This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.
Facts
The Worker suffered a back injury in July 1994 while employed by the Employer. Following a recurrence of back pain in December 1998, the Worker underwent corrective surgery for a herniated disc and reached maximum medical improvement in August 1999. The Worker sought total temporary disability (TTD) benefits for the recovery period, but the Employer denied the request, citing prior lump-sum payments and a provision in a 1996 order releasing the Employer from further liability (paras 2-6).
Procedural History
- Workers' Compensation Administration, October 1995: Recommended resolution awarded the Worker 50 weeks of TTD and 450 weeks of permanent partial disability (PPD) benefits, totaling 500 weeks (para 2).
- Workers' Compensation Administration, November 1996: Approved a partial lump-sum payment order, including a provision releasing the Employer from further liability for benefits, even if the Worker’s condition worsened (para 3).
- Workers' Compensation Administration, April 1997: Approved another partial lump-sum payment order (para 28).
Parties' Submissions
- Worker: Argued that the 1996 order’s provision releasing the Employer from liability for future benefits violated statutory provisions, and that he was entitled to TTD benefits for the 32-week recovery period following his surgery (paras 6, 8, 19).
- Employer: Contended that the Worker had exhausted his entitlement to benefits through lump-sum payments and that the 1996 order barred further claims. Additionally, the Employer argued that the Worker’s challenge to the 1996 order was untimely under the two-year limitation period (paras 6, 16, 25).
Legal Issues
- Did the 1996 order’s provision releasing the Employer from liability for future benefits violate statutory provisions?
- Was the Worker entitled to additional TTD benefits for the 32-week recovery period?
- Did the Worker exhaust his entitlement to benefits by receiving the monetary equivalent of 500 weeks of benefits?
- Was the Worker’s claim barred by the two-year limitation period under Section 52-5-9(B)?
Disposition
- The Court reversed the dismissal of the Worker’s claim for TTD benefits and remanded the case to determine the amount of TTD benefits, attorney fees, and costs (paras 1, 31-32).
Reasons
Per Castillo J. (Fry and Robinson JJ. concurring):
Invalidity of the 1996 Order’s Provision: The Court held that the provision in the 1996 order releasing the Employer from liability for future benefits violated Section 52-5-12 of the Workers' Compensation Act. Subsection (C) of the Act, governing partial lump-sum payments, does not permit such releases, unlike Subsection (B), which applies to total lump-sum payments. The provision was therefore invalid as a matter of law (paras 8-17).
Exhaustion of Benefits: The Court determined that the Worker’s receipt of the monetary equivalent of 500 weeks of benefits through lump-sum payments did not preclude him from seeking additional benefits during the statutory 500-week period. Section 52-1-56 allows for modification of benefits based on a change in condition within the statutory period, regardless of the timing of payments (paras 18-22).
Entitlement to TTD Benefits: The Court found that the Worker’s December 1998 back injury was causally related to the 1994 injury and that he was temporarily totally disabled for 32 weeks. As the Worker met the burden of proving a change in condition, he was entitled to TTD benefits for this period (paras 23-24).
Timeliness of the Worker’s Claim: The Court rejected the Employer’s argument that the Worker’s claim was time-barred under Section 52-5-9(B). The two-year limitation period began to run from the date of the last benefit payment (September 1997) or the denial of benefits (1999), making the Worker’s 1999 complaint timely (paras 25-28).
Mootness of Attorney Testimony Issue: The Court deemed moot the Worker’s argument regarding the exclusion of the Employer’s attorney as a witness, as the invalidity of the 1996 order’s provision resolved the issue (para 30).