Fowler v. City of Rexburg

773 P.2d 269, 116 Idaho 1, 1989 Ida. LEXIS 79

• Court: Idaho Supreme Court
• Decided: May 1, 1989
• Docket: 17046
• Status: Published

Opinions

BAKES, Justice.

The appellant Don E. Fowler appeals a decision of the Industrial Commission which held that his application for a hearing was barred by the statute of limitations. Fowler, who was employed as a police officer by the City of Rexburg, was covered by Idaho’s Workmen’s Compensation Law under a policy of insurance issued by the State Insurance Fund. Fowler was injured twice during the course of his employment. The first injury occurred in 1972 when Fowler was riding in a police car that hit a snowbank, injuring his right knee. In May of 1973, Fowler, the city, and the State Insurance Fund entered into a compensation agreement, which was approved by the Industrial Commission and which provided that the claimant had a permanent partial disability equal to 7% of the loss of a leg.

The second injury occurred in 1974 when Fowler was involved in a scuffle with some prisoners, and he suffered an injury to his left knee. In August of 1976, Fowler, the city, and the State Insurance Fund entered into a second compensation agreement, approved by the commission, which provided that Fowler had a permanent partial disability equal to 50% of the loss of a leg.

Fowler subsequently had additional problems with his knees. In 1980, he underwent surgery in which his left knee was fused. On May 14, 1985, the State Insurance Fund paid $1,932.50 to Madison Memorial Hospital and $261.50 in other medical bills for treatment of Fowler’s knees. On June 13, 1985, Fowler filed two applications for hearing requesting further compensation for the separate injuries to his knees.¹

By agreement of the parties, the only issue submitted to the commission was whether Fowler’s two applications for hearing filed June 13, 1985, were barred by the statute of limitations set forth in I.C. §§ 72-706² and 72-719.³ The commission found that Fowler’s applications were not filed within five years of the accidents, and thus they were barred by I.C. § 72-719(1). The commission also held that I.C. § 72-706 was not applicable to Fowler’s claims.

On appeal, Fowler alleges that the Industrial Commission’s decision was in error because the payment of wage benefits and medical benefits in 1985 constituted payments of “compensation” within the meaning of I.C. § 72-706 and thus his applications, which were filed within one year thereafter, were timely under that section. For the following reasons, we reject Fowler’s contentions and affirm the decision of the Industrial Commission.

There are two discrete statutes of limitations which apply to applications for hearings of worker’s compensation claims, I.C. § 72-706 and I.C. § 72-719. I.C. § 72-706 applies to applications for hearing where no commission-approved compensation agreement and/or Industrial Commission award has been made. However, when such an Industrial Commission award has been made, I.C. § 72-718 provides that the “decision of the commission, in the absence of fraud, shall be final and conclusive as to all matters adjudicated____” Woodvine v. Triangle Dairy, Inc., 106 Idaho 716, 682 P.2d 1263 (1984); Sines v. Appel, 103 Idaho 9, 644 P.2d 331 (1982). However, there is a limited authority in I.C. § 72-719 to reopen such a “final and conclusive” award.

In this case, both of Fowler’s injuries were covered by compensation agreements entered into between Fowler and the State Insurance Fund, and approved by the Industrial Commission. These agreements provided Fowler with compensation for the disability and medical expenses resulting from the separate injuries to his knees. These agreements, when they were approved by the Industrial Commission, became awards which were final and conclusive as to the injuries covered therein. I.C. § 72-718; Sines v. Appel, supra; Woodvine v. Triangle Dairy, supra. Thus, I.C. § 72-719 provided the only basis for reopening the earlier commission awards, and the applicable statute of limitations was contained in I.C. § 72-719(1). I.C. § 72-706 was not applicable to Fowler’s applications. That section does not apply where there has been a final award entered by the Industrial Commission. The Industrial Commission found that Fowler’s new applications'were not filed within five years of either accident in 1972 and 1974, respectively, and therefore they were barred by the five-year statute of limitations in I.C. § 72-719.

