Opinion
No. 2290 C.D. 2012
08-23-2013
Pat A. Garcia, Petitioner v. Unemployment Compensation Board of Review, Respondent
BEFORE: HONORABLE RENÉE COHN JUBELIRER, Judge HONORABLE MARY HANNAH LEAVITT, Judge HONORABLE ROCHELLE S. FRIEDMAN, Senior Judge
OPINION NOT REPORTED
MEMORANDUM OPINION BY JUDGE COHN JUBELIRER
Pat A. Garcia (Claimant), pro se, petitions for review of the Order of the Unemployment Compensation Board of Review (Board) finding Claimant ineligible for Unemployment Compensation (UC) benefits pursuant to Section 402(e) of the Unemployment Compensation Law (Law). On appeal, Claimant contends that Pamela L. Meyer, DO, PC (Employer) did not meet its burden to show that Claimant's actions constituted willful misconduct. Discerning no error, we affirm.
Act of December 5, 1936, Second Ex. Sess., P.L. (1937) 2897, as amended, 43 P.S. § 802(e) (providing, in relevant part, that an employee is ineligible for UC benefits for any week the employee's unemployment is due to willful misconduct connected with the employee's work).
Claimant worked as a full-time Billing Manager for Employer when she was discharged for "repeated tardiness and failure to communicate [to Employer] critical issues occurring in the billing department." (Notice of Determination, R. at Item 5.) Claimant filed an application for UC benefits with the Allentown UC Service Center (Service Center). The Service Center determined that Claimant did not admit to the incident causing her separation from employment and that Employer did not provide information showing that Claimant was involved in the incident; therefore, the Service Center found that Claimant was not disqualified for UC benefits pursuant to Section 402(e) of the Law. (Notice of Determination, R. Item 5.)
Employer appealed and, on August 13, 2012, a hearing was held before the Unemployment Compensation Referee (Referee) at which Employer's Practice Administrator and Claimant presented testimony. The Referee affirmed the Service Center's determination, noting that "[t]he Pennsylvania Courts have consistently held the mere incompetence[,] inexperience or inability to do the job is not willful misconduct." (Referee Decision at 2.) The Referee concluded that, while Claimant may have not followed Employer's procedures, Employer did not meet its burden to prove that Claimant's actions rose to the level of willful misconduct. (Referee Decision at 2.)
Employer appealed to the Board. Resolving conflicts in the testimony in favor of Employer, the Board made the following finding of facts:
1. The claimant worked as a full-time billing manager for [Employer] from April 16, 2009 through February 1, 2012 earning $14.96 per hour.
2. The claimant's job included billing patients and posting payments from the patients' insurance companies.
3. The employer's largest insurance provider was Medicare/Medicaid.
4. In August and October 2011, letters were sent to the claimant informing her that in order to continue to receive electronic reports of payments for Medicare and Medicaid services, the claimant would need to secure a special modem for the employer's computer system.
5. The claimant did not understand the instructions in the letter she received concerning the need for a special modem.
6. The claimant did not tell the employer about the letters.
7. As a result[,] effective December 1, 2011, the claimant was no longer able to post any Medicare and Medicaid payments against the patients' bills.
8. Even though the claimant was aware that she was unable to post the payments, she mailed out incorrect statements to patients that indicated that there had been no payments from Medicare and Medicaid.
9. The patients began to call the employer indicating that their bills were incorrect in that the bills did not show Medicare and Medicaid reimbursements.
10. The claimant admitted the bills were incorrect but alleged that she told the practice administrator not to send out the incorrect bills.
11. The claimant did not tell practice administrator to not send the incorrect bills.
12. The employer discharged the claimant for failing to tell them that she did not understand the letters and as a result was sending incorrect bills.(Board Decision, Findings of Facts (FOF) ¶¶ 1-12.) The Board credited the testimony of Employer's Practice Administrator that Claimant did not inform Employer about the letters or that she was sending incorrect bills. (Board Op. at 2.) The Board concluded that Claimant "had no good cause for her failure to communicate" with Employer. (Board Op. at 2.) Claimant now petitions this Court for review of the Board's Order.
Our "review is limited to determining whether constitutional rights were violated, whether an error of law was committed, whether a practice or procedure of the Board was not followed or whether the findings of fact are supported by substantial evidence in the record." The Western and Southern Life Insurance Company v. Unemployment Compensation Board of Review, 913 A.2d 331, 334 n.2 (Pa. Cmwlth. 2006).
On appeal, Claimant argues that: (1) Claimant did inform Employer about the letters when she gave them to, and communicated with, Practice Administrator; and (2) Employer did not meet its burden to prove that Claimant was ineligible for benefits under Section 402(e) of the Law.
Claimant first argues, contrary to the Board's findings, that she did inform Employer about the letters by informing Practice Administrator as she had been instructed to do by Employer. Claimant contends that she did so in a timely manner, met all of Employer's protocols, never received a bad review in four years, and never received a warning of any kind. Essentially, Claimant challenges the Board's findings and argues her own version of the facts.
