Court Opinion

ID: 4560066
Source: CourtListenerOpinion
Date Created: 2020-08-26 21:01:37.352211+00
Date Added: 2024-06-11T09:22:03.671968
License: Public Domain

TENNESSEE  BUREAU  OF WORKERS’  COMPENSATION                     
                      WORKERS’  COMPENSATION    APPEALS BOARD                       
                                                                                    
          Torey Andrews                   )  Docket No. 2016-05-0854                
                                          )                                         
                                                                                    
          v.                              )  State File No. 58300-2016              
                                          )                                         
          Yates Services, LLC, et al.     )                                         
                                          )                                         
                                          )                                         
          Appeal from the Court of Workers’ )                                       
                                                                                    
          Compensation Claims             )                                         
          Dale Tipps, Judge               )                                         
                                                                                    
                      Affirmed and Certified as Final – Filed May 8, 2018           
                                                                                    
          The employee sought attorneys’ fees and expenses as a result of the employer’s alleged
          wrongful denial of the employee’s claim for benefits pursuant to Tennessee Code
                                                                                    
          Annotated section 50-6-226(d)(1)(B) (2016). In an “Agreed Stipulation,” the parties
          acknowledged the employee’s entitlement to certain permanent disability benefits and
          agreed the employee “has the right to seek additional benefits at the conclusion of the
          [initial] compensation period.” Thereafter, the employee filed a “renewed motion” for
          attorneys’ fees and expenses and argued “‘wrongfully denies’ should be interpreted such
          that an employer who has denied benefits . . . must pay for attorney’s fees/expenses . . .
          once a favorable decision of employee benefits has been issued absent some compelling
                                                                                    
          reason to the contrary.” In response, the employer argued that “wrongful” means more
          than a mere mistake or error and, in any event, the court should not address the
          employee’s claim for attorneys’ fees and expenses prior to the conclusion of the case.
          The trial court denied the employee’s motion for attorneys’ fees and expenses,
          concluding that “‘wrongfully’ in this context requires more than the mere existence of a
          denial” and “requires, at a minimum, a finding that the employer’s denial lacked good
                                                                                    
          cause.” Upon careful consideration of the record, we affirm the trial court’s decision on
          other grounds and certify the compensation order as final.                
                                                                                    
          Judge Timothy W. Conner delivered the opinion of the Appeals Board in which Presiding
          Judge Marshall L. Davidson, III, joined. Judge David F. Hensley concurred separately.
                                                                                    
          Samuel B. Garner, Jr., Pulaski, Tennessee, for the employee-appellant, Torey Andrews
                                                                                    
                                                                                    
          John R. Rucker, Jr., Murfreesboro, Tennessee, for the employer-appellee, Yates Services,
          LLC                                                                       
                                                                                    
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                            Factual and Procedural Background                       
                                                                                    
               Torey Andrews (“Employee”), an assembly line worker employed by Yates
          Services, LLC (“Employer”), alleged an injury to his back on July 21, 2016, while
          installing windows in car doors. Employer initially accepted the claim as compensable
                                                                                    
          and provided a panel of physicians. However, Employer denied additional benefits after
          receiving a medical opinion from the authorized physician indicating Employee’s
          condition did not arise primarily out of his employment. Employee sought treatment on
          his own and obtained a medical opinion that his injury arose primarily out of his
          employment. Following an expedited hearing, the trial court accepted the opinion of
          Employee’s physician, found Employee was likely to prevail at trial, and ordered
          temporary disability and additional medical benefits. That decision was not appealed.
                                                                                    
