Case Title: Matter of Injury to Spera

Citation: 

Docket Number: 

State: wyoming

Court: Wyoming Supreme Court

Date: 1986-02-05T00:00:00Z

Document:
Matter of Injury to Spera1986 WY 31713 P.2d 1155Case Number: 85-160Decided: 02/05/1986Supreme Court of Wyoming
IN THE MATTER OF INJURY TO ROBERT A. SPERA, AN EMPLOYEE OF 
APOLLO DRILLING. ROBERT A. SPERA, APPELLANT (CLAIMANT/EMPLOYEE),

 
 
v. 

 
 
THE STATE OFWYOMING, EX REL. WYOMING WORKER'S 
COMPENSATION DIVISION, APPELLEE, APOLLO DRILLING 
(RESPONDENT/EMPLOYER).

 
 
Appeal from the District 
Court, CampbellCounty, Terrence L. 
O'Brien, J.

 
 
 
 
Representing 
Appellant:

James R. Murray, 
Gillette.

 
 
Representing 
Appellee:

A.G. McClintock, Atty. 
Gen., Terry J. Harris, Asst. Atty. Gen., and Patrick J. Crank, Legal 
Intern.

 
 
Before THOMAS, C.J., and 
ROONEY,* BROWN and CARDINE, JJ., and 
GUTHRIE, J., Retired.

* Retired November 30, 
1985.

 
 

CARDINE, 
Justice.

 
 

[¶1.]     This is a worker's 
compensation case of first impression in Wyoming. We must decide whether an employee's 
temporary total disability award should be suspended when he is imprisoned. We 
will reverse the district court's suspension of payments and hold that a 
worker's incarceration does not, in and of itself, require a suspension of 
temporary total disability payments.

 
 

[¶2.]     Appellant, Robert A. 
Spera, was injured in an industrial accident on October 26, 1984, while employed 
by Apollo Drilling Company. His fractured right ankle was expected to heal by 
February 1985, and he was expected to return to work at that time. Appellant's 
claim for temporary total disability was approved by the court. Payments were 
made until January 21, 1985, when the district court learned that appellant had 
been incarcerated in the CampbellCounty jail continuously since December 
20, 1984. While the court declined to order return of the benefits that were 
paid from December 20 to January 21, the court did, on its own motion, order the 
suspension of further payments while appellant remained in jail.1 Appellant was released by his 
physician to return to work on February 4, 1985. The record does not indicate 
whether he was also released from jail at that time.

 
 

[¶3.]     On March 27, 1985, 
appellant moved for additional benefits consisting of the payments that were 
withheld during the two-week period from January 21 to February 4. The court 
held a short hearing on the matter, at which only the appellant and his attorney 
appeared. The district judge noted that there was a difference of opinion as to 
whether incarceration required the suspension of temporary total disability 
payments. He pointed out that he had consistently withheld these payments during 
periods of incarceration upon the grounds that incarceration was an intervening 
cause; that a worker was not entitled to payments which replace lost wages that 
would never have been earned if he were healthy; and that incarceration, rather 
than the work-related injury, was the legal cause of lost wages.2

 
 

[¶4.]     The problem with the 
district court's rationale, which has also been advanced by the State on appeal, 
is that it is based on tort law principles. We stated in Cottonwood Steel Corporation v. Hansen, 
Wyo., 655 P.2d 1226, 1236 (1982):

 
 
"The amendment to Art. 
10, § 4 of the Wyoming Constitution and subsequent enabling legislation did not 
contemplate that tort law would hold any office in the Worker's Compensation Act 
except that the employer could defend against claims of the injured employee on 
the grounds that he or she was culpably negligent. Soon after the amendment to 
Art. 10, § 4 of the Wyoming Constitution, this court said that the Wyoming worker's 
compensation scheme was in the nature of an industrial-accident 
policy.

 
 
* * * * * 
*

 
 
"We have never changed 
our minds about that proposition. Sometimes we have had trouble keeping tort 
concepts out of the worker's compensation law, Stephenson v. Mitchell, Wyo., 569 P.2d 95 (1977), and Meyer v. Kendig [Wyo., 
641 P.2d 1235 (1982)], but we have never deviated from our adherence to the 
proposition that the worker's compensation law of this state is in the nature of 
industrial-accident insurance." (Citation omitted.)

