Stiles v. Workers' Compensation Appeal Board

853 A.2d 1119, 2004 Pa. Commw. LEXIS 498

• Court: Commonwealth Court of Pennsylvania
• Decided: July 13, 2004
• Status: Published

Opinions

OPINION BY

Judge COHN.

Before the Court is the question of whether the efficacy of a Workers’ Compensation Compromise and Release (C & R) Agreement can be attacked on the basis that a claimant was.mentally incompetent to comprehend what she was agreeing to or whether such an attack is precluded by the doctrine of collateral estoppel.¹ This is an issue of first impression, and has far-reaching consequences. Marcella Stiles (Claimant) appeals an order of the Workers’ Compensation Appeal Board (WCAB) that upheld the order of Workers’ Compensation Judge (WCJ) Charles A. Getty, dismissing the petition to set aside on the basis that the litigation was precluded by the doctrine of collateral estoppel.

The pertinent facts are as follows. On October 7, 1995, while employed by the Department of Public Welfare (Employer), Claimant sustained a work-related injury described as “post-concussion syndrome.” As a result, she received total disability benefits pursuant to a Notice of Compensation Payable (NCP), dated October 24, 1995, with subsequent periods of partial and total disability pursuant to various supplemental agreements.

In April of 2000, Claimant’s then attorney filed a petition on Claimant’s behalf, seeking approval of a “Compromise and Release Agreement by Stipulation pursuant to Section 449 of the Workers’ Compensation Act” (Act).² This proceeding was held before WCJ Francis J. Desimone. The C & R Agreement, which was approved by WCJ Desimone, was signed by Claimant, Employer, and their respective counsel. It provided that Employer would pay Claimant one final indemnity payment of $100,000.00, representing all of Claimant’s future wage loss claims attributable to her October 7, 1995 work injury, but that Employer would continue to pay all reasonable and necessary medical bills related to that injury.³ (O.R., C & R Agreement at para. 8, 10; WCJ Desimone’s Findings of Fact 2.)

At the C & R Agreement hearing, Claimant was questioned by her counsel, and by Employer’s counsel with respect to the C & R Agreement. Responding to questions posed, Claimant agreed that she understood and accepted the terms of the C & R Agreement and that she had been fairly represented by her attorney. WCJ Desimone credited Claimant’s testimony and specifically found that Claimant “understands the full legal significance of the Compromise and Release Agreement which she signed.” (WCJ Desimone’s Findings of Fact 4.) Accordingly, he approved the C & R Agreement on June 2, 2000. Thereafter, Employer paid Claimant the settlement amount of $100,000.00.

Claimant did not appeal from WCJ Desi-mone’s order approving the C & R Agreement. However, in August of 2001, she filed a petition to set aside final receipt and reinstate compensation, in which she alleged that, “[a]t the time [Claimant] entered into her Compromise and Release, she was suffering from severe psychological, psychiatric and physical injuries which gave her post-traumatic stress syndrome and [she] did not understand the economic value of her claim. The agreement was totally inadequate under the circumstances and should be set aside and benefits reinstated.” Employer filed a timely answer generally denying the allegations of Claimant’s petition and, more specifically, averring that “Claimant received the sum of $100,000 upon approval of a Compromise and Release Agreement issued by [WCJ] Desimone on June 2, 2000. Accordingly, benefits cannot be reinstated.”

The petition was assigned to WCJ Getty, who conducted a hearing on September 20, 2001. Claimant’s counsel presented no evidence at that hearing but, instead, requested that Claimant’s testimony be deferred until counsel could schedule a deposition from Dr. Michelle R. Arbitell, Claimant’s treating psychologist. (O.R., N.T. at 4-5.) Employer’s counsel submitted a copy of WCJ Desimone’s June 2, 2000, decision approving the C & R Agreement, as well as a signed copy of the C & R Agreement. WCJ Getty admitted both submissions into the record as Judge’s Exhibits # 1 and # 2, respectively. (N.T. at 7-8; WCJ Getty’s Finding of Fact 3.) WCJ Getty then marked the matter continued for the deposition of Dr. Arbitell. (N.T. at 9.)

