Weaver, S. v. Breon, T., II ( 2017 )

J-S70013-17
NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
SHEILA WEAVER : IN THE SUPERIOR COURT OF
: PENNSYLVANIA
Appellant :
:
v. :
:
THOMAS BREON, II :
:
Appellee : No. 781 MDA 2017
Appeal from the Order Entered March 30, 2015
In the Court of Common Pleas of Centre County
Civil Division at No(s): 13-0267
BEFORE: GANTMAN, P.J., SHOGAN, J., and OTT, J.
MEMORANDUM BY GANTMAN, P.J.: FILED DECEMBER 14, 2017
Appellant, Sheila Weaver (“Wife”), appeals from the order entered in
the Centre County Court of Common Pleas, which required Thomas Breon, II
(“Husband”) to pay Wife a total of $148.31 for unreimbursed medical
expenses, in this action for spousal support/alimony pendente lite. We affirm.
The relevant facts and procedural history of this case are as follows.
The parties married on July 15, 1985, and separated on June 25, 2013. On
July 10, 2013, Wife filed a complaint for spousal support/alimony pendente
lite. The court held a support conference on August 21, 2013. By order dated
August 21, 2013, and entered August 27, 2013, the court ordered Husband
to pay Wife a total of $1,400.00 per month in support. The order contained
the following provision regarding unreimbursed medical expenses:
The monthly support obligation includes cash medical
support in the amount of $250 annually for unreimbursed
J-S70013-17
medical expenses incurred for each child and/or spouse as
ordered herein. Unreimbursed medical expenses of the
obligee or children that exceed $250 annually shall be
allocated between the parties. The party seeking allocation
of unreimbursed medical expenses must provide
documentation of expenses to the other party no later than
March 31st of the year following the calendar year in which
the final medical bill to be allocated was received. The
unreimbursed medical expenses are to be paid as follows:
76.00% by [Husband] and 24.00% by [Wife].
(Support Order, filed August 27, 2013, at 3; R.R. at 007). The effective date
of the order is July 10, 2013. (See id. at 1; R.R. at 005).
On June 19, 2014, Wife filed a petition for contempt in the Centre County
Court of Common Pleas, alleging Husband had failed to comply with the
August 2013 support order. Specifically, Wife claimed she had sent Husband
a letter on March 10, 2014, requesting payment for unreimbursed medical
expenses Wife incurred in 2013 and 2014, and submitted documentation of
those expenses. Wife sought payment of $18,201.04, the majority of which
pertained to Wife’s dental/orthodontic treatment. Wife claimed Husband
refused to pay. Husband filed a motion to quash the petition on June 26,
2014. Following a hearing on August 8, 2014, the court granted Husband’s
motion to quash, directing Wife to file her petition in the Domestic Relations
Section (“DRS”).1
On August 25, 2014, Wife filed a “Petition for Enforcement of Support
____________________________________________
1 The August 8, 2014 hearing transcript is not in the certified record.
-2-
J-S70013-17
Order and for Civil Contempt” in the DRS, claiming Husband failed to comply
with the August 2013 support order.2 Conference Officer Jeffrey Martin
responded to Wife’s petition by letter dated September 3, 2014, explaining
Wife’s petition would be forwarded to Enforcement Officer Timothy Weight to
determine what, if any, further enforcement action would take place. The
letter directed Wife to contact Mr. Weight for a status update regarding
enforcement of Wife’s claims. Mr. Martin’s letter also included a copy of the
DRS’ policy on “Collection of Unreimbursed Medical Expenses.” The policy
states, in relevant part:
It is the responsibility of the Plaintiff to utilize any and all
forms of health insurance coverage or medical assistance to
meet expenses before a bill is forwarded to the Defendant
for payment. The bill submitted for payment of
unreimbursed medical expenses should be forwarded to the
other party within 30 days of being finalized with the
medical provider or insurance company. In other words,
when a client obtains the “bottom line” on what is owed in
out-of-pocket expenses, (s)he has 30 days to submit that
expense to the other party for payment. In return, the
Defendant should remit payment directly to the Plaintiff
within 30 days. Bills can be submitted to the Defendant via
certified mail. All unreimbursed medical bills must be
provided to the other party not later than March 31 of the
year following the calendar year in which the final bill was
received by the party seeking allocation. Any unreimbursed
medical expense that is not resolved between the parties
may be submitted to DRS only between January 1st and
May 31st for the previous calendar year. Domestic
____________________________________________
2 Meanwhile, Wife filed a petition to modify, seeking an increase in support.
On September 10, 2014, the DRS entered a new support order, effective June
24, 2014, which reduced Husband’s allocation for payment of unreimbursed
medical expenses from 76% to 56%. Wife initially objected to the new support
order, but she later withdrew those objections.
-3-
J-S70013-17
Relations is not responsible for sorting through bills and
receipts, nor for tallying expenses; therefore, the official
DRS medical bill submission form must accompany any
documentation submitted for collection. A certified receipt
confirming the expense was received in a timely manner by
the Defendant can be submitted to the DRS with a copy of
the unpaid bill(s). Proof of receipt must be submitted to the
DRS in order for enforcement services to be provided. If a
bill is not paid in the appropriate time period, the party who
failed to make payment may be cited for Contempt of Court
or the total amount owed may be added to the case balance
with the arrears payment and wage attachment increased
to pay on this expense. It is important to note that a
possible consequence of a contempt citation is
incarceration. Any expense submitted to the DRS AFTER
May 31st for the previous calendar year, per Centre County
Court of Common Pleas policy, will not be enforced by the
DRS.
