Ex parte Everest National Insurance Company. PETITION FOR WRIT OF MANDAMUS (In re: Ronald D. Gray v. Danny Gray Flooring et al.)

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REL: 09/16/2011 Notice: T h i s o p i n i o n i s s u b j e c t t o formal r e v i s i o n b e f o r e p u b l i c a t i o n i n t h e advance s h e e t s o f Southern R e p o r t e r . R e a d e r s a r e r e q u e s t e d t o n o t i f y t h e R e p o r t e r o f D e c i s i o n s , Alabama A p p e l l a t e C o u r t s , 300 D e x t e r A v e n u e , M o n t g o m e r y , A l a b a m a 3 6 1 0 4 - 3 7 4 1 ((334) 2 2 9 - 0 6 4 9 ) , o f a n y t y p o g r a p h i c a l o r o t h e r e r r o r s , i n o r d e r t h a t c o r r e c t i o n s may b e made b e f o r e t h e o p i n i o n i s p r i n t e d i n Southern R e p o r t e r . ALABAMA COURT OF CIVIL APPEALS SPECIAL TERM, 2011 2100711 Ex p a r t e E v e r e s t N a t i o n a l I n s u r a n c e Company PETITION FOR WRIT OF MANDAMUS (In re: Ronald D. Gray v. Danny Gray F l o o r i n g e t a l . ) (Jefferson Circuit THOMPSON, P r e s i d i n g Everest this court National Court, CV-00-6240) Judge. I n s u r a n c e Company f o r a writ o f mandamus ("Everest") directing petitions the Jefferson 2100711 Circuit Court to set aside i t s order granting Ronald motion to compel E v e r e s t to p r o v i d e a p a n e l of f o u r pursuant set t o § 2 5 - 5 - 7 7 ( a ) , A l a . Code. forth herein, This i s the we deny the second time 1975. For Gray's physicians the reasons petition. this action, arising under Workers' Compensation A c t , § 25-5-1 e t s e q . , A l a . Code has court. been Gray, before this 8 98 procedural contained So. 2d history 753 Fireman's (Ala. Civ. relevant i n Fireman's See to App. the Fund 2004 ) . present 1975, I n s . Co. Some of proceeding Fund: " R o n a l d Gray sued Danny Gray F l o o r i n g ('Gray F l o o r i n g ' ) , a b u s i n e s s o w n e d b y [ G r a y ] , on O c t o b e r 13, 2000, s e e k i n g t o r e c o v e r w o r k e r s ' c o m p e n s a t i o n b e n e f i t s f o r i n j u r i e s he s u s t a i n e d t o h i s l o w e r b a c k on N o v e m b e r 1, 1 9 9 8 . Gray F l o o r i n g answered the c o m p l a i n t on O c t o b e r 2 5 , 2 0 0 0 . On May 17, 2001, E v e r e s t N a t i o n a l I n s u r a n c e Company ( ' E v e r e s t ' ) moved t o i n t e r v e n e i n t h e w o r k e r s ' c o m p e n s a t i o n a c t i o n as a real party in interest. Everest alleged that [ G r a y ] was t h e o w n e r o f G r a y F l o o r i n g ; t h a t i t was the workers' compensation i n s u r e r f o r Gray F l o o r i n g f r o m F e b r u a r y 7, 1 9 9 8 , t h r o u g h F e b r u a r y 7, 2 0 0 0 ; a n d t h a t t h e c a s e was n o t a d v e r s a r i a l i n n a t u r e b e c a u s e [ G r a y ] was t h e owner o f G r a y F l o o r i n g . Everest sought to i n t e r v e n e i n order to f u l l y defend the claim against Gray Flooring and to seek a d e t e r m i n a t i o n o f i t s o b l i g a t i o n s , i f any, p u r s u a n t to the Alabama Workers' Compensation Act ('the Act'). The t r i a l c o u r t e n t e r e d an o r d e r on J u n e 1 8 , 2001, g r a n t i n g E v e r e s t ' s m o t i o n t o i n t e r v e n e . " 2 the v. the is 2100711 898 So. 2d a t 753-54. several other Insurance insurance Company action. Both Fireman's On 7, and 2002, petitioned the t r i a l agreement between to medical Fund"), Everest Gray, Fireman's were asserted court those Gray joined Fund i n the claims Flooring, f o r the approval against of a settlement agreed from Gray's remaining the Everest court arising which and trial a l l claims parties, f o r $105,000, w i t h E v e r e s t November liable 1, 1 9 9 8 , f o r future benefits. After the including intervention, t o the s e t t l e m e n t agreement, E v e r e s t Pursuant settle injury companies, ("Fireman's Gray to Everest's Fund. May granted. Subsequent Gray, settlement proceeding, Gray Flooring, agreement, after which and E v e r e s t the t