Stuckey v. Sturgis Pizza Ranch

2011 S.D. 1, 2011 SD 1, 793 N.W.2d 378, 2011 S.D. LEXIS 1, 2011 WL 115877
CourtSouth Dakota Supreme Court
DecidedJanuary 12, 2011
Docket25605
StatusPublished
Cited by7 cases

This text of 2011 S.D. 1 (Stuckey v. Sturgis Pizza Ranch) 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
Stuckey v. Sturgis Pizza Ranch, 2011 S.D. 1, 2011 SD 1, 793 N.W.2d 378, 2011 S.D. LEXIS 1, 2011 WL 115877 (S.D. 2011).

Opinion

SEVERSON, Justice.

[¶ 1.] Michele Stuckey initiated this workers’ compensation proceeding to secure future benefits for a work-related injury. The Department of Labor did not award Stuckey a lump sum of future disability benefits, but it did award a partial lump sum to cover her attorney’s fees, costs, and litigation expenses. It also approved a life care plan for Stuckey’s future medical care. The circuit court reversed the Department’s denial of a lump sum award of future disability benefits but affirmed all other aspects of the Department’s decision. We affirm in part, reverse in part, and remand.

BACKGROUND

[¶ 2.] Stuckey was employed by the Pizza Ranch restaurant (Employer) in Sturgis, South Dakota. Stuckey suffered a work-related injury on October 8, 2003, when her left hand was crushed in a machine used to flatten pizza dough. She returned to work following the injury and worked until February 23, 2004. By that time, her condition had deteriorated significantly, and she was diagnosed with Reflex Sympathetic Dystrophy and Complex Regional Pain Syndrome. As a result of her injury, Stuckey is unable to care for herself, her family, and her residence. She *381 requires assistance for personal care, meal preparation, and housekeeping.

[¶ 3.] At the time of her injury, Stuck-ey was the primary wage-earner for her family and the sole caretaker of her thirteen-year-old daughter and disabled husband. Her gross weekly wage was $298.52, and her net weekly wage was approximately $250. Based on the date of her injury, Stuckey’s weekly workers’ compensation rate is now $249, which Employer has consistently paid. Stuckey receives an additional $97 per month from Social Security. Her current sources of income include her weekly workers’ compensation benefits, Medicare benefits, and Social Security benefits payable to her, her husband, and her daughter. Although her weekly workers’ compensation benefits are not taxed, they partially offset her Social Security benefits.

[¶ 4.] In March 2004, Stuckey retained an attorney to represent her concerning product liability and workers’ compensation matters. In August 2004, Stuckey’s attorney filed a petition for hearing with the Department. Stuckey alleged that she is unable to return to work due to her injury and requested “medical benefits and disability benefits as may be determined by the Department.” In November 2005, after she served her petition and a request for admissions, Employer agreed that Stuckey is permanently and totally disabled. In January 2006, the Department entered an order declaring Stuckey permanently and totally disabled and entitled to lifetime benefits under SDCL 62-4-7.

[¶ 5.] The case continued to resolve several issues, including:

1. Whether Stuckey is entitled to a lump sum award of future disability benefits under SDCL 62-7-6.
2. Whether Stuckey is entitled to a partial lump sum award of future disability benefits to cover her attorney’s fees, costs, and litigation expenses under SDCL 62-7-6.
3. Whether the Department erred by approving a life care plan for Stuck-ey’s future medical care.

In January 2008, Stuckey filed a partial motion for directed decision requesting approval of a life care plan. In March 2008, the Department granted Stuckey’s motion but determined that genuine issues of material fact existed as to the reasonableness and medical necessity of two treatments in the life care plan. The Department addressed the remaining issues in April 2009. The Department did not award Stuckey a lump sum of future disability benefits, but it did award a partial lump sum to cover her attorney’s fees, costs, and litigation expenses. The circuit court reversed the Department’s denial of a lump sum award of future disability benefits but affirmed all other aspects of the Department’s decision. Employer appeals.

ANALYSIS AND DECISION

[¶ 6.] 1. Whether Stuckey is entitled to a lump sum award of future disability benefits under SDCL 62-7-6.

[¶ 7.] Employer argues that the Department erred by awarding Stuckey a lump sum of future disability benefits under SDCL 62-7-6. 1 South Dakota’s work *382 ers’ compensation statutes do not favor lump sum awards. After all, the primary emphasis must be providing an injured employee with a reliable stream of income to replace lost wages. Steinmetz v. State, D.O.C. Star Acad., 2008 S.D. 87, ¶ 10, 756 N.W.2d 392, 396 (quoting Thomas v. Custer State Hosp., 511 N.W.2d 576, 580 (S.D.1994)).

Since compensation is a segment of a total income insurance system, it ordinarily does its share of the job only if it can be depended on to supply periodic income benefits replacing a portion of lost earnings. If a ... totally disabled worker gives up these reliable periodic payments in exchange for a large sum of cash immediately in hand, experience has shown that in many cases the lump sum is soon dissipated and the [worker] is right back where [she] would have been if [workers’] compensation had never existed.

Id. ¶ 8, 756 N.W.2d at 395 (quoting Enger v. F.M.C., 2000 S.D. 48, ¶ 11, 609 N.W.2d 132, 135). Lump sum awards “must be made in accordance with the goal of preserving future wage replacement benefits.” Thomas, 511 N.W.2d at 581. Ultimately, “[t]he allowance of a lump sum award is the exception and not the general rule.” Steinmetz, 2008 S.D. 87, ¶ 8, 756 N.W.2d at 395 (quoting Enger, 2000 S.D. 48, ¶ 11, 609 N.W.2d at 135).

[¶ 8.] But SDCL 62-7-6 does allow for a lump sum award of future disability benefits in certain circumstances. First, an injured employee must establish that a lump sum award is in her best interest. SDCL 62-7-6(1). Second, in the case of an injured employee who is permanently and totally disabled, a lump sum may be awarded if she establishes that she has an “exceptional financial need that arose as a result of reduced income due to the injury” or that a lump sum award is “necessary to pay attorney’s fees, costs, and expenses.” SDCL 62-7-6(2). The injured employee bears the ultimate burden of proving all facts essential to sustaining an award of compensation by a preponderance of the evidence. Darling v. W. River Masonry, Inc., 2010 S.D. 4, ¶ 11, 777 N.W.2d 363, 367 (citing

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Bluebook (online)
2011 S.D. 1, 2011 SD 1, 793 N.W.2d 378, 2011 S.D. LEXIS 1, 2011 WL 115877, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stuckey-v-sturgis-pizza-ranch-sd-2011.