Whittaker v. Hall

OPINION OF THE COURT

An Administrative Law Judge (ALJ) awarded benefits to a deceased worker’s estate and to her surviving spouse. Liability was apportioned equally to the employer and Special Fund. During the pendency of an appeal concerning the duration of the defendants’ payment periods under the award, the surviving spouse remarried. After the award became final, the employer moved for “clarification” and a reopening of the award, seeking an adjustment in the defendants’ payment periods based upon the reduced value of the award due to the surviving spouse’s remarriage. Relying upon Wheatley v. Bryant Auto Service, Ky., 860 S.W.2d 767 (1993), an ALJ granted the motion, reopened the award, and ordered the employer and Special Fund to pay their proportionate share of the benefits that would actually be due under the award. The Workers’ Compensation Board (Board) and the Court of Appeals affirmed. Having concluded, however, that the reopening was unauthorized, we reverse.

On July 15, 1993, Cynthia Hall was injured while working. She filed a workers’ compensation claim and was awarded a 50% permanent, partial disability, with benefits apportioned equally between the employer and Special Fund. Following an appeal, this Court remanded the claim for further consideration. Shortly thereafter, on October 7, 1999, Mrs. Hall died from a cause that was unrelated to her claim, and her surviving spouse, James C. Hall, was substituted as a party. On May 2, 2000, an Administrative Law Judge (ALJ) awarded a permanent, total disability, apportioned equally. Following petitions for reconsideration, an order of July 24, 2000, indicated that income benefits were payable to Mrs. Hall’s estate from October 23, 1993, through October 7, 1999, the date of her death. As provided by KRS 342.730(3), 50% of the benefit was payable to her surviving spouse from October 8, 1999, for the remainder of her life expectancy. The order provided that if Mr. Hall remarried before the compensable pe*818riod expired, he was entitled to a lump sum payment under KRS 342.730(3)(e). Following the Special Fund’s petition for reconsideration of the July 24 order, an order entered on September 20, 2000, repeated that liability for the benefits awarded was apportioned equally between the defendants. The order directed the employer to pay all benefits initially, subject to its proportionate share.

Appealing, the Special Fund asserted that, despite Mrs. Hall’s death, the defendants’ payment periods should have been based upon her life expectancy at the time she became totally disabled. Rejecting the argument, the Board affirmed the ALJ’s decision to apportion the known value of the award. The Court of Appeals affirmed on October 26, 2001, and no appeal was taken from that decision.

On January 4, 2002, after the award became final, the employer filed a motion for clarification of the award. On January 23, 2002, the employer also filed a motion to reopen and for clarification of the award. The motions asserted that the value of the entire award could now be determined with certainty because Mr. Hall had remarried during the pendency of the appeal to the Court of Appeals. Maintaining that the employer had already paid 50% of the income benefits that actually would be due under the award, the motion asserted that the Special Fund was responsible for the balance.

Responding to the motion, the Special Fund asserted that the Department of Workers’ Claims (Department) lost jurisdiction over the claim when the Court of Appeals’ decision became final. Thus, the ALJ did not have jurisdiction to grant the employer’s motion and reopen the award. Under the terms of the final award, the employer was responsible for the initial 50% of the- benefits awarded. Based upon the facts as they existed at the time, the ALJ awarded $253.34 per week from October 29, 1993, through October 7, 1999, and $127.67 per week from October 8, 1999, through the remainder of Mrs. Hall’s life expectancy on the date of accident. The Special Fund’s position was that since Mr. Hall remarried during the employer’s payment period under the award, the employer was responsible for the two-year lump sum to which Mr. Hall was entitled under KRS 342.730(3)(e).

Relying upon Wheatley v. Bryant Auto Service, supra, the ALJ reopened the claim in order to resolve the dispute between the parties as a result of “the unforeseen circumstances following its rendition” and to render “a more explicit award.” Noting that the award held the defendants equally liable for all benefits awarded, the ALJ determined that there was no discernable legal distinction between the question that the Court of Appeals had considered when affirming the underlying award and the question that was presently in dispute. The ALJ concluded, therefore, that the defendants were equally liable for “all known benefits.” Affirming the decision, the Board determined that “the contingency of the widower’s remarriage necessitated a reopening so that the award could conform with reality.” The Court of Appeals affirmed and adopted the Board’s opinion.

A final workers’ compensation award is the equivalent of a judgment and is enforceable as such in circuit court. KRS 342.305. Nonetheless, KRS 342.125(1) permits the reopening of an otherwise final award upon a showing of one of several specified grounds for reopening. A motion to reopen, accompanied by prima facie evidence of one of the specified grounds, is the procedural device by which a party may invoke the Department’s jurisdiction to do so. Id. If one of the *819specified grounds exists, an ALJ may also reopen an award sua sponte. Id.

