Ricks, Carmen v. Methodist Healthcare , 2017 TN WC 8 ( 2017 )


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  • FILED
    January 30, 2017
    TN COURT OF
    WORKERS’
    mS COMPENSATION
    TENNESSEE BUREAU OF WORKERS’ COMPENSATION CL ATMS
    IN THE COURT OF WORKERS’ COMPENSATION CLAIMS = time 19-25 PM
    AT MEMPHIS
    CARMEN L. RICKS, ) Docket No. 2015-08-0454
    Employee, )
    V. )
    METHODIST HEALTHCARE, ) State File No. 93545 2014
    Employer, )
    And )
    PMA GROUP, ) Judge Allen Phillips
    Insurance Carrier. )
    COMPENSATION HEARING ORDER FOR MEDICAL BENEFITS
    (DECISION ON THE RECORD)
    This matter came before the undersigned Workers’ Compensation Judge on
    January 25, 2017, for a Compensation Hearing. Upon a joint motion, the parties
    requested a decision on the record, in lieu of convening an evidentiary hearing. The Court
    issued a Docketing Notice listing the documents to be considered. This Court gave the
    parties until January 5, 2017, to file objections to the admissibility of the listed
    documents and until January 9, 2017, to brief the issues. This Court finds it needs no
    additional information to determine the disputed issues. Accordingly, the Court decides
    this matter upon a review of the written materials.
    The central legal issue is whether Ms. Ricks’ requested mileage reimbursement
    constitutes a reasonable medical expense. For the following reasons, the Court holds Ms.
    Ricks is entitled to the requested reimbursement.
    History of Claim
    On October 15, 2015, the parties entered into a settlement agreement that provided
    Ms. Ricks future medical benefits. The authorized medical providers for her care are
    located in Memphis; Ms. Ricks lives approximately sixty miles away. Methodist refused
    to pay Ms. Ricks a mileage reimbursement based upon the distance she traveled between
    her home and Memphis. Instead, it offered to pay reimbursement based upon the distance
    Ms. Ricks would be required to travel if she made appointments for days that she works
    at her new job, nearer to Memphis.
    The disagreement prompted Ms. Ricks to file a Petition for Benefit Determination
    seeking reimbursement of mileage expenses from her home to her providers. When the
    parties could not resolve the dispute through mediation, the mediator issued a Dispute
    Certification Notice that listed Methodist’s defense as: “Employee should go to doctor on
    her scheduled work days.”
    Methodist did not contest the alleged distance Ms. Ricks traveled between her
    home and the providers. However, Methodist did contest that the Workers’
    Compensation Law requires it to reimburse her for those distances. Instead, Methodist
    contended “reasonable” travel expenses are those incurred by Ms. Ricks for traveling
    between her current employer and her providers. Methodist argued the law does not
    require it to pay a larger mileage reimbursement because of Ms. Ricks’ choice to travel
    from her home to the providers, a practice “which she finds to be more convenient for
    her.” Methodist contended its position of paying only mileage between her current
    employer and her providers is an “equitable result,” and the amount “she would be paid if
    she was still working for Methodist.”
    Ms. Ricks admitted she scheduled appointments on her days off from her new job.
    She explained that “scheduling doctor’s visits on her work days would mean a loss of real
    wages for which [Methodist] is not responsible for covering or reimbursing.” Thus, to
    avoid a wage loss, she is required to travel from her home to Memphis, a roundtrip of
    over sixty miles, and has incurred, to date, $221.29 in mileage expenses. (Ex. 1.) She
    asked the Court to order Methodist “to reimburse her for the mileage she actually traveled
    from her home to her doctor’s appointments.” T.R. 4 at 4.
    Findings of Fact and Conclusions of Law
    Standard Applied
    Because the sole issue is one of statutory interpretation, the Court must determine
    the reasonableness of Ms. Ricks’ request by construing the applicable law fairly,
