ABF Freight System, Inc. v. Fretts , 2015 IL App (3d) 130663 ( 2015 )


Menu:
  •                                        
    2015 IL App (3d) 130663
    Opinion filed August 12, 2015
    _____________________________________________________________________________
    IN THE
    APPELLATE COURT OF ILLINOIS
    THIRD DISTRICT
    A.D., 2015
    ABF FREIGHT SYSTEM, INC.,                     )      Appeal from the Circuit Court
    )      of the 21st Judicial Circuit,
    Plaintiff-Appellant,                   )      Kankakee County, Illinois,
    )
    v.                                     )      Appeal No. 3-13-0663
    )      Circuit No. 12-L-78
    DENNIS FRETTS,                                )
    )      Honorable
    Defendant-Appellee.                    )      Kendall O. Wenzelman,
    )      Judge, Presiding.
    _____________________________________________________________________________
    JUSTICE LYTTON delivered the judgment of the court, with opinion.
    Justice Schmidt specially concurred.
    Presiding Justice McDade dissented.
    _____________________________________________________________________________
    OPINION
    ¶1          Plaintiff, ABF Freight System, Inc. (ABF), appeals from an order dismissing its
    complaint alleging fraud and seeking to recover workers' compensation benefits paid to
    defendant, Dennis Fretts, pursuant to section 2-619(a) of the Code of Civil Procedure (Code)
    (735 ILCS 5/2-619(a) (West 2012)). We hold that the trial court lacked jurisdiction to hear
    ABF's claims and affirm.
    ¶2                                             FACTS
    ¶3          ABF, a trucking company that provides long-haul trucking, employed Fretts as a semi-
    tractor trailer driver for a number of years. In 2009, Fretts filed two workers’ compensation
    claims against ABF in which he alleged he suffered injuries to his right shoulder in 2007 and
    again in 2009 while loading and unloading a semi-truck. In his workers’ compensation cases,
    Fretts was evaluated by doctors who opined Fretts was in need of lifting restrictions based in part
    on information Fretts provided. One of the doctors believed that the restrictions should be
    permanent. Because of these lifting restrictions, Fretts claimed he was unable to work for ABF.
    Relying on these statements, ABF paid Fretts temporary total disability (TTD) payments through
    September 15, 2011.
    ¶4          On September 15, 2011, ABF received information suggesting Fretts was driving and
    receiving pay from another trucking company, Havener Enterprises (Havener). ABF hired a
    private investigator who followed Fretts and videotaped him lifting weights at a local gym. After
    reviewing the videotaped surveillance, orthopedic surgeon Dr. Steven Mash concluded that
    Fretts was physically capable of exceeding the lifting restrictions placed upon him by his doctor
    and that he was able to return to his prior work with ABF.
    ¶5          On May 7, 2012, ABF brought a motion for determination of workers' compensation
    fraud before the Illinois Workers' Compensation Commission (Commission). In its motion, ABF
    asserted that Fretts (1) made knowing misrepresentations regarding the extent of his injuries and
    disabilities in order to obtain workers' compensation benefits, including TTD payments, (2) was
    secretly driving for Havener, (3) made knowing misrepresentations regarding the extent and
    nature of his shoulder injuries, his alleged disabilities and his alleged inability to work, and (4)
    intentionally made false and fraudulent material statements as to the nature and extent of his
    2
    injuries, the nature and extent of his physical limitations, his alleged disability and his alleged
    inability to work to both ABF and his physicians.
    ¶6          ABF's motion for a determination of fraud was heard before a Commission arbitrator in
    August of 2012. At the hearing, Fretts testified that he was unable to obtain other work. He
    admitted that he worked for Havener for a couple of days driving a flatbed and a pickup truck to
    Louisiana. The arbitrator determined that a few days of light duty work did not constitute a
    stable labor market for purposes of determining TTD eligibility under the Workers'
    Compensation Act (Act) (820 ILCS 305/1 et seq. (West 2012)). In a written order denying
    ABF's fraud claims, the arbitrator found that "[ABF] failed to show any statement by [Fretts] that
