Sheena H. for Russell H. v. W. Va. Ofc. of the Insurance Commissioner/Amfire, LLC
235 W. Va. 132
W. Va.2015Background
- Russell H., a 24-year-old coal miner, suffered a head injury at work in March 2009; he died in his sleep on December 7, 2010. No treating physician or employer linked the death to the 2009 injury at the time of death.
- The Office of the Chief Medical Examiner performed an autopsy on December 8, 2010, but the autopsy report (finding the death resulted from a traumatic seizure disorder stemming from the 2009 work injury) was not completed and provided to the family until August 24, 2011—over eight months after death.
- West Virginia law generally requires applications for dependent’s death benefits be filed within six months of death (W. Va. Code § 23-4-15(a)). Ms. Sheena H., acting for her six-year-old granddaughter L.H., filed an application on February 24, 2012—six months after receiving the autopsy report.
- The claims administrator denied benefits as untimely, and also argued Ms. H. was not a proper party because she was not L.H.’s legal guardian. The Office of Judges and the Board of Review affirmed the denial as time-barred.
- The Supreme Court reversed and remanded, holding (1) the six-month limitation may be tolled where a claimant could not reasonably learn death was work-related due to delay in the medical examiner’s autopsy report, and (2) a grandparent may file on behalf of a minor dependent under the statute.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the 6‑month filing deadline for dependent’s death benefits can be tolled when the claimant lacked knowledge that death was work-related until after an autopsy report issued | Tolling should apply because no indication death was work-related until autopsy report was completed and provided to claimant; statute should run from when claimant could reasonably learn compensability | The statute is jurisdictional and contains no exception; the six-month period begins at date of death and cannot be tolled | Tolling permitted, but narrowly: if claimant, despite reasonable diligence, could not have learned death was work-related due to delay by the medical examiner in issuing an autopsy report, the six-month period is tolled until claimant could have learned of the autopsy finding; claimant still must file within six months after learning |
| Whether a grandparent (non‑guardian) may file an application on behalf of a minor dependent | Ms. H. (grandmother) may file because statute allows filing by a member of the family when dependent is incapable | Employer argued only a legal guardian may apply | Held: A family member (e.g., grandmother) may file on behalf of a minor dependent; rejection for lack of legal guardianship was error |
Key Cases Cited
- Chrystal R.M. v. Charlie A.L., 194 W.Va. 138, 459 S.E.2d 415 (de novo review applies to statutory interpretation)
- Bailey v. SWCC, 170 W.Va. 771, 296 S.E.2d 901 (held filing limitations were procedural; later abrogated by statute)
- Click v. Click, 98 W.Va. 419, 127 S.E. 194 (courts must disregard a literal construction that leads to injustice or absurdity)
- Wilkins v. State Comp. Comm’r, 120 W.Va. 424, 198 S.E. 869 (statute should allow reasonable time for investigation; literal cutoff may defeat legislative intent)
- Miller v. Romero, 186 W.Va. 523, 413 S.E.2d 178 (tolling a statute of limitation in wrongful-death context for fraudulent concealment; analogous principle discussed)