JAMES MUNCY v. ELMO GREER & SONS; HON. HOWARD E. FRASIER, JR., ADMINISTRATIVE LAW JUDGE; AND WORKERS' COMPENSATION BOARD
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RENDERED: FEBRUARY 23, 2007; 10:00 A.M.
NOT TO BE PUBLISHED
Commonwealth of Kentucky
Court of Appeals
NO. 2006-CA-001742-WC
JAMES MUNCY
v.
APPELLANT
PETITION FOR REVIEW OF A DECISION
OF THE WORKERS' COMPENSATION BOARD
ACTION NO. WC-03-93415
ELMO GREER & SONS;
HON. HOWARD E. FRASIER, JR.,
ADMINISTRATIVE LAW JUDGE; AND
WORKERS' COMPENSATION BOARD
APPELLEES
OPINION
AFFIRMING
** ** ** ** **
BEFORE: ABRAMSON AND DIXON, JUDGES; HOWARD,1 SPECIAL JUDGE.
ABRAMSON, JUDGE: The sole issue presented by this appeal is whether the applicable
limitations period for filing a workers' compensation claim was tolled during the time in
which Appellant James Muncy received personal injury protection (PIP) benefits from
1
Special Judge James I. Howard completed this opinion prior to the expiration of his Special Judge assignment
effective February 9, 2007. Release of the opinion was delayed by administrative handling..
his employer's automotive insurance carrier. Finding no error in the Workers'
Compensation Board's decision that PIP benefits are not “income benefits” under the
applicable statute and thus the limitations period was not tolled, we affirm.
On February 28, 2003, James Muncy was injured in a motor vehicle
accident. At the time of the accident, he was operating a vehicle owned by Elmo Greer &
Sons (Elmo Greer) and was in the course and scope of his employment. Elmo Greer,
through its workers' compensation insurance carrier, paid Muncy temporary total
disability benefits from March 1, 2003, through July 18, 2003. Muncy also received PIP
benefits from Elmo Greer's automotive insurance carrier until October 2, 2003.
On August 8, 2003, the Department of Workers' Claims sent a Notice of
Termination of income benefits to Muncy. The notice informed Muncy that payment of
his income benefits ceased effective July 18, 2003. The notice further stated that if he
wished to seek additional benefits, an application “must be filed within two years after
the date your injury occurred, or, within two years after the last voluntary payment of
income benefits . . . .” (Emphasis in original.)
Muncy filed an application for additional benefits on July 25, 2005. On
September 23, 2005, the Department of Workers' Claims issued a Notice of Claim
Denial. One of the reasons given for denial of Muncy's claim is that the statute of
limitations found in Kentucky Revised Statute (KRS) 342.185 barred his claim because
he did not file it within two years of the cessation of voluntary income benefit payments.
Muncy sought review with the Board, arguing that the PIP benefits he received from
Elmo Greer's automotive insurance carrier constituted “excess” workers' compensation
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benefits and therefore the true termination date for the payment of income benefits was
October 2, 2003, rather than July 18, 2003. Following a hearing, the Administrative Law
Judge (ALJ) upheld the denial of further benefits after finding that Muncy's application
was not timely filed. The ALJ disagreed with Muncy's contention that the PIP benefits
constituted “excess” workers' compensation benefits, stating:
Despite his failure to file a claim within two years of the
suspension of the payment of income benefits by the
Defendant under its workers compensation policy, the
Plaintiff argues that since he continued to receive PIP benefits
until October 3, 2003, from the insurance carrier for the
motor vehicle insurance on the vehicle he was driving at the
time of the accident, his claim was timely filed. Mr. Muncy
is relying upon the language contained in the PIP Worksheet
that such benefits were being paid in excess of workers
compensation coverage.
However, the problem with this argument is that the PIP
benefits were not paid in lieu of or in the place of workers
compensation benefits but IN ADDITION to workers
compensation benefits. As correctly argued by the
Defendant, PIP benefits are designed to pay 100% of lost
wages up to the maximum amount permitted by law while
workers compensation benefits are paid at a rate of no more
than 2/3's of the average weekly wage prior to the time that
the Plaintiff reaches MMI or is able to perform his customary
work.
...
Basic reparation benefits are designed to provide for wage
loss and medical benefits in the context of a motor vehicle
accident regardless of whether such accident is work-related.
An employee could use his personal vehicle for a business
purposes [sic] and his personal automobile insurance would
provide him with basic reparation benefits whether or not he
files a claim for workers' compensation benefits. On the other
hand, workers compensation benefits are intended to
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compensate injured workers whether or not such accident
occurs in the context of a motor vehicle accident.
