THRESHERMENS MUTUAL INSURANCE COMPANY, Plaintiff-Appellant, Dorothy GROSS, Involuntary-Plaintiff-Respondent, v. Robert PAGE, National Building Service and CNA Insurance Companies, Defendants-Respondents-Petitioners.
No. 95-2942
Supreme Court of Wisconsin
Oral argument December 2, 1997.—Decided May 5, 1998.
217 Wis. 2d 451 | 577 N.W.2d 335
For the plaintiff-appellant there was a brief by James C. Ratzel and Otjen, Van Ert, Stangle, Lieb & Weir, S.C., Milwaukee and oral argument by James C. Ratzel.
¶ 1. JANINE P. GESKE, J. We are faced with one question in this review: Whether the Worker‘s Compensation Act permits a worker‘s compensation insurer to assert a claim for an injured worker‘s pain and suffering in an action against a third party, when the employee has specifically declined to participate in the action? The court of appeals reversed a circuit court order barring the compensation insurer from presenting evidence of the injured worker‘s pain and suffering.1 We conclude that the Worker‘s Compensation Act, specifically
FACTS AND PROCEDURAL HISTORY
¶ 2. On January 22, 1993, Dorothy Gross fell in her employer‘s parking lot and sustained injuries. The parties do not dispute that Gross was injured in the course and scope of her employment and that Threshermens Mutual Insurance Company (Threshermens), the worker‘s compensation insurer, made payments to Gross for her injuries resulting from the fall. On October 21, 1994, Threshermens sued Robert Page, National Building Service, and CNA Insurance Companies (collectively Page) claiming that Page was negligent and seeking to recover the amount
¶ 3. Gross was notified of Threshermens’ lawsuit against Page but declined to actively participate in it. She did not file an independent action against Page. Consequently, Threshermens joined Gross as an involuntary plaintiff in its complaint, pursuant to
¶ 4. On September 25, 1995, Threshermens filed a motion to amend its pleadings. Page opposed the motion, viewing it as Threshermens’ attempt to assert a cause of action on behalf of the involuntary plaintiff Gross for recovery of pain and suffering and other damages. The circuit court denied Threshermens’ motion to amend its complaint, and precluded Threshermens from offering any argument or evidence regarding Gross‘s pain and suffering. Threshermens appealed this non-final order.
¶ 5. The court of appeals reversed. The court of appeals concluded that because it is undisputed that an employee can recover pain and suffering from a third party, the worker‘s compensation insurer must also be permitted to seek this amount even if the insurer did not pay those damages to the employee. We accepted Page‘s petition for review of the court of appeals’ determination.3
STANDARD OF REVIEW
¶ 6. This case requires us to interpret and apply
¶ 7. A compensation insurer must establish three elements to recover damages under
¶ 8. The court of appeals dispensed with the first two elements briefly. There was no dispute that Threshermens has satisfied the first element. Threshermens’ claim for reimbursement under the compensation statute is an action grounded “in tort.” Threshermens’ complaint alleges that Page negligently maintained the parking lot at Gross‘s workplace. Second, Threshermens’ claim is a claim “for the employee‘s injury.” The compensation insurer‘s suit is predicated on Gross‘s underlying claim for the injuries she received when she fell in her employer‘s parking lot, and is not apart from that claim. See id.
¶ 9. Addressing the third element, the court of appeals relied on Kottka v. PPG Indus., 130 Wis. 2d 499, 511-15, 388 N.W.2d 160 (1986), to conclude that pain and suffering damages fall within the category of claims to which
I.
¶ 10. To adequately interpret and apply the statute at issue here, some background is helpful. Under Wisconsin‘s Worker‘s Compensation Act, the benefit to
Instead, the . . . benefit [for injury] is part of an all-pervasive legislative scheme which attempts to effect a compromise between the employer and the employee‘s competing interests by granting the worker a certain award in lieu of all common law remedies he may otherwise have had against the employer in exchange for abrogation of the employer‘s defenses. (Emphasis added.)
Johnson, 193 Wis. 2d at 48. Likewise, the compromise abrogates any common law defenses, such as contributory negligence, that the employer or its insurer might raise.
