PetSmart, Inc. and Indemnity Insurance Company of North America v. Lori Miles

CourtCourt of Appeals of Virginia
DecidedJanuary 12, 2021
Docket0765204
StatusUnpublished

This text of PetSmart, Inc. and Indemnity Insurance Company of North America v. Lori Miles (PetSmart, Inc. and Indemnity Insurance Company of North America v. Lori Miles) 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.

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PetSmart, Inc. and Indemnity Insurance Company of North America v. Lori Miles, (Va. Ct. App. 2021).

Opinion

COURT OF APPEALS OF VIRGINIA

Present: Judges Huff, AtLee and Athey UNPUBLISHED

Argued by videoconference

PETSMART, INC. AND INDEMNITY INSURANCE COMPANY OF NORTH AMERICA MEMORANDUM OPINION* BY v. Record No. 0765-20-4 JUDGE CLIFFORD L. ATHEY, JR. JANUARY 12, 2021 LORI MILES

FROM THE VIRGINIA WORKERS’ COMPENSATION COMMISSION

William H. Schladt (GodwinTirocchi, LLC, on brief), for appellants.

Philip J. Geib (Philip J. Geib, P.C., on brief), for appellee.

PetSmart, Inc. and Indemnity Insurance Company of North America (“employer”) assign

error to the decision of the Workers’ Compensation Commission (“Commission”) that Lori

Miles (“employee”) is not subject to the limitations set out in Code § 65.2-605.l(F), thus

requiring the employer to pay the employee’s health providers for services rendered to the

employee. However, the Commission announced an additional independent holding in the

alternative, which is sufficient to support its decision, to which the employer did not assign error.

Therefore, the employer has waived further appellate review of the Commission’s decision, and

accordingly, we affirm the Commission.

I. BACKGROUND

The employee sustained compensable injuries to her right shoulder and right upper

extremity on November 15, 2016. She subsequently filed a claim with the Commission on April

* Pursuant to Code § 17.1-413, this opinion is not designated for publication. 25, 2017, seeking a lifetime medical award and an order requiring the employer to pay for

medical treatment related to her injuries either recommended by, or provided to, the employee by

her orthopedist, Dr. Samuel Klein. The employee filed a second claim on August 19, 2017,

related to the denial of recommended physical therapy.

A hearing on the issues was scheduled for November 16, 2017. On October 30, 2017, the

Commission entered a 30-day order cancelling that hearing. However, since no written

agreement resolving the claims was ever finalized, the claims were subsequently rescheduled for

hearing on June 29, 2018. On June 22, 2018, the parties requested that the claims be resolved by

stipulated order, which was subsequently entered by the Commission on July 6, 2018.

The stipulated order acknowledged the employer’s responsibility for costs related to a

surgery previously performed by Dr. Klein on January 23, 2018, and required the employer to

pay for pre-operative diagnostic and radiological studies, pre-operative medical treatment, as

well as reasonable and medically necessary post-operative treatment, including physical therapy.

The order was also conditioned upon the “employer [withdrawing] their defenses to the present

claims pending before the Virginia Workers’ Compensation Commission.”

On June 9, 2019, the employee filed another claim regarding medical expenses yet to be

paid by the employer as a result of the accident, including unpaid expenses owed to Southern

Physical Therapy in the amount of $885 and Chesapeake Regional Imaging Centers in the

amount of $806. The employer did not dispute that the services provided at both Southern

Physical Therapy and Chesapeake Regional Imaging Centers were reasonable, necessary, and

causally related to the compensable accident, and both parties stipulated that the claims for these

payments were filed more than a year after the employer’s last payment was received by the

medical providers.

-2- The employer denied payment based on its contention that the claims were barred by the

limitation period in Code § 65.2-605.l(F). The employer argued that the employee’s claim was a

de facto health care provider’s claim filed more than one year after the last payment to the

provider and therefore barred by the statute. In response, the employee relied, in part, on Code

§ 65.2-605.l(D), which states in pertinent part, that “[a]n employer’s liability to a health care

provider under this section shall not affect its liability to an employee.”

Following a hearing held on November 18, 2019, the deputy commissioner found that the

claims of the employee were not barred:

Subsections D and F are consistent with each other. If the legislature wanted to limit claimant’s ability to request payment of bills, they could have done so by omitting Subsection D and modifying Subsection F to limit the ability of health care providers and claimants to submit claims to the Commission after June 1, 2014. [Employer’s] argument that the provisions of Va. Code § 65.2-605.1 “should apply equally to the medical providers and claimants regarding claims raised for payment of medical bills” is contrary to the plain language of the statute. . . . Accordingly, the claimant’s claims for the underpayment of $885 to Southern Physical Therapy and $806 to Chesapeake Regional Imaging Centers are not barred by the statute of limitations set forth at Va. Code § 65.2-605.1 (F) and the [employers] are responsible for payment of the same.

(emphasis in original).

The employer appealed the deputy commissioner’s finding to the full Commission, and in

a June 4, 2020 split decision, later amended on June 17, 2020, the Commission upheld the

previous finding by the deputy commissioner that the employee was not barred by the statute.

The Commission also held that, in the alternative, even if Code § 65.2-605.1(F) applied to the

employee, the claims would still be timely under subsection (F)(ii):

[T]he claim was contested by the [employer]. The parties attempted to settle the claim long before they submitted an executed order. The length of time that elapsed and the multiple hearings scheduled, as well as the explicit statement that the -3- defendants withdrew their defenses in the Stipulated Order, established the claim was contested. The Commission did not approve the parties’ Stipulated Order including a medical award to the claimant until July 6, 2018. Southern Physical Therapy and Chesapeake Regional Imaging Centers received partial payment before the date the award was entered. Their right to receive payment flowed from the July 6, 2018 Order. Accordingly, the two health care providers’ claims would have been timely if filed directly by them within one year of the date the medical award became final. The [employee] filed her claim on June 9, 2019, within one year of the July 6, 2018 Order.

The employer appeals the Commission’s decision to this Court.

II. ANALYSIS

The employer presents a single assignment of error, which states: “The full Workers’

Compensation Commission erred as a matter of law in finding that the one-year statute of

limitations found in Virginia Code § 65.2-605.l did not apply to the medical providers bills for

underpaid/unpaid medical expenses.” The employer fails to assign error to the Commission’s

alternative holding that even if the employee is subject to the limitations in Code § 65.2-605.l(F),

by virtue of being contested by the employer, the claims were validly filed within the limitations

set forth under Code § 65.2-605.l(F)(ii). Because the employer failed to assign error to this

alternative holding, the employer waived any claim of error with respect to that issue in this case.

This Court’s jurisprudence is clear that “in ‘situations in which there is one or more

alternative holdings on an issue,’ [an] appellant’s ‘failure to address one of the holdings results in

a waiver of any claim of error with respect to the court’s decision on that issue.’” Johnson v.

Commonwealth, 45 Va. App. 113, 116 (2005) (quoting United States v.

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PetSmart, Inc. and Indemnity Insurance Company of North America v. Lori Miles, Counsel Stack Legal Research, https://law.counselstack.com/opinion/petsmart-inc-and-indemnity-insurance-company-of-north-america-v-lori-vactapp-2021.