Margaret JOHNSON, Appellant, v. NORTH DAKOTA WORKERS COMPENSATION BUREAU, Appellee.
Civ. No. 880009.
Supreme Court of North Dakota.
Aug. 17, 1988.
427 N.W.2d 514
Dean J. Haas, Asst. Atty. Gen. (argued), North Dakota Workers Compensation Bureau, Bismarck, for appellee.
ERICKSTAD, Chief Justice.
This appeal arises from a dispute between the North Dakota Workers Compensation Bureau and claimant Margaret Johnson regarding the amount of reimbursement she is entitled to receive for expenses connected with traveling to and from medical treatment. Johnson appeals from a district court judgment. The Bureau reimburses claimants for travel expenses pursuant to its own “Directive No. 15-C Amended.” We conclude the Bureau‘s directive is ineffective as it relates to Johnson because
Johnson was injured while working at the “Bonanza Steakhouse” in Jamestown, North Dakota. The Bureau accepted Johnson‘s claim and paid disability and certain medical benefits. However, Johnson asserted that she was not fully reimbursed for the expenses of traveling to and from medical and rehabilitation treatment. Johnson requested twenty cents per mile reimbursement for the cost of driving her own vehicle and “per diem allowance for food and lodging at the same rate as state employees....”
The Bureau rejected Johnson‘s assertion in an administrative order, stating that its “payment of nine cents per mile and actual costs of the meals and lodging is reasonable and is compatible” with
Johnson made several trips from Jamestown to Fargo (93 miles one way), and Oakes to Fargo (approximately 117 miles one way). She was apparently reimbursed for these trips pursuant to Directive 15-C. Johnson alleges she made 19 trips to Lisbon Hospital for physical therapy. She traveled 41 miles one way on each of these trips. The Bureau refused to reimburse her for these trips as they were less than 50 miles one way.
After the Bureau refused to grant Johnson a hearing to consider the amount of reimbursement, Johnson requested a rehearing asserting the Bureau‘s reimbursement policy was “arbitrary” and “unreasonable.” The Bureau denied Johnson‘s request for a rehearing, noting that the Bureau is not required by statute to reimburse claimants for travel expenses. The Bureau noted that “[t]he facts in dispute in this matter are legislative about policy. Therefore, the Bureau is not required under law to hold a formal hearing in this matter.” The Bureau also denied payment of Johnson‘s attorney‘s fees on the ground that Johnson‘s claim was frivolous.
Johnson appealed the Bureau‘s decision to district court, reasserting that the Bureau‘s practice of reimbursing claimants for travel expenses is “arbitrary, unreasonable, and capricious, is not in accordance with The North Dakota and United States Constitutions and is not in accordance with North Dakota law and statute, particularly the Administrative Agencies Practice Act,
The district court apparently concluded that the Bureau pays travel expenses pursuant to its own rule; that the rule the Bureau relies on is invalid because it has not been adopted pursuant to the North Dakota A.A.P.A. (
“[I]nvalid under
Chapter 28-32 NDCC , and will continue to be so until the Attorney General makes a ruling as to its legality. Thus, this Court declines to make a ruling on [Johnson‘s] contentions until such time as an Attorney General‘s opinion has been issued.“The [Bureau] is hereby ordered to comply with
Sec. 28-32-02 NDCC , and once an opinion has been issued, this Court will consider the appeal on its merits.”
“II.
“Bureau Directive No. 15-C is an administrative rule and subject to the Administrative Agencies Practice Act,
N.D.C.C. Chapter 28-32 .“III.
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N.D.C.C. § 28-32-02 requires Bureau Directive No. 15-C to be reviewed by the Attorney General as to its legality.“IV.
“The Bureau must obtain an Attorney General‘s opinion as to the legality of Directi[ve] No. 15-C, in order for the Court to consider this appeal on its merits.”
In a judgment based on the above order the district court held that the Bureau could not set the rates at which claimants were to be reimbursed for their travel expenses without first promulgating a rule pursuant to the A.A.P.A. Despite the fact that the district court partially ruled in Johnson‘s favor, Johnson appealed from the judgment of the district court to this Court raising four basic contentions.