                                                                                    
               Thereafter, Employee filed a motion for attorneys’ fees and expenses. Relying on
          Tennessee Code Annotated section 50-6-226(d)(1)(B), Employee asserted Employer
          denied benefits “absent [a] valid basis” and, thus, “wrongfully denied” his claim.
          Employer opposed the motion and noted section 50-6-226(d)(1) was silent as to when a
          determination of attorneys’ fees and costs should be made. It argued fees and costs
          should be determined at the end of the case rather than in the midst of the litigation. In
                                                                                    
          denying Employee’s motion, the trial court did not explicitly address the meaning of the
          phrase “wrongfully denies” as used in section 50-6-226(d)(1)(B), but found Employer’s
          actions were reasonable under the circumstances. The court explained that “[i]t is
          unrealistic to expect [Employer] to continue to provide benefits once the authorized
          doctor opined the injury was not work-related, and it would be inequitable to punish it for
          observing the statutory presumption of correctness of that opinion.” On appeal, we
                                                                                    
          vacated the trial court’s order and remanded the case, concluding “the better practice is to
          resolve [attorneys’ fee disputes] after the litigation has run its course and the parties and
          the court no longer face uncertainties over future developments.” Andrews v. Yates
          Servs., LLC, No. 2016-05-0854, 2017 TN Wrk. Comp. App. Bd. LEXIS 35, at *7 (Tenn.
          Workers’ Comp. App. Bd. May 23, 2017). We further cautioned against “adjudicating
          disputes over attorney’s fees and expenses in piecemeal fashion as the case winds its way
          through the litigation process.” Id. at *7-8.1                            
                                                                                    
                                                                                    
               After the case was remanded, the parties entered into an “Agreed Stipulation”
          indicating “Employee’s claimed injury is compensable and [he] is entitled to receive
          permanent partial disability benefits” based on the calculation described in Tennessee
          Code Annotated section 207(3)(A) (2017). In addition, the parties agreed “Employee has
          the right to seek additional benefits at the conclusion of the [initial] compensation
                                                                                    
                                                                                    
                                                                                    
                                                                                    
          1 We did not foreclose the possibility of an award of attorneys’ fees and expenses prior to the conclusion
          of the case in all instances, “as each case must be evaluated based on the particular circumstances
          presented.” Id. at *8.                                                    
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          period.”2 The parties also asked the court to schedule an additional hearing to address
          Employee’s claim for attorneys’ fees and expenses. In his renewed motion for attorneys’
          fees and expenses, Employee argued “‘wrongfully denies’ should be interpreted such that
          an employer who has denied benefits . . . must pay for attorney’s fees/expenses . . . once a
          favorable decision of employee benefits has been issued absent some compelling reason
                                                                                    
          to the contrary.” In response, Employer argued that the word “wrongful” as used in the
          statute means more than a mere mistake or error and, in any event, the court should not
          address Employee’s claim for attorneys’ fees prior to the conclusion of the case. The trial
          court denied Employee’s motion for attorneys’ fees and expenses, concluding that
          “‘wrongfully’ in this context requires more than the mere existence of a denial” and
          “requires, at a minimum, a finding that the employer’s denial lacked good cause.”
          Employee has appealed.                                                    
                                                                                    
                                                                                    
                                   Standard of Review                               
                                                                                    
               The standard we apply in reviewing a trial court’s decision presumes that the
          court’s factual findings are correct unless the preponderance of the evidence is otherwise.
          See Tenn. Code Ann. § 50-6-239(c)(7) (2017). However, the interpretation and
          application of statutes and regulations are questions of law that are reviewed de novo with
                                                                                    
          no presumption of correctness afforded the trial court’s conclusions. See Mansell v.
          Bridgestone Firestone N. Am. Tire, LLC, 417 S.W.3d 393, 399 (Tenn. 2013). We are
          also mindful of our obligation to construe the workers’ compensation statutes “fairly,
          impartially, and in accordance with basic principles of statutory construction” and in a
          way that does not favor either the employee or the employer. Tenn. Code Ann. § 50-6-
          116 (2017).                                                               
                                                                                    
                                                                                    
                                       Analysis                                     
                                                                                    
               The pertinent statute in this case, Tennessee Code Annotated section 50-6-
          226(d)(1), provides in part:                                              
                                                                                    
               In addition to attorneys’ fees provided for in this section, the court of
                                                                                    
               workers’ compensation claims may award reasonable attorneys’ fees and
               reasonable costs, including reasonable and necessary court reporter  
               expenses and expert witness fees, for depositions and trials incurred when
               the employer:                                                        
                                                                                    
