Opinion ID: 1280719
Heading Depth: 2
Heading Rank: 1

Heading: Workers' Compensation: A Legislatively-Administered Program

Text: The first mistake with the majority's reasoning is its misunderstanding of the nature of the workers' compensation system as a legislatively created and legislatively administered program. In 1913, the Legislature created the State's workers' compensation system. [2] As a result of this legislation, we frequently have recognized that [t]he right to workmen's compensation benefits is wholly statutory. Syl. pt. 2, in part, Dunlap v. State Comp. Dir., 149 W.Va. 266, 140 S.E.2d 448 (1965). Accord Boyd v. Merritt, 177 W.Va. 472, 474, 354 S.E.2d 106, 108 (1986) (The right to workers' compensation benefits is wholly a creature of statute[.]). For this reason, [i]t has been held repeatedly by this Court that the right to workmen's compensation benefits is based wholly on statutes, in no sense based on the common law; that such statutes are sui generis and controlling; that the rights, remedies and procedures thereby provided are exclusive; that the commissioner is authorized to award and pay benefits and that a claimant is authorized to demand payment of benefits only in such manner and in such amounts as are authorized by applicable statutes. Roberts v. Consolidation Coal Co., 208 W.Va. 218, 234, 539 S.E.2d 478, 494 (2000) (quoting Bounds v. State Workmen's Comp. Comm'r, 153 W.Va. 670, 675, 172 S.E.2d 379, 382-83 (1970) (citations omitted)) (additional citations omitted). Due to the statutory nature of the workers' compensation program, the Legislature possesses exclusive authority over the workers' compensation fund, itself, and the distribution of such monies to injured workers. See generally Lester v. State Workmen's Comp. Comm'r, 161 W.Va. 299, 315, 242 S.E.2d 443, 452 (1978) ([T]he legislature has the power to modify this state's industrial insurance program as it sees fit so long as no constitutional provision is infringed.); Bailes v. State Workmen's Comp. Comm'r, 152 W.Va. 210, 212, 161 S.E.2d 261, 263 (1968) (The right to workmen's compensation is wholly statutory and is not in any way based on the common law. The statutes are controlling and the rights, remedies and procedure provided by them are exclusive. (citation omitted)). One such power the Legislature exercises in this regard, and which is the subject of the case sub judice, is the authority to adopt rules and regulations to be used in quantifying a claimant's work-related injury into a compensable disability rating. In furtherance of this task, the Legislature has delegated the corresponding rule-making function to the Commissioner of the Bureau of Employment Programs and the Workers' Compensation Division thereof. See W. Va. Code ง 23-1-1(b) (2000) (Supp.2001) (The commissioner is authorized to promulgate rules and regulations to implement the provisions of this chapter.); W. Va.Code ง 21A-2-6(2) (1996) (Supp.2001) (recognizing Commissioner's authority to promulgate rules); Syl. pt. 7, Smith v. State Workmen's Comp. Comm'r, 159 W.Va. 108, 219 S.E.2d 361 (1975) (The State Workmen's Compensation Commissioner may exercise not only the powers expressly granted the office by statute, but also such additional powers of a procedural or administrative nature as are reasonably implied as a necessary incident to the expressed powers of the office.). See also W. Va.Code ง 23-1-13(a) (1995) (Repl. Vol.1998) (The workers' compensation division shall adopt reasonable and proper rules of procedure, regulate and provide for ... the nature and extent of the proofs and evidence, the method of taking and furnishing the same to establish the rights to benefits or compensation from the fund ... or directly from employers ..., and the method of making investigations, physical examinations and inspections[.]); W. Va.Code ง 23-4-6(i) (1999) (Supp.2001) (The workers' compensation division shall adopt standards for the evaluation of claimants and the determination of a claimant's degree of whole body medical impairment.). To facilitate the adoption of such rules and regulations for disability determinations, the Legislature authorized the Commissioner to create the Health Care Advisory Panel to assist with the [e]stablish[ment of] protocols and procedures for the performance of examinations or evaluations performed by physicians or medical examiners[.] W. Va.Code ง 23-4-3b(b) (1990) (Repl.Vol.1998). Similarly, the Legislature established the Compensation Programs Performance Council, [hereinafter referred to as the Performance Council] W. Va.Code ง 21A-3-1 (1993) (Repl.Vol.1996), to further assist the Commissioner with the development of such criteria and to [r]ecommend legislation and establish regulations designed to ensure the effective administration and financial viability of ... the workers' compensation system of West Virginia. W. Va.Code ง 21A-3-7(b) (1993) (Repl.Vol.1996). [3] The Performance Council is additionally charged with the [r]eview and approv[al], reject[ion] or modif[ication of] rules and regulations that are proposed or promulgated by the commissioner for the operation of the workers' compensation system before the filing of the rules and regulations with the secretary of state. W. Va.Code ง 21A-3-7(c). In pursuit of this rule-making function, the Commissioner and the Performance Council, informed by the Health Care Advisory Panel, adopted Guidelines for Permanent Impairment Evaluations, Evidence, and Ratings. See W. Va.C.S.R. ง 85-16-1, et seq. As it relates to the instant appeal, these rules specifically direct that on and after the effective date of this rule all evaluations, examinations, reports, and opinions with regard to the degree of permanent whole body medical impairment which a claimant has suffered shall be conducted and composed in accordance with the Guides to the Evaluation of Permanent Impairment, (4th ed.1993), as