SD Sub. Injury Fund v. Casualty Rep. Exchange

1999 SD 2
CourtSouth Dakota Supreme Court
DecidedJanuary 6, 1999
DocketNone
StatusPublished

This text of 1999 SD 2 (SD Sub. Injury Fund v. Casualty Rep. Exchange) is published on Counsel Stack Legal Research, covering South Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
SD Sub. Injury Fund v. Casualty Rep. Exchange, 1999 SD 2 (S.D. 1999).

Opinion

Unified Judicial System

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SOUTH DAKOTA SUBSEQUENT INJURY FUND,
Appellant,
v.
CASUALTY RECIPROCAL EXCHANGE

and Dakota Truck Underwriters,
Appellees.
[1999 SD 2]

South Dakota Supreme Court
Appeal from the Sixth Judicial Circuit, Hughes County, SD
Hon. Steven L. Zinter, Judge
#20531--Affirmed

Mark Barnett, Attorney General
Timothy E. Reilly, Assistant Attorney General and Division Counsel,
South Dakota Division of Insurance, Pierre, SD
Attorney for Appellant.

Susan Jansa Brunick, Dana M. Van Beek
Davenport, Evans, Hurwitz & Smith, Sioux Falls, SD
Attorneys for Appellees.

Considered on Briefs Dec 3, 1998; Opinion Filed Jan 6, 1999

AMUNDSON, Justice.

[¶1] Subsequent Injury Fund (SIF) appeals the circuit court's decision affirming Department of Labor's (Department) determination that both Casualty Reciprocal Exchange (CRE) and Dakota Truck Underwriters (DTU) established claims for reimbursement from SIF. We affirm.

FACTS

[¶2] Two cases were combined for consideration because they involve similar facts and present the same legal issue.

Casualty Reciprocal Exchange/Niederman

[¶3] Darlene Niederman was employed as a cook for Employer, Lumberyard Restaurant, Inc. On July 21, 1986, Niederman reported a work-related back injury. During the treatment of her back injury, Niederman was diagnosed with a somatoform pain disorder(fn1)  in addition to the mechanical back pain disorder. Niederman had sustained a number of physical, mental and substance abuses during the years preceding her back injury, which resulted in a preexisting psychological condition. This preexisting psychological condition increased her chances of developing somatoform pain disorder.

[¶4] The claim for workers' compensation benefits was ultimately settled through a Compromise Agreement approved by Department. The agreement provided that Niederman's disability was the result of the low-back injury combined with the aggravation of a preexisting psychological condition, resulting in somatoform pain disorder. The agreement provided for a lump-sum payment of $100,000. This payment was in addition to disability benefits of $28,657.56, and medical expenses of $20,701.30 paid to Niederman prior to settlement.

[¶5] On April 10, 1996, CRE filed a claim for reimbursement from the SIF. CRE claimed Niederman suffered from a preexisting psychological condition and her subsequent injury was the low-back injury in July 1986. On November 19, 1996, the SIF denied CRE's claim, stating there was no disability or impairment rating attributable to the employee's alleged preexisting psychological condition. Therefore, no subsequent injury to employee.

Dakota Truck Underwriters/Bush

[¶6] Everett Bush was employed as a truck driver by Midwest Coast Transport, L.P. On August 28, 1995, Bush reported a work-related injury to his back. Bush was examined and treated by several doctors, but his condition did not improve. Subsequent X-rays revealed Bush had a compression fracture, as well as significant osteopenia.(fn2) 

Bone density testing revealed marked osteoporosis.(fn3) 

With regard to Bush's condition, Dr. Robert Suga stated, "the fracture, in my opinion, would have to be considered a pathologic(fn4)  fracture related to his osteopenia which was documented on bone densitometry. The fracture was however, incurred as a result of his work related activity."

[¶7] Bush's workers' compensation claim was settled. The compromise agreement, approved by Department, paid a lump sum of $23,000 in addition to the disability already paid. The lump sum also includes $1,400 as an advance toward future medical expenses. Total indemnity benefits paid to Bush over the course of the claim were $33,616.64 and total medical expenses were $2,810.99.

[¶8] DTU filed a claim for reimbursement from SIF. SIF denied DTU's claim under the rationale that no disability or impairment rating existed that was attributable to the preexisting condition of osteopenia and, as a result, there had been no subsequent injury to the employee.

[¶9] CRE and DTU filed a petition for hearing with Department on December 5, 1996.(fn5)  Department determined that, under the 1995 amendment to SDCL 62-4-34, a preexisting injury need not have resulted in a disability to obtain reimbursement from the SIF. Therefore, Department approved CRE and DTU's claims for reimbursement. The circuit court affirmed. SIF now appeals, raising the following issues for review:

[¶10] 1. Whether an eligible claim for reimbursement from the Subsequent Injury Fund must show that a prior injury or preexisting condition be of a disabling quality.

[¶11] 2. Whether claimants have demonstrated that their respective employees have received subsequent injuries within the meaning of the Subsequent Injury Fund.

STANDARD OF REVIEW

[¶12] The issue on appeal is a statutory interpretation of the 1995 amendment to SDCL 62-4-34. On issues of statutory interpretation, this Court reviews Department's decision de novo. Dahn v. Trownsell, 1998 SD 36, ¶14, 576 NW2d 535, 539.

DECISION

[¶13] 1. Whether an eligible claim for reimbursement from the Subsequent Injury Fund must show that a prior injury or preexisting condition be of a disabling quality.

[¶14] The Subsequent Injury Fund was set up to assist workers with some type of preexisting disability, condition or handicap, to obtain employment notwithstanding the liability exposure of an employer who would hire such worker in the event of a second injury. See 5 Larson, Worker's Compensation Law, § 59.30 (1998). SIF reimburses an employer for two-thirds of compensation paid due to a subsequent injury had there been no preexisting injury or condition. SDCL 62-4-34.

[¶15] In 1995, the statute governing reimbursement to employers was amended. SDCL 62-4-34, as amended, provides in relevant part:

If an employee who has previously sustained an injury or suffers from a preexisting condition, receives a subsequent compensable injury resulting in additional permanent partial or permanent total disability so that the degree or percentage of disability caused by the combination of the subsequent injury and the preexisting injury or condition is substantially greater than that which resulted from the last injury, considered alone; and if the employee is entitled to receive compensation on the basis of the combined disabilities, the employer shall pay all medical and hospital expenses and compensation provided by this title. The employer shall be reimbursed from the "subsequent injury fund" for two-thirds

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Related

Fenner v. Trimac Transportation, Inc.
1996 SD 121 (South Dakota Supreme Court, 1996)
Howie v. Pennington County
1997 SD 45 (South Dakota Supreme Court, 1997)
Dahn v. Trownsell
1998 SD 36 (South Dakota Supreme Court, 1998)
Moss v. Guttormson
1996 SD 76 (South Dakota Supreme Court, 1996)
Petition of Famous Brands, Inc.
347 N.W.2d 882 (South Dakota Supreme Court, 1984)
Delano v. Petteys
520 N.W.2d 606 (South Dakota Supreme Court, 1994)
US West Communications, Inc. v. Public Utilities Commission
505 N.W.2d 115 (South Dakota Supreme Court, 1993)
In re Dwyer
207 N.W. 210 (South Dakota Supreme Court, 1926)
Sioux Falls School District v. South Dakota Subsequent Injury Fund
504 N.W.2d 107 (South Dakota Supreme Court, 1993)

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