Opinion ID: 1286586
Heading Depth: 1
Heading Rank: 2

Heading: the exclusive remedy provision of the workers' compensation act and the industrial commission's exclusive jurisdiction to award benefits under the act

Text: Whether the Commission has exclusive jurisdiction to determine entitlement to workers' compensation benefits is an issue of law subject to a correctness standard of review. See State Dep't of Social Servs. v. Vijil, 784 P.2d 1130, 1132 (Utah 1989). Sheppick's basic argument is that the district court had jurisdiction to decide his eligibility under the Act for medical and travel benefits for the injury to the L3-4 area of his spine and to award him damages for defendants' bad faith refusal to settle his claim for those expenses. Specifically, he argues that the district court had jurisdiction to do so because Utah Code Ann. § 35-1-59 permits a worker to enforce a Commission order by docketing the award in a district court so that it can be enforced as a judgment. Sheppick concludes from this that the Act recognizes the jurisdiction of the district court to make compensation awards. Plaintiff's argument is founded on a misunderstanding of the jurisdiction of the Commission and the district courts with respect to the award of benefits under the Act. The Workers' Compensation Act is a comprehensive scheme enacted to provide speedy compensation to workers who are injured as a result of an accident occurring in the course and scope of their employment, irrespective of negligence on the part of employers or employees. The Act basically creates a no-fault type insurance protection scheme for work-related injuries in lieu of traditional common law tort remedies. Although in some cases, the amount of compensation a worker can receive under the Act is more limited than the worker might receive in common law damages, compensation is available without regard to fault, is more flexible in providing for physical disabilities and loss of wages, medical benefits, and benefits for dependents and survivors, and is provided more speedily and generally with less expense. The remedies provided by the Act for injuries to workers are exclusive of common law remedies. Section 35-1-60 of the Utah Code provides that compensation awarded under the Act is exclusive and the liabilities of the employer imposed by the Act shall be in place of any and all other civil liability whatsoever, at common law or otherwise. That section further provides that no action at law may be maintained against an employer or against any officer, agent, or employee of the employer based upon any accident, injury, or death of an employee. Although the Act does not specifically state that no court may award benefits provided by the Act, that is its clear import. District courts have no jurisdiction whatsoever over cases that fall within the purview of the Workers' Compensation Act. See Morrill v. J & M Constr. Co., 635 P.2d 88, 89 (Utah 1981); Bryan v. Utah Int'l, 533 P.2d 892 (Utah 1975); Ortega v. Salt Lake Wet Wash Laundry, 108 Utah 1, 5, 156 P.2d 885 (1945); Murray v. Wasatch Grading Co., 73 Utah 430, 435, 274 P. 940 (1929). They may enforce an award only if it is properly docketed. Utah Code Ann. § 35-1-59. The court of appeals has power only to exercise appellate review of Commission awards, not to make awards itself. Utah Code Ann. § 35-1-86. The Act allows for only two instances in which resort to a district court may be had for a judicial common law remedy but not for a compensation award. First, an employee injured by a willful or intentional tortious act of an employer or a fellow employee may sue in a district court for a common law remedy. Mounteer v. Utah Power & Light Co., 823 P.2d 1055 (Utah 1991); Bryan v. Utah Int'l, 533 P.2d 892 (1975); see Lantz v. National Semiconductor Corp., 775 P.2d 937 (Utah Ct.App.1989); see also Eric Hollowell, Annotation, Willful, Wanton, or Reckless Conduct of Coemployee as Ground of Liability Despite Bar of Workers' Compensation Law, 57 A.L.R.4th 888 (1987). Second, if an employer fails to comply with the insurance requirements stated in Utah Code Ann. § 35-1-46, which requires employers either to provide workers' compensation insurance or to be self-insured if the Commission finds that certain requirements are met, an employee may sue in district court for personal injuries arising out of or in the course of employment caused by the wrongful act, neglect or default of the employer or any of the employer's officers, agents or employees. Utah Code Ann. § 35-1-57. In such an action, an employer may not defend on the ground of the fellow-servant rule, assumption of risk, or contributory negligence. Proof of the worker's injury constitutes prima facie evidence of negligence on the part of the employer, and the burden is on the employer to show freedom from negligence resulting in the employee's injury. [1] Plaintiff argues that the district court had jurisdiction under § 35-1-59 to adjudicate its claim for medical benefits. That section provides: An abstract of any award may be filed in the office of the clerk of the district court. . . . Execution may be issued thereon within the same time and in the same manner and with the same effect as if said award were a judgment of the district court. The purpose of this provision is to provide an employee with a judicial remedy for enforcing compensation awards in cases the Industrial Commission has adjudicated. The Commission itself has no authority to issue a judgment that can be enforced against the property of an employer or an insurance company that fails to pay an award. Thus, § 35-1-59 does not confer jurisdiction on a court to make a workers' compensation award; it only authorizes courts to enforce judgments on awards made by the Commission. If defendants had failed to pay the compensation ordered by the Commission, Sheppick could have docketed the orders in a district court and proceeded to enforce a judgment based thereon. Defendants did, however, comply with the awards made by the Commission. The instant dispute arose subsequent to those awards when Sheppick claimed for the first time that he was entitled to compensation for an injury to a somewhat different area of his back, the L3-4 area. Defendants contended that this injury was not caused by the industrial accident but was incurred after Sheppick's employment was terminated. Rather than submitting the issue of whether that injury was prior-work-related