Twombly v. Association of Farmworker Opportunity Programs

          United States Court of Appeals
                      For the First Circuit

No. 99-2063

              LILIA TWOMBLY, f/k/a LILIA MAJERCZYK,

                      Plaintiff, Appellant,

                                 v.

        ASSOCIATION OF FARMWORKER OPPORTUNITY PROGRAMS,

                       Defendant, Appellee.



          APPEAL FROM THE UNITED STATES DISTRICT COURT

                    FOR THE DISTRICT OF MAINE

          [Hon. Morton A. Brody, U.S. District Judge]



                               Before

                     Selya, Boudin, and Lynch,

                          Circuit Judges.



   David M. Lipman, with whom Karen E. Lipman and Lipman & Katz, P.A.
were on brief, for appellant.
    Mark K. McDonough, with whom Cuddy & Lanham was on brief, for
appellee.


                           May 16, 2000
          LYNCH, Circuit Judge.       In   this   diversity action the

district court entered summary judgment against Lilia Twombly, an

AmeriCorps participant, on her breach of contract claims against her

AmeriCorps contracting agency, the Association of Farmworker

Opportunity Programs (AFOP). Twombly claimed that AFOP failed to

provide her with "health and medical coverage" and "worker's

compensation" as recited in her contract. We affirm summary judgment

on the health coverage claim and reverse on the workers' compensation

claim. Resolution of the latter claim involves exploration of the

Restatement (Second) of Contracts provisions excusing performance

because of impracticability caused by governmental regulation.

                                 I.

          Twombly had a contract with AFOP to run pesticide safety

programs for farm workers from January 8, 1995, through December 15,

1995. On March 23, 1995, she executed a two page contract with AFOP,

under which AFOP agreed to provide her with a stipend and benefits

including "health and medical coverage, child care if needed, [and]

worker's compensation." AFOP enrolled her in a health insurance policy

issued by Allianz/SRC, which had a maximum payout of $10,000. AFOP

paid 85% of the premiums; the Training and Development Corporation

(TDC), the host agency for AFOP in Maine, paid the remaining 15%.




                                 -2-
          For her part, Twombly provided the services she was required

to provide under the contract. Participants such as Twombly had full-

time work assignments averaging 40 hours per week and were paid

stipends at an annual rate of $7,650 in exchange for their service.

Twombly was the single parent of a seven-year-old child and relied on

AFOP's promises to provide health insurance and workers' compensation.

          On June 16, 1995, Twombly was in a serious automobile

accident on Interstate 95 while heading back from a training

demonstration in Houlton, Maine. She suffered severe injuries that

resulted in a substantial loss of physical and mental functioning. The

health insurer paid out the $10,000 maximum. Twombly's plight is

described in another opinion arising out of her accident. See Twombly

v. AIG Life Ins. Co., 199 F.3d 20, 21-23 (1st Cir. 1999).

          In 1997, Twombly filed an application for workers'

compensation with the Maine Workers' Compensation Board. On October

28, 1998, the Board dismissed the petition against AFOP. As to AFOP,

the Board concluded that while Twombly was AFOP's employee under Maine

workers' compensation law, Maine law was preempted by the National and

Community Service Act of 1990 (NCSA), 42 U.S.C. § 12501 et seq. The

NCSA states that an AmeriCorps participant such as Twombly "shall not




                                 -3-
be considered to be an employee of the program in which the participant

is enrolled."     Id. § 12511 (17).1    Twombly then brought this suit.

                                 II.

          At the trial court, Twombly argued that the contract was

ambiguous as to the scope of the health insurance AFOP was required to

provide. She also said that resolution of the ambiguity required

reference to certain federal minimum standards, specifically those

under the NCSA.    The relevant provision states:

                  A State or other recipient of assistance
          under section 12571 of this title shall provide
          a basic health care policy for each full-time
          participant in a national service program carried
          out or supported using the assistance, if the
          participant is not otherwise covered by a health
          care policy. Not more than 85 percent of the
          cost of a premium shall be provided by the
          [Corporation for National and Community Service
          (CNCS)], with the remaining cost paid by the
          entity receiving assistance under section 12571
          of this title. The [CNCS] shall establish
          minimum standards that all plans must meet in
          order to qualify for payment under this part, any
          circumstances in which an alternative health care
          policy may be substituted for the basic health
          care policy, and mechanisms to prohibit
          participants from dropping existing coverage.

