Willoughby v. Arthur G. McKee & Co.

No. 79-10 I N THE SUPREME COURT OF THE STATE OF M N A A O T N - 1980 CLARENCE WILLOUGHBY, C l a i m a n t and R e s p o n d e n t , VS . ARTHUR G. McKEE & C O . , Employer, and GENERAL ACCIDENT FIRE & LIFE, D e f e n d a n t and A p p e l l a n t . Appeal from: Workers' Compensation C o u r t C o u n s e l o f Record: For Appellant: H e n n i n g s e n , P u r c e l l & G e n z b e r g e r , B u t t e , Montana For Respondent: B u r g e s s , J o y c e a n d Whelan, B u t t e , Montana S u b m i t t e d o n b r i e f s : F e b r u a r y 2 7 , 1980 Decided: APR 1 - 7 F i l e d : li-" !. , 1 . ' ,. Mr. Justice John Conway Harrison delivered the Opinion of the Court. This is an appeal from an order of the Workers' Compen- sation Court granting claimant, Clarence Willoughby, a partial lump sum settlement of benefits due. Claimant is a fifty-eight year old man whose work history consists of holding jobs in heavy labor. He has been employed as a miner, concrete finisher, and bricklayer. In November 1974 claimant was employed as a bricklayer for the Arthur G. McKee Company. During that month he suffered an industrial accident injury while performing construction work for his employer at the Anaconda smelter in Anaconda, Montana. He fell off a scaffold which was located approxi- mately six feet above a concrete floor and sustained injuries to his neck, left arm and left thumb. He has not worked since the accident. Claimant underwent a spinal fusion and surgery to his left elbow and thumb. At the time of the injury, claimant was earning approxi- mately $9.50 per hour or $380 weekly. He had no education or work experience in any other type of employment, and his formal education consisted of completing grades one through eight. A petition for compensation was filed with the Workers' Compensation Court to determine what benefits, if any, to which claimant was entitled. A hearings examiner, Robert B. Sherman, was appointed by the court, and a hearing was held with respect to the petition on April 19, 1978. After the hearing, the examiner entered findings of fact and conclu- sions of law. The examiner found that claimant was entitled to compensation, as a totally and permanently disabled person under the Workers' Compensation Act, and that claimant was entitled to compensation for all medical expenses in- curred with respect to injuries which were causally related to the accident in November. On September 21, 1978, the Workers' Compensation Court adopted the examiner's findings of fact and conclusions of law. During the settlement of the workers' compensation claim and following the Workers' Compensation Court's order, McKee Company's insurance carrier, General Accident Fire and Life, made payments to claimant. Claimant also received benefits under the Social Security Disability Act. Pursuant to section 39-71-702, MCA, the carrier reduced claimant's workers' compensation benefits by one-half of the benefits received under the Social Security Act. On August 8, 1978, it was discovered that General Accident had overpaid claimant by approximately $8,180.38. The Workers' Compensation Court ordered claimant to make repayment of that amount at a weekly rate of $25. Including his liability for repayment, claimant presently receives individual weekly benefits of $96.29 from Social Security and $23.26 from Workers' Compensation, or $518.85 in total individual monthly benefits. This compares to his monthly salary of approximately $1,650 while he was working as a bricklayer. Claimant also receives two auxiliary benefits for his minor children, who live in Seattle with claimant's first wife. Claimant was divorced and has since remarried. On May 13, 1979, claimant petitioned the Workers' Compensation Court for a partial lump sum settlement. Attached to the petition was a list of expenses to which the settlement, if granted, was to be applied. The expenses were the following: House Trailer Refrigerator and TV Lot Rental Phone Power Water Hospital Bernie's Pharmacy Dr. Rotar Durritts Bill Willoughby--personal loan--brother Walnut St. Grocery Taxes on House Trailer Trailer Insurance A-1 Ambulance Car--monthly payments New Roof on Trailer Monthly