Gamma Healthcare Inc. v. Estate Burrell Grantham

• Court: Mississippi Court of Appeals
• Writing for the Court: WILSON, P.J., FOR THE COURT:
• Citation: Gamma Healthcare Inc. v. Estate Burrell Grantham, 356 So.3d 135 (Miss. App. 2020)
• Docket Number: 2019-WC-00913-COA.
• Decision Date: 01 December 2020
• Parties: GAMMA HEALTHCARE INC. and Employers Insurance Company of Wausau, Appellants v. ESTATE OF Sharon Burrell GRANTHAM, Appellee.

356 So.3d 135

GAMMA HEALTHCARE INC. and Employers Insurance Company of Wausau, Appellants

v.ESTATE OF Sharon Burrell GRANTHAM, Appellee.

NO. 2019-WC-00913-COA.

Court of Appeals of Mississippi.

December 1, 2020.

Rehearing Denied March 30, 2021.

ATTORNEYS FOR APPELLANTS: M. REED MARTZ , D. BETH SMITH ,

ATTORNEY FOR APPELLEE: STEVEN HISER FUNDERBURG , Jackson.

EN BANC.

WILSON, P.J., FOR THE COURT:

¶1. Sharon Grantham experienced permanent paraplegia as a result of a work-related automobile accident. Her employer, Gamma Healthcare Inc., and its workers' compensation insurance carrier, Employers Insurance Company of Wausau (collectively, "the Employer/Carrier") began paying workers' compensation benefits and providing medical treatment, but disputes later arose regarding Grantham's requests for modifications to her home and a wheelchair-accessible van. The administrative judge (AJ) ordered the Employer/Carrier to pay for necessary modifications and a wheelchair-accessible van. As relevant to this appeal, the AJ and the Workers' Compensation Commission also ordered the Employer/Carrier to replace the failed or failing septic and HVAC systems at Grantham's home and to pay for property/collision insurance for Grantham's van. In a separate order, the Commission also ordered the Employer/Carrier to pay attorney's fees of $4,000 as a sanction for appealing the AJ's order to replace the septic and HVAC systems.

¶2. On appeal, the Employer/Carrier challenges the Commission's orders regarding the septic and HVAC systems, insurance, and sanctions. Unfortunately, Grantham passed away after the appeal was filed. Grantham's Estate was substituted as the appellee, and the Estate concedes that Grantham's death abates the Employer/Carrier's obligations to make home repairs and pay for insurance on the van. For that reason, the primary issues in this appeal are moot, and the appeal from Commission's orders requiring the Employer/Carrier to replace the septic and HVAC systems and pay for van insurance is dismissed. In addition, the Commission's and AJ's orders on those subjects are vacated. We do not address the merits of those issues because they are moot, but we vacate the underlying orders because they require the Employer/Carrier to take actions that the parties agree are no longer required. Finally, we reverse and render the Commission's sanctions order. Sanctions were inappropriate because the Employer/Carrier presented at least a colorable legal argument in support of its appeal.

FACTS AND PROCEDURAL HISTORY¹

¶3. In October 2015, Grantham experienced permanent paraplegia as a result of a work-related automobile accident. The Employer/Carrier reported the injury and began paying workers' compensation benefits and providing medical treatment.

¶4. Several months later, disputes arose between Grantham and the Employer/Carrier regarding the scope and nature of necessary modifications to Grantham's home. In August 2016, Grantham filed a petition to controvert with the Workers' Compensation Commission and a motion to compel the Employer/Carrier to make necessary modifications to her home. In February 2017, Grantham filed a motion to compel the Employer/Carrier to provide a wheelchair-accessible van. In March 2017, the AJ ordered the Employer/Carrier to make necessary home modifications, provide Grantham with a wheelchair-accessible van, and pay "for property/collision insurance premiums associated with the enhanced cost of the handicapped vehicle." The AJ later entered an order clarifying that Grantham would "be responsible for premiums associated with liability and/or uninsured motorist coverage and that the [Employer/Carrier would] be responsible for insurance premiums associated with property/collision coverage for the vehicle." The Employer/Carrier filed a petition for full Commission review of the AJ's ruling on insurance. However, the Commission declined to review the AJ's interlocutory ruling and dismissed the petition without prejudice.

¶5. In April 2017, Grantham filed a motion asking the AJ to appoint a "neutral case manager" to assist with recurring disagreements between the parties regarding home modifications. Grantham argued that "a neutral case manager appointed by the Commission to assess, observe and make recommendations to the [AJ] would be in the best interest of [Grantham] and would promote smooth administration of this claim." In response, Employer/Carrier argued that the Workers' Compensation Law did not authorize the AJ to appoint a neutral case manager and that a neutral case manager was "not needed." In June 2017, the AJ granted Grantham's motion and appointed Barbara Oltremari, a registered nurse, "to perform nurse case management services limited to ... an inspection of [Grantham's] residence to include home modifications and to provide the parties and the [AJ] with a report and opinions as to whether the home modifications are complete, reasonable and adequate for [Grantham's] health and safety." Oltremari performed her inspection and submitted her report in July 2017.

