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 a hip injury in a work-related accident on the premises of a third party. The employer paid for medical expenses and disability benefits. The worker later sued the third party and was awarded damages by a jury, which apportioned 60% of the negligence to the worker and 40% to the third party. The employer and its insurer sought reimbursement from the worker's third-party recovery for the benefits they had paid (paras 1-3).

Procedural History

• Workers' Compensation Administration: The Workers' Compensation Judge (WCJ) applied the formula from Gutierrez v. City of Albuquerque to determine the employer and insurer's reimbursement rights, awarding them $5,145.32 and requiring them to pay the worker's future medical expenses (para 4).

Parties' Submissions

• Appellants (Employer and Insurer): Argued that the WCJ misapplied the Gutierrez formula, claiming it was factually and legally inappropriate for this case. They contended that the worker was made whole by the third-party recovery and that the WCJ erred in reducing their reimbursement by 60% based on the worker's comparative negligence. They also argued that the WCJ improperly awarded future medical expenses (paras 5-6, 13-14).
• Appellee (Worker): Defended the WCJ's application of the Gutierrez formula and argued that the employer and insurer were only entitled to reimbursement for duplicative recovery. The worker also supported the WCJ's decision to award future medical expenses as consistent with the Workers' Compensation Act (paras 6, 14-16).

Legal Issues

• Was the Gutierrez formula applicable to determine the employer and insurer's reimbursement rights in this case?
• Did the WCJ err in reducing the employer and insurer's reimbursement by 60% based on the worker's comparative negligence?
• Was the WCJ's award of future medical expenses to the worker proper under the Workers' Compensation Act?

Disposition

• The Court of Appeals affirmed the WCJ's decision (para 17).

Reasons

Per Pickard CJ (Alarid and Apodaca JJ. concurring):

• The Court held that the Gutierrez formula was applicable to this case, rejecting the employer and insurer's argument that the factual distinction between a jury verdict and a settlement made the formula inapplicable. The Court emphasized that the formula focuses on preventing duplicative recovery, not fault, and applies regardless of whether damages are determined by a jury or settlement (paras 6-10).
• The Court found no error in the WCJ's reduction of the employer and insurer's reimbursement by 60%, as this was consistent with the Gutierrez principle that reimbursement is limited to duplicative recovery. The purpose of reimbursement is to prevent a windfall to the worker, not to ensure full recovery for the employer (paras 11-13).
• The Court upheld the WCJ's award of future medical expenses, noting that the Workers' Compensation Act obligates employers to provide reasonably necessary medical care for as long as it is required. The jury's failure to award future medical expenses in the tort case did not preclude the WCJ from addressing this issue under the Act (paras 14-16).
• The Court awarded $1,000 in attorney fees to the worker for the appeal (para 18).