Reserve TOTAL A hearing was held on August 30, 1979, with respect to the petition. The only evidence presented at the hearing was claimant's testimony. On September 10, 1979, the Workers' Compensation Court ordered that the petition be granted in the amount requested. From this order, appellant in this action, General Accident Fire and Life, appeals. A single issue is presented for review: Did the Workers' Compensation Court abuse its discretion in granting claimant's petition for a partial lump sum settlement? Statutory authority for the conversion of regular periodic benefits payable under the Workers' Compensation Act to a total or partial lump sum settlement is found in section 39-71-741, MCA. In 1979, section 39-71-741, MCA, was amended to give the Workers' Compensation Court the authority to settle disputes concerning lump sum settlements where an insurer and a claimant disagreed. Prior to 1979 the sole discretion for determining the amount and advisa- bility of lump sum settlements was vested in either the Workers' Compensation Division or the Industrial Accident Board. The general rule concerning the award or denial of lump sum settlements under the Workers' Compensation Act is well settled in this state. Lump sum settlements are only granted in exceptional circumstances. Where the best interests of the claimant are generally served by paying compensation in regular periodic installments, the conversion of benefits to a lump sum settlement has ecognized as the exception rather than the rule. Comp. Ins. Fund) (1979), Mont. , 593 P.2d 739, 741, 36 St.Rep. 799, 801; Kuehn v. Nat. Farmers Union Co. (1974), 164 Mont. 303, 307, 521 P.2d 921, 923; Legowik v. Montgomery Ward (1971), 157 Mont. 436, 440, 486 P.2d 867, 869; Kent v. Sievert (1971), 158 Mont. 79, 81, 489 P.2d 104, 105. "The fundamental basis of workmen's compensation laws is that there is a large element of public interest in accidents occurring from modern in- dustrial conditions, and that the economic loss caused by such accidents shall not necessarily rest upon the public but that the industry in which the accident occurred shall pay, in the first instance, for the accident. [Citation omit- ted.] Generally, the best interests of the dis- abled workman or his dependents will be best served by paying the compensation in regular in- stallments as wages are paid. Such payments supply in a measure the loss of the regular pay- check. [Citation omitted. ] "'Commutation being a departure from the normal method of payment is to be allowed only when it clearly appears that the condition of the bene- ficiaries warrants such a departure, but there should be no hesitancy in permitting such depar- ture where the best interests of the parties demand it. [Citation omitted.]'" Laukaitis v. Sisters of Charity (1959), 135 Mont. 469, 472- 73, 342 P.2d 752, 755. Lump sum settlements are only granted where there is "outstanding indebtedness," "pressing need," or where "the best interests of the claimant, his family and the general public will be served." "The c r i t e r i a d e t e r m i n a t i v e of t h e a d v i s a b i l i t y of c o n v e r s i o n t o a t o t a l o r p a r t i a l lump sum award have g e n e r a l l y been h e l d t o be I * * * t h e b e s t i n t e r e s t s of t h e c l a i m a n t , h i s f a m i l y and f o r t h e b e s t i n t e r e s t s o f t h e p u b l i c * * *.' K u s t u d i a v . I n d . A c c . Brd., 127 Mont. 115, 123, 258 P.2d 965, 969. See a l s o Legowik v . Mont- gomery Ward, 157 Mont. 436, 486 P.2d 867. The e x i s t e n c e of a ' p r e s s i n g n e e d ' and/or ' o u t s t a n d - i n g i n d e b t e d n e s s ' h a s l i k e w i s e been h e l d t o be r e l e v a n t c r i t e r i o n , Kent v. S i e v e r t , s u p r a . " Kuehn v . N a t . Farmers Union Co., s u p r a , 1 6 4 Mont. a t 307, 521 P.2d a t 924. I n t h i s c a s e , w e a r e f a c e d w i t h r e v i e w i n g whether t h e Workers' Compensation C o u r t s h o u l d have awarded a lump sum settlement t o claimant. Where we have c o n s i d e r e d t h i s i s s u e i n o t h e r c a s e s , we have s t a t e d t h a t t h e d e c i s i o n t o award o r deny a lump sum s e t t l e m e n t w i l l n o t be i n t e r f e r e d w i t h on a p p e a l u n l e s s t h e r e h a s been an a b u s e of d i s c r e t i o n . Utick v . S t a t e Comp. I n s . Fund, s u p r a ; S u l l i v a n v . Anselmo Mining Corp. ( 1 9 2 8 ) , 82 Mont. 543, 557-58, 268 P. 495, 501; Landeen v . Toole County R e f i n i n g Co. ( 1 9 2 9 ) , 85 Mont. 4 1 , 47, 277 P . 