Death & Permanent Total Disability Trust Fund v. Legacy Insurance Services and Lumbermen's Mutual Casualty
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DEATH & PERMANENT TOTAL DISABILITY TRUST
FUND v. LEGACY INS. SERVS. and Lumbermen’s Mutual
Casualty
CA05-732
Court of Appeals of Arkansas
Opinion delivered May 10, 2006
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W ORKERS’ COMPENSATION – INSURANCE CARRIER RECEIVED CREDIT AGAINST ITS
MAXIMUM LIABILITY FOR PAYMENTS CLASSIFIED BY THE C OMMISSION AS PERMANENTTOTAL- DISABILITY PAYMENTS.–
The Commission’s decision was supported by
substantial evidence where the parties’ stipulated that claimant’s healing period ended
on December 10, 2002, at which time he was permanently and totally disabled, and
the Commission effectively adopted December 10 as the date that payments for
temporary-total-disability benefits ended and permanent disability payments began,
and the Commission therefore classified all payments made after December 10, 2002,
as permanent-total-disability payments that could be applied towards the insurance
carrier’s $75,000 maximum liability pursuant to Ark. Code Ann. § 11-9-502 (Repl.
1996).
Appeal from Arkansas Workers’ Compensation Committee; affirmed.
Judy Rudd, for appellant.
Rieves, Rubens & Mayton, by: David C. Jones, for appellees.
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O LLY N EAL, Judge.
This appeal from the Arkansas Workers’ Compensation
Commission (Commission) presents the question of whether an insurance carrier is entitled
to a credit for payments made toward a twenty-nine percent permanent-anatomicalimpairment rating against its $75,000 maximum liability for permanent-total-disability
benefits pursuant to Ark. Code Ann. § 11-9-502(b) (Repl. 1996). We answer this question
in the affirmative; therefore, we affirm the decision of the Commission.
Joseph Thomas worked for appellee Legacy Insurance Services (Legacy) when he was
injured in a motor-vehicle accident on November 14, 2000. He sustained unscheduled
closed-head and hand injuries, and Legacy and its carrier, appellee Lumbermen’s Mutual
Casualty Company, accepted his accident as compensable. In addition to the stipulation of
compensability, the parties made several other stipulations, including that (1) Thomas
reached maximum-medical improvement and his healing period ended on December 10,
2002; (2) Thomas’s permanent- anatomical-impairment rating was being paid, with $38,628
ultimately being the total amount paid over 130.5 weeks; and (3) Thomas was permanently
and totally disabled as of December 10, 2002.
The only issues presented to the
administrative law judge (ALJ) were whether an actuarial valuation study dated June 30,
2003, and offered by appellant Death & Permanent Total Disability Trust Fund, was
admissible into evidence and whether appellees were entitled to a credit for the payments
made for the impairment rating toward their $75,000 cap for weekly permanent-total-
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disability benefits. The Commission issued its own opinion in which it affirmed the ALJ’s
determinations that the actuarial valuation study was inadmissible and that appellees were
entitled to a credit. It is from this decision that appellant appeals.
Appellant does not challenge the Commission’s determination on the admissibility of
the actuarial valuation study; instead, for reversal, appellant asserts only that the Commission
erred in its interpretations of Ark. Code Ann. §§ 11-9-501, 502, 519, and 522 as allowing
appellees credit for payment of the permanent-anatomical-impairment rating against their
maximum $75,000 liability as provided in Ark. Code Ann. § 11-9-502.
In appeals involving claims for workers’ compensation, our court views the evidence
in a light most favorable to the Commission’s decision and affirms the decision if it is
supported by substantial evidence. Wallace v. West Fraser South, Inc., ___ Ark. ___, ___
S.W.3d ___ (Jan. 26, 2006). Substantial evidence exists if reasonable minds could reach the
Commission’s conclusion. Foster v. Personnel Servs., ___ Ark. App. ___, ___ S.W.3d ___
(Jan. 4, 2006). We will not reverse the Commission’s decision unless we are convinced that
fair-minded persons with the same facts before them could not have reached the conclusions
arrived at by the Commission. Dorris v. Townsends of Arkansas, Inc., ___ Ark. App. ___,
___ S.W.3d ___ (Nov. 30, 2005).
In affirming the decision of the ALJ, the Commission wrote in part:
The parties in the present matter stipulated that the claimant was permanently
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and totally disabled. The parties also stipulated that claimant’s healing period ended
on December 10, 2002.
Respondent No. 1 [Legacy Insurance Services and
Lumbermen’s Mutual Casualty] must therefore pay the claimant “weekly benefits”
representing permanent total disability pursuant to Ark. Code Ann. § 11-9-502(b)
from the date of the end of claimant’s healing period, until the respondent-carrier has
paid the claimant $75,000. Benefits paid pursuant to Ark. Code Ann. § 11-9-522(a)
are partial benefits and once a determination of permanent and total disability has
been made, the benefits due a claimant are no longer governed by 11-9-522 but are
found in Ark. Code Ann. § 11-9-502(b) and Ark. Code Ann. § 11-9-519(e). Thus,
when a determination of permanent total disability has been made, the benefits paid
by a respondent after the end of the healing period are classified as permanent and
total disability benefits under Ark. Code Ann. § 11-9-502(b). The statute then
provides, “all benefits in excess of seventy-five thousand dollars ($75,000) shall be
payable from the Death and Permanent Total Disability Trust Fund.”
