Porter v. Queens Med. Ctr., CAAP-13-0006215
| Decision Date | 27 March 2015 |
| Docket Number | NO. CAAP-13-0006215,CAAP-13-0006215 |
| Court | Hawaii Court of Appeals |
| Parties | ADELINE N. PORTER, Claimant-Appellant, v. THE QUEENS MEDICAL CENTER, Employer-Appellee, Self-Insured |
NOT FOR PUBLICATION IN WEST'S HAWAI'I REPORTS AND PACIFIC REPORTER
APPEAL FROM THE LABOR AND INDUSTRIAL RELATIONS APPEALS BOARD
(CASE NO. AB 2012-438)
(2-02-15470, 2-02-14441, 2-02-14445, 2-02-15471, 2-10-07337)
(
Claimant-Appellant Adeline N. Porter (Porter) appeals from the December 3, 2013 "Order" and the December 3, 2013 "Decision and Order," both issued by the Labor and Industrial Relations Appeals Board (LIRAB).
On appeal, Porter contends the LIRAB erred when it affirmed a decision from the Department of Labor and Industrial Relations, Disability Compensation Division (DCD), which denied her request to reopen her workers' compensation case for Multiple Chemical Sensitivity (MCS) related injuries that occurred on August 9, 2002, August 31, 2002, November 6, 2002, and November 8, 2002, and on May 13, 2003 (together, injury claims). As best as can be determined, Porter also contends the LIRAB erred in not reopening her workers' compensation cases because (1) the State of Hawai'i did not recognize her injury as compensable until after her case had concluded and (2) Employer-Appellee, Self-Insured Queen's Medical Center (QMC) engaged in fraudulent conduct.
Porter filed claims for workers' compensation benefits on August 1, 2003 and September 19, 2003, alleging that she suffered from work-related MCS injuries on August 9, 2002, August 31, 2002, November 6, 2002, and November 8, 2002 (collectively, 2002 injuries). On March 19, 2004, the DCD denied Porter's request for compensation for her 2002 injuries because it did not recognize MCS as a compensable injury. On July 19, 2005, LIRAB affirmed the DCD's denial of Porter's request for compensation. Porter did not pursue judicial review of LIRAB's decision.1
On October 14, 2008, Porter filed a new claim for workers' compensation benefits for an additional MCS injury that allegedly occurred on May 13, 2003 (2003 injury) and re-requested compensation for her 2002 injuries. In letters dated October 22, 2008 and December 1, 2009, the DCD notified Porter that it was unable to process her request for a hearing for her 2002 injuries. In support of its determination, the DCD's letters referred Porter to its March 19, 2004 decision, denying her claim for her 2002 injuries, and LIRAB's July 19, 2005 "Decision and Order", affirming the DCD's denial (July 19, 2005 D&O).
On March 10, 2011, the DCD denied Porter compensation for her 2003 injury claim. In its decision, the DCD determined that Porter's 2003 injury was barred under HRS § 386-82 (1993),2 which limits a claimant's period of recovery to "two years afterthe date at which the effects of the injury for which the employee is entitled to compensation have become manifest, and . . . within five years after the date of the accident or occurrence which caused the injury." Porter did not appeal the DCD's March 10, 2011 decision to LIRAB.3
On July 30, 2010, while Porter's October 14, 2008 request for compensation was still pending, Porter filed yet another workers' compensation claim for her 2002 injuries and 2003 injury. On the same day, Porter sent a letter to the DCD requesting that the Director of the DCD (Director) reopen her 2002 injury claims that were previously denied in LIRAB's July 19, 2005 D&O, pursuant to HRS § 386-89(c) (1993)4 (July 30, 2010 Request to Reopen). Porter's July 30, 2010 Request to Reopen stated that "[a]s per the letter of Gary S. Hamada [Administrator of the DCD] dated September 6, 2006 . . . the Department of Labor now recognizes Multiple Chemical Sensitivity (MCS), as an injury which may be compensable." Porter further claimed that "[t]here was obviously a mistake in the determination of fact previously which precluded [Porter] from pursuing her claim, i.e., that MCS was not a physical condition which was recognized as an injury."