The undersigned finds that in light of the completely different
purposes of the two statutes, the Kentucky Legislature did not
intend for “income benefits” in KRS 342.185 to include the
payment of basic reparation benefits under an automobile or
truck insurance policy. To hold otherwise would completely
defeat the process of notification of termination or suspension
of benefits and the ability of an employer and workers
compensation carrier to restart the running of the statute of
limitations.
By providing a statute of limitations for the filing of workers
compensation claims, the Kentucky Legislature has intended
to encourage the prompt filing of claims. Just as the
Legislature tolls the need to file such a claim while TTD is
being paid to an employee, the Legislature has chosen to
resume the running of the statute of limitation after
termination and prompt notice of such benefits. Any tolling
of the need to file a workers compensation claim because of
the payment of PIP benefits under a motor vehicle policy
would be contrary to such purposes.
ALJ's Opinion and Order, pp. 4-6.
Muncy appealed the ALJ's decision and the Board affirmed in a July 21,
2006 decision. Muncy now seeks review in this Court. Finding no error in the Board's
decision, we affirm.
When reviewing a final decision of the Board, this Court gives great
deference to the Board's findings and only intervenes where its action constitutes a
flagrant error resulting in gross injustice. Western Baptist Hosp. v. Kelly, 827 S.W.2d
685 (Ky. 1992). This matter, however, turns only on a question of law. As a result, we
give no deference to the Board's findings, and our review is de novo.
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The statute of limitation at issue herein is found in KRS 342.185(1), which
states:
Except as provided in subsection (2) of this section, no
proceeding under this chapter for compensation for an injury
or death shall be maintained unless a notice of the accident
shall have been given to the employer as soon as practicable
after the happening thereof and unless an application for
adjustment of claim for compensation with respect to the
injury shall have been made with the office within two (2)
years after the date of the accident . . . whether or not a claim
has been made by the employee himself for compensation.
. . . If payments of income benefits have been made, the
filing of an application for adjustment of claim with the office
within the period shall not be required, but shall become
requisite within two (2) years following the suspension of
payments or within two (2) years of the date of the accident,
whichever is later.
The sole question now before us concerns the date on which this two-year period began
to run with respect to Muncy's claim for additional benefits. If, as the Board found, the
statute of limitations began to run with the cessation of total temporary disability benefits
on July 18, 2003, rather than with the cessation of the PIP payments, Muncy's claim was
not filed before expiration of the limitations period.
As noted above, the running of the statute of limitation is triggered with the
suspension of income benefit payments. “Income benefits” are defined in KRS
342.0011(12) to be those payments “made under the provisions of this chapter to the
disabled worker or his dependents in case of death, excluding medical and related
benefits.” Under this definition, we must agree with the Board that PIP benefits are not
income benefits because they are not made pursuant to the provisions of KRS Chapter
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342. Rather, PIP benefits, also referred to as basic reparation benefits, are defined in, and
their purpose and use governed by, KRS 304.39-010 et seq.
Moreover, as “income benefits” and PIP benefits do not compensate for the
same loss, the latter cannot be deemed to simply be an extension of the former. While
“income benefits” excludes “medical and related benefits,” PIP benefits provide
reimbursement for all “net loss suffered through injury” as the result of an automobile
accident. The reason for this is obvious—PIP benefits are meant to provide for a loss
resulting from a motor vehicle accident regardless of whether the vehicle being used was
owned by an employer or was being operated for any work-related purpose.
Conversely, workers' compensation income benefits are designed to replace income
which is lost as a result of a work-related injury. See, e.g., Leeco, Inc. v. Crabtree, 966
S.W.2d 951 (Ky. 1998). As a result, the fact that Muncy's injuries occurred while
performing a work-related task is immaterial to whether he was entitled to PIP benefits.
It was merely his operation of the vehicle in question, not his purpose for using it, that
triggered his entitlement to PIP benefits.
Because of the distinction between “income benefits” and PIP benefits, the
automotive insurance carrier's single handwritten notation on a PIP worksheet that the
PIP benefits paid to Muncy were “excess workers comp” cannot change their character
from an automotive insurance benefit to a workers' compensation benefit. It was
therefore incumbent upon Muncy to file his application for additional benefits by or
before July 18, 2005. He did not do so, and thus we affirm the Board's decision
dismissing his claim as untimely.
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ALL CONCUR.
BRIEF FOR APPELLANT:
BRIEF FOR APPELLEE:
McKinnley Morgan
Morgan, Madden, Brashear & Collins
London, Kentucky
Ronald J. Pohl
Crystal L. Moore
Pohl, Kiser & Aubrey, P.S.C.
Lexington, Kentucky
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