¶ 11. Under the compromise reached by the legislature, the sole liability of the employer or its insurer to the employee is liability under the Compensation Act. Because the employer‘s liability is solely statutory, there is no common liability of the employer and a third-party tortfeasor to the injured employee, even though their concurring negligence may have caused the injury. See Wisconsin Power and Light Co. v. Dean, 275 Wis. 236, 241, 81 N.W.2d 486 (1957).
¶ 12. The statute also provides for claims against third parties when a person suffers a work-related injury. The employee, the employer, the compensation insurer and/or any other representative of the injured employee can seek recovery against a third party.
[T]he right of the employe, the employe‘s personal representative, or other person entitled to bring action, to make claim or maintain an action in tort against any other party for such injury or death . . . The employer or compensation insurer who
shall have paid or is obligated to pay a lawful claim under this chapter shall have the same right to make claim or maintain an action in tort against any other party for such injury or death.
¶ 13. The legislature enacted a distribution scheme that effects the original compromise underlying the Act. See Nelson v. Rothering, 174 Wis. 2d 296, 303, 496 N.W.2d 87 (1993). The scheme of
¶ 14. Although the employer‘s or compensation insurer‘s recovery rights under the statute are often referred to as rights of subrogation, they are not. We
¶ 15. Page raises four arguments as to why Threshermens ought not be permitted to make a claim for Gross‘s pain and suffering in this third-party action, when Gross has declined to participate. Those arguments can be summarized as follows: 1) Threshermens can only raise claims for damages for which it has legal liability under the Act; 2) Threshermens can only claim Gross‘s pain and suffering if Gross voluntarily participates in the lawsuit; 3) pain and suffering damages are personal to the injured employee and cannot be claimed in her absence; and 4)
II.
¶ 16. Page first argues that Threshermens cannot bring a claim for Gross‘s pain and suffering because a compensation insurer may only seek reimbursement for those amounts it has or had legal liability to pay. Page contends that our statutory interpretations in Kottka and Johnson dictate this result. Page asks us to limit Kottka, which allowed the surviving spouse to recover the employee‘s pain and suffering damages, to cases where pain and suffering claims are brought directly by the employee or his or her estate. Page also asserts that Johnson explicitly restricted a compensation insurer‘s cause of action to reimbursement for payments it made or will make because of the liability imposed upon it by the Worker‘s Compensation Act.
¶ 18. Threshermens, however, asserts that an insurer is entitled to share in all claims flowing from the employee‘s compensable injury. Because Gross‘s pain and suffering clearly flowed from her work-related injury, according to Threshermens, the worker‘s compensation insurer can also share in that claim. Threshermens relies on Kottka and Nelson to support this assertion.
¶ 19. Threshermens regards as mere “semantics” Page‘s contention that recovery for pain and suffering is not contemplated by the worker‘s compensation statutory scheme. Threshermens points out that in a jury trial, the jury is not asked to award temporary total disability or permanent partial disability. Those terms are particular to the worker‘s compensation system. Instead, Threshermens asserts that the injured worker‘s loss for pain and suffering is encompassed within the worker‘s compensation indemnity award.
¶ 20. To resolve this question, we look first to the language of the statute itself. The language of
¶ 21. Further, we disagree with Page‘s attempt to partition out pain and suffering from Gross‘s other damages.
¶ 22. One commentator agrees that this section of the Act “preserves to an employer or compensation insurer, the same right possessed by an employee to bring suit against a third-party whose negligence caused injuries to the employee. The employer and compensation insurer therefore, have the right to maintain an action where the employee fails or refuses
¶ 23. Case law is consistent with this plain language interpretation. In Kottka, the wife of an employee who later died from his work-related injuries sought to exclude payment of her husband‘s pain and suffering damages from the allocable settlement amount. The wife asserted that her husband‘s claim for pain and suffering “was not a ‘claim’ within the meaning of
¶ 24. In Kottka, we did not read the language of
¶ 25. That language from Kottka, when viewed in context with the language preceding and immediately following it, can only mean that the insurer is not permitted to recover pain and suffering damages awarded
¶ 26. Our interpretation of the statute in Kottka is compatible with our holding in Nelson. In Nelson we concentrated on the types of damages which flow from the injury. There, even though the insurer had originally denied coverage for the particular injury, the court determined that damages flowing from the compensable injury were recoverable against the tortfeasor, and subject to distribution under the
¶ 27. The rationale of Nelson can be applied to damages for pain and suffering. Pain and suffering as a result of a work-related injury clearly flow from that injury. Page does not dispute that Gross herself would be entitled to claim pain and suffering as damages. Nowhere does the language of
EVALUATION OF PERMANENT DISABILITY
The evaluation of disability in an injured or ill worker is a necessary part of the patient‘s treatment, and as such is a combination of both art and science. The final rating of the patient‘s disability should be the personal opinion of the doctor. . . Some elements of disability, such as range of motion, can be measured with some degree of objectivity. . . Other elements of disability are more subjective and less capable of being measured precisely. Pain is a good example. There is no question that pain can be disabling. Pain is not easily measured, and judgement (sic) is required. . .