r i a l i t entered court rule. held a judgment o t h e r t h i n g s , t h a t F i r e m a n ' s F u n d was l i a b l e last-injurious-exposure had e n t e r e d an o r e finding, into tenus among t o Gray under the 1 The l a s t - i n j u r i o u s - e x p o s u r e r u l e i s used " t o determine which insurance carrier bears responsibility f o r paying w o r k e r s ' c o m p e n s a t i o n b e n e f i t s when a n e m p l o y e e s u f f e r s t w o o r m o r e e p i s o d e s o f c o m p e n s a b l e d i s a b i l i t y w i t h an i n t e r v e n i n g change o f employers o r change o f i n s u r a n c e c a r r i e r s by t h e same e m p l o y e r . " E x p a r t e P i k e C n t y . Comm'n, 740 S o . 2 d 1 0 8 0 , 1083 ( A l a . 1999). 1 3 2100711 Fireman's Fund f i l e d reversed the trial court's of a new judgment. 2005, the trial Fireman's F u n d as to 2010, Gray. prescription physician, a Gray's to terminate benefits some o f to response It to filed had wrongfully requested t h a t the t r i a l it not held that and to records Everest's be 2d at 760. that Gray's motion released among he from a f t e r Dr. him he to specializing physician. provide in See pain him with a management § 25-5-77(a), Ala. 4 t h a t the panel for Code of him medical from other his things, Gray filed that Dr. care. He t o show c a u s e immediately Everest him his with a pain specialist requested the misusing argued for failing and against i t . treatment. Everest of pain-management i n contempt from h i s care, 10, been his him court order June future had i n which released for a motion to reopen i t s motion, of case On claims Gray had court remand i n f a v o r Everest's Kendrick, Kendrick should and This remanded the a j u d g m e n t on alleged attached medical So. court. i t s o b l i g a t i o n to provide Michael Everest the 898 Everest medications Dr. to t h i s j u d g m e n t and court entered N o v e m b e r 4, c a s e and care. appeal the entry On an to provide Kendrick trial four to 1975. why him released court order physicians select a new 2100711 On December denying did 21, Everest's 2010, motion referred Gray On February 11, Everest which to provide he could management released taken and Everest provide physician Everest had who had Addressing replace from the after pain- Gray was He s t a t e d t h a t E v e r e s t had because i t p r e v i o u s l y had p r o v i d e d a panel of Gray argued t h a t , pursuant to § worker entitled four a response to Gray's motion to compel i t to of four a "new a panel surgeons. of four p h y s i c i a n s after to 25-5- of a panel is Gray w i t h i n which i t argued that i t a panel of four physicians G r a y had become d i s s a t i s f i e d had p e r f o r m e d s u r g e r y chosen compel of previously provided doctor to physicians authorized care. physician. a panel filed a panel to physicians. motion four It i t d i d not have to p r o v i d e at Gray's request Gray a of a order benefits. of four filed an that injured physicians Gray a panel f r o m Dr. K e n d r i c k ' s an entered medical f o r a panel with surgeons to Gray. 77(a), court terminate 2011, choose the p o s i t i o n trial t o a n o t h e r pain-management him physician four physicians had to n o t r u l e on G r a y ' s r e q u e s t Everest four the on h i m . physician/surgeon" Gray's c o n t e n t i o n that 5 Everest from § 25-5-77(a) with argued that provides the that panel. for a 2100711 panel of four physicians surgeons, and, is Everest argued as a r e s u l t , for a that panel effectively and, s e p a r a t e l y , of that used both " a l l surgeons " i f an i n j u r e d four f o r a panel are physicians" worker's of h i s p o t e n t i a l first then surgeons, or he panel of four request she h a [ s ] requests a t one time." The t r i a l 2011, with a court i t entered a panel physician held a hearing, an o r d e r compelling of four physicians to replace after Dr. K e n d r i c k filed an a p p e a l t o t h i s treated court. as a p e t