ARCTEC SERVICES, an ASRC Company, and ASRC Service Center, Appellants, v. Gayle CUMMINGS, Appellee.
No. S-14457.
Supreme Court of Alaska.
March 8, 2013.
295 P.3d 916
Michael J. Wenstrup, Law Office of Michael J. Wenstrup, LLC, Fairbanks, for Appellee.
Before: FABE, Chief Justice, WINFREE, STOWERS, and MAASSEN, Justices.
OPINION
MAASSEN, Justice.
I. INTRODUCTION
While receiving workers’ compensation benefits for an injury, an employee periodically endorsed benefit checks that included a certification that she had “not worked in any employment or self-employment gainful or otherwise.” Her employer obtained surveillance videos of her activities at an herb store owned by her boyfriend and filed a petition with the Workers’ Compensation Board alleging that she had fraudulently misrepresented her employment status for the purpose of obtaining benefits. The Board denied the petition, finding credible the employee‘s testimony that she did not consider her activities to be work that needed to be reported. On appeal, the Alaska Workers’ Compensation Appeals Commission concluded that the Board erred in determining that the employee had not “knowingly” misrepresented her work status, but it affirmed the Board‘s denial of the petition on the alternative ground that the employer had not shown the requisite causal link between the allegedly fraudulent check endorsements and the payment of benefits.
We hold that the Commission erred in its interpretation of the “knowingly” element of the test for fraud. We nonetheless affirm the Commission‘s decision because, based on the Board‘s binding credibility determination, the employee‘s statements were not knowingly false and therefore not fraudulent.
II. FACTS AND PROCEEDINGS
Gayle Cummings lived in Fairbanks and worked as a cook for ARCTEC Services at Clear Air Force Station from 1998 until 2006. In August 2006 she hurt her neck, back, and hip while lifting a grill cover. She went to see the medic at Clear, then received treatment from a chiropractor in Fairbanks. ARCTEC accepted that the claim was compensable and began paying workers’ compensation benefits. Cummings continued to receive chiropractic treatment.
In January 2007, Cummings underwent an employer‘s medical examination (EME) with Barry Matthisen, a chiropractor. Dr. Matthisen opined that her treatment to that point had been reasonable and necessary but that she was not yet medically stable. Cummings‘s treating chiropractor referred her to Advanced Pain Centers, where she saw several medical doctors. One of them rated
Cummings applied for reemployment benefits, waiving her right to receive job dislocation benefits instead.1 She developed a reemployment plan with Dan LaBrosse, a rehabilitation counselor with Compensation Risk Consultants (CRC). She told him that her long-term goal was to open a store that sold herbal remedies. They were unable to develop this option in Cummings‘s reemployment plan, however, due to the lack of labor market information about it; LaBrosse did not think the reemployment benefits administrator (RBA) would approve the plan without such information. Given Cummings‘s interests they also considered the occupations of naturopathic doctor and nutritionist, ultimately excluding these options due to the length of training,2 need to relocate, and cost.3 The reemployment plan submitted to the RBA was limited to training as a food services manager. According to LaBrosse, the plan would give Cummings some background in business management, which she could later use in her preferred occupation of selling herbal remedies.
Cummings‘s reemployment plan required that she attend classes at the University of Alaska, Fairbanks. She went to one day of class in early 2008, but her doctor excused her from further attendance after she experienced a flare-up of her neck pain while riding the campus shuttle-bus. Her reemployment plan was medically suspended, and she again began receiving benefits for temporary total disability.
In November 2006, several months after her injury but about a year before she began the reemployment process, Cummings had received a business license as a sole proprietor in the name of Alaska Herb USA. She allowed the license to expire a month later. Cummings‘s boyfriend, Larry Schander, used the same business name in November 2007 to obtain a business license as a sole proprietor. Schander testified later that he had planned to wait until retirement to open a business with Cummings selling herbs, but after she was injured he felt that he “had to get her out of the house before she committed suicide.” The two of them rented a storefront in the Regency Court Mall in Fairbanks.
