ROBERT L. WHITTAKER, DIRECTOR OF SPECIAL FUND v. JAMES C. HALL, SURVIVING SPOUSE OF CYNTHIA K. HALL; PEYTON'S INC.; HON. SHEILA C. LOWTHER, CHIEF ADMINISTRATIVE LAW JUDGE; and WORKERS' COMPENSATION BOARD and PEYTON'S INC. v. JAMES C. HALL, SURVIVING SPOUSE OF CYNTHIA K. HALL; HON. ROBERT WHITTAKER, DIRECTOR OF SPECIAL FUND; ADMINISTRATIVE LAW JUDGE, SHEILA C. LOWTHER, ADMINISTRATIVE LAW JUDGE, DENIS S. KLINE, and WALTER W. TURNER, COMMISSIONER, WORKERS' COMPENSATION BOARD
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RENDERED:
OCTOBER 26, 2001; 10:00 a.m.
NOT TO BE PUBLISHED
C ommonwealth O f K entucky
C ourt O f A ppeals
NO.
2001-CA-000390-WC
ROBERT L. WHITTAKER,
DIRECTOR OF SPECIAL FUND
v.
PETITION FOR REVIEW OF A DECISION
OF THE WORKERS' COMPENSATION BOARD
ACTION NO. WC-93-27664
JAMES C. HALL, SURVIVING
SPOUSE OF CYNTHIA K. HALL;
PEYTON’S INC.;
HON. SHEILA C. LOWTHER,
CHIEF ADMINISTRATIVE LAW JUDGE; and
WORKERS’ COMPENSATION BOARD
AND
APPELLEES
NO. 2001-CA-000395-WC
PEYTON’S INC.
v.
APPELLANT
APPELLANT
PETITION FOR REVIEW OF A DECISION
OF THE WORKERS' COMPENSATION BOARD
ACTION NO. WC-93-27664
JAMES C. HALL, SURVIVING
SPOUSE OF CYNTHIA K. HALL;
HON. ROBERT WHITTAKER,
DIRECTOR OF SPECIAL FUND;
ADMINISTRATIVE LAW JUDGE,
SHEILA C. LOWTHER, ADMINISTRATIVE
LAW JUDGE, DENIS S. KLINE, and
WALTER W. TURNER, COMMISSIONER,
WORKERS’ COMPENSATION BOARD
APPELLEES
OPINION
AFFIRMING
** ** ** ** **
BEFORE:
GUDGEL, Chief Judge, BUCKINGHAM and McANULTY, Judges.
BUCKINGHAM, JUDGE: This workers’ compensation case involves
separate petitions for review of an opinion of the Workers’
Compensation Board (Board).
The first petition for review was
filed by the employer, and the second petition for review was
filed by the Special Fund.
We conclude that the Board ruled
correctly on both matters and thus affirm.
The claimant, Cynthia K. Hall, was employed with
Peyton’s, Inc., for twenty-four years at the time of her injury.
Peyton’s was a food service vendor for the Kroger Company, and
Hall was employed by Peyton’s as a forklift operator on July 15,
1993, the date of her injuries.
On that date, she was injured
when another forklift struck her forklift.
As a result of the
incident, Hall suffered injuries to her hip and low back.
Hall
was off work for one week of rest following the accident.
She
then began a program of physical therapy that caused pain in her
low back.
In September 1993, Hall returned to work but continued
to suffer pain from her injuries.
The pain increased to the
point that it became unbearable and, on October 29, 1993, Hall
quit her job.
back.
On January 26, 1994, Hall underwent surgery on her
From the time she quit her job in October 1993, until her
death on October 7, 1999, due to a cause that was not workrelated, Hall remained unemployed.
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In an order entered on January 28, 1997, an
administrative law judge (ALJ) determined that Hall was only
fifty percent occupationally disabled and not totally disabled.
Hall appealed to the Board, and the Board reversed and remanded
the ALJ’s decision.
In a concurring opinion, one member of the
Board noted that the opinion did not necessitate a finding of
total occupational disability but rather required further
findings of fact.