Fowler argues, however, that our decision in Woodvine v. Triangle Dairy, supra, holds that the one-year statute of limitations in I.C. § 72-706(2) applies even to “awards and agreements” if the application for hearing is filed within one year after the payment of any “compensation.”⁴ According to Fowler, Woodvine stands for the proposition that his claim is not barred under either 72-706 or 72-719 even though it was made more than five years after the injury if his claim was filed within one year of the time when the employer either discontinued the payment of total temporary disability payments or paid medical benefits under the compensation agreement. However, an analysis of the Woodvine case discloses that it does not support Fowler’s contention. In Woodvine, the claimant and the surety had entered into a compensation agreement which was approved by the Industrial Commission. On appeal the claimant in Woodvine argued that the compensation agreement had only settled the issue of his impairment and had not determined his permanent disability as defined in I.C. § 72-425 because the commission had not evaluated his non-medical factors. Thus, the claimant in Woodvine argued that, having never received a permanent disability evaluation because he had never had a consideration of his non-medical factors, the case was not final as to that issue.⁵ The Court in Woodvine, after examining the compensation agreement, determined that it was ambiguous on the question of whether the parties had intended to settle the issue of permanent disability, or whether they merely agreed as to the claimant’s permanent impairment rating in that case. Accordingly, this Court “reverse[d] the conclusion of the [Industrial] Commission that the award was for permanent disability, and remand[ed] to the Commission for a [factual] determination of whether the parties actually agreed that the award was for permanent impairment, or whether the parties agreed that the award was for permanent disability.” Woodvine v. Triangle Dairy, 106 Idaho at 722, 682 P.2d at 1269.

The commission in Woodvine had also concluded that the claimant was a member of the “odd lot” category and therefore was totally and permanently disabled, and would have awarded him additional benefits, but for the five-year statute of limitations in I.C. § 72-719. This Court in Wood-vine held that if on remand the commission found that the settlement agreement had actually settled the claimant’s permanent disability rather than permanent impairment, then the agreement, when approved by the commission, was final and conclusive and could not be reopened. However, if the commission found that the settlement agreement between the claimant and the surety only settled the amount of permanent impairment and not permanent disability, then it would not have been final and therefore could have been reopened under I.C. § 72-706(2). The Court in Woodvine stated:

“Should the Commission find that the compensation agreement provided claimant with a permanent disability award, then the agreement is final and conclusive as to claimant’s permanent disability. However, should the Commission find that the compensation agreement provided claimant with a permanent impairment award only, then the agreement is not final and conclusive as to claimant’s permanent disability, and the Commission is instructed to enter an award for claimant consistent with Conclusion of Law III that claimant is a member of the ‘odd lot’ category and, therefore, ‘is totally and permanently disabled as a result of his accident of November 14, 1974, and his subsequent back surgeries.’ ” 106 Idaho at 722, 682 P.2d at 1269.

This Court’s ultimate conclusion in Wood-vine was that if on remand the compensation agreement was found by the commission, as a matter of fact, to provide for permanent disability, rather than permanent impairment, “then the agreement is final and conclusive as to claimant’s permanent disability.” Id.

There is no claim here, as there was in Woodvine, that the two compensation agreements executed by Fowler and approved by the Industrial Commission adjudicated merely impairment rather than permanent disability. Accordingly, as we held in Woodvine, those compensation agreements, when approved by the commission, became awards which are “final and conclusive as to claimant’s permanent disability.” Id.; Sines v. Appel, supra. The only statutory provision for modification of such a “final and conclusive” agreement is I.C. § 72-719. However, Fowler’s two applications for hearings filed on June 13, 1985, were long after the five-year deadline set out in I.C. § 72-719, and accordingly the Industrial Commission correctly ruled that claimant’s applications were barred by the statute of limitations.⁶

The Industrial Commission’s order is affirmed. Costs to respondents.

SHEPARD, C.J., and BISTLINE, HUNTLEY and JOHNSON, JJ., concur.

1 . Subsequent to the filing of the applications for hearing, the State Insurance Fund paid further medical bills for treatment of the claimant’s knees.

2 . "72-706. Limitation on time on application for hearing. — (1) When no compensation paid. When a claim for compensation has been made and no compensation has been paid thereon, the claimant, unless misled to his prejudice by the employer or surety, shall have one (1) year from the date of making claim within which to make and file with the commission an application requesting a hearing and an award under such claim.

