Brooks v. Standard Fire Ins. Co., 17666

• Decision Date: 07 June 1990
• Docket Number: No. 17666,17666
• Citation: 117 Idaho 1066,793 P.2d 1238
• Court: Idaho Supreme Court
• Parties: David L. BROOKS, Employee, and Associated Foods, Employer, and American Insurance Company, and Fireman's Fund, Surety, Claimants-Respondents, v. STANDARD FIRE INSURANCE COMPANY, and Aetna Casualty & Surety, Surety, Defendants-Appellants.

Page 1238

793 P.2d 1238

117 Idaho 1066

David L. BROOKS, Employee,

and

Associated Foods, Employer, and American Insurance Company, and Fireman's Fund, Surety, Claimants-Respondents, v. STANDARD FIRE INSURANCE COMPANY, and Aetna Casualty & Surety, Surety, Defendants-Appellants.

No. 17666.

Supreme Court of Idaho.

June 7, 1990.

Imhoff & Lynch, Boise, for defendants-appellants. Alan R. Gardner, argued.

Quane, Smith, Howard & Hull, Boise, for claimants-respondents. Alan K. Hull, argued.

BOYLE, Justice.

In this worker's compensation case we are called upon to determine whether the Industrial Commission has authority and jurisdiction to hear and order reimbursement between carriers for compensation benefits paid to a claimant.

American Insurance Company and Fireman's Fund (hereafter Fireman's Fund) provided worker's compensation insurance coverage to Associated Foods prior to June 1, 1984. After June 1, 1984, worker's compensation insurance coverage was provided to Associated Foods by defendants Standard Fire Insurance Company and Aetna Casualty & Surety (hereafter Aetna). David Brooks, an employee of Associated Foods, suffered his initial employment injury in November, 1983, while Fireman's was providing coverage. While Aetna was providing coverage, Brooks suffered a reoccurrence of the same injury. Fireman's Fund paid Brooks' worker's compensation benefits for his injuries and made a claim against Aetna for reimbursement of benefits paid as a consequence of the injury Brooks suffered during the period of Aetna's coverage. Fireman's Fund requested a hearing before the Industrial Commission to determine whether it was entitled to reimbursement for worker's compensation benefits paid to Brooks after November of 1984. In its Findings of Fact, Conclusions of Law and Order, the Commission ordered Aetna to pay Fireman's Fund the sum of $26,083.07.

David Brooks worked for Associated Foods as a truck driver. In the summer of 1983, Brooks injured his right wrist in a non-employment related motorcycle accident for which he did not seek medical attention. On November 11, 1983, Brooks slipped at work and injured his right wrist. Several days later Brooks went to the Minor Emergency Center where his wrist was x-rayed and he was referred to Stanley Moss, M.D. Brooks reported the injury to his supervisor on November 18, 1983, and continued working. On November 15, 1983, Dr. Moss examined Brooks and diagnosed the injury as a fractured right wrist. In a written report, Dr. Moss stated that he would have to presume that the motorcycle accident caused the fracture initially, however the fall in November of 1983 caused further displacement and symptoms from the preexisting non-union fracture. When Dr. Moss once again x-rayed the wrist on December 8, 1983, there was an indication that the wrist was healing.

On February 23, 1984, Dr. Moss removed the cast and x-rayed Brooks' wrist. The fracture appeared at that time to be healing and the cast was not replaced. Dr. Moss examined Brooks on March 22, 1984 and advised him to return in six months. Brooks continued working as a truck driver and testified that several times during the course of loading and unloading trucks, he experienced severe sharp pain in his right wrist. Brooks testified that the pain in his wrist was much worse and more constant in the late summer of 1984.

On November 27, 1984, Brooks returned to Dr. Moss for the six-month checkup. X-rays taken at that time revealed that Brooks had refractured his right wrist since the prior x-rays had been taken in March, 1984. Dr. Moss testified before the Industrial Commission that the new fracture was a culmination of minor injuries.

Brooks reported the results of this doctor visit to his employer and continued working. On January 11, 1985, Dr. Moss performed surgery on Brooks' wrist and stabilized the bone by using a graft. Brooks was required to wear a cast until May 24, 1985, at which time the cast was removed and a splint placed on the wrist.

On March 16, 1986, Dr. Moss released Brooks to return to work at Associated Foods. Dr. Moss testified that from January 11, 1985, until March 16, 1986, Brooks was totally disabled due to the wrist fracture. Dr. Moss testified that the 1983 motorcycle accident, the November, 1983 fracture, and the 1984 fracture were equally one-third responsible for the eventual bone graft surgery and the resultant twenty percent permanent impairment.

