Davis v. Dol
Civil Action No. 1979-2561
| D.D.C. | Jun 16, 2017Background
- Earl C. Davis, found permanently disabled in 1982 under the LHWCA, is entitled to payment/reimbursement of covered medical expenses; the district court issued an August 24, 1982 order governing submissions and payments.
- The 1982 order was modified March 15, 2001 to require Liberty Mutual to (1) itemize approvals/denials in responses and (2) pay or provide an adequate response within 30 days, or incur a $500/day fine payable to Davis.
- Davis submitted four reimbursement requests at issue historically; the Court previously found Liberty Mutual violated the 2001 order as to the March 7, 2002 request and imposed a fine. The D.C. Circuit later remanded to determine compliance as to three earlier requests (March 14, April 3, and November 26, 2001).
- The magistrate judge held an evidentiary hearing, heard Liberty Mutual witnesses and reviewed documents and payment ledgers, and addressed whether Liberty Mutual complied with Paragraphs 4(A)/(B) and the 30-day rule of the 2001 order.
- The court found (a) March 14, 2001: Liberty Mutual failed to itemize medications in its response but paid the approved items within 30 days, so no fine; (b) April 3, 2001: Liberty Mutual failed to itemize CVS prescriptions but paid most items; there was a one-day delay for orthopedic shoes, producing a $500 fine; (c) November 26, 2001: Liberty Mutual failed to separately identify medications and paid them late, producing fines totaling $27,500.
- The magistrate rejected Liberty Mutual’s equitable defenses (ambiguity, condition precedent, tolling, that a promise to pay obviates timely payment) and imposed a total fine of $28,000 in favor of Davis.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Liberty Mutual’s written responses to March 14, 2001 complied with the 2001 Order | March 14 response inadequate because medications were not separately itemized as required | Response not governed because request predated the March 15, 2001 order; or response was otherwise adequate | Court: Liberty Mutual’s March 26 response failed to itemize meds, but payment in full was made within 30 days so no fine imposed |
| Whether Liberty Mutual’s April 3, 2001 response complied with the 2001 Order | April 20 letter failed to separately list each CVS medication as required; plaintiff seeks sanction | Liberty Mutual says some items not covered by the 2001 Order and that payment/adequate response occurred; any delay was de minimis | Court: April 20 letter did not itemize CVS meds; orthopedic-shoe payment was one day late → $500 fine imposed |
| Whether November 26, 2001 responses complied with the 2001 Order | December 21 response failed to identify meds by date/prescription and payments were late → fine | Liberty Mutual contends denials/handling were proper; some items not covered or were adequately denied | Court: Liberty Mutual did not adequately identify medications and paid CVS and glucosamine/chondroitin late; imposed $27,500 (27 and 28 day periods at $500/day) |
| Validity of Liberty Mutual’s legal/equitable defenses (ambiguity, condition precedent, promise-to-pay, tolling) | N/A (defendant bears these defenses) | Liberty Mutual: order ambiguous; Davis failed to meet 1982 order condition(s); a promise to pay or an adequate response excuses delayed payment; tolling applies | Court: rejected all defenses as insufficient; circuits remand required imposition; defenses do not negate fines where no adequate response or timely payment occurred |
Key Cases Cited
- Doe v. Gen. Hosp. of D.C., 434 F.2d 423 (D.C. Cir. 1970) (court may consider clarity/ambiguity of orders when assessing enforcement remedies)
- Davis v. Dir., Office of Workers' Comp. Programs, [citation="124 F. App'x 1"] (D.C. Cir. 2005) (appellate decision affirmed BRB on merits but did not consider district-court compliance with 2001 order; remand later directed enforcement findings)