Newport News Shipbuilding & Dry Dock Co., n/k/a, etc. v. Wardell Orthopaedics, P.C.
67 Va. App. 404
| Va. Ct. App. | 2017Background
- Charles B. Bell suffered a compensable left-knee industrial injury on August 26, 1995; employer Newport News Shipbuilding (NNSB) accepted liability under both Virginia Workers’ Compensation Act (the Act) and the federal Longshore Act.
- NNSB initially provided a panel of physicians; Bell selected a panel doctor in 1995, but after that doctor retired Bell signed a Choice of Physician Authorization and in 2010 elected Dr. Arthur Wardell (not on NNSB’s panel).
- Wardell treated Bell from 2010–2013; NNSB paid Wardell under the DOL/Longshore fee schedule ($17,205.96). Wardell later sought the prevailing community rate and claimed an additional $10,951.04 under the Act.
- Wardell requested a hearing, arguing full payment was owed under the Act; NNSB defended that Bell waived Act rights by rejecting the panel, that payments under the DOL schedule constituted accord and satisfaction, and that equitable doctrines (laches, waiver) barred recovery.
- The Commission found NNSB’s Choice of Physician form ambiguous/misleading about Act rights, concluded Bell did not validly waive his Act rights, rejected laches and accord-and-satisfaction defenses, and awarded Wardell the additional $10,951.04.
- The Court of Appeals affirmed: it deferred to the Commission’s factual findings (that the form failed to adequately inform Bell and no prejudice/delay or accord/satisfaction occurred) and upheld Wardell’s recovery of the difference between community rates and DOL payments.
Issues
| Issue | Plaintiff's Argument (Wardell) | Defendant's Argument (NNSB) | Held |
|---|---|---|---|
| Validity of employer panel form and who may challenge it | Wardell argued it need not accept DOL-only payment and could seek full prevailing rate when not properly informed | NNSB argued Wardell (third party) could not challenge the panel form and Bell waived Act rights by choosing a non-panel doctor | Court declined to consider NNSB’s procedural challenge raised on appeal; Commission’s factual finding that form was misleading was supported and stands |
| Waiver of Act rights by Bell | Wardell: Bell did not knowingly waive Act rights because the form’s language was ambiguous | NNSB: Bell knowingly elected Longshore treatment and waived Act remedies by rejecting panel physicians | Held: waiver not proven by clear, precise, unequivocal evidence; ambiguous form defeated waiver finding |
| Whether Wardell was an authorized treating physician under the Act | Wardell: because Bell did not validly waive rights, Wardell became authorized and entitled to Act rates | NNSB: because Bell rejected a valid panel and Wardell was never authorized, employer not liable under the Act except in narrow exceptions | Held: Commission reasonably found Bell did not refuse care; Act’s penalty provision did not bar recovery; Wardell entitled to difference between community rate and DOL payment |
| Accord, satisfaction, and laches as defenses | Wardell: acceptance of DOL payments did not communicate full-satisfaction intent to NNSB; suit timely after discovering underpayment | NNSB: acceptance and internal write-offs showed implied accord and satisfaction and delay barred recovery | Held: debtor (NNSB) failed to prove accord and satisfaction; no prejudicial delay—laches inapplicable; recovery permitted |
Key Cases Cited
- Layne v. Crist Elec. Contr., Inc., 64 Va. App. 342 (framework for appellate review of Commission factual findings)
- Ford Motor Co. v. Favinger, 275 Va. 83 (Commission awards conclusive on facts)
- Anderson v. Anderson, 65 Va. App. 354 (deference to Commission on facts; review de novo on law)
- Rusty’s Welding Serv., Inc. v. Gibson, 29 Va. App. 119 (questions of law reviewed de novo)
- Stockbridge v. Gemini Air Cargo, Inc., 269 Va. 609 (elements and burden for waiver)
- Stanley’s Cafeteria, Inc. v. Abramson, 226 Va. 68 (waiver must be proved by clear, precise, unequivocal evidence)
- Southland Corp. v. Welch, 33 Va. App. 633 (use of unauthorized medical service not necessarily a refusal of service)
- Ceres Marine Terminals v. Armstrong, 59 Va. App. 694 (employer bears burden to show medical fee excessive; claimant may recover difference between community rate and DOL payment)
- Gelles & Sons Gen. Contr. v. Jeffrey Stack, 264 Va. 285 (elements of accord and satisfaction)
- Berglund Chevrolet, Inc. v. Landrum, 43 Va. App. 742 (laches—burden to prove delay and prejudice)
- Stewart v. Lady, 251 Va. 106 (laches has no fixed guideline; depends on circumstances)
- Princess Anne Hills v. Susan Constant Real Est., 243 Va. 53 (definition of laches)