Present: Carrico, C.J., Compton, Stephenson, Lacy, Hassell,
Keenan, JJ., and Poff, Senior Justice
BOGLE DEVELOPMENT COMPANY, INC., ET AL.
v. Record No. 950065 OPINION BY JUSTICE ELIZABETH B. LACY
November 3, 1995
ROY BUIE
FROM THE COURT OF APPEALS OF VIRGINIA
William Roy Buie suffered a work-related injury in 1988.
The Workers' Compensation Commission (Commission) determined
that his injury was compensable, and that his statutory
employer, Bogle Development Company, Inc., and its workers'
compensation carrier, Rockwood Insurance Company (collectively
"Bogle"), were liable for Buie's lost wages and medical
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expenses.
In 1991, Bogle refused to pay some of Buie's claims for
reimbursement of medical expenses, asserting they were
unauthorized expenses. On March 9, 1992, the Commission
entered an order holding that the disputed medical treatment
was justified and that "the defendants are responsible for
payment of the treatment." Based on this order, Buie submitted
a claim for reimbursement of medical expense payments which he
and his insurance carrier, Blue Cross/Blue Shield of Tennessee
(Blue Cross/Blue Shield) had made. In response to his request
for payment, Bogle informed Buie that Guaranty Fund Management
Services (the Fund) had taken over the handling of the claim 2
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Buie's employer, R.G. Excavating, had allowed its workers'
compensation insurance to lapse.
2
In August of 1991, Rockwood Insurance Company became
insolvent and, pursuant to Code §§ 38.2-1600 through -1623, the
Guaranty Fund Management Services assumed responsibility for
and had agreed to reimburse Buie for his "out-of-pocket
expenditures" upon receipt of satisfactory documentation, but
refused to reimburse Blue Cross/Blue Shield, asserting that it
"does not reimburse third-party providers under any
circumstances."
Buie again sought an order from the Commission requiring
the Fund to pay his reimbursement claims. The chief deputy
commissioner refused Buie's request, stating that the
Commission did not have jurisdiction to decide the dispute
because it "involves interpreting Code Sections 38.2-1600 et
seq." and because "the rights of the claimant are not at stake
and therefore the litigants must resort to the common-law
remedies." Following Buie's request for review, the Commission
reversed the decision of the chief deputy commissioner and
determined that it had jurisdiction to enforce its awards and
"to order reimbursement of those payments both to Blue Cross
and to the claimant." The Commission remanded the matter for a
hearing. On January 21, 1993, the day after the Commission
issued its opinion, the Fund paid Buie $1,897.35 as
reimbursement of his out-of-pocket medical expenses.
On remand, the deputy commissioner held that the Fund was
also required to reimburse Blue Cross/Blue Shield. This
determination was affirmed by the full Commission in an opinion
issued November 5, 1993. The Court of Appeals affirmed the
payment of Rockwood's obligations.
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decision of the Commission. Bogle Dev. Co. v. Buie, 19 Va.
App. 370, 451 S.E.2d 682 (1994). Bogle and the Fund filed a
petition for appeal in this Court. Finding that the petition
presented matters of siginficant precedential value, we awarded
Bogle and the Fund an appeal. Code § 17-116.07(B).
Bogle and the Fund raise five assignments of error. Under
our analysis, however, the dispositive issue in this appeal is
whether the Commission's jurisdiction over this controversy
ceased when the Fund reimbursed Buie for his out-of-pocket
medical expenses. Bogle and the Fund assert that the Court of
Appeals erred in holding that the Commission had subject matter
jurisdiction to consider Buie's request for reimbursement of
Blue Cross/Blue Shield because, after the Fund paid Buie for
his out-of-pocket payments for his medical expenses, no issues
regarding the claimant Buie remained before the Commission.
Thus, they conclude, the judgment of the Court of Appeals
affirming the Commission's order that the Fund reimburse Blue
Cross/Blue Shield must be vacated. We agree and, for the
reasons stated below, will reverse the judgment of the Court of
Appeals.
Code § 65.2-700 vests the Commission with jurisdiction to
determine all questions "arising under" the Virginia Workers'
Compensation Act. This grant of subject matter jurisdiction
includes the authority of the Commission to enforce its orders
and to resolve coverage and payment disputes. The jurisdiction
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is not unlimited, however. As the Court of Appeals correctly
stated in Hartford Fire Ins. Co. v. Tucker, 3 Va. App. 116,
121, 348 S.E.2d 416, 419 (1986):
Questions between the insurer and the employer
or another insurer do not "arise under" the Act
except insofar as they affect the rights of an
injured employee. Code § 65.1-92. When the rights
of the claimant are not at stake, the Act clearly
leaves the litigants to their common law remedies
. . .
Applying this analysis to the facts here, we conclude that once
Buie was reimbursed for his out-of-pocket expenses, no right of
the claimant was "at stake." The only remaining issue involved
the reimbursement claims of Blue Cross/Blue Shield.
Buie was reimbursed on January 21, 1993. After that date,
the Commission did not have subject matter jurisdiction to
consider Blue Cross/Blue Shield's claims for reimbursement or
to enter its November 5, 1993 order requiring the Fund to
reimburse Blue Cross/Blue Shield.
Buie maintains, however, that the jurisdictional issue
cannot be considered here. Buie argues that the Fund's appeal
is actually an untimely collateral attack on the March 1992
order of the Commission holding that "the defendants are
responsible for payment for the treatment rendered." Buie
maintains that prior to entry of the 1992 order, the Fund knew
that Blue Cross/Blue Shield had paid portions of the bills for
the contested medical treatment and, therefore, could have
asserted its position regarding reimbursement of Blue
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Cross/Blue Shield at that time. The Fund failed to raise the
issue or to appeal the decision of the Commission. Thus, Buie
maintains, this appeal is no more than a collateral attack on
that final, binding decision.
Buie's argument overlooks the nature of the 1992
proceedings before the Commission. The issue in that
proceeding was whether Buie had a right to coverage for certain
medical expenses challenged by Bogle. A right of the claimant
was at stake in that proceeding. Consequently there was
clearly no basis for the Fund to question the jurisdiction of
the Commission. The failure to appeal the 1992 order only
precluded the Fund from challenging the claimant's right to
coverage for the contested medical treatment. Accordingly, the
jurisdictional issue which arose later and is now asserted by
the Fund is not an untimely collateral attack on a final
decision of the Commission.
For the above reasons, we conclude that the Court of
Appeals erred in determining that the Commission had
jurisdiction to consider whether Blue Cross/Blue Shield was
entitled to reimbursement from the Fund when no right of the
claimant remained in issue. Accordingly, we will reverse the
decision of the Court of Appeals affirming the November 5, 1993
order of the Commission, and dismiss the petition.
Reversed and dismissed.
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