Sheree Cleveland v. Advance Auto Parts and Indemnity Insurance Company of North America;

CourtCourt of Appeals of Mississippi
DecidedDecember 10, 2019
DocketNO. 2018-WC-01659-COA
StatusPublished

This text of Sheree Cleveland v. Advance Auto Parts and Indemnity Insurance Company of North America; (Sheree Cleveland v. Advance Auto Parts and Indemnity Insurance Company of North America;) is published on Counsel Stack Legal Research, covering Court of Appeals of Mississippi primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sheree Cleveland v. Advance Auto Parts and Indemnity Insurance Company of North America;, (Mich. Ct. App. 2019).

Opinion

IN THE COURT OF APPEALS OF THE STATE OF MISSISSIPPI

NO. 2018-WC-01659-COA

SHEREE CLEVELAND APPELLANT

v.

ADVANCE AUTO PARTS AND INDEMNITY APPELLEES INSURANCE COMPANY OF NORTH AMERICA

DATE OF JUDGMENT: 11/06/2018 TRIBUNAL FROM WHICH MISSISSIPPI WORKERS’ COMPENSATION APPEALED: COMMISSION ATTORNEYS FOR APPELLANT: DAVID N. GILLIS JAMES E. LEVER ATTORNEYS FOR APPELLEES: DANIEL PAUL CULPEPPER MATTHEW RYAN ANTHONY NATURE OF THE CASE: CIVIL - WORKERS’ COMPENSATION DISPOSITION: REVERSED AND REMANDED - 12/10/2019 MOTION FOR REHEARING FILED: MANDATE ISSUED:

EN BANC.

McDONALD, J., FOR THE COURT:

¶1. This appeal arises from a workers’ compensation dispute. Sheree Cleveland filed

post-settlement motions for relief1 before the Mississippi Workers’ Compensation

Commission (the Commission) against Advance Auto Parts and Indemnity Insurance

Company of North America (collectively Employer/Carrier) in an effort to get the

Employer/Carrier to pay two of Cleveland’s outstanding medical bills. These bills were

1 These were combined in a “Motion for Certification of the Facts to the Circuit Court for Punishment for Contempt, Motion for Reasonable Expenses, Including Attorney’s Fees, and Motion for Levy of Civil Penalty.” incurred, and all parties were aware that they existed prior to the order approving a “Final

Compromise and Settlement” (settlement agreement) and the filing of the Form B-31.

Cleveland sought payment from the Employer/Carrier twice within the next year, but

Cleveland filed her post-settlement motions with the Commission after the one-year period

outlined in Mississippi Code Annotated section 71-3-53 (Rev. 2011). In response to the post-

settlement motions, the Employer/Carrier filed a response, arguing that the Commission did

not have authority to rule because it lacked jurisdiction.

¶2. The administrative judge (AJ) heard the motions on April 16, 2018, and granted

Cleveland relief, but after an appeal by the Employer/Carrier, the Commission vacated the

AJ’s order on statute-of-limitations grounds.

¶3. On Cleveland’s appeal to this Court, we find that the Commission erred, and we

reverse its decision for two reasons. First, the Employer/Carrier is estopped from asserting

the statute-of-limitations defense because it knew of and previously agreed to pay

Cleveland’s outstanding bills and because it represented to the AJ that it was processing one

bill and had paid the other bill. Second, although the Form B-31 was properly filed,

Cleveland’s contact with the Employer/Carrier sufficiently tolled any statutory limitations

period that may be applicable. We remand for the reinstatement and enforcement of the AJ’s

order.

FACTS AND PROCEDURAL HISTORY

¶4. On November 25, 2014, Cleveland sustained an injury to her lower back while

unloading freight during her employment with Advance Auto Parts in Hazlehurst,

2 Mississippi. The following day, Cleveland sought medical attention and was prescribed

medication and physical therapy. During this time, she accrued a bill at Allreds’ Pharmacy.

On February 3, 2015, Cleveland filed a petition to controvert with the Mississippi Workers’

Compensation Commission regarding her injury.

