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Northrop Grumman Shipbuilding, Inc. v. Wardell Orthopaedics, P.C.

Court of Appeals of Virginia

February 28, 2017

NORTHROP GRUMMAN SHIPBUILDING, INC., N/K/A HUNTINGTON INGALLS INCORPORATED
v.
WARDELL ORTHOPAEDICS, P.C.

         FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION

          Bradley D. Reeser (Jonathan H. Walker; Christopher R. Hedrick; Mason, Mason, Walker & Hedrick, P.C., on briefs), for appellant.

          Kira A. Cook (Philip J. Geib; Philip J. Geib, P.C., on brief), for appellee.

          Present: Judges Humphreys, Beales and O'Brien Argued at Norfolk, Virginia

          OPINION

          RANDOLPH A. BEALES JUDGE.

         In this appeal, Huntington Ingalls Incorporated ("employer") appeals the decision of the Workers' Compensation Commission awarding payments for medical services provided by Wardell Orthopaedics, P.C. ("provider") to Charles Everett ("claimant"). On appeal, employer argues that the Commission erred (1) "by exercising jurisdiction over a dispute that did not involve any right of any injured worker, " (2) "by ignoring and perverting the terms of the Employer's settlement with the Claimant of all claims for past, present, and future medical expenses, " (3) "by finding that Dr. Arthur Wardell was an authorized treating physician under the Virginia Workers' Compensation Act, " (4) "by failing to require the Medical Provider to establish by preponderant evidence that the treatment provided was due to a compensable injury by accident that occurred during the course of and arose out of employment, " (5) "by permitting [provider] retroactively to seek additional sums under the Virginia Workers' Compensation Act when reimbursement had been paid fully and finally pursuant to the Longshore and Harbor Workers' Compensation Act, 33 U.S.C. §§ 901-950 (2012), and when the provider admitted it had long since written off the remaining account balance upon receipt of the Longshore payment, " and (6) "by liberally applying the doctrine of waiver and estoppel against the Employer, equating ironically the settlement of all claims with the knowing waiver of all defenses to such claims, and by refusing to apply the doctrine of accord and satisfaction to bar the claim of [provider] from reviving previously written off medical bills." For the following reasons, we affirm the Commission's ruling.

         I. Background

         Claimant suffered an injury at work on October 8, 2010 while in the employ of Newport News Shipbuilding, later known as Northrop Grumman Shipbuilding, Inc. and now known as Huntington Ingalls Incorporated. On December 13, 2010, claimant filed a claim for benefits with the Commission. On December 3, 2012, claimant and employer filed a joint petition to the Commission requesting the entry of a settlement order. In the petition, the parties agreed that claimant would receive a lump sum payment of $57, 500, less a deduction for attorney's fees. In exchange, employer would be "released from any and all further liability for further compensation, past, present or future, and future medical benefits." The joint petition asserted, "Employer shall be responsible for medical treatment pursuant to Section 65.2-603 incurred by the Claimant through the date of the entry of the Order approving the settlement and the Claimant shall be responsible for any and all medical expenses or any other costs incurred thereafter." Employer contested the compensability of claimant's claim in the joint petition. The joint petition also asserted that claimant had already been paid $61, 115.57 pursuant to the Longshore and Harbor Workers' Compensation Act ("the LHWCA"), 33 U.S.C. §§ 901-950 (2016), for claimant's October 8, 2010 injury.

          On January 14, 2013, the deputy commissioner entered an order that incorporated the settlement agreement of the parties ("the settlement order"). The settlement order stated, "Employer shall be responsible for medical treatment pursuant to Section 65.2-603 incurred by the Claimant through the date of the entry of the Order approving the settlement." Claimant was awarded a $46, 000 (after subtracting $11, 500 in attorney's fees) lump sum pursuant to the provisions of the settlement order. Employer signed the settlement order without objection.

         On October 20, 2014, provider filed a healthcare provider's application with the Commission seeking payment by employer of outstanding balances for medical services rendered to claimant for injuries he sustained as a result of his October 8, 2010 injury. A hearing on the issue was held by the deputy commissioner on January 11, 2016. Employer offered numerous defenses: (1) that claimant did not suffer a compensable accident arising out of and in the course of his employment; (2) that provider was not an authorized treating physician under the Virginia Workers' Compensation Act; (3) that provider's bills have already been paid pursuant to the LHWCA; and (4) that the provisions of laches apply to provider's claim. The deputy commissioner found in favor of provider and awarded to provider $12, 438.43 in unpaid medical services rendered to claimant prior to the entry of the settlement order.

         In support of his opinion, the deputy commissioner relied on the language of the January 14, 2013 settlement order in which employer agreed to be "responsible for medical treatment pursuant to Section 65.2-603 incurred by the Claimant through the date of the entry of the Order approving the settlement." The deputy commissioner also found that "resolution of the issues of the compensability of [claimant's] October 8, 2010 accident and the status of [provider] as an authorized treating physician is not relevant to the ultimate issue in this claim." Thus, "[b]y the terms of the settlement, [employer] accepted responsibility for the costs associated with the medical attention [claimant] received for injuries associated with his October 8, 2010 accident through the date of the entry of the [settlement] Order, rendering moot a decision regarding the compensability of his accident." The deputy commissioner also found that the settlement order did "not include a limitation or exclusion on [employer's] agreement to pay for medical treatment" based on the fact that provider did not serve as an authorized treating physician under the Act." Finally, the deputy commissioner also rejected employer's accord and satisfaction defense, finding that "there is no evidence in that representatives of [provider] gave assurances to [employer] that [provider] agreed to be bound by the payments made under the LHWCA."

         Employer appealed the matter to the full Commission. The full Commission affirmed the findings of the deputy commissioner in a unanimous opinion dated June 23, 2016. Before the full Commission, employer had argued that the Commission lacked jurisdiction to hear the matter because employer alleged that provider's claim did not involve a right or claim of an injured worker. The Commission found that it "has authority pursuant to Virginia Code § 65.2-201 to enforce its lawful orders and awards." It also concluded, "the Virginia Workers['] Compensation Commission has exclusive jurisdiction over disputes of physician fees or charges, Va. Code Ann. sec. 65.2-714(A)." The full Commission also rejected employer's argument that the Commission's decision in Riddick v. Newport News Shipbuilding & Dry Dock Co., 2016 VA Wrk. Comp. LEXIS 75 (VA Wrk. Comp. Feb. 8, 2016) was applicable to the facts of this matter. The full Commission held that the facts of this case were distinguishable from Riddick because the employer in Riddick had not agreed that it would be responsible for the payment of medical treatments that occurred during a specific time frame. This appeal followed.

         II. Analysis

         A. The Commission's ...


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