ALASKA WORKERS' COMPENSATION BOARD
P.O. Box 25512 Juneau, Alaska 99802-5512
LESLIE E. LIPMAN, Employee, Respondant, v. ANCHORAGE SCHOOL DISTRICT, (Self-Insured), Employer Petitioner. |
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FINAL DECISION AND ORDER AWCB Case No. 199617563 AWCB Decision No. 00-0028 Filed in Anchorage, Alaska on February 17, 2000. |
We heard the employer’s petition for review on January 27, 2000 at Anchorage, Alaska. The employee appeared, represented by Attorney, Chancy Croft. Attorney Patricia Shake represented the employer. We proceeded as a two-member panel, which constitutes a quorum (AS 23.30.005(f)). We closed the record at the hearing’s conclusion.
ISSUES
SUMMARY OF THE EVIDENCE
We incorporate by reference the facts as detailed in our previous decision and orders. In Lipman v. Anchorage School District, AWCB Decision No. 98-0107 (April 27, 1998) (Lipman I), we found the reemployment benefits administrator (RBA) Designee did not abuse her discretion finding the employee eligible for reemployment benefits, and awarded attorney’s fees and costs. In Lipman v. Anchorage School District, AWCB Decision No. 98-0126 (May 26, 1998) (Lipman II), we denied and dismissed the employer’s petition for reconsideration, affirming our decision in Lipman I that the employee is eligible for reemployment benefits. We emphasized the statutorily required competitive component in AS 23.30.041(e)(2), that an employee be able to compete in a labor market for a job he has held within the past 10 years, must be considered before that job could render him not eligible for reemployment benefits.
Subsequently, the employer appealed to the Superior Court. In Anchorage School District v. Lipman, 3AN-98-7260 (Alaska Super., September 23, 1999) (ASD Super. I), the Honorable John Reese affirmed our decisions in Lipman I and II. Specifically, the court in ASD Super. I at 6 held:
The compete clause is not meaningless. The court finds that the legislature intended to include the compete clause in the statute. The svp (specific vocational preparation) code analysis and the determination regarding the compete clause are both necessary as it is presumed that every word in a statute has a purpose and is to be given effect.
It is not logical to advocate that the compete clause applies only to skills acquired before the injury and not after. Fairness dictates that the compete clause must apply to positions held or training received both before and after the injury.
In addition, Judge Reese concluded we did not err in Lipman I when we precluded the employer from introducing new evidence: "The Board was correct in precluding the evidence due to ASD’s lack of `due diligence’ in producing the report to the evaluator prior to her decision [under] 8 AAC 45.070(b)(a)(A). The court held:
ASD had from October 1996 when Lipman requested an evaluation until November 17, 1997 when eligibility was granted to produce its own report or to notify (rehabilitation specialist) Lau of its intentions. After the determination by Lau ASD could have asked for a continuance of the Board Hearing until the eligibility evaluator and RBA designee had an opportunity to consider any evidence ASD needed to procure. As it stood, the evaluator and designee had no reason to think ASD had any intention to submit evidence. ASD was not duly diligent in producing the report to the evaluator and designee before the Board hearing, and the lack of diligence does not make the report newly discovered evidence. The court finds no abuse of discretion and the Board’s decision is AFFIRMED.
We based our decision in Lipman I on the testimony and arguments heard at the April 15, 1998 hearing. On April 16, 1998 the employee underwent additional shoulder surgery with his treating physician, Robert E. Gieringer, M.D. (See also, Douglas G. Smith’s February 7, 1998 SIME report, concurring with the need for the 1998 reconstructive shoulder decision). In his December 7, 1998 report, Dr. Gieringer noted:
He is having pain when he does his exercises. He is eight months since a Weaver Dunn reconstruction with allograft and in my observation and his estimation when I asked him today, we don’t think he will go back to his previous type of work, for the Anchorage School District. I think at most he will be able to do medium duty work and I think we should prepare for that.
In his January 18, 1999 work slip, Dr. Gieringer checked the box which released the employee to "light duty" and checked the box indicating "Partial disability dates," adding the following notation: "Medium duty work or less." The following restrictions were also noted: "No lifting over 50 pounds; No repetitive lifting over 20 pounds; No forceful use of left shoulder." In that same note, Dr. Gieringer commented: "Cannot return to custodial (previous) work." In responding to the employer’s January 28, 1999 inquiry, Dr. Gieringer indicated the employee was medically stable and could be rated for permanent impairment (PPI).
At the request of the employer, the employee’s physical capacities were evaluated by Forooz Sakata, O.T.R., R.N., and by J. Michael James, M.D., for a PPI rating. In her April 6, 1999 report, Ms. Sakata concluded the employee’s physical assessment was consistent and valid, and placed him in the "medium-heavy category of physical demand level of work. "I have reviewed the job analysis that was provided to me by the school district at the time of this evaluation (DOT: 382-664.010). He is capable of performing this position based on his strength and functional capacities."