515, 617. The f i n d i n g s of t h e lower t r i b u n a l o r board w i l l be presumed c o r r e c t and a f f i r m e d i f s u p p o r t e d by s u b s t a n t i a l evidence. Newman v . Kamp ( 1 9 6 2 ) , 1 4 0 Mont. 487, 490, 374 P.2d 100, 1 0 2 . The d e c i s i o n w i l l be r e v e r s e d , however, i f t h e evidence c l e a r l y preponderates a g a i n s t it. Legowik, supra. Here, t h e Workers' Compensation C o u r t based i t s d e c i - s i o n t o award c l a i m a n t a p a r t i a l lump sum s e t t l e m e n t on t h e b a s i s of e v i d e n c e adduced a t a h e a r i n g . Claimant, t h e only w i t n e s s t e s t i f y i n g , p r e s e n t e d e v i d e n c e of s e v e r a l o u t s t a n d - ing debts. He t e s t i f i e d , f o r example, t h a t he owed a n o u t s t a n d i n g b a l a n c e on a TV and r e f r i g e r a t o r he had p u r c h a s e d and t h a t he was " b e h i n d " on h i s g r o c e r y , phone, w a t e r and power b i l l s . A l e t t e r from t h e Montana Power Company was i n t r o d u c e d w i t h r e s p e c t t o h i s power b i l l . It stated that services would be terminated if claimant's account was not paid in full. Claimant also presented evidence that pay- ments remained on his trailer house, that additional sums were owed for taxes and insurances, and that expenses had been incurred for the rental of his trailer house lot. In addition to these debts, claimant testified that he needed money for future expenses. His trailer house roof needed repair, he needed a new washing machine, and he wanted to buy an economy car that was fuel-efficient. He also stated, though it was not specifically mentioned on his list of debts, that he expected to incur a $1,500 dental bill for a set of false teeth for his wife, who did not work because she had heart trouble. Appellant contends upon this appeal that the court abused its discretion in awarding claimant compensation to pay these ordinary debts and anticipated future expenses. Appellant objects particularly to the court awarding sums for the purchase of a fuel-efficient economy car and the payment of dental bills for his wife's false teeth. Appel- lant submits, with reference to these future expenses, that there was no demonstration of "outstanding indebtedness" or "pressing need. " In considering appellant's argument, we note, first of all, that several courts have allowed a claimant to pay his past debts with proceeds from a total or partial lump sum settlement. Employers Mut. Liability Ins. Co. v. Hood (1976), 137 Ga.App. 555, 224 S.E.2d 460; Texas ~mployers Ins. Ass'n v. Trapp (Tex.Civ.App. 1953)r 258 S.W.2d 112; U.S. Fid. & Guar. Ins. Co. v. Bradley (1977), 142 Ga.App. 572, 236 S.E.2d 543. Courts have also allowed claimants to use lump sum settlement proceeds to pay installments on automobiles or to pay bills for future medical expenses. See, Bethlehem Steel Co. v. Taylor (1952), 199 Md. 648, 87 A.2d 844; Simpson Lumber Co., Inc. v. Brown (Ky. 1975), 520 Other jurisdictions have denied claimants lump sum settlements to pay past debts. See, Johnson v. General Motors Corp. (1967), 199 Kan. 720, 433 P.2d 585; Gill v. Ozark Forest Prods., Inc. (1974), 255 Ark. 951, 504 S.W.2d 357; Woods v. Sumter Stress-Crete Inc. (1976), 266 S.C. 245, 222 S.E.2d 760. At least one authority has criticized the practice on the following basis: ". . . If a partially or totally disabled worker gives up these reliable periodic payments in ex- change for a large sum of cash immediately in hand, experience has shown that in many cases the lump sum is soon dissipated and the workman is right back where he would have been if work- men's compensation had never existed. One rea- son for the persistence of this problem is that practically everyone associated with the system has an incentive--at least a highly-visible short-term