published by the American Medical Association[.] W. Va.C.S.R. ง 85-16-4.1 (1996). In short, the practical effect of this regulation is to require examining physicians to evaluate claimants according to the Diagnosis-Related Estimates [hereinafter referred to as DRE] model as opposed to the Range of Motion [hereinafter referred to as ROM] model. [4] To this point, I agree with the majority's analysis. However, it is beyond this juncture that I must part ways with my colleagues and disagree with their reasoning and resultant holdings. Rather than according deference to the Legislature and its attendant entities charged with administering the West Virginia workers' compensation system, the Court takes it upon itself to impermissibly sit as a superlegislature and replace the Commissioner's well-informed guidelines with its preferred method of impairment evaluation for spinal injury claims. See Lewis v. Canaan Valley Resorts, Inc., 185 W.Va. 684, 692, 408 S.E.2d 634, 642 (1991) ([T]he judiciary may not sit as a superlegislature to judge the wisdom or desirability of legislative policy determinations made in areas that neither affect fundamental rights nor proceed along suspect lines. (citing City of New Orleans v. Dukes, 427 U.S. 297, 303, 96 S.Ct. 2513, 2517, 49 L.Ed.2d 511, 517 (1976) (per curiam))); Boyd v. Merritt, 177 W.Va. at 474, 354 S.E.2d at 108 (This Court does not sit as a superlegislature, commissioned to pass upon the political, social, economic or scientific merits of statutes pertaining to proper subjects of legislation. It is the duty of the legislature to consider facts, establish policy, and embody that policy in legislation.). As the majority aptly notes, [i]t is fundamental law that the Legislature may delegate to an administrative agency the power to make rules and regulations to implement the statute under which the agency functions. In exercising that power, however, an administrative agency may not issue a regulation which is inconsistent with, or which alters or limits its statutory authority. Syl. pt. 3, Rowe v. W.Va. Dept. of Corrs., 170 W.Va. 230, 292 S.E.2d 650 (1982). Once such a delegation has been made, we typically defer to said agency's interpretations of its governing legislation absent a departure from the original statutory authority imbuing the agency with such power. Syl. pt. 8, Smith v. State Workmen's Comp. Comm'r, 159 W.Va. 108, 219 S.E.2d 361 (`Where a statute is of doubtful meaning, the contemporaneous construction placed thereon by the officers of government charged with its execution is entitled to great weight, and will not be disregarded or overthrown unless it is clear that such construction is erroneous.' Syllabus point 7., Evans v. Hutchinson, [158] W. Va. [359], 214 S.E.2d 453 (1975).). It goes without saying that [t]he practice of deferring to rationally based legislative enactments is a paradigm of judicial restraint. State ex rel. Affiliated Constr. Trades Found. v. Vieweg, 205 W.Va. 687, 698, 520 S.E.2d 854, 865 (1999) (per curiam) (Workman, J., concurring) (internal quotations and citation omitted). Furthermore, with respect to the scenario presently at hand, we have held that [i]nterpretations as to the meaning and application of workers' compensation statutes rendered by the Workers' Compensation Commissioner, as the governmental official charged with the administration and enforcement of the workers' compensation statutory law of this State, pursuant to W. Va.Code ง 23-1-1 (1997) (Repl.Vol. 1998), should be accorded deference if such interpretations are consistent with the legislation's plain meaning and ordinary construction. Syl. pt. 4, State ex rel. ACF Indus., Inc. v. Vieweg, 204 W.Va. 525, 514 S.E.2d 176 (1999). Despite these assurances of deference to the Commissioner, who has been entrusted by the Legislature with the administration of the workers' compensation system and the promulgation of rules and regulations to achieve that end, the majority nevertheless substitutes its own judgment for that of the Commissioner, who was duly advised by the Performance Council. If the Commissioner's position could be shown to be contrary to the governing statutes from which he derived his rule-making authority, or if the impairment criteria he has adopted contravened the Legislature's purpose of compensating injured workers, the Court's decision would be tenable. However, apart from a sua sponte declaration that the Commissioner's actions oppose the legislative intent, no support is given for the majority's position. Absent this clear indication that the Commissioner has acted inappropriately by promulgating and applying W. Va.C.S.R. ง 85-16-4.1, the majority has made a grievous mistake. Moreover, the majority has erred not only by refusing to defer to the Commissioner but by further imbuing the Office of Judges [hereinafter referred to as the OOJ] with rule-making powers which the Legislature never intended it to possess. Throughout its Opinion, the Court references the now infamous Cottrell decision [5] wherein the Chief Administrative Law Judge determined the DRE model of impairment evaluation to be unreliable and announced his intention to disregard such evidence in future claims. My colleagues then laud this position as being the surest course to achieving the legislative objective of providing relief to ailing claimants. Ironically, though, the Legislature never intended to accord decisions of the OOJ such deference as it specifically prohibits that entity from formulating, establishing, or otherwise adopting any rule or regulation: The office of judges shall not have the power to initiate or to promulgate legislative rules[.] W. Va.Code ง 23-5-8(e) (2001) (Supp.2001) (emphasis added). As the OOJ is not, and never has been, imbued with such rule-making authority, the majority's decision to rely upon and embrace the Cottrell ruling is just plain wrong.