Evans & Associates Util. Serv. v. Espinosa

• Decision Date: 07 October 2011
• Docket Number: No. 108,017.,108,017.
• Citation: 2011 OK 81,264 P.3d 1190
• Court: Oklahoma Supreme Court
• Parties: EVANS & ASSOCIATES UTILITY SERVICES, and Zurich American Insurance Company, Petitioners,v.Ruben ESPINOSA and The Workers' Compensation Court, Respondents.

264 P.3d 1190

2011 OK 81

EVANS & ASSOCIATES UTILITY SERVICES, and Zurich American Insurance Company, Petitioners,

v.Ruben ESPINOSA and The Workers' Compensation Court, Respondents.

No. 108,017.

Supreme Court of Oklahoma.

Oct. 4, 2011.As Corrected Oct. 7, 2011.

Certiorari to the Court of Civil Appeals Division III; Honorable Cherri Farrar, Workers' Compensation Judge.¶ 0 The petitioner, Ruben Espinosa, sought permanent partial disability benefits for injuries to his hands, arms, and shoulders. The Workers' Compensation Court awarded benefits, but a three-judge en banc panel reduced the award to account for Espinosa's previously awarded benefits for injuries to other parts of his body. The Court of Civil Appeals vacated the panel, determining that both the trial court and the panel misapplied the applicable statute, 85 O.S.2001 § 22(7). We granted certiorari to resolve a conflict between two Court of Civil Appeals' opinions with differing interpretations of the limitations provided in § 22(7). We hold that when the Workers' Compensation Court awards compensation for an accidental personal injury or occupational disease, pursuant to 85 O.S.2001 § 22(7), the sum of all permanent partial disability awards is limited to a total of 100% or 520 weeks (10 years) for any individual, but awards against the Multiple Injury Trust Funds, or awards for amputations and surgeries are excluded from both of these limitations.CERTIORARI PREVIOUSLY GRANTED; COURT OF CIVIL APPEALS OPINION VACATED; EN BANC PANEL OVERRULED; TRIAL COURT OVERRULED; CAUSE REMANDED WITH INSTRUCTIONS.Timothy E. Lurtz, Oklahoma City, Oklahoma, for Petitioners.John C. Forbes, Midwest City, Oklahoma, for Respondent Espinosa.KAUGER, J.:

¶ 1 We granted certiorari to resolve a conflict between the Court of Civil Appeals differing interpretations ¹ of the Workers' Compensation statute 85 O.S.2001 § 22(7).² This statute provides the schedule of compensation for permanent and temporary disability and subsection (7) limits the sum of all cumulative awards for an individual employee's lifetime. It provides in pertinent part:

... the sum of all permanent partial disability awards, excluding awards against the Multiple Injury Trust Fund and awards for amputations, and surgeries, shall not exceed one hundred percent (100%) permanent partial disability for any individual. An individual may not receive more than five hundred twenty (520) weeks' compensation for permanent partial disability, but may receive other benefits under the Workers' Compensation Act if otherwise eligible as provided in the Workers' Compensation Act.

¶ 2 One division of the Court of Civil Appeals had interpreted the exclusion of awards against the Multiple Injury Trust Fund and awards for amputations, and surgeries, to apply to both the 100% limitation and the 520 week limitation. In this cause, the appellate court determined that the exclusion applies to the 100% limitation, but not the 520 week limitation. We hold that when the Workers' Compensation Court awards compensation for an accidental personal injury or occupational disease, pursuant to 85 O.S.2001 § 22(7), ³ the sum of all permanent partial disability awards is limited to a total of 100% or 520 weeks for any individual, but awards against the Multiple Injury Trust Funds, or awards for amputations and surgeries are excluded from both limitations.

FACTS

¶ 3 The petitioner, Evans & Associates Utility Services (employer) employed the respondent, Ruben Espinosa (Espinosa/employee) as a manual laborer. During the course of his employment, Espinosa suffered several injuries which resulted in multiple Workers' Compensation awards. The first award was in 2006, in which the employee was awarded permanent partial disability benefits for 27% binaural hearing loss totaling 89.1 weeks of benefits.⁴ The second award was in July of 2009, in which the employee's lungs were determined to be 6% impaired for which he received 30 weeks of compensation.⁵

¶ 4 The third award, on August 11, 2009, was for injuries Espinosa sustained to his right leg, knee, neck or cervical spine, back, and lumbar spine. He was determined to be 20% impaired to the right leg and knee, 10% to the neck and 40% to the back for a total of 305 weeks of benefits. Apparently the back and knee injuries required surgery.⁶ The present cause relates to an alleged cumulative trauma injury to Espinosa's shoulders, arms and hands.

