United States District Court, S.D. Ohio, Eastern Division
OPINION AND ORDER
C. SMITH, JUDGE UNITED STATES DISTRICT COURT.
matter is before the Court upon Defendant The Lincoln
National Life Insurance Company's Motion to Dismiss
Plaintiff Christopher Yerington's Amended Complaint
(“Lincoln's Motion”) (Doc. 20). The motion is
fully briefed and ripe for disposition. For the following
reasons, Lincoln's Motion is GRANTED.
Christopher Yerington was employed by Consultant
Anesthesiologists, Inc. as a Physician Anesthesiologist from
July 1, 2006 to January 17, 2010. (Doc. 10, Am. Compl. ¶
5). While employed by Consultant Anesthesiologists, Yerington
was a participant in a group long-term disability insurance
policy (the “Plan”) issued and administered by
Defendant The Lincoln National Life Insurance Company
(“Lincoln”). (Id. ¶¶ 2, 6). On
January 17, 2010, Yerington left his employment with
Consultant Anesthesiologists due to a disability, and he was
approved for long-term disability benefits under the Plan
effective on that date. (Id. ¶¶ 5, 8).
under the Plan are determined in part based on what
“period” the claimant is in at the time he or she
seeks benefits. The “Elimination Period” is
defined as “90 calendar days of Disability caused by
the same or a related Sickness or Injury, which must be
accumulated within a 180 calendar day period.” (Doc.
10-1, Plan at 3). Following the end of the Elimination
Period, the claimant enters the “Own Occupation
Period” or “OOP.” (Id.)
Ordinarily, disability plan documents set forth a beginning
and an end date for the OOP, but the Plan document effective
as of Yerington's separation of employment on January 17,
2010, defined the OOP as “a period beginning at the end
of the Elimination Period and ending CUSTOM WORDING
Plan also provides for benefits to claimants who are engaged
in Partial Disability Employment under certain circumstances
during the OOP. (Doc. 10-1, Plan at 24). During the first
five years he received benefits under the Plan, and at least
once thereafter, Yerington inquired with Lincoln as to
whether he could engage in employment and still receive
benefits, and, if so, to what extent. (Doc. 10, Am. Compl.
¶ 15). Lincoln allegedly “refused at all times to
provide accurate and complete answers to his
inquiries.” (Id.). As a result of
Lincoln's refusal to provide him with a clear answer,
Yerington did not avail himself of various employment and
earnings opportunities during the OOP. (Id. ¶
commenced this action on August 23, 2017, in the Court of
Common Pleas of Franklin County, Ohio. Lincoln timely removed
the action to this Court on September 27, 2017.
Yerington's current First Amended Complaint (Doc. 10)
seeks: (1) an injunction, under 29 U.S.C. §
1132(a)(1)(B) and/or § 1132(a)(3), enjoining Lincoln
“from ending the OOP”; and (2) damages in the
amount of at least $2, 000, 000, under 29 U.S.C. §
1132(a)(1)(B), incurred by Yerington in forgone employment
opportunities as a result of Lincoln's refusal to answer
his questions to his satisfaction. Lincoln now moves to dismiss
both counts under Federal Rule of Civil Procedure 12(b)(6)
for failure to state a claim upon which relief can be
STANDARD FOR DISMISSAL UNDER RULE 12(b)(6)
the Federal Rules, any pleading that states a claim for
relief must contain a “short and plain statement of the
claim” showing that the pleader is entitled to such
relief. Fed.R.Civ.P. 8(a)(2). To meet this standard, a party
must allege sufficient facts to state a claim that is
“plausible on its face.” Bell Atl. Corp. v.
Twombly, 550 U.S. 544, 555 (2007). A claim will be
considered “plausible on its face” when a
plaintiff sets forth “factual content that allows the
court to draw the reasonable inference that the defendant is
liable for the misconduct alleged.” Ashcroft v.
Iqbal, 556 U.S. 662, 678 (2009).
12(b)(6) allows parties to challenge the sufficiency of a
complaint under the foregoing standards. In considering
whether a complaint fails to state a claim upon which relief
can be granted, the Court must “construe the complaint
in the light most favorable to the plaintiff, accept its
allegations as true, and draw all reasonable inferences in
favor of the plaintiff.” Ohio Police & Fire
Pension Fund v. Standard & Poor's Fin. Servs.
LLC, 700 F.3d 829, 835 (6th Cir. 2012) (quoting
Directv, Inc. v. Treesh, 487 F.3d 471, 476 (6th Cir.
2007)). However, “the tenet that a court must accept a
complaint's allegations as true is inapplicable to
threadbare recitals of a cause of action's elements,
supported by mere conclusory statements.”
Iqbal, 556 U.S. at 663. Thus, while a court is to
afford plaintiff every inference, the pleading must still
contain facts sufficient to “provide a plausible basis
for the claims in the complaint”; a recitation of facts
intimating the “mere possibility of misconduct”
will not suffice. Flex Homes, Inc. v. Ritz-Craft Corp of
Mich., Inc., 491 Fed.Appx. 628, 632 (6th Cir. 2012);
Iqbal, 556 U.S. at 679.
seeks an injunction preventing Lincoln from ever deeming the
OOP to be at an end, and damages incurred by Yerington in
forgone employment opportunities as a result of his
dissatisfaction with Lincoln's answers to his questions
regarding available benefits during employment. The Court
will address each claim in turn.