I
Bureau Directive 15-C is invalid because it was not enacted pursuant to the A.A.P.A. and, even if Directive 15-C were valid under the A.A.P.A., it would remain in violation of
II
The Bureau deprived Johnson of her state and federal constitutional rights to due process of law by refusing to grant Johnson a hearing to determine the amount of money she should be reimbursed for travel expenses.
III
The Bureau deprived Johnson of her state and federal constitutional rights to equal protection of the laws because the Bureau pays its employees more for travel expenses than it pays claimants.
IV
The Bureau must pay interest on attorney‘s fees due when the Bureau fails to pay attorney‘s fees in a “timely” manner.
Because of our disposition of Johnson‘s first contention, we find it unnecessary at this juncture to address Johnson‘s two constitutional attacks on Directive 15-C. Johnson‘s first contention rests in part on the assumption that
“65-05-07. Injured employee given medical and hospital service required—Furnished artificial limbs and appliances for rehabilitation. Immediately after an injury sustained by an employee and during the resulting period of disability, the fund shall furnish to the employee such medical, surgical, and hospital service and supplies as the nature of the injury may require.” [Emphasis added.]
The express language of
Johnson contends not only that travel expenses “ought to be” implied from a statute which provides for “medical, surgical, and hospital service ...” but additionally that the Bureau‘s reimbursement be “reasonable.” Johnson suggests that the reimbursement rates for state employees found in
The principal defect of Johnson‘s argument is that, if adopted, it would require this Court to usurp the function of the legislative branch of government. We decline to formulate a “reasonable” rate of reimbursement or direct the Bureau to formulate a “reasonable” rate in the absence of a statute which expressly directs this Court or the Bureau to do so.
The district court‘s order and judgment did not address the threshold issue of whether or not the Bureau is required to pay travel expenses by statute. The Bureau concedes that travel expenses may be implied from
We are aware that other jurisdictions have decided that travel expenses are an implied part of medical services. See e.g., Hite v. Evart Products Co., 34 Mich.App. 247, 191 N.W.2d 136, 141 (1971) (absent showing state‘s travel regulation allowing state employees nine cents was unreasonable, workers compensation claimant traveling 18 miles from her home was entitled to same mileage allowance); Pavel v. Hughes Brothers, Inc., 167 Neb. 727, 94 N.W.2d 492, 499 (1959) (“reasonable” medical and hospital services includes the cost of travel incident to obtaining such services); Gonzales v. Bates Lumber Co., 96 N.M. 422, 631 P.2d 328, 330 (Ct.App.1981) (statute requiring employer to provide “reasonable” medical services impliedly includes travel expenses incident to medical treatment); Ney v. State Workmen‘s Compensation Commissioner, 297 S.E.2d 212, 215 (W.Va.1982) (“Although the language of the statute does not expressly provide for reimbursement for travel expenses in-
Johnson argues that the Bureau Directive 15-C is invalid because it was not promulgated pursuant to the A.A.P.A.
“6. ‘Rule’ means the whole or a part of an agency statement of general applicability that implements, interprets, or prescribes law or policy, or the organization, procedure, or practice requirements of the agency. The term includes the amendment, repeal, or suspension of an existing rule. The term does not include:
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“g. A form whose contents or substantive requirements are prescribed by rule or statute or are instructions for the execution or use of the form.”
The district court concluded that the Bureau‘s present rule was not an excepted rule pursuant to
“65-02-08. Rulemaking power of the bureau—Fees prescribed by bureau. The bureau shall make, promulgate, and enforce such rules, not inconsistent with the provisions of this title, as may be necessary to carry out the provisions of this title. All fees on claims for legal, medical, and hospital services rendered under this title to any claimant must be in accordance with schedules of fees adopted or to be adopted by the bureau....” [Emphasis added.]
The Bureau argues that it pays travel expenses voluntarily without statutory command and that
The Bureau argues that the emphasized language in
We find nothing in the language of
In its order and judgment the district court may have ruled that Directive 15-C would comply with A.A.P.A. “once an [attorney general‘s] opinion has been issued” upholding Directive 15-C. If so, the district court was mistaken.
“Prior to the adoption, amendment, or repeal of any rule, the agency shall adopt a procedure whereby all interested persons are afforded reasonable opportunity to submit data, views, or arguments, orally or in writing. In case of substantive rules, opportunity for oral hearing must be granted if requested. The agency shall consider fully all written and oral submissions respecting the proposed rule.”