Cummings spent a considerable amount of time at the store, assisting customers and selling herbs. She did not keep time records and was not paid for her work, and the store was not profitable. Both Cummings and Schander testified that the store did not always keep regular hours and that Cummings could choose not to work if she did not feel like it. Cummings and Schander shared responsibility for the store: she kept track of inventory and sales, and he took the information to an accountant or bookkeeper. Both Schander and Cummings had access to the store‘s bank account.
Cummings also bought and sold herbs online through a website with the same name as the store. She testified that she purchased herbs for the store through the website, used herbs from the store to fill online orders, and used money from online sales to buy items for the store.
Cummings testified that she considered her work at the store to be a hobby. She testified that she spent much of her time at the store in activities that were not business-related, such as assembling care packages for troops in Iraq and Afghanistan and sending letters and emails to soldiers to boost their morale. She also testified that she was not the only person who staffed the store: her son, who was then in his late teens, worked there periodically, as did a friend. Schander testified that he sometimes worked there too.
ARCTEC hired a private investigator for Cummings‘s case in August 2007, several
In July 2008, ARCTEC filed a petition for a finding of fraud; it alleged that Cummings had misrepresented her work status as well as “her condition and her physical capabilities to several doctors” and sought reimbursement of past benefits, costs, and attorney‘s fees. ARCTEC filed a controversion notice the same day, alleging that Cummings was “working on a full time basis and thus[ ]is no longer entitled to time loss benefits or reemployment benefits.” ARCTEC filed with the Board copies of six cancelled benefits checks Cummings had signed. Each check had a stamp with the following statement on the back: “I certify, as attested by my signature, that I have not worked in any employment or self-employment, GAINFUL OR OTHERWISE DURING THE PERIOD OF DISABILITY COVERED BY THIS CHECK.”
The Board held a hearing on the fraud petition in June 2010. Witnesses included Cummings; her rehabilitation counselor, LaBrosse; the claims adjuster for ARCTEC; the private investigator; and Dr. Patrick Radecki, a physician ARCTEC had hired to do a second EME. Schander and Dr. George Allen, Cummings‘s treating chiropractor, testified by deposition. At the end of the hearing, ARCTEC narrowed its request to seek only reimbursement of those benefits paid while Cummings was working at the herb store—from December 2007 through July 2008—and agreed to waive attorney‘s fees and costs as long as Cummings agreed not to pursue her workers’ compensation claim any further.
The Board denied ARCTEC‘s petition. The Board found first that Cummings had not misrepresented her physical capabilities to doctors during the course of the claim. It noted that the only doctor who thought Cummings was exaggerating her symptoms was Dr. Radecki, whose testimony the Board gave little weight because he had never examined Cummings but rather had formed his opinion based on a review of medical records and surveillance videos.
The Board found Cummings to be credible when she testified that she considered her activities at the store to be volunteer work that she did not need to report. The Board therefore concluded that Cummings had not knowingly made false or misleading statements for the purpose of obtaining workers’ compensation benefits. The Board found in the alternative that even if Cummings had knowingly made false statements, ARCTEC had failed to prove that these statements were a causal factor in its payment of benefits.
ARCTEC appealed only that part of the decision related to the alleged overpayment of benefits during the time Cummings worked at the store. It argued that it had proven both a knowing misrepresentation and justifiable reliance as matters of law. It argued that the Board should have used an objective standard to evaluate Cummings‘s claim that she considered her activities a hobby: it contended that her “rationalizations” had to be “objectively reasonable.”
The Commission agreed with ARCTEC that Cummings had knowingly misrepresented her employment status. It said that “Cummings’ credibility is not the issue here” and framed the issues instead as “1) whether her belief that her volunteer work was not employment was objectively reasonable, and 2) whether the circumstances that she credibly testified to legally constitute[d] a violation of ...
The Commission did, however, agree with the Board‘s alternative holding on causation. It cited the adjuster‘s testimony that the purpose of the certification on the benefits checks was to remind claimants about the need to report work, and it observed that there was no evidence that the adjuster actually looked at the backs of the cancelled checks before issuing more checks. The Commission therefore decided that ARCTEC had not met its burden of proving that any misrepresentation was a causal factor in the continuing payment of benefits. ARCTEC appeals.
