Opinion
C.A. No. 00A-11-001-JRS
Submitted: March 23, 2001
Decided: June 19, 2001
On Appeal from the Industrial Accident Board. Affirmed.
ORDER
This 19th day of June, 2001, upon consideration of Appellant's opening brief and the record in this case, it appears to the Court that:
Appellee did not file an answering brief.
1. Alex R. Smith ("Smith") initially sustained an injury to his lower back and left leg while employed by Rodel, Inc. ("Rodel" or "Employer"). After a hearing on Smith's petition for compensation, the Industrial Accident Board (the "Board" or "IAB"), in a decision dated March 10, 1999, granted Smith compensation for those injuries. That decision was affirmed on appeal to this Court.
Rodel, Inc. v. Smith, Del. Super., C.A. No. 99A-04-006, Quillen, J. (Jan. 13, 2000) (Letter Op.).
2. On January 21, 2000, Smith, through counsel, submitted a claim seeking compensation for subsequent treatment of his injuries to counsel for Rodel and its insurance carrier. Rodel did not respond to that claim until March 30, 2000, when, by letter to Smith's attorney, it refused to pay for the treatments.
3. On October 18, 2000, a hearing officer of the Board heard Smith's "Petition to Determine Additional Compensation Due." During that hearing, Smith argued that Rodel's untimely refusal to pay his medical expenses violated Industrial Accident Board Rule 4(B), and that this violation alone was a basis to require payment of his medical expenses in full.
IAB Hr'g No. 1130759.
4. Board Rule 4, titled "Notice of Denial of Liability," provides, in part:
(B) All medical expenses shall be paid by the carrier within 30 days after bills for said expenses are sent to the carrier for payment, unless the carrier notifies claimant or his/her attorney in writing that said expenses are contested or that further verification is required.
(C) Should claimant allege to the Board that the insurance carrier or self-insured has failed in its responsibilities under Sections (A) and (B) the Department will schedule a hearing. The claimant and the insurance carrier or self-insured employer will present their respective positions.
After the hearing, if warranted, the Board will assess a fine of not less than $100 nor more $1000.
5. Smith argued to the Board that since payment was not tendered "within 30 days after" he submitted the medical bills, the carrier was obligated to pay the entire amount. This argument was based on Rule 4(B), which states that the carrier "shall" pay the medical expenses unless it gives notice "that said expenses are contested or that further verification is required" within 30 days of their submission.
6. The Board agreed that Rodel had not provided a timely rejection of the claim for medical expenses in violation of Rule 4(B). Nevertheless, the Board rejected Smith's argument that a violation of Rule 4(B) automatically would require payment of the submitted expenses in full. In its decision, the Board ruled:
I agree with Rodel that a violation of this rule results in a fine, not a finding of responsibility for payment of the bills.
* * *
[G]iven that Rodel provided what I consider to be written notice that it was disputing the claim to [Smith] by letter dated March 30, 2000 . . ., just more than 60 days after the bills were sent and several months before the scheduled hearing, I find that a fine of $200 is appropriate."
Bd. Decision at 14.
7. In this appeal, Smith challenges only the Board's interpretation of Rule 4. The Board's decision with respect to the additional compensation due has not been appealed by either party.
8. In support of his interpretation of Rule 4, Smith has submitted a Board decision which reflects a reading of Rule 4 that arguably is inconsistent with the conclusion of the Board in this case. In Milotte, the State (as Milotte's employer) never responded to the claimant's submission of expenses in accordance with Rule 4(B), but only appeared at the hearing to contest the submission. The Board rejected all of the State's challenges to the submitted expenses (even after indicating they were meritorious) and held that, under Rule 4(B), since the State never notified Milotte of its intention to contest the claims, it was obligated to pay those claims in full.
See Milotte v. State, IAB No. 1145587 (Feb. 13, 2001)(ORDER).
Id. at 2.
9. The Board clearly has the power to promulgate rules of procedure to govern matters before it, provided, however, that those rules do not extend beyond the statutory boundaries of its authority as delineated by the General Assembly. When examining a decision of the Board, "the Superior Court must limit its scope of review to correcting errors of law and determining whether substantial evidence exists in the record to support the Board's findings of fact and conclusions of law." When considering the Board's legal conclusions, this Court "shall determine whether the Board erred as a matter of law in formulating or applying legal precepts." The Board's interpretation and application of its own rules is entitled to great deference, and the Court will upset the Board's interpretation only when it determines that "the Board exercised its power arbitrarily or committed an error of law. . . ." On occasion, however, the Board's interpretation of its rules will be rejected where that interpretation constitutes clear legal error.
See 19 Del. C. § 2121(a); Bethlehem Shipbuilding Corp. v. Mullen, Del. Super., 119 A. 314, 316 (1922).
M M, Inc. v. Wade, Del. Super., 297 A.2d 403, 405 (1972), overruled on other grounds, Mosley v. Bank of Del., Del. Supr., 372 A.2d 178, 180 (1977).
