Grotte v. North Dakota Workers' Compensation Bureau

MESCHKE, Justice,

dissenting.

I respectfully dissent. In my opinion, the limitation time for this claim was equitably tolled by payments made by claimant’s employer in lieu of a workers’ compensation claim.

While working as an oil field operator for Phillips Petroleum, Timothy Grotte was exposed to corrosive chemicals, including hydrogen sulfide gas. In June 1987, Grotte was hospitalized with pneumonia. After using Unavoidable Absence Benefits for employee illness, furnished by his employer and approved by his supervisor, LeRoy Sandberg, Grotte returned to work two weeks later. Grotte later developed bronchitis, and by fall his breathing was raspy, he was short-winded, and his lungs burned.

On November 23, 1987, accompanied by his Phillips “boss,” Sandberg’s Relief Supervisor Ron Ritzke, Grotte was examined by Dr. Ebel, a company-approved physician. Dr. Ebel reported that Grotte’s “condition indeed has been aggravated by the fumes that he is exposed to during his time of work.” Dr. Ebel reported that, “being exposed to the fumes and irritants at work, it is quite conceivable that continuous irritation in the respiratory tract, especially in the right lung (that was previously diseased [in June 1987]) continued, leaving him with a type of chronic condition and some sort of disability.” Dr. Ebel recommended that Grotte “should be put on sick leave for approximately one week after which his condition should be re-evaluated.” Grotte was off work for one week. On November 30, Dr. Ebel reported that Grotte’s lungs “seem a lot better.” Grotte then returned to work.

During his time off between November 23 and 30, Grotte was seen shopping at the grocery store by his supervisor. A few days later, Sandberg phoned Grotte at home, accused him of using his sick leave as vacation, and suspended him. Grotte quarreled with Sandberg and McCollum, Sandberg’s superior, but was reinstated after enlisting the assistance of John Morrison, a Human Resource Representative *883from the Phillips’ Denver office. In addition to intervening on Grotte’s behalf with Sandberg and McCollum, Morrison had the company physician contact Dr. Ebel with suggestions about treating Grotte’s condition. On December 8, Grotte was given “a minimum of a month off” to recover.

Because Grotte had worked for Phillips for four years at the time of his illness, he was eligible for up to 12 weeks of Unavoidable Absence Benefits (UAB) from his employer. These benefits covered employee illness, non-occupational injuries, and alcoholism or drug rehabilitation, as well as “On-Job” injuries and illnesses. Phillips’ Summary Plan Description explains “On-Job” benefits:

WHAT IS “ON-JOB” UAB?
“On-job” UAB is a Company-sponsored benefit policy covering ... employees ... who are injured while on the job or suffer a sickness which is directly job connected.

For Grotte, the plan scheduled benefits of 100% regular pay for the first four weeks of unavoidable absence, and 50% regular pay for the next eight weeks.

Grotte’s month-long convalescence was compensated by On-Job UAR, partly at 100% and partly at 50% of his regular pay. When he couldn’t “cut it” on the reduced paychecks, Grotte inquired about workers’ compensation benefits stated in his company’s UAB policy for On-Job benefits:

DO WORKER’S COMPENSATION PAYMENTS AFFECT MY BENEFITS? Each absence under this policy is covered by provisions of and charged against the on-job benefits schedule. Any time worker’s compensation benefits are or may be payable in connection with an injury or absence the matter must be referred to Phillips Property Taxes, Real Estate and Claims office before UAB payments are made. This is where a determination will be made as to the amount, if any, of worker’s compensation benefits payable. If your worker’s compensation payments, excluding hospital or medical expenses, are less than the amounts shown in the schedule of benefits for your sickness or injury ..., partial on-job disability benefit payments will be made. These payments will be in such amount as is necessary to bring the total benefit you receive up to the proper amount shown in the schedule.