Wisconsin Worker‘s Compensation Division, Dept. of Workforce Development Publication WKC-7761-P (R. 01/96), How to Evaluate Permanent Disability, 1.6 The handbook goes on to cite guidelines in the evaluation of pain, at p. 2:
Grading of Pain as a Subjective Symptom . . . Moderate: When the examination reveals the definite evidence of a pathological state of the involved structures that would reasonably produce the degree of pain indicated to be present. This degree of pain might require treatment and could be expected to contribute in a minor degree to permanent physical impairment.
The Wisconsin Administrative Code also refers to the place of pain in overall rating and compensation for workplace-derived disabilities:
The disabilities set forth in this section are the minimums for the described conditions. However, findings of additional disabling elements shall result in an estimate higher than the minimum. The minimum also assumes that the member, the back, etc., was previously without disability. Appropriate reduction shall be made for any preexisting disability. Note: An example would be where in addition to a described loss of motion, pain and circulatory disturbance further limits the use of an arm or a leg. A meniscectomy in a knee with less than a good result would call for an estimate higher than 5% loss of use of the leg at the knee. The same principle would apply to surgical procedures on the back.
¶ 28. Page also relies on Smith v. Long, 178 Wis. 2d 797, 505 N.W.2d 429 (Ct. App. 1993) for his assertion that Threshermens has no liability to Gross for her pain and suffering, and therefore cannot include those damages in its suit against Page. Smith considered whether a compensation insurer could seek reimbursement from a settlement reached between the injured employee and a lawyer sued by the injured employee for legal malpractice for failure to bring a third-party tort action in a timely manner.
¶ 29. Smith actually lends support to our conclusion that Threshermens has met all three elements
¶ 30. Finally, just three years ago this court decided a case applying the three elements identified in Kottka. A spouse of a decedent worker brought a wrongful death action against several third parties after recovering death benefits from her husband‘s worker‘s compensation insurer. See Johnson, 193 Wis. 2d 35. The circuit court approved distribution of that portion of the settlement proceeds paid to the estate for pain and suffering, and burial expense, but did not approve distribution of those proceeds paid to the spouse for loss of consortium or pecuniary damages. See id. at 40-41. The insurer appealed, asserting that pecuniary damages recovered by a surviving spouse from a third-party settlement are subject to distribution. See id.
¶ 31. This court rejected the surviving spouse‘s theory that her pecuniary damage claim against the third parties was not subject to allocation under
¶ 32. The plaintiff spouse in Johnson tried to parse the elements of recovery under the Act as distinct from elements of recovery available in a civil suit for personal injury or wrongful death. See Johnson, 193 Wis. 2d at 48-49. Mrs. Johnson argued that the statutory death benefit used only the deceased employee‘s earnings as a factor, and thus the insurer only had liability for those lost earnings, and similarly could only be reimbursed from amounts she recovered from the third party for lost earnings. We disagreed, concluding that the statutory death benefit does not compensate only for lost earnings, but is part of an overall scheme, effecting “a compromise between the employer and the employee‘s competing interests by granting the worker a certain award in lieu of all common law remedies he may otherwise have had against the employer in exchange for abrogation of the employer‘s defenses” Id. at 48 (citations omitted).
¶ 33. Similarly, Threshermens had liability under the Act for Gross‘s injuries. Even though amounts awarded under the Act are labeled “total temporary disability” or “permanent partial disability,” those awards do not only compensate for lost earnings.
¶ 34. The rationale behind Kottka, Nelson, and Johnson convinces us that despite the historical musings of the dissent, our opinion today in no way undermines the original policy decisions reached in enacting the Worker‘s Compensation Act. Our conclusion does not recognize any new category of liability of the employer or insurer under the Act. We simply recognize that an injured employee‘s physical pain has always been a factor in calculating the rating level of disability, upon which impairment of earning capacity is established.