42 U.S.C. § 12594(d)(1) (emphasis added); see also 45 C.F.R.

§ 2522.250(b) (requiring grantees to provide eligible participants with

minimum health benefits).




     1    The Board denied the petition against TDC on the ground that
Twombly was not an employee of TDC.

                                 -4-
            The district court concluded that the phrase "health and

medical coverage" was unambiguous and that Twombly was in fact provided

the health insurance required by the contract, so AFOP did not breach

the contract. The district court determined that the NCSA had no

bearing on whether the contract was ambiguous, and that any failure to

comply with the CNCS minimum standard may or may not give rise to a

cause of action, but that that was a separate matter from breach of

contract.

            In response to Twombly's claim for workers' compensation,

AFOP argued that the claim for workers' compensation was both barred by

res judicata and preempted by federal law. AFOP also argued that its

performance was excused because of legal impossibility. The court

rested its grant of summary judgment for AFOP on the last ground,

finding that under § 264 of the Restatement (Second) of Contracts there

was an intervention of federal law that made performance impracticable

and therefore discharged any duty.      See Restatement (Second) of

Contracts § 264 cmt. a (1981).    The district court also relied on

American Mercantile Exchange v. Blunt, 66 A. 212 (Me. 1906), in

reaching this conclusion.




                                 -5-
                                 III.

          Our review on summary judgment is de novo. See National

Foreign Trade Council v. Natsios, 181 F.3d 38, 49 (1st Cir.), cert.

granted, 120 S. Ct. 525 (1999). On appeal, Twombly argues that AFOP

was not entitled to summary judgment. She says that the district court

erred in finding the contract unambiguous as it related to health

coverage and granting AFOP summary judgment on the issue. Twombly also

argues that AFOP contracted to provide her with workers' compensation,

either under the state system or through private purchase of equivalent

coverage, and that performance of this obligation was not excused.

A. Health Insurance

          Twombly argues that the district court did not apply the

principle that a contract is construed against the drafter; in any

event, she says, the contract is ambiguous as to the scope of the

promise to provide health insurance, and she was entitled to discovery

on what AFOP intended the phrase "health and medical coverage" to mean.

She says typical health insurance policies do not contain dollar

limits, and the policy that AFOP provided did not comply with the

federal requirements for AmeriCorps Programs. AFOP says, supported by

affidavit, that its minimal health policy was in compliance with

federal law regulating AmeriCorps, and that, in fact, the insurance was

exactly what was arranged for and recommended by AmeriCorps.

          The question whether contractual terms are ambiguous is,

under Maine law, initially a matter of law for the court.          See


                                 -6-
Fitzgerald v. Gamester, 658 A.2d 1065, 1069 (Me. 1995). This case

comes to us on summary judgment, and so the question of contractual

meaning has a factual context.

          We affirm the entry of summary judgment on the health

insurance claim.    The payment of $10,000 in benefits met AFOP's

contractual obligation to provide health and medical coverage. There

may be extreme cases where the health coverage provided is so minimal,

say $1 worth of coverage, that it cannot be said to comply with the

obligation to provide health insurance. But that is not this case.

Further, the federal regulations required AFOP to provide "minimum"

health benefits as determined by the CNCS, and the policy met that

definition. See 45 C.F.R. § 2522.250(b). The defendants produced

undisputed evidence that the insurance provided was exactly what the

CNCS, which was responsible for setting the minimum benefits, arranged

for and recommended.2

B. Workers' Compensation

          The district court erred, Twombly argues, in granting summary

judgment on the workers' compensation claim and in relying on

Restatement § 264. She also says it was possible for AFOP to perform

even if the state denied benefits. AFOP, she points out, could have


     2     Twombly says that her requested discovery was restricted by
the district court. This is true, but most of the discovery sought was
irrelevant to this issue. The defendant's affidavit -- establishing
that AFOP complied with what CNCS recommended -- was filed in support
of the summary judgment motion, and plaintiff did not contest the fact
asserted or seek discovery on this specific issue. We take this fact
as undisputed.

