St. Clair v. County of Grant

• Decision Date: 02 August 1990
• Docket Number: No. 11630,11630
• Citation: 797 P.2d 993,1990 NMCA 87,110 N.M. 543
• Parties: Quaid ST. CLAIR, Plaintiff-Appellee, v. COUNTY OF GRANT and American General Insurance Company, Defendants-Appellants.
• Court: Court of Appeals of New Mexico

Page 993

797 P.2d 993

110 N.M. 543

Quaid ST. CLAIR, Plaintiff-Appellee, v. COUNTY OF GRANT and American General Insurance Company Defendants-Appellants.

No. 11630.

Court of Appeals of New Mexico.

Aug. 2, 1990.

Joseph Goldberg, William H. Carpenter, David J. Stout, Carpenter & Goldberg, P.A., Albuquerque, for plaintiff-appellee.

Alice Tomlinson Lorenz, Miller, Stratvert, Torgerson & Schlenker, P.A., Albuquerque, for defendants-appellants.

OPINION

DONNELLY, Judge.

Defendants, Grant County and American General Insurance Company, appeal from an order of the district court in a workers' compensation action directing that defendants pay medical expenses to plaintiff, Quaid St. Clair, for home nursing and attendant care furnished by plaintiff's wife. We discuss: (1) whether the district court had jurisdiction to award home nursing and attendant care expenses; and (2) if the court had jurisdiction to order payment of such expenses, whether the award was excessive. We affirm in part and reverse in part.

Plaintiff was injured on March 17, 1983, when the road grader he was operating struck a large rock. Plaintiff suffered a severe head injury. Following his injury, plaintiff's mental condition deteriorated. After a hearing on the merits, the district court on June 20, 1984, entered a judgment determining that plaintiff had suffered brain damage and that he was permanently totally disabled, and directing, among other things, that defendants pay plaintiff's medical expenses, and "provide [plaintiff's] medical care and treatment as reasonably necessary ... including reasonable travel expenses...."

Following plaintiff's accident, his wife assisted in caring for him at home. On August 24, 1984, plaintiff filed a motion to reopen his workers' compensation action, asking the court to direct that defendants pay his accrued medical expenses. The motion did not, however, request reimbursement for home care or attendant care furnished by plaintiff's wife. At the hearing on the motion, plaintiff presented evidence that he remained totally disabled and that he was in need of some form of care and supervision twenty-four hours a day. At the completion of the hearing, the district court directed that defendants pay workers' compensation benefits and compensate "the various health care providers who have treated him for his injuries." The court further ordered that defendants "shall continue to provide reasonable medical care and treatment for his future medical condition resulting from such injury ... for 600 weeks, or until further Orders of the Court," and provide plaintiff with professional care whenever his wife was required to be absent from the home.

Defendants continued to pay plaintiff's medical expenses until early 1986 when they stopped paying medical benefits and requested that he submit to further medical evaluation. On March 5, 1986, defendants filed a motion seeking to compel plaintiff to submit to a physical examination, or alternatively requesting that the court diminish or terminate the payment of benefits.

On July 7, 1986, plaintiff's counsel moved to modify prior court orders relating to plaintiff's care and treatment seeking, inter alia, that the court "determine the future course of medical treatment needed by [him], and establish rules ... that [defendants] must abide by [in order] to provide prompt and necessary treatment of plaintiff's injuries." After a hearing, the district court entered an order on January 23, 1989, directing that plaintiff be compensated for his wife's medical and attendant services from the date of the accident on March 17, 1983 at a rate of $16.00 per hour for LPN-level care provided to her husband for eight hours per day, and $4.00 per hour for attendant-caretaker services for sixteen hours per day. The court entered judgment for plaintiff in the amount of $350,400.00 for home medical services provided to plaintiff by his wife from the date of the accident to March 17, 1988, and ordered that plaintiff receive monthly compensation for medical expenses reasonably necessary for the care and treatment of plaintiff. Additionally, the court directed that defendants pay for future necessary services rendered by plaintiff's wife from March 17, 1988 "into the future at a rate of $16.00 per hour for eight (8) hours and $4.00 per hour for sixteen (16) hours for LPN-type care and attendant care respectively."

I. JURISDICTION

Defendants challenge the jurisdiction of the trial court to issue its January 23, 1989 order modifying the trial court's prior orders relating to the payment of plaintiff's home care expenses. Defendants contend that because plaintiff did not experience any significant change in his condition and because his medical expenses had been originally adjudicated at the 1984 trial, the court lacked jurisdiction to reopen the case and grant plaintiff's motion for an award of additional home medical care expenses rendered by plaintiff's wife dating back to the time of his accident.