¶5. Cleveland returned to work and sustained a second injury to her lower back on March

23, 2015. Cleveland sought medical attention following this second injury. Subsequently,

she underwent additional physical therapy in April and May 2015.

¶6. On October 19, 2015, Cleveland filed a petition to controvert regarding the second

injury. At Cleveland’s request, the claims were consolidated by the Commission. Advance

Auto Parts’ insurance carrier, Indemnity Insurance Company of North America, was granted

leave to intervene.

¶7. The Employer/Carrier had received notice of Cleveland’s Allreds’ Pharmacy bill on

April 14, 2015, when she responded to the Employer/Carrier’s first set of requests for

production of documents for the first injury.2 On March 14, 2016, Cleveland filed a

pre-hearing statement with the Commission and attached an itemization of her medical

expenses including both the pharmacy and physical therapy bills. The Employer/Carrier

never denied the legitimacy of these bills, and the parties settled.

¶8. On August 17, 2016, Cleveland and the Employer/Carrier filed a “Petition for

Approval of Final Compromise Settlement” with the Commission. On the same day, the

Commission entered an order, finding that Cleveland and the Employer/Carrier “ha[d]

2 Cleveland included an itemization of the medical expenses that she had incurred at the time of the first injury.

3 negotiated a compromise settlement of all claims arising out of the Claimant’s alleged

injuries for which compensation is being made herein and that the parties have reached a full

and final statement of all claims . . . .” The Commission further found that the

Employer/Carrier

has paid for or will pay for the necessary and reasonable medical expenses incurred by Claimant related to [her] injuries for which claim is being made herein which [were] incurred before the date of the Petition for Approval of Final Compromise Settlement and [provided that] those expenses are covered charges as contemplated by Miss. Code Ann. § 71-3-15 (1972) and Mississippi Workers’ Compensation Commission General Rule 9.

(Emphasis added). The Employer/Carrier filed the Form B-31 with the Commission on

September 12, 2016.

¶9. Within the one-year deadline imposed by Mississippi Code Annotated section 71-3-

53, Cleveland’s attorney contacted the Employer/Carrier’s attorney and requested payment

of Cleveland’s outstanding bills on two occasions. On November 30, 2016, Cleveland’s

attorney sent an email to the Employer/Carrier’s attorney requesting that the

Employer/Carrier pay the Allreds’ Pharmacy bill in the amount of $1,099.09. The

Employer/Carrier did not respond to this email. Cleveland’s attorney then sent a letter to the

Employer/Carrier’s attorney, enclosing copies of the outstanding Medicomp physical therapy

and Allreds’ Pharmacy bills on July 13, 2017.3 The letter stated as follows:

Enclosed please find copies of the following unpaid medical and pharmaceutical bills concerning the captioned matters:

1) Billing statements (4 pages) from Copiah Wellness & Rehab/

3 Cleveland incurred both bills, and the Employer/Carrier had notice of both bills, before the settlement agreement was approved.

4 Medicomp Physical therapy for service dates April 30, 2015; and, May 5, 7 & 11, 2015.

2) Billing Log printed (7/12/2017 from Medicomp Physical Therapy (1 page)) showing the balances due after adjustments and indicating that no payments have been made.

3) Itemized billing statement from Allreds[’] Pharmacy (2 pages) showing a balance due of $1,099.99.

As you know, the workers’ compensation carrier is responsible for the payment of Sheree Cleveland’s medical expenses pursuant to the settlement agreement reached in the captioned causes and pursuant to the order rendered in these causes.

By email dated 11/30/2016, I forwarded notice to you concerning the non-payment of the pharmacy bill, but I never received a response from you. Request is hereby made that these medical expenses be paid immediately. I further request that you contact me upon receipt of this letter and advise the reason for non-payment of these bills and provide assurance that these bills will be paid at this time.

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Sheree Cleveland v. Advance Auto Parts and Indemnity Insurance Company of North America;, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sheree-cleveland-v-advance-auto-parts-and-indemnity-insurance-company-of-missctapp-2019.