AI Generated Opinion Summaries

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

A worker sustained work-related injuries in a car accident caused by an uninsured motorist while employed as a courier. The worker received benefits under the employer's workers' compensation policy and also recovered funds from two uninsured motorist policies, one provided by the employer and the other by the worker's mother. The employer sought reimbursement and credits against future benefits for the amounts paid under its uninsured motorist policy (paras 2-4).

Procedural History

• Workers' Compensation Administration: The WCA awarded the employer reimbursement and credits against future benefits, finding that the employer was entitled to a dollar-for-dollar reimbursement, subject to certain deductions for attorney's fees and costs (paras 7-8).

Parties' Submissions

• Worker-Appellant: Argued that the employer was only entitled to reimbursement for duplicative benefits under New Mexico law and that the WCA erred in awarding full reimbursement without considering whether the worker had been made whole. The worker also challenged the finding that he returned to work at a wage equal to or greater than his pre-injury wage and sought attorney's fees (paras 9-10, 25-28).
• Employer/Insurer-Appellees: Contended that they were entitled to full, dollar-for-dollar reimbursement for benefits paid under the uninsured motorist policy and argued that the Gutierrez decision, which limited reimbursement in third-party tort recoveries, did not apply to uninsured motorist recoveries. They also maintained that the worker returned to work at a wage equal to or greater than his pre-injury wage and that the pretrial offer of judgment was more favorable than the trial outcome, precluding an award of attorney's fees (paras 10, 13, 18, 28).

Legal Issues

• Is the employer entitled to a dollar-for-dollar reimbursement for workers' compensation benefits paid, or should reimbursement be limited to duplicative benefits under the Gutierrez methodology?
• Did the worker return to work at a wage equal to or greater than his pre-injury wage?
• Is the worker entitled to attorney's fees?

Disposition

• The WCA's reimbursement award was reversed, and the matter was remanded for recalculation of the employer's reimbursement rights under the Gutierrez methodology (para 24).
• The WCA's finding that the worker returned to work at a wage equal to or greater than his pre-injury wage was affirmed (para 27).
• The issue of attorney's fees was remanded for reconsideration in light of the recalculated reimbursement award (para 28).

Reasons

Majority Opinion (Per Armijo J., Pickard CJ. and Sutin J. concurring in part)

• Reimbursement: The court held that the Gutierrez methodology, which limits an employer's reimbursement to duplicative benefits when a worker receives a partial recovery, applies to uninsured motorist recoveries. The court rejected the employer's argument that uninsured motorist recoveries should be treated differently from third-party tort recoveries, emphasizing that the focus should be on whether the worker received a partial recovery and whether the damages differ from workers' compensation benefits. The case was remanded for a determination of the worker's total damages and recalculation of the employer's reimbursement rights (paras 10-24).
• Wage Determination: The court found substantial evidence supporting the WCA's conclusion that the worker returned to work at a wage equal to or greater than his pre-injury wage. The worker's failure to present all relevant evidence on appeal led the court to affirm the WCA's finding (paras 25-27).
• Attorney's Fees: The court remanded the issue of attorney's fees for reconsideration after recalculating the employer's reimbursement rights, as the pretrial offer of judgment could not be properly evaluated without the recalculated amounts (para 28).

Dissenting Opinion (Per Sutin J., dissenting in part)

• Sutin J. dissented from the majority's reversal of the WCA's reimbursement award, arguing that the plain language of Section 52-5-17(C) entitles the employer to full reimbursement from uninsured motorist recoveries when the employer paid the policy premiums. The dissent emphasized that the Gutierrez methodology should not apply to uninsured motorist recoveries, as the statute explicitly distinguishes between third-party tort recoveries and uninsured motorist recoveries. Sutin J. would have affirmed the WCA's reimbursement award in full (paras 31-46).