                                 -7-
purchased the equivalent of workers' compensation insurance to meet its

obligations. The fact that AFOP purchased a workers' compensation-like

policy from AIG, see Twombly, 199 F.3d at 21-22, is evidence, Twombly

claims, of AFOP's intent that she be provided with such benefits.3 If

AFOP's obligation were meant to be limited, Twombly says, then the

contract would have said "worker's compensation to the extent provided

by law." Finally, Twombly says that since the Workers' Compensation

Board determined it did not have jurisdiction, there is no res judicata

effect because there was no adjudication on the merits.

           AFOP says, citing 4 Arthur Larson, The Law of Workmen's

Compensation § 87.73 (1989), that if it were the intent of the parties

that AFOP privately purchase the equivalent of workers' compensation,

then the contract should have explicitly said so and referred to a

scale of benefits. Further, AFOP claims that Twombly showed that she

interpreted the contract to mean the standard state-operated system by

filing for benefits. (Plaintiff says this is not so; the employer

could have chosen not to contest her application in the state system.)

AFOP also says that res judicata results from the unappealed Board

finding.

           We think the issue turns on whether the Restatement (Second)

of Contracts excuses AFOP from performance of a commitment to provide



     3     At the Workers' Compensation Board hearing, AFOP's witness
seemed to take the position that any workers' compensation obligation
could and should be satisfied by AFOP's insurer, AIG. That issue is
not before us.

                                 -8-
workers' compensation.     The commitment is unambiguous. set the
                                                        We

factual context for discussing the Restatement issue.         Based in

Virginia, AFOP is a private non-profit group with national operations.

AFOP is an AmeriCorps grant recipient. As such, it is, as it knew,

subject to the terms of the NCSA, the federal act governing grants from

the AmeriCorps program.     Since 1991, the NCSA has provided that

participants in an approved AmeriCorps program -- such as Twombly --

"shall not be considered employees of the program." National and

Community Service Technical Amendments Act of 1991, Pub. L. No. 102-10

§ 3(4), 105 Stat. 29 (codified as amended at 42 U.S.C. § 12511(17)(B)).4

Despite this language, AFOP prepared a standard form contract for its

participants, which Twombly signed in 1995. The contract promised that

AFOP would provide workers' compensation.        Twombly accepted the

contract in reliance on that promise and performed her part of the

contract by working for AFOP.

           When Twombly filed for workers' compensation benefits with

the state, AFOP had the choice to contest or not contest the claim. If

AFOP had not contested the claim and it had been allowed, AFOP would

have borne the costs of the compensation. Alternatively, if the claim

     4     There is no need to decide the issue of whether the federal
Act provision preempts the Maine Workers' Compensation Act, as the
Workers' Compensation Board held. The transcript before the Board
contains evidence that the U.S. Department of Labor considers
participants not to be federal employees for purposes of the federal
unemployment compensation system, but leaves it to the states to
determine eligibility for the state unemployment systems. Nor is there
any need to decide what, if any, are the res judicata effects of that
decision as to Twombly given our disposition of the matter.

                                  -9-
for benefits had been denied (whether the claim had been contested or

uncontested), AFOP could have paid Twombly workers' compensation in

another form.

          The provisions of the Restatement (Second) of Contracts at

issue have to do with situations in which a court relieves a party from

performance of an obligation because

          [a]n extraordinary circumstance may make
          performance so vitally different from what was
          reasonably to be expected as to alter the
          essential nature of that performance. In such a
          case the court must determine whether justice
          requires a departure from the general rule that
          the obligor bear the risk that the contract may
          become more burdensome or less desirable.


Restatement (Second) of Contracts ch. 11, introductory note at 309-10.

          The analysis begins with Restatement § 261, which provides:

          Discharge by Supervening Impracticability

          Where, after a contract is made, a party's
          performance is made impracticable without his
          fault by the occurrence of an event the non-
          occurrence of which was a basic assumption on
          which the contract was made, his duty to render
          that performance is discharged, unless the
          language or the circumstances indicate the
          contrary.