¶ 5 On January 11, 2005, the employee filed his Form 3 with the Workers' Compensation Court alleging cumulative trauma injury to both hands and arms with January 5, 2005, as the last date of exposure. On June 22, 2005, he added injury to both shoulders. On April 13, 2005, The employer denied that Espinosa sustained any injury in the course and scope of employment.

¶ 6 After several interim orders relating to medical treatment, medical case management, and temporary disability, a hearing was held August 31, 2009. ⁷ At the hearing, the court was notified of the previous 2006 and two 2009 Workers' Compensation awards for permanent partial disability. The court entered its order on September 8, 2009, awarding permanent partial disability benefits related to the hands, arms and shoulders injuries.

¶ 7 The September 8, 2009, order provides that: 1) the employee became aware of his injuries in November of 2003; 2) the last date of exposure to injury was January 7, 2005; and 3) the employee was entitled to $264.00 per week for permanent partial disability. The court also determined Espinosa to be permanently impaired 20% to the left hand, 20% to the right hand, 24% to the left arm, 20% to the right arm, 20% to the left shoulder and 20% to the right shoulder. The court found that the employee was entitled to be paid for 409 weeks of permanent partial disability. The employer noted the fact that the employee had previously been awarded 89.1 weeks in 2006, and 30 and 305.0 weeks in 2009 for a total of 424.1 weeks and requested that the award be limited to 95.9 weeks pursuant to 85 O.S.2001 § 22(7).⁸ An award of 95.9 would have met the maximum total award of 520 allowed by § 22(7). [The 520 statutory limit minus the 424.1 previously awarded equals 95.9]. The court denied this request and also directed the employer to pay medical expenses.

¶ 8 The employer appealed the order to a three-judge panel, contending that the award exceeded the cumulative 520 week limit on permanent partial disability because the employee had previously been awarded permanent partial disability for past injuries. On January 27, 2010, the panel vacated a portion of the trial court's findings and substituted its own findings. It found that Espinosa was entitled to 409 weeks of compensation for his injuries, just as the trial court had found. It also determined, like the trial court, that prior to this cause, the employee had been awarded 424.1 weeks of compensation for previous injuries.

¶ 9 Nevertheless, the panel found that because 200 weeks of compensation was attributable to back surgery and 20 weeks were attributable to the right knee, 220 weeks should be subtracted from the 424.1 weeks previously awarded. We note that if 220 weeks were subtracted from 424.1 previously awarded, the total number would be 204.1, however the inexplicable number the panel came up with was 169.1. It made this determination even though the record is unclear as to what portion of the employee's prior awards were actually attributable to surgeries.

¶ 10 Ultimately, the panel determined that the employee was entitled to 350.9 weeks of compensation. [The statutory limit of 520 minus 169.1, but the correct number should have been 520 minus 204.1 for a total of 315.9 weeks of benefits.] The employer appealed.

¶ 11 The Court of Civil Appeals: 1) noted the lack of evidence regarding previous surgeries and the erroneous calculations of the panel; 2) vacated the panel's decision and held that an employee may receive either a total permanent partial disability award of 100%, after excluding Multiple Injury Trust Fund awards and awards for surgeries and amputations or 520 weeks of permanent partial disability without such exclusions; and 3) recognized that its decision was contrary another division's opinion in United General Contractors v. Campbell, 2010 OK CIV APP 10, 231 P.3d 703. We granted certiorari on March 28, 2011, to resolve the two conflicting statutory constructions.

¶ 12 PURSUANT TO 85 O.S.2001 § 22(7), AWARDS AGAINST THE MULTIPLE INJURY TRUST FUNDS, OR AWARDS FOR AMPUTATIONS AND SURGERIES ARE EXCLUDED FROM BOTH THE 100% AND 520 WEEK LIMITATIONS.

¶ 13 The employer argues that the clear language of 85 O.S.2001 § 22(7) ⁹ indicates that there are two distinct and separate caps on aggregate permanent partial disability awards—one lower cap of 100% which allows the exclusion of surgeries and one higher as a cap on lifetime awards to 520 weeks without any exclusions. The employee contends that the surgery exclusion must be read in conjunction with both limitations.

¶ 14 The Workers Compensation Act was designed to provide compensation to covered workers for loss of earning capacity, incurred as a result of work-related accidents.¹⁰ It is a mutual compromise in which the employee relinquishes his/her right to sue for damages sustained in job-related injuries; and the employer accepts no-fault liability for a statutorily prescribed measure of damages.¹¹ However, in exchange for the employer's greater and more certain exposure, the Act also provides the employer with certain advantages. It offered the employer a maximum loss and protected employers from excessive judgments.¹² The object of the Act is to compensate, within the limits of the act, for loss of earning power and disability to work occasioned by injuries to the body in the performance of ordinary labor.¹³

¶ 15 In Rivas v. Parkland Manor, 2000 OK 68, 12 P.3d 452, the Court addressed one of the limitations provided to employers within the Act. Rivas...