In a letter addressed to the DCD and dated March 23, 2011, (March 23, 2011 Request to Reopen) Porter claimed that she had not received a response to her July 30, 2010 Request to Reopen and had not received a hearing date for her workers' compensation claim dated July 30, 2010. In her letter, Porter further alleged that QMC committed fraudulent acts that led the DCD to deny her workers' compensation claim for her 2003 injury. Specifically, Porter alleged the following:
1. Employer concealed "The Report of industrial Accident or Incident" and the Emergency Room Record of 5/13/03. . . .
2. On June 23, 2003, Mr. J. Taylor enclosed in his letter to Mr. Scott Leong, copies of medical records including Emergency Room document and Report of Industrial Accident of 5/13/03 . . . .
3. On October 1, 2010, in [Mr.Leong's] letter to the Department of Labor & Industrial Relations, Mr. Leong wrote,
Porter also alleged that on November 18, 2002, QMC fraudulently requested an extension to complete their investigation by misrepresenting facts. Porter requested the DCD reopen her case as to her 2003 injury5 and penalize QMC under HRS § 386-98 (d) (Supp. 2014).6
On May 16, 2011, QMC sent a response to Porter's March 23, 2011 Request to Reopen, in which QMC addressed Porter'sallegations of fraud as to QMC's October 1, 2010 letter. QMC contended that QMC maintained that "[b]ecause [QMC] had always considered the May 13, 2003 treatment to be part of the 2002 claims, the October 1, 2010 letter was correct, however, to the extent that a new injury of May 13, 2003 was later being claimed, the letter could be considered inaccurate but not intentionally so."
On June 16, 2011, the DCD issued its decision, denying Porter's request as follows:
The DCD indicated that it "considered [Porter's] cases closed and therefore, [it] was unable to reopen the cases." The DCD also dismissed Porter's fraud complaint without an explanation as to the basis of its dismissal.
On June 18, 2011, Porter appealed the DCD's dismissal of her injury and fraud claims to LIRAB. On October 28, 2011, LIRAB issued its "Order of Remand for Further Proceedings," ordering Porter's case be remanded to the DCD for a hearing and decision.
On September 27, 2012, the DCD held a hearing on whether QMC committed fraud for any of Porter's workers' compensation claims and whether Porter was entitled to reopen her claims pursuant to HRS § 386-89 (1993).
On November 28, 2012, the DCD issued its decision. In its decision, the DCD denied Porter's request to reopen her claims and denied her allegations of fraud, finding that QMC did not commit fraud, conceal evidence, or engage in stallingtactics.
On December 3, 2012, Porter appealed the DCD's November 28, 2012 decision to LIRAB. On April 9, 2013, LIRAB issued a "Pretrial Order" that limited the issues to be determined on appeal to the following issues:
QMC filed its motion for summary judgment on August 13, 2013, in which, QMC argued that Porter failed to appeal LIRAB's July 19, 2005 D&O and the DCD's March 10, 2011 decision and, therefore, "[was] prohibited from reopening her cases to re-litigate her five denied MCS claims." QMC contended that "[Porter's] failure to exhaust her administrative remedies preclude[d] her from re-litigating the cases and issues via the reopening procedure." QMC also argued that it did not commit fraud for any of Porter's claims and that, nevertheless, Porter's fraud complaint was time-barred, pursuant to HRS § 386-98(f) (Supp. 2014).7
On September 17, 2013, LIRAB issued its "Decision and Order," partially granting and partially denying QMC's motion for summary judgment (MSJ D&O). LIRAB agreed with QMC that Porter was not entitled to reopen her injury claims because Porter failed to appeal LIRAB's July 19, 2005 D&O and the DCD's March 10, 2011 decision. In addition, LIRAB also determined that Porter's fraud claims for acts that may have occurred before 2009 were time-barred, pursuant to HRS § 386-98(f), and that the DCD did not exercise its discretion to pursue fraud claims against QMC on its own right, so as to warrant reopening her pre-2009 fraud claims. Thus, LIRAB concluded that Porter was not entitled to relief as to her injury and pre-2009 fraud claims. LIRABconcluded that the only issue that remained was whether QMC's October 1, 2010 letter constituted fraud.
On September 30, 2013, Porter filed a "Request for Reconsideration or Appeal" from LIRAB's MSJ D&O (Motion for Reconsideration).
On December 3, 2013, LIRAB issued its ...
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