Published on 07/10/2005

Joe Fischnaller discusses the Snohomish County medical benefits case in this letter written in July of 2005. It is a good review of the case and demonstrates the rights and protections enjoyed by LEOFF 1 member where medical benefits are concerned. It is also a good lesson for all of us to be very concerned about the membership of your local disability board. It is important that you be very well represented on you local disability board.

THE LAW OFFICES OF
J. E. FISCHNALLER
ATTORNEY AT LAW

July 20, 2005

AN OPEN LETTER
TO: All WSLEA Member Boards
AND TO: Their Members and Staff

RE: Snohomish County Fire District No. 1 v. Snohomish Count Disability Board.

As most of you will recall, I have, for years, been telling you that Disability Boards have very broad discretion in the designation of what medical services are to be made available to LEOFF I active and retired members at the expense of their employers, or previous employers in the case of retired members. I have insisted that a Disability Board has the power to provide a dental benefit for LEOFF I members, and to approve for payment by an employer the cost of routine and other dental work; and the discretion to determine that regular dental checkups are a medical necessity for which a LEOFF I employer must pay.

Some time ago, partly because of this advice, and partly because of the ever-increasing body of medical evidence to the effect that poor dental health can result in a wide variety of other serious medical problems, the Snohomish County Disability Board saw fit to establish a comprehensive dental benefit for the LEOFF I members under their Jurisdiction. Snohomish County Fire District No. 1, one of the employers affected by the decision, filed a lawsuit in Snohomish County Superior Court challenging the discretion of the Board to provide dental benefits or, for that matter, any medical benefits, beyond those minimum benefits required by RCW 41.26.030(22). In addition, they also challenged the Board’s authority to publish rules which designated those medical and dental services which would likely be approved for payment.

The case was tried on cross motions for summary judgment before Judge Linda Krese who ruled in favor of the Snohomish County Disability Board on all issues before the court. The Snohomish County Fire District No. 1 appealed to Division I of the Court of Appeals which recently heard the case and has now rendered an opinion. At the last WSLEA conference, I told those attending that I would keep you updated on the progress of this very important case; and that is the purpose of this open letter.

The case was heard by a three judge panel consisting of the Honorable H. Joseph Coleman, the Honorable Faye Kennedy, and the Honorable Ronald Cox. The opinion was authored by Judge Coleman with the concurrence of Judges Kennedy and Cox. The decision is thus unanimous in affirming the Superior Court ruling and favoring the Board on all issues.

This is an extremely import decision because it resolves, once and for all, subject only to the possibility of an appeal by the District, which seems unlikely, the questions relating to the power, authority, and discretion vested in Disability Boards by the LEOFF Act with regard to the designation of those medical services which are to be made available to LEOFF I members at the expense of their employers.

The Court, in its opinion, made four points very clearly: 1) the Board’s promulgation of rules is entirely permissible; 2) the Act does not condition the availability of medical services on the existence of sickness or disability; 3) the Board may designate medical services beyond those required by RCW 41.26.030(22) as available to LEOFF I members; and 4) the Board did not abuse its discretion in determining that preventative dental services, including periodic checkups and teeth cleanings, are necessary medical services.

This landmark decision not only reaffirms the holding in Stegmeier V. City of Everett, 21 Wn.App. 290, 584 P.2d 488 (1978), to the effect that Disability Boards have the power to approve medical expenses over and above those enumerated in RCW 41.26.030(22) as the minimum services to be provided; but goes a big step further in holding that a member need not be sick or disabled to be entitled to receive medical or dental services, as long as the Disability Board finds those services to be necessary medical services.

Anyone having any questions about the meaning or effect of this opinion may feel free to contact me regarding it. This decision speaks volumes about the true nature of the LEOFF I medical benefit, and the power and discretion of Disability Boards throughout the State.

Very truly yours,

J.E. Fischnaller