i t i o n which t h i s court to provide Gray This that authorized by from h i s care. court, Everest's f o r a writ i n an o r d e r a petition Everest Everest issued a p p e a l was d u e t o o f mandamus. has s e t f o r t h t h e f o l l o w i n g considers Gray f r o m w h i c h G r a y was t o s e l e c t had r e l e a s e d Our supreme c o u r t Everest the physician on May 3 1 , 2 0 1 1 , d e t e r m i n e d be a f t e r w h i c h , on M a r c h 2 2 , f o ra writ standard o f mandamus: "Mandamus i s a d r a s t i c a n d e x t r a o r d i n a r y w r i t , t o b e i s s u e d o n l y w h e r e t h e r e i s (1) a c l e a r l e g a l r i g h t i n t h e p e t i t i o n e r t o t h e o r d e r s o u g h t ; (2) a n imperative d u t y upon t h e r e s p o n d e n t to perform, a c c o m p a n i e d b y a r e f u s a l t o do s o ; (3) t h e l a c k o f a n o t h e r a d e q u a t e r e m e d y ; a n d (4) p r o p e r l y invoked j u r i s d i c t i o n of the court." 6 by 2100711 Ex p a r t e Integon petitioner bears before writ Corp., 6 the all by Boykin, "[T]he writ issue." presumptions judgment appealed parte f r o m , and 2d 1089, Section Ex 4 97 , 4 99 ( A l a . 1 995). each of these parte Glover, f a v o r i n g the 801 568 is So. not to 1090 2d be So. 1, indulge of the this c o u n t e r v a i l i n g evidence." Ex 1244 granted (Ala. Civ. unless court." ( A l a . C i v . App. 25-5-77(a) we 2d must overcome 1243, trial "The elements correctness the p e t i t i o n e r satisfactorily showing of e r r o r i n the So. 2d M o r e o v e r , " i n mandamus p r o c e e d i n g s , reasonable presumption So. the burden of p r o v i n g will (Ala. 2001). 672 provides Ex there parte App. is 1 990). a clear Shepherd, 560 1990). in relevant part: "If the employee i s d i s s a t i s f i e d w i t h the initial t r e a t i n g p h y s i c i a n s e l e c t e d by t h e e m p l o y e r and i f f u r t h e r t r e a t m e n t i s r e q u i r e d , t h e e m p l o y e e may so advise the employer, and the employee shall be e n t i t l e d to s e l e c t a second p h y s i c i a n from a panel o r l i s t o f f o u r p h y s i c i a n s s e l e c t e d by t h e e m p l o y e r . If surgery is required and i f the employee is d i s s a t i s f i e d w i t h t h e d e s i g n a t e d s u r g e o n , he o r s h e may so a d v i s e t h e e m p l o y e r , a n d t h e e m p l o y e e s h a l l be e n t i t l e d t o s e l e c t a s e c o n d s u r g e o n f r o m a p a n e l o r l i s t o f f o u r s u r g e o n s s e l e c t e d by t h e e m p l o y e r . " This court recently discussed 5-77(a) w i t h regard the proper application t o t h e p r o v i s i o n o f p h y s i c i a n and panels: 7 of § 25- surgeon 2100711 "By i t s plain language, the [Workers' Compensation] A c t d i f f e r e n t i a t e s between p h y s i c i a n s and s u r g e o n s . As t o p h y s i c i a n s , t h e A c t g r a n t s t o an e m p l o y e e d i s s a t i s f i e d w i t h t h e i n i t i a l treating p h y s i c i a n the r i g h t to request that the employer p r o v i d e a p a n e l o f f o u r new p h y s i c i a n s f r o m w h i c h the employee can s e l e c t a replacement. As t o s u r g e o n s , t h e A c t s t a t e s t h a t an e m p l o y e e s h a l l have a r i g h t t o have t h e employer p r o v i d e a p a n e l o f f o u r different surgeons i f surgery i s needed and t h e employee i s d i s s a t i s f i e d w i t h t h e surgeon d e s i g n a t e d by t h e e m p l o y e r . The t w o c l a u s e s a t i s s u e a r e n o t overlapping; they are supplemental t o one a n o t h e r , intended to cover two different situations. Therefore, the p l a i n language of § 25-5-77(a) suggests that the f u r n i s h i n g of the panel of four physicians pursuant to the f i r s t c l a u s e does n o t relieve the employer of the duty to provide an additional panel of four surgeons in the circumstances o u t l i n e d i n the second c l a u s e . "Our l i t e r a l r e a d i n g of § 25-5-77(a) comports with i t s p u r p o s e as w e l l . The h i s t o r y of the e n a c t m e n t o f § 2 5 - 5 - 7 7 ( a ) shows t h a t t h e l e g i s l a t u r e i n t e n d e d t o g i v e a n e m p l o y e e some r a n g e o f c h o i c e i n the matter of the person p r o v i d i n g h i s or her medical treatment i n order t o g i v e t h e employee c o n f i d e n c e t h a t h i s o r h e r m e d i c a l n e e d s w i l l b e met and t o t h e r e b y e n c o u r a g e and e x p e d i t e t h e h e a l i n g process. S e e C i t y o f A u b u r n v . B r o w n , 638 S o . 