 
 

[¶5.]     When we say that 
worker's compensation law is based on a concept of industrial insurance, we mean 
that it is based on contract rather than tort principles. In Markle v. Williamson, Wyo., 518 P.2d 621, 624 (1974), we specifically 
noted:

 
 
"To say that workmen's 
compensation in Wyoming is in the nature of insurance is to 
say it stems from contract. Indeed, the clear implication in Zancanelli v. Central Coal & Coke Co., 
25 Wyo. 
511, 173 P. 981, 989, is that our Workmen's Compensation Act is in contract and 
not in tort."

 
 
Instead of suing his 
employer for negligence and having to prove duty, breach, proximate cause, and 
damages, the worker in our state must file for worker's compensation benefits 
for which his employer is ultimately liable. Baker v. Wendy's of Montana, Inc., 
Wyo., 687 P.2d 885, 888 (1984). Essentially, the system provides disability insurance coverage 
for the worker. His right to benefits arises when certain conditions precedent 
occur, primarily, when he suffers a disabling work-related injury. Under 
contract principles, the worker should not be denied his benefits after the 
contingency arises, unless a provision in the statutory contract between the 
worker, on the one hand, and the State and employer, on the other, explicitly 
suspends the benefits.

 
 

[¶6.]     Under the Worker's 
Compensation Act, temporary total disability payments are to cease only under 
one circumstance: when "the recovery is so complete that the earning power of the employee at a 
gainful occupation for which he is reasonably suited by experience or training, 
is substantially restored * * *." (Emphasis added.) Section 27-12-402(b), W.S. 
1977 (June 1983 Replacement). Benefits under the statute terminate only when the 
worker recovers because only then does he regain his earning power. 
Incarceration has no effect upon benefits which are in the nature of insurance 
which has become payable as a covered loss. Incarceration does not restore a 
disabled worker's earning power.

 
 

[¶7.]     Several state courts 
interpreting temporary total disability statutes similar to ours have concluded 
that benefits should be paid to the disabled worker, even if he would be unable 
to work absent the disability. For example, the Michigan Supreme Court stated in 
Sims v. R.D. Brooks, Inc., 389 Mich. 
91, 204 N.W.2d 139, 140-141 (1973):

 
 
"Under the Workmen's 
Compensation Act it is loss of wage earning capacity - not actual loss of wages 
- which is compensable. The award of compensation, based as it was on a finding 
of total disability, is not affected by plaintiff's later 
imprisonment."

 
 
Similarly, the court of 
appeals of Arizona has held that:

 
 
"Workmen's compensation 
temporary benefits were not reduced or eliminated in the case of an injured 
worker who was subsequently imprisoned for a criminal offense and thereby 
removed from the labor market. * * * The rationale of such cases is that the 
purpose of workmen's compensation is to reimburse injured workers for loss in 
earning capacity, not loss of earnings." Franco v. Industrial Commission of 
Arizona, 130 Ariz. 37, 633 P.2d 446, 449 
(1981), citing Bearden v. Industrial 
Commission, 14 Ariz. App. 336, 483 P.2d 568 
(1971).

 
 

[¶8.]     In its brief, the State 
argues that a worker receives a double recovery if his temporary total 
disability payments are not suspended during his time in jail. The State 
contends that the worker is supported by the county and does not need his 
disability payments.

 
 

[¶9.]     Even if we agreed with 
the State that jail time amounts to a governmental benefit rather than 
punishment, we would still uphold his right to benefits. The worker's disability 
payments cannot be characterized as mere governmental largesse that can be 
eliminated when the worker's needs are fulfilled from another governmental 
source. Rather, the worker's statutory right to disability payments is akin to a 
contract right. Nobody would argue, in the private insurance context, that an 
insurer could withhold payments due under an insurance contract just because the 
insured had a second policy which covered the same disability. The insurers 
would ordinarily have to pay under both policies unless one of the insurance 
contracts contained an excess insurance or exclusionary clause which provided 
otherwise. 

 
 

[¶10.]  We believe this same principle should 
apply to industrial insurance created by statute. Because there is no statutory 
exception which eliminates benefits when a worker is jailed, the benefits are 
due the worker even if his needs are fulfilled from another governmental source. 
The state legislature can change our statute to suspend payments during periods 
of incarceration, much like a private insurer might place conditions on his 
coverage.3 But in the absence of legislation, 
we decline the State's invitation to make that policy shift ourselves. In Matter of Johner, Wyo., 643 P.2d 932, 934 
(1982), we explicitly stated that "worker's compensation is a statutory 
responsibility and any change or addition to the law is a function of the 
legislature and not the courts."