(Emphasis added). Grotte testified that he asked Sandberg several times if he could file for workers’ compensation benefits, but that Sandberg told him, “No. I told you, our insurance benefits are good enough to take care of this.” No company action was taken about a workers’ compensation claim. By January 4, 1988, Grotte’s lungs were clear enough to return to work.

In March 1988, Grotte broke a rib during work. A company safety person took him to the hospital and also filed a workers’ compensation claim for him. Although Grotte continued to have mild respiratory problems, he took no additional time off from work.

When Phillips’ facilities were purchased by Amerada Hess in July 1988, Grotte was laid off. After the layoff, Grotte reported that the “coughing or burning or the raspiness” stopped, and he “felt good for a change.”

Unable to find another job, Grotte received unemployment benefits until February 1989. In March 1989, Grotte began work for another company as an oil field sales representative. This work again exposed Grotte to hydrogen sulfide gas and, within a short time, he developed bronchitis. In April 1989, Grotte was hospitalized with pneumonia. Grotte filed a workers’ compensation claim in May 1989 for the lingering lung condition that stemmed from his work with Phillips.

The Bureau dismissed the claim as untimely, concluding that the “claim was filed more than one year after [Grotte] reasonably knew the condition was work related.” Grotte petitioned the Bureau for rehearing and, after a telephone hearing, the Bureau affirmed the dismissal. Grotte appealed. The district court affirmed the Bureau’s decision. Grotte appeals.

The central question is whether Grotte timely applied for workers’ compensation benefits. Grotte was aware of the occupa*884tional nature of his condition by November 1987, but he had no permission from his employer to file a compensation claim while he was receiving Unavoidable Absence Benefits pursuant to the employer’s controlling policy for an “On-Job” condition.

Grotte argues that he failed to file timely because he was, at least, “discouraged” from filing a claim, if not “actively and purposely misle[]d” by his employer. Grotte testified that, when he showed Sandberg that the UAB policy indicated that he might be entitled to workers’ compensation, Sandberg refused to consider it.

Grotte’s testimony corresponds with Phillips’ written policy stating that its Claims office would determine “the amount, if any, of worker’s compensation benefits payable.” Furthermore, Grotte followed policy directions to seek benefits through his supervisor:

WHAT MUST I DO TO START MY BENEFITS?
You must notify your immediate supervisor as far as possible in advance of all absences.

The Bureau relies on Sandberg’s denial of any conversation with Grotte about workers’ compensation benefits, arguing that “Sandb[e]rg had no motivation to keep Grotte from filing.” However, consistent with Grotte’s testimony, Sandberg testified: “We had administrative people that took care of that.” Sandberg’s otherwise inconsistent position, that “it’s the employee’s responsibility to take the [workers’ compensation] form and get it filled out,” cannot be fairly credited. See State v. Nelson, 488 N.W.2d 600 (N.D.1992). Moreover, documentary evidence belies Sand-berg. The employer’s policy delegated to its Claims office the “determination ... as to the amount, if any, of worker's compensation benefits payable” when Phillips paid On-Job Unavoidable Absence Benefits. The employer’s policy directed the employee to work with his “immediate supervisor” on a job-connected sickness.

We have not addressed a like question on an untimely workers’ compensation claim before, but parallel precedents from other jurisdictions persuade me that equitable tolling applies. Frost v. Anaconda Co., 198 Mont. 216, 645 P.2d 419 (1982) (Payment of benefits to employee pursuant to a benefit program for employees unable to work due to a disability, whether or not work related, equitably tolled the statute of limitations where payments were substantially comparable to workers’ compensation benefits and when the employer had knowledge that the claim was based on an industrial accident); Godwin v. Scott Paper Co., 571 So.2d 1126 (Ala.Civ.App.1990) (Employer’s in-lieu payments to partially-disabled claimant of full salary despite reduced work equitably tolls statute of limitations for workers’ compensation claim). See, generally, 2B Larson’s Workmen’s Compensation Law § 78.43(c) (1989): “When payment of either income or medical benefits has been made by a private employer-employee benefit association or insurance plan, this has usually, but by no means invariably been held to toll the statute.”

