Opinion ID: 1562586
Heading Depth: 2
Heading Rank: 2

Heading: The Pretrial Order Reducing Benefits

Text: Mr. Pimental also ascribes error to the trial judge's denial of his motion to dismiss the city's petition to reduce his benefits to 70 percent, thereby allowing the pretrial order of October 7, 2004, to remain in effect. He argues that the reduction of his benefits before he had an opportunity for a full hearing on the issue of maximum medical improvement, constitutes a deprivation of his due-process rights. His argument calls into question the adequacy of the pretrial procedures of the Workers' Compensation Court. We had occasion to review the constitutionality of a substantially similar pretrial procedure in John J. Orr & Sons, Inc. v. Waite, 479 A.2d 721, 723 (R.I.1984), in which we adopted the three-part test articulated by the United States Supreme Court in Mathews v. Eldridge, 424 U.S. 319, 335, 96 S.Ct. 893, 47 L.Ed.2d 18 (1976). Although we decided Waite before the Workers' Compensation Commission became the Workers' Compensation Court, it remains controlling. [7] In Waite, 479 A.2d at 723-24 (citing Mathews, 424 U.S. at 335, 96 S.Ct. 893), we identified three factors to be considered in determining whether the pretrial procedure violated due process: (1) the private interest that will be affected by the official action, (2) the risk of an erroneous deprivation of such interest through the procedures used and the possible value, if any, of additional or substitute procedural safeguards, and (3) the government's interest, including the function involved and the fiscal and administrative burdens that the additional or substitute procedural requirements would entail. When state action threatens to deprive a qualified person of benefits to which he is statutorily entitled, due process concerns are implicated. See Goldberg v. Kelly, 397 U.S. 254, 260-62, 90 S.Ct. 1011, 25 L.Ed.2d 287 (1970) (termination of welfare benefits implicated due process). The pretrial conference section of the Workers' Compensation Act allows both parties to submit medical evidence and other documentary evidence, to be represented by counsel at the preliminary hearing, and to submit written arguments in favor of or against the proposed order. [8] The judge may, at his or her discretion, enter a preliminary order that shall be effective upon entry. Section 28-35-20(c). On the specific issue of reduction of benefits under § 28-33-18(b), the trial judge may delay the implementation of the order after considering the employee's efforts to actively seek employment. Mr. Pimental argues that the reduction of his benefits before he had the opportunity to fully litigate the MMI determination was a denial of due process. We first must evaluate the private interest at stake in the proceeding. Mr. Pimental's sole interest appears to be the receipt of unreduced workers' compensation benefits until he could be heard at trial. Significantly, the trial judge did not make the October 7, 2004 pretrial reduction order effective until March 1, 2005, a delay of nearly five months. This interregnum afforded Mr. Pimental ample opportunity to perform his duty to actively seek employment. Section 28-33-18(b). Additionally, in Mathews, 424 U.S. at 340, 96 S.Ct. 893, the Court emphasized that the availability of retroactive relief was a strong mitigating factor; we have subsequently applied that reasoning to workers' compensation decisions. Waite, 479 A.2d at 724 (the availability of retroactive relief is a factor to be considered in assessing the potential injury). In the case at hand, we are satisfied that the degree and duration of the possible deprivation [did] not rise, in and of itself, to the level of denial of due process. Id. at 725. We next consider the probable value, if any, of additional or substitute procedural safeguards. Mathews, 424 U.S. at 335, 96 S.Ct. 893. Here, we must distinguish between the initial MMI order and the order reducing benefits. A maximum medical improvement determination, as the term indicates, is primarily a medical evaluation. The Mathews Court distinguished the probative value of oral testimony during a Social Security Administration medical assessment of a person's disability from the Court's earlier discussion in Goldberg of the high value of live testimony before terminating welfare benefits. Compare Goldberg, 397 U.S. at 269, 90 S.Ct. 1011 (holding that because welfare benefits often rest on matters of credibility and veracity, written submissions are a wholly unsatisfactory basis for decision), with Mathews, 424 U.S. at 343, 96 S.Ct. 893 (holding that a disability assessment is a more sharply focused and easily documented decision than the typical determination of welfare entitlement). A maximum medical improvement decision probably will be grounded in the same type of routine, standard, and unbiased medical reports by physician specialists that the Mathews Court determined would not benefit from allowing oral testimony. Mathews, 424 U.S. at 344, 96 S.Ct. 893 (quoting Richardson v. Perales, 402 U.S. 389, 404, 91 S.Ct. 1420, 28 L.Ed.2d 842 (1971)). Requiring oral testimony at the preliminary hearing will not appreciably reduce the risk of erroneous decision-making, as an employee's credibility is not at issue. Mathews, 424 U.S. at 344, 96 S.Ct. 893. Moreover, as we observed in Waite, 479 A.2d at 725, § 28-35-20 provides for a hearing at which both parties are entitled to be represented by counsel. The statute also provides for the submission of medical reports and other documentary evidence. It is clear to us, as it was to the Waite Court, that the procedures provided for in § 28-35-20 are both fair and reliable. Waite, 479 A.2d at 725. A pretrial order becomes effective upon entry under the provisions of § 28-35-20(c). Thus, once the pretrial order determining that Mr. Pimental had reached MMI was entered, the trial judge was required to reduce his benefits in accordance with the mandatory language of § 28-33-18(b) upon petition of the city. As previously noted, however, the latter statute expressly permits a trial judge to delay implementation of the reduction in benefits by considering the employee's efforts to actively seek alternative employment. This determination assuredly implicates the employee's credibility and seemingly would be aided by allowing the employee to testify before his benefits are reduced. Nevertheless, we are convinced that within the context of Mr. Pimental's case the probable value of any additional procedural safeguards was very slight. We first observe that under § 28-33-18(b) the consideration of an employee's efforts to seek employment, as well as the timing of any reduction in benefits, is fully entrusted to the discretion of the trial judge. Additionally, in this case, the trial judge exercised his discretion in favor of Mr. Pimental by delaying implementation of the pretrial order for a period of nearly five months. [9] Finally, we must weigh the public interest, including the state's interest in administrative efficiency. As we noted in Waite, 479 A.2d at 725, a clear policy goal of the Workers' Compensation Act is the promotion of expeditious resolution of workers' compensation disputes. [10] We are mindful that requiring a pre-termination hearing before the modification of workers' compensation benefits would delay the resolution of many disputes, often to the detriment of injured workers seeking immediate benefits, and would likely make the administration of workers' compensation benefits more costly to the taxpayers of Rhode Island. The express purpose of the mandatory pretrial conference is to expedit[e] the case and reduc[e] the issues in dispute to a minimum. Section 28-35-20(a). The clear policy behind this laudatory purpose is to promote the expeditious resolution of workers' compensation disputes, see Waite, 479 A.2d at 725, a factor that weighs heavily in the balancing calculus set forth in Mathews and Waite. After considering this three-part test, therefore, we hold that the pretrial procedures employed in Mr. Pimental's case did not violate his due-process rights.