Plaintiff maintains that the order was proper and that NMSA 1978, Section 52-1-56 (Orig.Pamp.) invests the court with continuing jurisdiction over the worker's disability claim until the complete statutory period for payment of benefits has expired. See Churchill v. City of Albuquerque, 66 N.M. 325, 347 P.2d 752 (1959) (judgment not final until full statutory period has elapsed).

Plaintiff's injury and disability arose in 1983, predating subsequent amendments to the Workers' Compensation Act. Thus, the jurisdictional issue raised by respondents is governed, in part, by Section 52-1-56 as it existed at the time plaintiff's cause of action originally accrued. See Noffsker v. K. Barnett & Sons, 72 N.M. 471, 384 P.2d 1022 (1963). After plaintiff's disability, the legislature by 1986 N.M.Laws, chapter 22, section 35, enacted NMSA 1978, Section 52-5-9 (Repl.Pamp.1987), authorizing a workers' compensation hearing officer to modify a prior compensation order "at any time within two years after the date of the last payment or the denial of benefits upon certain grounds, including 'mistake, inadvertance, surprise or excusable neglect.' " This statute, enacted during the pendency of the present case, does not apply to plaintiff's motion to modify filed in the instant action. See USLife Title Ins. Co. v. Romero, 98 N.M. 699, 652 P.2d 249 (Ct.App.1982).

Although acknowledging that Section 52-1-56 grants the court continuing jurisdiction to increase a workers' compensation award where his disability has been shown to have increased, defendants nevertheless argue that under Holliday v. Talk of the Town Inc., 98 N.M. 354, 648 P.2d 812 (Ct.App.1982), and DiMatteo v. County of Dona Ana, 109 N.M. 374, 785 P.2d 285 (Ct.App.1989) (DiMatteo II ), the trial court lacked jurisdiction to enter its January 23, 1989 order because there was no evidence of any increase or aggravation of plaintiff's original disability. Defendants also assert that since plaintiff's medical expenses were litigated in the original action, Section 52-1-56 does not authorize a retroactive additional award to plaintiff for his wife's services rendered from date of his initial injury, where such evidence was not previously presented and the court's order was entered more than four years after entry of the initial judgment on June 20, 1984.

Section 52-1-56(A), as it existed at the time of plaintiff's disability, provided in part that:

The district court ... shall order diminution or termination of payments of compensation as the facts may warrant ... and if it shall appear upon such hearing that the disability of the workman has become more aggravated or has increased without the fault of the workman, the court shall order an increase in the amount of compensation allowable as the facts may warrant.

It is black-letter law that upon application of a party alleging the existence of facts warranting court action to increase or decrease a worker's adjudicated percentage of disability, the district court has continuing jurisdiction to reopen a workers' compensation award under Section 52-1-56. Jaramillo v. Consolidated Freightways, 109 N.M. 712, 790 P.2d 509 (Ct.App.1990); Glover v. Sherman Power Tongs, 94 N.M. 587, 613 P.2d 729 (Ct.App.1980); Martinez v. Earth Resources Co., 90 N.M. 590, 566 P.2d 838 (Ct.App.1977). See also Holliday v. Talk of the Town Inc.; Rumpf v. Rainbo Baking Co., 96 N.M. 1, 626 P.2d 1303 (Ct.App.1981). Compare Armijo v. Save 'N Gain, 108 N.M. 281, 771 P.2d 989 (Ct.App.1989) (discussing right to reopen workers' compensation proceedings in cases tried by the workers' compensation division). See generally 3 A. Larson, The Law of Workmen's Compensation Sec. 81.00 (1989).

The Workers' Compensation Act does not limit the court's continuing jurisdiction to enforce prior workers' compensation awards only to instances where the worker or employer has moved to increase or diminish disability benefits. Both NMSA 1978, Sections 52-1-38 and -56 (Orig.Pamp.) invest the court with continuing jurisdiction in workers' compensation actions.

NMSA 1978, Section 52-1-49(A) (Orig.Pamp.), as it existed at the time of plaintiff's disability, also provided:

A. After injury, and continuing as long as medical or surgical attention is reasonably necessary, the employer shall furnish all reasonable surgical, physical rehabilitation services, medical, osteopathic, chiropractic, dental, optometry and hospital services and medicine unless the workman refuses to allow them to be so furnished. [Emphasis added.]

The obligation to furnish reasonably necessary medical services also includes a duty to pay necessary future reasonable medical and nursing maintenance expenses arising out of the work-related disability. Shadbolt v. Schneider, Inc., 103 N.M. 544, 710 P.2d 738 (Ct.App.1985); Gearhart v. Eidson Metal Prods., 92 N.M. 763, 595 P.2d 401 (Ct.App.1979). Since the trial court cannot practically determine the worker's future medical needs at the...