(Collection of Unreimbursed Medical Expenses Policy at 1; R.R. at 473)
(emphasis in original). Husband subsequently objected to Wife’s petition.
Enforcement Officer Mr. Weight investigated Wife’s petition but was
unable to resolve whether she was entitled to payment for the alleged
unreimbursed medical expenses based on the documentation provided.
Consequently, on October 23, 2014, the DRS filed a “contempt” petition3
against Husband, requesting an evidentiary hearing before the court. The
court scheduled a hearing for December 3, 2014, but ultimately relisted the
____________________________________________
3According to Mr. Weight, the petition was not a true “contempt” petition but
was the only available mechanism for the DRS to bring the parties’ dispute
before the court.
-4-
J-S70013-17
matter for February 3, 2015.4
The court held a hearing on February 3, 2015, at which Wife and Mr.
Weight testified. Wife testified about the various unreimbursed medical
expenses she incurred in 2013 and 2014, and produced documents of the
medical bills she had received.5 Mr. Weight testified he requested a hearing
in this matter because he could not resolve whether Wife was entitled to
payment for her alleged unreimbursed medical expenses. Mr. Weight
explained that some of Wife’s claims pre-dated the effective date of the
support order, other claims did not include original bills or receipts, and he
could not discern whether Wife met the $250.00 threshold for 2013 or 2014.
Following the hearing, the court requested submission of post-hearing
briefs. Wife filed her post-hearing brief on February 19, 2015, and Husband
filed his post-hearing brief on March 6, 2015. On March 30, 2015, the court
entered an order requiring Husband to pay Wife a total of $148.31 for
unreimbursed medical expenses Wife incurred in 2013. The court decided
____________________________________________
4 The record suggests the court held a brief hearing on or around December
3, 2014, but that hearing transcript is not in the certified record. According
to Wife, the parties appeared before the court on that date, at which time a
representative from the DRS advised the court the DRS would not enforce
Wife’s petition with respect to her 2013 unreimbursed medical expenses,
pursuant to the DRS’ policy that expenses submitted to the DRS after May 31st
will not be enforced, and because Mr. Weight was unavailable to testify.
5 Wife claimed in earlier proceedings that Husband was responsible for
$18,201.04 in unreimbursed medical expenses, but Wife sought only
$14,735.33 at the February 3, 2015 hearing.
-5-
J-S70013-17
Wife did not meet the eligibility threshold for the expenses she submitted for
2014.
Wife filed a notice of appeal on April 29, 2015, at docket No. 754 MDA
2015. On July 16, 2015, this Court issued a per curiam rule to show cause
why the appeal should not be dismissed where no transcripts were prepared
for the appeal because Wife did not properly serve the Court Reporter with
the notice of appeal and request for transcript, per Pa.R.A.P. 1911(a), (d)
(stating appellant shall request any required transcript and make necessary
payment; appellate court may dismiss appeal if appellant fails to take action
for preparation of transcript). That same date, this Court issued a separate
rule to show cause why the appeal should not be quashed as interlocutory,
due to the pendency of the parties’ divorce proceedings. See generally
Thomas v. Thomas, 760 A.2d 397 (Pa.Super. 2000) (holding spousal support
order entered during pendency of companion divorce action is interlocutory
and not appealable until final disposition of divorce and all economic claims
connected to divorce action). Wife did not respond to either rule to show
cause. On September 22, 2015, this Court dismissed Wife’s appeal by per
curiam order, due to the pendency of the parties’ divorce proceedings and
Wife’s failure to serve the Court Reporter with the notice of appeal and request
for transcripts.
By order dated April 6, 2017 (with notice per Pa.R.C.P. 236 provided to
Wife’s counsel on April 10, 2017), the court entered a divorce decree, which
-6-
J-S70013-17
incorporated the parties’ marital settlement agreement. Wife timely filed a
notice of appeal at the current docket No. 781 MDA 2017, on May 10, 2017.
On May 25, 2017, the court ordered Wife to file a concise statement of errors
complained of on appeal pursuant to Pa.R.A.P. 1925(b). Wife timely complied
on June 5, 2017.6
Wife raises the following issues for our review:
DID THE TRIAL COURT DIRECTLY OR INDIRECTLY
THROUGH ITS DOMESTIC RELATIONS SECTION ABUSE ITS
DISCRETION IN ADOPTING AND IMPLEMENTING A POLICY
FOR THE ENFORCEMENT OF UNREIMBURSED MEDICAL
EXPENSES THAT VIOLATES THE PLAIN LANGUAGE OF
PA.R.CIV.P. [1910.16-6] ABDICATING ITS OBLIGATION TO
ENFORCE THE REIMBURSEMENT OF ARREARAGES FOR
MEDICAL EXPENSES DUE FROM SPOUSAL SUPPORT
OBLIGORS?
WHETHER THE TRIAL COURT ABUSED ITS DISCRETION IN
DENYING [WIFE] REIMBURSEMENT FOR MEDICAL
EXPENSES THAT IT ACKNOWLEDGED WERE MEDICALLY
NECESSARY AND WHICH THE EVIDENCE SUBMITTED TO
THE TRIAL COURT CONFIRMED [WIFE] WAS NOT
REIMBURSED?
(Wife’s Brief at 5).
