Rader v. American Ass'n of Christian Schools

506 S.E.2d 794, 203 W. Va. 198, 1998 W. Va. LEXIS 66
CourtWest Virginia Supreme Court
DecidedJune 24, 1998
DocketNo. 24893
StatusPublished
Cited by1 cases

This text of 506 S.E.2d 794 (Rader v. American Ass'n of Christian Schools) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rader v. American Ass'n of Christian Schools, 506 S.E.2d 794, 203 W. Va. 198, 1998 W. Va. LEXIS 66 (W. Va. 1998).

Opinion

STARCHER, Justice:

This case is before this Court on two questions certified from the United States Court of Appeals for the Fourth Circuit. The case arises from a September 1994 injury sustained by a partner in a two-man partner[199]*199ship, in the course of and as a result of his work for the partnership. Because the partnership did not subscribe to the West Virginia Workers’ Compensation Fund, the injured partner sought medical benefits for his injuries from his wife’s employer’s health insurance plan. The health insurance carriers refused to provide medical benefits, relying upon an exclusion in the health insurance plan against injuries compensable under any workers’ compensation law.

The partner, plaintiff James Leland Rader, filed a lawsuit to recover medical benefits against the health insurance carriers, defendants American Association of Christian Schools (“AACS”) and Gallagher Bassett Services, Inc. (“Gallagher”). The health insurance carriers defended the action, claiming that under West Virginia law the plaintiff would have been eligible for workers’ compensation benefits if he had applied for such benefits. A federal magistrate judge ruled that the plaintiff was not eligible for workers’ compensation benefits and was therefore entitled to medical benefits from the health insurance plan. The insurance carriers appealed to the Court of Appeals.

The dispositive question from the Court of Appeals asks whether a partnership, which does not employ any persons other than the partners, is required to subscribe to the West Virginia Workers’ Compensation Fund. If the plaintiffs partnership was required to subscribe, then he may be entitled to workers’ compensation benefits under West Virginia law, and conversely, ineligible for medical benefits from the health insurance plan. The Court of Appeals concluded that this question is unsettled under West Virginia law, and determined that this question is disposi-tive of the issues in this case.

As set forth below, we hold that the plaintiffs partnership was not required to subscribe to the workers’ compensation fund, and further that the plaintiff would not have been entitled to workers’ compensation benefits under West Virginia’s workers’ compensation laws.

I.

Facts and Background

Plaintiff Karen Sue Rader is employed as a teacher at Elk Valley Christian School in Elkview, West Virginia. Elk Valley Christian School is a member of defendant AACS, which provides a health benefits plan (“the Plan”) to the employees of its members. The Plan is administered by defendant Gallagher. Mrs. Rader elected health coverage under the Plan and she listed her husband, plaintiff James Rader, as a dependent.

In 1988, Mr. Rader and a friend, Terry Bradshaw, formed a partnership known as T & J Painting. All of the work of T & J Painting has been performed solely by the two partners, and the partnership does not employ other persons. T & J Painting has never subscribed to or contributed to the West Virginia Workers’ Compensation Fund.

In September 1994, Mr. Rader was injured in the course of his employment when he fell from a ladder. Mr. Rader incurred over $48,000.00 in medical expenses because of the injury, and he filed a claim for benefits with his wife’s health insurance carriers, defendants AACS and Gallagher. The claim was denied on the basis of a provision in the Plan that precludes coverage for, inter alia,

... [a]ny accidental bodily injury which arises out of or in the course of any employment with any Employer and/or for which the individual is entitled to benefits under any workers’ compensation law or ... receives any settlement from a workers’ compensation carrier.

The defendants asserted that Mr. Rader was entitled to receive workers’ compensation benefits, notwithstanding the failure of T & J Painting partnership to make contributions to the workers’ compensation fund, and thus Mr. Rader was excluded from health insurance coverage under the Plan.

The Raders filed an action in state court claiming they were entitled to benefits under the Plan. The defendants removed the action to federal court on the basis of diversity of citizenship. After discovery, the parties agreed to submit the matter to a magistrate judge for decision. The magistrate judge ruled in favor of the Raders on their claim that the defendants improperly denied them [200]*200benefits under the Plan. The defendants appealed that decision to the Court of Appeals.

II.

Question Certified by the Court of Appeals

The primary question certified to this Court by the United States Court of Appeals for the Fourth Circuit is:

Under the law of West Virginia as it existed in 1994, was a partnership that did not employ anyone other than the members of the partnership an employer within the meaning of W.Va.Code § 23-2-1 (1994), such that the partnership was required by West Virginia law to furnish contributions to the workers’ compensation fund on behalf of the members of the partnership?

As discussed below, we answer this question in the negative.1

m.

Discussion

An “employer” that is “required to subscribe to and pay premiums into the workers’ compensation fund” is defined by W.Va.Code, 23-2-1 (a) [1991] as “all persons, firms, associations and corporations regularly employing another person or persons[.]”2

The defendants contend that under West Virginia law, a partnership is recognized as a [201]*201separate legal entity distinct from the individual partners.3 The defendants therefore argue that a partnership is by statute an employer, and that the partners are “persons” regularly employed by the partnership. The defendants essentially argue that every partnership is required by W.Va.Code, 23-2-1(a) [1991] to subscribe to the workers’ compensation fund. The defendant contends that this principle is recognized in another portion of the workers’ compensation act, which states that “[i]f an employer is a partnership ... such employer may elect not to include as an ‘employee’ ... any member of such partnership^]” W.Va. Code, 23-2-1(g)(2) [1991].4

The defendant then argues that, under W.Va.Code, 23-2-5(g) [1993], even though the plaintiffs partnership never subscribed to the workers’ compensation fund, the plaintiff may still successfully pursue a workers’ compensation claim. W.Va.Code, 23-2-5(g) [1993] stated that:

No employee of an employer required by this chapter to subscribe to the workers’ compensation fund shall be denied benefits provided by this chapter because the employer failed to subscribe or because the employer’s account is either delinquent or in default.

The plaintiffs argument focuses entirely on the language of W.Va.Code, 23-2-l(a) [1991], and that section’s definition of “employer.” The plaintiff argues that only employers “regularly employing another person” are required to subscribe to the workers’ compensation fund. The plaintiff contends that because his partnership has never employed anyone, it was never required to subscribe to the fund.5 We agree with the plaintiffs construction of the statute.

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Bluebook (online)
506 S.E.2d 794, 203 W. Va. 198, 1998 W. Va. LEXIS 66, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rader-v-american-assn-of-christian-schools-wva-1998.