In his April 7, 1999 report, Dr. James rated the employee PPI at 10% of the whole person. In this report, Dr. James answered as follows, questions posed by the employer:
The patient has reached medical stability by his own admission. I believe the patient’s medical stability probably occurred about three months ago. In looking at the objective database, by suspicion is that he reached medical stability by September of 1998 regarding his left shoulder surgery. The patient had a 10% impairment rating of the left upper extremity as a consequence of his injury as well as the surgery. I do not believe that there is any impairment rating regarding his neck as I do not believe this is an issue. Regarding his left shoulder myofacial syndrome, I believe this is covered under his original injury.
He will have some permanent restrictions as a consequence of his industrial injury. He has a 30 pound occasional bimanual overhead lifting limits, frequent at 15 pounds. He has a maximum safe lifting capacity from floor to knuckle height of 75 pounds, which places in a medium–heavy work category.
I have reviewed the patient’s job description as janitor any industry DOT 382.664–010 and I believe this patient is fully capable of performing that job description based on his physical capacities evaluation.
I believe the patient is capable returning to work at this point in time at that position defined by his accompanying job description.
On September 21, 1999, Loretta C. Cortis, C.D.M.S., the employee’s rehabilitation specialist, filed the employee’s reemployment plan dated September 15, 1999. The plan proposed to return the employee to employment as an accounting clerk in seven months, with plan costs totaling $9,600.00. As mentioned earlier, the Superior Court affirmed our decisions in Lipman I & II finding the employee eligible for reemployment benefits on September 23, 1999.
On October 22, 1999 the employer filed the present Petition for Modification. "ASD is seeking to modify the RBA’s determination and Board decision finding employee Leslie Lipman eligible for reemployment benefits. ASD asserts that a change in the employee’s physical capacities has occurred since the eligibility determination which renders him ineligible for reemployment benefits." (Employer’s October 22, 1999 Memorandum).
In his October 27, 1999 letter, the RBA deferred approval of the employee’s plan pending receipt of additional information regarding the employee’s learning abilities. In his December 29, 1999, letter, the RBA approved the September 21, 1999 plan. Neither the employer nor the employee have appealed the RBA’s plan approval.
The employer argues the change in the employee’s physical capacities after his reconstructive surgery requires the Board to modify its prior decision regarding the employee’s eligibility. The employee disagrees. The employee asserts the employer’s petition is procedurally incorrect, medically unjustified, and time barred. The employee seeks interest, attorney’s fees and costs, and payment of the rehabilitation specialist’s fees.
Also at the January 27, 2000 hearing, the employee argued a claim for interest on a compensation rate adjustment the employer acknowledged and paid on January 25, 1999. At the time of the employee’s injury (1996), he worked other jobs during the summer when school was not in session. On December 11, 1998, the employee filed a claim for a compensation rate adjustment to increase his rate to include his summer, non-ASD work. The employee provided some incorrect wage information on December 23, 1998. The employee acknowledged the error, and on January 13, 1999, the employee provided the correct wage information. The employer acknowledged a rate adjustment was due, and on January 25, 1999 paid the employee a lump amount reflecting the increased compensation rate.
FINDINGS OF FACT AND CONCLUSIONS OF LAW
I. Modification.
AS 32.30.130 provides in pertinent part:
Upon its own initiative, or upon the application of any party in interest on the ground of change in conditions, . . . the Board may . . . before one year after the rejection of a claim, review a compensation case under the procedure prescribed in respect to claims in a AS 23.30.110. Under a AS 23.30.110, the Board may issue a new compensation order which terminates, continues, reinstates, or increases or decreases the compensation or award compensation.
We find the employer’s petition to modify our earlier decisions under section 130 is not timely. The employer rejected the employee’s entitlement to reemployment benefits when it appealed the RBA Designee’s determination of eligibility. Our decisions regarding the employee’s eligibility for reemployment benefits in Lipman I and I were issued on April 27, 1998 and May 26, 1998, respectively. We find our authority to modify our earlier decisions expired no later than May 26, 1999. The employer did not file its petition to modify until October 22, 1999. We specifically note that Ms. Sakata’s April 6, 1999 report and Dr. James’ April 7, 1999 report were both issued, at the employer’s request, prior to this deadline.
The employer began paying the employee AS 23.30.041(k) stipend benefits on September 5, 1999. Prior to that time, the employee was paid his AS 23.30.190 PPI benefits in periodic installments between January 19, 1999 through September 4, 1999. The employee last received temporary total disability (TTD) benefits under AS 23.30.185 for January 18, 1999. (See, September 20, 1999 compensation report).
