Stein v. Workforce Safety & Insurance

2006 ND 34, 710 N.W.2d 364, 2006 N.D. LEXIS 38, 2006 WL 266008
CourtNorth Dakota Supreme Court
DecidedFebruary 6, 2006
Docket20050196
StatusPublished
Cited by10 cases

This text of 2006 ND 34 (Stein v. Workforce Safety & Insurance) 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
Stein v. Workforce Safety & Insurance, 2006 ND 34, 710 N.W.2d 364, 2006 N.D. LEXIS 38, 2006 WL 266008 (N.D. 2006).

Opinion

KAPSNER, Justice.

[¶ 1] Ronald Stein appealed from a judgment affirming an order of Workforce Safety and Insurance (“WSI”) establishing Stein’s average weekly wage to be $520 per week for purposes of reinstating his disability benefits under N.D.C.C. § 65-05-09(1). We conclude WSI correctly applied the statute in calculating Stein’s average weekly wage, and we affirm.

I

[¶ 2] On April 8, 1997, Stein injured his left knee while employed as a janitor with Motor Coach Industries in Pembina. WSI accepted liability and paid him associated benefits. On May 1, 1997, WSI determined Stein’s average weekly wage at the time was $479 and paid him disability benefits based on that amount from April 16, 1997, to September 28, 1997. Stein returned to work on September 29,1997, and his disability benefits were discontinued.

[¶ 3] Stein filed a reapplication for disability benefits on August 28, 2000, because he underwent knee surgery and was unable to work from July 28, 2000, through August 13, 2000. WSI determined Stein was entitled to temporary total disability benefits, and because Stein had worked *366 more than twelve consecutive months since he last received disability benefits, WSI recalculated his average weekly wage to be $520. Stein did not request reconsideration of this informal decision and WSI paid him disability benefits based on the $520 average weekly wage from July 28, 2000, through August 13, 2000.

[¶ 4] Stein returned to work on August 14, 2000, but he was laid off from work on November 3, 2000. In April 2001, he reapplied for disability benefits. Although WSI originally accepted Stein’s reapplication for benefits, WSI reversed its informal decision. The parties eventually reached a stipulated settlement in which Stein waived disability benefits through December 31, 2001, and agreed to reinstatement of disability benefits effective January 1, 2002. WSI reinstated Stein’s benefits based on his last calculated average weekly wage of $520 for July and August 2000. Stein then requested a recalculation of his average weekly wage, arguing that because his disability benefits had been reinstated effective January 1, 2002, more than twelve consecutive months after his last disability benefits were paid, he was entitled to recalculation of his average weekly wage based on his work from August 2000 through April 2001 when he reapplied for benefits. He claimed his average weekly wage for 2000 was approximately $700 per week. WSI refused to recalculate because Stein had not returned to work for twelve consecutive months since his last period of disability in July and August 2000, and because Stein had not appealed WSI’s calculations of his average weekly wage in May 1997 and in September 2000. WSI also refused Stein’s request for issuance of an appealable order on his request for recalculation of his average weekly wage.

[¶ 5] In December 2002, Stein requested a writ of mandamus asking the district court to order that WSI issue an appeal-able order on its refusal to recalculate Stein’s average weekly wage. The district court ordered WSI “to recalculate the total disability benefits of Ronald Stein and issue an appealable Order.” WSI issued an order again determining that, because he had not worked for twelve consecutive months before his latest reqúest for disability benefits in April 2001 and because he did not appeal from the previous average weekly wage determinations in 1997 and 2000, Stein’s average weekly wage was $520 per week. Stein requested an administrative hearing and WSI adopted the Administrative Law judge’s recommendation that its decision be affirmed. The district court also affirmed WSI’s order, and this appeal followed.

II

[¶ 6] Under N.D.C.C. § 28-32-46, the district court must affirm an order of an administrative agency unless it finds any of the following are present:

1. The order is not in accordance with the law.
2. The order is in violation of the constitutional rights of the appellant.
3. The provisions of this chapter have not been complied with in the proceedings before the agency.
4. The rules or procedure of the agency have not afforded the appellant a fair hearing.
5. The findings of fact made by the agency are not supported by a preponderance of the evidence.
6. The conclusions of law and order of the agency are not supported by its findings of fact.
7. The findings of fact made by the agency do not sufficiently address the evidence presented to the agency by the appellant.
*367 8. The conclusions of law and order of the agency do not sufficiently explain the agency’s rationale for not adopting any contrary recommendations by a hearing officer or an administrative law judge.

On appeal from a district court’s decision in an administrative appeal, we review the agency order in the same manner. Rojas v. Workforce Safety and Ins., 2005 ND 147, ¶ 10, 703 N.W.2d 299. Questions of law, including the interpretation of a statute, are fully reviewable on appeal from an administrative decision. Bjerklie v. Workforce Safety and Ins., 2005 ND 178, ¶ 9, 704 N.W.2d 818.

A

[¶ 7] Stein argues that WSI, in recalculating his average weekly wage, misapplied N.D.C.C. § 65-05-09(1), which provides:

If an injury causes temporary total or permanent total disability, the fund shall pay to the disabled employee during that disability a weekly benefit equal to sixty-six and two-thirds percent of the gross weekly wage of.the employee, subject to a minimum of sixty percent and a maximum of one hundred ten percent of the average weekly wage in the state. If an employee is disabled due to an injury, that employee’s benefits will be based upon the employee’s wage and the organization benefit rates in effect on the date of first disability.
1. If an employee suffers disability but is able to return to employment for a period of twelve consecutive calendar months or more, that employee’s benefits will be based upon the wage in effect at the time of the recurrence of the disability or upon the wage that employee received prior to the injury, whichever is higher. The organization benefit rates are those in effect at the time of that recurrence.

[¶ 8] Stein argues he is entitled to have his average weekly wage recalculated based upon his 2000 calendar year earnings of $36,426.64, because he had once returned to work for “twelve consecutive calendar months or more” when he filed his reapplication for disability benefits in August 2000. Although Stein had not returned to work for a period of twelve consecutive months when he reapplied for disability benefits in April 2001, he contends that he met the initial twelve-month work requirement after his first period of disability when he worked from September 29, 1997, through July 27, 2000. Stein argues he need not return to work for twelve consecutive months before he is entitled to a recalculation of his average weekly wage upon a recurrence of the disability after he has fulfilled the “threshold” requirement of twelve consecutive months of work.

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Cite This Page — Counsel Stack

Bluebook (online)
2006 ND 34, 710 N.W.2d 364, 2006 N.D. LEXIS 38, 2006 WL 266008, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stein-v-workforce-safety-insurance-nd-2006.