 
 

[¶11.]  The Ohio Supreme Court has recently taken 
the same cautious jurisprudential route in a case similar to this one. State, ex rel. Ashcraft v. Industrial 
Commission of Ohio, 15 Ohio St.3d 126, 472 N.E.2d 1077 (1984). The Ashcraft case arose when the Ohio Industrial Commission 
adopted a rule suspending workers' disability payments during incarceration. 
Pursuant to this rule, the commission suspended an incarcerated worker's 
temporary total disability payments. The supreme court reversed, holding that 
although

 
 
"[t]he policy to be 
served by the terms of the [rule] is not repugnant to the purposes of the 
Workers' Compensation Act, in that it would preclude the payment of benefits to 
claimants who, regardless of a prior industrial injury, are unable to work 
because they are incarcerated. Such a policy decision * * * must emanate from 
the General Assembly." Ashcraft, 
supra, 472 N.E.2d  at 1079.4

 
 
THE 
DISSENT

 
 

[¶12.]  The dissent concedes that the decision of 
this court is supported by "logic" and is in accord with "precedent" (law) but 
suggests it is "without reason based upon experience." That is another way of 
saying, "I do not wish to apply the law as I find it, but will make new law." As 
appealing as that might be, it is something we should not 
do.

 
 

[¶13.]  It is suggested we should legislate in 
this case, first, because we have a contract dealing with a tort claim. That is 
not a reason for departing from established law. Many contracts deal with tort 
claims and are still enforceable contracts. For example, we note the millions of 
liability insurance policies (contracts) that deal only with tort claims for 
damage.

 
 

[¶14.]  Second, it is said that this injured 
worker is taking advantage of society by entering jail to partake of the jail 
food and lodging, a devious plan which brands him a "double dipper." I do not 
see a beneficiary of an insurance contract being called a double dipper just 
because the contract requires payment.

 
 

[¶15.]  Simply stated, this worker suffered an 
injury for which he has a lawful right to compensation. He gave up the right to 
sue his employer in exchange for this worker's compensation payment. He would 
not have lost the right otherwise to sue his employer by being jailed. He should 
not now lose his right to worker's compensation as the dissent 
suggests.

 
 

[¶16.]  We hold, therefore, that temporary total 
disability payments may not be suspended under our statute simply because the 
worker is incarcerated; whether such payments ought to be suspended is a matter 
that should be left to the legislature.

 
 

[¶17.]  Reversed.

 
 

1 The court's decision 
that mistaken payments need not be returned was based on our holding in Matter of Johner, Wyo., 643 P.2d 932 
(1982).

 
 

2 We note that the Oregon 
Court of Appeals has applied the district court's logic to a case in which a 
worker retired during his period of disability. Stiennon v. State Accident Insurance Fund 
Corporation, 68 Or. App. 735, 683 P.2d 556, 558 (1984). The court 
stated:

 
 
"The entire statutory 
scheme illustrates that TTD [temporary total disability] was established for the 
purpose of compensating a claimant for wages lost because of inability to work 
as a result of compensable injury. If the claimant has retired voluntarily 
following the injury, he can suffer no loss of wages, because, by definition, he 
has no expectation of receiving wages. The Board did not err in holding that 
claimant is not entitled to TTD for the period covering his surgery and his 
recovery therefrom if he had already retired." Stiennon, supra.

 
 
As the body of our 
opinion indicates, we do not accept this approach which is based on tort 
principles.

 
 

3 Article 10, § 4 of the 
Wyoming Constitution creates legislative power to control worker's compensation 
coverage.

 
 

4 Ohio's temporary total disability benefits statute 
provides that "once determined eligible, the worker shall receive compensation 
`* * * so long as such disability is total * * *'" State, ex rel. Ashcraft v. Industrial 
Commission of Ohio , 15 Ohio St.3d 126, 472 N.E.2d 1077, 1078 (1984). Ohio's statute is like ours because it creates 
only one ground for termination, the reduction in 
disability.

 
 

THOMAS, Chief Justice, 
dissenting, with whom ROONEY, 
Justice, Retired, joins.

 
 

[¶18.]  I must dissent from the disposition 
reached by the majority opinion in this case. I cannot fault the ineluctable 
logic of the majority opinion. The precedent from other states which is relied 
upon certainly does lead to the result reached.

