On Demand Sedan v. Valdes
| Decision Date | 20 April 2023 |
| Docket Number | 84586-COA |
| Parties | ON DEMAND SEDAN; PTSIG; AND SEDGWICK CMS, Appellants, v. LAZARO VALDES (DECEASED), MARIA BON-ALVAREZ, SURVIVING SPOUSE, Respondents. |
| Court | Nevada Court of Appeals |
UNPUBLISHED OPINION
ORDER OF AFFIRMANCE
Gibbons C.J.
On Demand Sedan Services, Inc., Preferred Transportation Self-Insured Group (PTSIG), and York Risk Services Group Inc. (acquired by Sedgwick CMS), appeal from a district court order denying their petition for judicial review. Eighth Judicial District Court, Clark County; Nadia Krall, Judge.
While driving a limousine for On Demand Sedan Services, Lazaro Valdes was involved in a motor vehicle accident in which he sustained serious injuries.[1] He was transported to a hospital and diagnosed with traumatic brain injury, aortic dissection liver and spleen lacerations, kidney infarction, and rib fractures. Doctors attempted to operate to repair the aortic dissection, but Valdes did not survive. Paperwork followed including an Employee's Claim for Compensation/Report of Initial Treatment (Form C-3) completed on behalf of Valdes at the hospital, a fatality report prepared by On Demand Sedan Services, and a police traffic accident report that was completed shortly after the accident.
The documents were inconsistent about the cause of the accident. While On Demand Sedan Services' fatality report stated that the accident was caused when "[o]ur driver was cut off by a white truck and we swerved to avoid accident," the police traffic accident report included no information indicating that Valdes was, in fact, cut off. The police traffic accident report indicated that Valdes lost control of the car he was driving, crossed the median, and drove headfirst into oncoming traffic. Form C-3 stated that Valdes lost control of the car while trying to avoid an accident. Additionally, one witness told the reporting police officer that he saw Valdes slumped over the steering wheel in the car as he crossed the median.
The coroner performed a postmortem examination of Valdes's body and prepared an autopsy report that included toxicology results revealing the presence of methamphetamine, amphetamine, and THC in Valdes's blood.[2] The coroner opined that the cause of death was "multiple blunt force injuries due to motor vehicle collision," and that "[o]ther significant contributing conditions include[ed] aortic dissection and methamphetamine intoxication."
Valdes's spouse, Maria Bon-Alvarez, submitted a timely claim for spousal survivor death benefits pursuant to NRS 616C.505.[3] The claim was submitted to York Risk Services Group, Inc., the third-party administrator for the insurer, PTSIG. York denied Maria's claim pending further investigation. Maria appealed this initial denial to a hearing officer, but the hearing officer never heard that appeal. After receiving the toxicology report and further investigation, York issued a denial of Maria's claim based on Valdes's toxicology results. Maria again appealed York's denial of her claim to a hearing officer. The parties agreed to bypass a hearing officer on both appeals and the two appeals were consolidated and brought directly before an appeals officer.
During the hearing before the appeals officer, Maria offered her own testimony and the testimony of an expert forensic toxicologist, Dr. Raymond Kelly. Dr. Kelly testified that he did not agree with the medical examiner's opinion that methamphetamine intoxication significantly contributed to Valdes's death.[4] Dr. Kelly also concluded that there was insufficient evidence to show that there was any impairment based on the lack of a description of bad driving before the collision and his belief that the nature of the event may have made it difficult for the investigating officers to piece together how the accident transpired. Lastly, Dr. Kelly testified that the findings of the NMS Lab report did not support or rebut Valdes's impairment or non-impairment because it reported levels that were not drug levels, meaning they were "just levels of normal body constituents . . . nothing that's out of the normal range in terms of these substances tested for." Maria also testified at the hearing before the appeals officer. She testified Valdes missed work the day before the fatal accident because he was sick and took over-the-counter medications for his symptoms.
The appeals officer affirmed the denial of compensation for Maria's claim, finding that she "failed to prove, by a preponderance of the evidence, that the controlled substances in [Valdes's] system were not the proximate cause of his death." The appeals officer concluded that the totality of the circumstances based on the evidence and testimony presented did not overcome the presumption that Valdes's accident was not industrially related due to illicit drug use.
