UFE Inc. v. Labor and Industry Review Com'n

• Decision Date: 22 May 1996
• Docket Number: No. 94-2794,94-2794
• Parties: UFE INCORPORATED and Pacific Indemnity Company, Plaintiffs-Appellants-Petitioners, v. LABOR AND INDUSTRY REVIEW COMMISSION and Jerry Huebner, Defendants-Respondents.
• Court: Wisconsin Supreme Court

Page 57

548 N.W.2d 57

201 Wis.2d 274

UFE INCORPORATED and Pacific Indemnity Company, Plaintiffs-Appellants-Petitioners, v. LABOR AND INDUSTRY REVIEW COMMISSION and Jerry Huebner,

Defendants-Respondents.

No. 94-2794.

Supreme Court of Wisconsin.

Argued April 2, 1996.

Decided May 22, 1996.

For the plaintiffs-appellants-petitioners there were briefs by Bradley C. Lundeen, R. Michael Waterman and Mudge Porter Lundeen & Seguin, S.C., Hudson and oral argument by Bradley C. Lundeen.

For the defendants-respondents the cause was argued by Lowell E. Nass, Assistant Attorney General, with whom on the brief was James E. Doyle, Attorney General.

Amicus curiae brief was filed by Philip Lehner and Capwell and Berthelsen, Racine for the Wisconsin Manufacturers and Commerce and Civil Trial Counsel of Wisconsin.

STEINMETZ, Justice.

The issue in this case is whether Wis.Stat. § 102.42(2)(a) (1993-94), ¹ a section of the Worker's Compensation Act (the Act), requires UFE Incorporated (UFE) to pay the out-of-state health care expenses incurred by one of its employees without UFE's consent. The court of appeals interpreted Wis.Stat. § 102.42(2)(a) as not requiring UFE's consent to the out-of-state health care expenses since the expenses were incurred through a referral from a practitioner who was chosen in accordance with the statute. See UFE Inc. v. LIRC, 193 Wis.2d 361, 369-70, 534 N.W.2d 627 (Ct.App.1995). We conclude that the statute is ambiguous and the interpretation of the Labor & Industry Review Commission (LIRC) should be given due deference. Since we agree that this interpretation is the most reasonable under the statute, and since it promotes the underlying purpose of the Act, we affirm the court of appeals.

Jerry Huebner worked as a press operator for UFE. After 13 years of employment, Huebner developed work-related right and left wrist problems. After obtaining medical treatment from several doctors, Huebner's family physician, Dr. Eugene Jonas, eventually referred him to the Mayo Clinic in Rochester, Minnesota, for further evaluation. Huebner visited the Mayo Clinic on three occasions and incurred medical expenses totalling $2,204.40. Although Huebner did not seek or obtain UFE's consent prior to obtaining treatment at the Mayo Clinic, he presented his medical expenses to UFE for payment. Relying on Wis.Stat. § 102.42(2)(a), UFE informed Huebner that it would not pay the Mayo Clinic expenses because Huebner had failed to obtain its consent prior to undergoing medical treatment out-of-state.

Huebner subsequently filed an application with the LIRC seeking payment of the Mayo Clinic medical expenses. A hearing was held before an administrative law judge (ALJ) who concluded that UFE was responsible for the expenses. The ALJ found that Wis.Stat. § 102.42(2)(a) only requires an employee to obtain consent from his or her employer before undergoing out-of-state medical care when the employee "chooses" to obtain the out-of-state treatment. Here, however, the ALJ reasoned, Huebner's Wisconsin licensed physician referred him to the Mayo Clinic; Huebner did not "choose" the out-of-state treatment.

On review, LIRC agreed with the ALJ's conclusion and reasoning. It stated:

[T]he commission agrees with the administrative law judge that the applicant did not go to the Mayo Clinic by choice but because his family doctor referred him there, and that prior permission of the carrier was not necessary for the referral to the Mayo Clinic.

UFE, pursuant to Wis.Stat. § 102.23, petitioned for judicial review of the commission's decision. The St. Croix County Circuit Court, Judge C.A. Richards, affirmed LIRC's interpretation of the statute. UFE then sought relief from the court of appeals claiming that LIRC's interpretation contravened the plain language of the statute. The court of appeals affirmed and UFE and Pacific Indemnity Company, UFE's insurer, petitioned this court for review.

This case requires us to interpret Wis.Stat. § 102.42(2)(a) of the Worker's Compensation Act. The ultimate goal of statutory interpretation is to ascertain the intent of the legislature. See Rolo v. Goers, 174 Wis.2d 709, 715, 497 N.W.2d 724, 726 (1993). The first step of this process is to look at the language of the statute. See In Interest of Jamie L., 172 Wis.2d 218, 225, 493 N.W.2d 56, 59 (1992). If the plain meaning of the statute is clear, a court need not look to rules of statutory construction or other extrinsic aids. State Historical Society v. Maple Bluff, 112 Wis.2d 246, 252, 332 N.W.2d 792 (1983). Instead, a court should simply apply the clear meaning of the statute to the facts before it. If, however, the statute is ambiguous, this court must look beyond the statute's language and examine the scope, history, context, subject matter and purpose of the statute. See Rolo, 174 Wis.2d at 715, 497 N.W.2d 724. Furthermore, if an administrative agency has been charged with the statute's enforcement, a court may also look to the agency's interpretation. ² See State ex rel. Parker v. Sullivan, 184 Wis.2d 668, 699, 517 N.W.2d 449 (1994).

