Gary L. Adams v. United StatesGary L. Adams v. United States
The Adams appeal the dismissal of their tort action brought under
I.
Jason Lee Adams was born at Eglin Air Force Base on July 25, 1976. Within 24 hours of his birth, the Air Force arranged for the child to be sent to Sacred Heart Hospital in Pensacola, Florida, for special treatment and evaluation. The Air Force then had him returned for care to Eglin.
The test results disclosed that the child had cerebral palsy secondary to hypoxic encephalopathy with spastic quadriplegia and microcephaly. The evaluation indicated that the child’s condition was caused by brain damage resulting from a lack of oxygen to the brain, and that the child’s prognosis was very poor. It is unlikely that his condition will ever improve or that he will have a very meaningful life. Jason will always require total care.
Gary L. Adams and Deborah A. Adams filed a claim with the Air Force against the United States on behalf of themselves and their son Jason pursuant to the Federal Tort Claims Act (FTCA),
The claims officer responded on March 81, requesting, under authority of
We will fully develop this claim with respect to the private physicians and thenecessary future expenses, and when you have had an opportunity to fully investigate everything at your disposal, we will be more than happy to exchange information in full.
In an April 18 letter, the claims officer stated that the requested information was “necessary to evaluate this claim and [was] required by this agency.” He added that Jason had been transferred to Sacred Heart without a diagnosis; the Air Force physicians had been unable to determine the cause of the child’s problems. The claims officer also stated,
I assume that from your conversations with me you do not evaluate cases without having all the facts and also would not expect us to evaluate this case without having all the facts. In addition, your failure to cooperate and supply us with the necessary information could result in a denial of your claim on that basis and prejudice your rights to proceed in federal court.
On June 12, appellants replied, “I hope you understand that we are in no way refusing to cooperate with your office and will furnish to you all of the items requested in your earlier letters as soon as we have received them ourselves.” The Adams’ executed medical authorizations were forwarded to the claims officer on July 5.
The claims officer wrote on July 19, asking that x-rays picked up by Mrs. Adams be returned as soon as possible “in order for me to complete the investigation of this claim.” Responding on July 24, the Adams offered to return the x-rays, if the Air Force would promise to return them within ten days after receipt. On July 26, the claims officer insisted on the return of the x-rays, emphasizing that they were crucial to the evaluation of the claim and that without them the claim’s merits could not be determined. They were returned on August 15.
In an affidavit dated November 14, the Adams’ attorney stated that prior to filing the administrative claim, he had discussed Jason’s condition with Air Force pediatrician Dr. Harlan W. Sindell. He stated further that he was told that Dr. Sindell had the “benefit of the medical information” obtained by Sacred Heart. Dr. Sindell’s affidavit denies this fact. The claims officer’s affidavit states that he never received this information or damage information. In short, there is a factual controversy as to what information was available to Air Force physicians. The Adams’ attorney contends that he read the claims officer’s letters as narrowing his requests, whereas the claims officer contends that his requests were cumulative.
After more than six months had passed without the settlement of their claim, the Adams brought this action in federal district court. They alleged that Jason’s severe and permanent disabilities resulted from the negligent prenatal and delivery care provided by Air Force physicians. The district court found that the Adams had failed to make a proper claim with the Air Force. The court held that, even if the Air Force had the information needed to process their claim, the Adams were obligated both to state that they had not incurred any medical expenses of which the Air Force was not informed and to provide the Air Force with information regarding necessary future medical expenses. On this basis, their action was dismissed. The court did not reach the statute of limitations issue raised by the United States.
II.
Title
Under
The Air Force, therefore, basically argues that the Adams’ failure to comply with
III.
The argument of the Air Force fails for two reasons. First, it erroneously assumes that the notice requirements of
IV.
Congress’ intent in enacting
The relevant legislative history indicates two congressional purposes in requiring claimants to provide the relevant agency with notice of their claims. First, in enacting the notice requirement, Congress sought “to ease court congestion and avoid unnecessary litigation, while making it possible for the Government to expedite the fair settlement of tort claims asserted against the United States.” S.Rep.No.1327, 89th Cong., 2d Sess. 6 [hereinafter cited as S.Rep.], reprinted in [1966] U.S.Code Cong. & Admin.News, pp. 2515, 2516. This efficiency purpose, however, accompanies a second purpose “of providing for more fair and equitable treatment of private individuals and claimants when they deal with the Government or are involved in litigation with their Government.” S.Rep. at 5, reprinted in [1966] U.S.Code Cong. & Admin. News at pp. 2515-16.
The
Congress thought it preferable that claimants go first to the relevant agency. If the agency found settlement to be appropriate and if the case were settled at that point, considerable benefit would accrue to all parties concerned. 7 If no settlement obtained, the claimant could still proceed with his or her claim in federal court.