III.
¶ 35. Page asserts that it makes a difference whether or not Gross, the injured employee, participates in the suit against Page. Page points to Nelson, Holmgren v. Strebig, 54 Wis. 2d 590, 196 N.W.2d 655 (1972), and Johannsen v. Peter P. Woboril, Inc., 260 Wis. 341, 51 N.W.2d 53 (1952), as supporting recovery for pain and suffering only where the injured worker directly participates in the third-party lawsuit. Because Gross has declined active participation in Threshermens’ suit, Page argues that Threshermens is precluded from claiming as damages Gross‘s pain and suffering. Page admits that had Gross filed the suit, or agreed to participate in Threshermens’ suit, a claim for her pain and suffering would be proper.
¶ 36. Threshermens reads both Kottka and Johnson to mean simply that if the worker has or at one time had a claim against a third-party tortfeasor, the compensation insurer can share in any award or settlement resulting from the worker‘s claim. If there
¶ 37. The court of appeals has answered the question presented here, though without lengthy analysis. In Employers Mut. Liab. Ins. Co. v. Liberty Mut. Ins. Co., 131 Wis. 2d 540, 541, 388 N.W.2d 658 (Ct. App. 1986), the question presented was whether the employer‘s compensation carrier had standing to bring an action on behalf of injured employees in a third-party suit under
¶ 38.
IV.
¶ 39. Next, Page asserts that a claim for pain and suffering is personal to the employee. Because such damages are personal, Page asserts that no one but the employee can claim them. Citing Kottka, Page contends that there are some damages for which the insurer or employer cannot seek reimbursement, because the statute “does not permit employers or their
V.
¶ 40. During the course of this appeal, the statute of limitations11 ran on any claim Gross herself could have made to recover her pain and suffering damages from Page. Page thus asserts that only Gross could have made a claim for her pain and suffering, and because the statute of limitations has expired, Gross‘s cause of action for pain and suffering is completely extinguished. Page cites Heifetz v. Johnson, 61 Wis. 2d 111, 211 N.W.2d 834 (1973) as support for this restriction. The Heifetz court stated that “[i]n Wisconsin the running of the statute of limitations not only bars recovery but it completely extinguishes the party‘s cause of action.” 61 Wis. 2d at 124. Page contends that the term “full amount of the employe‘s damages” as
¶ 41. As part of this argument, Page contends that to allow Threshermens to subvert the statute of limitations on Gross‘s claim for pain and suffering would be unfair to alleged third-party tortfeasors. Such subjective damages are harder to prove, and defending parties need formal and seasonable notice of the claims against them. Page also asserts that the employee, who waived her opportunity to sue for these damages, would be unjustly enriched if the insurer could obtain those damages for her.
¶ 42. A similar argument was rejected by the court of appeals in Guyette, 102 Wis. 2d 496. In Guyette, the court of appeals held that an injured employee‘s filing of suit tolled the statute of limitations on the compensation insurer‘s claim. See id. at 501. The compensation insurer had already provided the employee with notice of its intent to participate in any proceeds the employee recovered from the tortfeasor. The Guyette court, interpreting the plain meaning of
¶ 43. Threshermens asserts that the liability of a third-party tortfeasor should not be reduced merely because the injured worker has chosen not to participate in the suit, when the alleged tortfeasor has received adequate notice of the claim. No language in the statute evinces a legislative intent to preclude such liability of the alleged tortfeasor, based upon the worker‘s refusal to participate. In fact, the statutory language providing that “liability of the tortfeasor shall be determined as to all persons having a right to bring a claim, irrespective of whether they joined suit” on its own, imposes no timeliness restriction on any person “having a right to bring a claim” other than the named plaintiff.
¶ 44. Further, the statutory notice “is the only condition precedent to participation in the distribution” of proceeds in an action under
¶ 45. We agree that such a rationale naturally includes presentation of the claim for pain and suffering. There is no dispute that Gross received notice of Threshermens’ lawsuit against Page. Therefore, she may participate in the distribution, including recovery of an amount for pain and suffering, if proven.