 
 

[¶19.]  Sir Edward Coke said, "Reason is the life 
of the law * * *." Some three hundred years later Justice Oliver Wendell Holmes, 
Jr. said, "The life of the law has not been logic: it has been experience." My 
separation from the decision of my brothers then is not that it is without 
logic, but that it is without reason based on experience. Long before now 
experience should have taught us that so long as the members of our society are 
willing to play the role of patsy there will be among its members those who will 
take advantage of that predilection. My interpretation of the trial court's 
disposition is that it concluded that the proximate cause of this workman's 
inability to resume his chosen prior occupation no longer was his injury; 
instead it was his incarceration. Thus the trial judge forestalled this 
individual from taking advantage of society.

 
 

[¶20.]  The majority of the court reject that 
position concluding that it is based on tort principles rather than contract 
law, and then concluding that principles of contract law govern in worker's 
compensation matters. That approach does not address the proposition that the 
statutory contract itself encompasses tort principles. See, e.g., § 
27-12-603(a)(i), W.S. 1977 (the employee must demonstrate a "direct causal 
connection" between conditions of work and his injury); § 27-12-603(a)(ii), W.S. 
1977 (the injury must fairly be "traced to the employment as a proximate 
cause"); and § 27-12-606, W.S. 1977 ("increase or decrease of incapacity due 
solely to the injury.") In prior cases this court has recognized tort principles 
in resolving worker's compensation cases. Pacific Power & Light v. Parsons, 
Wyo., 692 P.2d 226, 229 (1984); Collins v. Goeman General Tire, 
Wyo., 682 P.2d 332, 334 (1984); Herring v. Welltech, Inc., Wyo., 660 P.2d 361, 366 
(1983).

 
 

[¶21.]  Furthermore, I discern a conclusion by 
the majority that "temporary total disability payments are to cease only under 
one circumstance: `[w]hen the recovery is so complete that the earning power of 
the employee at a gainful occupation for which he is reasonably suited by 
experience or training, is substantially restored' § 27-12-402(b), W.S. 1977 
(June 1983 replacement)." Another provision of the statute, however, provides 
that no total temporary disability compensation shall be paid during a period in 
which the employee refuses to submit to an examination requested by his 
employer. § 27-12-611(c), W.S. 1977. By definition, "temporary total disability 
means a compensable injury which temporarily incapacitates the employee from 
performing any work." § 27-12-402(a), W.S. 1977.

 
 

[¶22.]  For my part, I prefer the approach taken 
by the federal government when it provided in the social security statutes that 
a prisoner's disability benefits would be suspended. 42 U.S.C. § 402(x) 
(formerly 42 U.S.C. § 423(f)) This statute was upheld as constitutional. Jones v. Heckler, 774 F.2d 997, (10th 
Cir. 1985). In Buccheri-Bianca v. 
Heckler, 768 F.2d 1152 (10th Cir. 1985), the court pointed out that the 
classification was not unconstitutional because it was not "patently arbitrary" 
and that since the goal of social security is to replace the lost earnings of a 
worker (See Pacific Power & Light v. 
Parsons, supra.) there is no need to provide social security to a confined 
felon.

 
 

[¶23.]  In a similar vein Oregon has held that 
temporary total disability is for the purpose of compensating the claimant for 
wages lost because of inability to work as a result of a compensable injury, and 
it follows that if he has retired he suffers no loss of wages because he has no 
expectation of receiving wages. In Re 
Stiennon, 68 Or. App. 735, 683 P.2d 556 (1984), review denied 298 Or. 238, 
691 P.2d 482 (1984). This decision appears to follow from ORS 656.206(3), which 
requires an employee to assume the burden of proving permanent total disability 
and requires "that the worker is willing to seek regular gainful employment and 
that the worker has made reasonable effort to obtain such employment." See Cutright v. Weyerheuser Co., 299 Or. 
290, 702 P.2d 403 (1985).

 
 

[¶24.]  I am satisfied that the legislature did 
not intend to support a miscreant in jail and at the same time provide a 
windfall in the form of replacement of lost wages through temporary total 
disability payments. I would hope that since the statute has been construed in a 
contrary fashion the legislature might attend to that problem as the Congress of 
the United 
States did. I have set forth here my 
difficulties as a jurist with the result reached by the majority. As a citizen, 
I feel a strong sense of frustration at permitting what I perceive to be 
miscreant double dipping.