ROADWAY EXPRESS, INC.
SAMMY T. ROBERTSON
Session: Date July 8, 2014
Appeal from the Circuit Court for Bradley County No. V13615 J. Michael Sharp, Judge
Stephen K. Heard and Adam O. Knight, Nashville, Tennessee, for the appellant, Roadway Express, Inc.
Robert G. Norred, Jr., Cleveland, Tennessee, for the appellee, Sammy T. Robertson.
D. Michael Swiney, J., delivered the opinion of the Court, in which Charles D. Susano, Jr., C.J., and Thomas R. Frierson, II, J., joined.
D. MICHAEL SWINEY, JUDGE
This case has its origins in a workers' compensation claim. Robertson, a Roadway worker, filed a workers' compensation claim related to a 2005 injury. The parties reached a settlement in 2008. Under the settlement, Robertson was granted lifetime future authorized medical treatment pursuant to Tenn. Code Ann. § 50-6-204.
At one point, Robertson sought to have a surgical procedure performed on his lumbar spine. Robertson went through a utilization review process regarding the procedure. The utilization review physician ruled that the procedure was not warranted at that time. Robertson appealed this ruling to the Tennessee Department of Labor Medical Director. The Director ratified the decision of the utilization review physician.
Robertson filed a petition in the Trial Court seeking to compel Roadway to pay for the surgical procedure. Roadway responded, arguing that all administrative remedies had not yet been exhausted as required. The Trial Court ruled in favor of Robertson and ordered Roadway to pay for the procedure. Roadway complied with the Trial Court's order, and the total amount ultimately paid towards Robertson's treatment came to $152, 511.59. In the meantime, Roadway appealed the Trial Court's order to the Tennessee Supreme Court Special Workers' Compensation Appeals Panel. The Panel, in vacating the Trial Court's order, concluded as follows:
In sum, we conclude that, based on statutory provisions and rules noted herein, parties are required to exhaust the benefit review conference process as a condition precedent to filing suit. It is undisputed that a request for a benefit review conference was not filed in this case. The benefit review process was never initiated and, therefore, was never exhausted; consequently, the trial court did not have subject matter jurisdiction to hear the case, and Employee's petition should be dismissed.
Robertson v. Roadway Exp., Inc., No. E2011-01384-WC-R3-WC, 2012 WL 2054170, at *7 (Tenn. Workers Comp. Panel June 8, 2012).
In August 2013, Roadway filed the instant suit seeking reimbursement for the sums that it had paid for Robertson's procedure as required by the Trial Court's earlier invalid order. Robertson filed an answer and counterclaim. Robertson also filed a motion to dismiss, stating in part that he sought "a determination that the trial court lacks subject matter jurisdiction to provide some type of repayment under the Tennessee Workers' Compensation Act since the parties have not exhausted or initiated the benefit review process." Roadway argued in response that their suit did not sound in workers' compensation but rather was a common law action for reimbursement of sums paid under an erroneous court order. In November 2013, the Trial Court entered an order granting Robertson's motion to dismiss. In its order, the Trial Court stated the following:
This cause came on to be heard before the Honorable Michael Sharp on October 4, 2013, upon the Defendant Sammy T. Robertson's Motion to Dismiss. After argument of counsel, the Court finds that the Plaintiff's Complaint falls within the Tennessee Workers' Act and that the parties have to submit to a Benefit Review Conference prior to the filing of this complaint. Therefore, since the parties have not submitted to a Benefit Review Conference prior to the filing of the Complaint, it is hereby ORDERED, ADJUDGED AND DECREED that the Defendant's motion to dismiss shall be granted and the Plaintiff's ...