Our standard and scope of review in this case are as follows:
____________________________________________
6 Following Wife’s May 10, 2017 notice of appeal, this Court issued a per
curiam rule to show cause why the appeal should not be quashed as
interlocutory where it was unclear if the parties’ divorce action was still
pending. Wife responded to the rule, producing copies of the parties’ divorce
decree and marital settlement agreement. This Court subsequently
discharged the rule to show cause and deferred the issue to the merits panel.
As the parties’ divorce proceedings are now complete, there are no
jurisdictional impediments to our review. See Thomas, supra.-7-
J-S70013-17
[A]n appellate court’s standard of review in cases involving
support matters is whether the trial court abused its
discretion. An abuse of discretion exists when the judgment
of the trial court is manifestly unreasonable or is the result
of prejudice, bias or ill-will. While it is not an appellate
court’s duty to create the record or assess credibility, we
must nevertheless examine the existing record to ascertain
whether sufficient facts are present to support the trial
court’s order. If sufficient evidence exists in the record to
substantiate the trial court’s action, and the trial court has
properly applied accurate case law to the relevant facts,
then we must affirm.
Hibbitts v. Hibbitts, 749 A.2d 975, 976-77 (Pa.Super. 2000) (internal
citations omitted).
In her first issue, Wife argues the DRS’ policy establishing May 31st as
the deadline for bills to be submitted for enforcement purposes is inconsistent
with Pa.R.C.P. 1910.16-6. Wife asserts the Rule plainly states that where the
obligor has been provided notice of unreimbursed medical expenses before
March 31st, then for purposes of subsequent enforcement, unreimbursed
medical bills do not have to be submitted to the DRS prior to that date. Wife
insists she timely provided notice of her unreimbursed medical expenses to
Husband by letter dated March 10, 2014. When Husband failed to comply
with her request for payment, Wife claims she filed her initial petition for
contempt on June 19, 2014. Wife highlights that the DRS ultimately
investigated her claim and filed its own contempt petition against Husband in
October 2014. Wife contends she did not receive notice that the DRS was
refusing to enforce her petition until the December 3, 2014 hearing, at which
time a representative from the DRS took the position that Wife’s medical
-8-
J-S70013-17
expenses for 2013 were unenforceable pursuant to the DRS’ policy. Wife
proclaims that the DRS’ policy unfairly limited Wife’s available options for
seeking payment of her unreimbursed medical expenses. Wife concludes the
DRS’ policy on the collection of unreimbursed medical expenses is inconsistent
with the Rules of Civil Procedure, and this Court must reverse the order on
appeal and remand to the DRS to enforce Wife’s petition in a manner
consistent with the Rules of Civil Procedure. We disagree.
Preliminarily, “it is the responsibility of the [a]ppellant to supply this
Court with a complete record for purposes of review.” Smith v. Smith, 637
A.2d 622, 623 (Pa.Super. 1993), appeal denied, 539 Pa. 680, 652 A.2d 1325(1994) (emphasis in original). “[A] failure by an [a]ppellant to insure that the
original record certified for appeal contains sufficient information to conduct a
proper review constitutes a waiver of the issue(s) sought to be examined.”
Id. at 623-24. See also Kessler v. Broder, 851 A.2d 944 (Pa.Super. 2004),
appeal denied, 582 Pa. 676, 868 A.2d 1201 (2005) (reiterating appellant’s
responsibility to produce complete record for appeal).
Instantly, Wife initially sought reimbursement for medical expenses by
filing a petition for contempt on June 19, 2014, in the Centre County Court of
Common Pleas, alleging Husband had failed to comply with the August 2013
support order. Husband filed a motion to quash the petition on June 26, 2014.
Following a hearing on August 8, 2014, the court granted Husband’s motion,
directing Wife to file her petition in the DRS. Notably, the August 8, 2014
-9-
J-S70013-17
hearing transcript is not in the certified record.
On August 25, 2014, Wife filed a “Petition for Enforcement of Support
Order and for Civil Contempt” in the DRS. Conference Officer Jeffrey Martin
responded to Wife’s petition by letter, explaining Wife’s petition would be
forwarded to Enforcement Officer Timothy Weight to determine what, if any,
further enforcement action would take place. The letter directed Wife to
contact Mr. Weight for a status update regarding enforcement of Wife’s
petition. Mr. Martin’s letter also included a copy of the DRS’ policy on
“Collection of Unreimbursed Medical Expenses.”
Enforcement Officer Mr. Weight investigated Wife’s claim but was unable
to resolve whether she was entitled to payment for the alleged unreimbursed
medical expenses based on the documentation provided. Consequently, on
October 23, 2014, the DRS filed a “contempt” petition against Husband,
requesting an evidentiary hearing before the court. According to Wife, the
parties appeared before the court on December 3, 2014, at which time a
representative from the DRS advised the court the DRS would not enforce
Wife’s petition regarding her alleged 2013 unreimbursed medical expenses
pursuant to its policy that expenses submitted after May 31st will not be
enforced, and because Mr. Weight was unavailable to testify. Significantly,
the December 3, 2014 hearing transcript is also missing from the certified
record.
