Radmila Pavlicek v. Jerabek, Inc., etc.Radmila Pavlicek v. Jerabek, Inc., etc.
Mary G. Commander, Norfolk (Goldblatt, Lipkin & Cohen, on brief), for appellee Jerabek, Inc., t/a Monastery Restaurant.
No brief or argument for appellee Uninsured Employer’s Fund.
Present: COLEMAN, WILLIS and BRAY, JJ.
BRAY, Judge.
Incidental to an award of benefits to Radmila Pavlicek (claimant) under the
The pertinent facts are substantially uncontroverted. On February 19, 1994, claimant was accidentally injured incidental to her employment. She subsequently retained counsel to pursue benefits under the Act, and a claim was lodged with the commission on March 11, 1994, accompanied by interrogatories and a request for production directed to employer. Employer received notice of the filing on March 12, 1994, and immediately retained counsel, Ms. Mary G. Commander, who “thereafter began [an] investigation into the facts of the injury, wages, insurance coverage, etc.”
On March 30, 1994, the commission noticed employer and Lumbermen’s Mutual Casualty Co. (Lumbermen’s), then identified as employer’s “carrier,” of the pending claim, together with a request for related documentation. This correspondence was followed on April 1, 1994, by an order of the commission directing the “carrier” to complete and return attached form “Order(s)” reporting the status of the claim. In response, the commission received the “Employer’s First Report Of Accident” from Ms. Commander on April 14, 1994, accompanied by a letter which expressed her “understanding that Kemper2 will be assuming the handling, and defense, if any, of this claim.” On that same date, however, Kemper notified the commission that it had declined coverage to employer.
In response to your concern, the Commission has never been advised that there is coverage so I assume that they have been treating this (or should have been, in any event) as a case which should be handled through the Uninsured Fund. That has been my assumption throughout. You may want to confirm this directly.
In the interim, counsel moved the commission, on April 4, 1994, to compel employer’s response to the pending discovery. Thereafter, on April 20, 1994, employer answered claimant’s interrogatories, declaring its intention to assert the defense that “[c]laimant was a casual worker,” not committed to “working on a regular basis,” with a “full-time job elsewhere.”3 Employer also reported claimant’s wage at $12.00 per week, plus tips. These responses prompted counsel to propound supplemental interrogatories to employer, “narrowly tailored” to the “casual worker” defense and wage issues. By letter to counsel dated April 23, 1994, Ms. Commander then advised that she did “not believe that there is a defense to the claim” and denied the existence of “any records” of claimant’s wages.
Pursuing the wage issue, counsel noticed employer to take the depositions of its employee, Anna Jerabek. However, Ms. Commander moved to quash, arguing that employer had “no idea whatsoever as to claimant’s average weekly wage” and that the scheduled time and date conflicted with a prior commitment. The commission thereafter quashed the notice, “for good cause shown,” and “encourage[d] the parties to
Following a hearing, the deputy, by opinion dated September 7, 1994, awarded temporary total disability and medical benefits to claimant, a fee to counsel and imposed a fine upon employer for failure to maintain the requisite insurance.4 Counsel thereafter moved the commission to allow additional attorney’s fees from those monies payable from the award to claimant’s health care providers pursuant to
Before the commission acted on counsel’s request, Ms. Commander objected, contending that the underlying claim was not contested and had not required “the services of an attorney” from “which the health care providers benefited.” Counsel disagreed and, following much correspondence between counsel, Ms. Commander, and the commission, a deputy determined that the original claim “was not ‘contested’” and “[t]he Commission does not have jurisdiction to award attorney’s fees, pursuant to
THE MOTION TO DISMISS
As a threshold issue, employer urges us to dismiss the appeal “for failure of the appellant/claimant to join all indis-
Fees of attorneys and physicians and charges of hospitals for services, whether employed by employer, employee or insurance carrier under this title, shall be subject to the approval and award of the Commission.
Id. Further,
[i]f a contested claim is held to be compensable under this title and, after a hearing on the claim on its merits or after abandonment of a defense by the employer or insurance carrier, benefits for medical services are awarded and inure to the benefit of a third party insurance carrier or health care provider, the Commission shall award to the employee’s attorney a reasonable fee and other reasonable pro rata costs as are appropriate from the sum which benefits the third party insurance carrier or health care provider.
Rule 18 of the Workers’ Compensation Commission Rules addresses consideration of those attorney’s fees authorized by
An attorney’s fee shall be awarded from sums recovered for the benefit of a third-party insurance carrier or a health care provider pursuant to § 65.2-714, Code of Virginia, only upon (1) evidence that such insurance carrier or health care provider was given reasonable notice that a motion for an award of such fee would be made and (2) evidence of the sum due such carrier or health care provider.
Employer does not dispute this well-established authority of the commission to control the “fees” and “charges” of both attorneys and health care providers or the sufficiency of notice
This argument ignores the procedural history of the claim. Despite notice, the record discloses that no health care provider sought party status at any time during the proceedings before the commission. Providers, including Sentara, appear in the record before the commission only to concur in the claim, joining in proposed orders awarding fees to counsel from the funds payable to each. Sentara’s challenge and assertion of a right to party status is first raised before this Court in a motion to dismiss the appeal. Employer likewise first argued on appeal that the health care providers were indispensable parties.
However, the question of party status to a health care provider in proceedings before the commission incidental to
THE CLAIM
In denying counsel’s prayer for attorney’s fees pursuant to
Here, we find that the words, “contested claim” in
Under such circumstances, we find that the claim was contested, as a matter of law, by a recalcitrant employer,
Reversed and remanded.