On petition for review, a panel of this court affirmed
the Board’s decision.
The court held that “[o]n remand, the ALJ
must consider all of the factors set forth in KRS 342.0011(11)
and Osborne v. Johnson, Ky., 432 S.W.2d 800 (1968).”
On appeal,
the Kentucky Supreme Court affirmed in part, reversed in part,
and remanded.
The court held:
We agree with the decisions below to the
extent that the ALJ’s opinion and the order
denying the petition for reconsideration does
not make it clear that the ALJ truly
considered all of the factors enumerated in
KRS 342.0011(11) and Osborne v. Johnson or
that the ALJ considered only evidence which
was material to the question at hand. When
those factors are considered, it is apparent
that a worker need not be unemployable in
order to be totally occupationally disabled.
Likewise, there is no requirement that a
worker who is unable to return to her prior
employment, or to similar employment, must be
awarded a total occupational disability. We
conclude that the claim must be remanded for
more specific findings from the evidence
which indicate an analysis of the extent of
claimant’s occupational disability under the
law and for the entry of an award which is
consistent with those findings. Keeping in
mind that claimant had the burden to
demonstrate that her occupational disability
was total, we are not persuaded that the
evidence was so overwhelming that it
necessarily compelled a conclusion that she
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was totally occupationally disabled and
reverse the decision of the Court of Appeal
to the extent that it might imply otherwise.
By the time this case had completed its travel through
the first appeal and had been remanded to the ALJ, the ALJ who
originally heard the case had returned to private practice.
As a
result, the case was assigned to the chief administrative law
judge (CALJ).
In an opinion rendered on May 2, 2000, the CALJ noted that:
The Supreme Court of Kentucky ultimately
ruled that this claim must be remanded to the
Administrative Law Judge for a more specific
findings from the evidence, indicating an
analysis of the extent of the claimant’s
occupational disability under the law and for
the entry of an award consistent with those
findings.
The CALJ then concluded that Hall was totally and permanently
occupationally disabled as a result of the accident.
Further,
the CALJ apportioned the total amount of benefits, to include
those which were owed during the period from her injury until her
death, equally between Peyton’s and the Special Fund.
In a
subsequent order, the CALJ ordered that weekly benefits in the
amount of $253.34 were to be paid to Hall’s estate for the period
from October 29, 1993, through the date of her death on
October 7, 1999.
Further, the CALJ ordered that weekly benefits
in the sum of $126.67 be paid to James C. Hall, surviving spouse
of Cynthia Hall, from October 8, 1999, and continuing thereafter
for the remainder of Hall’s life expectancy.
The order directed
all benefits to be apportioned equally between Peyton’s and the
Special Fund.
On appeal by Peyton’s and the Special Fund to the
-4-
Board, the Board affirmed the CALJ’s orders as entered.
These
petitions for review by Peyton’s and the Special Fund followed.
2001-CA-000395-WC
In Peyton’s petition for review, it argues that the
CALJ was directed by the Kentucky Supreme Court in its opinion to
find evidence to support the original ALJ’s finding of fifty
percent disability.
It argues that the court’s opinion precluded
a finding by the ALJ on remand that Cynthia was totally
occupationally disabled.
Peyton relies on the language in the
supreme court’s opinion which stated that “we are not persuaded
that the evidence was so overwhelming that it necessarily
compelled a conclusion that she was totally occupationally
disabled[.]”
We disagree with Peyton’s argument.
Once the case
reached the Kentucky Supreme Court, it had two obvious options
for resolving the dispute.
First, it could have concluded that
the evidence was so overwhelming as to require a different result
from that reached by the ALJ.
Had it elected to do so, it would
have then merely remanded the case and instructed the ALJ to
enter a finding of total occupational disability.
The second
alternative facing the court was to agree with the ALJ’s order
finding fifty percent occupational disability.
Had the supreme
court desired to do this, it would have merely ordered that the
ALJ’s opinion be reinstated.
If the court had wished to
reinstate the ALJ’s original finding, there would have been no
need for it to remand the case for further findings of fact to
support the finding that Hall had a fifty percent occupational
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disability.
