Willis v. Montgomery County

• Decision Date: 25 August 2010
• Docket Number: No. 138, Sept. Term, 2009.,138, Sept. Term, 2009.
• Citation: 415 Md. 523,3 A.3d 448
• Parties: Valerie J. WILLIS v. MONTGOMERY COUNTY, Maryland.
• Court: Maryland Court of Appeals

415 Md. 523

3 A.3d 448

Valerie J. WILLIS

v.MONTGOMERY COUNTY, Maryland.

No. 138, Sept. Term, 2009.

Court of Appeals of Maryland.

Aug. 25, 2010.

COPYRIGHT MATERIAL OMITTED.

COPYRIGHT MATERIAL OMITTED.

Douglas M. Gross (Chirumbole, Gross & Conrad, P.C. of Gaithersburg, MD), on brief, for Petitioner.

Wendy B. Karpel, Associate Co. Atty. (Marc P. Hansen, Acting Co. Atty., and Karen L. Federman Henry, Div. Chief, of Rockville, MD), on brief, for Respondent.

Argued before BELL, C.J., HARRELL, BATTAGLIA, GREENE, MURPHY, ADKINS and BARBERA, JJ.

HARRELL, J.

This case evolves from Valerie J. Willis's claim for workers' compensation benefits, under the Workers' Compensation Act, §§ 9-101-9-1201 of the Labor and Employment Article, Maryland Code (1999, 2008 Repl. Vol.), ¹ for injuries ostensibly sustained on 20 July 2001 in the course of her employment as a police officer with the Montgomery County Police Department (the “County”). The County paid for some of her medical treatment, but learned later of a non-work-related event, not previously disclosed, that may have contributed to her need for treatment. The County filed with the Workers' Compensation Commission (the “Commission”) a request for a hearing and to refer Willis's case to the Maryland Insurance Fraud Division (the “Division”). The Commission determined, after a hearing, that no fraud occurred and denied the County's request. The County sought judicial review in the Circuit Court for Montgomery County of the Commission's refusal to refer the matter to the Division. The court held that the Commission's order was not an appealable decision. We are tasked with deciding whether the Commission's refusal to refer a person to the Division under the Workers' Compensation Act is a final administrative decision subject to a petition for judicial review.

I. FACTS

On 20 July 2001, Willis claimed to have injured her left knee while participating in a departmental training exercise designed to simulate a Columbine High School terrorist situation.

She did not miss any actual days from work because of that injury because she used three previously-scheduled days off from work to recuperate before returning to duty. She did not seek immediate medical treatment for this injury. She did not report the injury in accordance with formal departmental procedures, although she advised orally her supervisor, Lieutenant Rodney Hill, of the episode. He suggested to her that she file a workers' compensation claim. Willis did not act on this advice immediately. In August 2001, Willis assertedly sustained a second injury to her left knee while participating in a shooting exercise with the Police Department. She did not seek medical treatment, miss any time from work, or immediately report this event to her employer either.

On 31 December 2001, Willis sustained an injury to her left knee, while off-duty, when she jumped from the back of a pick-up truck. She sought immediate medical attention. She told the first two doctors that she saw only of the December incident as the cause of her injury. She consulted thereafter with Dr. David L. Higgins, to whom she described the injuring events of July and December, but not the August episode. Dr. Higgins's record of his visit with Willis indicates that his impression was that she suffered from a torn anterior cruciate ligament, torn medial meniscus, and torn lateral meniscus in her left knee. Dr. Higgins performed surgery on 30 January 2002 to repair these injuries.

On 4 March 2002, Willis and her then attorney prepared paperwork for a claim to be filed with the Commission, asserting that she sustained injury to her left knee as a result of the training exercise on 20 July 2001. On 14 March 2002, Dr. Higgins sent a letter to Willis's attorney, expressing his “opinion with a reasonable degree of medical certainty that Ms. Valerie Willis tore her left knee anterior cruciate ligament while on duty as a police officer with a twisting injury in 7/01. She had continued symptoms since that initial injury.” With this letter in hand, her attorney submitted the claim to the Commission. A corrected claim was filed on 21 April 2002 stating that Willis also injured her back, in addition to her knee, during the 20 July training exercise. In neither iteration of her claim did Willis mention the August or December incidents or injuries. On 4 July 2002, the Commission determined that Willis sustained an accidental injury or occupational disease/ illness, as defined in § 9-101, ² arising out of and in the course of her employment on 20 July 2001. The Commission determined that her weekly wage was $557.