Robinson v. Metal Masters, Inc., Del. Super., C.A. No. 99A-12-004, Ridgely, P.J. (July 14, 2000), Mem. Op. at 3 (citing Histed v. E.I. DuPont de Nemours Co., Del. Supr., 621 A.2d 340, 342 (1993); Johnson v. Chrysler Corp., Del. Supr., 213 A.2d 64, 66 (1965)).
Keller v. Conco Tellus, Inc., Del. Super., C.A. No. 96A-02-014, Alford, J. (Sept. 25, 1996), Mem. Op. at 7 (citing State v. Cephas, Del. Supr., 637 A.2d 20, 23 (1994)).
See, e.g., Yellow Freight Sys. v. Berns, Del. Super., C.A. No. 98A-09-022, Barron, J. (March 5, 1999), Order at 11 ("[T]his Court will not force the Board to impose a literal and hyper-technical interpretation of [its] rules where the Board itself has chosen not to do so."); Riley v. Chrysler Corp., Del. Super., C.A. No. 85A-JN-10, Balick, J. (Mar. 6, 1987)(" Riley I"), Op. and Order at 2 ("The Board's interpretation of its own rule is entitled to great weight. . . ."); Bingham v. Jamesway, Del. Super., C.A. No. 91A-09-5, Balick, J. (Sept. 2, 1992), Op. and Order at 2 ("The Board's ruling involves the interpretation of a rule of the Board and the exercise of discretion.").
Riley v. Chrysler Corp., Del. Supr., No. 92, 1987, Moore, J. (Sept. 16, 1987)(" Riley II"), Order at ¶ 5, aff'g Riley I, supra (citing Olney V. Coach, Del. Supr., 425 A.2d 610 (1981)). See also Bingham, supra, Op. and Order at 2 ("The court w[ill] not reverse [the Board's interpretation of its own rule] unless clear error, abuse of discretion, or unfair prejudice is shown.").
See, e.g., Simmons v. Del. State Hosp., Del. Supr., 660 A.2d 384, 391-92 (1995) (ruling that the Board incorrectly applied Board Rule 24(D) in light of 19 Del. C. § 2127's mandate).
10. The Court has concluded that the Board's decision in this case should be affirmed. Smith's argument, upon initial examination, makes sense. When section (B) is read in isolation from the rest of Rule 4, it does appear to obligate Employer to pay the entire claim when it neglects to notify claimant of its rejection of the expenses within 30 days after submission of a claim. This interpretation of the Rule, however, breaks down when read in the context of section (C) of the Rule. And this Court will not force on the Board an interpretation of its own rule that altogether ignores an entire section of that rule.
Cf. Rainey v. Wilmington Parking Auth., Del. Super., 488 A.2d 906, 909 (1984) (pointing to the "basic premise of statutory construction that a statute should be construed to give effect to all of its provisions") (citing Nationwide Ins. Co. v. Graham, Del. Supr., 451 A.2d 832 (1982); DiSabatino v. Ellis, Del. Supr., 184 A.2d 469 (1962)).
11. Again, Rule 4(C) provides: "[a]fter the hearing [concerning alleged violations of section (B)], if warranted, the Board will assess a fine of not less than $100 nor more $1000." In this regard, section (C) clearly provides the Board with a remedy for violations of the rule's charge. The Board accepted this remedy, and found that the delay between January 21 and March 30 warranted a $200 fine. The Board's interpretation of Rule 4, including its application of the Rule, was not only within the Board's discretion, but also the correct legal result. Based on the foregoing, the Court cannot conclude that the Board committed "an error of law in interpreting" Rule 4.
The fines authorized by Rule 4(C) for noncompliance are analogous to the sanctions authorized by Superior Court Civil Rule 37. Specifically, the Court's civil rules require that parties meet certain deadlines. When they fail to do so, the Rules dictate the appropriate sanctions which can be meted out to the offending party in the Court's discretion. A violation of our civil rules does not, however, give rise to sanctions not called for in the rules themselves. Novak v. Tigani, Del. Super., 112 A.2d 853 (1955). Likewise, having specifically designated a sanction for a violation of Rule 4 within the Rule itself, the Board, unless otherwise specified, is obliged to observe the designated sanction, and to refrain from creating ad hoc sanctions when moved by no more than the spirit to do so.
Riley II, supra, Order at ¶ 5.
12. The Board's decision in Milotte can not alter the result reached here. The provisions of Rule 4 are quite clear: if a party fails to pay or notify the claimant that the claim will be contested under section (B), the claimant may petition the Board for a hearing on the matter. If the Board determines that a violation of the Rule occurred, section (C) provides for the imposition of a fine for noncompliance. The Rule does not set forth, as an available remedy, the result which Appellant now seeks and which the Board sanctioned in Milotte. For this reason, the Board reached a result in Milotte that is inconsistent with Rule 4's clear mandate. Accordingly, the Board's decision in this case, and specifically its interpretation of Rule 4, should be, and hereby is, AFFIRMED.
IT IS SO ORDERED.