OPINION OF THE COURT
This wоrkers’ compensation appeal concerns whether there was substantial evidence at reopening to support increasing a settled award to one for total disability. It also concerns the proper methоd for crediting payments made pursuant to the settlement.
Claimant was a 68-year-old maintenance worker with an eighth grade education. He fell and injured his back at work in February, 1987. He underwent back surgery by Dr. Kavolus in November, 1989, after which he returned to work for approximately ten months up until December, 1990. On July 24, 1991, he filed a workers’ compensation claim in which he alleged a permanent, partial occupational disability due to the back injury. The claim was settled with the defendants in December, 1991, for a 28.84% occupational disability which was paid in a lump sum of $25,646.00. Liability was apportioned 68.5% to the employer and 31.5% to the Special Fund.
In June, 1992, claimant was referred to Dr. Madauss, a neurosurgeon, who performed a spinal fusion in November of that year; however, claimant’s condition continued to worsen. He applied for and was awarded Social Security Disability which, was dated back to his last employment in December, 1990. Claimant underwent a second spinal fusion in 1994 and testified that after that point he was unable to perform even the most sedentary tasks. After a prior motion to reopen was dismissed for regulatory noncompliance, the present motion was filed on July 3, 1996.
At reopening, the employer’s human resources director indicated his belief that claimant was capable of holding other employment at the time he quit work. Claimant and his wife testified concerning various activities which he was аble to perform at the time of settlement and could not perform at reopening. In his deposition, claimant testified that he had never been able to return to work after leaving the employment; however, at the hearing, he dеnied that he had been totally disabled the entire time. Claimant also offered testimony from Dr. Madauss concerning the change in his medical condition, including testimony that he had never released claimant to return to work. The employer offered no medical evidence.
After noting that it was a difficult case, the Administrative Law Judge (ALJ) de
The employer asserts that there was no substantial evidence to support the finding of an increase in occupational disability. The Special Fund and the employer both assert that claimant waived the compensa-bility of 40% of his ultimate disability by settling the initial claim and that credit for the proceeds of the settlement should equal 40% of a permanent, total disability award for its entire duration. Claimant responds that there was substantial evidence to support thе findings of 40% disability at settlement and 100% disability at reopening. He also asserts that there is no authority for the position of the Special Fund with regard to the question of a credit. He points to the finding that, at settlement, he had sustained a 40% permanеnt, partial disability and notes that the credit which the ALJ permitted against the ultimate award was for a 40% permanent, partial disability.
The claimant bears the burden of proof and risk of nonpersuasion before the fact-finder with regard to every element of the claim.
Wolf Creek Collieries v. Crum,
Ky.App.,
It is clear that the parties are entitled to a sufficient explanation by the ALJ of the basis for the decision.
Big Sandy Community Action Program v. Chaffins,
Ky.,
More recently, in
Western Baptist Hospital v. Kelly,
Ky.,
Here, the evidence was conflicting, and the ALJ’s findings in claimant’s favor have been affirmed by both the Bоard and the Court of Appeals. We have reviewed the opinions below, the evidence, and the employer’s assertions concerning why the findings are not properly supported by the evidence. Having done so, we are nоt persuaded that a decision in the defendants’ favor was compelled. The employer has failed to convince us that any relevant evidence was overlooked or misunderstood. The view of the evidence which was tаken by the ALJ, the Board and the Court of Appeals was neither patently unreasonable nor flagrantly implausible, and we are not persuaded that any controlling statute or precedent was overlooked, misapplied, or misconstrued.
With regard to the question of credit, it must be remembered that this appeal does not concern the reopening of a litigated award. The parties agreed to the terms by which they would settle the claim for the underlying injury, and upоn claimant’s receipt of the agreed-upon sum, the liability of the employer and the Special Fund for whatever occupational disability existed at the time of settlement was extinguished. The figure for occupational disability which is contained in a settlement agreement represents a compromise and might or might not equal the worker’s actual occupational disability at the time; therefore, additional benefits are authorized at the reopеning of the settled claim only to the extent of an actual increase in the worker’s occupational disability. See
Newberg v. Davis,
Ky.,
When considering the arguments which have been raised and the standard for reopening a settled award which was set fоrth in
Newberg v. Davis,
it is useful
The decision of the Court of Appeals is affirmed.
