Armstrong v. StateArmstrong v. State
- Workers’ Compensation: Appeal and Error. A judgmеnt, order, or award of the compensation court may be modified, reversed, or set aside only upon the grounds that (1) the compensation court acted without or in excess of its powers, (2) the judgment, order, or award was procured by fraud, (3) there is not sufficient competent evidence in the record to warrant the making of the order, judgment, or award, or (4) the findings of fact by the compensation court do not support the order or award.
- ____: ____. On apрellate review, the factual findings made by the trial judge of the Workers’ Compensation Court have the effect of a jury verdict and will not be disturbed unless clearly wrong.
- ____: ____. In workers’ compensation cases, an appellate court determines questions of law.
- Workers’ Compensation: Words and Phrases. Earning power, as used in
Neb. Rev. Stat. § 48-121(2) (Reissue 2010), is not synonymous with wages. It includes eligibility to procure employment generally, ability to hold a job obtained, and capacity to perform the tasks of the work, as well as the ability of the worker tо earn wages in the employment in which he or she is engaged or for which he or she is fitted. - ____: ____. Total disability does not mean a state of absolute helplessness. It means that because of an injury (1) a worker cannot earn wages in the same kind of work, or work of a similar nature, that he or she was trained for or accustomed to perform or (2) the worker cannot earn wages for work for any other kind of work which a person of his or her mentality and attainments сould do.
- Workers’ Compensation. A worker is not, as a matter of law, totally disabled solely because the worker‘s disability prevents him or her from working full time.
- ____. Under the “odd-lot” doctrine, total disability may be found in the case of workers who, while not altogether incapacitated for work, are so handicapped that they will not be employed regularly in any well-known branch of the labor market.
- ____. A worker may be totally disabled for all practical purposes, despite being able tо find trivial, occasional employment under rare conditions at small remuneration.
- ____. Whether a claimant has suffered a loss of earning power or is totally disabled are questions of fact.
- Appeal and Error. For an appellate court to consider an alleged error, a party must specifically assign and argue it.
- Workers’ Compensation: Penalties and Forfeitures: Time. Under
Neb. Rev. Stat. § 48-125(1)(b) (Cum. Supp. 2014), an employer must pay a 50-percent waiting-time penalty if (1) the employer fails to pay compensation within 30 days of the employеe‘s notice of disability and (2) no reasonable controversy existed regarding the employee‘s claim for benefits. - Workers’ Compensation: Appeal and Error. For the purpose of
Neb. Rev. Stat. § 48-125 (Cum. Supp. 2014), a reasonable controversy exists if (1) there is a question of law previously unanswered by the Supreme Court, which question must be answered to determine a right or liability for disposition of a claim under the Nebraska Workers’ Compensation Act, or (2) if the properly adduced evidence would support reasonable but oppositе conclusions by the compensation court about an aspect of an employee‘s claim, which conclusions affect allowance or rejection of an employee‘s claim, in whole or in part. - Workers’ Compensation: Attorney Fees: Penalties and Forfeitures: Words and Phrases. Whether a reasonable controversy exists under
Neb. Rev. Stat. § 48-125 (Cum. Supp. 2014) is a question of fact. - Workers’ Compensation: Evidence: Time. Evidence showing a reasonable controversy does not have to be known to the employer at the time it refuses benefits.
- Statutes: Judicial Constructiоn: Legislature: Presumptions: Intent. Ordinarily, when an appellate court judicially construes a statute and that construction does not evoke an amendment, the court presumes that the Legislature acquiesced in the court‘s determination of the Legislature‘s intent.
- Workers’ Compensation. Because an employer is liable under
Neb. Rev. Stat. § 48-120 (Reissue 2010) for reasonable medical and hospital services, the employer must also pay the cost of travel incident to and reasonably necessary for obtaining these services.
Appeal from the Workers’ Compensation Court: DANIEL R. FRIDRICH, Judge. Affirmed in part, and in part reversed and remanded with directions.
