Johnson v. Aetna Life & Casualty Co.

559 A.2d 838, 131 N.H. 698, 1989 N.H. LEXIS 43
CourtSupreme Court of New Hampshire
DecidedJune 13, 1989
DocketNo. 88-382
StatusPublished
Cited by4 cases

This text of 559 A.2d 838 (Johnson v. Aetna Life & Casualty Co.) is published on Counsel Stack Legal Research, covering Supreme Court of New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Johnson v. Aetna Life & Casualty Co., 559 A.2d 838, 131 N.H. 698, 1989 N.H. LEXIS 43 (N.H. 1989).

Opinion

Johnson, J.

The plaintiff, Troy Johnson, appeals from a decision of the Superior Court (Hollman, J.) dismissing his appeal from a decision of the State Department of Labor. We reverse and remand.

On June 26, 1984, the plaintiff, Troy Johnson, who owned and operated a tree service business in Keene, was injured in a work-related accident. Thereafter he began to receive temporary total [699]*699disability benefits from the defendant, Aetna Life and Casualty Co. (Aetna), for this injury. In September 1985, Aetna requested permission to place Mr. Johnson on the diminished earning capacity rate. The change from the temporary total disability rate to the diminished earning capacity rate would reduce the benefits paid Mr. Johnson from $418 per week to $344.85 per week. The request was supported by a medical report which opined that although Mr. Johnson could not perform the outdoor activities associated with his business, he nevertheless had light duty work capabilities, and could thus perform the clerical duties associated with his occupation.

On October 3, 1985, the State Department of Labor (the Department), without holding a hearing, granted Aetna permission to place Mr. Johnson on the diminished earning capacity rate. See RSA 281:40. The Department notified Mr. Johnson of its decision and advised him of his right to request a hearing. Payments at the reduced rate commenced November 6, 1985.

On November 26, 1985, Mr. Johnson’s counsel below requested a hearing to contest this reduction in the rate of compensation. Following a hearing held on March 17, 1986, the Department concluded in a decision dated April 15, 1986, that “the claimant continues to have light duty work capabilities [and,] [therefore, shall continue to receive the diminished earnings capacity rate.” In its letter informing Mr. Johnson’s counsel of its decision, the Department advised him of Mr. Johnson’s right to appeal the decision to the superior court within thirty days. See RSA 281:37, I. No appeal was taken, and the decision became final thirty days thereafter. See RSA 281:37, II; N.H. Admin. Rules, Lab 203.08.

On June 3, 1987, counsel for the plaintiff requested the Department to reinstate the temporary total disability rate, and asked that such rate be made retroactive to November 6, 1985, the date benefits had been reduced. The reduction from the temporary total disability rate to the diminished earning capacity rate, according to Mr. Johnson’s counsel, “was in error in light of the new medical evidence,” which consisted of several medical opinions and reports. The Department held a hearing on May 31, 1988, and issued an order dated June 17, 1988, which stated, inter alia, that “the claimant is temporarily disabled effective May 31, 1988. Consequently, he is entitled to temporary total disability benefits commencing May 31, 1988 and [such benefits] shall continue into the future.” The Department found, as well, that “the claimant failed to meet his burden of proof [that] he was totally disabled prior to May 31, 1988.” The decision stated that the determination [700]*700regarding the extent of disability could be appealed to the superior court within thirty days.

On June 27, 1988, Mr. Johnson filed a timely appeal in the superior court requesting the difference between the temporary total disability benefits rate and the diminished earning capacity rate for the period November 6, 1985, to May 31, 1988. Aetna filed a motion to dismiss that appeal on August 1, 1988, which was granted following a hearing. In its decision dated September 7, 1988, the superior court held:

“The claim made by plaintiff in this appeal ... is in effect the same claim which the Department of Labor denied in its decision dated April 1[5], 1986. . . .
Having failed to appeal the . . . decision of the Department of Labor within the 30 day period provided in RSA 281:37 or to petition the Superior Court to be allowed an appeal within the 1 year provided in RSA 281:42, the plaintiff is not entitled to have his claim considered now.”

Accordingly, the superior court granted the defendant’s motion to dismiss. This appeal followed.

On appeal, Mr. Johnson argues that the superior court erred in dismissing his appeal on the ground that the res judicata effect accorded to the Department’s decision of April 15, 1986, barred adjudication of the issue of retroactivity which was now before the court. He argues that if the Department’s decision of June 17, 1988, increasing his award, is supported by a “change in conditions,” see RSA 281:40, the increased rate should be made retroactive to the date when the change occurred. According to Mr. Johnson, the superior court should be required to hold a hearing to determine whether he can meet the burden of proving that the change occurred prior to May 31, 1988. Aetna, on the other hand, argues that this court should affirm the dismissal because RSA 281:40, which provides for the reopening of a final Department decision on a number of grounds, does not permit retroactive relief when the basis for that relief is a “change in conditions.”

For the reasons which follow, we hold that the superior court erred in dismissing the appeal, and we therefore remand the case. We agree with plaintiff’s contention that the superior court must determine whether a “change in conditions” occurred before dismissing the case, because we hold that if a “change in conditions” justifies the increase in rate, the court should grant an award which is retroactive to the date the change in conditions occurred, but not [701]*701before June 3, 1987, the date when Mr. Johnson requested the Department to review the earlier award.

RSA 281:40 allows a final decision of the Department to be reopened and reviewed upon the filing of a petition by a party in interest “not later than the fourth anniversary of the date of [a] denial [of compensation] or the last payment of compensation . . . upon the ground of a change in conditions, mistake as to nature or extent of the injury or disability, fraud, undue influence or coercion.” Although the Department did not explicitly state the ground on which its decision of June 17, 1988, to allow temporary disability benefits was based, the plaintiff does not on appeal allege mistake, fraud, undue influence or coercion. Rather, he claims that the trial court erred first, in failing to determine whether the facts support a modification of the award based on a “change in conditions,” and second, if they do, to award retroactive benefits as of the date the “change in conditions” occurred. We therefore address only the issue of whether an award modified because of a “change in conditions” can be made retroactive.

The superior court dismissed the plaintiff’s appeal on the ground that the April 15, 1986 decision by the Department had already found that Mr. Johnson had “light duty work capabilities.” The decision of that date was “an adjudication as to the condition of the injured workman at the time it [was] entered,” see Morin v. J. H. Valliere Co., 113 N.H. 431, 434, 309 A.2d 153, 155 (1973). Thus the doctrine of res judicata bars relitigation of Mr. Johnson’s condition as of April 15, 1986, although it does not bar adjudication of his condition after that date. See id. We note, as well, that modification based on a “change in conditions” requires that the condition has changed.

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Cite This Page — Counsel Stack

Bluebook (online)
559 A.2d 838, 131 N.H. 698, 1989 N.H. LEXIS 43, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-aetna-life-casualty-co-nh-1989.