We first, therefore, turn to the statute itself to determine if it is ambiguous. Wisconsin Statute § 102.42(2)(a) allows an employee to have "his or her choice of any physician, chiropractor, psychologist or podiatrist licensed to practice and practicing in this state for treatment of the injury." If, however, the employee wishes to choose a non-Wisconsin practitioner, the employer must consent. The last sentence of the subsection, however, reads: "Treatment by a practitioner on referral from another practitioner is deemed to be treatment by one practitioner." Wis.Stat. § 102.42(2)(a).

It is unclear whether the requirement of employer consent applies to all out-of-state medical care or only the initial choice of practitioner made by the employee. One reasonable interpretation is that if treatment by a second practitioner through a referral is characterized by the statute as "treatment" by the original practitioner, then only the original practitioner need be licensed to practice in Wisconsin. UFE's position, however, that the statute expressly forbids all out-of-state treatment without mutual consent, is also reasonable.

The statute's ability to support two reasonable constructions creates an ambiguity which cannot be resolved through the language of the statute itself. "[A] statutory provision is ambiguous if reasonable minds could differ as to its meaning." Harnischfeger Corp. v. LIRC, 196 Wis.2d 650, 662, 539 N.W.2d 98 (1995). We therefore must turn to extrinsic sources and rules of statutory construction in order to determine the intent of the legislature in enacting Wis.Stat. § 102.42(2)(a).

One such extrinsic source is the interpretation of the agency charged with enforcing the statute. LIRC concluded that a referral by a practitioner in Wisconsin for out-of-state treatment remains "treatment" by the original Wisconsin practitioner. Furthermore, it reasoned that if an employee receives out-of-state treatment recommended by his or her initial Wisconsin practitioner, it is not because the employee has chosen such treatment, but because his or her physician has determined that such care is necessary for the employee's well-being. Since Huebner's original physician was chosen pursuant to the statute, and since Huebner did not voluntarily choose to obtain the out-of-state treatment, LIRC determined that he was not required to obtain approval from UFE.

Although we are not bound by LIRC's interpretation, we do defer to agency interpretations in certain situations. See Parker, 184 Wis.2d at 699, 517 N.W.2d 449. This court has identified three distinct levels of deference granted to agency decisions: great weight deference, due weight deference and de novo review. See Jicha v. State DILHR, 169 Wis.2d 284, 290, 485 N.W.2d 256 (1992). Which level is appropriate "depends on the comparative institutional capabilities and qualifications of the court and the administrative agency." Parker, 184 Wis.2d at 699, 517 N.W.2d 449. Many times, as in this case, the parties to an action strongly disagree on the proper standard to be employed.

LIRC contends that its interpretation of Wis.Stat. § 102.42(2)(a) should be accorded great weight deference. We disagree. This court recently addressed great weight deference in detail in Harnischfeger. In order for an agency interpretation to be accorded great weight deference, all four of the following requirements must be met:

(1) the agency was charged by the legislature with the duty of administering the statute; (2) that the interpretation of the agency is one of long-standing; (3) that the agency employed its expertise or specialized knowledge in forming the interpretation; and (4) that the agency's interpretation will provide uniformity and consistency in the application of the statute.

Harnischfeger, 196 Wis.2d at 660, 539 N.W.2d 98.

LIRC's experience with Wis.Stat. § 102.42(2)(a) clearly does not satisfy the requirements of the Harnischfeger test. It has only issued three decisions regarding which out-of-state medical expenses incurred without the employer's consent are covered under the Act. See AMC v. LIRC, No. 84-CV-5736 Dane County (June 10, 1985), based on commission decision dated September 27, 1984; Allans Electric Inc. v. LIRC, No. 88-CV-1058 Wood County (Nov. 16, 1989), based on a commission decision dated October 10, 1988; and Olson v. Northern Engraving Corp., No. 90-053540 (Dec. 30, 1992). Furthermore, only one of these, Olson, addressed the specific issue involved in this case. Although LIRC's position in Olson is consistent with its position here, one holding hardly constitutes the type of expertise and experience needed by an agency for it to be afforded great weight deference by a court. Cf. Harnischfeger, 196 Wis.2d at 660-61, 539 N.W.2d 98; Parker, 184 Wis.2d at 700-03, 517 N.W.2d 449.

UFE, on the other hand, argues that this court should apply a...