Argonaut Insurance Co. v. Labor & Industry Review Commission

392 N.W.2d 837, 132 Wis. 2d 385, 1986 Wisc. App. LEXIS 3598
CourtCourt of Appeals of Wisconsin
DecidedJune 25, 1986
Docket85-2167
StatusPublished
Cited by9 cases

This text of 392 N.W.2d 837 (Argonaut Insurance Co. v. Labor & Industry Review Commission) is published on Counsel Stack Legal Research, covering Court of Appeals of Wisconsin primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Argonaut Insurance Co. v. Labor & Industry Review Commission, 392 N.W.2d 837, 132 Wis. 2d 385, 1986 Wisc. App. LEXIS 3598 (Wis. Ct. App. 1986).

Opinion

EICH, J.

Argonaut Insurance Company appeals from a judgment affirming an order of the Labor and Industry Review Commission. The commission's order confirmed an award of worker's compensation benefits to Luthresa N. Johnson for a permanent total disability. While the parties raise several issues on appeal, we consider one to be dispositive: did the hearing examiner abuse her discretion in denying Argonaut's request to postpone the hearing to permit it to obtain an independent medical examination? We answer the question in the affirmative and reverse.

The facts are not in dispute. Johnson, a nursing home employee, injured her back while lifting a patient out of bed. Prior to this incident, she had suffered *387 from a variety of illnesses, notably rheumatic heart disease in association with severe aortic insufficiency and congestive heart failure. Johnson was hospitalized shortly after the lifting incident and applied to the Department of Industry, Labor and Human Relations for worker's compensation benefits. Her treating physician, Dr. Roger Lim, submitted a medical report to the department stating his opinion that Johnson's work injury had probably aggravated and accelerated her preexisting heart condition, resulting in permanent and total disability.

Argonaut, the nursing home's insurer, was given a copy of Dr. Lim’s report at a prehearing conference, and announced its intention to obtain an independent medical examination. On June 20,1983, Argonaut's attorneys interviewed Lim with respect to the opinions expressed in his report. The following day, June 21, Argonaut sent a letter to Lim summarizing the interview:

1. You indicated that Ms. Johnson's work-related injury was a cervical strain or sprain.
4. You indicated that, assuming the cervical strain did aggravate her heart condition in the manner described above such aggravation was temporary not permanent. That is,. . . the strain . . . is not now part of the cause for her permanent total disability.
5. You indicated Ms. Johnson is permanently disabled because of her cardiac problems which predated the injury and that her heart condition has not permanently worsened as a result of the injury to her back at work.

The letter was sent to Lim, who returned it to Argonaut after signing a statement that he had read it *388 and that it "accurately reflects my opinion." After receiving the letter from Lim, Argonaut did nothing more about obtaining an independent medical examination.

On December 12,1983, the department noticed the hearing on Johnson's claim for February 15, 1984. As the hearing date approached, settlement discussions with Johnson's attorneys led Argonaut to believe that Lim might testify in support of Johnson's claim for permanent disability benefits despite the statements in the June 21 letter. Argonaut immediately attempted to schedule an examination in late January but was advised that Johnson was in Arizona, could not be reached by telephone, and would not return to Wisconsin until the eve of the hearing.

Argonaut then wrote to the hearing examiner requesting a postponement or, in the alternative, permission to present additional evidence at a later date, after Johnson could be examined by one of its doctors. The examiner did not respond to the letter. Argonaut renewed the request when the hearing convened on February 15, 1984, but the examiner did not rule on the motion. The hearing proceeded, and Dr. Lim testified that Johnson's heart ailments were aggravated to the point of permanent total disability by her back injury — not by the cervical injury discussed in the June 21 letter but by lumbosacral pain, a condition not mentioned in the letter. At the close of the hearing, Argonaut again requested a continuance, and the examiner concluded the proceedings without responding. Several days later the examiner wrote to Argonaut, denying the request for a continued hearing without further comment or explanation.

*389 Whether to postpone or continue a hearing is committed to the sound discretion of the agency. Theodore Fleisner, Inc. v. ILHR Department, 65 Wis. 2d 317, 326, 222 N.W.2d 600, 606 (1974). The agency's decision to deny a motion for continuance will not be upset absent a "flagrant abuse" of that discretion. Nelson Mill & Agri-Center, Inc. v. ILHR Dept., 67 Wis. 2d 90, 94, 226 N.W.2d 435, 437 (1975). We believe this is such a case.

Section 102.13(1), Stats., requires a compensation claimant to submit to a "reasonable" examination by a physician selected by the employer. It is true, as the commission suggests, that Argonaut had ample time to arrange for an independent medical examination prior to the hearing. We also are aware of the commission's rule that it will consider requests for postponement only if received "within a reasonable time before the date of the hearing," and that such requests will not be granted because of "scheduling problems [or] the convenience of the parties" but only for "extraordinary circumstances." Wis. Adm. Code, sec. Ind 80.09. Both parties concede, however, that the sole issue on appeal is the reasonableness of Argonaut's conduct under the circumstances; and we are satisfied that it was reasonable for Argonaut to forego the examination in reliance on the June 21 letter.

That letter, attested to as an accurate summary of the opinion of Johnson's treating cardiologist, unambiguously states that her work injury was a cervical strain which did not cause any permanent disability. When Argonaut learned from Johnson's counsel shortly before the hearing that Dr. Lim might testify that she had indeed become permanently disabled as a result of the injury to her back, it immediately took steps to secure an examination, only to find that John *390 son was in Arizona, incommunicado, where she would remain until the hearing was scheduled to commence.

In Dietz v. Hardware Dealers Mut. Fire Ins. Co., 88 Wis. 2d 496, 276 N.W.2d 808 (1979), Hardware's insured, the defendant in an automobile accident case, gave a statement to the plaintiff's counsel six days before trial in which he retracted his earlier accounts of the accident and essentially conceded his own negligence. The trial court denied Hardware's request for a continuance. The supreme court reversed, noting the "crucial fact" that the insured's contradictory statements were exposed only six days before trial, concluding:

Without being granted a continuance to allow for a more exhaustive investigation based upon the effects of the new facts related in the June 19th statement, we hold it constituted surprise of a prejudicial nature leaving the insurer in a precarious position as to a proper trial defense of the claim. The insurer's request for a continuance was legitimate and timely.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

JUNEAU COUNTY DEPT. OF HUMAN SERVICES v. James B.
2000 WI App 86 (Court of Appeals of Wisconsin, 2000)
Baldwin v. Labor & Industry Review Commission
599 N.W.2d 8 (Court of Appeals of Wisconsin, 1999)
Milwaukee Journal v. UW Board of Regents
472 N.W.2d 607 (Court of Appeals of Wisconsin, 1991)
Schneller Ex Rel. Schneller v. St. Mary's Hospital Medical Center
455 N.W.2d 250 (Court of Appeals of Wisconsin, 1990)
Johnson v. Allis-Chalmers Corp.
455 N.W.2d 657 (Court of Appeals of Wisconsin, 1990)

Cite This Page — Counsel Stack

Bluebook (online)
392 N.W.2d 837, 132 Wis. 2d 385, 1986 Wisc. App. LEXIS 3598, Counsel Stack Legal Research, https://law.counselstack.com/opinion/argonaut-insurance-co-v-labor-industry-review-commission-wisctapp-1986.