¶ 46. We are not persuaded by Page‘s argument that because Gross is an involuntary plaintiff, her claim for her pain and suffering is “extinguished.”
[T]he fact that the employees did not join in the prosecution of the action, or state their intent to share in the proceeds, within the period of the stat-
ute of limitations is inconsequential. There is no question that the action was commenced within the limitation period, and . .sec. 102.29(1), Stats. is silent on time limits for the employees to take action to join the action or lay claim to a share of the proceeds. . .The employees’ damage claims were advanced in an action which was properly and timely commenced by a party with the authority to do so. As long as the action is filed within the appropriate limitation period, the other eligible parties may share in the recovery according to the statutory formula. . .as long as they give notice of their intention to do so prior to trial. It is immaterial that the statute of limitations may have run before they announce that intention.
¶ 47. Page‘s claims of lack of notice and unfairness are unwarranted and contrary to the plain language of the statute. Threshermens timely filed its motion to amend the pleadings to include pain and suffering. The Nelson court, 174 Wis. 2d at 306, reaffirmed the mandatory nature of the legislative formula for apportioning proceeds of a third-party settlement in a claim for reimbursement for worker‘s compensation payments:
Accordingly, we conclude that applying sec. 102.29(1), Stats., does not require a determination of the equities involved but rather a mathematical application of the legislative formula for apportioning the settlement proceeds. The legislature could have mandated a different result here had it so desired. Absent such legislation, however, the courts of this state are not free to select a method they might consider to be the most equitable for allocating the proceeds of a particular third-party settlement.
¶ 48.
¶ 49. Page‘s arguments all seem to ignore the fact that under the distribution formula of
¶ 50. In light of our conclusion that
¶ 51.
¶ 52. Page suggested that if Threshermens is entitled to claim Gross‘s pain and suffering, that there will be no logical stopping point. We disagree. Under the statute, the employer or compensation insurer is entitled to assert those claims that the injured employee would be able to assert against the third-party tortfeasor. The employer or compensation insurer cannot assert claims belonging to someone else. See, e.g., Kottka, 130 Wis. 2d at 521 (holding that claim for loss of consortium is “personal” to the injured employee‘s spouse). Thus,
¶ 53. Based on the foregoing, we conclude that the Worker‘s Compensation Act does not prohibit a worker‘s compensation insurer from seeking reimbursement from an alleged third-party tortfeasor for the payments it has or will make to the employee by
By the Court.—The decision of the court of appeals is affirmed.
¶ 54. ANN WALSH BRADLEY, J. (dissenting). As we celebrate the sesquicentennial of the statehood of Wisconsin and reflect upon the history of this state, I am reminded of the significant role that Wisconsin played in the development of worker‘s compensation law. Wisconsin pioneered the development of that law and was one of the first states in the nation to enact such legislation. This unique legislation represented a compromise between the worker and the employer. Because the majority‘s opinion changes the terms of that initial compromise, misinterprets case law and related statutory language, and arrives at an inequitable result, I respectfully dissent.
¶ 55. As the twentieth century began and industrial expansion accelerated, participants in the American workplace faced an ongoing question: who should bear the financial burden attendant upon the injury or death suffered by a worker in the course of employment? At that time the status quo answer was that the worker generally bore the burden. While the employer might occasionally be exposed to liability, it could often escape, or at least significantly delay, financial responsibility through the use of common law doctrines such as assumption of risk and contributory negligence.
¶ 56. However, starting in 1910, the allocation of responsibility for industrial accidents began to change as Wisconsin and other states began passing worker‘s compensation legislation. See, e.g., ch. 50, Laws of
The legislature, in response to a public sentiment which cannot be mistaken, has passed a law which attempts to solve certain very pressing problems which have arisen out of the changed industrial conditions of our time. It has endeavored by this law to provide. . .a system by which every employee. . .may receive at once a reasonable recompense for injuries accidentally received in his employment under certain fixed rules, without a lawsuit and without friction. . . . [The employer] can never be mulcted in heavy damages, and will know whenever an employee is injured practically just what must be paid for the injury.”
Borgnis v. Falk Co., 147 Wis. 327, 337, 354, 133 N.W. 209 (1911). See also Anderson v. Miller Scrap Iron Co., 169 Wis. 106, 110, 114–15, 171 N.W. 935 (1919). Thus, the legislature imposed a compromise between the interests of the employer and those of the employee. See Manitowoc Co. v. Industrial Comm‘n, 273 Wis. 293, 77 N.W.2d 693 (1956); Nelson v. Rothering, 174 Wis. 2d 296, 302, 496 N.W.2d 87 (1993).