Jon Bruning, Attorney General, and Elizabeth A. Gregory for appellee.
WRIGHT, CONNOLLY, STEPHAN, MCCORMACK, MILLER-LERMAN, and CASSEL, JJ.
CONNOLLY, J.
SUMMARY
Terry J. Armstrong was injured while working as a nurse in the employ of the State of Nebraska. The Workers’ Compensation Court found that Armstrong was permanently partially disabled and suffered a 75-percent loss of earning power. On appeal, Armstrong argues that a worker who is permanently restricted to part-time work is, as a matter of law, totally disabled. Armstrong also argues that evidence produced by an employer at trial—but unknown at the time benefits are denied—cannot create a reasonable controversy for purposes of the employee‘s entitlement to a waiting-time penalty. We disagree on both points, but remand the cause so that the court may decide if the State is liable for certain mileage expenses.
BACKGROUND
FACTUAL BACKGROUND
On May 22, 2010, Armstrong injured her left shoulder while working as a staff nurse at the Eastern Nebraska Veterans’ Home. Armstrong and her employer stipulated that Armstrong suffered a rotator cuff tear in her left shoulder for which she was “entitled to compensation.” The State paid Armstrong temporary total disability (TTD) benefits from May 22, 2010, until April 23, 2012, when it concluded that Armstrong had reached maximum medical improvement.
As one physician noted, Armstrong‘s “medical history is indeed complicated.” Armstrong underwent surgery to repair the rotator cuff tear in August 2010. Her surgeon stated in September 2011 that Armstrong had reached maximum medical improvement as to her rotator cuff injury.
But multiple physicians opined that Armstrong developed complex regional pain syndrome (CRPS) after the surgery. CRPS is a chronic pain condition that usually affects a limb after an injury to that limb.
At the request of Armstrong‘s attorney, Dr. D.M. Gammel reviewed the “countless medical records” and examined Armstrong on October 8, 2013. Gammel concluded that Armstrong‘s rotator cuff injury caused her CRPS and that her CRPS had reached maximum medical improvement. Gammel opined that Armstrong was permanently limited to working 4-hour days.
PROCEDURAL BACKGROUND
In January 2013, Armstrong filed a petition in Workers’ Compensation Court alleging that she suffered from CRPS and had sustained injuries to both her left and right upper limbs because of the May 2010 accident. Armstrong also alleged that she suffered from bipolar, anxiety, and adjustment disorders because of the accident. Armstrong requested TTD benefits from May 22, 2010, to October 8, 2013—the date Gammel opined that shе reached maximum medical improvement as to her CRPS—and permanent total disability benefits starting on October 8, 2013.
The court appointed a vocational rehabilitation counselor to provide a loss of earning capacity analysis. Karen Stricklett, the appointed counselor, authored a report that gave different estimates based on the opinions of various physicians. Because of Gammel‘s opinion that Armstrong could wоrk only 4 hours per day, Stricklett estimated that Armstrong would have a 75-percent loss of earning capacity.
The compensation court entered an award finding that Armstrong was entitled to TTD and permanent partial disability benefits. In addition to the rotator cuff tear, the court found that Armstrong suffered from CRPS because of the accident. The court also found that Armstrong‘s preexisting anxiety had worsened because of the May 2010 accident. But it concluded that any changes in Armstrong‘s depression or cognition were unrelated to the workplace injury.
The court awarded Armstrong TTD benefits from April 24, 2012, to October 8, 2013. After that date, the court awarded her permanent partial disability benefits measured by her lost earning power. The court stated that Armstrong met her burden of proving a permanent impairment “through the medical report of Dr. Gammel, who opined that [Armstrong] could work four hours per day in the light demand category.”