Although each of these options were available to the
Kentucky Supreme Court, it elected to do neither.
It is clear from the language used by the court that
while it did not believe the evidence “necessarily compelled” a
finding of total disability, neither did it usurp the ALJ’s role
as a fact finder and set a predetermined level of disability.
Rather, the court remanded the case for the reevaluation of the
evidence, the entry of findings based on that evidence, and the
entry of an award of disability consistent with the new findings.
We agree with the Board’s clear interpretation of the supreme
court’s directive:
Very simply, it was the directive of the
Supreme Court that while the evidence may not
have compelled a finding of total
occupational disability, it remained
incumbent upon an ALJ upon remand to again
review the evidence of record and reach a
conclusion as to the extent of occupational
disability being experienced by Hall. This
is precisely what the CALJ did.
The Board’s opinion as it relates to Peyton’s petition for review
is affirmed.
2000-CA-000390-WC
In its petition for review, the Special Fund argues
that the CALJ incorrectly apportioned the award when she ordered
that it was responsible for fifty percent of the known award
value.
This dispute arose because of the fact that Hall died
from non-work related causes by the time the CALJ had entered her
final order and prior to any payments being made.
Hall’s estate
was entitled to the full weekly amount from the date she was
injured till the date of her death.
-6-
From the date of her death
through the remainder of her life expectancy, Hall’s surviving
spouse is entitled to receive fifty percent of the award.
KRS1 342.730(3).
See
Because the CALJ could readily ascertain the
full value of the award, she divided the total amount of benefits
between the employer and the Special Fund who had stipulated
liability on a 50/50 basis.
The Special Fund argues that because Hall died, the
initial assessment of one hundred percent liability from the date
of the injury until her death would have been during Peyton’s
payment period and that pursuant to Williamson v. Island Creek
Coal Co., Ky. App., 899 S.W.2d 499 (1995), the CALJ erred in
apportioning the benefits equally between Peyton’s and the
Special Fund.
The Special Fund argues that instead of
apportioning the ascertainable value of the award, the CALJ
should have apportioned the life expectancy time period thus
leaving each party responsible for the amount of the award during
its respective time period.2
In its brief to this court, the
Special Fund acknowledged that “the issue presented herein is
pending before the Supreme Court.”
1
Kentucky Revised Statutes. All statutes referenced in
this opinion are to those in effect at the time of the claim.
2
Under KRS 342.120 the employer is responsible for initial
payments for the time period necessary to meet its respective
obligation. Once the employer has met its obligation, the
Special Fund takes over payments. Hall’s death occurred during
Peyton’s payment period. Thus, under the Special Fund’s
argument, Peyton’s incurred responsibility for a larger portion
of the total ascertainable value of the award.
-7-
On September 27, 2001, the Kentucky Supreme Court
rendered its opinion in the case of Whittaker v. Patrick, 2000SC-1095-WC.
Therein, the court held as follows:
We conclude, therefore, that where a
worker dies before receiving an award of
income benefits, the benefits that accrue
before his death and any benefits that
continue to his survivors after his death
must both be viewed by the ALJ as parts of
the same award. As a result, any benefits
that are payable to the worker’s estate and
any remaining benefits that are payable to
survivors must be treated as parts of a
whole, and the sum of those benefits must be
apportioned. By operation of KRS 342.120,
the employer must then be ordered to pay its
apportioned share of all benefits awarded,
after which the Special Fund’s payment period
begins.
Based on the Patrick case, we conclude that the Board did not err
in ordering the known value of the award to be apportioned
equally between Peyton’s and the Special Fund.
The opinion of the Board in this regard is also
affirmed.
ALL CONCUR.
BRIEF FOR APPELLANT, SPECIAL
FUND:
BRIEF FOR APPELLEE, JAMES C.
HALL, Surviving Spouse of
Cynthia Hall
David R. Allen
Frankfort, Kentucky
Edward A. Mayer
Louisville, Kentucky
BRIEF FOR APPELLANT, PEYTON’S,
INC.:
Walter E. Harding
Louisville, Kentucky
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