Amguard Insurance Company v. Kerkela.

THIRD DIVISION
ELLINGTON, P. J.,
ANDREWS and RICKMAN, JJ.
NOTICE: Motions for reconsideration must be
physically received in our clerk’s office within ten
days of the date of decision to be deemed timely filed.
http://www.gaappeals.us/rules
March 13, 2018
In the Court of Appeals of Georgia
A17A1498. AMGUARD INSURANCE COMPANY v. KERKELA.
RICKMAN, Judge.
This Court granted the discretionary appeal application of Amguard Insurance
Company to appeal the superior court’s judgment reversing and remanding an award
of the Appellate Division of the State Board of Workers’ Compensation (“the Board”)
to the extent that the award failed to include continuing assessed attorney fees. For
the following reasons, we vacate the trial court’s judgment and remand the case.
After Matthew Kerkela, a restaurant manager, submitted a claim that he was
injured on the job, one week before a scheduled hearing before an administrative law
judge (ALJ), Amguard, the employer’s workers’ compensation insurance carrier,
accepted Kerkela’s claim as compensable. Amguard authorized Kerkela’s continued
medical treatment and payment of past medical bills; paid Kerkela a lump sum of past
due temporary total disability (“TTD”) income benefits, from the date he had stopped
working to the date the claim was accepted; paid a 15 percent late-payment penalty
of the lump sum; and agreed to pay attorney fees equal to 25 percent of the income
benefits already paid. A hearing before the ALJ was later held on the issue of whether
Kerkela was entitled to additional assessed attorney fees equal to 25 percent of future
TTD income benefits.
Evidence was presented on the issue, and the ALJ denied Kerkela’s request for
continued assessed attorney fees. The ALJ concluded that Amguard’s payment of 25
percent of back income benefits and the late-payment penalty as attorney fees was
“more than sufficient.” The ALJ also concluded that Amguard’s defense of Kerkela’s
claim had been reasonable, finding that Amguard conducted discovery expeditiously,
made its decision to accept the claim in a brief period of time, and paid a lump sum
amount of attorney fees as a good-faith attempt to compromise the demand for
attorney fees.1 The ALJ explained that during discovery, a second adjuster who took
over the claim learned detailed facts about the mechanism and place of injury, and
1
Pursuant to OCGA § 34-9-108 (b) (1), “[u]pon a determination that
proceedings have been brought, prosecuted, or defended in whole or in part without
reasonable grounds, the administrative law judge or the board may assess the adverse
attorney’s fee against the offending party.”
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additional information about Kerkela’s medical status and its relationship to his
injury. The ALJ found that Amguard accepted the claim as compensable shortly after
Kerkela had been deposed and received an independent medical evaluation.
The Board adopted the ALJ’s decision. The Board accepted the ALJ’s findings
of fact, stating that they were supported by a preponderance of competent and
credible evidence, and that the ALJ was in the best position to determine the
credibility and weight of the evidence. The superior court determined that the Board
had misinterpreted evidence when it concluded that Amguard had acted reasonably
in its defense of Kerkela’s claim and listed numerous instances of Amguard’s failure
to comply with its statutory obligations. The court further determined that the “only
evidence at trial was that 25%” of back and future benefits was a reasonable fee; and
the court reversed the Board’s decision and remanded the case to the Board for
actions consistent with its order. In reaching its decision, the court applied a de novo
standard of review, finding that such standard was appropriate given that “it is clear
that evidence has been misconstrued and misinterpreted[.]” Amguard appeals,
contending, inter alia, that the trial court applied an incorrect standard of review. We
agree.
3
The superior court may not disturb the factual findings of the Board if there is
any evidence to support them, as the superior court does not have the power to find
facts. See J & R Schugel Trucking v. Logan, 336 Ga. App. 899, 901 (785 SE2d 581)
(2016); YKK (USA) v. Patterson, 287 Ga. App. 537 (652 SE2d 187) (2007); see also
Hallisey v. Fort Howard Paper, Co., 268 Ga. 57, 58-59 (1) (484 SE2d 653) (1997).
However, “[e]rroneous applications of law to undisputed facts, as well as decisions
based on erroneous theories of law . . . are subject to the de novo standard of review
in the superior court.” (Citation and punctuation omitted.) Heritage Healthcare v.
Ayers, 323 Ga. App. 172, 173 (746 SE2d 744) (2013). Whether an employer has
unreasonably defended against a claim is a factual determination, subject to the any
evidence standard of review. See Printpack, Inc. v. Crocker, 260 Ga. App. 67, 72-73
(3) (b) (579 SE2d 225) (2003); Seabolt v. Beaulieu of America, 255 Ga. App. 750,
752 (566 SE2d 444) (2002).
Here, the superior court deemed the Board’s conclusion that Amguard’s
defense was reasonable as a “misinterpretation” of the evidence. Such a conclusion
appears to be a disagreement with the Board’s factual findings and is subject to the
any evidence standard of review, which the superior court failed to apply. See
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Printpack, 260 Ga. App. at 72-73 (3) (b). Therefore, we vacate the judgment and
remand the case for application of the correct standard of review.
We take this time to mention to trial courts and litigants that it might seem as
though we are putting form over substance when we remand cases such as this for the
trial court to apply the proper standard, rather than just reviewing the evidence
ourselves under the correct standard. However, the application of the correct standard
underpins our system of appellate review and ensures that the fact finder – be that a
trial court, administrative tribunal, etc. – is given the appropriate amount of deference
as the entity that is tasked with fact finding. Therefore, we find it appropriate and
important to insist that it be applied in the first instance. See generally Burke County
v. Askin, 291 Ga. 697, 701 (2) (732 SE2d 416) (2012) (vacating judgment and
remanding case for court to reconsider its decision in light of the applicable legal
standard).
Judgment vacated and case remanded. Ellington, P. J., and Andrews, J.,
concur in judgment only.*
* THIS OPINION IS PHYSICAL PRECEDENT ONLY. COURT OF
APPEALS RULE 33.2(a).
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