In a footnote in the “Statement of the Case” section of her appellate
- 10 -
J-S70013-17
brief, Wife states she ordered all relevant transcripts in this case with her
notice of appeal, and if any missing transcripts are necessary to decide Wife’s
issues on appeal, this Court should remand for transcription of the proceedings
without prejudice to Wife. (See Wife’s Brief at 11-12 n.1). Nevertheless, Wife
knew when she filed her first and premature appeal, back in April 2015, that
no transcripts were included in the certified record; and this Court dismissed
Wife’s appeal at docket No. 754 MDA 2015, in part, on that basis. Wife filed
the current notice of appeal at docket No. 781 MDA 2017, on May 10, 2017,
which included a request for transcripts dated August 8, 2014, December 4,
2014,7 and February 3, 2015. The certified record before us, however,
includes only the February 3, 2015 hearing transcript.
Initially, the record does not indicate whether Wife paid for the August
or December 2014 hearing transcripts. See Pa.R.A.P. 1911(a). Significantly,
Wife has had over two years to procure the missing transcripts, which she
knew were absent from the certified record since this Court’s July 16, 2015
rule to show cause order issued in her earlier 2015 appeal. Wife obviously
obtained the February 3, 2015 hearing transcript between the time of her
premature appeal and the current appeal, which shows she knew how to get
the necessary transcripts, and had plenty of time to ensure they were in the
record. Wife, however, simply failed to do so with respect to the 2014 hearing
____________________________________________
7 On appeal, Wife contends the hearing took place on December 3, 2014.
- 11 -
J-S70013-17
transcripts.
Under these circumstances, we cannot fully analyze Wife’s claim
concerning what inconsistencies, if any, exist between the DRS’ policy on the
collection of unreimbursed medical expenses and the relevant Rule of Civil
Procedure. Therefore, Wife’s first issue is waived. See Pa.R.A.P. 1911(d)
(stating if appellant fails to take action required by these rules and
Pennsylvania Rules of Judicial Administration for preparation of transcript,
appellate court may take such action as it deems appropriate); Kessler,
supra; Smith, supra.Additionally, other than reciting the Rule and the DRS’ policy, Wife
provides no legal authority to support her position that the policy at issue
conflicts with Rule 1910.16-6. Wife also fails to explain how the policy is
inconsistent with Rule 1910.16-6. Wife’s first issue is arguably waived for
these reasons as well. See generally Jones v. Jones, 8778 A.2d 86(Pa.Super. 2005) (explaining failure to argue and cite to supporting relevant
authority constitutes waiver of issue on appeal; arguments that are not
developed appropriately are waived); Bunt v. Pension Mortg. Associates,
Inc., 666 A.2d 1091 (Pa.Super. 1995) (stating it is appellant’s responsibility
to establish entitlement to relief by showing that trial court’s ruling is
erroneous; where appellant presents position without elaboration or citation
to case law, this Court can decline to address appellant’s bare argument).
Moreover, to the extent we can resolve Wife’s first issue on the appeal
- 12 -
J-S70013-17
based on the limited record before us, Pennsylvania Rule of Civil Procedure
1910.16-6 provides, in pertinent part:
Rule 1910.16-6. Support Guidelines. Adjustments to
the Basic Support Obligation. Allocation of Additional
Expenses
The trier of fact may allocate between the parties the
additional expenses identified in subdivisions (a)—(e). If
under the facts of the case an order for basic support is not
appropriate, the trier of fact may allocate between the
parties the additional expenses.
* * *
(c) Unreimbursed Medical Expenses.
Unreimbursed medical expenses of the obligee or the
children shall be allocated between the parties in proportion
to their respective net incomes. Notwithstanding the prior
sentence, there shall be no apportionment of unreimbursed
medical expenses incurred by a party who is not owed a
statutory duty of support by the other party. The court may
direct that obligor’s share be added to his or her basic
support obligation, or paid directly to the obligee or to the
health care provider.
(1) For purposes of this subdivision, medical expenses
are annual unreimbursed medical expenses in excess of
$250 per person. Medical expenses include insurance co-
payments and deductibles and all expenses incurred for
reasonably necessary medical services and supplies,
including but not limited to surgical, dental and optical
services, and orthodontia. Medical expenses do not include
cosmetic, chiropractic, psychiatric, psychological or other
services unless specifically directed in the order of court.
Note: While cosmetic, chiropractic, psychiatric,
psychological or other expenses are not required to be
apportioned between the parties, the court may apportion
such expenses that it determines to be reasonable and
appropriate under the circumstances.
- 13 -
J-S70013-17
(2) An annual limitation may be imposed when the
burden on the obligor would otherwise be excessive.
(3) Annual expenses pursuant to this subdivision (c),
shall be calculated on a calendar year basis. In the year in
which the initial support order is entered, or in any period
in which support is being paid that is less than a full year,
the $250 threshold shall be pro-rated. Documentation of
unreimbursed medical expenses that either party
seeks to have allocated between the parties shall be
provided to the other party not later than March 31 of
the year following the calendar year in which the final
bill was received by the party seeking allocation. For
purposes of subsequent enforcement, unreimbursed
medical bills need not be submitted to the domestic
relations section prior to March 31. Allocation of
unreimbursed medical expenses for which documentation is
not timely provided to the other party shall be within the
discretion of the court.
* * *
Pa.R.C.P. 1910.16-6(c)(1-3) (emphasis added).
Almost identical to the first sentence of the highlighted language of the
Rule, the DRS’ policy states: “All unreimbursed medical bills must be provided
to the other party not later than March 31 of the year following the calendar
year in which the final bill was received by the party seeking allocation.”
(Collection of Unreimbursed Medical Expenses Policy at 1; R.R. at 473). The
policy continues: “Any unreimbursed medical expense that is not resolved
between the parties may be submitted to DRS only between January 1st and
May 31st for the previous calendar year. … Any expense submitted to the
DRS AFTER May 31st for the previous calendar year…will not be enforced by
the DRS.” (Id.) (emphasis in original).
