Garcia v. General Electric

1999 NMCA 139, 992 P.2d 304, 128 N.M. 291
CourtNew Mexico Court of Appeals
DecidedSeptember 15, 1999
DocketNo. 19,856
StatusPublished
Cited by3 cases

This text of 1999 NMCA 139 (Garcia v. General Electric) 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
Garcia v. General Electric, 1999 NMCA 139, 992 P.2d 304, 128 N.M. 291 (N.M. Ct. App. 1999).

Opinion

OPINION

PICKARD, Chief Judge.

{1} Ernest Garcia (Worker) suffered a hip injury in a work-related accident for which General Electric (Employer) paid medical costs and disability payments. Worker recovered damages against a third-party tortfeasor after a jury trial, but the jury apportioned the comparative negligence of Worker at 60% and that of PJ Albuquerque, Inc. (Defendant) at 40%. The Workers’ Compensation Judge (WCJ) applied the formula from Gutierrez v. City of Albuquerque, 1998-NMSC-027, 125 N.M. 643, 964 P.2d 807, to determine what portion of the jury award Worker must use to reimburse Employer. Employer and Electric Mutual Insurance (Insurer) appeal the decision of the WCJ, arguing that the WCJ incorrectly determined their reimbursement rights. We affirm.

FACTUAL AND PROCEDURAL BACKGROUND

{2} The parties stipulated to the facts of this case. Worker was injured on the premises of Defendant. He received temporary total disability benefits for 53 weeks and permanent partial disability benefits for 185 weeks. Employer paid Worker’s medical expenses in full. Worker attained maximum medical improvement on June 6, 1994, and has not been released to return to work. The hip injury is a 15% injury that constitutes a 25% permanent partial disability.

{3} Worker filed a tort claim against Defendant, and the district court permitted Insurer to intervene. After trial, the jury entered a special verdict in favor of Worker, awarding Worker $41,362.87 in damages for medical expenses, $321,246.00 for lost wages and earning capacity, and $60,000 for “other” damages. The jury also found that Worker was 60% negligent and Defendant was 40% negligent. After reduction for Worker’s negligence, Worker’s recovery totaled $181,-043.55. Defendant paid Worker’s award and costs, and Worker paid his attorney a one-third contingency, or $60,347.85, in fees.

{4} Employer and Insurer presented their case for reimbursement to the WCJ. The WCJ applied the analysis developed by the Supreme Court in Gutierrez to determine that Employer and Insurer were entitled to reimbursement out of Worker’s third-party recovery in the amount of $5,145.32, and that Worker was entitled to have Employer and Insurer pay his reasonable future medical expenses. The $5,145.32 figure represents the amount of Employer’s share of the tort recovery based on the Gutierrez formula ($36,820.19) less certain offsets. The offsets included (1) Employer’s share of the attorney fees paid and (2) the present value of future disability benefits, which Employer and Insurer were relieved of paying. Employer and Insurer appeal.

DISCUSSION

{5} Employer and Insurer propound several arguments. Their threshold argument is that the Supreme Court’s recent treatment of the issue of reimbursement in the workers’ compensation context is inapplicable in this case. See Gutierrez, 1998-NMSC-027, 125 N.M. 643, 964 P.2d 807. Because the parties stipulated to the facts, we review the legal question of whether Gutierrez is the applicable law of the case de novo. See Gallegos v. State of N.M. Bd. of Educ., 1997-NMCA-040, ¶ 11, 123 N.M. 362, 940 P.2d 468 (appellate court reviews de novo questions of law decided by trial court). We address Employer’s and Insurer’s arguments in turn, combining the first two for the purpose of streamlining our discussion.

Applicability of Gutierrez

{6} Employer and Insurer first argue that the “application of [Gutierrez ] in this case is misplaced, because it is factually and legally inappropriate.” Their subsequent argument, that Worker was made whole by his third-party recovery, speaks to the same issue, allowing us to address both issues in this section. The premise of this argument is that because this case involved a jury verdict for Worker in the third-party suit that was reduced for Worker’s negligence, as opposed to the settlement of the third-party action for significantly less than the damages found by the WCJ as in Gutierrez, the Gutierrez ease is inapposite. We disagree.

{7} The Gutierrez case offers an exhaustive treatment of the issue of how to allocate reimbursement to an employer or insurer when a worker receives damages from a third party. In Gutierrez, the worker fell over a pile of construction materials and suffered injury as a result. See 1998-NMSC-027, ¶ 2, 125 N.M. 643, 964 P.2d 807. She received workers’ compensation disability and medical benefits from her employer. See id. She filed a workers’ compensation claim contesting her entitlement and later filed a third-party negligence suit against the company that had left the material at the construction site. See id. Gutierrez ultimately settled her tort claim for $140,000, and the issue in that ease became what portion of that settlement should be used to reimburse the employer for the benefits it paid, in light of the WCJ’s finding that her actual damages totaled $367,609.13. See id. ¶ 3.

{8} The Gutierrez court devised a system of analysis for such reimbursement claims. In a nutshell, it held that the employer “is entitled to recoup the amount of a worker’s duplicative recovery. Those monies a worker reasonably receives in tort to compensate for injuries not addressed by workers’ compensation are beyond the reach of the employer.” Id. ¶28. Employer and Insurer propose two main distinctions between the instant case and Gutierrez that they claim prevent the application of the Gutierrez formula in their case.

1. Jury Verdict

{9} Employer and Insurer claim that the factual distinction between the settlement in Gutierrez and the jury verdict in this case is legally significant. However, the language in Gutierrez is not so restricted as to preclude the application of the analysis in that case to the jury award in this case. Rather, the Court noted that in determining whether the employer’s contribution is duplicated by the tort recovery, the judge must determine “the actual amount of tort damages suffered, the elements of damage (including the amounts thereof), the degree of the tortfeasor’s fault, and the amount of the tort award or good faith settlement.” Id. ¶ 13 (emphasis added). This language suggests that, while a comparative negligence issue may not have been specifically before the Court, the same analysis would apply in such a situation.

{10} It is essential to an understanding of this case and Gutierrez to recognize that workers’ compensation benefits are paid “without regard to fault....” Id. ¶ 12. Thus, Employer’s and Insurer’s argument that they should not have to pay for Worker’s negligence misses the mark. Gutierrez controls the issue in this case because that issue is duplication of recovery, not fault. See id. ¶ 10 (holding that an employer is only allowed to be reimbursed from a tort recovery to the extent that the “recovery duplicates the elements of damage covered by compensation benefits”). Fault is simply never an issue with ordinary workers’ compensation cases. Therefore, whether fault is determined by a jury (as in this case) or left undiscovered (as in Gutierrez) is irrelevant to the issue of reimbursement.

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Related

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11 P.3d 1229 (New Mexico Court of Appeals, 2000)

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Bluebook (online)
1999 NMCA 139, 992 P.2d 304, 128 N.M. 291, Counsel Stack Legal Research, https://law.counselstack.com/opinion/garcia-v-general-electric-nmctapp-1999.