to the Commission for adjudication as Sheppick had done in the supplemental proceeding, he withdrew his petition for an award of additional medical benefits before the Commission could decide whether the L3-4 injury was caused by the industrial accident. The Commission, therefore, had no option but to dismiss the petition. Because the Commission issued no order respecting the alleged L3-4 injury and the district court had no order on which a judgment could be entered, it had no jurisdiction to adjudicate plaintiff's claim, and the Commission had exclusive jurisdiction thereof. Cf. United States Smelting, Refining & Mining Co. v. Evans, 35 F.2d 459 (8th Cir.1929). Thus, although Utah Code Ann. § 35-1-60 explicitly speaks only in terms of an exclusive remedy and although an exclusive remedy does not necessarily mean exclusive jurisdiction, it is clear from the context of that provision and other provisions that the exclusive remedy provided in § 35-1-60 and the means for adjudicating the right to such a remedy rests with the Commission, and only the Commission. See also Utah Code Ann. §§ 35-1-16, 35-1-27. Plaintiff argues that the district court could and should have enforced the Commission's supplemental order of May 17, 1993, which in effect provided lifetime medical benefits for treatment of the injuries arising out of the industrial accident. Plaintiff asserts that on that basis, the district court should have granted him medical benefits for the L3-4 injury. The argument assumes that the district court could have made the factual and legal determinations necessary for such an award, i.e., that the L3-4 injury was related to the industrial accident. That determination, however, lies squarely within the exclusive jurisdiction of the Industrial Commission. The whole scheme of the Workers' Compensation Act contemplates that only the Commission can make awards of benefits under the Act and the necessary factual and legal conclusions in support thereof. Not only do the terms of the Act refer exclusively to the Commission in those sections dealing with the adjudication of claims and the award of benefits, but the Commission itself is intended to develop and apply the kind of expertise that grows out of the special situations to which the Act applies and to give full force to the remedial provisions of the Act. In contrast to like actions at common law, under the Workers' Compensation Act, the Commission has continuing jurisdiction to modify awards to injured employees. Utah Code Ann. § 35-1-78. This continuing jurisdiction includes the authority to modify an award for medical benefits, and the doctrine of res judicata does not bar the Commission from making such a modification. Mannes-Vale, Inc. v. Vale, 717 P.2d 709, 712 (Utah 1986). This Court has specifically held that the continuing jurisdiction extends to modification of medical expense awards. Id.; see also Spencer v. Industrial Comm'n, 733 P.2d 158 (Utah 1987). See generally Morrill v. J & M Constr. Co., 635 P.2d 88 (Utah 1981); Ortega v. Salt Lake Wet Wash Laundry, 108 Utah 1, 156 P.2d 885 (1945); Murray v. Wasatch Grading Co., 73 Utah 430, 274 P. 940 (1929). [2] Sheppick's complaint for a declaratory judgment does not give the district court jurisdiction to rule on a matter committed to the authority of another adjudicatory body. District courts are authorized to declare rights, status, and other legal relations. Utah Code Ann. § 78-33-1. However, not only may a court decline to exercise this authority, but it must do so when it has no subject matter jurisdiction. The Utah Code provides, The court may refuse to render or enter a declaratory judgment or decree where such judgment or decree, if rendered or entered, would not terminate the uncertainty or controversy giving rise to the proceeding. Utah Code Ann. § 78-33-6. If the court had entered a judgment, it would have been a nullity. Having decided that the Commission has exclusive jurisdiction not only to issue compensation awards authorized by the Act, but also to make the necessary factual findings upon which such awards may be made, we turn now to Sheppick's contention that he was entitled under the open courts provision of the Utah Constitution, Article I, section 11, to have his claim for a bad faith refusal to deal on the part of defendants adjudicated in the district court. Such a claim, if cognizable, could be adjudicated only in the district court. Such a claim is a common law cause of action, which the Commission has neither the authority nor the jurisdiction to adjudicate. In this case, plaintiff asserts that he has had great difficulty in obtaining payment of medical expenses; that defendants have violated the Commission's order in not making prompt payment; and that they have acted in bad faith in providing ... information regarding plaintiff to persons who are not authorized to receive same, by refusing to authorizing [sic] treatment prescribed by Plaintiff's physicians and otherwise using threats, intimidation, coercion and other unlawful means to violate Plaintiff's rights under the Commission's original and supplemental orders. Assuming, but not deciding, that a plaintiff might under certain circumstances have a common law action against a self-insured employer for refusal to pay a workers' compensation award made by the Commission, the facts plaintiff alleges still fail to establish district court jurisdiction to adjudicate such a claim. The premise of plaintiff's theory of bad faith is that the claim for additional medical expenses was required by the Commission's original order of February 13, 1990, and its supplemental order of May 17, 1993. Whether those orders could be construed to require defendants to pay medical expenses for plaintiff's L3-4 injury depends on whether that injury was caused by plaintiff's 1986 industrial accident or by some subsequent event. As stated above, that determination lies within the exclusive jurisdiction of the Commission. For that reason, the district court had no jurisdiction to adjudicate the claim. Plaintiff had every opportunity to seek a Commission ruling on the causation issue. Not only did he fail to obtain such a ruling, he apparently intended to preclude the Commission from making such a determination by withdrawing his petition before the Commission for such an adjudication. [3] Affirmed. ZIMMERMAN, C.J., and HOWE, DURHAM, and RUSSON, JJ., concur in Associate Chief Justice STEWART'S opinion.