- 14 -
J-S70013-17
We see no inconsistency between the DRS’ policy and Rule 1910.16-
6(c). To the contrary, Rule 1910.16-6 and the policy both make clear the
party seeking payment for unreimbursed medical expenses must submit her
expenses to the obligor by March 31st of the year following the calendar year
in which the final bill was received. Under the DRS policy, any dispute
regarding payment of unreimbursed medical expenses must be submitted to
the DRS between January 1st and May 31st. The provision that Wife relies on
simply provides that, for purposes of enforcement, Wife was not required to
submit her petition for enforcement to the DRS prior to March 31st. The Rule,
however, does not afford Wife an unlimited deadline to submit her petition to
the DRS. Rather, the DRS policy sets the deadline on claims submitted to the
DRS at May 31st. Read together, the Rule and the policy are consistent as far
as deadlines go.
Wife sent Husband a letter detailing her alleged unreimbursed medical
expenses on March 10, 2014, but Wife did not file her initial contempt petition
until June 19, 2014, in the Court of Common Pleas, or file her claim with the
DRS until August 25, 2014. If a representative from the DRS informed the
court at the December 3, 2014 hearing that it could not enforce Wife’s claim
for unreimbursed medical expenses incurred in 2013 (which we cannot verify
due to the missing transcript), then that statement is consistent with both the
DRS policy as well as Rule 1910.16-6. In any event, notwithstanding Wife’s
belated filing in the DRS, the court still considered all of Wife’s alleged
- 15 -
J-S70013-17
unreimbursed medical expenses incurred in 2013, and awarded her payment
for some of those expenses. Therefore, even if Wife had preserved her first
issue for our review, it would merit no relief.
In her second issue on appeal, Wife argues she was required to prove
only that she incurred unreimbursed medical expenses in excess of $250.00
to establish Husband’s duty to pay the proportionate share of the expenses
incurred. Wife asserts she presented documentary evidence at the February
3, 2015 hearing, of all unreimbursed expenses she incurred in 2013 and 2014.
Wife claims the court improperly placed the burden on Wife to prove the
insurance company did not reimburse her for the amounts she alleged she
paid out of pocket. Wife complains the court’s denial of her claim for payment
of substantial dental treatments was “egregious,” where the court initially
decided Wife’s dental expenses were medically necessary but then denied her
claim because Wife provided no follow-up information regarding whether the
dental and/or medical insurance companies reimbursed her for those
expenses. Wife contends the court completely ignored her
testimony/evidence that she took out a line of credit to pay for the substantial
dental expenses. Wife insists she also testified and produced an explanation
of benefits (“EOB”) form, showing the insurance company paid only $966.00
of her $18,500.00 dental expenses incurred in 2013 and 2014.8 Wife
____________________________________________
8 The EOB form Wife submitted pertains only to Wife’s dental work in 2013.
- 16 -
J-S70013-17
concludes the court abused its discretion by awarding Wife only $148.31 for
unreimbursed medical expenses, and this Court must reverse. We disagree.
After a thorough review of the record, the briefs of the parties, the
applicable law, and the well-reasoned opinion of the Honorable Jonathan D.
Grine, we conclude Wife’s second issue merits no relief. The trial court opinion
comprehensively discusses and properly disposes of the question presented.
(See Opinion in Support of Order, filed March 30, 2015, at 4-11) (analyzing
Wife’s claims for unreimbursed medical expenses submitted for 2013 and
2014, under August 2013 support order; rejecting claims Wife incurred before
effective date of support order, claims for which Wife offered no testimony to
demonstrate they were reasonably necessary treatment or supplies, and
claims for which Wife failed to provide sufficient follow-up information
regarding how much, if any, insurance covered or reimbursed her for alleged
expenses;9 court decided Wife submitted $315.00 in eligible unreimbursed
____________________________________________
9 Wife submitted a claim for $6,500.00 she incurred for dental work at Sabatini
Dental on June 25, 2013. Wife insists she is entitled to reimbursement on this
claim because she obtained a line of credit to pay for this expense, and
payment on the line of credit was due on December 9, 2013, after the support
order was in effect. Wife also insists she produced an EOB form demonstrating
her insurance company paid only $966.00 of the expense. Regarding Wife’s
latter claim, the billing statement from Sabatini Dental indicates that office
billed Wife’s medical and dental insurance companies. The EOB form Wife
provided indicates only what her medical insurance covered. Wife failed to
submit sufficient evidence regarding how much, if any, her dental insurance
covered. In any event, we agree with the trial court that Wife was not entitled
to reimbursement for this expense where her dental work was done in June
2013, before the effective date of the support order. See Hibbitts, supra.- 17 -
J-S70013-17
medical expenses for 2013 and $46.05 in 2014; Wife is responsible for first
$119.86 in unreimbursed medical expenses for each year (her pro-rated
portion of $250.00 for each year), so Wife is entitled to 76% of remaining
$195.14 for 2013 claims, or $148.31 from Husband for total unreimbursed
medical expenses).10 Accordingly, we affirm Wife’s second issue based on the
trial court’s opinion.
Order affirmed.
Judgment Entered.
Joseph D. Seletyn, Esq.