2 d 1339, 1340-41 ( A l a . C i v . App. 1 993) . The l e g i s l a t u r e e v i d e n t l y c o n c l u d e d t h a t when s u r g e r y i s required, an employee deserves the additional s e c u r i t y p r o v i d e d by a separate p a n e l of f o u r . That l e g i s l a t i v e i n t e n t appears e s p e c i a l l y i n s i g h t f u l i n cases l i k e t h i s i n which the d i s s a t i s f a c t i o n of the employee w i t h t h e surgeon d e s i g n a t e d by t h e employer stems from t h e f a c t t h a t t h e employee has t w i c e s u b m i t t e d t o s u r g e r y by t h a t surgeon w i t h o u t l a s t i n g recovery. In such cases, the intent of the legislature to assuage the employee's dissatisfaction with the employer's designated 8 2100711 surgeon and t o assure and e x p e d i t e the healing p r o c e s s b a s i c a l l y demands t h a t t h e e m p l o y e e r e c e i v e a p a n e l o f f o u r new s u r g e o n s f r o m w h i c h t o c h o o s e a new s u r g i c a l p r o v i d e r . To h o l d t h a t a n e m p l o y e e h a s exhausted h i s o r h e r s u r g i c a l o p t i o n s by p r e v i o u s l y selecting a different initial treating physician would defeat that b e n e f i c e n t purpose of the A c t . See A l a . Acts 1 992, A c t No. 92-537, § 1 ('The Alabama Workers' Compensation A c t i s r e m e d i a l i n nature and should be liberally construed to effectuate the intended b e n e f i c i a l purposes.')." Ex parte K i s h , 45 S o . 3 d 7 7 2 , 7 7 5 - 7 6 Everest with a panel not contends that o f f o u r p h y s i c i a n s and, as a r e s u l t , and "[a] second panel Everest of four physicians. 1 999. I t states Craddock's chose Dr. Everest but, states almost that Gray's initial that Gray requested Thomas Staner, became a panel a authorized d i s s a t i s f i e d with of four neurosurgeon, s t a t e s t h a t Dr. S t a n e r from d i d not perform d i r e c t e d the course treatment." Thus, of Gray's Everest 9 Dr. p h y s i c i a n s , and 10 y e a r s a n d " a c t e d s o l e l y t o c o o r d i n a t e management authorized C r a d d o c k , who p e r f o r m e d s u r g e r y on G r a y care, instead, I t argues i s o n l y mandated i f s u r g e r y i s r e q u i r e d s u r g e o n was D r . R o b e r t in Gray t h a t Gray i s the employee i s not s a t i s f i e d w i t h the p r o v i d e d surgeon." 2010). i t had p r e v i o u s l y p r o v i d e d e n t i t l e d to a second panel that ( A l a . C i v . App. that panel. s u r g e r y on G r a y treatment over [Gray]'s pain- concludes, Gray "has 2100711 been g r a n t e d to h i s one a new evidence o f p h y s i c i a n s and example, Everest petition mail to of record attached terminate exchange in a few medical between the this attorneys to Gray's motion to of physicians Everest's four evidence was entitled the one overriding the requested w r i t necessary performing medical 76. medical sparse. records and a copy for Everest the response to of and question of an e¬ is a G r a y was be answered Craddock because a d d i t i o n a l not satisfied with Dr. treatment. Indeed, the See panel surgery Craddock's panel, p h y s i c i a n f o r the performance of § 25-5-77(a); materials before Kish, this 45 court So. No directly t h a t s u r g e r y o r w h e t h e r , i n r e q u e s t i n g a new s e e k i n g a new panel thereto. t h a t must its Gray and provision For 2 to