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Dietz v. South Mississippi Regional Center

Court of Appeals of Mississippi, En Banc

April 11, 2017

ALESHIA DIETZ APPELLANT
v.
SOUTH MISSISSIPPI REGIONAL CENTER AND MISSISSIPPI STATE AGENCIES WORKERS' COMPENSATION TRUST APPELLEES

          DATE OF JUDGMENT: 03/01/2016

         TRIBUNAL FROM WHICH APPEALED: MISSISSIPPI WORKERS' COMPENSATION COMMISSION

          ATTORNEYS FOR APPELLANT: JAMES KENNETH WETZEL GARNER JAMES WETZEL

          ATTORNEY FOR APPELLEES: JEFFREY STEPHEN MOFFETT

          IRVING, P.J.

         ¶1. On June 30, 2015, an administrative judge (AJ) ruled in favor of Aleshia Dietz, finding that she was not time-barred from asserting her claim to continue receiving medical benefits from her employer, South Mississippi Regional Center (Employer), because Employer had previously paid her wages in lieu of compensation, thereby tolling the two-year statute of limitations. On March 1, 2016, the Workers' Compensation Commission (Commission) reversed the AJ's ruling, finding that Dietz's claim was time-barred because she was not paid wages in lieu of compensation and, therefore, the statute was not tolled; thus, her failure to file a claim within two years precluded her from recovering additional benefits. Dietz now appeals, arguing that she did not file a formal claim within two years of her injury because she relied on assurances from Mississippi State Agencies Workers' Compensation Trust (Carrier) that it would "take care of everything." Dietz argues that the Employer/Carrier should be estopped from asserting the statute of limitations as a defense.

         ¶2. We reverse and render and remand to the Commission for further proceedings.

         FACTS

         ¶3. In May 2011, Dietz began working as a nurse for Employer. She worked twelve-hour shifts on a "rotating schedule."[1] Dietz's shifts involved caring for twenty to twenty-four patients, which required some moderate physical activity. On January 10, 2012, Dietz was involved in a car accident while running an errand for work.[2] Dietz immediately reported the accident to her supervisor. Later that evening, Dietz reported that she was feeling some pain in her neck and back. She filled out the requisite paperwork and saw a nurse practitioner the following day. In April 2012, Dietz began seeing Dr. Eric Wolfson, who recommended that Dietz visit a chiropractor three to four times a week; Dietz began doing so on August 23, 2012. Dietz maintains that, post-injury, she continued to work for Employer in a "modified, light duty position." Because Dietz continued working, Employer/Carrier did not pay her workers' compensation indemnity benefits; however, Employer/Carrier did authorize and pay for Dietz to receive medical treatments and attend medical appointments pertaining to her injury.

         ¶4. In March 2012, Dietz first met with Alice Posey, the adjuster for Carrier. Dietz asserts that she expressed concerns to Posey about how to proceed with her claim because this was her first experience with workers' compensation; however, Posey assured Dietz "not to worry because she would take care of everything." When Dietz asked Posey whether she should hire an attorney, Posey told her there was no need because she was "going to take care of it all." Posey authorized payment of all of Dietz's medical expenses. Furthermore, Posey even assigned a nurse case manager to Dietz's claim, who scheduled and attended all of Dietz's injury-related medical appointments.

         ¶5. Dietz maintains that she ultimately missed a substantial amount of work as a result of these medical treatments and appointments; at trial, Dietz testified that she often took full days off for medical appointments, and sometimes took off a day or more at a time when she had epidurals to her neck performed. Dietz further contended that she missed work as a result of migraine headaches brought on by her injury. Dietz filled out various leave-of-absence forms for the days that she missed work.[3] Dietz conceded at trial that she "obviously . . . kept terrible records" during this time because she was unsure what to write on the forms; for example, sometimes she would write "comp."[4] or "fmla" on the forms, while other times she marked "medical" as the reason for taking leave or just did not specify at all. Ultimately, however, when asked how many days she had off during the calendar years 2012, 2013, and 2014, Dietz replied, "There's been so many I couldn't guess."