Shortly thereafter, by correspondence dated September 27, 2001, Employer’s counsel moved for dismissal of Claimant’s petition on the ground that the issue was controlled by the doctrine of collateral es-toppel. In the motion to dismiss, Employer’s counsel noted that, in the decision approving the C & R Agreement, WCJ Desimone had specifically found that Claimant understood the full legal significance of the C & R Agreement, which she had signed. Because Claimant never appealed from that decision, Employer’s counsel asserted that Claimant’s petition to set aside, in which she sought to prove that she did not understand the full legal significance of the C & R Agreement, must be dismissed. Both parties submitted legal briefs regarding application of the collateral estoppel defense. After considering the arguments made therein, WCJ Getty concluded that Employer’s motion to dismiss should be granted due to WCJ Desimone’s finding that Claimant understood her decision to proceed and execute the C & R Agreement and Claimant’s failure to appeal from that decision. (WCJ Getty’s Finding of Fact 5; WCJ Getty’s Conclusion of Law 3.) Claimant appealed the WCJ’s dismissal order to the WCAB, which affirmed.

Claimant now petitions this Court for review,⁴ arguing that Employer waived the right to raise the defense of collateral es-toppel by failing to include it in its answer to Claimant’s petition. Alternatively, Claimant argues that, even if this defense were properly raised, the doctrine of collateral estoppel does not apply here because Claimant did not have a full and fair opportunity to litigate in the underlying C & R Agreement- proceeding before WCJ Desimone. Her specific objections to that hearing are that (1) she was not represented by counsel of her own choosing and (2) she was not mentally capable of exercising independent judgment. Claimant reasons that because the C & R Agreement procedures suffered from these alleged deficiencies, she should have been provided an opportunity, in the context of her petition to set aside, to present evidence in support of her allegations of mental incapacity.

Before addressing Claimant’s arguments, we note that, although Claimant styled her pleading as a petition to set aside final receipt, this was not the proper means by which to request the relief she sought. This is because at the time a final receipt is signed, the parties acknowledge that the claimant is no longer disabled from the work-related injury. Therefore, a claimant seeking to set aside a final receipt must demonstrate by sufficient, competent, credible evidence that all disability attributable to his work-related injury had not ceased at the time of signing. Hartner v. Workmen’s Compensation Appeal Board (Phillips Mine & Mill, Inc.), 146 Pa.Cmwlth.167, 604 A.2d 1204 (1992), petition for allowance of appeal denied, 531 Pa. 662, 613 A.2d 1210 (1992). In this case, however, when Employer and Claimant entered into the C & R Agreement, they agreed that Claimant remained totally disabled due, at least in part, to Claimant’s 1995 work injury. (O.R., C & R at para. 6, 16.) Thus, the circumstances here are not within the ambit of a petition to set aside. However, relief may be granted under a section of the Act different from that invoked by Claimant, provided that relief is appropriate based on the evidence presented. Hartner.

What Claimant actually seeks here is to set aside the C & R Agreement approved by WCJ Desimone and, thereby, reinstate her disability benefits.⁵ In an effort to secure this relief, Claimant asserts that, contrary to representations in the Employee’s Certification portion of the C & R Agreement and to WCJ Desimone’s Findings of Fact 4, she did not understand the full legal significance of the C & R Agreement at the time she signed that document. Moreover, Claimant asserts that, contrary to her signed acknowledgement in the Employee Certification portion of the C & R Agreement that she was represented by an attorney of her own choosing as required under Section 449(c)(ll) of the Act, 77 P.S. § 1000.5(c)(ll), that was not, in fact, the case. In actuality then, Claimant’s petition is in the nature of a petition to set aside the C & R Agreement pursuant to Section 413(a) of the Act, which gives the WCJ authority to set aside an agreement of the parties “if it be proved that such ... agreement was in any material respect incorrect.” 77 P.S. § 771(a).

With this in mind, we consider whether Claimant’s petition was properly dismissed based upon collateral estoppel.⁶ The doctrine of collateral estoppel forecloses re-litigation of an issue of law or fact that has been finally decided when the following factors are demonstrated: (1) the legal or factual issues are identical; (2) they were actually litigated; (3) they were essential to the judgment; and (4) they were material to the adjudication. Township of McCandless v. McCarthy, 7 Pa. Cmwlth. 611, 300 A.2d 815 (1973). The party against whom the plea is asserted must have been a party, or in privity to a party, in the prior action and must have had a full and fair opportunity to litigate the issue in question. Id.