Maria filed a petition for judicial review of the appeals officer's decision and order in the district court and argued that the methamphetamine found in Valdes's blood was not sufficiently shown to have derived from a controlled substance. The district court found that "the underlying record on appeal does not contain substantial evidence to support the Appeals Officer's finding that the methamphetamine chemical variant found in the Decedent['s] body, is a 'controlled substance' for purposes of denying [Maria's] industrial spousal death benefit claim." The court also found that the appeals officer's conclusion was made "without evidentiary support in the record" and "notwithstanding there exists a legal over-the-counter, commercially available, chemical variant of methamphetamine that was not tested for by the Coroner, nor any other party." The district court remanded the matter to the appeals officer to ascertain if NRS 616C.230(1)(d) is applicable to Maria's claim and directed the appeals officer to determine if any factual and legal bases existed as to whether the methamphetamine chemical variant found in Valdes's body was a controlled substance for purposes of NRS 616C.230(1)(d).
The appeals officer on remand issued an interim order directing York to request NMS labs to differentiate the isomers of the methamphetamine found in Valdes's body so that the appeals officer could determine whether the methamphetamine chemical variant was a controlled substance or was the exempted form found in legal over-the-counter medications. NMS Labs informed York that it did not have any additional samples from Valdes to test and, therefore, could not provide the test results that the appeals officer requested.
The appeals officer then issued a supplemental decision and order reversing York's denial of liability for Maria's claim and concluding that Maria was entitled to industrial spousal death benefits under NRS 616C.505. The supplemental decision and order concluded the following: (1) that Maria overcame the presumption that controlled substances were a contributing cause of her husband's industrial accident and death by clear and convincing evidence; (2) that the manifest weight of the evidence indicated that Valdes most likely lost control of his vehicle during an evasive maneuver and faced an increased risk of injury under the street-risk rule;[5](3) that under Nevada's no fault based workers' compensation laws,[6] the negligence or fault of Valdes had no bearing on the compensability of Maria's claim; and finally, (4) that under the "mixed-risk" analysis as set forth in Baiguen[7], although there may have been multiple causes that contributed to Valdes losing control of his vehicle and crashing it, Valdes's workplace conditions contributed to his accident and death and controlled substances did not play a role in the accident. The supplemental decision and order required PTSIG, by way of York, to initiate the spousal death benefit payments to Maria as accrued from the date of Valdes's death plus statutory interest and all retroactive benefits owed.
On Demand Sedan Services, PTSIG, and York (collectively On Demand) appealed the reversal by filing a petition for judicial review, which was denied by the district court. The district court found that the appeals officer correctly applied the actual street-risk and mixed-risk doctrines to the facts of the case. The district court also found that On Demand never showed if the chemical variant of methamphetamine found in Valdes's body was legal or illegal, so NRS 616C.230 was not triggered, and Maria did not need to rebut a presumption that Valdes was under the influence of a controlled substance during his accident. This appeal followed.
On appeal, On Demand argues that the appeals officer's supplemental decision and order is unsupported by substantial evidence, and therefore the district court's order of denial of judicial review should be reversed. We disagree.
An administrative decision is reviewed for substantial evidence under an abuse of discretion standard. Nellis Motors v. Dep't of Motor Vehicles, 124 Nev. 1263, 1269, 197 P.3d 1061, 1066 (2008). "Substantial evidence is that which a reasonable mind might accept as adequate to support a conclusion." Id. (internal quotation marks omitted). An abuse of discretion occurs when an administrative agency's decision is arbitrary or capricious. Weaver v. Dep't of Motor Vehicles, 121 Nev. 494, 498, 117 P.3d 193, 196 (2005). Review of an administrative decision does not include reweighing evidence or reassessing a witness's credibility. Id.
On Demand argues that Maria failed to rebut the presumption raised by NRS 616C.230(1)(d) because she did not prove that the methamphetamine chemical variant found in Valdes's blood came from an over-the-counter medication by clear and convincing evidence. On Demand also challenges several of Dr Kelly's statements and opinions. ...
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