989 F. Supp. 2d 211
D.R.I.2013Background
- This Rhode Island case concerns how much of a third-party settlement a plaintiff must reimburse his workers’ compensation carrier.
- Vellucci argues the carrier is entitled only to the portion of the third-party recovery that corresponds to payments Ohio Casualty actually made, excluding pain and suffering.
- Ohio Casualty contends § 28-35-58 requires reimbursement of the full third-party settlement amount regardless of what the settlement represented.
- Vellucci sued for a declaratory judgment; the case was removed to federal court and cross-motions for summary judgment were filed.
- Facts: Vellucci's workers’ compensation payments totaled $763,762.45; he settled with Binnacle for $80,000 and reimbursed $38,122; two other defendants offered $150,000; Ohio Casualty claims a lien on any third-party recovery; the court must decide apportionment if necessary.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Vellucci must reimburse the full settlement or only the portion reflecting compensation paid. | Vellucci: only the amount corresponding to compensation paid is reimbursable. | Ohio Casualty: statute requires full reimbursement of the third-party recovery. | Partial reimbursement allowed; apportionment to be determined. |
| Whether the recovery for pain and suffering and unpaid wages is reimbursable to the carrier. | Pain and suffering not compensated by Ohio Casualty should not be reimbursed. | Any amount in the settlement is potentially subject to reimbursement. | Pain and suffering not reimbursable; but some portion may be (medical/indemnity) pending apportionment. |
| Whether Rhode Island § 28-35-58 permits apportionment of a third-party settlement between reimbursed and non-reimbursed components. | Statute permits allocation and apportionment. | Statute requires reimbursement to the extent of compensation paid, with ambiguous allocation. | Statute supports apportionment; evidentiary hearing required to fix amounts. |
| What is the procedural posture and result on summary judgment given disputed apportionment facts. | Favor the employee on statutory interpretation; grant summary judgment for apportionment. | No total reimbursement without apportionment; deny full relief. | Plaintiff granted-in-part on summary judgment; damages to be determined after evidentiary hearing. |
| Is there authority guiding interpretation of the statute in this context? | Rhode Island precedent favors employee; liberal interpretation. | Rison suggests excess recovery goes to employee; limits on reimbursement. | Court favors employee; liberal interpretation applied; remanded for apportionment. |
Key Cases Cited
- Curry v. Great Am. Ins. Co., 80 Mass.App.Ct. 592 (Mass. App. Ct. 2011) (pain and suffering not compensable under workers’ compensation; not reimbursable)
- Benders v. Bd. of Governors for Higher Educ., 636 A.2d 1313 (R.I.1994) (pain and suffering not compensable under RI workers’ compensation)
- Rison v. Air Filter Sys., 707 A.2d 675 (R.I.1998) (excess of damage recovery over compensation goes to employee)
- Accent Store Design, Inc. v. Marathon House, Inc., 674 A.2d 1223 (R.I.1996) (statutory interpretation: plain meaning governs)