Opinion ID: 1347613
Heading Depth: 1
Heading Rank: 4

Heading: Summary Judgment on the Alleged Violation of W.Va.Code, 23-5A-1 and 2

Text: The appellant first challenges the circuit court's determination that no discrimination occurred in violation of W.Va.Code, 23-5A-1 and -2, and, in effect, its conclusion that RCESA could legally demand reimbursement for medical insurance premiums paid while the appellant was seeking workers' compensation benefits. The appellant also disputes the circuit court's suggestion that even if a violation of those statutes occurred, that the appellees were entitled to summary judgment because no questions of material fact remained for resolution. The appellant contends that RCESA and Mr. Bowden violated two provisions of the Workers' Compensation Act that protect workers' compensation claimants such as the appellant from discrimination by an employer. The first provision, W.Va.Code, 23-5A-1 [1978], broadly protects a workers' compensation claimant from discrimination in the workplace, and states that: No employer shall discriminate in any manner against any of his present or former employees because of such present or former employee's receipt of or attempt to receive benefits under this chapter. [8] The second statutory provision, W.Va.Code, 23-5A-2 [1982], is specifically at issue in this case, and prohibits an employer from discriminating against an employee seeking workers' compensation benefits by altering the employee's medical insurance. That statute states, in pertinent part (with emphasis added): Any employer who has provided any type of medical insurance for an employee or his dependents by paying premiums, in whole or in part, on an individual or group policy shall not cancel, decrease his participation on behalf of the employee or his dependents, or cause coverage provided to be decreased during the entire period for which that employee during the continuance of the employer-employee relationship is claiming or is receiving benefits under this chapter for a temporary disability.... The appellant argues that these two statutes, applied together, prohibited the appellee's threats to collect from the appellant medical insurance premiums paid by the appellee while the appellant was seeking workers' compensation benefits. The appellees contend that RCESA never decreased RCESA's medical insurance participation on behalf of the appellant or her dependents, or caused the level of her medical insurance coverage to be decreased while the appellant was claiming benefits. The appellees argue that RCESA continued to pay the appellant's medical insurance premiums through to the day her claim was denied by the Workers' Compensation Division, through to the day she resigned from her job, June 17, 1996, and in fact, paid her premiums through the entire month of June 1996. [9] The appellee takes the position, then, that no discrimination occurred pursuant to W.Va.Code, 23-5A-1 and -2. The appellant argues that W.Va.Code, 23-5A-2 prohibits an employer from demanding reimbursement of medical insurance premiums paid during the pendency of a workers' compensation claim, even when that claim is ultimately denied. The appellant argues that the conditional payment of premiums in this case by the appellees decreased the participation by the appellees and provided less coverage to the appellant than an unconditional payment. In other words, the appellant argues that she received medical insurance coverage on a contingent basis that was dependent upon the successful outcome of her workers' compensation claim, while other employees at RCESA received unconditional coverage. The appellant contends that the appellees violated W.Va.Code, 23-5A-2 by threatening to collect medical insurance premiums paid while she was unsuccessfully seeking workers' compensation benefits. We agree with the appellant's argument. When this Court is called upon to construe a statute, our primary goal is to give effect to the intent of the Legislature. Syllabus Point 1, Smith v. State Workmen's Compensation Comm'r, 159 W.Va. 108, 219 S.E.2d 361 (1975). The legislative intent behind the workers' compensation anti-discrimination statutes was discussed in Rollins v. Mason County Bd. of Educ., 200 W.Va. 386, 489 S.E.2d 768 (1997). We stated that, [a]rticle 5A of Chapter 23 was enacted in 1978 for the express purpose of prohibiting employers from [engaging in] certain discriminatory practices with the core objective of protecting employees from retaliatory conduct in response to the filing of workers' compensation claims. 200 W.Va. at 390, 489 S.E.2d at 772. Through the enactment of W.Va.Code, 23-5A-2, the Legislature intended to extend health insurance coverage to employees during that time period between an injury and the receipt of benefits[.] Rollins, 200 W.Va. at 392, 489 S.E.2d at 774 (1997). W.Va.Code, 23-5A-2 is intended to protect an employee's right to employer-provided medical insurance coverage for themselves and their dependents while a workers' compensation claim is pending. The statute protects the employee who is claiming or receiving temporary total disability benefits. In Rollins, we examined whether an employee who had been denied workers' compensation temporary total disability benefits, and who was appealing the Workers' Compensation Division's denial order, fell within the definition of an employee who was claiming or receiving benefits. We concluded that W.Va.Code, 23-5A-2 was not intended to require an employer to provide medical insurance coverage throughout the duration of the appeal stage of the claims process. We held, at Syllabus Point 6, that: A workers' compensation claimant who is protesting the closure of her claim for temporary total disability benefits and/or the denial of additional temporary total disability benefits does not come within the meaning of the terms is claiming found in West Virginia Code § 23-5A-2 (1994). Accordingly, an employer who ceases to pay the health insurance premiums for a claimant who is protesting or appealing the closure or denial of temporary total disability benefits does not commit an act of discrimination within the legislative intent of West Virginia Code § 23-5A-2. In Rollins, we specifically defined a type of employee who does not fit in the definition of an employee who is claiming workers' compensation benefits under W.Va.Code, 23-5A-2. In this case, we