    was both intentional and fraudulent regarding his working for Havener Enterprises while
    collecting TTD." She also concluded that ABF "[had] not proven by a preponderance of the
    evidence, that [Fretts] committed a fraudulent act."
    ¶7          On May 14, 2012, one week after it had filed the workers' compensation motion, ABF
    filed a civil complaint against Fretts alleging that Fretts (1) fraudulently obtained TTD benefits
    from ABF while receiving compensation from another employer, (2) made material
    misrepresentations to obtain insurance benefits, and (3) committed workers' compensation fraud
    under section 25.5 of the Act (820 ILCS 305/25.5 (West 2012)).
    ¶8          After the arbitrator issued her decision in the workers' compensation case, ABF filed an
    amended complaint in circuit court, reducing its civil claims to two counts. Count I alleged that
    Fretts committed insurance fraud pursuant to section 17-10.5 of the Criminal Code of 2012 (720
    ILCS 5/17-10.5(e)(1) (West 2012)) when he obtained insurance benefits from ABF through
    misrepresentation and deception. Count II alleged that Fretts committed common law fraud
    when making multiple misrepresentations to ABF to obtain workers’ compensation benefits.
    3
    ¶9            Fretts moved to dismiss ABF’s amended complaint pursuant to sections 2-615 and 2-
    619(a) of the Code (735 ILCS 5/2-615, 2-619(a)(9) (West 2012)). In an attached affidavit, Fretts
    admitted that he drove a straight truck for Havener to Louisiana on two occasions: once in
    August 2011 and again in October 2011. In his motion to dismiss, Fretts argued that ABF's
    complaint should be dismissed because, among other things, (1) the doctrines of res judicata and
    collateral estoppel barred ABF’s claims, and (2) the trial court lacked jurisdiction to hear fraud
    claims related to a workers’ compensation case.
    ¶ 10          The trial court granted Fretts’s motion to dismiss. The court held that:
    "Clearly there is privity of the parties. And it appears that the fact in issue, the
    alleged filing of a fraudulent workers’ compensation claim, is identical to an issue
    critical to the remaining fraudulent theories contained in the first amended
    complaint. And lastly, the issue of fraud was brought to a final determination by
    the [Commission]. Thus under a collateral estoppel analysis, the court finds that
    the [section] 2-619 basis of the motion to dismiss should be and hereby is
    allowed."
    ¶ 11                                               ANALYSIS
    ¶ 12          An order dismissing a cause of action pursuant to section 2-619 of the Code is reviewed
    de novo. Selective Insurance Co. of South Caroline v. Cherrytree Cos., 
    2013 IL App (3d) 120959
    , ¶ 18. In reviewing a motion to dismiss, it is axiomatic that we review the judgment of
    the lower court, not its reasoning. Rodriguez v. Sheriff's Merit Comm'n of Kane County, 
    218 Ill. 2d
    342, 357 (2006). Therefore, we may uphold the court's judgment on any ground called for by
    the record. 
    Id. 4 ¶
    13          ABF argues that the trial court erred in dismissing its petition because the causes of
    action for insurance fraud and common law fraud were not adjudicated during the workers'
    compensation proceedings and a dismissal based on collateral estoppel would defeat the
    equitable purpose of the doctrine by preventing ABF from ever litigating its fraud claims.
    ¶ 14          Illinois courts have original jurisdiction over all justiciable matters. Ill. Const. 1970, art.
    VI, § 9. The legislature may vest exclusive original jurisdiction in an administrative agency.
    However, if the legislative enactment does divest the circuit courts of their original jurisdiction
    through a comprehensive statutory administrative scheme, it must do so explicitly. People v. NL
    Industries, 
    152 Ill. 2d 82
    , 96-97 (1992).
    ¶ 15          Section 18 of the Workers' Compensation Act specifically states that "[a]ll questions
    arising under this Act, if not settled by agreement of the parties interested therein, shall, except
    as otherwise provided, be determined by the Commission." 820 ILCS 305/18 (West 2012). In
    Employers Mutual Cos. v. Skilling, 
    163 Ill. 2d 284
    (1994), our supreme court held that section 18
    does not divest circuit courts of jurisdiction. The court held that, since no language in section 18
