Blythe v. University of Oklahoma

2003 OK 115, 82 P.3d 1021, 75 O.B.A.J. 21, 2003 Okla. LEXIS 129, 2003 WL 22998855
CourtSupreme Court of Oklahoma
DecidedDecember 23, 2003
Docket98,371
StatusPublished
Cited by18 cases

This text of 2003 OK 115 (Blythe v. University of Oklahoma) is published on Counsel Stack Legal Research, covering Supreme Court of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Blythe v. University of Oklahoma, 2003 OK 115, 82 P.3d 1021, 75 O.B.A.J. 21, 2003 Okla. LEXIS 129, 2003 WL 22998855 (Okla. 2003).

Opinions

LAVENDER, J.

T1 The issue in the present cause is whether the collateral source rule applies in the context of a workers' compensation claim for prescription expense reimbursement. If applicable, the collateral source rule ensures that the injured employee's recovery is not diminished by benefits, saving or insurance of the injured employee. We hold that the collateral source rule, to the extent it is codified in the Workers' Compensation Act at 85 0.8.2001 § 45(A.), applies in this case and the COCA erred in sustaining the WCC's refusal to apply that rule and/or the terms of that statute in the instant case.

I

FACTS AND PROCEDURAL HISTORY1

12 Claimant initiated her workers' compensation action in July, 1994 alleging [1024]*1024she suffered a work-related injury during her employment with the University of Oklahoma. Claimant alleged primarily neck injury and consequential psychological overlay injury arising from lifting, bending and straining. In June, 1999, the WCC awarded PTD benefits and further ordered Employer to provide Claimant with reasonable and necessary continuing medical maintenance "limited to medications needed to maintain the [Cllaimant's physical and psychological state, to be provided under the care of Dr. Ed Ellis (including examinations to provide same)." This order was affirmed by a three-judge panel of the WCC. Employer appealed and the COCA affirmed the PTD award and order regarding continuing medical maintenance limited to medications necessary to maintain Claimant's physical injury, but reversed the trial court's determination regarding Claimant's alleged psychological injury. In accordance with its determination that competent medical evidence did not support a finding that Claimant suffered a psychological injury, the COCA modified the trial court's order by eliminating Claimant's award for continuing medical maintenance related to her psychological conditions.2

13 In January, 2000, Claimant filed her Form 19 in the Workers' Compensation Court, seeking reimbursement for the cost of prescription medications. Employer challenged Claimant's recovery of the cost of prescriptions on three bases: (1) Claimant sought reimbursement for cost of prescriptions unrelated to her work-related injury; (2) the reasonableness and necessity for the numerous quantities of preseription medications being obtained by Claimant; and (3) Claimant sought reimbursement for cost of prescriptions not personally paid out of her own pocket, but actually paid on Claimant's behalf by her health insurance carrier. Pursuant to Employer's objections, the WCC entered an Order for an Independent Medical Opinion on reasonable and necessary prescriptions. The record reflects that ultimately, the parties stipulated to a detailed itemization of related, reasonable and necessary prescription medications, which included stipulated amounts of Claimant's out-of-pocket expenses in the amount of $19,882.42 as well as the total amount of prescription medication expenses (Claimant's actual out-of-pocket cost plus the cost actually paid by [1025]*1025Claimant's health insurance carrier) in the amount of $46,344.24.

T4 The record illuminates little detail regarding Claimant's health care coverage other than the fact that the third-party payor, Blue Cross and Blue Shield health insurance carrier, was a "group health policy" provided to Claimant by Employer as a part of a disability/ecompensation package as an employee at the University of Oklahoma. Claimant alleges (and Employer does not dispute) that she personally paid at least a portion of premiums 3 for her own health insurance with Blue Cross. Unfortunately, we are prevented from verifying specifics concerning the subject insurance coverage because neither the policy, nor the terms thereof were included in the record.

T5 Claimant argued her entitlement to reimbursement for the total amount of $46,344.24 for prescription expenses pursuant to application of the collateral source rule and 85 0.8. § 454, which provides in pertinent part as follows:

A. No benefits, saving or insurance of the injured employee, independent of the provisions of this act shall be considered in determining the compensation or benefit to be paid under this act.

Id. (footnote omitted). Employer argued that 85 O.S. § 45 had no application in this case because there is no statutory authority for prescription reimbursement.5

T6 The WCC entered a "Miscellaneous Order" on September 25, 2002, wherein the WCC specifically rejected Claimant's demand for application of the collateral source rule to this case and limited reimbursement to $19,882.42 for Claimant's actual out-of-pocket prescription expenses and denied recovery for the additional amount expended for prescriptions on her behalf by her health insur[1026]*1026ance carrier. Claimant appealed and the COCA sustained.

II

THE COLLATERAL SOURCE RULE, AS CODIFIED IN 85 O.8.2001 § 45(A.), APPLIES IN THIS WORKERS COMPENSATION ACTION

A. The collateral source rule and 85 O.S. 2001 § 45(A.) compared

17 The collateral source rule traditionally applies in the context of common law tort actions to determine the amount of compensatory damages "which will compensate [the injured party] for all detriment proximately caused." See 23 0.8.2001 § 616; Denco Bus Lines, Inc. v. Hargis, 1951 OK 11, 229 P.2d 560, 564. The general rule applied to determine the proper amount which will compensate for the injured party's "whole loss" in a common law tort action is as follows: "total or partial compensation for an injury received by the injured party from a collateral source wholly independent of the wrongdoer will not operate to lessen the damages recoverable from the person causing the injury." Id. at 564 (quoting 15 AM. JUR. Damages § 198). Further,

[it is well settled that damages recoverable for a wrong are not diminished by the fact that the party injured has been wholly or partly idemnified [sic] for his loss by insurance effected by him and to the procurement of which the wrongdoer did not contribute.... The same has been held true of compensation received by an employee from a benefit fund maintained by the employer.

Id. (quoting 15 AM. JUR. Damages § 201)(emphasis added). Pursuant to these authorities, in Hargis, this Court determined that "[u)nder the [damages] statute the receipt of compensation by the injured party from a collateral source wholly independent of the wrongdoer would not operate to lessen the damages recoverable from the person causing the injury." 7 Id.

T8 85 0.8. § 45 has been the law since its enactment in 1915.8 The language of that statute is clear and unambiguous on its face.9 Case law generated since that time indicates that this statute has been construed consistently with its plain meaning10, and this Court has accordingly refused to consider "benefits, saving or insurance of the injured employee, independent of [the Workers' Compensation Act] ... in determining the compensation or benefit to be paid under this act." 85 0.8. § 45(A.). While this seetion of The Workers' Compensation Act has [1027]

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Blythe v. University of Oklahoma
2003 OK 115 (Supreme Court of Oklahoma, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
2003 OK 115, 82 P.3d 1021, 75 O.B.A.J. 21, 2003 Okla. LEXIS 129, 2003 WL 22998855, Counsel Stack Legal Research, https://law.counselstack.com/opinion/blythe-v-university-of-oklahoma-okla-2003.