Leslie Fernandes v. Handyman Services, Inc.

460 S.E.2d 602, 20 Va. App. 708, 12 Va. Law Rep. 96, 1995 Va. App. LEXIS 644
CourtCourt of Appeals of Virginia
DecidedAugust 22, 1995
Docket2182944
StatusPublished
Cited by1 cases

This text of 460 S.E.2d 602 (Leslie Fernandes v. Handyman Services, Inc.) 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
Leslie Fernandes v. Handyman Services, Inc., 460 S.E.2d 602, 20 Va. App. 708, 12 Va. Law Rep. 96, 1995 Va. App. LEXIS 644 (Va. Ct. App. 1995).

Opinion

COLEMAN, Judge.

Leslie Fernandes, claimant, appeals a decision of the Workers’ Compensation Commission which held that his claim for disability benefits based upon a change in condition was time barred by Code § 65.1-99 (now Code § 65.2-708). The claimant contends that the commission should have held that the employer waived its right to plead the statute of limitations or is barred from asserting the defense because of the doctrines of estoppel or imposition. We hold that because the employer had agreed in writing, before the statute of limitations ran, to pay for the claimant’s surgery and the related temporary total disability benefits, but then delayed approval of the surgery until the statutory period for claiming the related disability benefits had expired, the employer is estopped from relying upon the statute of limitations.

The claimant suffered a compensable injury to his elbow in 1987. In 1988, he suffered a second compensable injury to the same elbow. Dr. Charles Ubelhart treated both injuries. The claimant last received disability benefits for those injuries pursuant to an award by the commission through February 4, 1990. Thus, February 4, 1990, was the date from which the two year statute of limitations under Code § 65.2-708 ran for filing a change in condition claim in the event that the claimant suffered a subsequent period of disability.

*710 In early February 1990, Dr. Ubelhart advised the claimant that he needed surgery to decompress the ulnar nerve in his arm. However, Dr. Ubelhart later informed the claimant that he would not perform the surgery because the employer’s insurance carrier had “cancelled” it by refusing to pay for the procedure. The claimant then filed a change in condition application in late February 1990, requesting that the commission approve the surgery and the related period of disability. The employer and carrier, by a letter to claimant’s counsel dated March 29, 1990, agreed to pay both the surgical and associated disability benefits. 1 A copy of that letter, together with another letter from defense counsel which stated, “the employer and carrier have agreed to the surgery proposed by Dr. Ubelhart,” were sent to the commission. The commission took no action on claimant’s February 1990, application.

In May 1990, Dr. Ubelhart determined that surgery was not immediately necessary, but would be required at a later date. In November 1991, Dr. Ubelhart determined that the claimant should have the surgery. However, the insurance carrier advised the claimant and Dr. Ubelhart that it would not pay for the claimant’s surgery until it deposed the claimant and until he had an independent medical éxamination to determine the necessity for the surgery. The claimant filed an application with the commission on February 19, 1992, seeking approval to have the surgery. By order dated June 29,1992, the commission dismissed the claimant’s petition, stating that “the parties have amicably resolved the matter in controversy.”

The claimant had surgery in June 1998. However, because the employer would not pay compensation benefits for the *711 period of disability occasioned by the surgery, the claimant filed an application July 1, 1998. On an information form provided by the commission, signed and dated July 21, 1993, the employer and carrier stated that the claim for disability benefits was compensable and the only unresolved issue was the period of claimant’s disability.

Nevertheless, at the hearing, the employer defended the change in condition application on the ground that the claim for disability benefits was barred by Code § 65.1-99 (now Code § 65.2-708). Following the hearing, the commission ruled that the claim was time barred as of February 5, 1992.

When the employee was injured, Code § 65.1-88 (now Code § 65.2-603) required an employer to provide for reasonable and necessary medical attention for “[a]s long as necessary after an accident.” However, when an employee has been awarded compensation benefits and the award has been terminated upon the employee’s return to work, Code § 65.1-99 (now Code § 65.2-708) limits the time in which the commission may review an award under a change in condition application. Code § 65.1-99, which was applicable when the employee filed a change in condition application, provided:

Upon its own motion or upon the application of any party in interest, on the ground of a change in condition, the Industrial Commission may review any award and on such review may make an award ending, diminishing or increasing the compensation previously awarded, subject to the maximum or minimum provided in this Act, and shall immediately send to the parties a copy of the award---- No such review shall be made after twenty-four months from the last day for which compensation was paid, pursuant to an award under this Act, except: (i) thirty-six months from the last day for which compensation was paid shall be allowed for the filing of claims payable under § 65.1-56 or (ii) twenty-four months from the day that the claimant undergoes any surgical procedure compensable under § 65.1-88 to repair or replace a prosthesis.

*712 The statute of limitations contained in Code § 65.1-99 is not a jurisdictional requirement, Binswanger Glass Co. v. Wallace, 214 Va. 70, 74, 197 S.E.2d 191, 194 (1973), and a party can be equitably estopped from raising the statute as a defense. Cibula v. Allied Fibers & Plastics, 14 Va.App. 319, 324-26, 416 S.E.2d 708, 711-12 (1992), aff'd, 245 Va. 337, 428 S.E.2d 905 (1993).

“In the absence of fraud, [the] elements necessary to establish an equitable estoppel are a representation, reliance, a change of position, and detriment.” Rucker v. Thrift Transfer, Inc., 1 Va.App. 417, 420, 339 S.E.2d 561, 562 (1986). “Where a party seeks to invoke the doctrine of estoppel he has the burden of proving it by clear, precise and unequivocal evidence.” Rose v. Red’s Hitch and Trailer Service, 11 Va. App. 55, 59-60, 396 S.E.2d 392, 395 (1990).

Initially, the carrier and employer agreed to pay for the claimant’s surgery and the related period of disability benefits. One year and eight months later, when the doctor recommended that the claimant have the surgery, the insurance carrier represented that it would not pay for the surgery until the claimant submitted to depositions and an independent medical examination. At that time, neither the employer nor the carrier informed the claimant that were the need for surgery verified, it, nevertheless, would not pay the related disability benefits as had been previously agreed.

This claimant cannot be charged with the knowledge that, beyond verifying the need for surgery, the carrier intended to abrogate its previous agreement to pay the benefits. See Cibula, 14 Va.App.

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Bluebook (online)
460 S.E.2d 602, 20 Va. App. 708, 12 Va. Law Rep. 96, 1995 Va. App. LEXIS 644, Counsel Stack Legal Research, https://law.counselstack.com/opinion/leslie-fernandes-v-handyman-services-inc-vactapp-1995.