incentive--to resort to lump-summing ... "The only solution lies in conscientious admin- istration, with unrelenting insistence that lump- summing be restricted to those exceptional cases in which it can be demonstrated that the purpose of the Act will be best served by a lump-sum -- award." Larson, Workmen's compensation -Law, 882.71 at 15-572, 573. This Court has had at least two occasions to review cases where lump sum settlements and past debts were con- cerned. In Kuehn, 164 Mont. at 307-08, 521 P.2d at 924, we approved of a lump sum settlement where proceeds would be applied to remaining installments on a home, a pickup truck and other miscellaneous bills, including attorney fees. In Kustudia, 127 Mont. at 123-24, 258 P.2d at 969, we affirmed the granting of a lump sum settlement where claimant intended t o u s e t h e p r o c e e d s t o pay p a s t d e b t s and a t t o r n e y f e e s and a p p l y t h e remaining b a l a n c e toward f u t u r e e x p e n s e s he would i n c u r i n h k s and h i s f a m i l y ' s move t o a more d e s i r a b l e l o c a - tion. The move was n e c e s s i t a t e d b e c a u s e of h i s m e n t a l and p h y s i c a l h e a l t h problems. A p a r t from t h i s p r e c e d e n t , however, we have s t a t e d p r e v i o u s l y , and r e a f f i r m h e r e , t h a t e a c h c a s e f o r a lump sum payment s t a n d s o r f a l l s on i t s own merits. U t i c k , 593 P.2d a t 7 4 1 , 36 St.Rep. a t 802. With r e g a r d t o t h e p a r t i c u l a r f a c t s and c i r c u m s t a n c e s o f t h i s c a s e , w e f i n d t h a t t h e r e was no a b u s e of d i s c r e t i o n . The Workers' Compensation C o u r t p r o p e r l y awarded c l a i m a n t a lump sum s e t t l e m e n t . Prior t o t h e award, t h e c l a i m a n t d e m o n s t r a t e d b o t h " p r e s s i n g need" and " o u t s t a n d i n g i n d e b t e d n e s s . " The award was made i n t h e b e s t i n t e r e s t s of t h e c l a i m a n t , h i s f a m i l y and t h e g e n e r a l public. The compensation s o u g h t h e r e was n o t , a s i n some cases, f o r pursuing a choice i n a d i f f e r e n t l i f e s t y l e . See L a u k a i t i s , s u p r a ; Malmedal v . Ind. Acc. Bd. ( 1 9 5 9 ) , 135 Mont. 554, 342 P.2d 745. R a t h e r , it was s o u g h t t o s a t i s f y d e b t s which had been o r would be i n c u r r e d f o r b a s i c n e c e s - sities. A t s t a k e was c l a i m a n t ' s need f o r s h e l t e r , g r o c e r i e s , w a t e r , power, m e d i c a l t r e a t m e n t , and t r a n s p o r t a t i o n . None o f t h e s e t h i n g s may be c a l l e d l u x u r i e s . Claimant presented v i r t u a l l y u n c o n t r o v e r t e d e v i d e n c e of h i s need a t t h e h e a r - i n g , and we f i n d t h a t t h e c o u r t a c t e d w i t h p r o p e r d i s c r e t i o n . A s a n a p p e l l a t e c o u r t of r e v i e w , we have c o n s i s t e n t l y r e c o g n i z e d i n c a s e s of t h i s k i n d t h a t a t r i b u n a l o r b o a r d w i l l be a f f o r d e d wide d i s c r e t i o n i n d e t e r m i n i n g whether a lump sum s e t t l e m e n t s h o u l d o r s h o u l d n o t be g r a n t e d . Kuehn, 164 Mont. a t 307, 521 P.2d a t 923; Kent, 158 Mont. a t 81, 489 P.2d at 105. Where the Industrial Accident Board awarded a lump sum settlement in Legowik, 157 Mont. at 440, 486 P.2d at 869, we stated: "'The determination of this question requires the exercise of sound discretion. The board is more favorably situated than the court to famil- iarize itself with the circumstances surrounding the applicant, to consider his needs, and the results which probably will follow action grant- ing or denying the application; the power "must be exercised in conformity with the law and so as to best promote the ends of justice."'" In this instance, the Workers' Compensation Court was in the best position to judge the needs of the claimant. There was no abuse of discretion. Where the solution to the lump-summing problem lies in conscientious administration, we find that the court acted properly. Accordingly, we affirm the judgment of the court. We concur: s Chief Justice M v 6?dd&&Q