i s s u e : whether Gray sought the d o c t o r s t o r e p l a c e Dr. G r a y was compel is c o n t a i n e d i n the m a t e r i a l s b e f o r e t h i s c o u r t addresses of and case benefits, attached for i s not panel." The panel 3d other at 775¬ contain very B e c a u s e t h i s p r o c e e d i n g b e g a n as an a p p e a l , t h e c i r c u i t c l e r k p r e p a r e d and t r a n s m i t t e d t o t h i s c o u r t a r e c o r d o f t h e proceedings i n the t r i a l court. Normally, i n a mandamus p r o c e e d i n g , the t r i a l c o u r t c l e r k would not prepare a r e c o r d , a n d t h i s c o u r t w o u l d r e l y on t h e d o c u m e n t s a t t a c h e d t o t h e petitioner's petition. See R u l e 2 1 , A l a . R. A p p . P. We note t h a t E v e r e s t d e s i g n a t e d o n l y c e r t a i n p o r t i o n s of the trial c o u r t ' s r e c o r d f o r i n c l u s i o n i n the a p p e l l a t e r e c o r d . 2 10 2100711 little first evidence panel As to Gray. has Integon provided this materials overcome decision the i t was Everest's things, that Corp., burden i t h a d "a c l e a r Ex p a r t e G l o v e r , 672 S o . 2 d a t 4 9 9 . to legal 801 S o . 2 d a t 6; Although Everest c o u r t w i t h a r g u m e n t , we c a n n o t d i s c e r n f r o m before this presumption he r e q u e s t e d . See a l s o Ex p a r t e court in to require Everest physicians 1244. other of four physicians. parte the noted, t o t h e d e n i a l of Gray's motion t o compel i t t o p r o v i d e a panel Ex among generally to the p r o v i s i o n of the 3 previously demonstrate, right" relating any favor to provide See Ex p a r t e evidence of the that trial would court's Gray w i t h the panel of Boykin, 568 S o . 2 d a t S h e p h e r d , 560 S o . 2 d 1 08 9, 10 90 ( A l a . The p a r t i e s ' b r i e f s c o n t a i n numerous f a c t u a l a s s e r t i o n s r e l a t i n g t o t h e p r o v i s i o n o f t h e p a n e l t o G r a y f r o m w h i c h he s e l e c t e d Dr. S t a n e r . However, t h o s e s t a t e m e n t s are largely unsupported by any e v i d e n c e or c i t a t i o n to evidentiary material; the statements themselves do not c o n s t i t u t e evidence. S e e E x p a r t e R u s s e l l , 911 S o . 2 d 7 1 9 , 725 ( A l a . Civ. A p p . 2 0 0 5 ) ("The u n s w o r n s t a t e m e n t s , f a c t u a l a s s e r t i o n s , and a r g u m e n t s o f c o u n s e l a r e n o t e v i d e n c e . " ) . C f . Ex p a r t e ADT S e c . S e r v s . , I n c . , 933 S o . 2 d 3 4 3 , 345 ( A l a . 2 0 0 6 ) ( " ' I n c o n s i d e r i n g a mandamus p e t i t i o n , we m u s t l o o k a t o n l y t h o s e facts before the t r i a l court.' Ex p a r t e A m e r i c a n R e s . I n s . Co., 663 S o . 2 d 9 3 2 , 936 ( A l a . 1 9 9 5 ) ( e m p h a s i s a d d e d ) . Of c o u r s e , f a c t s must be b a s e d upon ' e v i d e n t i a r y m a t e r i a l , ' w h i c h does n o t i n c l u d e s t a t e m e n t s o f c o u n s e l i n m o t i o n s , b r i e f s , and arguments."). 3 11 2100711 Civ. App. because, lacked of although (denying under 1 9 8 0 , 28 U.S.C. court had e r r e d court a basis to cite raised by i t s p e t i t i o n , clear legal without Based due on w h i c h on w h i c h PETITION Bryan, f o rwrit o f mandamus that the t r i a l Because bearing has f a i l e d on the i t has issue to demonstrate o f mandamus, a n d t h i s a court i s the p e t i t i o n . Everest's mandamus petition i s denied. Thomas, a n d M o o r e , 12 court the evidence DENIED. Pittman, evidence mandamus Prevention Act 1986), conclusion). to grant on t h e f o r e g o i n g , t o be, and i s hereby, Supp. of the t r i a l to determine Everest to a writ that Kidnapping on p e t i t i o n any r e l e v a n t right a basis (West i n i t s contrary failed f o r writ contended Parental § 1738A the appellate not provide petition the father jurisdiction before did 1990) J J . , concur.

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