Based on our de novo review of the entire record, . . . [t]he Full Commission
affirms the administrative law judge’s finding, “Respondent #1 is entitled to a credit
for the amount of permanent anatomical impairment rating benefits ultimately paid
to Claimant, against the first $75,000 of permanent and total disability benefits
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Respondent #1 must pay, thereby reducing the balance of the $75,000.00 due from
Respondent No. 1.”
We hold that substantial evidence supports the Commission’s decision. There are two
distinct forms of disability payments—temporary and permanent. See Ark. Code Ann. §
11-9-101 (Repl. 1996) (“ The primary purposes of the workers’ compensation laws are to pay
timely temporary and permanent disability benefits to all legitimately injured workers who
suffer an injury or disease arising out of and in the course of their employment....”).
Temporary disability is that period within the healing period in which an employee suffers
a total or partial incapacity to earn wages. Breakfield v. In & Out, Inc., 79 Ark. App. 402,
88 S.W.3d 861 (2002). The healing period is defined as that period for healing of an
accidental injury that continues until the employee is as far restored as the permanent
character of the injury will permit, and that ends when the underlying condition causing the
disability has become stable and nothing in the way of treatment will improve that condition.
See Poulan Weed Eater v. Marshall, 79 Ark. App. 129, 84 S.W.3d 878 (2002). When a
claimant’s healing period has ended so has his right to temporary disability. See Legacy
Lodge v. McKellar, 26 Ark. App. 260, 763 S.W.2d 101 (1989). Until the healing period has
ended, there is no way to determine whether there is permanent disability. See Sparks Reg’l
Med. Ctr. v. Death & Permanent Total Disability Bank Fund, 22 Ark. App. 204, 737 S.W.2d
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463 (1987) (where claimant’s healing period ended on February 7, 1983, any payments made
subsequently were for permanent-total disability and only those payments may be applied
toward the employer-carrier’s maximum-liability limit).
Permanent benefits are only awarded upon a determination that the compensable
injury was the major cause of a disability or impairment.
Ark. Code Ann. § 11-9-
102(4)(F)(ii)(a) (Repl. 1996). Arkansas Code Annotated section 11-9-502 (Repl. 1996) sets
forth the exceptions to the limitations on compensability for death and total permanent
disability benefits. Subsection b provides:
(b)(1) For injuries occurring on and after March 1, 1981, the first seventy-five
thousand dollars ($75,000) of weekly benefits for death or permanent total disability
shall be paid by the employer or its insurance carrier in the manner provided in this
chapter.
(2) An employee or dependent of an employee who receives a total of seventy-five
thousand dollars ($75,000) in weekly benefits shall be eligible to continue to draw
benefits at the rates prescribed in this chapter, but all benefits in excess of
seventy-five thousand dollars ($75,000) shall be payable from the Death and
Permanent Total Disability Trust Fund.
In this instance, the parties stipulated that Thomas’s healing period ended on December 10,
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2002. Generally, a stipulation is “[a] voluntary agreement between opposing parties.”
Ferguson v. State, ___ Ark. ___,___, ___ S.W.3d ___, ___ (June 9, 2005) (Hannah, J.,
concurring) (citing B LACK’S L AW D ICTIONARY 1455 (8th ed. 2004)). It has long been settled
law in Arkansas that a stipulation is the equivalent of undisputed proof, and it leaves nothing
for the fact-finder to decide regarding the stipulated subject. Riddell Flying Serv. v.
Callahan, ___ Ark. App. ___, ___ S.W.3d ___ (Apr. 6, 2005). As such, on December 10,
2002, Thomas became permanently and totally disabled. “Permanent total disability” means
“inability, because of compensable injury or occupational disease, to earn any meaningful
wages in the same or other employment.” Ark. Code Ann. § 11-9-519 (e)(1) (Repl. 1996).
Furthermore, Arkansas Code Annotated section 11-9-501(c)(2) (Repl. 1996) states
that “[a]ny weekly benefit payments made after the commission has terminated temporary
total benefits shall be classified as warranted by the facts in the case and as otherwise
provided for in this chapter.” By accepting the parties’ stipulation that Thomas’s healing
period ended on December 10, 2002, at which time he was permanently and totally disabled,
the Commission effectively adopted December 10 as the date that payments for temporarytotal-disability benefits ended and permanent disability payments began. Therefore all
payments made after December 10, 2002, were classified by the Commission as permanenttotal-disability payments that could be applied towards the $75,000 maximum pursuant to
Ark. Code Ann. § 11-9-502 (Repl. 1996).
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Affirmed.
G LADWIN and G RIFFEN, JJ., agree.
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