Claimant argues that collateral estoppel does not apply to the question of her mental competence because that issue was not actually litigated in the proceeding before WCJ Desimone. We disagree. • Under Section 449(b) of the Act, the WCJ presiding over a Compromise and Release Agreement hearing is mandated to determine that “the claimant understands the full legal significance of the agreement.” Inherent in that responsibility is a requirement that the WCJ determine that the claimant is mentally competent to comprehend the legal ramifications of entering into such an agreement. This is exactly what WCJ Desimone did. In his Findings of Fact 4, WCJ Desimone specifically found that Claimant “understands the full legal significance of the Compromise and Release Agreement which she signed.” Thus, Claimant’s mental competence was an issue actually litigated at the hearing before WCJ Desimone. Based on this same reasoning, Claimant’s mental competence was essential to the judgment approving the C & R Agreement and material to the adjudication that did so. Therefore, collateral estoppel does preclude re-litigation of this question.

The next issue is whether collateral es-toppel bars Claimant’s contention that she was not represented by counsel of her choice. The record reflects that the C & R Agreement included a section entitled “Employee’s Certification,” which Claimant admitted she signed. Paragraph 5 of that. section of the C & R Agreement states, “I have been represented by an attorney of my own choosing during this case. My attorney has explained to me the content of this agreement and its effects upon my rights.” This provision was initialed by Claimant. Additionally, the record shows that at the C & R Agreement hearing Claimant was specifically asked whether she was satisfied with her attorney’s representation of her, to which she replied, “Yes.” (N.T. 11-12.) Based on this evidence, we hold that she was precluded under collateral estoppel from re-litigating the issue of whether she was represented by counsel of her choice.⁷

Our. decision that the doctrine of collateral estoppel properly applies here is supported by strong public policy favoring voluntary settlements and finality. The importance of giving effect to the finality of a Compromise and Release settlement has been recognized by other courts. In fact, the Supreme Court of Texas rejected the notion that even a mutual mistake of fact could justify opening a Compromise and Release settlement in a workers’ compensation case, observing:

[Vjoluntary settlements are so favored, that if a doubt or dispute exists between parties with respect to their rights, and all have the same knowledge or means of obtaining knowledge concerning the circumstances involving those rights, and there is no fraud, misrepresentation, concealment, or other misleading incident, a compromise into which they have voluntarily entered must stand and be enforced, although the final issue may be different from that which was anticipated, and although the disposition made by the parties in their agreement may not be that which the court would have decreed, had the controversy been brought before it for decision.

Mullens v. Texas Employers’ Insurance Association, 507 S.W.2d 317, 320 (Tex.Civ. App.1974) (quoting Houston and Texas Central Railroad Company v. McCarty, 94 Tex. 298, 60 S.W. 429 (Tex.1901), overruled on other grounds in Williams v. Glash, 789 S.W.2d 261 (Tex.1990)).⁸ Unlike in Texas, this Court has declined to apply the same level of strictness. Rather, we have permitted a C & R Agreement to be set aside in a situation where we perceived a mutual mistake of fact. See North Penn Sanitation Inc. v. Workers’ Compensation Appeal Board (Dillard), 850 A.2d 795 (Pa.Cmwlth.2004). In North Penn, we stated that, “At common law, a compromise and release agreement can be set aside upon a clear showing of fraud, deception, duress or mutual mistake.... We see no reason why the test for setting aside releases at common law should not be applied to workers’ compensation cases.” (Op., p. 798).⁹,¹⁰ In addition, we have stated, “we believe that the legislature intended that a C & R should be on equal footing with civil settlements, which are based on a public policy that encourages settlements and stresses finality.” Stroehmann Bakeries v. Workers’ Compensation Appeal Board (Plouse), 768 A.2d 1193, 1196 (Pa.Cmwlth. 2001).¹¹ These important public policy concerns, i.e., encouraging settlements and promoting finality, reinforce the basis for our holding here.

Accordingly, having determined that the doctrine of collateral estoppel did prevent the setting aside of the C & R Agreement, and that there are strong policy reasons that militate against allowing persons to disavow such agreements, absent circumstances such as fraud, misrepresentation, concealment, or mutual mistake of fact, which are not present here, we affirm the order of the Board, upholding the dismissal of Claimant’s petition.

ORDER

NOW, July 13, 2004, the order of the Workers’ Compensation Appeal Board in the above-captioned matter is hereby affirmed.

1 . The record discloses that the terms collateral estoppel and res judicata are used interchangeably by the parties. They are not precisely the same thing. See Township of McCandless v. McCarthy, 7 Pa.Cmwlth. 611, 300 A.2d 815, 820 (1973). Collateral estoppel is the term that properly applies and we will use it here.

2 . Act of June 2, 1915, P.L. 736, as amended, added by Section 22 of the Act of June 24, 1996, P.L. 350, 77 P.S. § 1000.5.