For Armstrong‘s lost earning power, the court found that she “suffered a 75 percent loss of earning capacity as opined by . . . Stricklett.” The court said that it “simply believes that [Armstrong] is capable of doing more than she led her doctors to believe.” In particular, the court noted reports from emergency room doctors who said that Armstrong showed no signs of stress while using her cell phone but “‘cries out in pain with any motion that we do.‘” The court also said that it observed Armstrong during triаl and noticed that she manipulated papers and moved her limbs without apparent difficulty.
Finally, the court denied Armstrong a waiting-time penalty, attorney fees, and interest under
ASSIGNMENTS OF ERROR
Armstrong аssigns that the compensation court erred by (1) finding that Armstrong suffered a 75-percent loss of earning capacity, because “a 20-hour workweek is not suitable gainful employment as a matter of law“; (2) finding that Armstrong was not entitled to a
STANDARD OF REVIEW
1 A judgment, order, or award of the compensation court may be modified, rеversed, or set aside only upon the grounds that (1) the compensation court acted without or in excess of its powers, (2) the judgment, order, or award was procured by fraud, (3) there is not sufficient competent evidence in the record to warrant the making of the order, judgment, or award, or (4) the findings of fact by the compensation court do not support the order or award.1
2,3 On appellate review, the factual findings made by the trial judge of the Workers’ Compensation Court have the effect of a jury verdict and will not be disturbed unless clearly wrong.2 In workers’ compensation cases, we determine questions of law.3
ANALYSIS
PARTIAL DISABILITY
Armstrong argues that an injured worker with a permanent disability that prevents her from working “full-time” is, as a matter of law, totally disabled.4 According to Armstrong, only “full-time, 40-hour per week employment positions” may be considered when determining a permanently disabled worker‘s lost earning power.5 She frames the issue as follоws: “[C]an a worker who is permanently restricted to working 4-hour days, resulting in a 20-hour workweek, be less than permanently and totally disabled pursuant to Nebraska Workers’ Compensation law?”6
The State contends that Armstrong “confuses wages with earning power.”7 Additionally, the State argues that Armstrong‘s interpretation would lead to “absurd results,” such as an injured worker with a 39-hour workweek restriction being deemed totally disabled solely on that ground.8 In response, Armstrong says that she “does not suggest that the Court adopt a bright-line rule with respect to how many hours worked per week constitutes full-time or part-time employment.”9 Instead, she appears to argue that she is totally disabled unless she can earn “wages similar” to those she would earn in a 40-hour workweek.10
4 The compensation court awarded Armstrong permanent partial disability
5 Armstrong claims that she is permanently totally disabled. Total disability does not mean a state of absolute helplessness.15 It means that because of an injury (1) a worker cannot earn wages in the same kind of work, or work of a similar nature, that he or she wаs trained for or accustomed to perform or (2) the worker cannot earn wages for work for any other kind of work which a person of his or her mentality and attainments could do.16
The thrust of Armstrong‘s argument is that because her weekly wage for permanent disability benefits must be calculated on a 40-hour workweek, her earning power is necessarily zero if her disability prevents her from working full time. Generally,
We have acknowledged that the plain text of
6 We conclude that a worker is not, as a matter of law, totally disabled solely because the worker‘s disability prevents him or her from working full time. While
Of course, a worker‘s inability to work full time is relevant to the worker‘s earning power. For example, we held in Giboo v. Certified Transmission Rebuilders22 that the compensation court erred by relying on an earning power report that failed to consider the impact of a 6-hour workday restriction. We noted the numerical truism that, all else being equal, a person who works only 6 hours per day will earn less than a person who works 8 hours per day. But we also explained that such a restriction “reduce[s] a person‘s earning capacity by virtue of the fact that it reduces the number of jobs available to that individual.”23