The remaining portions of AS 23.30.130 provide, in pertinent part: The Board may "before one year after the date of the last payment of compensation benefits under AS 23.30.180, 23.30.185, 23.30.190, 23.30.200, or 23.30.215" review a compensation case. In Imhof v. Eagle River Refuse, AWCB Decision No. 94-0330 (December 29, 1994), the Board held:
Employee’s claim has not been rejected. Therefore, our authority to review his case is limited in time to "before one year after the date of the last payment of compensation benefits under AS 23.30.180, 23.30.185, 23.30.190, 23.30.200, or 23.30.215."
Although the literal reading of AS 23.30.130 supports Employee’s contention that the time for review has passed, we agree with Petitioners’ argument that such a reading could lead to an absurd result. We conclude that if a request for modification is filed within one year of the last payment of one of the specific benefits listed in subsection 130(a), we have jurisdiction to modify.
As we find the employee’s last payment for TTD was January 18, 1999, we must conclude the employer’s October 22, 1999 petition for modification is timely.1 We have jurisdiction to consider the Petition to Modify.
The Alaska Supreme Court discussed subsection 130(a) in Interior Paint Company v. Rodgers, 522 P.2d 161, 168 (Alaska 1974). Quoting from O'Keeffe v. Aerojet-General Shipyards, Inc., 404 U.S. 254, 256 (1971), the court stated: "The plain import of this amendment [adding "mistake in a determination of fact" as a ground for review] was to vest a deputy commissioner with broad discretion to correct mistakes of fact whether demonstrated by wholly new evidence, cumulative evidence, or merely further reflection on the evidence initially submitted."
The court went on to say:
The concept of mistake requires careful interpretation. It is clear that an allegation of mistake should not be allowed to become a back-door route to retrying a case because one party thinks he can make a better showing on the second attempt. 3 A. Larson, The Law of Workmen's Compensation Section 81.52 at 354.8 (1971).
Id. at 169.
We have adopted regulations to implement our authority to modify a decision. 8 AAC 45.150:
(a) The board will, in its discretion, grant a rehearing to consider modification of an award only upon the grounds stated in AS 23.30.130.
(b) A party may request a rehearing or modification of a board order by filing a petition for a rehearing or modification and serving the petition on all parties in accordance with 8 AAC 45.060.
(c) A petition for rehearing or modification based upon change of conditions must set out specifically and in detail the history of the claim from the date of the injury to the date of filing of the petition and the nature of the change of conditions. The petition must be accompanied by all relevant medical reports, signed by the preparing physicians, and must include a summary of the effects which a finding of the alleged change of conditions would have upon the existing board order or award.
(d) A petition for a rehearing or modification based on an alleged mistake of fact by the board must set out specifically and in detail
(1) the facts upon which the original award was based;
(2) the facts alleged to be erroneous, the evidence in support of the allegations of mistake, and, if a party has newly discovered evidence, an affidavit from the party or the party's representative stating the reason why, with due diligence, the newly discovered evidence supporting the allegation could not have been discovered and produced at the time of the hearing; and
(3) the effect that a finding of the alleged mistake would have upon the existing board order or award.
(e) A bare allegation of change of conditions or mistake of fact without specification of details sufficient to permit the board to identify the facts challenged will not support a request for a rehearing or a modification.
(f) In reviewing a petition for a rehearing or modification the board will give due consideration to any argument and evidence presented in the petition. The board, in its discretion, will decide whether to examine previously submitted evidence.
We take judicial notice that Ms. Sakata and Dr. James work for the same corporation; Dr. James adopted Ms. Sakata’s physical evaluation findings in his April 7, 1999 report. Accordingly, we consider these two reports together. Had these been the only reports filed regarding the employee’s ability to return to work at his job for the employer, we may have modified our decisions in Lipman I and II. Fortunately we have the benefit of Dr. Gieringer’s report.
Contrary to the assertions of the employer, we find Dr. Gieringer released the employee to "light" duty work, not "medium to heavy." On January 18, 1999, Dr. Gieringer specifically opined the employee can not return to work as a custodian. Dr. Gieringer has long served as the employee’s attending and surgical physician. Dr. James and Ms. Sakata only evaluated the employee once. As he has spent considerably more time over the entire history of the employee’s treatment, we give more weight to Dr. Gieringer’s opinion, regarding whether e should return to work as a custodian. Furthermore, we find, after reviewing the extensive medical and vocational history involved, that the totality of the record supports Dr. Gieringer’s conclusion that the employee should not return to work as a custodian.
Accordingly, we conclude we will not exercise our discretion and order modification of our earlier decisions in Lipman I and II. The employer’s petition to modify is denied and dismissed; the employee remains eligible for reemployment benefits.