Prothonotary
Date: 12/14/2017
____________________________________________
10 We deny Wife’s claim for costs of this appeal.
- 18 -
'Englert
Muir 1u11•111g OODOR758 ceGPRO 201�03
PM
IN THE COURT OF COMMON PLEAS OF CENTRE COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
)
SHEILA We,/1JJE�
Plaintiff, ) No. 2013-0267-S
) PACES No. 584114086
)
v.
)
)
THOMAS BREON, II,
)
Defendant.
Attorney for Petitioner: Robert F. Englert, Esq.
Attorney for Defendant: Karen G. Muir, Esq.
--..
---iT,-·.,
::<':;:::··�
OPINION AND ORDER re-
;:2.-< w
On July 10, 2013, Sheila . W e11. i e,f"(hereinafter "Wife") filed a complaint for spousal support
against Thomas Breon, II (hereinafter "Husband"). Following a conference on August 21, 2013,
an Order for support was entered providing that unreimbursed medical expenses of Wife in
excess of $250.00 annually are to be allocated between the parties, with Husband responsible for
76% and Wife responsible for 24%.
On October 23, 2014, the instant Petition for Contempt was filed against Husband. The
matter was scheduled for hearing, which ultimately took place on February 3, 2015.
DISCUSSION
I. Contempt
Pursuant to 23 Pa.C.S.A. §4345, a person who willfully fails to comply with a support order
may be found in contempt. The complaining party has the burden of proving, by a preponderance
of the evidence, that the opposing party violated the order in question. Chrysczanavicz v.
Chrysczanavicz, 796 A.2d 366 (Pa.Super. 2002). In the instant case, Wife alleges Husband is
responsible for $18,201.04 in unreimbursed medical expenses for 2013 and 2014. Husband
argues Wife did not sufficiently substantiate that she had paid the first $250.00 required by the
Order; did not present receipts evidencing the alleged expenses had actually been paid; and did
not present any testimony that the treatment and supplies for which she requests reimbursement
were medically necessary.
The Court notes that all involved parties, including Domestic Relations, appear to agree this
is not a true "contempt" petition in that it seeks to impose sanctions on Husband. Rather, as
indicated by Timothy E. Weight, an enforcement officer with the Centre County Court of
Common Pleas Domestic Relations Section, this was the only method available to Domestic
Relations to bring this matter before the Court for a determination of the amount of
unreimbursed medical expenses at issue.
a. Medical Expenses
Pursuant to 23 Pa.C.S.A. §4324, a court may order an obligor to bear responsibility for a
designated percentage of the obligee's ''reasonable and necessary health care expenses."
Pa.R.C.P. 1910.16-6(c)(l) defines medical expenses as "annual unreimbursed medical expenses
in excess of $250 per person," which includes "co-payments and deductibles and all expenses
incurred for reasonably necessary medical services and supplies."
i. Receipts
Husband argues he cannot be held responsible for Wife's medical expenses pursuant to 23
Pa.C.S.A. §4324 and/or Pa.R.C.P. 1910.16-6(c) until Wife demonstrates she has actually paid
those expenses. The Court disagrees.
Where "the language of a statute is plain and unambiguous and conveys a clear and definite
meaning ... the statute must be given its plain and obvious meaning." Mohamed v. Com., Dept.
of Transp., Bureau of Motor Vehicles, 40 A.3d 1186, 1194 (Pa. 2012). Pa.R.C.P. 1910.16-
2
6(c)(l) defines medical expenses to include "insurance co-payments and deductibles and all
expenses incurred for reasonably necessary medical services and supplies'' (emphasis added).
The Rule does not specify the expenses must have been paid by Wife, merely that they were
"incurred" by Wife; that is, that she has been charged those amounts and is obligated to pay them
to the various providers. The Court therefore finds Wife does not need to provide documentation
showing she has paid each expense in full, merely that she has incurred each expense and is
obligated to pay them.
ii. Admissibility of Documentation Provided by Wife
Husband objected to the admission of the documentation of medical expenses provided by
Wife at the hearing. Husband argues the documents were hearsay, and should not have been
admitted. Although Husband acknowledges Pa.R.C.P. 1029.29(a) provides a mechanism to
introduce the items despite their hearsay nature, Husband argues the documents do not fall
within this exception as they are unverified and Wife did not provide the requisite notice
pursuant to the rule. Wife argues she provided Husband with notice of her intent to use the
documents by providing them to him as attachments to her letter of March 10, 2014, and that
Husband's Motion to Quash and accompanying letter to the Domestic Relations Section was not
sufficient to serve as an objection because neither document made reference to the hearsay nature
of the documents.
Although the Court acknowledges the items were hearsay and that Wife did not provide the
specific notice of intent required by Pa.R.C.P. 1910.20(a), Wife testified these were expenses she
had incurred and documents she had received and, in most cases, had sent payment in response
to receiving said document. The Court found Wife's testimony regarding the amounts and
accuracy of these documents to be credible. However, the Court notes it has only accepted the
3
content of the documents for which Wife has provided sufficient testimony relating to their
qualification as eligible unreimbursed medical expenses. There are several documents for which
the Court did not find Wife's testimony to be credible or sufficient to establish the contents as
eligible unreimbursed medical expenses, as discussed in detail below.
