THE MISSISSIPPI LEGISLATURE

The Joint Committee on

Performance Evaluation and Expenditure Review

Report # 558

The Mississippi Workers’ Compensation Commission: A Review of Its Adjudicative Functions

Executive Summary

Introduction

Problem Statement

In Mississippi, the adjudication of workers’ compensation claims utilizes a three-member Workers’ Compensation Commission and administrative law judges appointed by the commission. In recent years, some members of the Mississippi Bar have raised concerns about potential biases of the current commission and whether its purpose is to adjudicate claims of injured workers fairly or whether its purpose is solely to protect the economic interests of employers.

A legislative request was made to the PEER Committee to review certain aspects of the adjudicative process to determine whether the commission’s practices have resulted in the fair administration of the Workers’ Compensation Act [MISS. CODE ANN. Section 71-3-1 et seq. (1972)].

Scope

PEER limited this review to the following issues:

• Has the Workers’ Compensation Commission adequately provided clear, principled legal grounds for reversal or modification of orders in cases wherein it specifically set aside a ruling of an administrative law judge consistent with commonly accepted standards of review and the need for expeditious delivery of benefits to claimants?
• Has the commission adopted rules and practices to ensure statutorily compliant and efficient operations?

Background: The Workers’ Compensation Commission

In 1948, the Mississippi Legislature adopted the Workers’ Compensation Act and made the Workers’ Compensation Commission responsible for administering that law. By statute, the commission has three members, one of which must be an attorney. The other two members represent employers and employees, respectively.

The commission has both rulemaking and adjudicative functions. Administrative law judges hear contested matters, including motions, and hearings on the merits. Their decisions are appealable to the full commission. The commission is the ultimate trier of fact in all cases and may derive new findings of fact or weigh evidence differently from the administrative law judge who initially hears the case.

The Concept of Workers’ Compensation

Workers’ compensation laws evolved during the early twentieth century in recognition of the fact that tort doctrine required that cases of workplace injury be litigated, thereby causing employees to wait for long periods for any recovery that they might receive. Workers’ compensation remedies ensured an expeditious provision of benefits to the injured employee in exchange for the employee’s surrendering any rights he or she might have had to sue in tort for negligence.

The decision upholding the constitutionality of the 1948 Mississippi workers’ compensation statute found compelling the need to provide an expeditious remedy for workplace injury and, while providing the employee with a relatively quick remedy, inured benefit to the employer by narrowing the benefits available to the claimant.

The courts have set out certain principles of statutory construction that are to guide adjudicators in making decisions regarding claims for workers’ compensation benefits. These principles make it clear that the purpose of the statute is not to make a “level playing field” for the resolution of claims, but to give all doubts in close cases to the claimant over the employer or carrier.

Conclusions Regarding Adjudicative Functions of the Workers’ Compensation Commission

PEER notes that state law gives the Workers’ Compensation Commission broad authority to review all matters of law and fact in any matter brought before the commission. This gives the commission broader authority than most appellate bodies in the legal system, as it essentially permits a re-trial of issues of fact already tried at the administrative hearing before an administrative law judge.

In appellate courts, the basis for deciding cases should be clearly articulated and understandable (i. e., applying the principle of transparent reasoning) for all interested parties in workers’ compensation cases. The need for transparent reasoning is just as compelling for workers’ compensation cases, as such explication may impact how decisions are made in similar cases in the future.

Also, the standards of review applied in appellate court are the most appropriate for ensuring that the processes of handling workers’ compensation appeals will be expeditious. In Mississippi, appeals courts generally will not reverse a trial court’s finding of fact except in those cases in which the court finds that the finding is clearly erroneous or not supported by substantial evidence. Additionally, courts have held that the trier of fact in a bench trial has sole responsibility for determining the credibility of witnesses.

Regarding the two questions that the review addressed, PEER found the following:

• Has the Workers’ Compensation Commission provided clear, principled legal grounds for reversal or modification of orders in cases wherein it specifically set aside a ruling of an administrative law judge consistent with commonly accepted standards of review and the need for expeditious delivery of benefits to claimants?
  
  No. The Workers’ Compensation Commission often modifies administrative law judges’ findings of fact without a clear basis for doing so. Additionally, the commission often orders reversals and modifications without clearly explicated reasons. Such actions result in parties not being able to rely on the results of an administrative law judge’s decision and add time to the adjudication of claims.
• Has the commission adopted rules and practices to ensure statutorily compliant and efficient operations?
  
  No. A portion of General Rule 9 of the commission (regarding hearings to compel medical treatment under certain conditions when a claimant’s temporary total disability benefits have been terminated) is not in conformity with MISS. CODE ANN. Section 71-3-17 (1972). Rule 10 gives the commission discretion regarding oral argument, which could work to the detriment of a party if such party is not able to argue against new evidence. Also, because the Workers’ Compensation Commission assigns a limited number of administrative staff to support the administrative law judges, the commission does not ensure efficient production of orders in controverted cases.

Policy Options and Recommendation

Policy Options for Legislative Consideration

The Legislature may wish to eliminate the commission or to make procedural modifications in the commission’s functions to ensure that cases are professionally adjudicated by persons knowledgeable in the workings of the workers’ compensation system.

To address the problems set out in this report, PEER sees two policy options for the Legislature to consider:

• Option One: Eliminate the Workers’ Compensation Commission--The Legislature could abolish the Workers’ Compensation Commission and subsequently create an office with an Executive Director appointed by the Governor, establish a procedure for appointing administrative law judges with set terms of office, and provide for appeals to the Mississippi Court of Appeals.
• Option Two: Revise the Role and Composition of the Workers’ Compensation Commission--The Legislature could amend MISS. CODE ANN. Section 71-3-85 (1972) and revise the commission’s membership to reflect the need for members who have extensive legal training. Also, the Legislature could amend MISS. CODE ANN. Section 71-3-47 (1972) to require the commission to review the appeals brought before it entirely on the record.

Administrative Recommendation

Whether the Legislature eliminates the commission and creates a new office, revises the role and composition of the commission, or retains the commission in its present form, the entity that administers Mississippi’s workers’ compensation law should:

• make internal adjustments in the duties of staff to provide the administrative law judges with necessary clerical and editing support for the preparation of orders; and,
• review the entity’s rules for conformity with statutes. In cases wherein the rules do not comport with statutes, the entity should make appropriate amendments to the rules or recommend that the Legislature make substantive changes to enabling legislation to reflect appropriate policy.

PEER Home Page         Full Text PDF (13,263K)