         ¶6. Dietz testified that despite all of these absences, her salary never decreased. Dietz speculated that she must have run out of her allotted leave time at some point; however, Employer's human-resources manager testified that, to her knowledge, Dietz never exceeded her leave time. Dietz testified that Employer/Carrier paid for her medical appointments without issue for two years from the date of Dietz's injury, and that at no point prior to January 13, 2014, did they represent that they planned to cease payment of Dietz's medical treatment. Dietz testified that on January 13, 2014, she attended an appointment with Dr. Wolfson, who "recommended additional cervical epidural injections, physical therapy again for three to four weeks and [a] follow-up in four to six weeks." Dietz testified that her Carrier-assigned nurse case manager attended this appointment, yet never indicated that Carrier was about to cease payment of Dietz's medical treatment.

         ¶7. In mid-January, shortly after her January 13, 2014 appointment with Dr. Wolfson and more than two years after Dietz initially sustained her injury, Dietz received a letter from Employer/Carrier in which Employer/Carrier declared that it would no longer pay for Dietz's injury-related medical treatment because Dietz had failed to file a formal claim within the applicable two-year statute of limitations. Dietz maintains that she was shocked by this letter, as she had received no indication that Employer/Carrier was planning to suspend her benefits. Dietz immediately retained legal counsel and filed a petition to controvert on January 16, 2014.

         ¶8. On June 30, 2014, an AJ conducted a hearing wherein Dietz testified that she was led to believe that she did not need to file a formal claim because of Posey's assurances that it was all being taken care of. The AJ ultimately held for Dietz, finding that Employer/Carrier's "voluntary payment of salary in lieu of compensation or its payment of medical benefits within two years after the date of injury waived the [necessity for] filing of a formal claim within that period." The AJ also reasoned that Carrier had assured Dietz that she did not need to take action to enforce her right to benefits, and that Dietz relied on those assurances to her detriment. The AJ held that Employer/Carrier was therefore estopped from asserting the statute of limitations as a defense.

         ¶9. Feeling aggrieved, Employer/Carrier appealed the AJ's order to the Commission. On March 1, 2016, the Commission reversed the AJ's order, finding that Employer/Carrier's payment of Dietz's medical benefits did not constitute wages in lieu of compensation; thus, the two-year statute of limitations was not tolled and Dietz was barred from continuing to receive benefits. Additionally, the Commission rejected the AJ's ruling that payment of medical benefits in the two years after the date of injury waived the necessity for filing a formal claim. Dietz filed a timely notice of appeal.

         DISCUSSION

         ¶10. This Court's review in workers' compensation cases "is limited to determining whether the Commission's decision was supported by substantial evidence, was arbitrary and capricious, was beyond the scope or power of the agency to make, or violated . . . constitutional or statutory rights." Pulliam v. Miss. State Hudspeth Reg'l Ctr., 147 So.3d 864, 868 (¶16) (Miss. Ct. App. 2014) (internal citations and quotations omitted). "Our supreme court has also stated the Commission will only be reversed 'for an error of law or an unsupportable finding of fact.'" Smith v. Johnston Tombigbee Furniture Mfg. Co., 43 So.3d 1159, 1164 (¶15) (Miss. Ct. App. 2010). "When the Commission's decision is supported by substantial evidence, then it must be upheld. This remains true even though we might have reached a different conclusion were we the trier of fact." Parker v. Ashley Furniture Indus., 164 So.3d 1081, 1083-84 (¶11) (Miss. Ct. App. 2015) (citations omitted). However, issues of law, including matters involving statutes of limitations, will be reviewed de novo. Ladner v. Zachry Constr., 130 So.3d 1085, 1088 (¶9) (Miss. 2014). Additionally, "when the agency has misapprehended a controlling legal principle, no deference is due, and our review is de novo." ABC Mfg. Corp. v. Doyle, 749 So.2d 43, 45 (¶10) (Miss. 1999).