               . . . .                                                              
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
          2 This stipulation culminated in a settlement agreement that was approved by the trial court on February 5,
          2018.                                                                     
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                    (B) Wrongfully denies a claim by filing a timely notice of      
                    denial, or fails to timely initiate any of the benefits to which
                    the employee is entitled under this chapter, including medical  
                    benefits under § 50-6-204 or temporary or permanent             
                    disability benefits under § 50-6-207, if the workers’           
                                                                                    
                    compensation judge makes a finding that such benefits were      
                    owed at an expedited hearing or compensation hearing.           
                                                                                    
          As we have noted previously, the legislature did not define the phrase “wrongfully
          denies” when it enacted section 50-6-226(d)(1)(B). See Thompson v. Comcast Corp., No.
          2017-05-0639, 2018 TN. Wrk. Comp. App. Bd. LEXIS 1, at *36 (Tenn. Workers’ Comp.
          App. Bd. Jan. 30, 2018) (Davidson, J., concurring). Indeed, other courts in other contexts
                                                                                    
          have interpreted the word “wrongful” in many different ways, ranging from “a mere
          mistake or inadvertence to unreasonableness or lack of good cause to bad faith or even
          malice.” Id. at *40 (Davidson, J., concurring). Thus, in construing the language of this
          statute in its form applicable to this case, we have only nominal guidance as to the
          meaning of the phrase “wrongfully denies.”                                
                                                                                    
               However, during the 2018 legislative session, the General Assembly amended
                                                                                    
          Tennessee Code Annotated section 50-6-226(d)(1), which now reads as follows:
                                                                                    
               In addition to attorneys’ fees provided for in this section, the court of
               workers’ compensation claims may award reasonable attorneys’ fees and
               reasonable costs, including, but not limited to, reasonable and necessary
               court reporter expenses and expert witness fees for depositions and trials,
                                                                                    
               incurred when the employer:                                          
                                                                                    
               . . . .                                                              
                                                                                    
                    (B) Wrongfully denies a claim or wrongfully fails to timely     
                    initiate any of the benefits to which the employee is entitled  
                    under this chapter, including medical benefits under § 50-6-    
                                                                                    
                    204, temporary or permanent disability benefits under § 50-6-   
                    207, or death benefits under § 50-6-210 if the workers’         
                    compensation judge makes a finding that the benefits were       
                    owed at an expedited hearing or compensation hearing. For       
                    purposes of this subdivision (d)(1)(B), “wrongfully” means      
                    erroneous, incorrect, or otherwise inconsistent with the law    
                    or facts.                                                       
                                                                                    
                                                                                    
          Pub. Ch. 757, H.B. 2304/S.B. 2475, 110th General Assembly (Tenn. Apr. 18, 2018)
          (emphasis added). While this recently enacted amendment applies only to work injuries
          occurring on or after April 18, 2018, we look to the new statute as persuasive authority in
                                                                                    
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          evincing the General Assembly’s original intent. See, e.g., Fretwell v. Chaffin, 652
          S.W.2d 755, 757 (Tenn. 1983) (holding that while a statutory amendment was not
          retroactive, it was “declaratory of the original legislative intent”); Washington Cnty. Sch.
          Sys. v. City of Johnson City, No. E2016-02583-COA-R9-CV, 2017 Tenn. App. LEXIS
          832, at *48-49 (Tenn. Ct. App. Dec. 27, 2017) (“[W]hen analyzing legislative intent, we
                                                                                    
          may view a subsequent, non-retroactive amendment as ‘declaratory of the original
          legislative intent.’ See Sneed v. City of Red Bank, 459 S.W.3d 17, 32 (Tenn. 2014).”).
          Given that this amendment is the legislature’s only expression of the intended meaning of
          the phrase “wrongfully denies” in the context of section 226(d)(1)(B), we consider this
          definition in assessing Employee’s claim for attorneys’ fees and expenses in the present
          case.                                                                     
                                                                                    