"(2) When compensation discontinued. When payments of compensation have been made and thereafter discontinued, the claimant shall have five (5) years from the date of the accident causing the injury or date of first manifestation of an occupational disease, or, if compensation is discontinued more than five (5) years from the date of the accident causing the injury or the date of first manifestation of an occupational disease, within one (1) year from the date of the last payment of compensation, within which to make and file with the commission an application requesting a hearing for further compensation and award.

"(3) Relief barred. In the event an application is not made and filed as in this section provided, relief on any such claim shall be forever barred.”

3 ."72-719. Modification of awards and agreements-Grounds — Time within which made.—

(1) An application made by a party in interest filed with the commission at any time within five (5) years of the date of the accident causing the injury or date of first manifestation of an occupational disease, on the ground of a change in conditions, the commission may, but not oftener than once in six (6) months, review any order, agreement or award upon any of the following grounds:

"(a) Change in the nature or extent of the employee’s injury or disablement; or “(b) Fraud.

“(2) The commission on such review may make an award ending, diminishing or increasing the compensation previously agreed upon or awarded, subject to the maximum and minimum provided in this law, and shall make its findings of fact, rulings of law and order or award, file the same in the office of the commission, and immediately send a copy thereof to the parties. "(3) The commission, on its own motion at any time within five (5) years of the date of the accident causing the injury or date of first manifestation of an occupational disease, may review a case in order to correct a manifest injustice.

"(4) This section shall not apply to a commutation of payments under section 72-404.”

4 . As referred to in I.C. § 72-706(2), "compensation” has been defined as either income or medical benefits. Bainbridge v. Boise Cascade Plywood Mill, 111 Idaho 79, 721 P.2d 179 (1986); Facer v. E.R. Steed Equipment Co., 95 Idaho 608, 514 P.2d 841 (1973).

5 . Income benefits payable under the Workmen's Compensation Law, with the exception of retraining benefits, I.C. § 72-450, are based upon disability, either temporary or permanent, but not merely impairment. I.C. § 72-407-432. While in some cases the non-medical factors will not increase the permanent disability rating over the amount of the permanent impairment rating, the ultimate award of income benefits is based upon the permanent disability rating, not merely the impairment rating.

6 . Although not cited by the parties, our recent case of Kindred v. Amalgamated Sugar Co., 114 Idaho 284, 756 P.2d 401 (1988), reh’g denied (1988), supports our analysis in this case. In Kindred, the claimant had entered into a compensation agreement, approved by the commission in September of 1976. Kindred continued in his employment with Amalgamated Sugar for several years at several make-work type jobs which were compatible with his injury. Later the employer voluntarily paid Kindred retraining benefits to attend Southern Idaho College. Less than one year after the termination of the payment of retraining benefits, Kindred filed an application for hearing with the Industrial Commission claiming that he was totally disabled. The commission first concluded that the payment of retraining benefits was not the voluntary payment of "compensation” within I.C. § 72-706(2), and therefore Kindred’s application was not timely filed. On reconsideration, the commission reversed itself, holding that the voluntary payment of tuition for Kindred’s retraining course at Southern Idaho College was in fact the payment of additional compensation benefits because, as this Court stated, “[Tjhese retraining benefits were not awarded pursuant to the compensation agreement filed in September, 1976.” Kindred, 114 Idaho at p. 119, 756 P.2d at p. 406. This Court affirmed, concluding that Amalgamated, by voluntarily paying additional retraining benefits which were not awarded pursuant to the compensation agreement, “[brought] the case within the application of § 72-706(2) Idaho Code." Id. Since Kindred’s application for hearing was filed within one year of the last payment of retraining benefits, it was timely under 72-706(2). The Court in Kindred stated:

"A compensation agreement is res judicata only with respect to matters already decided by that agreement. Banzhaf v. Carnation Co., 104 Idaho 700, 703, 662 P.2d 1144, 1147 (1983). Since the compensation agreement between Kindred and Amalgamated did not determine the retraining benefits, it cannot be considered res judicata with respect to any new awards, as I.C. § 72-718 distinctly provides: ‘A decision of the Commission ... shall be final and conclusive as to all matters adjudicated____’” Kindred, at p. 119, 756 P.2d at p. 406 (emphasis added in Kindred).