Nolan v. Commissioner of the Department of Industrial Accidents

26 Mass. L. Rptr. 88
CourtMassachusetts Superior Court
DecidedAugust 13, 2009
DocketNo. 052276
StatusPublished

This text of 26 Mass. L. Rptr. 88 (Nolan v. Commissioner of the Department of Industrial Accidents) is published on Counsel Stack Legal Research, covering Massachusetts Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nolan v. Commissioner of the Department of Industrial Accidents, 26 Mass. L. Rptr. 88 (Mass. Ct. App. 2009).

Opinion

Agnes, Peter W., J.

This case arises from claims by the plaintiffs3 for Workers’ Compensation benefits. The plaintiffs bring suit against the defendants, the Commissioner and Senior Judge of the Department of Industrial Accidents (the “Department”) ,4 for declaratory judgment, mandamus and violations of their due process rights. The plaintiffs argue they were aggrieved by the withdrawals of their claims by a conciliator and the subsequent affirmation of those withdrawals by the Senior Judge. The matter is before this court on the defendants’ Motion to Dismiss. For the reasons stated below, the defendants’ motion is ALLOWED.

BACKGROUND

The procedural system for filing a claim for benefits under the Workers’ Compensation system is governed by G.L.c. 152 and 452 Code Mass. Regs. §1.00 et seq. The Department administers this system. After a party files a claim or complaint it proceeds to conciliation. At this stage, a non-judicial administrative official, called the conciliator, reviews the claim, speaks to the parties and requests any further required documentation. G.L.c. 152, §10(1); 452 Code Mass. Regs. §1.08. If the claim is not resolved at conciliation, it is referred to a conference, an informal proceeding before an administrative judge. G.L.c. 152, §§10(2), 10A. If the parties wish to appeal the decision, they may do so under G.L.c. 152, §10A(3). An appeal of the conference order affords the parties a full evidentiary hearing before an administrative judge, usually the samejudge who presided over the conference. G.L.c. 152, §11; 452 Code Mass. Regs. §1.11. The hearing decision may be appealed to the Reviewing Board under G.L.c. 152, § 11C. The Reviewing Board, made up of administrative judges, reverses the hearing decision if it is beyond the scope of the administrative judge’s authority, was arbitrary or capricious, or contrary to law. G.L.c. 152, §11C. Decisions of the Reviewing Board may be appealed to the Appeals Court, and such appeals are taken pursuant to G.L.c. 30A, §14. G.L.c. 152, §12(2). Orders of the Department may be enforced when necessary in the Superior Court. G.L.c. 152, §12(1).

For the purposes of this motion, the facts as alleged in the plaintiffs’ Complaint are taken as true. Paula Eastwood filed a claim for benefits against three insurers for three separate injuries. At conciliation, the conciliator requested that a fourth insurer who had covered Eastwood for a period of time be added. Eastwood maintained that the fourth insurer was not necessary. The conciliator withdrew the claim.5 East[89]*89wood appealed to the Senior Judge, who affirmed the withdrawal, citing a failure to provide requested documentation and to add the fourth insurer.

Valerie Sullivan won a claim against an insurer, who then made payment to her after the statutory deadline. Sullivan filed a claim for a penalty for late payment, under G.L.c. 152, §13A. The conciliator stated that she had extended the conciliation period pursuant to G.L.c. 152, §13A(1), which allows for extension after consulting with the parties and appending a written statement to the file. No consultation occurred, and no record was put in the file. The conciliator withdrew the claim. Sullivan appealed to the Senior Judge, who affirmed the conciliator’s withdrawal.

Emile Tabea filed a claim for benefits for a back injury that caused him to miss work sporadically over time. The conciliator requested treatment records for each day missed. Because Tabea did not seek medical treatment every day he was absent from work due to his injury, he was unable to provide the requested documentation. The conciliator withdrew the claim and the Senior Judge affirmed.

Alvarez Hinton filed a claim for benefits, alleging he was totally disabled. The documentation he provided from his treating physician did not specifically state that he was “totally disabled.” The conciliator withdrew the claim for lack of sufficient documentation. Hinton appealed to the Senior Judge, arguing the evidence he presented was sufficient to show he was totally disabled. Hinton does not allege what, if any, decision the Senior Judge issued.

