Williams v. Eastern Coal Corp.

• Decision Date: 02 October 1997
• Docket Number: Nos. 96-SC-287-W,96-SC-332-WC,s. 96-SC-287-W
• Parties: Jess P. WILLIAMS, Appellant, v. EASTERN COAL CORPORATION; Vicki G. Newberg, Acting Director of Special Fund; Honorable Donna H. Terry, Administrative Law Judge; and Workers' Compensation Board, Appellees. EASTERN COAL CORPORATION, Appellant, v. Jess P. WILLIAMS, William O. Windchy, Acting Director of Special Fund; Donna H. Terry, Administrative Law Judge; and Workers' Compensation Board, Appellants.
• Court: United States State Supreme Court — District of Kentucky

Page 696

952 S.W.2d 696

Jess P. WILLIAMS, Appellant, v. EASTERN COAL CORPORATION; Vicki G. Newberg, Acting Director

of Special Fund; Honorable Donna H. Terry,

Administrative Law Judge; and Workers'

Compensation Board, Appellees.

EASTERN COAL CORPORATION, Appellant, v. Jess P. WILLIAMS, William O. Windchy, Acting Director of

Special Fund; Donna H. Terry, Administrative Law

Judge; and Workers' Compensation Board,

Appellants.

Nos. 96-SC-287-WC, 96-SC-332-WC.

Supreme Court of Kentucky.

Oct. 2, 1997.

William J. Baird, III, Baird, Baird, Baird & Jones, Pikeville, Terri Smith Walters, Pikeville, for Eastern Coal Corporation.

Mark C. Webster, Labor Cabinet, Division of Special Fund, Louisville, for Special Fund.

Robert J. Greene, Kelsey E. Friend Law Firm, Pikeville, for Jess P. Williams.

GRAVES, Justice.

I. PROCEDURAL HISTORY

This matter concerns the allowance of offsets when a worker receives both workers' compensation benefits and disability or retirement benefits paid pursuant to an employer-funded plan.

Appellant, Jess P. Williams (hereinafter "Williams"), and Appellee, Eastern Coal Corporation (hereinafter "Eastern"), had elected coverage under the Kentucky Workers' Compensation Act when Williams received a disabling work-related injury on August 24, 1991. The Administrative Law Judge (ALJ) determined that Williams was totally, occupationally disabled, apportioning a 45% disability to the employer, a 45% disability to the Special Fund, and a 10% disability to a noncompensable, pre-existing anxiety and panic disorder. The ALJ also determined that he was paid temporary total disability benefits from August 25, 1991, through December 30, 1991. Furthermore, Williams received salary continuation benefits during the three months following the injury. Pursuant to the terms of the plan, full salary continuation benefits were subject to an offset for workers' compensation benefits received. That offset was taken and is no longer in dispute.

On September 1, 1992, Williams was found totally disabled under the social security laws and began receiving social security disability benefits. As a consequence of qualifying for social security benefits, Williams also qualified for a disability retirement benefit under a separate, employer-funded plan for those workers with ten years' seniority who become totally disabled before the normal retirement age of 65. Under the disability retirement plan, normal retirement is age 65. However, disability retirement benefits are available to younger workers who have met a ten year vesting requirement and are eligible for social security disability. The plan essentially allows Williams to receive pension payments to which he would not otherwise be entitled until reaching the normal retirement age of 65. However, the plan stipulates that Williams is only entitled to receive such benefits so long as he remains disabled and qualifies for benefits under the social security laws. Although the plan provides for a reduction in benefits if the combination of social security and plan disability benefits exceeds the worker's pre-disability wage, the terms of the disability retirement plan do not provide for an offset of plan benefits if the worker also receives workers' compensation benefits.

Eastern seeks credit for payments paid pursuant to the employer-funded disability retirement plan against its workers' compensation liability since both the disability and workers' compensation benefits arose from the same injury. The specific issues on appeal include: 1) whether Eastern is entitled to credit against its past due workers' compensation liability for payments already made pursuant to its disability pension plan; 2) whether Eastern is entitled to prospective credit against its workers' compensation liability for post-award payments under the disability pension plan; and 3) whether ERISA precludes credit to Eastern since Williams was vested in the disability retirement plan.

