Romero v. Laidlaw Transit Services, Inc.

2015 NMCA 107, 8 N.M. Ct. App. 679
CourtNew Mexico Court of Appeals
DecidedSeptember 25, 2015
DocketNo. 35,499; Docket No. 33,032
StatusPublished
Cited by14 cases

This text of 2015 NMCA 107 (Romero v. Laidlaw Transit Services, Inc.) 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
Romero v. Laidlaw Transit Services, Inc., 2015 NMCA 107, 8 N.M. Ct. App. 679 (N.M. Ct. App. 2015).

Opinion

OPINION

ZAMORA, Judge.

{1} In this workers’ compensation case, Henry Romero (Worker) appeals from an order awarding him permanent partial disability (PPD) benefits, partial attorney fees, and imposing bad faith sanctions against Laidlaw Transit Services, Inc. d/b/a Saferide Services, Inc. (Employer), and the Insurance Company of the State of Pennsylvania (Insurer). Worker maintains that the bad faith sanctions imposed against Employer/Insurer were inadequate and that he should not have been required to pay half of his attorney fees. We affirm.

BACKGROUND

{2} Worker was employed as a patient transporter and driver for Employer. Worker was injured in two separate accidents, which both occurred within the scope of his employment. On April 13, 2006, a compensation order was entered finding that Worlcer had sustained compensable injuries as a result of the accidents. Worker was awarded temporary total disability (TTD) benefits. An interim order was entered March 9, 2012, reflecting a stipulation by the parties to reduce Worker’s TTD benefits to PPD benefits at 80 percent.

{3} In August 2012, the parties reached a settlement agreement. Worker agreed to accept a lump sum payment in lieu of additional workers’ compensation benefits, and Insurer agreed to continue paying Worker PPD benefits until the order approving settlement was filed. The agreement was presented to and approved by the Workers’ Compensation Judge (WCJ) on August 10, 2012, and the order approving settlement was filed on August 30, 2012. However, Insurer had discontinued payment of PPD benefits on August 10, 2012, the day the WCJ approved the settlement rather than August 30,2012, the day the order was filed.

{4} Worlcer sent letters requesting payment of PPD benefits for the period from August 10, 2012, to August 30, 2012, and received no response from Insurer. Worker requested that the WCJ enter an order directing payment of the PPD benefits along with post-judgment interest, a benefit penalty, and attorney fees. On March 7, 2013, the WCJ entered an order directing payment of the PPD benefits. The WCJ found that, contrary to the order approving settlement and despite Worker’s requests for payment, Insurer failed or refused to issue the missed PPD payments. The WCJ ordered Insurer to issue payment of the PPD benefits and post-judgment interest, which together totaled $864.76. The WCJ set a hearing to address Worker’s request for a benefit penalty and attorney fees.

{5} The hearing was held on March 20,2013. The WCJ found that Insurer: failed to timely issue payment of the lump sum settlement funds pursuant to the order approving settlement; failed to pay PPD benefits in compliance with the order approving settlement; took no action in response to Worker’s requests for payment; failed to respond to Worker’s application to the WCJ requesting the order directing payment; failed to timely comply with the WCJ’s order requiring payment of the PPD benefits; and offered no excuse or justification for its failure to comply with the WCJ’s orders.

{6} The WC J found that Insurer had willfully disregarded Worker’s rights and violated the WCJ’s orders and that Insurer knew that there was no reasonable basis for its conduct. The WCJ determined that Insurer’s conduct constituted bad faith and/or unfair claim processing. The WCJ ordered Insurer to pay Worker $864.76 in PPD benefits, plus a benefit penalty of $216.19, for a total award of $1,080.95. The WCJ also awarded $2,500 in attorney fees to be shared equally between Insurer and Worker. Worker was responsible for $1,250 in attorney fees, resulting in a $169.05 net loss to Worker. Worker appealed.

DISCUSSION

{7} On appeal, Worker argues that the Workers’ Compensation Act (the Act), NMS A 1978, §§ 52-1-1 to -70 (1929, as amended through 2015), provides an inadequate remedy for unfair claim-processing practices and bad faith claims. Worker also challenges the WCJ’s decision concerning attorney fees.

Standard of Review

{8} We review the WCJ’s factual findings under a whole record standard of review. Moya v. City of Albuquerque, 2008-NMSC-004, ¶ 6, 143 N.M. 258, 175 P.3d 926. We give deference to the WC J as fact finder where findings are supported by substantial evidence. See DeWitt v. Rent-A-Ctr., Inc., 2009-NMSC-032, ¶ 12, 146 N.M. 453, 212 P.3d 341. The WCJ’s application of the law to the facts is reviewed de novo. Ruiz v. Los Lunas Pub. Sch., 2013-NMCA-085, ¶ 5, 308 P.3d 983. W e also apply a de novo standard of review to the extent that our analysis involves the interpretation of workers’ compensation statutes. See Ramirez v. IBP Prepared Foods, 2001-NMCA-036, ¶ 10, 130 N.M. 559, 28 P.3d 1100 (stating that interpretation of a workers’ compensation statute is a question of law to be reviewed de novo), superseded by statute on other grounds as stated in Baca v. Los Lunas Cmty. Programs, 2011-NMCA-008, 149 N.M. 198, 246 P.3d 1070. The WCJ’s award of attorney fees is reviewed for abuse of discretion. Cordova v. Taos Ski Valley, Inc., 1996-NMCA-009, ¶ 15, 121 N.M. 258, 910 P.2d 334.

Unfair Claim-Processing Practices and Bad Faith

{9} Section 52-1-28.1(B) provides that when an employer/insurer engages in unfair claim processing or bad faith, the worker shall be awarded “any benefits due and owing” and “a benefit penalty not to exceed twenty-five percent of the benefit amount ordered to be paid.” In this case, the WCJ awarded a benefit penalty of $216.19, an amount equal to twenty-five percent of the benefit amount ordered to be paid. This is the maximum benefit penalty allowable under the statute.

{10} Worker argues that the benefit penalty allowed by Section 52-1-28.1 is insufficient to deter bad faith and unfair claim processing by employers/insurers and that workers are deterred from pursuing bad faith and unfair claim-processing claims because the cost of successfully pursuing such claims exceeds the available benefit penalty. Worker also argues against Section 52-1-28.1 as an exclusive remedy for workers’ bad faith claims.

{11} Section 52-1-28.1 was enacted in response to Russell v. Protective Insurance Co., 1988-NMSC-025, ¶¶ 8-9, 107 N.M. 9, 751 P.2d 693, abrogated by Cruz v. Liberty Mutual Insurance Co., 1995-NMSC-006, 119 N.M. 301, 889 P.2d 1223. See Meyers v. W. Auto, 2002-NMCA-089, ¶ 16, 132 N.M. 675, 54 P.3d 79. In Russell, the New Mexico Supreme Court held that, because the Act did not address bad faith claims in a workers’ compensation context, such claims could be brought in the district court. 198 8-NMSC-025, ¶¶ 8-9. Subsequently, the Legislature enacted Section 52-1-28.1 that provided workers with a remedy for bad faith and unfair claim-processing practices.

{12} In Cruz, the New Mexico Supreme Court addressed the question of whether the statute provides an adequate and exclusive remedy for workers’ bad faith claims. 1995-NMSC-006, ¶¶ 2, 4.

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Cite This Page — Counsel Stack

Bluebook (online)
2015 NMCA 107, 8 N.M. Ct. App. 679, Counsel Stack Legal Research, https://law.counselstack.com/opinion/romero-v-laidlaw-transit-services-inc-nmctapp-2015.