¶ 57. As part of the compromise, the worker‘s compensation law created a no-fault liability system in which injured employees are guaranteed “certain and speedy financial assistance,” for economic loss and disability, even where the employer is not at fault. Nelson, 174 Wis. 2d at 302. In exchange for this guarantee, employers are exempted from the exposure to “heavy damages” and are subject only to the exclusive remedy requirements of the worker‘s compensation laws. See Guse v. A.O. Smith Corp., 260 Wis. 403, 51 N.W.2d 24 (1952);
¶ 58.
¶ 59. The majority opinion changes the terms of that initial compromise. By citing to Shymanski, the majority states that pain and suffering which interferes with earning capacity is compensable under the Act. Majority op. at 469 n.7. However, it does not, because it cannot, cite to any authority which asserts that the general pain and suffering normally recoverable in a tort action is compensable under the Act. Pain and suffering recoverable in this tort action includes “mental anguish, apprehension, discomfort or sorrow.” Wis. JI-Civil 1855. Compensating for suffering which includes apprehension and sorrow is a concept foreign to worker‘s compensation law. Indeed, limiting the exposure of the employer for such tort recoveries was part of the initial compromise which was the very foun-
¶ 60. It is against this historical background that I conclude that the majority misinterprets our prior decisions and related statutory language. If viewed in the absence of historical context, I acknowledge that the majority‘s interpretations may be reasonable. However, given the ambiguities of the language of the cases and the statute, there is an alternative interpretation that is more reasonable because it is consistent with the underpinnings of Wisconsin worker‘s compensation law.
¶ 61. The majority concedes that Kottka v. PPG Industries, 130 Wis. 2d 499, 388 N.W.2d 160 (1986), the primary case upon which it relies in arriving at its conclusion, contains “some potentially confusing language.” Majority op. at 466. It is in the interpretation of that “potentially confusing language” where I part from the majority.
¶ 62. In Kottka an injured worker brought a tort action, including a demand for pain and suffering, against a third-party tortfeasor. His wife joined the suit alleging loss of consortium. After the worker‘s death, his widow settled the claims. In approving the settlement, the circuit court allocated the award between the wife and the employer contrary to the formula required by
¶ 63. The widow appealed the inclusion of the pain and suffering award in the employer‘s credit.
does not define a category of employe claims which is beyond the scope of this section. . . . Our construction gives full effect to the legislative scheme of the Worker‘s Compensation Act because it permits all parties with an interest in employe tort claims related to workplace injury or death to prosecute these claims against third parties and to share in the proceeds, but does not permit employers or their insurers to invade claims which belong to the employe only.
Kottka, 130 Wis. 2d at 514 (emphasis added).
¶ 64. In interpreting Kottka, the majority concludes that this language:
can only mean that the insurer is not permitted to recover pain and suffering damages awarded against a third party when that recovery would result in a reimbursement of more than the insurer paid or is liable to pay the injured employee as compensation under the Act.
Majority op. at 466-67. This part of the majority‘s interpretation is simply incorrect. There is no potential for windfall to an insurer under
¶ 65. I submit that the conflict inherent in the language of Kottka is resolved by reading the language of the case in the context of the case. The court in Kottka addressed the circumvention of the required
¶ 66. Viewing Kottka in this light, it is apparent that where injured employees are successful in suits against third-party tortfeasors, there is no “category of employe claim which is beyond the scope” of the allocation formula. However, where injured employees do not voluntarily bring suit asserting their pain and suffering, the statute will not allow employers “to invade claims which belong to the employe only.” Pain and suffering is a claim personal to the injured worker. It is a claim for which the employer has no liability under the worker‘s compensation law. The employer here should be barred from pursuing it absent the voluntary
¶ 67. The majority begins its statutory analysis with the incorrect assumption that the language of
¶ 68. However, this case presents the court with a different question of statutory interpretation. The court must consider whether the statute allows employers to bring pain and suffering actions against third-party tortfeasors on their own initiative when the employer has not been, and under the terms of the worker‘s compensation law cannot be, held responsible for the injured worker‘s pain and suffering. Having reviewed the statute, I find it ambiguous in this regard and reach a result at odds with that of the majority.
