Supreme Court Decides Review-Reopening Case Involving Statute of Limitations Issues
In Coffey v. Mid Seven Transportation Co., No. 11-1106 (Iowa May 10, 2013), claimant filed a review-reopening petition, which was found to be untimely by the commissioner and district court. The employee also requested reimbursement of certain post-arbitration medical expenses, which were also denied.
Claimant originally had an injury to his left leg in 1994, and was unable to return to work following the injury. After working part time, claimant was ultimately found eligible for social security disability benefits.
Prior to filing his workers' compensation claim, the employee had entered into a settlement with a third party for $275,000, of which he received $134,784.95 after payment of attorney's fees and medical costs. Claimant alleged in his workers' compensation claim that he had injured not only his leg, but his back. He also claimed that his post polio syndrome was aggravated by his injury. He was paid workers' compensation payments totaling $70,783.19 prior to the arbitration decision.
Prior to the arbitration decision, claimant and his wife entered into a third party settlement for $100,000, of which $60,000 was for loss of consortium. Claimant received $24,634.14 after payment of legal fees and expenses. The arbitration decision concluded that claimant had a 75% industrial disability. This finding was appealed through the Iowa Court of Appeals, with the commissioner's decision being affirmed. The last action was a denial of an application for further review on January 11, 2006.
Defendants' counsel wrote to claimant's counsel and indicated that the third party recoveries totally covered the workers' compensation award. Defendants' counsel indicated that payment for attorney's fees would be roughly $51,000. Claimant's counsel believed that approximately $155,000 was due. Defendants wrote a check to claimant for the smaller amount on January 30, 2006.
On April 2, 2008, claimant filed a petition for review-reopening. The deputy found that the claim was barred by the statute of limitations. The deputy found that the three year period began three years after the decision where no payment of weekly benefits occurred after the award. The deputy ordered defendants to pay medical expenses. The deputy found that the payment of $51,000 was not payment of benefits, but payment of attorney's fees. The commissioner reversed on the question of medical payments, finding that claimant had not proved that these costs were related to the injury.
The Court noted that the legislature had not delegated any special powers to the workers' compensation commissioner regarding statutory interpretation. Therefore, the question was one of law. The fighting issue on the statute of limitations claim was when the last payment of benefits had been made. Defendants argued that the SOL commenced from the date of the arbitration award while claimant argued that the payment of the $51,000 constituted weekly benefits or alternatively that the three year statute did not begin until the court's earlier denial of the application for further review.
On the record before the agency, the court found that it could not say that the credit under 85.22(1) covered all the weekly benefits awarded in the arbitration proceeding. Because there appeared to be an issue of whether all medical bills, mileage and interest had been paid, the court remanded the case to the agency to determine whether these payments had been made and whether they were offset by the third party payments. If the agency were to find that defendants still owed benefits after the date of the arbitration decision, the commissioner must decide whether defendants had paid the last installment of weekly benefits. If benefits were still owed, then the three year SOL was still alive.
If the employer was found to have paid all benefits prior to the date of the arbitration award, then the court still had to determine when the SOL commenced. The court concluded that payment of attorney's fees was a reimbursement for attorney's fees and not weekly benefits. Because of this, the SOL was not extended by that payment.
On the issue of whether a settlement from a third party extended the SOL, the court concluded there was no specific precedent addressing this issue, but that there was precedent, in Beier Glass v. Brundige, 329 N.W.2d 280, 287 (Iowa 1983), as to the extension of the SOL when medical benefits had been paid. This precedent noted that the three year SOL commenced from the date of the arbitration decision. The court found that the same rationale applied with respect to payment of the third party award prior to an arbitration decision. Thus, the date of the arbitration decision was the commencement date for the three year statute of limitations. Claimant argued that the final date for exhaustion of appeals was the correct date, but the court rejected this argument. On remand, the agency was to determine whether the obligation to pay weekly benefits was completely satisfied by the third party recovery.
