ALYSSA M. CLAYTON, Appellee, v. UNIVERSITY OF KANSAS HOSPITAL AUTHORITY and SAFETY FIRST INSURANCE COMPANY, Appellants.
No. 115,674
Court of Appeals of Kansas
January 13, 2017
388 P.3d 187
Opinion filed January 13, 2017.
Matthew Stretz, of Stretz/Quinn
James E. Martin, of The Law Office of James E. Martin, of Overland Park, for appellee.
BRUNS, J.: This is an appeal brought by the University of Kansas Hospital Authority and Safety First Insurance Company from an order entered by the Workers Compensation Board finding that Alyssa Clayton had overcome the statutory presumption, under
FACTS
The facts of this case are undisputed. On October 6, 2011, Clayton injured her left knee arising out of and in the course of her employment at the University of Kansas Hospital (Hospital). Clayton filed a claim for workers compensation benefits and ultimately settled. At a settlement hearing held on May 30, 2013, an administrative law judge approved the agreement of the parties to settle for a lump sum payment of $9,435—based on an 8.5 percent permanent partial impairment of the left knee—with future medical treatment and review left open.
At the hearing, the administrative law judge also considered a letter from Aakash A. Shah, M.D., of the Kansas City Spine and Sports Medicine Center, dated April 8, 2013. In his letter, Dr. Shah stated that he had last evaluated Clayton on March 5, 2012. At the time of his evaluation, Dr. Shah noted that Clayton had a left knee lateral femoral condyle high-grade articular chondral lesion. He further noted his understanding that Clayton wanted to pursue definitive nonoperative treatment.
Regarding future medical treatment, Dr. Shah opined in his letter:
“I believe [Clayton] will likely need future medical treatment that is directly related to this slip and fall injury given her high-grade articular chondral lesion over the lateral femoral condyle. Future medical treatment may necessitate steroidal injection, viscosupplementation injection, and/or surgical intervention utilizing arthroscopy with debridement, chrondroplasty, microfracture procedure.” (Emphasis added.)
On June 15, 2015, the Hospital filed an application for post-award medical termination and a motion to terminate future medical benefits pursuant to
On November 25, 2015, the administrative law judge found that Dr. Shah‘s letter was sufficient to constitute competent medical evidence to rebut the statutory presumption that no further medical care is needed by Clayton as a result of the injury she suffered in October 2011 at the Hospital. Specifically, the administrative law judge interpreted
The Hospital timely appealed to the Workers Compensation Board (Board). Instead of
ANALYSIS
On appeal, the primary issue presented is whether the Workers Compensation Board erred in concluding that Clayton had overcome the statutory presumption—under
When a statute is plain and unambiguous, we must give effect to its express language. It is not our role to determine what the law should or should not be. Graham v. Dokter Trucking Group, 284 Kan. 547, 554, 161 P.3d 695 (2007). This means we are not to speculate on legislative intent. Bergstrom v. Spears Mfg. Co., 289 Kan. 605, 607-08, 214 P.3d 676 (2009). Moreover, although both parties suggest in their briefs that we are to give deference to the Board‘s interpretation of the law, this is no longer true. May v. Cline, 304 Kan. 671, 675, 372 P.3d 1242 (2016). As the Kansas Supreme Court has made abundantly clear, the doctrine of operative construction has “been abandoned, abrogated, disallowed, disapproved, ousted, overruled, and permanently relegated to the history books.” Douglas v. Ad Astra Information Systems, 296 Kan. 552, 559, 293 P.3d 723 (2013).
Accordingly, we must attempt to determine legislative intent by applying the meaning of the statute‘s text—giving ordinary words their ordinary meaning—to the specific situation in controversy. See State v. Phillips, 299 Kan. 479, 495, 325 P.3d 1095 (2014). We do not read into the statute words not readily found there. Casco v. Armour Swift-Eckrich, 283 Kan. 508, 525, 154 P.3d 494 (2007). Only if the language of the statute is unclear or ambiguous do we employ the canons of statutory construction, consult legislative history, or consider other background information to determine legislative intent. Hoesli v. Triplett, Inc., 303 Kan. 358, 362, 361 P.3d 504 (2015).