DISCUSSION

On a motion to dismiss, the court takes as true the allegations of the complaint and such inferences favorable to plaintiff as may be drawn therefrom. Jacome v. Commonwealth, 56 Mass.App.Ct. 486, 487 (2002), citing Eyal v. The Helen Broadcasting Corp., 411 Mass. 426, 429 (1991); Spinner v. Nutt, 417 Mass. 549, 550 (1994). While a complaint “does not need detailed factual allegations,” the allegations “must be enough to raise a right to relief above the speculative level...” Iannacchino v. Ford Motor Co., 451 Mass. 623, 636 (2008), quoting Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 554 (2007). The defendants assert the plaintiffs’ claim should be dismissed for failure to exhaust their administrative remedies.

At issue in this case is the conciliation component of the Workers’ Compensation system. The purpose of conciliation is to attempt to resolve the dispute between the parties without resorting to more formal proceedings. “The conciliation unit within the division of dispute resolution may attempt to resolve the claim or complaint by informal means and the parties shall cooperate with any conciliator assigned to the case.” G.L.c. 152, §10(1). The conciliator “shall withdraw without prejudice the claim or complaint of any parly that fails to cooperate or to produce requested material.” G.L.c. 152, §10(1); see 452 Code Mass. Regs. §1.08(6), (7), (8). A party aggrieved by a conciliator’s withdrawal of a claim may appeal that determination to the Senior Judge of the Department, who issues a written decision either affirming the conciliator’s decision or sending the claim on to conference. G.L.c. 152, §10(2) (“Any party aggrieved by the conciliator’s withdrawal of a claim or complaint may file a written appeal with the senior judge who, if all requested information has been submitted, shall set a date for referral [to a conference]”). The statute and regulations are silent as to any further remedy available for a conciliator’s withdrawal decision.

Courts generally favor alternative dispute resolution mechanisms. See Drywall Sys., Inc. v. ZVI Constr. Co., Inc., 435 Mass. 664, 670 (2002), and cases discussed therein. Aprocess such as conciliation, embedded in the administrative law scheme of Workers’ Compensation and providing a non-binding opportunity for settlement, is such a mechanism. While the review of conciliator withdrawals by administrative judges is not problematic, it is not in keeping with the overall statutory scheme to interpret G.L.c. 152 in such a way that the parties are bound by the administrative judge’s decision without any remedy and deprived of access to the rest of the Workers’ Compensation system.6

Ordinarily, a party aggrieved by the action of an administrative agency may seek review through an action in the nature of certiorari in this court. G.L.c. 249, §4. “A ‘civil action in the nature of certiorari’ pursuant to G.L.c. 249, §4, serves to ‘correct errors’ in administrative proceedings by means of judicial review where such oversight is not otherwise provided by statute.” Yerardi’s Moody St. Rest, and Lounge, Inc. v. Board of Selectmen of Randolph, 19 Mass.App.Ct. 296, 300 (1985).

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Related

Bell Atlantic Corp. v. Twombly
550 U.S. 544 (Supreme Court, 2007)
Spinner v. Nutt
631 N.E.2d 542 (Massachusetts Supreme Judicial Court, 1994)
Boston Edison Co. v. Boston Redevelopment Authority
371 N.E.2d 728 (Massachusetts Supreme Judicial Court, 1977)
Yerardi's Moody Street Restaurant & Lounge, Inc. v. Board of Selectmen
473 N.E.2d 1154 (Massachusetts Appeals Court, 1985)
Caswell v. Licensing Commission for Brockton
444 N.E.2d 922 (Massachusetts Supreme Judicial Court, 1983)
Eyal v. Helen Broadcasting Corp.
583 N.E.2d 228 (Massachusetts Supreme Judicial Court, 1991)
Samel v. City of Pittsfield Licensing Board
377 Mass. 908 (Massachusetts Supreme Judicial Court, 1978)
Black Rose, Inc. v. City of Boston
744 N.E.2d 640 (Massachusetts Supreme Judicial Court, 2001)
Drywall Systems, Inc. v. ZVI Construction Co.
761 N.E.2d 482 (Massachusetts Supreme Judicial Court, 2002)
State Board of Retirement v. Woodward
446 Mass. 698 (Massachusetts Supreme Judicial Court, 2006)
Iannacchino v. Ford Motor Co.
451 Mass. 623 (Massachusetts Supreme Judicial Court, 2008)
Police Commissioner v. Robinson
716 N.E.2d 652 (Massachusetts Appeals Court, 1999)
Jacome v. Commonwealth
778 N.E.2d 976 (Massachusetts Appeals Court, 2002)

Cite This Page — Counsel Stack

Bluebook (online)
26 Mass. L. Rptr. 88, Counsel Stack Legal Research, https://law.counselstack.com/opinion/nolan-v-commissioner-of-the-department-of-industrial-accidents-masssuperct-2009.