                                                                                    
               Here, the trial court determined that “wrongfully,” in the context of section 50-6-
          226(d)(1)(B) as it was then written, “requires, at a minimum, a finding that the
          employer’s denial lacked good cause.” On this point, we respectfully disagree. There is
          nothing in the language of the statute supporting a conclusion that an employee must
          show “lack of good cause” in seeking attorneys’ fees and expenses for a wrongful denial
          of a claim. Instead, we conclude that the phrase “wrongfully denies” as used in
          Tennessee Code Annotated section 50-6-226(d)(1)(B) (2016) requires a finding that an
                                                                                    
          employer’s denial was erroneous, incorrect, or otherwise inconsistent with the law or
          facts to support a claim for reasonable attorneys’ fees and expenses.     
                                                                                    
               However, that analysis, when applied to the facts of the present case, does not end
          the inquiry. We must also determine at what point in time a trial court is to consider the
          incorrectness of an employer’s decision to deny a claim. In analyzing this issue, we first
                                                                                    
          note that a trial court’s decision to award attorneys’ fees and expenses pursuant to section
          226(d)(1) is discretionary. The statute provides that a trial court “may award reasonable
          attorneys’ fees and . . . costs” under the circumstances delineated above. Tenn. Code
          Ann. § 50-6-226(d)(1) (emphasis added). In Perdue v. Green Branch Mining Co., 837
          S.W.2d 56 (Tenn. 1992), the Tennessee Supreme Court addressed a similar statute that
          authorized trial courts to commute periodic payments of workers’ compensation benefits
          to one or more lump sum payments. The statute in question, Tennessee Code Annotated
                                                                                    
          section 50-6-229(a), also used the word “may” in authorizing a trial court to commute
          such payments. The Supreme Court concluded that “[t]his statute vests discretion in the
          trial court to permit or refuse lump-sum commutation.” Id. at 58. The Court also
          concluded that “the discretion thus vested in the trial judge is not absolute but is a judicial
          one[,] which is reviewable in the appellate courts and may be reversed if the appellate
          court finds that the decision of the trial court was an abuse of judicial discretion.” Id.; see
          also Steppach v. Thomas, 346 S.W.3d 488, 505 (Tenn. Ct. App. 2011) (“The word ‘may’
                                                                                    
          used in a statute ordinarily connotes discretion or permission and will not be treated as a
          word of command.”). Thus, we conclude the use of the word “may” in Tennessee Code
          Annotated section 50-6-226(d)(1) vests the trial court with discretion to award or not to
                                                                                    
                                                                                    
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          award attorneys’ fees and expenses pursuant to this section, and we will review any such
          decision under an abuse of discretion standard.                           
                                                                                    
               Next, the statute states a trial court may award reasonable attorneys’ fees and
          expenses “when the employer . . . [w]rongfully denies a claim.”3 Tenn. Code Ann. § 50-
                                                                                    
          6-226(d)(1). We conclude that the plain and ordinary meaning of this language, when
          read in the context of the statute as a whole, supports a conclusion that a trial court may
          consider whether an employer’s decision to deny a claim was erroneous, incorrect, or
          otherwise inconsistent with the law or facts at the time the denial decision was made.
          Thus, it is within a trial court’s discretion to consider an employer’s decision to deny a
          claim in light of evidence or other information reasonably available to the employer at the
          time the claim was denied. Moreover, such a determination is fact-dependent, and we do
                                                                                    
          not intend to suggest there is a bright-line test defining the parameters of such a decision.
          Instead, a trial court may consider the facts and circumstances of each individual case to
          assess whether an employer’s decision to deny a claim was incorrect, erroneous, or
          otherwise inconsistent with the law or facts at the time the decision was made.4
                                                                                    
               In the present case, the trial court concluded Employer was correct in relying on
          the authorized treating physician’s causation opinion to deny Employee’s claim in light
                                                                                    
          of: (1) the presumption of correctness afforded the authorized treating physician’s
          opinion; and (2) the absence of any other, contrary medical opinion available to
          Employer at that time of the denial decision. Thus, we conclude the trial court did not
          abuse its discretion in denying Employee’s claim for additional attorneys’ fees and
          expenses under these circumstances, as the decision to deny the claim was not erroneous,
          incorrect, or otherwise inconsistent with the law or facts at the time Employer made the
          decision.5                                                                
                                                                                    