7,8 Furthermore, a worker may be totally disabled even though she is able to work in some limited capacity. Under the “odd-lot” doctrine, total disability may be found in the case of workers who, while not altogether incapacitated for work, are so handicapped that they will not be employed regularly in any well-known branch of the labor market.24 A worker may be totally disabled for all practical purposes, despite being able to find trivial, occasional employment under rare conditions at small remuneration.25 For example, we have affirmed a finding of total disability where the claimant had a “low tolerance for prolonged sitting, standing, or walking”26; where the claimant could engage in activity for only 30 minutes before needing to rest27; and where the claimant worked 16 to 18 hours per week only “аt the sufferance of an employer willing to provide the extra supervision and who would tolerate his aberrational behavior.”28 But we have noted that “not all part-time work . . . is trivial.”29
9,10 Whether a claimant has suffered a loss of earning power or is totally disabled are questions of fact.30 Here, Armstrong assigns that the compensation court erred
by finding that she had a 75-percent loss of earning power because “a 20-hour workweek is not suitable gainful employment as a matter of law.” Having rejected this assignment, we do not
WAITING-TIME PENALTY, ATTORNEY FEES, AND INTEREST
Armstrong argues that she is entitled to a waiting-time penalty, attorney fees, and interest because of the State‘s failure to pay TTD benefits within 30 dаys of notice of her disability. The compensation court found that the State “did not have a basis for the discontinuation of [Armstrong‘s] TTD benefits at the time it did so.” But the court denied Armstrong a waiting-time penalty because the State “present[ed] evidence at trial that justified its discontinuation of benefits.” Armstrong contends that a reasonable controversy must exist at the time the employer denies benefits.
11 Under
12,13 Under the test we announced in Mendoza v. Omaha Meat Processors,35 for the purpose of
14 We have explained that “[u]nder the Mendoza test, when there is some conflict in the medical testimony adduced at trial, reasonable but opposite conclusions could be reached by the compensation court.”38
Here, [the employer] presented expert medical testimony that would have supported a finding that [the claimant‘s]
condition was not the result of an accident arising out of and in the course of employment. . . . While this opinion was not adduced until аfter the denial of benefits, it is evidence that [the employer] had an actual basis in law or fact for denying [the claimant‘s] claim.40
So, we concluded that a reasonable controversy existed based on testimony unknown at the time the employer denied benefits.
15 Ordinarily, when an appellate court judicially construes a statute and that construction does not evoke an amendment, we presume that the Legislature acquiesced in the court‘s dеtermination of the Legislature‘s intent.41 The Legislature has amended
Armstrong contends that Dawes discourages the prompt payment of benefits by giving the employer an incentive to delay. As we noted in Dawes, the purpose of the waiting-time penalties in
be noncontroversial, the employer is subject to the significant waiting-time penalties in
Armstrong concedes that the evidence produced at trial showed the existence of a reasonable controversy. We therefore affirm the court‘s denial of a waiting-time penalty, attorney fees, and interest based on the State‘s failure to pay benefits within 30 days of notice of Armstrong‘s disability.
MILEAGE EXPENSES
Armstrong argues that the court “overlooked”
16 Under
We agree that the court overlooked exhibit 22. Exhibits 22 and 53 contain mileage for trips to the same providers for the same services, such as mileаge to and from occupational therapy. It is not apparent why the court would award mileage expenses for Armstrong‘s occupational therapy on November 13, 2013, documented in exhibit 53, but not her trip to occupational therapy on November 8, 2013, documented in exhibit 22. We therefore direct the court to consider on remand which of the trips described in exhibit 22, if any, the State should pay.
CONCLUSION
We affirm the compensation court‘s finding that Armstrong is permanently partially disabled and has suffered a 75-percent loss of earning capacity. A worker is not, as a matter of law, totally disabled solely because she is unable to work full time. We also conclude that the court did not err by denying Armstrong a waiting-time penalty, attorney fees, and interest under
AFFIRMED IN PART, AND IN PART REVERSED AND REMANDED WITH DIRECTIONS.
HEAVICAN, C.J., participating on briefs.