    specifically excluded the circuit courts from deciding workers' compensation cases, the
    Commission and the circuit court have concurrent jurisdiction. 
    Id. at 287.
    The court noted that
    while administrative agencies should be given wide latitude in resolving factual issues, questions
    of law are more appropriately answered by the circuit court. It then concluded that determining
    the scope of coverage afforded under a workers' compensation insurance provision is a question
    of law which the circuit court, not the Commission, is in the best position to address. 
    Id. at 289.
    ¶ 16          Our supreme court has also determined that circuit courts have no original jurisdiction in
    cases involving a determination of workers' compensation benefits. Hartlein v. Illinois Power
    Co., 
    151 Ill. 2d 142
    , 157-58 (1992). This rule of law was further explained in Hollywood
    5
    Trucking, Inc. v. Watters, 
    385 Ill. App. 3d 237
    (2008). In Hollywood Trucking, the employer
    filed a complaint in the circuit court against its employee alleging that the employee fraudulently
    misrepresented his medical history during a medical examination. The employer alleged that had
    it been aware of the employee's medical history, it would not have hired him and would not have
    subsequently become liable to provide him workers' compensation benefits when he was injured.
    The circuit court dismissed the fraud count for lack of jurisdiction. 
    Id. at 240-41.
    ¶ 17          The appellate court relied on Hartlein and affirmed the dismissal. The court found that
    the allegations of fraud against the employee concerned the types of factual issues, such as the
    circumstances of the accident, the nature and extent of the injury and the employer's potential
    defenses, which should be determined by the Commission rather than the circuit court. 
    Id. at 245.
    ¶ 18          After reviewing these cases and the language of section 18, we have determined that the
    relevant inquiry is whether the issues in the case involve questions of law or factual issues
    related to the workers' compensation accident, the nature or extent of the employee's injury or the
    potential defenses to the workers' compensation claim. If they raise issues of fact related to the
    payment of workers' compensation benefits, the circuit court's role is appellate only.
    ¶ 19          Here, ABF filed a motion for determination of benefits before the Commission and then
    filed a complaint in the circuit court based on identical allegations of fraud and misrepresentation
    involving the determination of benefits and TTD payments. The circuit court complaint alleges
    theories of insurance fraud and common law fraud and presents questions of fact, such as the
    extent or existence of Fretts's injury and his representations to medical personnel regarding his
    injury both before and during the workers' compensation proceedings. These are questions of
    fact in which the Commission is in a better position to draw on its special expertise to answer.
    6
    See Hollywood 
    Trucking, 385 Ill. App. 3d at 245
    . ABF's complaint does not present a question
    of law as in Skilling. Therefore, the cause should be before the Commission rather than the
    circuit court.
    ¶ 20           ABF relies on Smalley Steel Ring Co. v. Illinois Workers' Compensation Comm'n, 386 Ill.
    App. 3d 993 (2008), in support of its argument that the appropriate forum for its allegations is in
    the circuit court. But its reliance is misplaced. Smalley Steel involved a workers' compensation
    proceeding where the evidence demonstrating fraud was not discovered until after the workers'
    compensation decision was entered. 
    Id. at 994-95.
    Unlike this case, the fraud evidence at issue
    in Smalley Steel was not presented during the pendency of the workers' compensation
    proceedings. Moreover, the court in that case found that the Act "expressly provides for recall of
    an arbitrator's decision in only one instance, i.e., to correct clerical or computational errors." 
    Id. at 997.
    The court noted that the arbitrator had no authority to recall his decision to address
    allegations of fraud learned after the workers' compensation decision. 
    Id. Where evidence
    of
    fraud is discovered after the arbitrator's decision, the appropriate forum to address the issue is the
    trial court. 
    Id. ¶ 21
