Letcher Cnty. Bd. of Educ. v. Hall
Decision Date | 01 July 2022 |
Docket Number | 2020-CA-1404-WC |
Parties | LETCHER COUNTY BOARD OF EDUCATION APPELLANT v. ROGER HALL; DR. DAVID A. NARRAMORE, DMD; RAWLINGS AND ASSOCIATES, PLLC; HONORABLE CHRISTINA D. HAJJAR, ADMINISTRATIVE LAW JUDGE; AND WORKERS' COMPENSATION BOARD APPELLEES |
Court | Court of Appeals of Kentucky |
NOT TO BE PUBLISHED
PETITION FOR REVIEW OF A DECISION OF THE WORKERS' COMPENSATION BOARD ACTION NO. 2015-01407.
BRIEF FOR APPELLANT: W. Barry Lewis Hazard, Kentucky
BRIEF FOR APPELLEE ROGER HALL: Daniel F. Dotson Whitesburg Kentucky
BEFORE: CLAYTON, CHIEF JUDGE; K. THOMPSON AND L. THOMPSON JUDGES.
The Letcher County Board of Education (hereinafter referred to as Letcher County) appeals from an award of workers' compensation benefits to Roger Hall. On Appeal, Letcher County argues that the Kentucky Department of Workers' Claims does not have jurisdiction, that it should not have been ordered to pay for certain medical bills, and that the entire award should be limited to a 6% interest rate. For the following reasons we affirm in part, reverse in part, and remand for further proceedings.
Letcher County Board of Education v. Hall, 576 S.W.3d 123, 125-26 (Ky. 2019). Letcher County then appealed to the Kentucky Supreme Court, which again affirmed. The case was remanded to the ALJ in order to determine if Hall was entitled to workers' compensation benefits.
On remand, additional medical evidence was entered into evidence. During this time, Letcher County filed a medical fee dispute arguing that certain medical bills presented for payment on October 3, 2019, violated regulatory laws.
After all evidence was submitted to the ALJ, the ALJ held that Hall was totally disabled and awarded him benefits at the rate of $153.81 per week from April 19, 2014, through age seventy. As for the medical fee dispute, the ALJ held that the medical bills in dispute were not timely submitted and violated KRS[1]342.020. The ALJ also held that Hall failed to submit a Form 114 pursuant to 803 KAR[2] 25:096 Section 11(2) and (3). This form is required by the regulations in order to be paid for medical treatment. Finally, the ALJ held that the medical bills were not complete statements of services as required by 803 KAR 25:096 Section 6. A statement of services requires a certain medical form, which includes treatment notes and other supporting documentation regarding the billed medical treatment. Finally, the ALJ awarded a 12% interest rate for all unpaid installments of compensation owed through June 28, 2017, and a 6% interest rate on all compensation owed on or after June 29, 2017.[3]
In addition to the above, Letcher County raised a jurisdictional issue. It claimed that the Kentucky Department of Workers' Claims did not have jurisdiction over claims regarding the Commonwealth of Kentucky, its agencies, and exposure to asbestos. Letcher County argued that the Kentucky Claims Commission had sole jurisdiction over this claim. Letcher County cited the 2017 version of KRS 49.020[4] which stated:
The Kentucky Claims Commission created by KRS 49.010 shall have the following powers and authority:
(1) To investigate, hear proof, and compensate persons for damages sustained to either person or property as a proximate result of negligence on the part of the Commonwealth, any of its cabinets, departments, bureaus, or agencies, or any of its officers, agents, or employees while acting within the scope of their employment by the Commonwealth or any of its cabinets, departments, bureaus, or agencies; except, however, regardless of any provision of law to the contrary, the Commonwealth, its cabinets, departments, bureaus, and agencies, and its officers, agents, and employees, while acting within the scope of their employment by the Commonwealth or any of its cabinets, departments, bureaus, or agencies, shall not be liable for collateral or dependent claims which are dependent on loss to another and not the claimant or damages for mental distress or pain or suffering, and compensation shall not be allowed, awarded, or paid for such claims for damages. Furthermore, any damage claim awarded shall be reduced by the amount of payments received or the right to receive payment from workers' compensation insurance; Social Security programs; unemployment insurance programs; medical, disability, or life insurance programs; or other federal or state or private program designed to supplement income or pay claimant's expenses or damages incurred. Any claim against the Commonwealth or its departments, agencies, officers, agents, or employees, or a school district board of education or its members, officers, agents, or employees, for damages sustained as the result of exposure to asbestos before, during, or after its removal from a facility owned, leased, occupied, or operated by the Commonwealth or a school district board of education shall be brought before the commission[.]
(Emphasis added.)
The ALJ was not convinced that this statute created an exclusive jurisdiction in this situation. The ALJ believed that a school employee could still bring an asbestos-related work injury claim against his school employer. In addition, the ALJ found as relevant that the statute indicated that any award would be reduced by workers' compensation awards. This indicated to the ALJ that the Claims Commission was not the exclusive remedy in this situation.
Letcher County appealed to the Workers' Compensation Board. As to the jurisdiction issue, the Board found no error in the ALJ's reasoning that the Department of Workers' Claims does have jurisdiction over this case. The Board reiterated the ALJ's opinion and also stated that KRS 342.630 specifically lists the state of Kentucky and its agencies, including school districts, as being employers that are subject to workers' compensation provisions. The Board also cited to KRS 342.640 which states that employees in service to the state or its agencies, including school boards, were subject to workers' compensation provisions. The Board held that the Kentucky Claims Commission did not have exclusive jurisdiction over this case.
As for the medical fee dispute, the Board found that the bills were timely submitted. The Board held that the bills were not required to be submitted until after an award had been entered. The Board found that Hall met this requirement. The Board also held that Hall's failure to submit his bill payment requests on a Form 114 did not prohibit him from recovering these costs because there was no evidence that Letcher County ever accepted responsibility for Hall's medical treatment or provided the appropriate form to him. The Board remanded this issue to the ALJ to determine if these bills were related to his work-related injuries and, if so, ordered them to be paid. Finally, the Board held that the ALJ did not err in finding some compensation payments are entitled to 12% interest and others 6% interest. This appeal followed.
Letcher County's first argument on appeal is that the Kentucky Claims Commission has exclusive jurisdiction over Hall's claim. As this issue concerns the interpretation of KRS 49.020, we review it de novo. Commonwealth v Long, 118 S.W.3d 178, 181 (Ky. App. 2003).
The Kentucky Claims Commission, also known as the Kentucky Board of Claims, allows people to sue the state of Kentucky and its agencies or agents for acts of negligence. The enacting statutes waive Kentucky's sovereign immunity. Withers v. University of Kentucky, ...
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