    impartially, and in accordance with basic principles of statutory construction.” It cannot
    construe the statute “remedially or liberally” in favor of Ms. Ricks, but instead must favor
    neither she nor Methodist. Tenn. Code Ann. § 50-6-116 (2016).
    Analysis
    Tennessee Code Annotated section 50-6-204(a)(6)(A) provides that: “When an
    injured employee is required to travel to an authorized medical provider or facility
    located outside a radius of fifteen (15) miles from the insured worker’s residence or
    workplace, then, upon request, the employee shall be reimbursed for reasonable travel.”
    Though the parties agreed this statute is controlling, they disagreed regarding its
    application. Hence, the Court must determine the correct application and, for the
    following reasons, holds the interpretation offered by Ms. Ricks is proper.
    When analyzing a statute’s meaning, the Workers’ Compensation Appeals Board
    directs the Court to begin its analysis by looking to the language of the statute itself. Syph
    v. Choice Food Grp., Inc., 2016 TN Wrk. Comp. App. Bd. LEXIS 18, at *9 (Apr. 21,
    2016). In so doing, the Court must define the statute’s words by their plain and ordinary
    meaning in the context in which they are used. /d. at *29. It must avoid a construction
    that unduly restricts or expands the meaning of the language used, as every word is
    presumed to have meaning and purpose. Jd. at *29-30. As the Appeals Board reminds,
    when the words of a statute “clearly mean one thing, the courts cannot give them another
    meaning under the guise of construing them.” Hadzic v. Averitt Express, 2015 TN Wrk.
    Comp. App. Bd. LEXIS 14, at *8 (May 18, 2015).
    Turning to the statute, Section 50-6-204(a)(6)(A) requires reimbursement of travel
    expenses when the authorized provider is fifteen or more miles from the “insured
    worker’s residence or workplace.” (Emphasis added). It is generally accepted that “the
    word ‘or,’ as used in a statute, is a disjunctive article indicating that the various members
    of the sentence are to be taken separately.” Leab v. S & H Mining Co., 76 8.W.3d 344,
    349 (Tenn. 2002), citing 73 Am. Jur. 2d Statutes § 241 (1974). Likewise, the word “or,”
    in its general use, is defined as “a function word to indicate an alternative.”
    www.merriam-webster.com/dictionary/or (last visited Jan. 20, 2017).
    Thus, the Court finds the statute requires Methodist to reimburse Ms. Ricks for
    mileage expenses incurred when traveling from either her home or her workplace. The
    Court respectfully disagrees with Methodist when it argues that Ms. Ricks cannot “pick
    and choose how [she] wishes to be reimbursed.” Instead, the statute actually provides that
    she might be reimbursed for either her mileage expenses from home or her mileage
    expenses from her workplace, not the lesser of the two. If the Court were to hold
    otherwise, it would ignore the clear use of the word “or” in the statute; an action
    forbidden by controlling authority. Syph, at *29-30. Likewise, the Court would also
    expand the meaning of the statute, another action forbidden by Syph, if it grafted onto the
    statute a directive that Methodist need only reimburse Ms. Ricks for the lesser of the two
    distances. Because the statute clearly allows for reimbursement of either the distance
    from Ms. Ricks’ home or her workplace, the Court construes it to mean exactly that;
    reimbursement for either distance regardless of which is the lesser.
    The Court reaches the same conclusion when construing the statute’s use of the
    word “reasonable.” Methodist contends it is reasonable for it to reimburse Ms. Ricks for
    traveling only the shorter distance between her new job and her doctors’ offices. In so
    doing, it points to what it calls improper reliance of Ms. Ricks upon Maupin v. Methodist
    Medical Ctr., No. E1999-02181-WC-CV 03S01-9901-CC-00009, 2000 Tenn. LEXIS 102
    (Tenn. Workers’ Comp. Panel Mar. 2, 2000). There, the employee was unable to work.
    Thus, she had to travel from her home to her doctor appointments. Jd. at *2. The
