Sandra J. Rusch v. Southeast Alaska Regional Health Consortium and Alaska National Insurance Company, Brenda Dockter v. SEARHC and Alaska National Insurance Company

453 P.3d 784
CourtAlaska Supreme Court
DecidedDecember 6, 2019
DocketS17069, S17070
StatusPublished
Cited by5 cases

This text of 453 P.3d 784 (Sandra J. Rusch v. Southeast Alaska Regional Health Consortium and Alaska National Insurance Company, Brenda Dockter v. SEARHC and Alaska National Insurance Company) is published on Counsel Stack Legal Research, covering Alaska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sandra J. Rusch v. Southeast Alaska Regional Health Consortium and Alaska National Insurance Company, Brenda Dockter v. SEARHC and Alaska National Insurance Company, 453 P.3d 784 (Ala. 2019).

Opinion

Notice: This opinion is subject to correction before publication in the PACIFIC REPORTER. Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts, 303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email corrections@akcourts.us.

THE SUPREME COURT OF THE STATE OF ALASKA

SANDRA J. RUSCH, ) ) Supreme Court Nos. S-17069/17070 Appellant, ) (Consolidated) ) v. ) Alaska Workers’ Compensation ) Appeals Commission No. 17-001 SOUTHEAST ALASKA REGIONAL ) HEALTH CONSORTIUM and ALASKA ) OPINION NATIONAL INSURANCE COMPANY, ) ) Appellees. ) ) ) No. 7422 - December 6, 2019 ) BRENDA DOCKTER, ) ) Alaska Workers’ Compensation Appellant, ) Appeals Commission No. 17-002 ) v. ) ) SOUTHEAST ALASKA REGIONAL ) HEALTH CONSORTIUM and ALASKA ) NATIONAL INSURANCE COMPANY, ) ) Appellees. ) ) )

Appeals from the Alaska Workers’ Compensation Appeals Commission.

Appearances: J. John Franich, Franich Law Office, LLC, Fairbanks, for Appellants. Michael A. Budzinski, Meshke Paddock & Budzinski, Anchorage, for Appellees. Before: Bolger, Chief Justice, Winfree, Stowers, Maassen, and Carney, Justices.

STOWERS, Justice.

I. INTRODUCTION An attorney began representing two injured workers after both encountered difficulties representing themselves in their workers’ compensation claims against the same employer. Both claimants then successfully resolved their claims through mediation, with both receiving substantial settlements. The parties were unable to resolve the question of their attorney’s fees, so the Alaska Workers’ Compensation Board held hearings on that issue. The Board limited the witnesses at the hearings and ultimately awarded significantly reduced attorney’s fees in both claims. The Alaska Workers’ Compensation Appeals Commission affirmed the Board’s decisions. Because the Commission incorrectly interpreted our case law about attorney’s fees, because the Board denied the claimants the opportunity to present witnesses, and because the amount of attorney’s fees awarded to both claimants was manifestly unreasonable, we reverse in part the Commission’s decisions and remand for further proceedings. II. FACTS AND PROCEEDINGS A. Factual Summary Of Each Case Through Settlement 1. Rusch v. Southeast Alaska Regional Health Consortium In June 2012 Sandra Rusch injured her back while working for Southeast Alaska Regional Health Consortium (SEARHC) at its clinic in Klawock. Her healthcare providers imposed various lifting restrictions while she received treatment. SEARHC filed a controversion in October 2012 claiming it had no evidence to support time loss from work. Rusch had fusion surgery on her lumbar spine in January 2013. Medical