The Administrative Law Judge, Workers' Compensation Board, and Court of Appeals have all agreed that, although a credit against past due workers' compensation liability was appropriate, Eastern had failed to demonstrate that a credit for future disability benefits was authorized. Since disability benefits could cease or be reduced in the future under circumstances which would not affect the payment of workers' compensation benefits, Eastern's assertion that plan benefits would duplicate workers' compensation was characterized as "speculative" by the Board and the Court of Appeals. The Court of Appeals did not address Eastern's argument that the award could be reopened and amended if plan benefits were reduced or terminated. Williams's argument that the disability benefits were vested retirement benefits (rather than disability benefits paid in lieu of workers' compensation) and that their offset was barred by ERISA was rejected, based on the authority of Saylor v. Parker Seal Co., 975 F.2d 252 (6th Cir.1992) which held that ERISA did not preempt Kentucky common law allowing an offset of workers' compensation payments against employee benefit plans. Id. at 255.

After hearing oral argument and reviewing the record, we conclude that Eastern is not allowed credit against its past due workers' compensation liability for payments already made pursuant to its disability pension plan. Furthermore, Eastern is not entitled to a prospective credit. In view of the foregoing, it is unnecessary to address whether ERISA precludes a retroactive credit.

II. DEFINITIONS

Workers' compensation is but one part of an overall system of wage-loss protection, the purpose of which is to be certain that income is available to provide the necessities of life for those affected by physical disability, economic unemployment, or old age. Unemployment compensation, Social Security, state pension and disability systems, as well as private pension and insurance plans are also part of the wage-loss system. Since all of these statutory programs and private plans are based upon a common principle of wage-loss protection, planning for the coordination or integration of benefits is essential in order to avoid an unnecessary and costly duplication of benefits. According to Professor Larson, avoiding a duplication of benefits is also sound public policy so that it does not become more profitable for an individual to become a beneficiary of various wage-loss programs than to be employed. Larson, The Law of Workmens' Compensation, § 97.51.

However in Kentucky, there is neither a legal basis nor a policy reason for allowing credit against any portion of this award. Workers' compensation is a creature of statute, and the remedies and procedures described therein are exclusive. Morrison v. Carbide and Carbon Chemicals Corp., 278 Ky. 746, 129 S.W.2d 547, 549 (1939). When an employer and employee submit themselves to the provisions of the act, their rights and liabilities are henceforth to be measured by the terms of the act. Id. at 550. A right created by statute cannot be defeated by the application of a common law principle. Eversole v. Eversole, 169 Ky. 793, 185 S.W. 487, 488 (1916). Thus, any analysis of a workers' compensation issue is necessarily an exercise in statutory interpretation.

Workers' compensation law in Kentucky consists of a statutory system which seeks to compensate an injured worker or the worker's dependents for economic loss sustained as a result of the worker's injury or death within the course and scope of employment. The economic loss which the system seeks to compensate consists of lost earnings or earning capacity, medical expenses, and rehabilitation expenses. Lost earnings (in the case of temporary total disability) and lost earning capacity (in the case of permanent disability) are only partially compensated in the form of "income benefits" which are calculated as a percentage of the worker's average weekly wage. Occupational disability is defined as:

[A] decrease of wage earning capacity due to injury or loss of ability to compete to obtain the kind of work the employee is customarily able to do, in the area where he lives, taking into consideration his age, occupation, education, effect upon employee's general health of continuing in the kind of work he is customarily able to do, and impairment or disfigurement.

(KRS 342.0011(11); Osborne v. Johnson, Ky., 432 S.W.2d 800 (1968). Workers' compensation benefits are payable only for that portion of the worker's occupational disability which results from the work-related injury. Prior, active and nonwork-related disabilities are not compensable.

Our workers' compensation act mandates an award of income benefits to a worker who suffers death or occupational disability as a result of a work-related accident or occupational disease. KRS 342.730; KRS 342.750. At the time of Williams's injury, there was no provision in the act permitting a reduction of that award simply because he was also eligible for benefits from a collateral source. ¹ There was formerly a provision in the act which allowed a credit against the award for payments made or supplies furnished by the employer in excess of those required by the act, i.e., as a result of the employer's largess. KRS 342.145. That provision was repealed effective January 1, 1973. Ky. Acts 1972, ch. 78, § 36.

Congress has defined the term "disability" for the regular social security disability program as an inability "to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than twelve months." 42 U.S.C. §§ 423(d)(1)(A) and 1382c(a)(3)(A). An individual:

shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his...