She underwent a second surgery in September 2005, for which the County, through the Montgomery County Self-Insured Fund, paid. In April 2006, Willis claimed temporary total disability benefits dating back to 2002. The County filed issues with the Commission, requesting a hearing for referral of Willis's case to the Maryland Insurance Fraud Division (the “Division”). The County filed this request on a form provided by the Commission on its website. The form states, in part, that “[t]he undersigned alleges that the person named below violated section 9-310.2(a) of the Labor & Employment Article and requests a hearing before the Commission.” ³ Willis is listed as the “Person to be Referred” and the “Montgomery County Self-Insured Fund,” is listed as the “Party Requesting a Hearing.” It appears that Joan Fitzwater, the senior adjuster for the Schaffer Companies (the company that apparently managed and administered the County's self-insured fund at the time), signed the form. Specifically, the County alleged that, in May 2002, Willis informed the County that she sustained a work-related injury on 20 July 2001 to her left knee and that the County paid her workers' compensation benefits for that injury. When she made a claim in 2006 for temporary total disability dating back to 2002, the County discovered, for the first time, the non-work-related injurious event that occurred on 31 December 2001. Claimant's attorney, in riposte, filed issues requesting attorney fees, costs and penalties, because the Employer/Insurer raised frivolous issues.

The Commission held a hearing on 17 April 2007. The Commission found that neither claimant nor her prior counsel committed fraud, and accordingly, declined to refer the case to the Division. From that decision, the County sought judicial review in the Circuit Court for Montgomery County. Willis filed a Motion for Summary Judgment or to Dismiss, arguing that the Commission's refusal to refer the case to the Fraud Division was not appealable because it was not a final administrative decision. The County opposed the Claimant's motion, arguing that the order was final because it denied the County the right to reimbursement under § 9-310.1. ⁴ The Circuit Court concluded that the Commission's order neither granted nor denied a benefit under the Workers' Compensation Act and, thus, was not a final order or decision. Therefore, the court granted Willis's motion for summary judgment and dismissed the County's petition for judicial review.

The County filed timely a notice of appeal to the Court of Special Appeals, which reversed the judgment of the Circuit Court in a reported opinion. Montgomery County v. Willis, 187 Md.App. 514, 979 A.2d 209 (2009). The intermediate appellate court agreed with the County that the Commission's decision was a final, appealable order, from which the County had the right to seek judicial review. Id. at 538, 979 A.2d at 223. In doing so, the intermediate appellate court rejected the County's argument justifying the appealability of the order on the basis that “[a] request under L.E. § 9-310.2 for referral to the Division is clearly not the same as a request for reimbursement of benefits wrongfully obtained by the employee, as set forth in L.E. § 9-310.1.” Id. at 540, 979 A.2d at 224. Rather, the court held that the County, an aggrieved party, had the right to petition for judicial review of the refusal to refer a person to the Division because the denial “would come close to vesting unchecked power in the Commission with respect to matters under L.E. § 9-310.2....” Id. at 548, 979 A.2d at 229. The Court conceived that its holding furthered the Legislature's intent in passing §§ 9-310.1 and 9-310.2, which was “to discourage fraud, and to deter employees from abusing the privileges afforded under the Workers' Compensation Act.” Id. We issued a writ of certiorari, 411 Md. 599, 984 A.2d 244 (2009), upon Willis's petition, to consider the following question:

When an employer raises an issue before the Workers' Compensation Commission seeking a request for referral to the Maryland Insurance Fraud Division pursuant to Md. Lab. & Employ. Code Ann. § 9-310.2 and that request for the referral is denied, is the denial an appealable issue [?] ^{[ 5 ]}

For the reasons that we shall explain, we reverse the judgment of the Court of Special Appeals and hold that the Commission's failure to grant the County's request to refer Willis to the Division was not an appealable final administrative action.

II. ANALYSIS

We start with the “basic premise that, in order for an administrative agency's action properly to be before this Court (or any court) for judicial review, there generally must be a legislative grant of the right to seek judicial review.”

Harvey v. Marshall, 389 Md. 243, 273, 884 A.2d 1171, 1189 (2005). “The right to an appeal is not a right required by due process of law, nor is it an inherent or inalienable right. An appellate right is entirely statutory in origin and no person or agency may prosecute such an appeal unless the right is conferred by statute.” Criminal Injuries Compensation Bd. v. Gould, 273 Md. 486, 500, 331 A.2d 55, 64 (1975) (citations omitted). ⁶

In the context of appeals from an administrative decision of the Commission, § 9-737 confers the right to appeal upon a party or any other ...