Kuntz v. Beltrami Enterprises, Inc.

Opinions of the United
2004 Decisions States Court of Appeals
for the Third Circuit
10-19-2004
Kuntz v. Beltrami Entr Inc
Precedential or Non-Precedential: Non-Precedential
Docket No. 03-3027
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NOT PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
No. 03-3027
DOROTHY E. KUNTZ,
(Widow of Nicholas Kuntz, Jr.),
Petitioner
v.
BELTRAMI ENTERPRISES, INCORPORATED; TRAVELERS INSURANCE
COMPANY c/o CONSTITUTION STATE SERVICES; DIRECTOR, OWCP, UNITED
STATES DEPARTMENT OF LABOR,
Respondent
On Petition for Review of an Order of the Benefits Review Board
(No. 02-619 BLA)
Submitted under Third Circuit LAR 34.1(a)
October 1, 2004
Before: RENDELL, FUENTES, SMITH, Circuit Judges.
(Filed: October 19, 2004)
OPINION OF THE COURT
FUENTES, Circuit Judge.
Appellant Dorothy Kuntz (“Kuntz”), a miner’s widow, filed a claim for survivor
benefits under the Federal Coal Mine Health and Safety Act of 1969, as amended (“the Act”),
30 U.S.C. § 901 et seq., a few years after her husband Nicholas died. The agency initially
found in her favor, and her husband’s employer and the employer’s insurer failed to
challenge those findings within the specified time. Ultimately, she was not awarded any
benefits, however, because an Administrative Law Judge (ALJ) found that good cause
existed to excuse the late challenge to the initial findings. On appeal, Kuntz contends that
the ALJ erred in finding that good cause existed to excuse the untimely challenge to her
claim. We affirm because the ALJ’s findings were supported by substantial evidence.1
I. Factual and Procedural Background
Kuntz’ husband Nicholas died on March 30, 1993. Kuntz’ procedural odyssey began
when she filed a claim for survivor benefits under the Act with the Office of Workers’
Compensation Programs (“OWCP”), a division of the Department of Labor. 2 OWCP issued
a Notice of Claim naming Beltrami Enterprises, Inc. (“Beltrami”) as the responsible
employer. The Notice of Claim listed Beltrami’s address as: P.O. Box 1146, Harrisburg, PA
and incorrectly identified, as Beltrami’s insurance company, Lackawanna Casualty Co. c/o
Travelers Ins. Co., with a business address at P.O. Box 1507, One Mellon Bank Center,
Pittsburgh, PA. The Notice of Claim instructed Beltrami to notify OWCP within 30 days of
1
We have jurisdiction over this appeal pursuant to 33 U.S.C. § 921(c).
2
For brevity’s sake, we are not undertaking an explanation of the administrative
apparatus which awards benefits to miners and survivors of miners.
2
receipt of the Notice of Claim whether Beltrami accepted liability as the responsible operator.
The Notice of Claim included an “Operator Response Form” to be completed by Beltrami.
Carol Roscher (“Roscher”), claims representative for Constitution State Services
(“Constitution”), timely submitted the Operator Response Form accepting Beltrami’s liability
as the responsible employer and listing Constitution as the responsible insurer. Roscher
listed Constitution’s address as: P.O. Box 1507, Pittsburgh, PA, the same address that OWCP
identified as Lackawanna’s address.
On June 6, 1997, the OWCP issued a Notice of Initial Finding (“Initial Finding”)
concluding that Kuntz was entitled to benefits. The Initial Finding listed Beltrami’s address
as it appeared on the Notice of Claim. However, instead of identifying Constitution as the
insurer, the Initial Finding, like the Notice of Claim, incorrectly identified Lackawanna as
the insurer. Not only did the Initial Finding name the wrong insurer, it was sent to the wrong
address: 16 South River Place, Wilkes-Barre, PA, rather than P.O. Box 1507, Pittsburgh,
PA. The Initial Finding instructed Beltrami and Lackawanna to challenge the Initial Finding
within 30 days if either of them contested the claim and indicated that an “Operator
Controversion” form was enclosed. At the end of the document there was a “cc” next to four
names, one of which was Constitution.
On July 15, 1997, more than a week after the challenge deadline had passed, OWCP
claims examiner Ken Lubinsky documented in a call report that he and Roscher of
Constitution spoke about the Initial Finding. Lubinsky noted that the Initial Finding was sent
3
to an address that differed from the insurer address listed on the Notice of Claims.
According to Lubinsky’s call report, Roscher represented the following in the conversation:
1) that she had never seen the Initial Finding, 2) she had not seen any of the corresponding
documents, 3) she would fax over a controversion form, and 4) Constitution is a subsidiary
of Travelers and they have accepted liability. Based on the conversation, Lubinsky
documented that he was changing the carrier identification number to reflect Travelers. That
same day, Roscher submitted the appropriate form to challenge the Initial Finding via fax.
Also on July 15, 1997, Lubinsky sent Roscher a letter acknowledging receipt of the challenge
to the Initial Finding. 3
In early fall of 1997, OWCP issued an Amended Notice of Initial Finding to
document that Travelers was the proper insurance carrier. The letter released Lackawanna
as a party to the claim.
