The South Dakota Supreme Court recently ruled in favor of an insurance company clarifying the minimum standards required for a Petition for Hearing under the administrative regulations of the South Dakota Department of Labor and Regulations (the “Department”).  On August 18, 2021, the South Dakota Supreme Court released its Opinion in the matter of William May v. Spearfish Pellet Co., LLC, and Western National Mutual Insurance Co., 2021 S.D. 48.

Claimant, William May (“May”), injured his left shoulder in 2009 and his right shoulder a year later in 2010 while working at Spearfish Pellet Co. (the “Employer”).  Employer’s insurer, Western National (“Insurer”), found the workers’ compensation claims were compensable and paid indemnity and medical benefits for surgeries to both shoulders.  Insurer continued to pay medical benefits but discontinued May’s indemnity benefits in 2013.

Around December 2013, May sent a letter to Insurer requesting a review of his workers’ compensation benefits, and also sent a copy of the letter to the South Dakota Department of Labor and Regulation (the “Department”), which was received December 2, 2013.  Insurer responded on January 24, 2014, advising May of the reasons for discontinuing the indemnity benefits, and told May that he had two years to file a petition with the Department if he disagreed.  May sent a second letter to the Insurer and the Department in February 2014, containing the same contents of the December 2013 letter, disputing the Insurer’s determination.  Although the Department stamped both letters as “Received”, the letters were not addressed to the Department and neither the Department nor the Insurer treated the letters as a Petition for Hearing.  Despite retaining counsel in April 2015, May allowed the two-year statute of limitations to expire without filing a formal Petition.

In March 2017, May’s counsel requested that May’s second February 2014 letter be considered a Petition under the Department regulation specifying the necessary contents of a Petition, ARSD 47:03:01:02 (the “Regulation”).  The Regulation requires, among other things, that a Petition be in writing, clearly and concisely state the cause of action, the names of the parties, the time of the place of the accident, how the accident occurred, and the nature and extent of the claimed disability.

May argued that as a pro-se litigant, the definition of a written petition under the Regulation should be liberally construed and that that each piece of information should not be required because it runs contrary to the informal nature of South Dakota’s workers’ compensation procedures.  May also argued that his claims should not be dismissed on mere technicalities.

The Department of Labor ruled against May and found that his February 2014 letter did not constitute a Petition.  May appealed to the Circuit Court, Judge Christina Klinger presiding.  The Circuit Court concluded that ARSD 47:03:01:02 is unambiguous, and therefore its only function was “to declare the meaning of the rule as clearly expressed.” May appealed to the South Dakota Supreme Court.

The South Dakota Supreme Court determined that, even when construed liberally, May’s letter failed to meet the requirements of ARSD 47:03:01:02 to constitute a valid petition.  Specifically, the Court found that the letter: (1) was not addressed to the Department; (2) failed to include basic information such as the name of May’s employer; (3) did not state where May sustained his injury; (4) and provided no details about the time, location, or injury to May’s shoulder.  Importantly, May’s letter complained of many other aliments besides his shoulder injury including heart disease, a lung infection, and muscle disorders.  The Court noted separately that May’s explanation of his disability was so intertwined with his other physical ailments that it failed to sufficiently identify “the nature and extent of his disability” under ARSD 47:03:01:02.

Accordingly, the Court held that due to the inadequacies in the correspondence from May, the Department and the Circuit Court did not err by determining that the February 2014 letter was not a Petition under ARSD 47:03:01:02 affirming the Circuit Court’s decision.