Johnson v. North Dakota Workers' Compensation Bureau

• Decision Date: 06 May 1992
• Docket Number: No. 910419,910419
• Parties: Russell B. JOHNSON, Appellee, v. NORTH DAKOTA WORKERS' COMPENSATION BUREAU, Appellant. Civ
• Court: North Dakota Supreme Court

Page 292

484 N.W.2d 292

Russell B. JOHNSON, Appellee, v. NORTH DAKOTA WORKERS' COMPENSATION BUREAU, Appellant.

Civ. No. 910419.

Supreme Court of North Dakota

May 6, 1992.

Thomas M. Peterson of Gunhus, Grinnell, Klinger, Swenson & Guy, Moorhead, for appellee.

Dean J. Haas, Asst. Atty. Gen., North Dakota Workers' Compensation Bureau, Bismarck, for appellant.

VANDE WALLE, Justice.

The North Dakota Workers' Compensation Bureau appealed from a district court judgment which, while affirming the Bureau's dismissal of Russell Johnson's claim for benefits, reversed the Bureau's order that Johnson reimburse the Bureau for benefits paid when a claims analyst erroneously determined that Johnson's injury was work related. We reverse in part and remand.

Johnson is a self-employed life insurance salesman who contracted with the Bureau for coverage as permitted by section 65-07-01, NDCC. In February 1989, Johnson injured his back during an early morning aerobics class. He filed a claim with the Bureau in January 1990, stating that he was "prospecting" for potential sales at the time of his injury. The Bureau's claims analyst accepted Johnson's claim and, consequently, Johnson received medical and disability benefits totaling $9,284.58. In January 1991, the Bureau dismissed Johnson's claim, concluding that the injury did not arise out of and in the course of employment activities, and ordered Johnson to repay the benefits he had received in error.

Johnson asked the Bureau to reconsider its denial of his claim and a hearing was held. The hearing officer affirmed the dismissal of Johnson's claim and the order that he repay the Bureau for the medical and disability benefits he had received. Johnson appealed to the district court which affirmed the Bureau's determination that Johnson's injury did not arise out of and in the course of employment activities. Johnson asked the district court to reconsider its decision; the court again affirmed the Bureau's determination that Johnson's injury was not work related, but concluded that the Bureau was estopped from claiming repayment of the benefits Johnson had been erroneously paid.

On appeal, the Bureau challenges only the district court's determination that it is estopped from ordering Johnson to repay the medical and disability benefits that the Bureau paid in error. The question of whether Johnson's back injury sustained during an aerobics class taken, in part, to meet potential clients was work related was decided against Johnson by the Bureau and the district court, and Johnson has not cross-appealed.

The Bureau argues that the court erred when it estopped the Bureau from ordering Johnson to repay his workers compensation benefits. In Blocker Drilling Canada, Ltd. v. Conrad, 354 N.W.2d 912, 920 (N.D.1984), we held that estoppel is available against governmental entities, although it should not be applied freely. "[Estoppel against the government] is a doctrine which must be applied on a case-by-case basis with a careful weighing of the inequities that would result if the doctrine is not applied versus the public interest at stake and the resulting harm to that interest if the doctrine is applied." Id. (emphasis in original). Johnson raised his estoppel argument for the first time in his appeal from the Bureau to the district court. He did not present any additional evidence respecting the Bureau's conduct; the only evidence reviewed by the district court was the record of the administrative proceedings. After reviewing that record, we conclude that Johnson failed to establish the basic elements of estoppel applicable even when the state is not involved; we therefore need not engage in the weighing required by Blocker.

An essential element of any estoppel claim is detrimental reliance by the person asserting estoppel. See, e.g., Farmers Cooperative Assoc. v. Cole, 239 N.W.2d 808 (N.D.1976). Johnson's attorney argued to the district court that:

"If Russell Johnson had known that his claim was not work-related and not covered by workers' compensation, he would have taken action to pay the medical benefits himself or to obtain payment from another insurer. Russell Johnson did not do so because he relied on the Bureau's award of benefits. Russell Johnson's inaction as to ... obtaining disability benefits from another insurer constituted a change of position or status to his injury, detriment and prejudice."

The record does not, however, support the factual assertions made in this argument. The only evidence presented at the administrative hearing respecting Johnson's ability to obtain benefits from other insurers is contained in this exchange between the Bureau's attorney and Johnson:

"Q Do you have any other insurance for health?

A For health?

Q Yes.

A For--

Q Blue Cross-Blue Shield?

A Yes.

Q Have they paid any of your medical bills for this incident?

A Yes, they did.

Q How much?

A I don't recall the specific amount."

The only evidence before the agency, and the district court, demonstrated that Johnson had other insurance and that he had been able to collect some medical benefits from that source for the injuries erroneously compensated by the Bureau. Johnson did not say whether other insurance covered his disability claim. He did not say whether it was still possible for him to collect from other insurance for his injuries. In other words, Johnson did not show how he was prejudiced by the Bureau's initial erroneous approval of his claim. The fact that he should repay that which he was not entitled to receive is not, in itself, sufficient to establish detrimental reliance. The district court erred when it found the Bureau estopped from ordering Johnson to repay the benefits.

Although the district court applied a different reason for reversing the Bureau's repayment order, Johnson, as he is entitled to do [e.g., Ward v. Shipp, 340 N.W.2d 14 (N.D.1983) ] defends the district court's decision by attacking the Bureau's authority to order repayment of benefits; he, therefore argues that the agency decision is not supported by the law.

In an appeal from a district court judgment reviewing a decision of an administrative agency, we review the record before the administrative agency and its decision rather than the decision of the district court. Pleinis v. North Dakota Workers Compensation Bureau, 472 N.W.2d 459 (N.D.1991). Our review of administrative agency decisions is governed by section 28-32-19, NDCC, which requires a three-step process to determine (1) if the findings of fact are supported by a preponderance of the evidence; (2) if the conclusions of law are supported by the findings of fact; and (3) if the agency decision is supported by the conclusions of law. Id.

Our duty in interpreting statutes is to fulfill the object and intent of the legislature. E.g., Aanenson v. Bastien, 438 N.W.2d 151 (N.D.1989). Several rules of construction guide our inquiry into legislative intent. Statutes must be construed as a whole to determine the intent of the legislature, deriving that intent by taking and comparing every section as a part of a whole. E.g., Ebach v. Ralston, 469 N.W.2d 801 (N.D.1991). We interpret statutes in context, e.g., Stutsman County v. State Historical Soc., 371 N.W.2d 321 (N.D.1985), and, in particular, read a statute in relation to others on the same subject in...