Carter v. Mountain Bell

727 P.2d 956, 105 N.M. 17
CourtNew Mexico Court of Appeals
DecidedOctober 7, 1986
Docket8738
StatusPublished
Cited by19 cases

This text of 727 P.2d 956 (Carter v. Mountain Bell) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carter v. Mountain Bell, 727 P.2d 956, 105 N.M. 17 (N.M. Ct. App. 1986).

Opinion

OPINION

ALARID, Judge.

Plaintiff Geraldine Carter appeals from a judgment awarding her compensation for a scheduled injury, and crediting defendant Mountain Bell with payments previously made to plaintiff under defendant’s benefits plans. On appeal, plaintiff raises two issues. She first challenges the trial court’s decision to give defendant credit. She next alleges that she should have been found to be totally disabled or, at least, to have suffered a separate and distinct impairment to the body as a whole, thereby allowing her to recover benefits for partial disability. The facts necessary for our discussion will be discussed as we analyze the legal issues raised by plaintiff in her appeal. We affirm the trial court on the credit issue and remand on the issue of scheduled versus non-scheduled injury.

DISCUSSION

I. Whether the trial court erred in granting defendant credit against worker’s compensation benefits for monies paid under its accident and disability plans.

Defendant is self-insured. Since 1913, all Bell System companies have had benefit plans similar to the ones at issue in this case. See Southwestern Bell Telephone Co. v. Siegler, 240 Ark. 132, 398 S.W.2d 531 (1966).

Defendant has had a “Sickness and Accident Disability Benefit Plan.” For sickness, defined as illness or off-the-job injury, the plan pays the employee full salary for a certain time, depending on the employee’s longevity with the company, and then half-salary for the remainder of the time up to fifty-two weeks. Then, for sickness, the employee is eligible for benefits of half-salary for as long as the employee is disabled under another plan, the “Company’s Long Term Disability Plan,” administered by Mutual of Omaha. For accident defined as on-the-job accident, the “Sickness and Accident Disability Benefit Plan” pays the employee full salary for a certain time, again depending on the employee’s longevity with the company, and then half-salary for as long as the employee remains disabled. Thus, the benefits are the same for sickness as for accident. The only difference is that for sickness, the long-term disability plan picks up the payments after one year, whereas, for accident, the “Sickness and Accident Disability Benefit Plan” pays all the benefits.

The sickness and accident plan provides that employees cannot get benefits for both sickness and accident at the same time. In addition:

In case any benefit, which the Committee shall determine to be of the same general character as a payment provided by the Plan, shall be payable under any law now in force or hereafter enacted to any employee of the Company, the excess only, if any, of the amount prescribed in the Plan above the amount of such payment prescribed by law shall be payable under the Plan; provided, however, that no benefit payable under this Plan shall be reduced by reason of any governmental benefit payable on account of military service or by reason of any benefit which the recipient would be entitled to receive under the Social Security Act.

The following testimony was given relating to this paragraph:

Q. Under paragraph 25, there was a committee referred to. What committee is this?
A. This is in our Corporate Benefit Office and the committee consists of managers of all departments.
Q. Do you know whether the committee has determined that the New Mexico worker’s compensation payments are of the same general character as those paid under the Accident and Sickness Plan?
A. Yes.
Q. Ok. And this has been the position of the committee at all times from 1973 to the present time?
A. Yes.

The long-term disability plan specifically includes worker’s compensation in the list of benefits which shall be deducted from the benefit paid by this plan.

The following facts are undisputed in this case: (1) plaintiff was injured in an on-the-job accident on January 10, 1983; (2) her salary at that time was $527.50 per week; (3) the compensation rate applicable to plaintiff was $271.76 per week; (4) plaintiff received $527.50 per week when she was unable to work due to the accident; (5) plaintiff went back to work and was downgraded in salary because of a change in position; when she went off work again because of disability related to the January 1983 accident, she was earning $382.50 per week; and (6) plaintiff received $382.50 during the time she was unable to work until her right to full salary under the plans was used up, then she began receiving $191.25 per week as half-salary under the plans. Defendant did neither ask for nor receive a dollar-for-dollar credit. It sought and received a week-for-week credit.

Thus, there are three time periods involved: (a) the time immediately after January 10, 1983, when plaintiff was receiving $527.50 from the plans; (b) the time immediately after she stopped working for the second time, when she was receiving $382.50 from the plans; and (c) the time when the plans only paid half-salary, during which plaintiff was receiving $191.25 from the plans. The way the court worked the credit was so that defendant did not have to pay compensation for the weeks in which plaintiff received either $527.50 or $382.50. Defendant received a credit of $170.62 per week against the $271.76 it owed plaintiff for the weeks it paid plaintiff half-salary pursuant to the plans. (The discrepancy between the credit given of $170.62 and defendant’s allegation that half plaintiff’s salary would have been $191.25 may be explained by the fact that defendant made a mistake in paying plaintiff benefits.)

Defendant does not believe that plaintiff should be able to get a double recovery of both worker’s compensation plus benefits under the plans. Defendant contends that a ruling in plaintiff’s favor would encourage it not to pay any benefits under the plans until plaintiff's right to worker’s compensation is established. This would result in a period of hardship for plaintiffs, but would insure that defendant would not have to pay both company benefits and worker’s compensation contrary to the language in the plans. Plaintiff contends that the Workmen’s Compensation Act does not preclude such double recovery and that she should be entitled to get all benefits that both the plans and the law allow. Plaintiff also asserts that the language in the sickness and accident plan is not clear enough to warrant a conclusion that worker’s compensation is to be deducted from the benefits under the plans.

Although both parties cited sections in Larson’s and cases which support their respective positions, these authorities cannot be categorized into the majority and minority rules, thereby allowing this court to pick which rule it wants to follow. The reason the authorities cannot be categorized is that they rely on statutes peculiar to their jurisdictions or language in benefit plans peculiar to those plans or they decide the case on grounds not related to either statutory or benefit plan language.

4 A. Larson, The Law of Workmen’s Compensation, Sections 97.51(a) and (c) (1986), states the rules as follows:

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Cite This Page — Counsel Stack

Bluebook (online)
727 P.2d 956, 105 N.M. 17, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carter-v-mountain-bell-nmctapp-1986.