen's Insurance Board ("SWIB"), a statutorily created board which administers SWIF; and the officers of SWIB, Linda S. Kaiser, the Commonwealth's insurance commissioner; Catherine Baker Knoll, the Commonwealth's former treasurer; and Johnny J. Butler, the Commonwealth's secretary of labor and industry. The Plaintiff failed to specify whether he is suing these defendants in their official capacities or their individual capacities, or both.

 In Count I of his complaint, Plaintiff alleges that Defendants unjustifiably denied him workmen's compensation benefits without due process of law in violation of the Fourteenth Amendment to the United States Constitution. In Count II, Plaintiff alleges that Defendants violated their obligations under the Pennsylvania Workmen's Compensation Act of 1915, as amended, 77 P.S. § 1 et seq. (Purdon's 1992). Plaintiff seeks only monetary relief in the form of compensatory damages, punitive damages, and attorneys fees.

 On April 29, 1996, Defendants filed motions to dismiss pursuant to Fed. R. Civ. P. 12(b)(1) and 12(b)(6). Defendants argued that the Eleventh Amendment barred Plaintiff's claims, that the individual defendants acting in their official capacities were not "persons" under Section 1983, and that Plaintiff failed to state a viable due process claim against any defendant. By Orders dated October 17, 1996, and November 5, 1996, the Court denied Defendants' motions to dismiss on the ground that Defendants had failed to meet their burden of proving the affirmative defense of the Eleventh Amendment. See Christy v. Pennsylvania Turnpike Comm'n, 54 F.3d 1140, 1144 (3d Cir. 1995). The Court also determined that Plaintiff's complaint alleged facts in support of his claims which could possibly entitle him to relief. See H.J. Inc. v. Northwestern Bell Tel. Co., 492 U.S. 229, 249-50, 106 L. Ed. 2d 195, 109 S. Ct. 2893 (1989); Conley v. Gibson, 355 U.S. 41, 45-46, 2 L. Ed. 2d 80, 78 S. Ct. 99 (1957).

 At a subsequent pre-trial conference, counsel for Defendants suggested that the case could be decided on summary judgment after limited discovery. Accordingly, by Order dated January 10, 1997, the Court invited the parties to submit motions for summary judgment. Defendants filed a motion for summary judgment on February 10, 1997, and Plaintiff filed his response on March 14, 1997, after obtaining leave from the Court for an extension of time. Defendants submitted a reply on March 25, 1997.

 II. STANDARD OF REVIEW

 The law is clear that when a motion for summary judgment is properly filed under Fed. R. Civ. P. 56, the non-moving party cannot rest on the mere allegations of the pleadings. Celotex Corp. v. Catrett, 477 U.S. 317, 91 L. Ed. 2d 265, 106 S. Ct. 2548 (1986); Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 91 L. Ed. 2d 202, 106 S. Ct. 2505 (1986). Rather, in order to defeat the motion for summary judgment, the non-moving party, by its own affidavits, or by depositions, answers to interrogatories or admissions on file, as stated in Rule 56(e), "must set forth specific facts showing that there is a genuine issue for trial."

 As Celotex teaches, "the plain language of Rule 56(c) mandates the entry of summary judgment, after adequate time for discovery and upon motion, against a party who fails to make a showing sufficient to establish the existence of an element essential to that party's case, and on which that party will bear the burden of proof at trial." Celotex, 477 U.S. at 322. Where the nonmoving party fails to make such a showing with respect to an essential element of its case, "there can be 'no genuine issue as to any material fact,' since a complete failure of proof concerning an essential element of the nonmoving party's case necessarily renders all other facts immaterial." Id. at 323. "The moving party is 'entitled to a judgment as a matter of law' because the nonmoving party has failed to make a sufficient showing on an essential element of her case with respect to which she has the burden of proof." Id.

 III. STATEMENT OF FACTS

 Plaintiff was injured on April 28, 1995, while working at his place of employment, Weymouth Stables, in Kennett Square, Pennsylvania. Plaintiff states that he injured his lower back and hip when a large tree limb he was clearing fell on him. He reported the injury to his employer, who submitted a claim in June, 1995 to its workmen's compensation carrier, the State Workmen's Insurance Fund. Plaintiff returned to work soon after his injury.

 Claims adjusters at SWIF initially determined that Plaintiff sought payment for only medical expenses, since he had returned to work within seven days of his injury and was thus ineligible for total disability benefits. See 77 P.S. § 511 (Purdon's 1992). Accordingly, SWIF began to pay the Plaintiff's medical bills associated with his April 28th injury. On September 29, 1995, however, Plaintiff stopped working upon suggestion of his orthopedic surgeon and requested total disability benefits under the Workmen's Compensation Act.

 SWIF received notice from Plaintiff's employer on October 5, 1995 that he had stopped working. Although a contractor for SWIF investigated Plaintiff's disability claim and recommended that it be accepted, SWIF employees Flemming and Bensley determined that the claim required further investigation to certify that Plaintiff's injuries were work-related. Therefore, SWIF issued Plaintiff a "Notice of Compensation Denial" on November 20, 1995, and suspended payment of his medical expenses.

 The Notice of Compensation Denial explained that Plaintiff's claim was being denied because SWIF could not conclude that his injuries were work-related. The denial also instructed the Plaintiff to cooperate further in the investigation of his claim. Plaintiff underwent an independent medical examination on December 8, 1995, pursuant to Section 314 of the Act, 77 P.S. § 651 (Purdon's 1992).

 When further efforts to process his claim proved fruitless, Plaintiff filed a formal petition for benefits on January 15, 1996, pursuant to Section 402 of the Act, 77 P.S. § 711 (Purdon's 1992). Plaintiff sought total disability benefits, medical expenses, and counsel fees. SWIF denied all substantive allegations in the petition. Soon thereafter, Plaintiff filed the instant civil rights action claiming that SWIF had unjustifiably denied him workmen's compensation benefits in violation of the Fourteenth Amendment and the Workmen's Compensation Act. Plaintiff alleged that the Defendants had unreasonably denied him benefits and had failed to respond to several requests for an explanation for his denial.

 After Plaintiff filed this lawsuit, SWIF accepted his workmen's compensation claim and issued him a "Notice of Compensation Payable" on March 1, 1996. Thus, at a hearing on April 11, 1996, Worker's Compensation Judge Seymour Nathanson ruled that the issue of Plaintiff's entitlement to total disability benefits had become moot. Judge Nathanson conducted an additional hearing on July 25, 1996, however, to consider the reasonableness of SWIF's actions as well as Plaintiff's petition for costs and penalties.


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