Kentucky Employers' Mutual Insurance v. Roger Hall

Court of Appeals of Kentucky·Decided November 8, 2024·No. 2024-CA-1021·Published

Opinion

RENDERED: NOVEMBER 8, 2024; 10:00 A.M.

TO BE PUBLISHED

Commonwealth of Kentucky

Court of Appeals

NO. 2024-CA-1021-WC

KENTUCKY EMPLOYERS’ MUTUAL INSURANCE APPELLANT

PETITION FOR REVIEW OF A DECISION v. OF THE WORKERS’ COMPENSATION BOARD ACTION NO. WC-15-01407

ROGER HALL; HONORABLE CHRIS DAVIS, ADMINISTRATIVE LAW JUDGE; ENCOVA MUTUAL INSURANCE GROUP (FORMERLY BRICKSTREET MUTUAL INSURANCE COMPANY); LETCHER COUNTY BOARD OF EDUCATION; AND WORKERS’ COMPENSATION BOARD APPELLEES

OPINION

REVERSING AND REMANDING

** ** ** ** **

BEFORE: CALDWELL, CETRULO, AND A. JONES, JUDGES.

CETRULO, JUDGE: This is the third appeal to this Court from rulings in a workers’ compensation case. The history of those proceedings becomes important in regard to the issues raised herein, even though the issues themselves have changed significantly.

FACTS AND PROCEDURAL HISTORY Roger Hall (“Hall”) was a full-time employee at Letcher County High School from 1976 to 2003, and, thereafter, occasionally worked as a substitute teacher until 2014. During that time, Hall regularly used a breakroom in a Letcher County building that, unbeknownst to him, contained asbestos. In September 2015, Hall filed his Form 102 application (“application”), alleging that he developed mesothelioma due to the asbestos exposure. In that initial application, he listed his date of last exposure as “gradual,” identified Letcher County Board of Education (“Letcher County”) as his employer, and identified Appellant Kentucky Employers’ Mutual Insurance (“KEMI”) as the school’s insurer in 1990. In 2017, Hall amended the application, listing the date of last exposure as approximately April 18, 2014.

In the first proceeding, the Administrative Law Judge (“ALJ”)

concluded that Hall’s mesothelioma was caused by his exposure to asbestos during his course of employment. However, the ALJ determined that Hall’s claim was untimely filed, finding that Hall’s last injurious exposure to asbestos occurred in

1990. Therefore, his workers’ compensation claim was dismissed. The Workers’ Compensation Board (“the Board”) reversed, based upon testimony that some of the asbestos was not removed until Hall retired in 2003 or sometime thereafter.1 The Board held that the statute of limitations was satisfied, and that Hall’s claims could proceed. Letcher County appealed, and this Court affirmed. On further appeal to the Supreme Court, in Letcher County Board of Education v. Hall, 576 S.W.3d 123 (Ky. 2019) (“Hall 1”), the Supreme Court agreed the ALJ had erred by finding the claim barred by the statute of limitations. The case was therefore remanded to the ALJ in order to determine if Hall was entitled to workers’ compensation benefits. Upon remand, the ALJ considered additional medical evidence and awarded Hall benefits, now concluding that Hall’s last exposure to the hazard occurred on April 18, 2014. That award was not entered until April 9, 2020, and determined Hall was totally disabled and entitled to income and medical benefits from the “defendant and/or its insurance carrier.”

Following this ruling, Letcher County appealed again, contending now that the Board of Claims had exclusive jurisdiction over Hall’s claim as it was a state government agency. First, the Board upheld the ALJ’s finding that the Department of Workers’ Claims (“Department”) had jurisdiction, despite the

1 Hall retired as a full-time teacher in 2003, but he continued to work as a substitute teacher for Letcher County until 2014.

provisions of Kentucky Revised Statute (“KRS”) 49.020 establishing the Board of Claims. Then, this Court agreed and found that requiring state employees to bring work-related injury claims in the Board of Claims would defeat the purpose of the Workers’ Compensation Act (“the Act”).2 Finally, the Kentucky Supreme Court again agreed and affirmed, noting that the sole issue on this second appeal was whether the Board had jurisdiction to hear Hall’s claim. The Court so found and issued that final opinion in June 2023. See Letcher Cty. Bd. of Educ. v. Hall, 671 S.W.3d 374 (Ky. 2023) (“Hall II”).

At this point, we note that the only real parties to all these actions before the ALJ, the Board, and the two appellate courts were Hall and Letcher County. However, in August 2021, while the second appeal was pending before this Court, KEMI filed a motion to intervene in the appeal, and a motion for partial remand. Therein, KEMI explained that it had determined that it did not insure Letcher County on the date of the last exposure, ultimately found in 2020 by the ALJ to be April 18, 2014.3 KEMI argued that Hall’s application had stated the date of last exposure was “gradual.” As mentioned, Hall’s application had

2 In this second appeal to this Court, the parties also addressed payment of medical bills and interest issues which were not presented to the Supreme Court nor are they relevant to this third appeal.

3 Throughout these proceedings, KEMI had been defending Letcher County, based upon the initial application by Hall.

identified Letcher County as the employer and identified KEMI as the school’s insurer in 1990. In 2017, Hall had filed a notice of correction listing the date of injury as approximately April 18, 2014, but that date of last exposure was not determined until 2020, when the ALJ issued the second opinion and award granting benefits to Hall.

While the second round of appeals was pending, KEMI’s motions to intervene and/or remand filed before this Court asserted that insurance records indicated that Encova Insurance (“Encova”) insured Letcher County on the 2014 last exposure date.4 However, KEMI’s motions to intervene and partially remand were summarily denied by both this Court and the Supreme Court. In denying the motions in 2021, our Court specifically stated as follows:

KEMI cites no authority to support its motion for a partial remand at this stage of the case directly to the ALJ. In addition, the scope of review by this Court is limited to matters that were subject to review by the Workers’

Compensation Board, and any remand would be to the Workers’ Compensation Board, not to the ALJ. KRS 342.290; see also Woods v. Private Investigations & Counter-Intelligence, Inc., 545 S.W.3d 854, 855 (Ky.

App. 2018) (stating Kentucky law does not permit a litigant to bypass the Board).

Hall II, No. 2020-CA-1404-WC, Order (Ky. App. Sep. 23, 2021).

4 Encova was formerly known as Brickstreet Mutual Insurance Company.

After both appellate courts had affirmed the jurisdiction of the Board, but denied the motions to intervene, the matter was again remanded. KEMI then filed another motion to intervene and asked the ALJ to certify coverage. Again, KEMI explained that it did not insure Letcher County on the now final date of last exposure and asked the ALJ to certify coverage or direct the Commissioner to do so, so that the correct insurer would be required to make the payments awarded to Hall. The ALJ declined to do so, ruling that coverage could not be certified to shift liability for this matter to the appropriate carrier because the motion was untimely. The ALJ stated that KEMI had made the motion before this Court as soon as notified of the issue relative to coverage on the date of last exposure, but still found it untimely. The ALJ further held “the responsibility to ask for coverage to be certified rests with the carrier on the risk” who believes they should not be on the risk.

KEMI appealed to the Board, and Encova then filed a notice of representation and its own cross appeal before the Board. Both parties briefed the issue before the Board, and on July 19, 2024, the Board entered an opinion and order dismissing, as follows:

Because neither KEMI nor Encova have [ever] been joined as a party to this claim, neither has standing to prosecute this appeal. Therefore, this appeal is hereby dismissed. (Opinion Dismissing Page 3)

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