In UC cases, it is axiomatic that the Board's findings of fact "are conclusive on appeal so long as the record, taken as a whole, contains substantial evidence to support those findings." Taylor v. Unemployment Compensation Board of Review, 474 Pa. 351, 355, 378 A.2d 829, 831 (1977). Here, Practice Administrator testified that: she found the letters on Claimant's desk on January 10, 2012; Practice Administrator became upset because she never knew of the problem, not realizing that it went back to August 2011; Claimant never told anyone about this; Claimant never did anything about it and tried to handle the issue herself, but it was not working; a second letter in October stated that a modem was needed, but Claimant did not understand it, did not seek help, did not ask the doctor, or tell anybody; and, by December 1, 2011, Claimant could no longer view Medicare and Medicaid payments online so she could not post any payments. (Hr'g Tr. at 9.) Practice Administrator further stated that Claimant did not communicate with her until January 2012 that Claimant had not been posting payments for six weeks and Claimant stated that she knew it was too late for her to catch up. (Hr'g Tr. at 31.)
Substantial evidence has been "defined as such relevant evidence which a reasonable mind might accept as adequate to support a conclusion." Philadelphia Gas Works v. Unemployment Compensation Board of Review, 654 A.2d 153, 157 (Pa. Cmwlth. 1995).
Practice Administrator testified that the letter she found on Claimant's desk on January 10, 2012 was dated August 22, 2011. (Hr'g Tr. at 10.)
Practice Administrator explained that when a payment is received electronically, it must be posted to each individual account that should be credited with the payment. Claimant had nothing posted from December 1, 2011 until January 10, 2012, when Practice Administrator became aware of the problem. Practice Administrator then requested help from Employer's Information Technology Specialist, who immediately knew what to do and ordered the modem that was needed to set the posting up properly. (Hr'g Tr. at 9-10.)
Claimant testified differently about these events. Claimant testified that: it was Claimant who brought the letters to the attention of Practice Administrator, stating that she "was having difficulty in trying to figure out, what the letter was really asking me to do"; Practice Administrator "couldn't figure it out either," but then called Medicare and Medicaid to try to obtain more information about what was going on; and Claimant did not know what Medicare was asking for in the letters or anything about modems and explained to Practice Administrator that this would be a problem if it was not handled in a timely manner because she would not be able to post. (Hr'g Tr. at 35-36, 38-40.)
"The evidence presented at the hearing was conflicting; it is not this [C]ourt's function to balance that evidence. Questions of credibility and the resolution of evidentiary conflicts are within the sound discretion of the Board, and are not subject to re-evaluation on judicial review." Miller v. Unemployment Compensation Board of Review, 405 A.2d 1034, 1036 (Pa. Cmwlth. 1979).
This is a classic case of two sides presenting divergent testimony concerning a particular event. The fact that conflicting evidence is presented does not mean that there is no substantial evidence to support the eventual finding since it is the function of the Board, and not this Court, to resolve questions of credibility and conflicts in testimony.Martin v. Unemployment Compensation Board of Review, 387 A.2d 998, 1000 (Pa. Cmwlth. 1978). Moreover, as the prevailing party below, Employer "is entitled to the benefit of all reasonable inferences drawn from the evidence." Ductmate Industries, Inc. v. Unemployment Compensation Board of Review, 949 A.2d 338, 342 (Pa. Cmwlth. 2008). That a claimant might view the facts differently does not create grounds for reversal if the Board's findings are supported by substantial evidence. Tapco, Inc. v. Unemployment Compensation Board of Review, 650 A.2d 1106, 1108-09 (Pa. Cmwlth. 1994).
As was its prerogative, the Board credited Practice Administrator's version of the facts that Claimant did not tell Employer about the letters and that she was sending incorrect bills to the patients. Accordingly, the Board's findings in this regard are supported by substantial evidence.
Claimant next argues that Employer did not meet its burden to prove that Claimant was ineligible for benefits under Section 402(e) of the Law because her actions did not rise to the level of willful misconduct. Claimant contends that she did not have any "wrongful intent" or "evil design" and did not intentionally disregard Employer's interests or her duties and obligations as an employee. (Petitioner's Br. at 9.)