On the medical cost issue, the agency found that there was insufficient evidence that the expenses were related to the work injury. The district court found that this was supported by substantial evidence. The court found that the decision of the agency was supported by substantial evidence.
Claimant originally had an injury to his left leg in 1994, and was unable to return to work following the injury. After working part time, claimant was ultimately found eligible for social security disability benefits.
Prior to filing his workers' compensation claim, the employee had entered into a settlement with a third party for $275,000, of which he received $134,784.95 after payment of attorney's fees and medical costs. Claimant alleged in his workers' compensation claim that he had injured not only his leg, but his back. He also claimed that his post polio syndrome was aggravated by his injury. He was paid workers' compensation payments totaling $70,783.19 prior to the arbitration decision.
Prior to the arbitration decision, claimant and his wife entered into a third party settlement for $100,000, of which $60,000 was for loss of consortium. Claimant received $24,634.14 after payment of legal fees and expenses. The arbitration decision concluded that claimant had a 75% industrial disability. This finding was appealed through the Iowa Court of Appeals, with the commissioner's decision being affirmed. The last action was a denial of an application for further review on January 11, 2006.
Defendants' counsel wrote to claimant's counsel and indicated that the third party recoveries totally covered the workers' compensation award. Defendants' counsel indicated that payment for attorney's fees would be roughly $51,000. Claimant's counsel believed that approximately $155,000 was due. Defendants wrote a check to claimant for the smaller amount on January 30, 2006.
On April 2, 2008, claimant filed a petition for review-reopening. The deputy found that the claim was barred by the statute of limitations. The deputy found that the three year period began three years after the decision where no payment of weekly benefits occurred after the award. The deputy ordered defendants to pay medical expenses. The deputy found that the payment of $51,000 was not payment of benefits, but payment of attorney's fees. The commissioner reversed on the question of medical payments, finding that claimant had not proved that these costs were related to the injury.
The Court noted that the legislature had not delegated any special powers to the workers' compensation commissioner regarding statutory interpretation. Therefore, the question was one of law. The fighting issue on the statute of limitations claim was when the last payment of benefits had been made. Defendants argued that the SOL commenced from the date of the arbitration award while claimant argued that the payment of the $51,000 constituted weekly benefits or alternatively that the three year statute did not begin until the court's earlier denial of the application for further review.
On the record before the agency, the court found that it could not say that the credit under 85.22(1) covered all the weekly benefits awarded in the arbitration proceeding. Because there appeared to be an issue of whether all medical bills, mileage and interest had been paid, the court remanded the case to the agency to determine whether these payments had been made and whether they were offset by the third party payments. If the agency were to find that defendants still owed benefits after the date of the arbitration decision, the commissioner must decide whether defendants had paid the last installment of weekly benefits. If benefits were still owed, then the three year SOL was still alive.
If the employer was found to have paid all benefits prior to the date of the arbitration award, then the court still had to determine when the SOL commenced. The court concluded that payment of attorney's fees was a reimbursement for attorney's fees and not weekly benefits. Because of this, the SOL was not extended by that payment.
On the issue of whether a settlement from a third party extended the SOL, the court concluded there was no specific precedent addressing this issue, but that there was precedent, in Beier Glass v. Brundige, 329 N.W.2d 280, 287 (Iowa 1983), as to the extension of the SOL when medical benefits had been paid. This precedent noted that the three year SOL commenced from the date of the arbitration decision. The court found that the same rationale applied with respect to payment of the third party award prior to an arbitration decision. Thus, the date of the arbitration decision was the commencement date for the three year statute of limitations. Claimant argued that the final date for exhaustion of appeals was the correct date, but the court rejected this argument. On remand, the agency was to determine whether the obligation to pay weekly benefits was completely satisfied by the third party recovery.
On the medical cost issue, the agency found that there was insufficient evidence that the expenses were related to the work injury. The district court found that this was supported by substantial evidence. The court found that the decision of the agency was supported by substantial evidence.
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