Further, all parties agree this is not a true contempt petition in which criminal or other
sanctions are sought-rather, this is a mechanism for the Domestic Relations Section to bring
this matter before the Court for a determination of the unreimbursed medical expenses in
question. "Except in the criminal context where hearsay can violate the Confrontation Clause ...
the inadmissibility of hearsay is not constitutionally mandated." Summers v. Summers 35 A.3d
786, n.4 (Pa.Super. 2012).
iii. Expenses in Excess of Threshold
Husband has been ordered to pay 76% of Wife's unreimbursed medical expenses beyond
$250.00. In order to demonstrate she is entitled to payment from Husband, Wife must prove by
preponderance of the evidence she has incurred more than $250.00 in unreimbursed medical
expenses. For the year in which the initial support order is entered, or in any period in which
support is being paid that is less than a full calendar year, the threshold should be pro-rated.
Pa.R.C.P. 1910.16-6(c)(3 ).
a. 2013
The effective date of the support Order is July 10, 2013. There are 175 days from July 10,
2013 through December 31, 2013. By this Court's calculation, the pro-rated portion of the
$250.00 threshold for 2013 would be $119.86. The amount of unreimbursed medical expenses
for 2013 Wife must demonstrate she incurred before she is eligible for reimbursement from
Husband, therefore, is $119.86.
4
Wife alleges she has provided documentation for $19, 717 .54 in unreimbursed medical
expenses, approximately $7,671.69 of which were incurred in 2013. Wife therefore alleges she
has met the pro-rated threshold for 2013. The Court agrees Wife has met the threshold amount
for 2013, but does not agree with the bulk of her submitted expenses.
Rather, the Court finds Wife has submitted $315 .00 in eligible unreimbursed medical
expenses for the year 2013. As she is responsible for the first $119 .86, she is enti tied to
reimbursement from Husband of76% of the remaining $195.14, or reimbursement in the amount
of$148.31.
The Court will address each expense for which Wife has provided documentation for the
2013 year in turn.
i. Eligible and Ineligible Expenses
For purposes of the instant matter, "medical expenses are annual unreimbursed medical
expenses" in excess of the threshold amount. "Medical expenses include insurance co-payments
and deductibles and all expenses incurred for reasonably necessary medical services and
supplies, including but not limited to surgical, dental and optical services, and orthodontia."
Pa.R.C.P. 1910.16-6(c)(l). Wife must demonstrate she has met the threshold amount in eligible
expenses incurred before she is entitled to reimbursement.
1. CVS
Wife testified she received numerous prescription medications throughout the course of
2013. Initially, the Court notes several of these expenses (totaling $70.89) were incurred prior to
the effective date of the support Order and therefore, are not eligible medical expenses. Of the
remaining $144.80, Wife presented no testimony regarding what conditions these prescriptions
were for, nor any other testimony which would indicate these prescriptions were for reasonably
5
necessary treatment or supplies. The Court cannot include these expenses in the total of eligible
unreimbursed medical expenses for 2013, as it does not have sufficient information before it to
determine whether these were reasonable and necessary treatment or supplies.
2. Lock Haven Clinic
Wife provided documentation for an unreimbursed expense of $21.40 incurred from Lock
Haven Clinic. Wife testified this visit took place with Dr. Pankaj Metha in June of 2013, but did
not testify to the purpose of the visit. As no purpose was testified to for this visit, the Court does
not have sufficient information before it to be able to determine this was a reasonably necessary
expense and therefore cannot include it in the total of eligible unreimbursed medical expenses for
2013. Further, this visit occurred prior to the effective date of the 2013 Order.
Wife provided additional documentation for an unreimbursed expense of $293.00 from her
women's health provider, Dr. Sanchita Yadalla. She testified this was a charge incurred as a
result of her annual women's health visit. The Court finds this to be a reasonably necessary
expense, and therefore includes it in the total of unreimbursed medical expenses for 2013.
3. Lock Haven Medical Center
Wife provided documentation showing she incurred an unreimbursed expense of $15.60 in
December of2013 during a visit to the Lock Haven Medical Clinic. Wife, however, was unable
to indicate the purpose of the visit. As no purpose was stated for this visit. the Court does not
have sufficient information before it to be able to determine this was a reasonably necessary
expense and cannot include it in the total of unreimbursed medical expenses for 2013.
4. Mount Nittany Physicians Group
Wife testified she visited Dr. Christopher Hester of the Mount Nittany Physician Group for
treatment related to a sinus infection, and incurred an unreimbursed charge of $22.00. The Court
6
finds this a reasonably necessary expenses and therefore includes it in the total of unreimbursed
medical expenses for 2013.
Wife also visited Dr. Christopher Yingling of the Mount Nittany Physician Group in
December of 2013 and incurred an unreimbursed charge of $103.20. However, as no testimony
was provided as to the nature of the visit, the Court does not have sufficient information before it
to determine this was a reasonably necessary expense and therefore cannot include it in the total
ofunreimbursed medical expenses for 2013.
5. Pittsburgh Ear Associates
Wife also provided documentation for a visit to Pittsburgh Ear Associates, during which she
incurred an unreimbursed charge of $14. 60. However, Wife did not testify to the purpose of this
visit The Court does not, therefore, have sufficient information before it to determine whether
or not this was a reasonably necessary expense and therefore cannot include it in the total of
unreimbursed medical expenses for 2013.
6. Sabatini Dental
Wife testified she has pain in her jaw and other issues with her mouth which cause her issues
with her chewing, headaches, and her ears. She received an orthotic from Sabatini Dental which
holds her jaw up and, in turn, helps to relieve the symptoms she was experiencing.
