Bogle Development Co., Inc. v. Buie

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
1
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
1
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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