At the hearing before the Industrial Commission, an adjustor with Fireman's Fund testified that Fireman's Fund paid all medical bills incurred by Brooks for injury to his right wrist from November, 1983 through the time of the hearing. Fireman's adjuster also testified that she sent a letter dated January 14, 1984, and copies of Dr. Moss's medical reports to Aetna advising that Brooks' injury had occurred after Aetna became the surety for Associated Foods. Fireman's adjuster testified that on January 25, 1985, she advised the Industrial Commission by letter that she was paying benefits to Brooks on behalf of the employer, but was reserving the right to request a hearing before the Industrial Commission to determine the responsible surety. The adjuster for Aetna testified that she received the January letter from Fireman's Fund, that shortly thereafter she investigated the claim and that Aetna denied the claim.

On January 30, 1987, Fireman's Fund filed an Application for Hearing requesting the Industrial Commission to determine the responsibility of the sureties. Aetna filed a motion to dismiss on May 26, 1987, on grounds that no Notice and Claim for Benefits was filed within the time specified by I.C. § 72-701. On January 26, 1987, Aetna filed another Motion to Dismiss for lack of standing and lack of subject matter jurisdiction. The Commission denied both motions and found in favor of Fireman's Fund.

The Commission determined 1) that it had subject matter jurisdiction over a claim between sureties involving a claim for contribution or reimbursement; 2) that the payment of worker's compensation benefits by Fireman's Fund tolled the statute of limitations as to a claim for reimbursement from Aetna; and 3) that Aetna was responsible for all medical expenses incurred and temporary total disability benefits paid after the discovery of claimant's refracture in November of 1984.

On appeal, Aetna urges this Court to rule 1) that the Industrial Commission does not have subject matter jurisdiction over a claim for reimbursement between sureties 2) that the Industrial Commission erred in finding that Brooks suffered an "accident" as defined by I.C. § 72-102(14)(b) and in holding Aetna responsible for all costs and medical treatment provided as a result of the 1984 refracture; 3) that the Commission erred in finding that Fireman's Fund has an equitable right of contribution against Aetna; and 4) that the Commission erred in ruling that Fireman's Fund's claim was not barred by the statute of limitations.

I. Jurisdiction

Aetna argues that the Industrial Commission does not have subject matter jurisdiction over a claim for reimbursement or contribution brought by a surety against another surety.

In Anderson v. Gailey, 97 Idaho 813, 555 P.2d 144 (1976), this Court considered the issue of jurisdiction between the courts and the Industrial Commission.

Although the Industrial Commission and the district court have mutually exclusive jurisdiction for the award of benefits to an injured claimant or damages to an injured plaintiff, they have concurrent jurisdiction to determine whether they have jurisdiction to consider the claim or hear the case.

97 Idaho at 824, 555 P.2d at 155. Idaho Code § 72-201 provides that all actions and claims which involve issues relating to a worker's injury are within the exclusive jurisdiction of the Industrial Commission. In addition, the legislature has specifically granted jurisdiction over all disputes and questions arising under the worker's compensation laws to the Industrial Commission in order to provide "sure and certain relief" for injured workers. Idaho Code § 72-707 states:

All questions arising under this law, if not settled by agreement or stipulation of the interested parties with the approval of the Commission, except as otherwise herein provided, shall be determined by the Commission. (Emphasis added.)

In Anderson v. Gailey, this Court also adopted the rule that the decision of the tribunal in which the question of jurisdiction is first filed shall prevail and as to that issue the ruling is res judicata. The question of which of the two sureties is responsible for claimant's injury is a "question arising under this law" as provided in I.C. § 72-707, and is a proper case to be determined by the Industrial Commission. Unless error is shown on appeal, the Industrial Commission's ruling is res judicata as to the issue of jurisdiction. We hold that the Industrial Commission had jurisdiction to hear and rule on the claim for reimbursement and contribution between sureties.

II. Findings of Commission Supported by Record

Aetna contends that the Commission erred in finding that Brooks suffered an "accident" as defined by I.C. § 72-102 during the summer of 1984 and consequently Aetna argues it cannot be held responsible for the injury. Aetna argues that where a preexisting compensable condition is exacerbated or aggravated by some subsequent minor event or incident, it will ordinarily be held that the subsequent reinjury is a direct, probable and compensable consequence of the original condition. See Larson, Law of Workmen's Compensation, § 13.11(a) (1986).

Idaho Code § 72-102(14)(b) states:

Accident means an unexpected, undesigned, and unlooked for mishap, or untoward event, connected with the industry in which it occurs and which can be reasonably located as to time when and place where it occurred, causing an injury.

This Court has held that under the foregoing definition of an accident, a claimant does not...