Final denial [of a presented claim] . includes instances where partial approval of a claim results in an offer unacceptable to the claimant and rejected by him. . However if the agency fails to act in 6 months, the claimant may at his option elect to regard this inaction as a final denial and proceed to file suit. It is obvious that there will be some difficult tort claims that cannot be processed and evaluated in this 6-month period.
S.Rep. at 8, reprinted in [1966] U.S.Code Cong. & Admin.News at p. 2518. 8
The two congressional purposes are adequately served if the prerequisite administrative claim is only the giving of “notice of an accident within a fixed time.” S.Rep. at 7,
reprinted in
[1966] U.S.Code Cong. & Admin.News at p. 2517. Congress intended the
The purpose of this notice [is] . . . — * * * to protect the [government] from the expense of needless litigation, give it an opportunity for investigation, and allow it to adjust differences and settle claims without suit.
Id.
(quoting 18 E. McQuillin,
The Law of Municipal Corporations
§ 53.153, at 545 (3d ed. 1977)). This requisite minimal notice, therefore, promptly informs the relevant agency of the circumstances of the accident so that it may investigate the claim and respond either by settlement or by defense. In addition, as
An individual with a claim against the United States, therefore, satisfies
V.
Section 2672 governs agency conduct, including administrative settlement and adjustment of properly presented claims, once notice has been given pursuant to section 2675.
See
S.Rep. at 8,
reprinted in
[1966] U.S.Code Cong. & Admin.News at 2518. It facilitates settlement by authorizing the Department of Justice to promulgate regulations defining the settlement process for administrative claims and authorizing federal agencies to promulgate additional regulations and to “consider, ascertain, adjust, determine, compromise, and settle any claim for money damages against the United States.”
The requirements of section 2675 and of
A claimant will ordinarily comply with
Congress explicitly recognized that, unlike routine cases, medical malpractice cases
A claimant’s refusal to settle his or her claim will not deprive the federal court of jurisdiction, if the claimant has provided the statutorily required notice. Although many claimants will rationally elect to settle their claims, 13 Congress clearly did not deem settlement mandatory. 14
VI.
Because Congress’ express goals were achieving fairness and efficiency by giving the relevant agency the opportunity to investigate and to settle claims without the expense and delay of litigation, we cannot perceive any legislative authorization for reading the requirements of section 2675 in light of
Having satisfied Congressional standards for presenting a claim under section 2675, the Adams are not barred from litigating their claim in federal court. The district court thus committed reversible error. The Adams notified the agency of their claim and assigned a value to it. 17 This compliance is not erased merely because they did not obey the Air Force’s demand that they provide additional information which would have been necessary for the administrative settlement of their claim.
A federal court’s power to adjudicate a tort claim brought against the United States depends solely on whether the claimant has previously complied with the minimal requirements of the statute.
VII.
If
A claim is considered to have been presented when the Air Force receives an executed SF 95 or written notification of an incident, together with a claim for money damage in a sum certain, for property loss or damage, personal injury or death from a claimant, his duly authorized agent, or his legal representative.
REVERSED and REMANDED.
Notes
.
(b) Personal injury. In support of a claim for personal injury, including pain and suffering, the claimant may be required to submit the following evidence or information:
(1) A written report by his attending physician or dentist setting forth the nature and extent of the injury, nature and extent of treatment, any degree of temporary or permanent disability, the prognosis, period of hospitalization, and any diminished earning capacity. In addition, the claimant may be required to submit to a physical or mental examination by a physician employed by the agency or another Federal agency. A copy of the report of the examining physician shall be made available to the claimant upon the claimant’s written request provided that he has, upon request, furnished the report referred to in the first sentence of this paragraph and has made or agrees to make available to the agency any other physician’s reports previously or thereafter made of the physical or mental condition which is the subject matter of his claim.
(2) Itemized bills for medical, dental, and hospital expenses incurred, or itemized receipts of payment for such expenses.
(3) If the prognosis reveals the necessity for future treatment, a statement of expected expenses for such treatment.
(4) If a claim is made for loss of time from employment, a written statement from his employer showing actual time lost from employment, whether he is a full or part-time employee, and wages or salary actually lost.
(5) If a claim is made for loss of income and the claimant is self-employed, documentary evidence showing the amounts of earnings actually lost.
(6) Any other evidence or information which may have a bearing on either the responsibility of the United States for the personal injury or the damages claimed.
(a) For purposes of the provisions ofsection 2672 of Title 28, United States Code, a claim shall be deemed to have been presented when a Federal agency receives from a claimant, his duly authorized agent or legal representative, an executed Standard Form 95 or other written notification of an incident, accompanied by a claim for money damages in a sum certain for injury to or loss of property, personal injury, or death alleged to have occurred by reason of the incident. If a claim is presented to the wrong Federal agency, that agency shall transfer it forthwith to the appropriate agency.