Section 449 of the Act provides, in relevant part:

(a) Nothing in this act shall impair the right of the parties interested to compromise and release, subject to the provisions herein contained, any and all liability which is claimed to exist under this act on account of injury or death.

(b) Upon or after filing a petition, the employer or insurer may submit the proposed compromise and release by stipulation signed by both parties to the workers’ compensation judge for approval. The workers’ compensation judge shall consider the petition and the proposed agreement in open hearing and shall render a decision. The workers' compensation judge shall not approve any compromise and release agreement unless he first determines that the claimant understands the full legal significance of the agreement. The agreement must be explicit with regard to the payment, if any, of reasonable, necessary and related medical expenses. Hearings on the issue of a compromise and release shall be expedited by the department, and the decision shall be issued within thirty days.

(c)Every compromise and release by stipulation shall be in writing and duly executed, and the signature of the employe, widow or widower or dependent shall be attested to by two witnesses or acknowledged before a notary public. The document shall specify:

(11) the fact that the claimant is represented by an attorney of his or her own choosing or that the claimant has been specifically informed of the right to representation by an attorney of his or her own choosing and has declined such representation.

77 P.S. § 1000.5 (emphasis added).

3 . We note that, in its opinion of June 6, 2003, the WCAB incorrectly states that, under the C & R Agreement, “Claimant had waived her right to future compensation (indemnity and medical benefits) in exchange for a lump sum payment of $100,000.00.” (WCAB op. at 3) (emphasis added).

4 . Our scope of review is limited to determining whether constitutional rights were violated, whether the adjudication is in accordance with the law and whether the necessary findings of fact are supported by substantial evidence. Section 704 of the Administrative Agency Law, 2 Pa.C.S. § 704.

5 . Claimant concedes that Employer would be entitled to a credit against future benefits in the amount of the $100,000.00 already paid to Claimant under the C & R Agreement. (Claimant’s brief at 9, n. 2.)

6 . Although Claimant argues that this issue was not raised in Employer’s answer, we disagree. Despite the fact that the words "collateral estoppel” were not used by Employer in its answer to the petition to set aside, as noted earlier, Employer did state in its answer, "The Claimant received the sum of $100,000 upon approval of a Compromise and Release Agreement issued by Workers’ Compensation Judge Desimone on June 2, 2000. Accordingly, benefits cannot be reinstated." WCJ Getty found that Employer's defense was in the nature of collateral estop-pel, and that it was "effectively raised” in Employer’s answer to the petition because it specifically referenced WCJ Desimone’s prior adjudication. (WCJ Getty’s Findings of Fact 2) (emphasis added). We agree. However, even if this defense were not raised in the answer, we are aware of nothing in the law that requires it to have been raised there, provided it was raised before the WCJ. Certainly, it was so raised in the motion to dismiss. Accordingly, we disagree that the issue was waived.

7 . Claimant also asserts that, at the hearing on the petition to set aside, she had no opportunity to submit expert medical evidence of her medical condition. However, although her attorney made a motion to continue the hearing for that purpose, and although the motion to continue the hearing was granted, the disposition of the motion to dismiss rendered her proposed medical evidence unnecessary as a matter of law.

8 . The case sub judice contains no such allegations of fraud, misrepresentation or concealment.

9 . We further observed that, "in order for a mistake to constitute a basis for invalidating a compromise and release, the mistake must be a material one and in existence at the time the release was executed.” (Op., p. 800.)

10 . In North Penn, the claimant’s injuries included work-related blindness. The attorney representing him at the C & R Agreement hearing was the insurer's attorney and the C & R Agreement was never read to the claimant. Moreover, the Agreement did not include his blindness in the description of his work-related injuries. This situation was further compounded by the fact that the WCJ was unaware of the claimant’s blindness and so did not inquire at the hearing whether anyone had read the document to the claimant. Claimant's alleged mental incapacity here does not constitute such a mutual mistake of fact.

11 .We observe, in addition, that noted commentators on this Commonwealth’s Workers’ Compensation jurisprudence also stress the importance of finality. Torrey and Greenberg have observed that, while the Workers’ Compensation Act is liberal in permitting review of notices of compensation payable and agreements, it is silent on the issue of opening Compromise and Release settlements. Torrey and Greenberg, Pennsylvania Workers' Compensation: Law & Practice, §§ 11:203, 15:111 (2002). In analyzing this issue, the authors suggest that "a pervasive interpretive guideline in the [Compromise and Release] context must be that finality, whenever just and reasonable, attend compensation settlements.” Id. (Emphasis in original.)