              In this case, AFB requested that the Commission hear the fraud claim and presented
    evidence of the alleged fraud in the workers' compensation case, and the arbitrator properly
    exercised the Commission's jurisdiction in ruling on the fraud claims because they involved
    factual issues directly related to the determination of the employee's workers' compensation
    benefits.   Consequently, the trial court lacked jurisdiction to hear ABF's complaint.           Our
    disposition of this jurisdictional issue obviates discussion of ABF's contention that the fraud
    claims are not barred by collateral estoppel.
    ¶ 22                                             CONCLUSION
    7
    ¶ 23          The judgment of the circuit court of Kankakee County granting Fretts's motion to dismiss
    is affirmed.
    ¶ 24          Affirmed.
    ¶ 25          JUSTICE SCHMIDT, specially concurring.
    ¶ 26          While I concur in the judgment, I write separately to point out three things. First, I
    disagree with Hollywood Trucking to the extent that it states the Commission has some special
    expertise that equips it better than the circuit court to deal with issues of fraud. Supra ¶ 17.
    Second, I do not understand why ABF did not appeal the Commission's decision to the worker's
    compensation appellate court. Third, I agree with the trial court that ABF's suit attempts to
    litigate issues that were raised at the Commission.    Therefore, I find the suit barred by res
    judicata rather than lack of jurisdiction.
    ¶ 27          PRESIDING JUSTICE McDADE, dissenting.
    ¶ 28          The majority has found that we do not have jurisdiction over allegations of fraud in
    worker's compensation cases unless the claim is discovered after the arbitrator for the Illinois
    Workers Compensation Commission (the Commission) has made a decision. For the reasons that
    follow, I respectfully dissent from that decision. Nos. 07 W.C. 51713, 10 I.W.C.C. 1287, 
    2010 WL 5584488
    .
    ¶ 29          In Leviege v. Ford Motor Co., (Ill. Indust. Com'n Dec. 28, 2010), the Commission itself
    denied it had jurisdiction to determine if fraud was committed in instances involving
    misrepresentations to acquire workers' compensation benefits. It held that the Commission can
    make findings regarding credibility of witnesses and weight of evidence but "[it] does not have
    jurisdiction to determine what, if any, fraud was committed; that issue is the jurisdiction of
    another tribunal." 
    Id. 8 ¶
    30          It is uncertain if this is the reason the Commission's arbitrator in this case made relevant
    findings but failed to make a determination regarding Fretts' allegedly fraudulent
    misrepresentations. However, as the majority has pointed out, the statute is clear that once the
    arbitrator has made a determination on issues presented to her or, as in this case, failed to make a
    determination, she is prohibited from relitigating the issue by setting aside their order absent
    fraud in the proceedings itself or a clerical or computational error.
    ¶ 31          Thus, if the majority is correct in stating our courts do not have jurisdiction to rule on
    issues of fraud in workers' compensation benefits cases and the Commission is also correct in
    concluding it too lacks jurisdiction, then a plaintiff like ABF Freight is left without a tribunal
    able to resolve its justiciable claim of fraud. This is untenable and unjust. Though our courts may
    not have original jurisdiction over cases involving a determination of workers' compensation
    benefits (Hartlein v. Illinois Power Co., 
    151 Ill. 2d 142
    , 158 (1992)), where the Commission has
    clearly stated that it is not the proper forum for determinations of fraud, our courts need not forgo
    our authority to handle the matter. Kellerman v. MCI Telecommunications Corp., 
    112 Ill. 2d 428
    ,
    445 (1986) ("[W]hen an agency's technical expertise is not likely to be helpful, or there is no
    need for uniform administrative standards, courts should not relinquish their authority over a
    matter to the agency.") We should find the courts also need not relinquish authority if the
    agency has denied its own authority to resolve the issue presented.
    9
    

Document Info

Docket Number: 3-13-0663

Citation Numbers: 2015 IL App (3d) 130663

Filed Date: 8/12/2015

Precedential Status: Non-Precedential

Modified Date: 4/18/2021