Gomez v. Nielson's Corp.

894 P.2d 1026, 119 N.M. 670
CourtNew Mexico Court of Appeals
DecidedApril 18, 1995
Docket15701
StatusPublished
Cited by5 cases

This text of 894 P.2d 1026 (Gomez v. Nielson's Corp.) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gomez v. Nielson's Corp., 894 P.2d 1026, 119 N.M. 670 (N.M. Ct. App. 1995).

Opinion

OPINION

WECHSLER, Judge.

Worker appeals from the order of the Workers’ Compensation Judge (WCJ) determining that Employer and its Insurer (Insurer), through their agent Crawford & Company, Health and Rehabilitation (Crawford), may have ex parte contact with Worker’s physicians outside the presence of Worker’s counsel. The order indicates that the constraints, limitations, and prohibitions set out in Church’s Fried Chicken No. 1010 v. Hanson, 114 N.M. 730, 845 P.2d 824 (Ct.App.1992), cert. denied, 114 N.M. 577, 844 P.2d 827 (1993), do not apply. We reverse.

Facts

Worker injured her neck, shoulder, and left wrist in an accident that occurred on March 13, 1992. By the time of the formal hearing on the claim, Worker had not yet reached maximum medical improvement with respect to the injury to her wrist. As a result, the WCJ awarded Worker temporary total disability benefits (the compensation order) until further order of the Workers’ Compensation Administration (Administration). Employer appealed the compensation order to this Court. The order was affirmed in an unpublished opinion. Gomez v. Nielson’s Corp., No. 15, 300 (N.M.Ct.App. Feb. 28, 1994).

About four months after the compensation order was filed, Insurer filed a motion to enforce medical management. The motion alleged, in essence, that Insurer had contracted with Crawford for medical case management of Worker’s case; that Crawford had assigned the matter to its employment consultants; and that Worker’s attorney refused to allow the consultants to meet with Worker or Worker’s treating physician, except in the presence of Worker’s attorney. Worker admitted Insurer’s factual allegations but argued that she was only required to cooperate with the case management system conducted by the Administration through an independent contractor and that there was no valid reason for Crawford’s consultants to contact Worker directly. In addition, Worker contended that Crawford’s consultants were not entitled to discuss the case with Worker or Worker’s treating physician, except in the presence of Worker’s attorney. We note in passing that while the motion was pending, Insurer and Worker agreed to an independent medical examination (IME) in order to obtain a second opinion concerning possible surgery for Worker’s wrist and an evaluation of her status.

On July 5,1994, the WCJ entered an order (the ex parte contact order) resolving the motion. The ex parte contact order did not contain specific findings of fact and conclusions of law, even though both parties submitted requested findings and conclusions. Instead, it stated that:

Neilson’s [sic] Corporation and CNA Insurance, through their agent Crawford & Company, may have ex parte contact with physicians outside the presence of Worker’s counsel, and that the health care provider would not be subject to the constraints, limitations or prohibitions set out in Church’s Fried Chicken v. Hanson [.] [Citation omitted.]

This appeal followed.

Finality of the Order

Worker contends that the ex parte contact order is final and appealable because the issue concerning ex parte contacts was the only issue pending before the WCJ and was fully resolved in the order. Employer contends that the ex parte contact order is not final and appealable because: (1) the compensation order contemplates further proceedings; and (2) the ex parte contact order is interrelated with a determination of the merits of the underlying compensation claim. See Kellewood v. BHP Minerals Int'l 116 N.M. 678, 866 P.2d 406 (Ct.App.1993) (order in change-of-health-care-provider proceeding is not a final, appealable order when a claim for benefits is pending before the Administration). For the reasons discussed below, we hold that the ex parte contact order is final for purposes of appeal.

By statute, a party is entitled to appeal to this Court only a “final order” of the WCJ. NMSA 1978, § 52-5-8(A) (Repl.Pamp.1991). Our Supreme Court has indicated that “the term ‘finality’ is to be given a practical, rather than a technical, construction.” Kelly Inn No. 102, Inc. v. Kapnison, 113 N.M. 231, 236, 824 P.2d 1033, 1038 (1992). In addition, we are mindful of the fact that there is no provision for the taking of interlocutory appeals from the orders of the WCJ. See Sanchez v. Bradbury & Stamm Constr., 109 N.M. 47, 48-49, 781 P.2d 319, 320-21 (Ct.App.), cert. denied, 109 N.M. 54, 781 P.2d 782 (1989).

In City of Albuquerque v. Sanchez, 113 N.M. 721, 724-25, 832 P.2d 412, 415-16 (Ct.App.1992), this Court held that an order denying an employer’s request to change health care providers is a final, appealable order when there is no claim for benefits pending before the Administration. Under the circumstances in that case, the change-of-health-care-provider proceeding was the only matter pending in the Administration and was fully resolved by the order. Id. at 724, 832 P.2d at 415. There, we considered the fact that the parties would never have been able to obtain review of the order had it not been deemed to be final. Id. Later, in Kellewood, this Court held that an order resolving a change-of-health-care-provider proceeding is not final and appealable when a claim for benefits is pending before the Administration. Id. at 679-81, 866 P.2d at 407-09. In so holding, we indicated that what remained to be decided by the Administration was whether the worker’s injuries were causally related to the employment and thus whether the worker was entitled to compensation, including medical benefits. Id. at 680, 866 P.2d at 408; see also Alcala v. St. Francis Gardens, 116 N.M. 510, 512, 864 P.2d 326, 328 (Ct.App.1993) (order awarding attorney fees in change-of-health-care-provider proceeding was not a final, appealable order because claim for benefits was still pending and entitlement to fees had not yet been proven).

In this case, as in City of Albuquerque, there was no compensation proceeding pending at the time that Insurer filed its motion. See Church’s Fried Chicken, 114 N.M. at 733, 845 P.2d at 827 (a claim is pending when it is actually filed and in the process of litigation, and the fact that an order is subject to later modification does not, without more, make a case pending). As in City of Albuquerque, it is possible that there will be no further formal proceedings in this matter because the remaining issues may be settled between the parties or resolved in mediation. Moreover, unlike the situation in Kellewood and Alcala, the issues of causation and entitlement to some benefits have already been determined. We also note that this is the type of order appropriate for a prompt appeal because any harm flowing from an erroneous ruling cannot be easily corrected later. Finally, Worker may never be able to appeal the ex parte contact order if it is not a final order for purposes of appeal.

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Bluebook (online)
894 P.2d 1026, 119 N.M. 670, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gomez-v-nielsons-corp-nmctapp-1995.