Goble v. Leisure Hills of Hibbing and Minn. Health Care Ass’n/CCMSI, et. al

Goble v. Leisure Hills of Hibbing and Minn. Health Care Ass’n/CCMSI, et. al., No. WC15-5900 (W.C.C.A. July 11, 2016)

Employer and insurer appealed the compensation judge’s conclusion that common law governing the effect of notice between a principal and agent does not prevail over the statutory intervention notice requirement of Minn. Stat. § 176.361, subd. 2(a). Standard of review is whether the findings of fact was clearly erroneous and unsupported by substantial evidence.

Employee, on August 6, 2003, suffered a work related injury to her upper back and neck.  On December 23, 2010, the employee filed a Claim Petition with MDHS.  MDHS was served with an intervention notice but did not intervene.

Following employee’s injuries, Medica paid a portion of the medical bills incurred by employee for treatment of the work related injury, including surgical care provided in 2005. Article 12 of a contact between Medica and MDHS provides that MCOs (including Medica), are agents of the state for obtaining third party reimbursement. Medica was not provided notice of intervention.

On April 22, 2013, employee filed a second Claim Petition seeking benefits.  Medica became aware of the claim and sought to intervene for reimbursement.  Employer and Insurer argued that Medica’s intervention interest is extinguished because Medica, being an agent MDHS, had notice through MDHS’s notice.  Medica argues employer and insurer had to follow statutory notice requirements under Minn. Stat. § 176.361, requiring notice to potential intervenors and giving interveners 60 days to intervene.

WCCA affirmed the workers’ compensation judge’s conclusion.  WCCA discussed that the court has explicitly rejected the application of the principal-agent relationship for extinguishing a reimbursement interest, citing to Rouse v. J.P. Food Serv., Inc., slip op. (W.C.C.A. Sept. 30, 1997).  Furthermore, the WCCA reasoned that notice was never served on Medica and therefore the 60-day period to intervene did not begin to run.

The WCCA did look into a second issue regarding a motion to strike documents the employer and insurer wished to introduce.  These documents were not offered at the time of the hearing, nor were they placed into the record.

The WCCA additionally affirmed the compensation judge’s conclusion on this issue reasoning that the court’s authority is limited to reviewing the record as submitted to the compensation judge.  Therefore, the motion to strike was granted.