We believe it is clear that Directive 15-C is a “substantive” rule within the meaning of
Johnson also contends that the Bureau must “pay interest on bills for legal services which were not timely paid as provided by
On its face,
“Every state agency ... which acquires property or services pursuant to a contract with a business shall pay for each complete delivered item ... on the date required by contract ... or, if no date for payment is specified by contract, within forty-five days after receipt of the invoice covering the delivered items or services.”
The term “business,” however, may imply an ambiguity. In order to determine the construction the Legislature put on this term, we look to the legislative history.
The Committee reports concerning
Further, no provision in
We conclude that because the Bureau reimburses for travel expenses, Johnson is entitled to reimbursement of travel expenses pursuant to a Bureau rule duly promulgated pursuant to the North Dakota Administrative Agencies Practice Act.
The judgment of the district court is affirmed to the extent we have indicated and it is reversed to the extent we have indicated. The case is remanded to the Bureau so that it may fully comply with the A.A.P.A. and more particularly
GIERKE, VANDE WALLE and LEVINE, JJ., concur.
MESCHKE, Justice, concurring.
With the understanding that the majority opinion directs that “Johnson is entitled to reimbursement of travel expenses pursuant to a Bureau rule duly promulgated,” I concur.
Notes
Johnson contends the Bureau concedes that
Subsequent to oral arguments before this Court, the Bureau amended its rule concerning payment of travel expenses in conjunction with medical services. Effective August 1, 1988,
“Mileage and per diem for travel to and from medical treatment. The North Dakota workers compensation bureau recognizes payment for travel to and from medical treatment as an implied benefit of reasonable and necessary medical expenses, pursuant to the terms of
North Dakota Century Code section 65-05-07 .“The North Dakota workers compensation bureau shall pay mileage for travel to and from medical treatment at the rate set by the legislative assembly for state employees, as provided in
North Dakota Century Code section 54-06-09 . Mileage must be measured from city limit to city limit. In order to foster efficiency and to administer the provisions of this rule, no payment for mileage may be paid when the distance traveled is less than fifty miles [80.47 kilometers] one way, unless the total mileage equals or exceeds two hundred miles [321.87 kilometers] in a calendar month.“The North Dakota workers compensation bureau shall pay the costs of necessary lodging and per diem when the claimant must be away from home as a result of necessary medical treatment at the rate set by the legislative assembly for state employees, as provided in
North Dakota Century Code section 44-08-04 , except that out-of-state lodging may not exceed one hundred twenty-five percent of the allowance for in-state lodging. However, the bureau may pay no more than actual cost of meals and lodging, with receipt required.”
“Particular controls general. Whenever a general provision in a statute is in conflict with a special provision in the same or in another statute, the two must be construed, if possible, so that effect may be given to both provisions, but if the conflict between the two provisions is irreconcilable the special provision must prevail and must be construed as an exception to the general provision, unless the general provision is enacted later and it is the manifest legislative intent that such general provision shall prevail.”
“13-01.1-02. When interest payment required. Interest shall accrue and be made on payments overdue under
1985 Senate State and Federal Government Committee Minutes (March 5, 1985). Senator Lips stated:
“The objective of the legislation is to make certain those businesses providing goods and services to government receive payment in a reasonable period of time and to also encourage government agencies to maintain efficient financial management practices. The legislation is aimed at making governmental entities operate in the same manner and with the same ground rules that the private sector operates on on a day to day basis. This legislation clarifies that state government and political subdivisions are subject to payment of interest on past due accounts.
“With depressed economy, such as we are presently experiencing, many small businesses in particular, have a difficult time maintaining adequate cash flow. This is a problem that should not be compounded by the failure of government to pay its bills in a timely manner. This legislation is intended to stimulate prompt payment and thus help those North Dakota businesses who are not receiving timely payment for the goods and services provided to governmental entities within the state.”
Myron Nelson, representing the Greater North Dakota Association stated:
“This bill originated from our small business council of the GNDA. The GNDA got involved with this primarily because of a result of a survey of small businesses taken over the state last fall. What we found is that there is a definite concern with the small businesses as they have to wait for the money being received while they are providing the services.”