We have recognized and described the doctrine of equitable tolling of a statute of limitations in another context:

The doctrine of equitable estoppel may operate to preclude the application of a statute of limitations as a defense by one whose actions mislead another, thereby inducing him to not file a claim within the statute of limitations. Thus, a delay may be excusable “where, provided it is not unreasonably protracted, it is induced by defendant’s promises, suggestions, or assurances which, if carried into effect, would result in a solution or adjustment without litigation.” The reason for the rule is that “one cannot justly or equitably lull his adversary into a false sense of security, and thereby cause his adversary to subject his claim to the bar of the statute of limitations, and then be permitted to plead the very delay caused by his course of conduct as a defense to the action when brought.” While “the mere conduct of settlement negotiations or discussions by a defendant with a plaintiff does not alone provide a basis for estop-ping the defendant from pleading the statute of limitations,” it is sufficient if the defendant's “ ‘conduct or promises *885are such as are naturally calculated to and do “induce plaintiff into a belief that his claim would be adjusted if he did not sue.” ’ ”

Schmidt v. Grand Forks Country Club, 460 N.W.2d 125, 129-80 (N.D.1990). (Citations omitted). Compare White v. North Dakota Workers Compensation Bureau, 441 N.W.2d 908 (N.D.1989) (Claim not time barred two years after injury when employer’s administrator advised employee that he was not allowed to file a claim that was not authorized by a doctor). Because NDCC 65-01-01 calls for “sure and certain relief” to a worker injured in hazardous employment, it is appropriate to apply equitable tolling to a worker’s compensation claim.

Larson elaborates on equitable tolling to excuse an untimely worker’s compensation claim:

A familiar defense to assertion of the bar of late claim is the plea that the lateness was the result of the employer’s assurances, misrepresentations, negligence, or even deliberate deceptions. In the states having statutes permitting for good cause or mistake, the [ ] excusing of late claims issue is simply whether the facts satisfy the statute; in other states the issue usually takes the form of the question whether the employer should be held estopped to invoke the bar.
The commonest type of case is that in which a claimant, typically not highly educated, contends that he was lulled into a sense of security by statements of employer or carrier representatives that “he will be taken care of” or that his claim has been filed for him or that a claim will not be necessary because he would be paid compensation benefits in any event. When such facts are established by the evidence, the lateness of the claim has ordinarily been excused.

2B Larson’s Workmen’s Compensation Law § 78.45. (Footnote omitted). Equitable tolling should excuse the lateness of Grotte’s claim.

In my opinion, the greater weight of all of the evidence in this case, particularly documentary evidence, demonstrates that Grotte was discouraged and directed by a company policy and by in-lieu payments not to file a timely claim for workers’ compensation benefits. As a good employee conforming to his employer’s policies, Grotte unwarily, depended on his “employer’s presumably greater knowledge.” Neuberger v. Hennepin County Workhouse, 340 N.W.2d 330, 332 (Minn.1983) (Employer equitably estopped from pleading statutory time bar against a worker’s compensation claim when employer was primarily responsible for the failure to file). After the in-lieu payments while he was employed by Phillips, apparently Grotte had no further need to file a claim until his relapse in March 1989. See Lass v. North Dakota Workmen’s Compensation Bureau, 415 N.W.2d 796 (N.D.1987) (Workmen’s Compensation Act did not permit Bureau, in denying present benefits, to deny future benefits upon a change in claimant’s medical condition). I would conclude that the limitation time for filing Grotte’s claim was equitably tolled because Phillips misled him by paying other benefits in lieu of workers’ compensation benefits.

I would reverse and remand to the Bureau for consideration of Grotte’s claim. Therefore, I respectfully dissent.