LaBeree v. Labor & Industry Review Commission

2010 WI App 148, 793 N.W.2d 77, 330 Wis. 2d 101, 2010 Wisc. App. LEXIS 790
CourtCourt of Appeals of Wisconsin
DecidedOctober 5, 2010
DocketNo. 2009AP1628
StatusPublished
Cited by4 cases

This text of 2010 WI App 148 (LaBeree 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
LaBeree v. Labor & Industry Review Commission, 2010 WI App 148, 793 N.W.2d 77, 330 Wis. 2d 101, 2010 Wisc. App. LEXIS 790 (Wis. Ct. App. 2010).

Opinion

BRUNNER, J.

¶ 1. Bowman Plumbing and Wausau Insurance Companies (collectively, Bowman) appeal a judgment reversing a Labor and Industry Review Commission decision finding that Paul LaBeree, whose medical care is paid for by Bowman, must demonstrate that his Wis. Stat. ch. 55 protective placement is medically necessary.1 Bowman argues it cannot be liable under the worker's compensation laws, Wis. Stat. ch. 102, for additional expenses associated with LaBeree's transfer from an institutional placement to a residential placement.

¶ 2. Based on the limited authority granted to the Department of Workforce Development in Wis. Stat. ch. 102, and Wis. Stat. ch. 55's clear legislative intent to [108]*108guarantee an individual subject to a protective placement order the maximum liberty possible, we conclude a circuit court's determination of the least restrictive placement for such an individual is not subject to review by the Department. The Department may determine only whether the medical expenses associated with the individual's placement are compensable under ch. 102. We also reject Bowman's challenges to the jurisdiction of both the Commission and the circuit court, and Bowman's procedural due process arguments.

¶ 3. LaBeree cross-appeals the circuit court's judgment. LaBeree asserts he is entitled to compensation for all care outlined in a community integration plan approved by the circuit court in the Wis. Stat. ch. 55 proceeding. He further contends the circuit court erred by remanding the case to the Department for further fact-finding. Because neither the Department nor the Commission considered whether the specific care LaBeree receives in his residential placement is compensable, we conclude remand to the Department is appropriate. Accordingly, we remand to the circuit court, and direct the circuit court to recommit the controversy and remand the record to the Commission for further proceedings. See Wis. Stat. § 102.24(1).

BACKGROUND

¶ 4. In 1979, LaBeree was severely injured when a train struck his vehicle. LaBeree sustained traumatic brain injuries and is a spastic quadriplegic. He suffers from extensive medical problems, including muscle spasms, sleep apnea, and periodic infections. LaBeree uses an electric wheelchair, but is unable to operate it himself. LaBeree is permanently and totally disabled, and requires around-the-clock care. His injuries undis[109]*109putedly occurred in the scope of his employment for Bowman, which has conceded liability and currently pays for all his medical treatment expenses. See Wis. Stat. § 102.03.

¶ 5. Because of his extensive injuries, LaBeree was deemed in need of protective placement under Wis. Stat. ch. 55. LaBeree has received institutional care since the accident, primarily at the Dunn County Health Care Center, whose staff attends to all his personal and medical needs. Sometime around 2005, a group composed of Laberee's father, nurse, guardian ad litem, and a representative and students from the University of Wisconsin — Stout began exploring ways to improve LaBeree's quality of life. Adopting the moniker "Team Corky,"2 the group monitored LaBeree's needs and assisted his guardian ad litem in determining his best interests. Team Corky determined LaBeree had not been adequately challenged while institutionalized and, though LaBeree was receiving good care, concluded he would be better off in his own home.

¶ 6. In the fall of 2005, LaBeree's guardian ad litem requested that Dunn County develop a community integration plan. The plan, as drafted, calls for construction of a specially equipped duplex on land owned by LaBeree's father. LaBeree is to live on the side opposite his father, where he will receive twenty-four-hour-a-day care from a social services provider. The estimated cost of LaBeree's care under the community integration plan is $549 per day; at the Dunn County Health Care Center, the daily cost of LaBeree's care is approximately $174.

¶ 7. Pursuant to Wis. Stat. ch. 55, the circuit court found LaBeree's placement in the Dunn County [110]*110Health Care Center was not the least restrictive setting consistent with his needs. See Wis. Stat. §§ 55.12(3); 55.18(3)(e). It determined the care provided by Dunn County was "insufficient to fully develop [LaBeree's] mental and physical potentials." The court found the home-based care program was the least restrictive environment under ch. 55, and entered an order on April 19, 2006, approving the community integration plan in full.

¶ 8. In November 2006, LaBeree filed a worker's compensation claim alleging that Bowman refused to pay for the additional expense of his home care. An administrative law judge denied LaBeree's claim following an evidentiary hearing. The ALJ conceded the Department has no authority to determine where LaBeree should live. However, the judge concluded the worker's compensation laws conferred authority to approve or deny additional medical expenses based on the medical necessity of the placement.

¶ 9. The ALJ dismissed LaBeree's claim without prejudice, finding that LaBeree failed to prove his transfer from institutional to home care was reasonable and necessary.3 However, the ALJ recognized that a "valid argument for a community[-]based setting could be made if supported by expert medical testimony." The ALJ then directed that any new application be accompanied by a medical expert's opinion stating that LaBeree's residential placement is medically necessary. LaBeree concedes he is unlikely to obtain such a report.

¶ 10. LaBeree petitioned the Commission for review. The Commission adopted the findings and order [111]*111of the ALJ. It concluded the Department possesses authority to determine the medical necessity of an injured worker's Wis. Stat. ch. 55 placement, and agreed LaBeree failed to prove the more expensive home-based care was required. "In short," the Commission wrote, "[we are] not persuaded that the Dunn County Circuit Court's order forecloses consideration of reasonableness and necessity for worker's compensation purposes under Wis. Stat. § 102.42(1)."

¶ 11. LaBeree then sought judicial review. The circuit court rejected Bowman's motion to dismiss, and determined the Commission exceeded its authority when it reviewed the reasonableness and medical necessity of LaBeree's placement. The circuit court's written order contains, in part, the following conclusions of law:

6. The commission acted without and / or in excess of its authority when it based its decision, in part, on issues relative to the medical necessity of placement in a home setting.
7. It is the position of the Court, per the statutory authority under Wis. Stat. Chapters 54 and 55, that medical treatment as determined under Wis. Stat. 102.42(1) is subordinate to a circuit court's determination as to what is the least restrictive placement under Wis. Stat. Ch. 55, and 55.16(4) and (5).
8.

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Bluebook (online)
2010 WI App 148, 793 N.W.2d 77, 330 Wis. 2d 101, 2010 Wisc. App. LEXIS 790, Counsel Stack Legal Research, https://law.counselstack.com/opinion/laberee-v-labor-industry-review-commission-wisctapp-2010.