Wife presented a letter from Sabitini Dental as well as Care Credit Card statements showing
she has paid a total of $6,500.00 in 2013. However, the documentation Wife presented from
Sabatini Dental states, in relevant part, "we are billing both Sheila's dental and medical
insurance for these costs. We do not know what they will pay. Sheila has paid $6,555.00 to
date." While the Court believes this was a medically necessary expense, based on Wife's
testimony, the Court cannot determine whether this is truly an "unreimbursed" medical expense,
7
as Wife has provided no follow-up information regarding what, if anything, her dental and
medical insurance reimbursed her for this expense.
Additionally, the $6,5000.00 charge was incurred on June 25, 2013. The effective date of the
2013 support Order was July 10, 2013. This charge was incurred prior to the effective date of
the 2013 support Order. Husband cannot be held responsible for medical expenses incurred by
Wife prior to the effective date of the Order. These expenses, therefore, cannot be included in
the total ofunreimbursed medical expenses for2013.
7. WalMart Vision Center
Wife testified she requires eyeglasses. She submitted a receipt from the W almart Vision
Center for charges of $209.00 for frames, lenses, and "scratchguard." However, Wife did not
indicate to the Court whether her insurance covered any part of this fee or provided her any
reimbursement for this fee. The Court does not have sufficient information before it to
determine whether this is truly an "unreimbursed medical expense" and therefore cannot include
it in the total of medical expenses for 2013.
8. Benner Chiropractic
Wife also presented documentation from Benner Pike Chiropractic, indicating she had
incurred charges of $277.20. However, the documentation provided does not give legible dates
for the visits. Further, Wife did not indicate to the Court that these visits were for any medical
issues or other purposes. Although this Court may, in its discretion, allocate expenses which are
not specifically contained in the Order, the Court does not have sufficient information before it to
determine either the actual amount incurred between July 10, 2013 and December 31, 2013, or
whether this amount was a reasonably necessary expense and therefore cannot include in in the
medical expenses for 2013.
8
b. 2014
Wife received support under the July 10, 2013 Order until June 25, 2014, the effective date
of the current support Order. Again, there are 175 days from January 1, 2014 through June 24,
2014, so the pro-rated threshold amount for 2014 would also be $119.86. Wife alleges she has
provided documentation for $19,717.54 in unreimbursed medical expenses, approximately
$12,046.05 of which were incurred in 2013. Wife therefore alleges she has met the pro-rated
threshold for 2014. The Court disagrees. The Court, as discussed further below, finds Wife has
incurred $46.05 in eligible expenses through June 24, 2014. This is less than the threshold of
$119.86 which Wife must meet for the period from January 1, 2014 through June 24, 2014. The
Court will address each expense for which Wife has provided documentation for the 2014 year in
turn.
i. Eligible and Ineligible Expenses
Wife must demonstrate she has met the threshold amount in eligible expenses incurred before
she is entitled to reimbursement.
a. Cochlear
Wife provided documentation for an expense of $22.85 for a "Dry & Store Dry-Brik
Desiccant" which she received from Cochlear Americas. Wife indicated to the Court she did not
receive any insurance reimbursement for this expense.
Wife testified this device was necessary to store her hearing aids. The Court finds this to be
a reasonably necessary medical expense. Again, although the support Order does not specifically
provide for audiological expenses, the Court may apportion such other expenses it determines to
be reasonable and appropriate under the circumstances. Wife testified she cannot hear at all out
of her left hear without the use of a bone-anchored hearing aid (BAHA), and has difficulty
9
hearing out of her right ear without the use of a hearing aid. Wife uses the Dry Brik to store her
audiological devices each night to prevent moisture buildup. The Court finds these supplies to
be reasonably and appropriate, considering Wife's hearing loss.
b. Geisinger
Wife also testified she attended an appointment with her dermatologist at Geisinger Health
System for "something" on her skin, and her dermatologist wished to determine whether it was
cancerous. Wife presented documentation indicating she had incurred an expense of $23.20
which was not covered by insurance. The Court finds this to be a reasonably necessary medical
expense.
e, Sabatini Dental
As noted above, Wife presented a Care Credit Card statement which indicated she has paid
Sabatini Dental an additional $12,000.00 for visits beginning in January of 2014. However,
again, the documentation provided from Sabatini Dental states, in relevant part, "we are billing
both Sheila's dental and medical insurance for these costs. We do not know what they will pay.
Sheila has paid $6,555.00 to date." While the Court believes, based on Wife's testimony, this
treatment was medically necessary, the Court cannot determine whether this is truly an
"unreimbursed" medical expense, as Wife has provided no follow-up information regarding
what, if anything, her dental and medical insurance reimbursed her for this expense.
Based on the foregoing discussion, the Court determines Wife has submitted
documentation for $315.00 in eligible unreimbursed medical expenses for the year 2013 and
documentation for $46.05 for the year of 2014. As she is responsible for the first $119.86 in
unreimbursed medical expenses for each year, she is entitled to reimbursement of $148.31 from
Husband, or 76% of the remaining $195.14.
10
The Court, therefore, enters the following Order:
ORDER
AND NOW, this 27th day of March, 2015, the Court having found Wife has incurred a
total of $315.00 in eligible unreimbursed medical expenses for the year 2013 and $46.05 for the
year 2014, based on the testimony and documentation provided to the Court, the Court enters the
following Order:
1. Wife is entitled to reimbursement from Husband in the amount of $148.31;
2. Husband shall pay this amount directly to Wife via check within ten ( 10) days of
the date of this Order.
Jonathan D. Grine, Judge
11