Id. § 261. Importantly, § 261 states "a principle broadly applicable

to all types of impracticability" and "'deliberately refrains from any

effort at an exhaustive expression of contingencies.'" Id. § 261 cmt.

a (quoting U.C.C. § 2-615 cmt. 2). The rules stated in §§ 262-64 guide

the determination whether the principle of § 261 applies in specific

circumstances.

                                 -10-
            In entering summary judgment on this claim, the district

court relied on the Restatement (Second) of Contracts § 264, which

provides:

            Prevention by Governmental Regulation or Order

            If the performance of a duty is made
            impracticable by having to comply with a domestic
            or foreign governmental regulation or order, that
            regulation or order is an event the non-
            occurrence of which was a basic assumption on
            which the contract was made.

Id. § 264. This is generally thought to be an issue of law for the

court, not the jury, to decide. See id. ch. 11 introductory note at

310.   While Maine has not yet decided whether it will adopt this

section, we assume arguendo that it will look to § 264 and this part of

the Restatement for guidance. See Bouchard v. Blunt, 579 A.2d 261, 263

n.3 (Me. 1990) (referring to Restatement (Second) of Contracts § 261).

            Section 264 of the Restatement provides a specific instance

of the general doctrine of "Discharge by Supervening Impracticability"

contained in § 261. See Restatement (Second) of Contracts § 264 cmt.

a, illus. 1, 2.    By the terms of its commentary, § 264 applies to

supervening government actions, as does § 261. See id. § 264 cmt. a;

id. § 261 (referring to performance made impracticable "after a

contract is made") (emphasis added). The 1991 amendment of the NCSA

cannot be supervening as to a 1995 contract. Indeed, the Restatement

says that when the government prohibition already exists at the time of

the making of the contract, the rule stated in § 266(1) applies. See

Restatement (Second) of Contracts § 264 cmt. a ("If the prohibition or

                                  -11-
prevention already exists at the time of the making of the contract,

the rule stated in § 266(1) rather than that stated in § 261 controls,

and this Section applies for the purpose of that rule as well.").

          Thus, § 261 does not apply, and we turn to § 266(1). Section

266(1) only excuses performance

          [w]here, at the time a contract is made, a
          party's performance under it is impracticable
          without his fault because of a fact of which he
          has no reason to know and the non-existence of
          which is a basic assumption on which the contract
          is made, no duty to render that performance
          arises, unless the language or circumstances
          indicate the contrary.


Id. § 266(1). AFOP is not entitled to relief under § 266(1). AFOP, an

organization of national scope and the drafter of the form contract,

cannot be said to be "without fault," or not to have reason to know of

the definition of "participant" enacted in 1991. See In re Estate of

Zellmer, 82 N.W. 2d 891, 894 (Wis. 1957) (holding that estate was not

excused from performance under Restatement where decedent should have

known of lapsed premiums on insurance policy). It is equally clear

that the "fact" in question was material. AFOP knowingly promised

workers' compensation, and Twombly relied on that promise in accepting

AFOP's offer.

          Finally, the "language and circumstances" of the contract are

such that AFOP is not excused from performance under § 266(1). Even if

AFOP were in fact ignorant of the 1991 provision -- and the evidence

presented to the Workers' Compensation Board is to the contrary -- the


                                -12-
risks of that ignorance are better borne by AFOP than by the individual

AmeriCorps participants. This is not a situation where a later law

makes it illegal for a plaintiff to perform or partially perform but

plaintiff still seeks to be paid the contract price, as in American

Mercantile Exchange, 66 A. at 213-14, the case on which the district

court relied. Rather, after entering into the contract in reliance on

the promise of workers' compensation, Twombly performed her side of the

contract.    It would be unjust to say AFOP is excused from its

obligation.5 If AFOP did not wish to oblige itself to provide workers'

compensation in any form, or to provide it if and only if the state

Workers' Compensation Board approved, it could have drafted the

contract accordingly.

            We affirm the entry of summary judgment on the health

coverage claim, reverse the entry of summary judgment on the workers'

compensation claim, and remand for further proceedings. No costs are

awarded.




     5    The Maine Workers' Compensation Board determined that
"Twombly was traveling as part of her duties . . . [at] AFOP" at the
time of her injury. We take that as established. If there are any
remaining issues about coverage, they may be explored on remand.

                                 -13-