Johnson v. North Dakota Workers' Compensation Bureau

484 N.W.2d 292, 1992 N.D. LEXIS 105, 1992 WL 91405
CourtNorth Dakota Supreme Court
DecidedMay 6, 1992
DocketCiv. 910419
StatusPublished
Cited by19 cases

This text of 484 N.W.2d 292 (Johnson v. North Dakota Workers' Compensation Bureau) is published on Counsel Stack Legal Research, covering North Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Johnson v. North Dakota Workers' Compensation Bureau, 484 N.W.2d 292, 1992 N.D. LEXIS 105, 1992 WL 91405 (N.D. 1992).

Opinion

VANDE WALLE, Justice.

The North Dakota Workers’ Compensation Bureau appealed from a district court judgment which, while affirming the Bureau’s dismissal of Russell Johnson’s claim for benefits, reversed the Bureau’s order that Johnson reimburse the Bureau for benefits paid when a claims analyst erroneously determined that Johnson’s injury was work related. We reverse in part and remand.

Johnson is a self-employed life insurance salesman who contracted with the Bureau for coverage as permitted by section 65-07-01, NDCC. In February 1989, Johnson injured his back during an early morning aerobics class. He filed a claim with the Bureau in January 1990, stating that he was “prospecting” for potential sales at the time of his injury. The Bureau’s claims analyst accepted Johnson’s claim and, consequently, Johnson received medical and disability benefits totaling $9,284.58. In January 1991, the Bureau dismissed Johnson’s claim, concluding that the injury did not arise out of and in the course of employment activities, and ordered Johnson to repay the benefits he had received in error.

Johnson asked the Bureau to reconsider its denial of his claim and a hearing was held. The hearing officer affirmed the dismissal of Johnson’s claim and the order that he repay the Bureau for the medical and disability benefits he had received. Johnson appealed to the district court which affirmed the Bureau’s determination that Johnson’s injury did not arise out of and in the course of employment activities. Johnson asked the district court to reconsider its decision; the court again affirmed the Bureau’s determination that Johnson’s injury was not work related, but concluded that the Bureau was estopped from claiming repayment of the benefits Johnson had been erroneously paid.

*294 On appeal, the Bureau challenges only the district court’s determination that it is estopped from ordering Johnson to repay the medical and disability benefits that the Bureau paid in error. The question of whether Johnson’s back injury sustained during an aerobics class taken, in part, to meet potential clients was work related was decided against Johnson by the Bureau and the district court, and Johnson has not cross-appealed.

The Bureau argues that the court erred when it estopped the Bureau from ordering Johnson to repay his workers compensation benefits. In Blocker Drilling Canada, Ltd. v. Conrad, 354 N.W.2d 912, 920 (N.D.1984), we held that estoppel is available against governmental entities, although it should not be applied freely. “[Estoppel against the government] is a doctrine which must be applied on a case-by-case basis with a careful weighing of the inequities that would result if the doctrine is not applied versus the public interest at stake and the resulting harm to that interest if the doctrine is applied.” Id. (emphasis in original). Johnson raised his estoppel argument for the first time in his appeal from the Bureau to the district court. He did not present any additional evidence respecting the Bureau’s conduct; the only evidence reviewed by the district court was the record of the administrative proceedings. After reviewing that record, we conclude that Johnson failed to establish the basic elements of estoppel applicable even when the state is not involved; we therefore need not engage in the weighing required by Blocker.

An essential element of any estop-pel claim is detrimental reliance by the person asserting estoppel. See, e.g., Farmers Cooperative Assoc. v. Cole, 239 N.W.2d 808 (N.D.1976). Johnson’s attorney argued to the district court that:

“If Russell Johnson had known that his claim was not work-related and not covered by workers’ compensation, he would have taken action to pay the medical benefits himself or to obtain payment from another insurer. Russell Johnson did not do so because he relied on the Bureau’s award of benefits. Russell Johnson’s inaction as to ... obtaining disability benefits from another insurer constituted a change of position or status to his injury, detriment and prejudice.”

The record does not, however, support the factual assertions made in this argument. The only evidence presented at the administrative hearing respecting Johnson’s ability to obtain benefits from other insurers is contained in this exchange between the Bureau’s attorney and Johnson:

“Q Do you have any other insurance for health?
A For health?
Q Yes.
A For—
Q Blue Cross-Blue Shield?
A Yes.
Q Have they paid any of your medical bills for this incident?
A Yes, they did.
Q How much?
A I don’t recall the specific amount.”

The only evidence before the agency, and the district court, demonstrated that Johnson had other insurance and that he had been able to collect some medical benefits from that source for the injuries erroneously compensated by the Bureau. Johnson did not say whether other insurance covered his disability claim. He did not say whether it was still possible for him to collect from other insurance for his injuries. In other words, Johnson did not show how he was prejudiced by the Bureau’s initial erroneous approval of his claim. The fact that he should repay that which he was not entitled to receive is not, in itself, sufficient to establish detrimental reliance. The district court erred when it found the Bureau estopped from ordering Johnson to repay the benefits.

Although the district court applied a different reason for reversing the Bureau’s repayment order, Johnson, as he is entitled to do [e.g., Ward v. Shipp, 340 N.W.2d 14 (N.D.1983) ] defends the district court’s decision by attacking the Bureau’s authority to order repayment of benefits; he, there *295 fore, argues that the agency decision is not supported by the law.

In an appeal from a district court judgment reviewing a decision of an administrative agency, we review the record before the administrative agency and its decision rather than the decision of the district court. Pleinis v. North Dakota Workers Compensation Bureau, 472 N.W.2d 459 (N.D.1991). Our review of administrative agency decisions is governed by section 28-32-19, NDCC, which requires a three-step process to determine (1) if the findings of fact are supported by a preponderance of the evidence; (2) if the conclusions of law are supported by the findings of fact; and (3) if the agency decision is supported by the conclusions of law. Id.

Our duty in interpreting statutes is to fulfill the object and intent of the legislature. E.g., Aanenson v. Bastien,

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Cite This Page — Counsel Stack

Bluebook (online)
484 N.W.2d 292, 1992 N.D. LEXIS 105, 1992 WL 91405, Counsel Stack Legal Research, https://law.counselstack.com/opinion/johnson-v-north-dakota-workers-compensation-bureau-nd-1992.