                                                                                    
          3 In using the word “employer” in this opinion, we include authorized representatives of an employer as
          well as authorized representatives of an employer’s workers’ compensation insurer or adjusting entity.
          See Tenn. Code Ann. § 50-6-102(13) (2017) (“[the term employer] shall include the employer’s insurer”).
                                                                                    
          4 Employee contends that attorneys’ fees and expenses should be awarded “whenever an employer denies
          a claim and a compensation judge later determines on the merits that the claim should have been
          allowed.” (Emphasis added.) Section 50-6-226(d)(1) could have easily been drafted to include such an
          expansive standard, but it was not.                                       
                                                                                    
          5 Tenn. Comp. R. & Regs. 0800-02-14-.04(7) (1999) states an employer shall make initial decisions on
          compensability within fifteen days of receipt of notice of the accident. We caution that an employer
          should not intentionally fail to obtain and consider information reasonably available at the time a
          compensability decision is made, or fail to consider new information that becomes available after the
          initial decision is made. Thus, in evaluating an employee’s claim for attorneys’ fees and expenses, a trial
          court may consider not only information reasonably available to an employer at the time the denial
          decision was made, but also pertinent, additional information or subsequent events that bear on the denial
          decision. In the present case, for example, once the trial court considered the expert medical proof and
          issued its expedited hearing order, Employer’s denial decision was deemed incorrect and Employer
          thereafter complied with the trial court’s order for benefits.            
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                                      Conclusion                                    
                                                                                    
               Although we disagree with the trial court’s definition of “wrongfully” as used in
          Tennessee Code Annotated section 50-6-226(d)(1)(B), we nevertheless affirm the trial
          court’s determination and certify the trial court’s order denying Employee’s renewed
                                                                                    
          motion for attorneys’ fees and expenses as final.                         
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
                                                                                    
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                   TENNESSEE  BUREAU  OF WORKERS’  COMPENSATION                     
                      WORKERS’  COMPENSATION    APPEALS BOARD                       
                                                                                    
          Torey Andrews                   )  Docket No. 2016-05-0854                
                                                                                    
                                          )                                         
          v.                              )  State File No. 58300-2016              
                                          )                                         
          Yates Services, LLC, et al.     )                                         
                                          )                                         
                                          )                                         
          Appeal from the Court of Workers’ )                                       
                                                                                    
          Compensation Claims             )                                         
          Dale Tipps, Judge               )                                         
                                                                                    
                           Concurring Opinion – Filed May 8, 2018                   
                                                                                    
          David F. Hensley, J., concurring in result only.                          
                                                                                    
                                                                                    
               I agree with the result reached by my colleagues in affirming the denial of the
          employee’s renewed motion for attorneys’ fees and costs. However, I believe the
          majority’s decision to apply the definition of “wrongfully” that is included in the 2018
          amendment to Tennessee Code Annotated section 50-6-226(d)(1)(B) to the statute
          applicable in the instant case is misplaced and unnecessary. The majority effectively re-
          writes part of the applicable statute to mirror the recent amendment, thereby announcing
                                                                                    
          its interpretation of the 2018 amendment in advance of a case in which the amendment is
          at issue. In my opinion, the definition of “wrongfully” that was added to the 2018
          amendment is, in large part, a response to the Appeals Board’s decision in Thompson v.
          Comcast Corporation, No. 2017-05-0639, 2018 TN Wrk. Comp. App. Bd. LEXIS 1
          (Tenn. Workers’ Comp. App. Bd. Jan. 30, 2018) and does not express legislative intent
          for the manner in which the 2016 statute is to be interpreted. In my view, the 2018
          amendment expresses legislative concerns with the Appeal Board’s decision in Thompson
                                                                                    
          and the General Assembly’s intent to define the meaning of “wrongful” rather than leave
          it to the courts to define the term.1 Coincidentally, House Bill 2304, which proposed to
          amend section 50-6-226(d)(1)(B), was filed for introduction on January 31, 2018, the day
                                                                                    