Furthermore, when the legislature revises an existing law, we presume that it intended to change the law as it existed prior to the amendment. City of Dodge City v. Webb, 305 Kan. 351, 356, 381 P.3d 464 (2016); Nuessen v. Sutherlands, 51 Kan. App. 2d 616, 621, 352 P.3d 587 (2015). Even when various statutory provisions are unambiguous, we are to consider them pari materia with a view of reconciling and bringing the provisions into workable harmony if possible. Neighbor v. Westar Energy, Inc., 301 Kan. 916, 919, 349 P.3d 469 (2015). Likewise, we must construe statutes to avoid unreasonable results and presume the legislature does not intend to enact meaningless legislation. Milano‘s, Inc. v. Kansas Dept. of Labor, 296 Kan. 497, 501, 293 P.3d 707 (2013).
Interpretation of K.S.A. 2015 Supp. 44-510k(a)(3)
Prior to 2011, the Kansas Workers Compensation Act,
“(3) If the claimant has not received medical treatment, as defined in subsection (e) of
K.S.A. 44-510h , and amendments thereto, from an authorized health care provider within two years from the date ofthe award or two years from the date the claimant last received medical treatment from an authorized health care provider, the employer shall be permitted to make application under this section for permanent termination of future medical benefits. In such case, there shall be a presumption that no further medical care is needed as a result of the underlying injury. The presumption may be overcome by competent medical evidence.”
At the same time, the legislature also amended
Based on our reading of plain language of the current version of the Kansas Workers Compensation Act, we conclude that the legislature has expressed its intent that future medical benefits should not be automatically ordered or left open by enacting
From a procedural perspective, we find that
Initially, the burden of proof is on the employer to come forward with evidence that the claimant has failed to obtain treatment from a health care provider for a period of 2 years from the original award or from the last date upon which the claimant received medical treatment. Upon successfully meeting its burden, the employer is entitled to a statutory presumption “that no further medical care is needed as a result of the underlying injury.” At that point, the burden of proof shifts to the claimant to attempt to overcome the statutory presumption.
In other words, once the presumption in favor of the employer comes into play, it is solely the claimant‘s burden to establish that “further medical care is needed as a result of the underlying injury.”
Furthermore,
We agree with the Hospital that in many instances new competent medical evidence may be required to overcome the statutory presumption that no additional medical treatment is needed resulting from the underlying injury. For example, an updated evaluation of the claimant by a health care provider to determine within a reasonable degree of medical probability whether the claimant needs additional medical treatment due to the work-related injury would be sufficient new evidence. We do not agree, however, that this will be necessary in every case. In some cases, the original medical evidence may be sufficient to establish within a reasonable degree of medical probability or likelihood that medical care in addition to what has already been received will be needed in the future as a result of the underlying injury. For example, a claimant may need a medical device arising out of the work-related injury that will require replacement in 5 or 10 years. Accordingly, we find that the question of whether the medical evidence is competent to overcome the statutory presumption must be determined on a case-by-case basis.
Application of K.S.A. 2015 Supp. 44-510k(a)(3)
In the present case, it is undisputed that Clayton did not receive medical treatment resulting from her work-related injury within 2 years from the date of the settlement hearing. As a result, the Hospital was entitled to the “presumption that no further medical care is needed as a result of the underlying injury.”
A review of the record reveals that the Board relied solely on the opinions stated in Dr. Shah‘s letter dated April 8, 2013—based on his evaluation of Clayton in March 2012—to conclude that she had overcome the statutory presumption that no further medical treatment was needed as a result of the underlying injury. The letter from Dr. Shah is not sworn to under oath and is based on a physical examination that was completed nearly 5 years ago. Although Dr. Shah believed at the time of the settlement hearing that it was likely that Clayton would need future medical care, the record does not reflect what his opinion might be today regarding whether there is a need for treatment in addition to what has already been received for the underlying injury. Thus, we do not find Dr. Shah‘s letter—in and of itself—to be sufficient to constitute competent medical evidence to overcome the statutory presumption under
Under the circumstances presented, we believe that the appropriate remedy is to reverse the Board‘s decision and to remand this matter for a new hearing on the Hospital‘s application and motion to terminate future medical benefits. At the new hearing, the burden of proof will be on Clayton to come forward with “competent medical evidence“—as that term is defined in this opinion—to overcome the presumption that no medical treatment is needed in addition to what has already been received as a consequence of her work-related injury suffered on October 6, 2011. In light of this conclusion, we do not find it necessary to reach the issue of whether Clayton‘s counsel is entitled to attorney fees.
Reversed and remanded with directions.