Under Section 402(e) of the Law, an employee is not eligible for UC benefits when her "unemployment is due to h[er] discharge . . . from work for willful misconduct connected with h[er] work." 43 P.S. § 802(e). Willful misconduct has been defined by our Court as:
(1) a wanton or willful disregard for an employer's interests; (2) a deliberate violation of an employer's rules; (3) a disregard for standards of behavior which an employer can rightfully expect of an employee; or (4) negligence indicating an intentional disregard of the employer's interest or an employee's duties or obligations.Philadelphia Parking Authority v. Unemployment Compensation Board of Review, 1 A.3d 965, 968 (Pa. Cmwlth. 2010). Employer has the burden to establish that Claimant's actions constituted willful misconduct. Weingard v. Unemployment Compensation Board of Review, 26 A.3d 571, 574 (Pa. Cmwlth. 2011). "This Court has stated that 'if the conduct clearly discloses breaches of duties and obligations which are inimical to the employer's best interest, such acts on the part of the employee may constitute willful misconduct.'" Eyring v. Unemployment Compensation Board of Review, 407 A.2d 86, 87 (Pa. Cmwlth. 1979) (quoting Loder v. Unemployment Compensation Board of Review, 296 A.2d 297, 300 (1972)). If supported by substantial evidence, findings of conduct disclosing an abrogation of responsibility or a conscious indifference to an employee's duty can support a finding of willful misconduct. Id.
If the employer satisfies its burden, the burden shifts to the employee to show that he or she had good cause for the conduct. McKeesport Hospital v. Unemployment Compensation Board of Review, 625 A.2d 112, 114 (Pa. Cmwlth. 1993). "A claimant has good cause if his or her actions are justifiable and reasonable under the circumstances." Docherty v. Unemployment Compensation Board of Review, 898 A.2d 1205, 1208-09 (Pa. Cmwlth. 2006). Whether an employee's conduct constituted willful misconduct and whether an employee had good cause for his or her actions are questions of law subject to this Court's review. Id. at 1208; Lee Hospital v. Unemployment Compensation Board of Review, 589 A.2d 297, 299 (Pa. Cmwlth. 1991).
Here, although Practice Administrator denies that Claimant ever told her about the letters, Claimant testified only that she did not inform Employer in a timely manner about the instructions in the letters regarding a modem or how it would affect Employer's billings. Claimant admitted, however, that "there was a period . . . [of] about two months that [she] was not able to get correct balances[,]" but she still sent out bills to patients even though she "couldn't post the patients' balances," and did not do something about this earlier because "there w[ere] too many things that were overwhelming [her]." (Hr'g Tr. at 38, 40.) From this admission it is reasonable to infer that Claimant would have known that she was sending out incorrect bills to those patients that did not reflect the latest payments remitted and Claimant admitted that "if [she] wasn't overworked and overwhelmed with . . . other things, this would not have occurred." (Hr'g Tr. at 49.) Claimant stated that she wanted to report this problem immediately, but there were "too many things on [her] desk." (Hr'g Tr. at 40-41.) Additionally, even though Claimant testified that she had no idea when she actually read the first letter sent in August, when the letter was presented to Claimant during the Referee's hearing Claimant admitted that it was her hand-written notation at the top of the letter indicating her receipt of it on September 1, 2011, and that a notation on the bottom of the letter dated January 10, 2012 with the name "Mark" was also hers. (Hr'g Tr. at 44-45.) Claimant further admitted that she had no idea what the payments were from Medicare and Medicaid for individual patients for the month of December 2011 up until January 12-13, 2012, and that she "couldn't post the patients' balances, so the statements couldn't go out correctly." (Hr'g Tr. at 38, 47.)
The identity of "Mark" is not clear from the hearing transcript. --------
The facts of this case are somewhat analogous to those in Eyring. In that case, a school business manager notified the claimant, the superintendent of school buildings, that his employment was being terminated because he failed to respond properly to heating and electrical system breakdowns, among other issues. This Court upheld the Board's conclusion that when there was substantial evidence that the claimant "chose to ignore instructions and to take no action in job areas for which he held responsibility[,]" this amounted to willful misconduct and disclosed an abrogation of and a conscious indifference to his responsibilities for which he offered no reasonable justification. Eyring, 407 A.2d at 87. Similarly, here, because substantial evidence supports the Board's findings that Claimant did not inform Employer about the letters in September 2011, did not seek assistance from Employer when Claimant did not understand the letters and, thereafter, knowingly sent out incorrect bills to Employer's patients, this disclosed a conscious indifference to and abrogation of responsibility towards Claimant's duties constituting "a disregard of the standards of behavior which an employer has a right to expect of an employee, or negligence indicating an intentional disregard of the employer's interests or of the employee's duties and obligations to the employer." (Board Op. at 2.)
Accordingly, the Board properly determined that Employer established that Claimant's conduct rose to the level of willful misconduct. Moreover, as concluded by the Board, Claimant did not have good cause for her actions. Being overwhelmed is not a justification for ignoring the letters, not informing Employer that it had to upgrade its computer system in order to continue to post payments to their patients' accounts, and knowingly sending out incorrect billing information.
For the foregoing reasons, we are constrained to affirm the Order of the Board.
/s/ _________
RENÉE COHN JUBELIRER, Judge ORDER
NOW, August 23, 2013, the Order of the Unemployment Compensation Board of Review entered in the above-captioned matter is hereby AFFIRMED.
/s/ _________
RENÉE COHN JUBELIRER, Judge