¶ 69.
The making of a claim for compensation against an employer or compensation insurer for the injury or death of an employe shall not affect the right of the employe. . .to make a claim or maintain an action in tort against any other party for such injury or death. . . . The employer or compensation insurer who shall have paid or is obligated to pay a lawful claim under this chapter shall have the same right
to make claim or maintain an action in tort against any other party for such injury or death. . . .
¶ 70. I part company with the majority in interpreting the word “claim” in the phrase “[t]he employer or compensation insurer who shall have paid or is obligated to pay a lawful claim under this chapter. . . .” In essence, the difference is that I interpret the word “claim” more narrowly than does the majority. In contrast, the majority implicitly, but without discussion, defines the word “claim” as used in this phrase to mean a general claim.
¶ 71. A “lawful claim” under this chapter cannot be a claim for general pain and suffering. The purpose of the statute is to allow the employer or compensation insurer to pursue reimbursement for claims which they were “obligated to pay.” As noted above, in worker‘s compensation law there is no claim for pain and suffering which includes mental anguish, apprehension, discomfort or sorrow that the employer or compensation insurer is “obligated to pay.”
¶ 72. Again, I acknowledge that if viewed in the absence of the historical context, the majority‘s interpretation may be reasonable. However, both the language indicated above and the underpinnings of the Worker‘s Compensation Act convince me that the legislature did not intend to grant employers the right to sue third-party tortfeasors for pain and suffering absent voluntary participation of the injured worker.
¶ 73. My conclusion that the majority misinterprets our prior decisions and related statutory language is buttressed by equitable principles. If worker‘s compensation benefits are paid for permanent disability and a third party is held liable, it is equitable for the insurance company to be reimbursed for those benefits. If worker‘s compensation benefits are paid for
¶ 74. In Kottka the court concluded that where an injured party brings an action against a third party and receives a pain and suffering award, an employer may be reimbursed out of the pain and suffering recovery. See id. at 514. Such a conclusion may be equitable. But here, where the injured party declines to bring a third-party action and is forced to join an action and parade her pain and suffering so that the insurance company can be reimbursed from that pain and suffering award, it is not equitable.
¶ 75. Even without the injured party, under the current law the insurance company is free to still maintain an action to seek reimbursement for benefits for which it had actual liability to pay under the Worker‘s Compensation Act. However, under current law, the insurance company could not get dollar-for-dollar reimbursement unless it was able to get reimbursement out of the plaintiff‘s pain and suffering award. This result is the consequence of the
¶ 76.
¶ 77. Consider the logger who borrows a chain saw from his father, who is not his employer. The father modified safety features on the saw for ease of use and then fails to warn his son. In the course of his employment the son injures himself because of the lack of safeguards on the saw and subsequently dies. His wife receives death benefits. She has no desire to sue her father-in-law for causing the death of his son. Yet, she can be forced to participate in such an action so that the insurer can claim reimbursement out of the pain and suffering award.
¶ 78. An injured worker may also lack the desire to bring a suit because he does not want to display the details of his personal suffering. He sustains a work-related injury and as a result experiences severe depression. As a consequence of that depression he receives in-patient psychiatric treatment and subsequently divorces his wife and is estranged from his children. While the injured worker can be required to be a witness on liability issues, he may have little desire to parade the details of the most personal events of his life in front of a jury in the form of his pain and suffering claim. Yet, under the majority‘s interpretation he can be forced to participate so that the insurer can receive reimbursement out of his pain and suffering.
¶ 79. The majority forces surviving spouses to participate in lawsuits and compels injured workers to display pain and suffering so that the insurance com-
¶ 80. In sum, two reasonable interpretations of case law and statutory authority are available in this case. The majority‘s interpretation is inconsistent with the historical underpinnings of worker‘s compensation law, the second is not. The majority‘s interpretation has the potential of revictimizng the victim, the other does not.
¶ 81. I opt for the interpretation that continues the terms of that initial bargain reached in 1911. That interpretation does not force unwilling parties into displaying pain and suffering in order to have the insurer get reimbursed out of an item of damages that it did not pay and was not legally obligated to pay. Accordingly, I dissent.
Notes
(1) An action to recover damages for injuries to the person.