III. STANDARD OF REVIEW
In workers’ compensation appeals, we directly review the decision of the Commission.4 When the issue presented is one of “statutory interpretation requiring the application and analysis of various canons of statutory construction,” we apply our independent judgment.5 We interpret statutes “according to reason, practicality, and common sense, considering the meaning of the statute‘s language, its legislative history, and its purpose.”6 We “adopt the rule of law
IV. DISCUSSION
We can affirm an administrative decision on any basis supported by the record, even if the agency did not rely on it.9 We do that here. The Commission rejected the Board‘s conclusion that Cummings had not knowingly made a false statement, but it affirmed the Board‘s denial of ARCTEC‘S fraud petition on grounds that ARCTEC had failed to prove causation. We conclude that the Commission erred in its decision. We conclude that “knowingly,” for purposes of fraud claims under
1. “Knowingly” for purposes of AS 23.30.250(b) means having the subjective intent to defraud.
This case requires that we again interpret
If the board, after a hearing, finds that a person has obtained compensation, medical treatment, or another benefit provided under this chapter by knowingly making a false or misleading statement or representation for the purpose of obtaining that benefit, the board shall order that person to make full reimbursement of the cost of all benefits obtained.12
Both subsection (a) and subsection (b) use the term “knowingly” to describe certain proscribed conduct.13
In Municipality of Anchorage v. Devon, we held that the Board‘s test for fraud claims “comport[ed] with the language of
As the Commission observed, we have not previously interpreted the “knowingly” element of the fraud test in the context of
ARCTEC asks us to adopt the Commission‘s “objectively reasonable” standard for “knowingly,” which it argues would appropriately limit the Board‘s “power to essentially ignore objective and undisputed facts by spinning them away through re-characterizations.” ARCTEC asks alternatively that we adopt the definition of scienter found in the
We cannot reconcile these arguments with the legislature‘s choice of the word “knowingly.” In construing a statute, we first consider the meaning of the words used. “Technical words and phrases and those that have acquired a peculiar and appropriate meaning, whether by legislative definition or otherwise, shall be construed according to the peculiar and appropriate meaning.”21 The workers’ compensation statutes do not give a context-specific definition of “knowingly,”22 but criminal law does define it for purposes of
Before the legislature rewrote
Because subsection (a) of the statute imposes criminal liability, we construe its term “knowingly” in accordance with criminal law.27
[A] person acts “knowingly” with respect to conduct or to a circumstance described by a provision of law defining an offense when the person is aware that the conduct is of that nature or that the circumstance exists; when knowledge of the existence of a particular fact is an element of an offense, that knowledge is established if a person is aware of a substantial probability of its existence, unless the person actually believes it does not exist....
The legislative history of
Given our “rule of statutory interpretation that the same words used twice in the same statute have the same meaning,”29 we conclude that “knowingly” in
2. The Board‘s credibility finding is binding for purposes of appellate review.
The Board found credible Cummings‘s testimony that she was never paid for her work at Alaska Herb USA, that it was purely voluntary, that “she was only pursuing a hobby to keep her engaged and positive while she was enduring her disability,” and that she did not consider it to be employment that she needed to report. The legislature has given the Board “the sole power to determine the credibility of a witness,” and the Board‘s determination of credibility “is conclusive even if the evidence is conflicting or susceptible to contrary conclusions.”34 Here, the Board‘s factual findings and credibility determination led it to the conclusion that Cummings did not knowingly make a false or misleading statement when she endorsed the disability checks.35
Here, the Board found Cummings‘s testimony credible, and the Commission was bound by that determination. Her credible testimony supports the Board‘s finding that ARCTEC failed to prove that she knowingly made a false or misleading statement for the purpose of obtaining workers’ compensation benefits.
V. CONCLUSION
For the foregoing reasons, we AFFIRM the Commission‘s decision.
CARPENETI, Justice, not participating.
MAASSEN
Justice
