BOARD OF SUP'RS OF HENRICO COUNTY v. Taylor

339 S.E.2d 565, 1 Va. App. 425, 1986 Va. App. LEXIS 219
CourtCourt of Appeals of Virginia
DecidedFebruary 4, 1986
DocketRecord No. 0815-85
StatusPublished
Cited by12 cases

This text of 339 S.E.2d 565 (BOARD OF SUP'RS OF HENRICO COUNTY v. Taylor) is published on Counsel Stack Legal Research, covering Court of Appeals of Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
BOARD OF SUP'RS OF HENRICO COUNTY v. Taylor, 339 S.E.2d 565, 1 Va. App. 425, 1986 Va. App. LEXIS 219 (Va. Ct. App. 1986).

Opinion

Opinion

COLE, J.

This is an appeal by Lumbermens Mutual Casualty Company (Lumbermens), insurance carrier for Henrico County, which raises the following issues: (1) whether it was denied due process of law because it received no notice of a hearing at which its obligation to pay medical expenses for the claimant was established; (2) whether the claimant proved that his medical expenses were related to his November 12, 1979, accident; and (3) whether the Commission erred when it assessed attorneys’ fees against Lumbermens. We hold that the Industrial Commission made the proper findings on each issue and we affirm.

On November 12, 1979, claimant, Joseph H. Taylor, injured his back while employed by Henrico County as an automobile mechanic. Henrico County (employer) and Lumbermens accepted the claim as compensable, and benefits were paid through April 16, 1980, at which time the award was terminated. On December 1, 1983, claimant filed an application for hearing alleging a change in condition, asserting that as a result of the ongoing effects of his November 12, 1979, back injury he had again suffered a period of work incapacity entitling him to disability benefits and medical expenses. At a hearing on January 17, 1984, claimant testified to the recurrent nature of his back problem, but also related that on April 26, 1983, while attempting to lift a brake drum onto a truck his back “just went out.” Claimant contacted Lumbermens after this occurrence, and was instructed to see Dr. Henry Yancey, an orthopedic surgeon, who in turn referred him to Dr. William White, a neurologist.

Because Henrico County had become self-insured in February, 1980, Lumbermens presented two defenses at the January 17, 1984, hearing. First, it contended that claimant’s medical expenses and work incapacity were unrelated to his 1979 injury, and *428 were instead the result of a new accident occurring on April 26, 1983. Second, it argued that if the claim stemmed from the 1979 injury, it was time-barred by the statute of limitations as set out in Code § 65.1-99.

By opinion dated January 23, 1984, the deputy commissioner found that the claimant’s application for a change in condition was not timely filed and the application was denied. In view of this holding, he did not decide whether the claimant had suffered a new accident in April, 1983, or the question of responsibility for claimant’s medical bills. Earlier awards of the Commission had determined that medical benefits were to continue as long as necessary.

On February 6, 1984, claimant filed an application alleging a new accident on April 26, 1983. A hearing was held on May 8, 1984, at which time Henrico County appeared and defended the claim. Lumbermens, however, received no notice of the hearing and did not appear. By opinion dated May 31, 1984, the claim was denied by the deputy commissioner, who found that the medical evidence failed to causally connect an injury to an incident occurring on April 26, 1983.

Claimant appealed the May 31, 1984, decision to the full Commission, which affirmed the decision of the deputy commissioner on September 21, 1984. The full Commission concluded that the claimant suffered from a progression of the injury sustained in the accident of November 12, 1979, and not from a new accident occurring on April 26, 1983. It further stated the following in its decision:

We note that the employer, Henrico County, has not, in its presentation of defense of this claim, included its former insurance carrier, Lumbermens Mutual Casualty Company. We do not include Lumbermens Mutual Casualty Company as a defendant in this opinion, although we state specifically that the employer continues to be responsible for payment of all necessary medical attention which the claimant may require arising out of the industrial accident of November 12, 1979.

*429 Henrico County refused to pay claimant’s medical expenses, maintaining that the medical expenses were the result of the recurrent 1979 injury and were the responsibility of Lumbermens. Lumbermens refused to pay the medical expenses, asserting in a letter to the Commission dated December 7, 1984, that the claimant’s medical treatment was unauthorized, that the evidence was insufficient to show that claimant’s medical expenses subsequent to April 26, 1983, were related to the 1979 accident, and that it was not bound by the September 21, 1984, decision of the Commission because it was not a party to that proceeding. The letter requested a hearing to determine whether the medical expenses claimed were related to the November 12, 1979, accident.

An evidentiary hearing was held on January 7, 1985, and Henrico County, Lumbermens and the claimant each appeared. Lumbermens was given a full opportunity to present evidence in support of its position.

By opinion dated January 18, 1985, the deputy commissioner held that there was no merit to Lumbermens’ assertion that the claimant’s treatment was unauthorized. The record shows that the claimant originally went to Dr. Henry Yancey on instruction from Lumbermens and that claimant’s treatment thereafter by Dr. William White was the result of a direct referral by Dr. Yancey. The deputy commissioner concluded that Lumbermens knew or should have known that the treatment for which the claimant seeks reimbursement was authorized.

The deputy commissioner further found that despite the failure of the employer, Henrico County, to forward notice of the September 21, 1984, hearing to Lumbermens, by operation of Code §§ 65.1-109 and 65.1-111, Lumbermens was bound by the September 21, 1984, opinion of the Commission which determined that claimant’s medical expenses were the result of his November 12, 1979, injury. Noting that the September 21, 1984, opinion stated that the insurance carrier was not included as a defendant in that hearing, the deputy commissioner reviewed the issue of causal relationship between the medical expenses and the 1979 accident. This review concluded that the evidence was sufficient to support the earlier finding that Lumbermens was responsible for the medical expenses incurred by the claimant since the reoccurrence of his back injury on April 26, 1983.

*430 On the issue of attorneys’ fees, the deputy commissioner noted that the September 21, 1984, opinion found Henrico County responsible for the payment of necessary medical expenses arising out of claimant’s 1979 accident. Henrico County did not appeal but simply refused to pay, stating its belief that Lumbermens was responsible. The deputy commissioner found that the dispute between the employer and the insurance carrier did not excuse Henrico County from making payment pursuant to the Commission’s order, and that pursuant to Code § 65.1-101, the claimant was entitled to attorneys’ fees, since he had to retain counsel and file a new application.

Attorneys’ fees were likewise assessed against Lumbermens for defending the claim without reasonable grounds. The deputy commissioner noted that in its letter of December 7, 1984, Lumbermens requested a hearing to “take evidence,” yet at the hearing Lumbermens offered “absolutely no additional evidence.” The deputy commissioner concluded that such circumstances indicated that appellant unreasonably defended the case and that attorneys’ fees were warranted.

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Bluebook (online)
339 S.E.2d 565, 1 Va. App. 425, 1986 Va. App. LEXIS 219, Counsel Stack Legal Research, https://law.counselstack.com/opinion/board-of-suprs-of-henrico-county-v-taylor-vactapp-1986.