Delaware River & Bay Authority v. Kopacz

574 F. Supp. 2d 438, 2008 A.M.C. 2771, 2008 U.S. Dist. LEXIS 66728, 2008 WL 4065886
CourtDistrict Court, D. Delaware
DecidedAugust 29, 2008
DocketCiv. 07-008-SLR
StatusPublished
Cited by1 cases

This text of 574 F. Supp. 2d 438 (Delaware River & Bay Authority v. Kopacz) is published on Counsel Stack Legal Research, covering District Court, D. Delaware primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Delaware River & Bay Authority v. Kopacz, 574 F. Supp. 2d 438, 2008 A.M.C. 2771, 2008 U.S. Dist. LEXIS 66728, 2008 WL 4065886 (D. Del. 2008).

Opinion

OPINION

SUE L. ROBINSON, District Judge.

I.INTRODUCTION

Plaintiff Delaware River & Bay Authority (“plaintiff’) brought suit against defendant Jan D. Kopacz (“defendant”) seeking a declaratory judgment; to wit, that plaintiff does not owe maintenance and cure to defendant. (D.I.l) The suit arises from defendant’s on-the-job injury and the extent to which, if at all, plaintiff must provide an allowance covering defendant’s food and lodging expenses under circumstances where an insurance policy also provides for defendant’s needs. A one-day trial was held on September 24, 2007. Post trial briefing is complete. (D.I.29, 31, 32, 33) The court has jurisdiction pursuant to 28 U.S.C. § 1333. 1 Pursuant to Fed. R.Civ.P. 52(a), the following are the court’s findings of fact and conclusions of law.

II. FINDINGS OF FACT

A. The Injury

1. At all times relevant to the dispute at issue, defendant was employed as a full-time, permanent deck hand on board plaintiffs ferries. (D.I. 28 at 66; PX 15 at ¶ 1) Deck hands, also known as “able seamen,” are responsible for the general operation of the ferries. (D.I. 28 at 66; PX 15 at ¶ 1) 2

2. On December 24, 2004, defendant sustained an injury. 3 (Id. at 67) According to defendant, he and a co-worker were attempting to lift a cable that weighed over 300 pounds. (Id. at 69) The co-worker dropped the cable, leaving defendant to bear all the weight. (Id.) Reluctant to drop the cable and have it fall on his or his co-worker’s feet, defendant held on to the cable, which pulled him forward. (Id.) Defendant’s hand and shoulder hit a receptacle, causing him to wrench his back. (See id.) Defendant reported the injury on the day that it occurred. (PX 15 at ¶ 2)

3. According to plaintiffs records, defendant worked on December 29, 30, and *440 31, 2004. (Id. at ¶ 3) Defendant called in sick on January 3, and then worked on January 4, 5 and part of January 6, 2005. (Id.) On January 5, 2005, defendant gave plaintiff a typed statement in which he recounted the injury. (D.I. 28 at 69-70) On January 6, 2005, defendant was directed to see a doctor for a determination of his fitness for duty. (PX 15 at ¶ 3) For timekeeping purposes, he was declared not fit for duty retroactive to January 5, 2005 and has not returned to work since that time. 4 (Id.; D.I. 28 at 70)

B. The Benefits

4. Defendant received and signed a copy of plaintiffs personnel manual on March 9, 2001. 5 (PX 5; D.I. 28 at 31) The manual states that the purpose of long term disability (“LTD”) insurance is to “provide a continuing income should the employee’s ability to earn a living be interrupted or terminated by a prolonged disability.” 6 (PX 5 at 26) Plaintiff has never bought an insurance policy specifically to cover only its maintenance obligations to seamen. (D.I. 28 at 41)

5. Under the collective bargaining agreement for marine employees that was in place as of the date of defendant’s injury, plaintiff was obligated to provide seamen with the same benefits to which all other permanent full-time employees were entitled. There is nothing in the agreement which pertains to maintenance payments; however, the agreement does address the LTD policy. 7 (DX 3a at 46; D.I. 28 at 30-31, 41-42)

6. It was plaintiffs policy to pay permanent full-time employees their full wages for the first 90 days following an on-the-job injury which rendered the employee unable to perform his duties. (PX 15 at ¶ 4; D.I. 28 at 32-33) “If it appears that the employee will not be returning to work within that 90 day period, a claim for LTD is started for the employee.” (D.I. 28 at 33) Starting on the 91st day, the employee is covered under LTD at a rate of 60% of his pay. (D.I. 28 at 33)

7. Pursuant to plaintiffs policy, defendant received 100% of his weekly wage ($9,906.67) from January 5, 2005 through April 5, 2005. (PX15aU4; D.I. 28 at 33) As there was a delay in processing defendant’s LTD benefits, however, plaintiff paid defendant the sum of $4,624.93, which represented the value of his accumulated sick and annual leave. 8 (PX 15 at ¶ 5)

8. According to Bonnie L. Miller (“Miller”), plaintiffs risk manager, the payment *441 of annual leave to defendant was not used as maintenance, but was paid to ensure that he received some kind of income to meet his living expenses until his LTD claim was approved. (D.I. 28 at 45-46) In Miller’s opinion, annual leave is unrelated to maintenance. (Id. at 43)

9.Defendant received checks from plaintiff, due to a mistake on Miller’s part, which were intended to partially cover its maintenance obligation for the period April 5, 2005 through May 31, 2005. 9 (PX 13E; D.I. 28 at 36) A check for $855.00 was sent to defendant with a note from Miller stating: “This check ... represents wages for the period of your disability from 4/5/05 through 5/31/05. Please be advised that maintenance wages paid by [plaintiff] directly will offset your LTD benefit — but together the payments will equal 60% of your base wages.” (PX 13E) Plaintiff also sent checks with similar notations for June and July 2005 in the amounts of $450.00 and $465.00, respectively. (Id.; D.I. 28 at 36) It was Miller’s impression, at that time, that these checks represented partial maintenance payments to defendant. (D.I. 28 at 36-37)

10. The Hartford Insurance Company (“Hartford”), the LTD provider during the period in dispute, calculates an employee’s monthly LTD benefit by: (1) multiplying the monthly income loss by the benefit percentage; (2) comparing the result with the maximum benefit; and (3) deducting other income benefits from the lesser amount. (DX 4a at 7) Other income benefits are defined as “the amount of any benefit for loss of income, provided to you or to your family, as a result of the period of disability for which you are claiming benefits under this plan.” (Id. at 16) Other income benefits include disability benefits received from Social Security. 10 (Id.) With respect to overpayments, Hartford notes that it has “the right to recover ... any amount that is an overpayment of benefits under this plan.” 11 (Id. at 14)

11. On June 17, 2005, Hartford approved defendant’s claim for LTD benefits.

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574 F. Supp. 2d 438, 2008 A.M.C. 2771, 2008 U.S. Dist. LEXIS 66728, 2008 WL 4065886, Counsel Stack Legal Research, https://law.counselstack.com/opinion/delaware-river-bay-authority-v-kopacz-ded-2008.