One of the permissible grounds for reopening is “mistake.” KRS 342.125(l)(c) [previously KRS 342.125(1) ]. Under the provision, reopening is permitted to address a mutual mistake of fact or a misconception of the cause, nature, or extent of disability at the time an award is rendered. See Fayette County Board of Education v. Phillips, Ky., 439 S.W.2d 319 (1969). Messer v. Drees, Ky., 382 S.W.2d 209 (1964). The provision may also be used to correct a mistake of law in an award that has not been reviewed on appeal. Wheatley v. Bryant Auto Service, supra; Stearns Coal and Lumber Co. v. Vanover, 262 Ky. 808, 91 S.W.2d 518 (1936).

In Wheatley v. Bryant Auto Service, supra, an ALJ mistakenly awarded income benefits for 425 weeks rather than life. No appeal was taken from the decision. Some 35 days later, after the award had become final, the ALJ realized the mistake and amended the opinion and order to reflect the correct duration. A question then arose over whether the ALJ’s action was authorized. Noting that an admitted mistake in applying the law could be corrected in a civil proceeding under CR 60.02, we determined that the ALJ was authorized by KRS 342.125(1) to reopen the award, sua sponte, in order to correct what was a patent error in applying the law as it existed at the time of the award.

Mrs. Hall died shortly after this Court remanded the claim for further consideration, and Mr. Hall was substituted as the plaintiff. On May 2, 2000, the ALJ awarded Mrs. Hall a total disability, payable for life. On July 24, 2000, after considering Mr. Hall’s petition for reconsideration, the ALJ amended the award based upon the facts that were in existence at the time it was rendered. As a result, benefits were awarded to Mrs. Hall’s estate up until her death, and survivors’ benefits were awarded to Mr. Hall thereafter for the duration of her life expectancy. The amended award also provided that in the event Mr. Hall remarried before the expiration of the compensable period, he was entitled to the lump sum payment that was authorized by KRS 342.730(3)(e). On September 20, 2000, when ruling on the Special Fund’s petition for reconsideration, the ALJ again ordered that “all benefits awarded herein are apportioned equally between the defendant-employer and the Special Fund, with the defendant-employer directed to pay all benefits initially, subject to its proportionate share.” After the Court of Appeals affirmed the apportionment of all known benefits, the award became final, and the defendants’ payment periods under the award were fixed.

Unlike the situation in Wheatley v. Bryant, supra, the ground for reopening the present award was not a mistake in the ALJ’s application of the law when rendering it. Furthermore, unlike the situation in Fayette County Board of Education v. Phillips, supra, or in Messer v. Drees, supra, the award was not the product of a misconception of the facts as they existed when it was rendered. Although characterized as a reopening to “clarify” the award, the basis for reopening was to address a post-award change in the facts, namely, that the total amount of benefits to be paid under the award had decreased because the surviving spouse remarried. Therefore, the employer maintained that the defendants’ payment periods should be recalculated.

KRS 342.125 does not authorize a reopening to clarify an award. Under certain circumstances, reopening is a remedy for a mistake in an award, but “mistake” is not a proper ground to reopen an award that was correct under the facts that existed when it was rendered. In other words, *820there is no mistake in an award simply because the recipient later dies and/or the surviving spouse remarries. Under KRS 342.120, the defendants’ payment periods under an award are based upon their respective shares of the total benefits that are awarded, and the employer pays its entire liability first. Just as the employer is not required to pay additional benefits if a worker outlives the projected life expectancy, its payment period is not shortened if a post-award change in the facts causes benefits to cease before the entire award is paid out. See Pickands Mather & Co. v. Newberg, Ky., 895 S.W.2d 3, 5-6 (1995); Pennwalt Corporation v. Beale, Ky.App., 840 S.W.2d 830, 832 (1992).

In the present case, benefits were awarded to Mrs. Hall’s estate and her surviving spouse based upon the facts that were in existence at that time. Although Mr. Hall’s subsequent remarriage changed the amount of benefits that would ultimately be due under the award, it did not render the award a “mistake.” Absent any of the grounds that are specified in KRS 342.125(1), a reopening and adjustment of the defendants’ payment periods due to subsequent events was unauthorized.

The decision of the Court of Appeals is reversed, and the defendants’ payment periods under the award that was entered on May 2, 2000, and amended on July 24, 2000, are reinstated.

LAMBERT, C.J., and GRAVES, JOHNSTONE, KELLER, STUMBO and WINTERSHEIMER, JJ„ concur. COOPER, J., files a separate opinion concurring in part and dissenting in part.