Petition for Review of a Decision and Order of the District of Columbia Department of Employment Services (OHA 01-142)
Before Schwelb and Glickman, Associate Judges, and Kern, Senior Judge.
Joseph Stevenson, a self-employed T.V. cable installer and a resident of Maryland, fell off the roof of a home in the District of Columbia while installing cable and suffered injuries to his wrist and head. Stevenson filed a claim against himself and his insurer, Hartford Insurance Company, with the District of Columbia Department of Employment Services (DOES). He claimed some six months of temporary total disability benefits and related medical expenses.
The DOES administrative law judge held a hearing on Stevenson's claim. At the outset, Hartford's attorney argued that Stevenson, an independent contractor, was neither an "employee" nor an "employer" within the definitions of the District of Columbia Workers' Compensation Act, see D.C. Code § 36-301 (9) and (10), and that Hartford had "insured him for Maryland . . . benefits . . . [b]ecause Maryland provides a statutory exception that says if you're a sole proprietor, you can elect in Maryland to be covered as if you were an employee. But that's a statutory Maryland exception." *fn1
Thereafter, the administrative law judge heard testimony from Stevenson and a Hartford official and then found that "claimant was not engaged in the service of another . . . he was an employee of his own business . . . [and] the employer/employee relationship became a non-issue in the instant case.*fn2 The inquiry, therefore, must focus on whether at the time of his injury claimant had liability insurance that covered his work in the District of Columbia." (Emphasis added.) The judge went on to conclude that Stevenson "was an employee of his sole proprietorship business and his insurance policy with Hartford provided liability protection for work performed in the District of Columbia." Accordingly, the judge entered a Compensation Order on February 28, 2002.
The DOES Director reviewed and affirmed the Compensation Order, reasoning: "To allow the Carrier [Hartford] to avoid paying workers' compensation benefits to the claimant [Stevenson] would work an undue and unfair hardship upon the claimant and contravene the humanitarian purposes of the Act where doubts are resolved in favor of the injured worker." The Director, citing to Hall v. Spurlock, 310 S.W.2d 259 (Ky. Ct. App. 1957), concluded, "[G]iven the circumstances of this case, the Carrier is estopped from denying coverage." *fn3
We conclude that the Director committed reversible error. First, the Director asserted that Hartford was denying benefits to Stevenson, but the record reflects that Hartford acknowledged that Stevenson was entitled pursuant to its policy to benefits in Maryland but not in the District.*fn4 Second, while the Director was quite correct in noting that doubts must be resolved in the worker's favor given "the humanitarian purposes of the [Workers' Compensation] Act," this did not permit the Director to favor an injured worker by entertaining his claim when he concededly does not meet the Act's definition of an "employee." Finally, and most importantly, DOES does not have jurisdiction to enforce contracts; rather, the applicable statute charges it with the responsibility of applying the worker's compensation law of the District of Columbia which, unlike the Maryland statute, does not allow a sole proprietor to be covered as though he were an employee.
Accordingly, we are persuaded under the particular circumstances here that the Director's decision was plainly wrong and inconsistent with the applicable statute. National Geographic Soc'y v. District of Columbia Dep't of Employment Servs., 721 A.2d 618, 620 (D.C. 1998). Therefore, the Director's decision must be reversed and the case remanded for appropriate disposition.