Boehm & Asociates v. Workers Compensatiion Appeals Bd.
| Decision Date | 29 November 1999 |
| Citation | 90 Cal.Rptr.2d 486,76 Cal.App.4th 513 |
| Court | California Court of Appeals Court of Appeals |
| Parties | (Cal.App. 3 Dist. 1999) BOEHM & ASSOCIATES et al., Petitioners, v. WORKERS' COMPENSATION APPEALS BOARD and SHELDON MOORE, INC., et al., Respondents. C031700 (San Joaquin) Filed |
Boehm & Associates, Robert Feinglass and Nancy Roberts for Petitioners.
David Bryan Leonard for California Society of Industrial Medicine & Surgery, Inc., as Amicus Curiae on behalf of Petitioners.
Richard A. Krimen, Robert W. Daneri and Don E. Clark for Respondents.
CERTIFIED FOR PUBLICATION
Pursuant to Labor Code section 4603.2, subdivision (b), interest accrues on unpaid bills for compensable treatment of an injured employee under the workers' compensation scheme when the employer challenges liability and does not pay the bill. The parties, here, dispute when the interest begins to accrue. We conclude that interest begins to accrue 60 days after the employer receives the bill, regardless of when the employer's liability is admitted or accepted.
In 1991, Florencio Lopez injured his back while working for Sheldon Moore, Inc. State Compensation Insurance Fund (State Fund) provided the company's workers' compensation coverage. During Lopez's treatment, it was discovered that there was a pre-existing mass in Lopez's back which was compressing his spine. Medical care providers submitted bills as lien claims to State Fund for numerous surgeries and other treatment. State Fund did not pay the bills, denying liability for the treatment.
Although Lopez settled the case with State Fund, the settlement did not resolve the lien claims. Boehm & Associates (Boehm), on behalf of Medi-Cal, U.C. Davis Medical Center, U.C. Davis Professional Billing Group, and St. Joseph's Hospital sought payment from State Fund of $280,050.54 for Lopez's treatment. A workers' compensation judge ruled State Fund was not liable for the costs of Lopez's treatment because the condition was pre-existing. In 1998, however, the Workers' Compensation Appeals Board (the appeals board) determined the injury was compensable under the workers' compensation scheme despite the pre-existing condition because the work-related incident caused the pre-existing condition to become symptomatic and disabling.
State Fund then paid the bills received years earlier for Lopez's treatment and paid interest from the date of the 1998 appeals board decision. Boehm also sought payment of interest pursuant to section 4603.2, subdivision (b)1 from the time of the billing. A workers' compensation judge determined that section 4603.2 did not apply, and the appeals board denied reconsideration.
The interpretation of a labor statute is a legal question which we review independently from the determination of the appeals board. (See Rymer v. Hagler (1989) 211 Cal.App.3d 1171, 1183.) Nonetheless, we generally defer to the appeals board's interpretation of labor statutes, unless the interpretation is clearly erroneous. (See State of California v. Workers' Comp. Appeals Bd. (1996) 44 Cal.App.4th 128, 142.) We begin with the familiar axiom that we must apply the plain language of the statute if it is unambiguous on its face. (Lewis v. Superior Court (1999) 19 Cal.4th 1232, 1245.)
Section 4603.2, subdivision (b) provides, in part: "If an employer contests all or part of a billing, any amount determined payable by the appeals board shall carry interest from the date the amount was due until it is paid." The dispute in this case concerns when a bill is due under this subdivision. The simple answer is found in the first sentence of the subdivision: "Payment for medical treatment provided or authorized by the treating physician shall be made by the employer within 60 days after receipt of each separate, itemized billing, together with any required reports." Accordingly, interest on the bill to be paid by the employer begins to accrue 60 days after a proper bill is received by the employer. If the employer contests liability and waits until the appeals board has determined the employer must pay the bill, the employer must then pay the bill plus interest accrued from 60 days after the employer received the bill.
Despite this plain language, State Fund contends, when it contests liability for the injury, interest on the bills it receives does not begin to accrue until after liability has been finally adjudicated. State Fund's first line of defense against payment of interest from 60 days after receipt of the bills is that it and a workers' compensation judge determined Lopez's injury was nonindustrial (a short-hand way of saying the injury was not compensable under the workers' compensation scheme); therefore, no payment was due until the appeals board reversed the determination of the workers' compensation judges and found that Lopez's injury was industrial. This reasoning defies logic. The appeals board's determination did not change the nature of the injury from nonindustrial to industrial. Instead, the appeals board's determination corrected an error made by State Fund and perpetuated by the workers' compensation judge in characterizing Lopez's injury.
The provision for interest found in section 4603.2, subdivision (b) is similar to prejudgment interest in a civil action. (See Civ. Code, 3287 et seq.; Olson v. Cory (1983) 35 Cal.3d 390, 401-402.) "Every person who is entitled to recover damages certain, or capable of being made certain by calculation, and the right to recover which is vested in him upon a particular day, is entitled also to recover interest thereon from that day, except during such time as the debtor is prevented by law, or by the act of the creditor from paying the debt." (Civ. Code, 3287, subd. (a).) A dispute concerning liability does not preclude prejudgment interest in a civil action. (Olson v. Cory, supra, at p. 402.) Similarly, in the workers' compensation context, a dispute concerning whether an injury is industrial does not preclude the accrual of interest beginning 60 days after a proper bill is received by an employer.
State Fund asserts Boehm was properly denied an award of interest under section 4603.2, subdivision (b) because the appeals board properly ordered State Fund to pay interest from the date of the award pursuant to section 5800.2 This is a non sequitur, a conclusion which does not follow from the premise. The fact that interest was properly awarded under section 5800 does not justify the failure to award interest from the date each bill came due under section 4603.2, subdivision (b). There is no authority for the proposition that these statutes are mutually exclusive.
Section 5800 provides that an appeals board award of compensation carries interest "from the date of the making and filing of said award." State Fund gives no reason why this statute imposing interest from the date of the award precludes interest under a different statute from the date a bill comes due. As with pre- and post-judgment interest in a civil action, pre- and post-award interest can coexist in the workers' compensation scheme.
State Fund complains we "should not adopt Boehm's novel and self-serving interpretation of Labor Code [section] 4603.2 because it defies common sense, it would frustrate the apparent intent of the Legislature, and it would lead to great mischief in the workers' compensation community." This bid to disparage the application of the plain language of the statute does not withstand scrutiny.
The common sense of applying the plain meaning of section 4603.2 is apparent in that it requires the employer rather than the lien claimant to finance the cost of treatment. That said, we must also acknowledge it is not our station to question the common sense of a clear legislative creation. Nevertheless, State Fund labels the accrual of interest from the time the bill is due as a "windfall" and laments that interest on more than a quarter of a million dollars over eight years is "staggering." These labels, however, do not convince us that the Legislature did not mean what it said.
State Fund argues our interpretation of section 4603.2, subdivision (b) would "frustrate the apparent intent of the Legislature" because section 5800 provides for post-award interest. As we noted above, this is a non sequitur.
In passing, State Fund also argues our interpretation of section 4603.2, subdivision (b) would have a chilling effect on employer's rights to litigate disputed liability. State Fund fails to explain why there would be such a chilling effect, and we are unable to discern one. If an employer...
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Boehm & Associates v. W.C.A.B.
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