LaPointe v. United Engineers & Constructors

GLASSMAN, Justice,

dissenting.

Although I would not affirm the decision of the Board, I cannot agree with the Court’s conclusion that the effect of the language of the 1991 Workers’ Compensation Commission decision is dispositive of the issue in this case. Accordingly, I respectfully dissent. It is well established that, unless without a rational basis, the factual findings of the Workers’ Compensation Board must be upheld on appeal if supported by competent evidence, even if the evidence supports a contrary result. Smith v. Great Northern Paper, Inc., 636 A.2d 438, 439 (Me.1994) (citing Dorey v. Forster Mfg. Co., 591 A.2d 240, 241-42 (Me.1991)). By failing to acknowledge the existence of the Board’s factual determination that the settlement of La-Pointe’s Massachusetts claim encompassed only the 1989 Massachusetts injury and not the 1986 Maine injury, the Court has failed to accord to the Board the deference our precedents require.

In support of its reasoning, the Court focuses on its interpretation of the provision of the 1991 decision awarding a “week by week setoff for benefits paid” during the period that Massachusetts was paying weekly benefits to the employee. It ignores the specific finding of the Board based on the evidence before it, that “[t]he employee did not lump the 1986. injury. He lumped a 1989 injury that occurred in another jurisdiction.” Because this was a factual determination, the proper inquiry is whether there is competent evidence in the record to support it. Smith, 636 A.2d at 439. One need look no further than the agreement settling the 1989 Massachusetts claim to determine that competent evidence exists to support the Board’s finding. The relevant portions of the settlement agreement read as follows:

The employee sustained a work-related injury on 2/03/89. He underwent disc surgery later that month and has regained full-time light duty work capacity_ The employee understands that settlement of his claim means he will never again be entitled to claim non-medical benefits for this injury.
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Received of Sentry Insurance the Lump Sum of one hundred twenty-five thousand dollars and 00 cents ($125,000.00). This payment is received in redemption of the liability for all weekly payments now or in the future due [LaPointe] under the [Massachusetts] Worker’s Compensation Act for all injuries received by Norman La-Pointe on or about February 3, 1989 while in the employ of Wormald Fire Systems, Inc.

(Emphasis added). The emphasized language and the lack of any reference to the 1986 injury clearly support the Board’s determination that, by this agreement, La-Pointe lump-sum settled only his injury attributable to the 1989 accident. See Bourque v. Frank X. Pomerleau, Inc., 472 A.2d 933, 935 (Me.1984) (lump-sum settlement and statute made clear that settlement “commutes liability for benefits only for the injury that is the subject of the agreement”).3

*463Although there is competent evidence to support this factual finding, the Board erred by its legal conclusion that United Engineers is not entitled to set-off any portion of the 1989 settlement. By its 1991 decision, the Commission had determined that the 1986 injury was “a substantial contributing factor” to LaPointe’s then-determined 50% incapacity without determining the precise percentage attributable to each injury. In its present decision the Board concluded that, although LaPointe had been compensated for his 1989 injury, United Engineers must commence paying to LaPointe benefits for the full 50% incapacity. In this determination, the Board failed to recognize the well-established principle, articulated by the Court, that “an employer is entitled to a credit for a duplicate recovery in a different state.” This principle, however, does not support the conclusion of the Court that United Engineers is entitled to set-off the entire $100,000. Rather, it supports only the Court’s determination that the Board erred by concluding that United Engineers is not entitled to any set-off.

To avoid a duplicate recovery, while at the same time ensuring that LaPointe is fully compensated for his injuries, the Board must determine the percentage of LaPointe’s 50% incapacity that is attributable to each accident. The only finding by the Commission related to this inquiry is that the 1986 accident was a “substantial contributing factor” to LaPointe’s present incapacity. Without more, it is impossible to determine the portion of LaPointe’s incapacity that remains uncompensated by reason of the 1986 injury now that he has been fully compensated for the 1989 injury. I would remand this case to the Board for a determination of the applicable percentages and reduce United Engineers’ liability by the percentage attributable to the 1989 accident. See generally Nichols v. Cantara & Sons, 659 A.2d 258, 263 (Me.1995) (when employee has work injury and then recovers from a third-party for damages resulting from an automobile accident resulting in a second injury for which employer accepts liability, hearing officer must “determine the percentage of the employee’s incapacity that is attributable to each injury and ... award a lien against the third-party recovery only for ... that portion of the employee’s incapacity for which the third party is responsible”); Larson, The Law of Workmen’s Compensation §§ 72.65, 74.31(c) (1994) (separation of liability for work injury from damages awarded from medical malpractice suit resulting from treatment for the work injury is “fair and sensible result”).

. It is noteworthy that a Massachusetts statute that sets forth the effect of workers' compensation lump-sum settlements in that state appears to be in accord with this view:

Whenever a lump sum agreement or payment has been approved by the reviewing board in accordance with the terms of this section, such agreement shall affect only the insurer and employee who are parties to such lump sum agreement and shall not affect any other action or proceeding arising out of a separate and distinct injury resulting in an incapacity *463whether the injury precedes or arises subsequent to the date of settlement.
Mass.Ann.Laws ch. 152, § 48(5) (Law.Co-op.Supp. 1995).