                                                                                    
          1 In Thompson, I disagreed with the majority’s affirmance of the award of attorneys’ fees and costs. As
          noted in my dissent, it is my opinion that the judges of the Court of Workers’ Compensation Claims do
          not have the authority to award attorneys’ fees or costs provided for in section 50-6-226(b)(3) (2017) at
          an expedited hearing held in accordance with section 50-6-239(d) (2017). However, in the instant case,
          Mr. Andrews’ motion for attorneys’ fees and costs was filed long after the trial court’s expedited hearing
          order was entered and is, therefore, not limited by section 50-6-239(d).  
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          following the filing of the Appeals Board’s decision in Thompson. House Bill 2304, as
          filed for introduction, did not define “wrongfully.” An amendment to the bill defining
          “wrongfully” was adopted and passed on March 26, 2018, and became effective on April
          18, 2018.                                                                 
                                                                                    
                                                                                    
               In Thompson, the trial court concluded “the word ‘wrongfully’ [in section 50-6-
          226(d)(1)(B)] applies to the phrase ‘fails to timely initiate any of the benefits to which the
          employee is entitled under this chapter.’” Id. at *23-24. The Appeals Board disagreed,
          reasoning that the comma between the two phrases in section 50-6-226(d)(1)(B) and the
          use of the word “or” between the two phrases “indicates that these phrases are separate
          and distinct, and the word ‘wrongfully’ modifies only the first phrase (‘wrongfully denies
          a claim by filing a timely notice of denial’).” Id. at *25-26. Indeed, the Appeals Board
                                                                                    
          noted in Thompson that “[h]ad the General Assembly intended the word ‘wrongfully’ to
          modify both phrases, it could have easily included that word twice, or it could have
          crafted the sentence in a way that applied the modifier to both scenarios.” Id. at *26. In
          the present case, the majority relies on the General Assembly’s 2018 definition of
          “wrongfully” to interpret the phrase “wrongfully denies a claim by filing a timely notice
          of denial” in the applicable 2016 statute. Ironically, the 2018 amendment deleted the
          provision authorizing an award of attorneys’ fees and costs when an employer wrongfully
                                                                                    
          denies a claim “by filing a timely notice of denial.”                     
                                                                                    
               Having adopted the General Assembly’s definition of “wrongfully” in the 2018
          amendment as applying to the 2016 statute applicable here, the majority then addresses
          the point in time that a trial court is to “consider the ‘incorrectness’ of an employer’s
          decision to deny a claim.” It bears noting that the term “incorrectness” does not appear in
                                                                                    
          the applicable statute, but, again, comes from the 2018 amendment defining
          “wrongfully.” In my view, the appropriate starting point for analyzing the applicable
          statute in the instant case is the point in time the employer timely filed its notice of
          denial. See Tenn. Code Ann. § 50-6-226(d)(1)(B) (2016).                   
                                                                                    
               Here, the parties do not dispute that, when the employer timely filed its notice of
          denial, only one medical causation opinion existed, which was the opinion of the
                                                                                    
          authorized treating physician and, as such, is presumed to be correct. See Tenn. Code
          Ann. § 50-6-102(14)(E) (2017). The physician opined that the employee’s condition was
          not primarily work-related. Based on that opinion, and consistent with the Tennessee
          Workers’ Compensation Act, the employer filed its notice of denial. In my opinion, the
          majority needed only to consider that the employer’s timely decision to file its notice of
          denial was made when a single medical causation opinion existed, which was, by statute,
          presumed to be correct. Respectfully, it was unnecessary here, in my view, to look
                                                                                    
          beyond that determination or to adopt a definition from the 2018 amendment to
          Tennessee Code Section 50-6-226(d)(1)(B) as applying to the applicable 2016 statute.
                                                                                    
                                                                                    
                                                                                    
                                          2