II. Interest.
Based on the employee’s testimony, we find the employee did not provide correct wage documentation for his summer, non-ASD work until January 12, 1999. We find the employer appropriately re-calculated his compensation rate to show the increased wage rate and paid in full by January 25, 1999 (13 days after receiving the wage information). We find the employer had no control over the employee's provision of this information, and could not calculate without it. We conclude the employer paid in a very timely matter once the employee provided the documentation. We conclude the employee’s request for interest on his compensation rate adjustment must be denied and dismissed.
III. Attorney’s Fees and Costs.
AS 23.30.145 provides in pertinent part:
(b) If an employer fails to file timely notice of controversy or fails to pay compensation or medical and related benefits within 15 days after it becomes due or otherwise resists the payment of compensation or medical and related benefits and if the claimant has employed an attorney in the successful prosecution of his claim, the board shall make an award to reimburse the claimant for his costs in the proceedings, including a reasonable attorney fee. The award is in addition to the compensation or medical and related benefits ordered.
The employee seeks an award of attorney's fee under subsection 145(b) for the successfully defending the employer's petition to modify our earlier decision finding the employee eligibility for reemployment benefits. We find the employer resisted the employee's eligibility by appealing the RBA Designee's determination, and requesting modification of our earlier decisions. Accordingly, we can award a fee under subsection 145(b). Alaska Interstate v. Houston, 586 P.2d 618, 620 (Alaska 1978).
Subsection 145(b) requires the attorney's fee awarded be reasonable. Our implementing regulation, 8 AAC 45.180(d), requires that a fee awarded under subsection 145(b) be reasonably commensurate with the work performed. It also requires we consider the nature, length, and complexity of the services performed, as well as the amount of benefits involved.
Although not highly complicated or lengthy,2 we find the benefits at issue, reemployment benefits, are very valuable, to the employee. According to the employee's physician, he can no longer work in his job at time of injury. We find the hours Mr. Croft billed to be reasonable (24.10 + 2.5 hearing time = 26.6); none of the hours billed appear to relate to the compensation rate interest issue. We also find Mr. Croft’s hourly rate is reasonable, considering the contingent nature of claimant's work, and Mr. Croft’s extensive experience; furthermore, the employer did not object to the employee’s attorney’s hourly rate. 26.6 X $250.00 = $6,650.00. We conclude the employer shall pay the employee $6,650.00 for a reasonable attorney's fee. The only costs claimed are 3.35 hours of paralegal costs at $90.00 per hour. We find these costs are reasonable and awardable under 8 AAC 45.180(f)(14), and shall be awarded. 3.35 X $90.00 = $301.50. $301.5 + $6,650.00 = $6,951.50. In total, we conclude the employer shall pay the employee’s reasonable attorney fees and costs of $6,951.50.
ORDER
Dated at Anchorage, Alaska this 17th day of February, 2000.
ALASKA WORKERS' COMPENSATION BOARD
/s/ Darryl Jacquot
Darryl Jacquot,
Designated Chairman
/s/ Marc D. Stemp
Marc Stemp, Member
APPEAL PROCEDURES
This compensation order is a final decision. It becomes effective when filed in the office of the Board unless proceedings to appeal it are instituted. Proceedings to appeal must be instituted in Superior Court within 30 days of the filing of this decision and be brought by a party in interest against the Board and all other parties to the proceedings before the Board, as provided in the Rules of Appellate Procedure of the State of Alaska.
RECONSIDERATION
A party may ask the Board to reconsider this decision by filing a petition for reconsideration under AS 44.62.540 and in accordance with 8 AAC 45.050. The petition requesting reconsideration must be filed with the Board within 15 days after delivery or mailing of this decision.
MODIFICATION
Within one year after the rejection of a claim or within one year after the last payment of benefits under AS 23.30.180, 23.30.185, 23.30.190, 23.30.200 or 23.30.215 a party may ask the Board to modify this decision under AS 23.30.130 by filing a petition in accordance with 8 AAC 45.150 and 8 AAC 45.050.
CERTIFICATION
I hereby certify that the foregoing is a full, true and correct copy of the Decision and Order in the matter of LESLIE E. LIPMAN employee / reondant; v. ANCHORAGE SCHOOL DISTRICT, (Self-Insured) employer / petiitoner; Case No. 199617563; dated and filed in the office of the Alaska Workers' Compensation Board in Anchorage, Alaska, this 17th day of February, 2000.
Debra C. Randall, Clerk
1
Payment of periodic PPI would not have resulted in the same conclusion. PPI, authorized under one of the enumerated payment classifications listed in AS 23.30.130, when paid periodically is done so pursuant to AS 23.30.041, and is not enumerated in AS 23.30.130.2
RBA appeals, under AS 23.30.041, are required to proceed to hearing in an expeditious manner.SNO