ASH-SMITH (DAVETTA J.) VS. COMMONWEALTH OF KENTUCKY- HAZELWOOD ICF/MR, ET AL.
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RENDERED: JANUARY 24, 2014; 10:00 A.M.
NOT TO BE PUBLISHED
OPINION OF NOVEMBER 1, 2013, WITHDRAWN
Commonwealth of Kentucky
Court of Appeals
NO. 2012-CA-001878-WC
DAVETTA J. ASH-SMITH;
NORMAN E. HARNED; and
HARNED BACHERT &
McGEHEE, PSC
v.
APPELLANTS
PETITION FOR REVIEW OF A DECISION
OF THE WORKERS’ COMPENSATION BOARD
ACTION NO. WC-93-19835
COMMONWEALTH OF KENTUCKY HAZELWOOD ICF/MR; CANNON
COCHRAN MANAGEMENT SERVICES,
INC.; PHILIP HARMON, Acting Director,
Office of Workers’ Claims; DR. DAVID
ROUBEN; HON. R. SCOTT BORDERS,
Administrative Law Judge; HON. JAMES
L. KERR, Administrative Law Judge; and
WORKERS’ COMPENSATION BOARD
APPELLEES
OPINION
AFFIRMING
** ** ** ** **
BEFORE: ACREE, CHIEF JUDGE; COMBS AND TAYLOR, JUDGES.
COMBS, JUDGE: Davetta Ash-Smith appeals the opinion of the Workers’
Compensation Board which vacated and remanded orders of the Administrative
Law Judge (ALJ). After our review, we affirm.
Ash-Smith’s work-related injury occurred in 1993 when she was employed
by Commonwealth of Kentucky-Hazelwood ICF/MR (Hazelwood). The parties
reached a settlement agreement in 2001. In 2007, Dr. David Rouben, Ash-Smith’s
treating physician, recommended a surgical procedure for repair of a previous
surgery that had failed. He requested pre-authorization from Hazelwood, which
Hazelwood denied. The parties went through a prolonged utilization review and
reconsideration process. Relevant to this appeal, the claim eventually resulted in
the imposition of sanctions and attorney’s fees on Hazelwood in 2012.
Ash-Smith appealed to the Workers’ Compensation Board. In a lengthy
opinion which we have reviewed closely, the Board vacated several orders and
remanded to the Administrative Law Judge (ALJ) for taking of proof and findings
of fact. Ash-Smith now appeals from that opinion.
Kentucky Revised Statute[s] (KRS) 342.285 limits the Board’s review of a
decision of an ALJ. The Board is not permitted to substitute its judgment
concerning the weight of the evidence on questions of fact. Instead, its review is
confined to determining whether:
(a) The administrative law judge acted without or in
excess of his powers;
(b) The order, decision, or award was procured by fraud;
(c) The order, decision, or award is not in conformity
to the provisions of this chapter;
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(d) The order, decision, or award is clearly
erroneous on the basis of the reliable, probative, and
material evidence contained in the whole record; or
(e) The order, decision, or award is arbitrary or
capricious or characterized by abuse of discretion or clearly
unwarranted exercise of discretion.
KRS 342.285. Similarly, when reviewing decisions of the Board, this Court may
correct only if it “has overlooked or construed controlling statutes or precedent, or
committed an error in assessing the evidence so flagrant as to cause gross
injustice.” Western Baptist Hosp. v. Kelly, 827 S.W.2d 685, 687-88 (Ky. 1992).
The decision of the ALJ should not be disturbed if it was supported by substantial
evidence in the record. Transportation Cabinet v. Poe, 69 S.W.3d 60, 62 (Ky.
2001).
In this case, the Board found that there was insufficient information in the
record to support the ALJ’s decisions regarding the issues of sanctions and
attorney’s fees. The sanctions were imposed in response to Ash-Smith’s claim that
Hazelwood had not complied with the statutes and regulations which govern the
utilization review and reconsideration process. The Board determined that the
record failed to address questions of fact regarding the timing of several pertinent
communications. Additionally, the record does not include proof of the method
that the ALJ used to calculate the award of attorney’s fees. The orders of the ALJ
regarding the sanctions and fees were conclusory and provided no factual findings.
Therefore, the Board did not commit error by remanding for additional prooftaking and fact-finding by the ALJ.
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Ash-Smith also argues that the Board did not have jurisdiction to vacate the
orders that imposed sanctions, costs, and attorney’s fees because Hazelwood did
not appeal those issues to the Board. We disagree.
The Board has the responsibility of insuring that the ALJ has acted
according to law. KRS 342.285(2)(a). The ALJ has the duty to include findings of
fact with respect to awards and decisions. KRS 342.275(2); Arnold v. Toyota
Motor Manufacturing, 375 S.W.3d 56, 61 (Ky. 2012). Our Supreme Court has
expressly held that the Board has the authority, sua sponte, to correct awards that
are erroneous as a matter of law. Whittaker v. Reeder, 30 S.W.3d 138, 143 (Ky.
2000). In this case, the Board found that the ALJ erred as a matter of law by not
providing statutorily mandated findings of fact. The state of the record that we
have received supports the analysis of the Board.
Therefore, we affirm the order of the Board remanding this case to the ALJ
for findings.
ACREE, CHIEF JUDGE, CONCURS IN RESULT ONLY.
TAYLOR, JUDGE, DISSENTS.
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BRIEF FOR APPELLANTS:
Norman E. Harned
Bowling Green, Kentucky
BRIEF FOR APPELLEE
COMMONWEALTH OF
KENTUCKY-HAZELWOOD:
Kathryn Manis
Lexington, Kentucky
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