    employer contended, as does Methodist in this case, that the employee should be
    reimbursed only for the shorter distance between the employer’s location and the
    provider. Jd. at *3. The Maupin panel found that the employee might receive
    reimbursement from her home even if it were further from the providers than her
    employer. Jd. But, as pointed out by Methodist, the Maupin panel specifically referenced
    the liberal construction of the Workers’ Compensation Law required at the time. Thus,
    this Court will not rely upon Maupin as Ms. Ricks urges it to do.
    However, the Court need not shackle the word “reasonable” to a more restrictive
    definition because the Legislature abrogated the liberal presumption. To the contrary,
    “reasonable” now means, as it did before the Reform Act of 2013, as follows: “having
    sound judgment; fair and sensible.” www.google.com/search/resonable. (last visited Jan.
    20, 2017). It is now, just as before, synonymous with “rational, logical, fair, just and
    equitable.” Jd. Hence, when this Court construes section 50-6-204(6)(A) fairly and
    impartially, it will consider reasonableness just as Tennessee courts always have; namely,
    it will determine what is reasonable based “upon all the particular facts of [the] case.”
    Trent v. Am. Serv. Co., 
    206 S.W.2d 301
    , 304 (Tenn. 1947).
    Here, Ms. Ricks endeavors to set her appointments with approved providers on
    days she is not scheduled to work at her new job. The Court finds this to be reasonable.
    To hold otherwise limits her earning capacity and reduces her wages. This is contrary to
    her rehabilitation, which is an attribute of an effective workers’ compensation system.
    The Court rejects Methodist’s argument that if it still employed Ms. Ricks it would set
    her appointments on workdays rather than off days, thus limiting her to a lower
    reimbursement. The Court finds such irrelevant to the case; now that Ms. Ricks no longer
    works for Methodist, it no longer controls how her wages are paid. Accordingly, it should
    not choose how to reimburse her for mileage expense. According to the statute’s own
    terms, Ms. Ricks may receive reasonable reimbursement for mileage expenses from
    either her home or workplace and choosing to earn a wage is reasonable and should not
    lessen her recovery.
    IT IS, THEREFORE, ORDERED as follows:
    1.
    ENTERED this the 30 day of January, 201
    Methodist shall pay Ms. Ricks mileage reimbursement in the amount of $221.29.
    Further, Ms. Ricks shall receive future reimbursement of mileage consistent with
    this order, namely reimbursement of mileage expenses incurred in travel from
    either her home or her workplace to the offices of approved medical providers.
    Costs of this cause of $150.00 are assessed against Methodist Healthcare pursuant
    to Tenn. Comp. R. and Reg. 0800-02-21-.07 (2015), to be paid directly to the
    Clerk within five (5) business days of the date this Order, becomes final.
    Allen Phillips, Judge\,
    Court of Workers’ Compensation Claims
    APPENDIX
    Technical record:
    2).
    Petition For Benefit Determination
    Dispute Certification Notice
    Docketing Notice For Compensation Hearing
    Employee’s Brief
    Employer’s Pre-Expedited [sic] Hearing Brief
    Exhibit:
    iF
    Employee’s Chart showing her mileage expenses
    CERTIFICATE OF SERVICE
    I certify that a true and correct copy of this Compensation Hearing Order was sent to the
    following recipients by the following methods of service on this the 30" day of January, 2017.
    Name Via Email Service Sent To:
    William B. Ryan, Esq., Xx billy@donatilaw.com
    Attorney for Employee
    Kevin W. Washburn, Esq., x kwashburn@allensummers.com
    Attorney for Employer
    Mop eu Mum
    Penny Shrum, Clerk of Court
    Court of Workers’ Compensation Claims
    5
    

Document Info

Docket Number: 2015-08-0454

Citation Numbers: 2017 TN WC 8

Judges: Allen Phillips

Filed Date: 1/30/2017

Precedential Status: Precedential

Modified Date: 8/26/2020