-2- 7422 records show that doctors disagreed about the degree of “incorporation” of the fusion. After the surgery Rusch’s healthcare providers continued restrictions on lifting. In January 2013 SEARHC paid Rusch temporary partial disability (TPD) from June through December 2012 and began to pay temporary total disability (TTD) as of early January. At about the same time SEARHC sent a form notice to the Reemployment Benefits Section of the Board informing it that Rusch had “been totally unable to return to [her] employment at the time of injury for 45 consecutive days as a result of the injury,” beginning on June 24, 2012.1 Its insurance adjuster handwrote that Rusch had received TPD from June 2012 until mid-December 2012 and had begun to receive TTD in early January 2013. The only communication in the record from the Board about reemployment benefits is a brief email to Rusch asking her to call if she had questions. Rusch was laid off from her job, purportedly due to a reduction in force, in April 2013. Rusch had been disciplined the previous month for an incident she said was related to “not lifting up to 50 pounds” as her job description required. Rusch’s surgeon had released her to “light duty as tolerated” effective March 1, 2013. The position she previously held was advertised the month after her layoff and included the ability to lift 70 pounds as a job requirement. In 2014 SEARHC offered Rusch “$15,000.00 in medical benefits to help defray the cost of additional care other than fusion revision, if medically necessary within the first year following Board approval” of a settlement; in exchange Rusch would give

1 See AS 23.30.041(c) (requiring notice of reemployment benefits to an employee who has been unable to return to work for 45 consecutive days because of a work-related injury). “Reemployment benefits are intended to return an injured worker to remunerative employment when she cannot return to her former job or jobs for which she has the relevant training or experience.” Vandenberg v. State, Dep’t of Health & Soc. Servs., 371 P.3d 602, 607 (Alaska 2016). -3- 7422 up all other compensation. The proposed agreement made clear that Rusch’s future medical benefits would be “restricted,” specifically providing that SEARHC would “be responsible for medical and related transportation benefits relating only to fusion revision, if medically necessary within one year from the date of [Board] approval or rejection of this Agreement.” Rusch initially agreed, but she did not sign SEARHC’s proposed settlement document. SEARHC’s attorney, Theresa Hennemann, informed Rusch in May 2015 that her settlement authority had lapsed and that the workers’ compensation insurance carrier would be closing its file related to her claim. Attorney David Graham of Sitka entered an appearance and filed a written claim on Rusch’s behalf in June 2015, seeking a number of compensation benefits including TTD, permanent partial impairment (PPI), medical costs, and reemployment benefits, and also claiming unfair or frivolous controversion. SEARHC filed an answer and a controversion in late July denying that any further compensation was owed. In October SEARHC offered to settle all claims for a total of $15,000, with $10,000 for future medical benefits and $5,000 for attorney’s fees. Rusch did not accept the offer. The case was contentious, with a number of discovery disputes. The parties later resolved all claims except attorney’s fees through mediation. The settlement agreement preserved Rusch’s claim for attorney’s fees and costs and required SEARHC to pay $1,000 to one medical provider and an additional $100,000 to Rusch. The Board approved the settlement in early August 2016. 2. Dockter v. Southeast Alaska Regional Health Consortium In February 2014 Brenda Dockter injured her left knee while working for SEARHC in Sitka. After physical therapy and medication did not resolve her pain complaints, she had arthroscopic knee surgery, which improved her symptoms but did not resolve them entirely. All doctors who examined her, including SEARHC’s

-4- 7422 orthopedic physicians, said she would at some point need further knee surgery as a result of the work injury. In June 2015, based on its doctor’s opinion, SEARHC controverted physical therapy and two medications. Dockter’s treating orthopedic physician recommended in October 2015 that she undergo a partial knee replacement. The surgeon’s office asked SEARHC to preauthorize the surgery; through its attorney, Hennemann, SEARHC informed the doctor it was “not in a position to preauthorize surgery at this time” [emphasis in original] because in its view Dockter’s pain complaints did “not appear to be supported by objective medical evidence.” If SEARHC sought an opinion from one of its orthopedic physicians about the partial knee replacement, it did not submit that opinion to the Board.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
453 P.3d 784, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sandra-j-rusch-v-southeast-alaska-regional-health-consortium-and-alaska-alaska-2019.