must determine what type of employee does fit within the definition. The Legislature's choice of the disjunctive or between the words is claiming and is receiving in W.Va.Code, 23-5A-2 makes it clear that the statute is intended to protect both employees who file a workers' compensation claim and receive benefits, and those employees who merely file a claim form and are awaiting a ruling on the compensability of their claim from the Workers' Compensation Division. The Legislature intended to protect a claimant's continued right to receive insurance benefits while their claim is pending, and regardless of the ultimate outcome of their claim. In the absence of this statute, an employee whose claim is contested might be pressured to forego the exercise of his or her right to file a claim for workers' compensation benefits, to avoid the risk of having to pay medical insurance premiums retroactively. We therefore hold that when an employer provides any type of medical insurance benefits for an employee or his or her dependents, W.Va.Code, 23-5A-2 [1982] protects the right of the employee, who is claiming workers' compensation benefits, to those employer-provided medical insurance benefits during the period after the employee has filed a claim for workers' compensation benefits, but before the Workers' Compensation Division has ruled on the compensability of the claim, regardless of the ultimate outcome of the claim. This statutory provision prohibits an employer demanding from the employee reimbursement of medical insurance premiums or benefits paid during the pendency of a workers' compensation claim, even if that claim is denied. The circuit court in this case appears to have concluded that the appellees did not violate W.Va.Code, 23-5A-1 and -2. In reaching this conclusion, the circuit court seems to have relied upon RCESA's neutral internal policy providing for a leave of absence without salary or medical benefits. The circuit court cited to our discussion in Rollins where we stated that when a neutral employment policy results in the termination of an employee, courts have generally held that termination of employment under such a policy does not violate a compensation antidiscrimination statute. 200 W.Va. at 391, 489 S.E.2d at 773 ( citing Powell v. Wyoming Cablevision, Inc., 184 W.Va. 700, 705, 403 S.E.2d 717, 722 (1991)). While we continue to stand by our holdings in Rollins and Powell, we hold that while an employment policy may be facially neutral, it cannot be applied in a manner that nullifies or trumps the protective requirements of W.Va.Code, 23-5A-2. The circuit court therefore erred in its interpretation of W.Va.Code, 23-5A-2, and its intimation that the conduct of the appellees could not constitute a violation of W.Va.Code, 23-5A-1 and -2. The appellant also argues that, in addition to erroneously interpreting W.Va.Code, 23-5A-2, the circuit court improperly dismissed her statutory claim on the principle of no harm, no foul. In other words, the circuit court held that even if the appellees technically violated W.Va.Code, 23-5A-2, RCESA nevertheless did not violate the statute because RCESA never followed up on its demands that the appellant reimburse RCESA for the past medical insurance premiums. Furthermore, the circuit court construed the evidence as showing that the appellant resigned her position with RCESA to obtain funds to pay prospective premiums rather than the past premiums. The circuit court therefore found no material facts were in dispute, and granted summary judgment to the appellees on this statutory claim. The appellant contends the circuit court overstepped its authority by granting summary judgment, because a circuit court's function at the summary judgment stage is `not to weigh the evidence and determine the truth of the matter but to determine whether there is a genuine issue for trial.' Williams v. Precision Coil, Inc., 194 W.Va. at 59, 459 S.E.2d at 336. We find substantial evidence that Mr. Bowden and RCESA improperly demanded reimbursement of medical insurance premiums paid while the appellant was pursuing her workers' compensation claim, in violation of W.Va.Code, 23-5A-2. One letter from Mr. Bowden indicates that, if the appellant was unsuccessful in her workers' compensation claim, the premiums paid by RCESA would later be deducted from her accrued compensatory time/vacation leave and/or future wages. Deposition testimony by the appellant and Matilda Webb, Mr. Bowden's administrative assistant, again indicated that RCESA intended to hold the appellant responsible for premiums paid from March through June 1996. This evidence, taken in the light most favorable to the appellant, indicates that Mr. Bowden and RCESA threatened to improperly recover from the appellant medical insurance premiums that were paid during the pendency of her workers' compensation claim. Furthermore, after a careful review of the record, we find conflicting evidence as to whether the appellant resigned her employment as a result of the allegedly improper actions of Mr. Bowden and RCESA. The circuit court appears to have concluded that the sole reason for the appellant's resignation was her perceived need to obtain funds to pay future premiums only. However, the deposition testimony of the appellant refutes this conclusion, because in her testimony she pointed to the denial of her workers' compensation claim and the subsequent conversation with Mr. Bowden's administrative assistant and the assistant director of RCESA as the reasons compelling her resignation. Both of these individuals appear to have told the appellant that she was required to pay both past and future medical insurance premiumsand that the only way to access her retirement fund to pay those past and future premiums was to resign. We hold that there is substantial evidence in the record that the appellees demanded that the appellant pay the premiums for her medical insurance during the period she was claiming workers' compensation benefits, in violation of W.Va.Code, 23-5A-2. Whether this demand triggered the plaintiff's resignation presents a question of material fact for jury resolution. We therefore hold that the circuit court erred in granting summary judgment on the appellant's claim that the appellees discriminated against her in violation of W.Va.Code, 23-5A-1 and -2, and reverse the circuit court's orders on this issue. B.