. The Air Force has promulgated its own additional regulations regarding administrative claims.
. Our decision only addresses the question whether an administrative claim has been presented in compliance with
. “Another objective of this bill is to reduce unnecessary congestion in the courts." S.Rep.
. “[I]n private practice where prelitigation settlements are allowed, only 40 percent of claimants for personal injuries file suit and of these cases, less than 10 percent reach trial and only 3 percent go to verdict.” S.Rep. at 6, reprinted in U.S.Code Cong. & Admin.News at p. 2517.
. Agency settlement of substantial numbers of tort claims would enable the Civil Division to give greater attention to those cases which involve difficult legal and damage questions in such areas as medical malpractice, drug and other products liability, and aviation accidents. These areas of litigation are expanding at a steady pace.
S.Rep. at 9, reprinted in [1966] U.S.Code Cong. & Admin.News at p. 2520.
. “The filing of the suit and the consequent expense to the Government in preparing the case would appear to be unnecessarily involved when the case is a proper one for early settlement.” S.Rep. at 8, reprinted in [1966] U.S. Code Cong. & Admin.News at p. 2518.
. In effect, therefore, Congress sought only to eliminate the middlemen, the courts and the U.S. attorneys. “The purpose of the [mandatory administrative claims procedure] was not to make recovery from the Government technically more difficult.”
Executive Jet Aviation, Inc. v. United States,
. In promulgating
This procedure [of filing claims with the appropriate federal agency] would make it possible for the claim first to be considered by the agency whose employee’s activity allegedly caused the damage. That agency would have the best information concerning the activity which gave rise to the claim.
S.Rep. at 7, reprinted in [1966] U.S.Code Cong. & Admin.News at p. 2517 (emphasis added).
This intent is also clearly discernible in congressional statements assessing the legislation’s likely impact on the workload of agencies:
The bill will not assign novel tasks to the agencies. They now investigate all accidents involving their employees, prepare litigation reports on all tort cases, suggest Government defenses to claims, and, at the request of the Department of Justice, comment on all settlement offers presented to the Department. The views of the affected agency have always been taken into account by the Department in accepting or rejecting an offer of settlement.
S.Rep. at 8, reprinted in [1966] U.S.Code Cong. & Admin.News at p. 2519 (emphasis added).
The Attorney General’s comments in a March 10, 1966, letter to the Speaker of the House of Representatives are similar:
These proposals are designed to improve the disposition of monetary claims by and against the Government — claims which now comprise the bulk of civil litigation involving the Government. The proposals should ease court congestion, avoid unnecessary litigation, speed up settlements, and reduce the number of stale claims.' Such results would, of course, not only benefit private litigants but be beneficial to the courts, the agencies, and the Department of Justice.
S.Rep. at 10, reprinted in [1966] U.S.Code Cong. & Admin.News at p. 2524.
. The portion of
. Neither claimants nor agencies are compelled to settle claims. If, however, an agency and a claimant deem settlement appropriate,
. In
Executive Jet Aviation, Inc. v. United States,
. We therefore propose that a procedure be instituted under which all claims would be presented to the appropriate agencies for consideration and possible settlement before court action could be instituted. A claim would first be considered by the agency whose employee’s activity allegedly caused the damage and which possesses the greatest information concerning that activity. As a result, it is expected that meritorious claims would be settled more quickly, without the need for expensive and time-consuming litigation or even for filing suit.
S.Rep. at 10, reprinted in [1966] U.S.Code Cong. & Admin.News at p. 2524 (comments of the Attorney General) (emphasis added).
. Assuming that claimants act rationally, Congress realized that a claimant would use settlement procedures if he or she would benefit from doing so:
This committee in recommending this legislation further points out that it grants the agencies of Government sufficient authority to make the administrative settlements a meaningful thing. The bill would provide the agencies with the authority to make settlement offers which could result in settlement in a large percentage of tort claims cases whereunder today’s conditions the present $2,500 limit means that administrative settlements are limited to property damage claims and relatively minor personal injury claims. There is good reason to believe that even in many of these cases a claimant may decide to file suit because of the present limits upon administrative settlement. This is because as soon as the case is filed, the Government can negotiate a settlement without regard to that limitation. It does not appear that this procedure is conducive to efficient claims administration. The filing of the suit and the consequent expense to the Government in preparing the case would appear to be unnecessarily involved when the case is a proper one for early settlement.
S.Rep. at 7-8, reprinted in [1966] U.S.Code Cong. & Admin.News at p. 2518.
. Seldom have circuit courts been presented with the precise question before us. A number of cases, however, have held that
In other cases, courts have also assumed that
. A contrary interpretation is not suggested by
. The propriety of regulations requiring a claimant to include a statement of money damages does not rest on the relation between