In a hearing before the ALJ, Kuntz argued that Constitution had waived its ability to
challenge the claim because it failed to respond within 30 days after the Initial Finding was
issued. On May 6, 2002, the ALJ issued a decision and order concluding that Constitution
demonstrated good cause for its late challenge because it had not been properly notified of
the Initial Finding. Specifically, the ALJ found that the carrier was misidentified in the
3
During the month of August, a number of letters were exchanged between counsel for
Beltrami/Constitution and OW CP relating to the submission of additional evidence.
None of the letters were referenced in the ALJ ruling and thus we decline to discuss them
here.
4
Initial Finding and that it had been sent to the wrong address. The ALJ also concluded that
he would not presume Constitution received the Initial Finding solely based on the “cc”
appearing at the end of the document. Kuntz appealed this decision to the Benefits Review
Board (“the Board”). The Board determined that the ALJ did not abuse its discretion in
determining that there was good cause to excuse the untimely filing of the challenge and that
substantial evidence supported the ALJ’s decision. The instant appeal followed.4
II. Standard of Review
We limit our review of the Board’s decision to a determination of whether an error
of law has been committed and whether the Board has adhered to its scope of review.
Kowalchick v. Dir., Office of Workers' Compensation Programs, 893 F.2d 615, 619 (3d Cir.
1990). The ALJ’s findings of fact are affirmed by the Board if the findings are supported by
substantial evidence. Oravitz v. Director, Office of Workers' Compensation Programs, 843
F.2d 738, 739 (3d Cir. 1988). Thus, our task is to independently review the record to
determine whether the ALJ’s findings are supported by substantial evidence. Walker v.
Universal Terminal & Stevedoring Corp., 645 F.2d 170, 172 (3d Cir. 1981). “‘Substantial
evidence’ is ‘more than a mere scintilla. It means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.’” Smith v. Califano, 637 F.2d 968,
970 (3d Cir. 1981) (internal citations omitted).
4
Kuntz actually received three adverse decisions from the ALJ, all of which were
appealed to the Board upon their issuance. The instant appeal involves only the May 6,
2002 ruling.
5
III. Discussion
Under § 725.4135 of the 1997 Code of Federal Regulations, an operator failing to
respond within 30 days after given notice of the Initial Finding waives its right to challenge
the claim unless the OWCP excuses the operator’s failure to respond for good cause. Federal
Coal Mine Safety and Health Act, 20 C.F.R. § 725.413 (1997).6 It is undisputed that
Constitution challenged the claim later than 30 days after the Initial Finding was issued. The
issue before the ALJ, and thus the issue before us, is whether there existed good cause to
excuse Constitution’s failure to challenge the claim within the permissible time. While both
parties agree that we must determine whether the ALJ’s finding of good cause was supported
by substantial evidence, neither party, nor the ALJ, nor the Board has proffered any standard
for determining what constitutes good cause. Although § 725.413, which sets forth the
regulations for contesting the Initial Finding, does not define good cause, the regulations
implementing the Act describe what constitutes good cause for excusing late filings in other
contexts. For example, when excusing a delay in the timely filing of support, § 410.216
discusses the concept of good cause as follows:
(a) What constitutes "good cause." Good cause may be found for failure to file proof
of support within ...the [specified] period where the [person] establishes to the
5
Section 725.413 does not exist in the 2004 Code of Federal Regulations.
6
The Initial Finding also warns:
If you fail to respond within thirty (30) days, you will be deemed to have accepted
the initial finding, and this failure shall be considered a waiver of your right to
contest this claim unless good cause is shown to excuse such failure. (20 CFR
725.413)
6
satisfaction of the Administration that such failure to file was due to:
(1) Circumstances beyond the individual's control, such as extended illness,
mental or physical incapacity, or communication difficulties; or...
Id. at 410.216 (emphasis added).
As it is well-settled law that a word or phrase used in different parts of the same
statute is presumed to have the same meaning throughout, Atlantic Cleaners & Dyers, Inc.
v. United States, 286 U.S. 427, 433 (1932), we discern that there is no rational basis for
having a standard for good cause in § 725.413 of the regulation that differs from the standard
set forth in § 410.216 of the regulation. Hence, Constitution’s untimely challenge of Kuntz’
claim is excused if the reason for the delay matches one of the scenarios establishing good
cause under § 410.216. The ALJ found that the Initial Finding was sent to Lackawanna
rather than Constitution. He reached this conclusion from three pieces of evidence: (1)
Lackawanna had been misidentified as the insurer on the Initial Finding, (2) the conversation
between Roscher and Lubinsky, and 3) the substitution of Travelers for Lackawanna in the
Amended Notice of Initial Finding. The ALJ also found that the “cc” appearing at the end
of the Initial Finding was not sufficient proof in the instant circumstances that a copy of the
Initial Finding was in fact mailed to Constitution. The ALJ offered substantial evidence that
Constitution was not properly served the Initial Finding because of confusion on the part of
OWCP as to where the Initial Finding was to be sent. This qualifies as a communication
difficulty beyond Constitution’s control, one of the scenarios establishing good cause under
the regulation. See 20 CFR § 410.216(a)(1). Because the Board correctly determined that
7
substantial evidence supported the ALJ’s finding that good cause excused Constitution’s late
challenge, we affirm.
We have considered all of the arguments advanced by the parties and conclude that
they are without merit and require no further discussion. Accordingly, the order of the
Benefits Review Board will be affirmed.
8