¶6. In November 2017, Grantham filed a motion to compel the Employer/Carrier to pay for various home modifications that Oltremari had recommended. Among other things, Grantham asked the AJ to compel the Employer/Carrier "to have [her septic and HVAC] systems evaluated and repaired, if necessary." The AJ granted Grantham's motion.

¶7. Evaluations showed that Grantham's "septic system [was] not working at all" and needed to be replaced and that her HVAC system was "extremely old" and also needed to be replaced. The HVAC system failed completely and ceased working after the evaluation was performed. In July 2018, Grantham filed a motion to compel the Employer/Carrier to replace her septic and HVAC systems.

¶8. In response, the Employer/Carrier argued that the evaluation of the septic system showed that the system's failure was the result of a myriad of "longstanding" issues that predated and were unrelated to Grantham's injury and were "not the responsibility of the [Employer/Carrier] to remedy." Similarly, the Employer/Carrier argued that the evaluation of the HVAC system showed that the system was already "two to four years beyond its life expectancy at the time of [Grantham's] accident" and revealed "numerous other problems with the system, most of which [were] attributable to lack of maintenance." They argued that the failure of the HVAC system was unrelated to Grantham's work-related injury and was "not the responsibility of the [Employer/Carrier] to remedy."

¶9. In September 2018, the AJ entered an order stating that she would "conference with the appointed nurse case manager before ruling on [Grantham's] motion."² In October 2018, the AJ directed the nurse case manager to conduct a new inspection and provide an updated report on the condition of Grantham's home. In November 2018, after considering the nurse case manager's updated report, the AJ ordered the Employer/Carrier to, among other things, replace Grantham's septic and HVAC systems.

¶10. The Employer/Carrier filed a petition for full Commission review of the AJ's order. As relevant to this appeal, the Employer/Carrier argued that the AJ's order to replace Grantham's septic and HVAC systems was "beyond the [Employer/Carrier's] obligations [under] Mississippi Code Annotated [section] 71-3-15(1)."³ The Employer/Carrier also "re-urge[d]" its prior petition for review regarding insurance for Grantham's van. Finally, the Employer/Carrier argued that the AJ's reliance on the opinions of a nurse case manager was an abuse of discretion and a due process violation. In a separate motion, the Employer/Carrier asked the Commission to admit additional evidence: a rebuttal report from "Accessible Housing Services."

¶11. In February 2019, the Commission entered a one-page order summarily affirming the AJ's order. The Commission also denied the Employer/Carrier's motion to admit additional evidence.

¶12. In addition, in a separate order entered the same day, the Commission sua sponte sanctioned the Employer/Carrier pursuant to Mississippi Code Annotated section 71-3-59(2) (Rev. 2011) and ordered the Employer/Carrier to pay $4,000 in attorney's fees. The Commission ruled that with respect to the AJ's order to replace Grantham's septic and HVAC systems, the Employer/Carrier had appealed "without reasonable grounds" because there was no "medical evidence" to dispute that the nature of Grantham's injuries required her to have working septic and HVAC systems.

¶13. After the Commission entered a final judgment in the case, the Employer/Carrier filed a notice of appeal. On appeal, the Employer/Carrier argues that (1) the Commission's orders requiring it to replace Grantham's septic and HVAC systems and pay for insurance on her van exceed the scope of relief available under the Workers' Compensation Law; (2) the Commission erred and violated the Employer/Carrier's due process rights by relying on the report of the nurse case manager and then excluding the Employer/Carrier's rebuttal evidence; and (3) the Commission erred by awarding sanctions against the Employer/Carrier for appealing the AJ's order to replace the septic and HVAC systems.

¶14. Unfortunately, Grantham passed away while this appeal was pending. We granted Grantham's Estate's motion to be substituted as the appellee. See M.R.A.P. 43(a). We then ordered the parties to file supplemental briefs addressing the effect, if any, of Grantham's death on the appeal, including whether the appeal was moot and whether any of the Commission's orders should be vacated. Grantham's Estate candidly concedes that Grantham's death abates the Employer/Carrier's obligations to replace the septic and HVAC system and pay insurance premiums. However, the parties agree that the Commission's order imposing sanctions is not moot. In addition, the parties both argue that we may or should address other issues raised by the appeal under exceptions to the mootness...