         ¶11. As stated, Dietz argued before the AJ-and the AJ agreed-that the two-year statute of limitations had been tolled because she was paid wages in lieu of compensation, based on the fact that she continued to receive her entire salary for the two years following her injury and her paycheck never varied despite missing a "substantial" amount of work to receive medical treatment pertaining to that injury. Dietz also argued-and the AJ agreed-that the Employer/Carrier should be estopped from asserting the two-year statute of limitations as a bar because she had relied on the Employer/Carrier's repeated assurances and representations that it would take care of everything.

         ¶12. Employer/Carrier argued-and the Commission agreed-that Dietz was not paid wages in lieu of compensation, based on the fact that Dietz enjoyed a flexible work schedule, which could have allowed her to schedule and attend medical appointments on days when she was not working. The Commission also rejected the finding of the AJ that the Employer/Carrier was estopped from asserting the two-year statute-of-limitations bar, finding instead "that the overwhelming weight of [Deitz's] testimony does not establish that the adjuster's statements misled or prevented [Dietz] from taking action on her claim." In support of its conclusion, the Commission then inserted a footnote, which states: "To the contrary, [Dietz's] counsel signed and dated the Petition to Controvert on the two-year anniversary of the injury date; it was just not filed with the Commission prior to the expiration of the two-year period."

         ¶13. Dietz's notice of appeal states, in relevant part: "Diet [sic], feeling aggrieved by the [d]ecision of the Commission, dated March 1, 2016, desires to appeal said [d]ecision and [o]rder of the Mississippi Workers' Compensation Commission to the Mississippi Supreme Court." In her appeal, Dietz states the issue as follows: "The Commission erred as a matter of law and fact in reversing the administrative . . . judge as same is arbitrary and capricious and not supported by substantial evidence and contrary to law and should be reversed and remanded."[5]

         ¶14. Dietz argues that she did not file a formal claim within two years after her injury because she relied on multiple reassurances from Employer/Carrier's adjuster that it would "take care of everything, " and that the Commission's finding to the contrary is not supported by substantial evidence. We agree. As stated, in addressing this argument, the Commission found "that the overwhelming weight of [Deitz's] testimony does not establish that the adjuster's statements misled or prevented [Dietz] from taking action on her claim."

         ¶15. We readily acknowledge that the Commission is the fact-finder, and as stated, our review is limited to a determination of whether the Commission's finding is supported by substantial evidence. So we look at the evidence. First, Dietz's testimony that she was repeatedly assured by the Employer/Carrier adjuster Posey that Employer/Carrier would take care of everything and that she did not need an attorney is not contradicted. Employer/ Carrier did not offer Posey to rebut Dietz's testimony. Second, Posey assigned a case manger to Dietz, and the case manager made, and attended, all of Dietz's medical appointments. Third, on January 13, 2014, three days after the expiration of the two-year statutory period for filing a petition to controvert, Employer/Carrier paid for medical expenses incurred by Dietz for her work related-injury.

         ¶16. We turn to the Commission's finding. What is the testimony, given by Dietz, that the Commission found to show overwhelmingly that Dietz did not rely on the assurances and representations of the Employer/Carrier that it would take care of everything? We quote the relevant portion of the Commission's order:

Lastly, the Order of Administrative Judge makes mention of Claimant's testimony regarding her interaction with the Adjuster for the Employer/Carrier. A closer look at Claimant's testimony reveals that in early March of 2012, the adjuster told Claimant that "she would take care" of compensation and medical benefits owed to Claimant. . . . Claimant further testified that she received similar assurances throughout the time of her medical care. However, Claimant testified during cross-examination that after her doctor's appointment on December 19, 2013, there were no assurances made by the Carrier nor discussions concerning her need for legal counsel in the claim. . . .The Commission finds that the overwhelming weight of Claimant's testimony does not establish that the adjuster's statements misled or prevented Claimant from taking action on her claim.

         The Commission, however, overlooked the rest of Dietz's testimony that she gave during direct examination, all of which was uncontradicted:

Q. Now, your conversation with Ms. Posey leading up - - you went through 2012, 2013. You were dealing directly with your adjuster?
A. Yes, sir.
Q. You had no attorney --
A. No.
Q. What was she telling you through [the] 2012, 2013 period leading up to January 2014 in reference to whether you needed an attorney, whether or not -- what she ...

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