Title: Pub. Agency Comp. Trust v. Blake

State: nevada

Issuer: Nevada Supreme Court

Document:

127 Nev., Advance Opinion 77
IN THE SUPREME COURT OF THE STATE OF NEVADA

PUBLIC AGENCY COMPENSATION No. 54822
‘TRUST (PACT),

ee FILED
DALE BLAKE,

Respondent. NOY 23 2011

 

Appeal from a district court order denying a petition for

judicial review in a workers’ compensation action. Bighth Judicial District
Court, Clark County; James M. Bixler, Judge.
Reversed and remanded with instructions,

Lynne & Associates and Jill M. Lynne, Las Vegas,
for Appellant,

King, Gross & Sutcliffe, Ltd., and Ward M. Sutcliffe, Las Vegas,
for Respondent.

BEFORE SAITTA, C.J., HARDESTY and PARRAGUIRRE, J.

OPINION

By the Court, HARDESTY, J.
In this appeal, we determine the proper method of

apportioning permanent partial disability (PPD) benefits between prior

 

and subsequent industrial injuries when the impairment ratings for those
injuries were based on different editions of the applicable guide. PPD
awards are based on the percentage of whole person impairment as

 
oe

 

determined by a rating physician, who makes the calculations using the
edition of the American Medical Association Guides to the Evaluation of
Permanent Impairment (AMA Guides) adopted by the Division of
Industrial Relations, See NRS 616C.490; NRS 616C.110, Relying on a
regulation that addresses the apportionment of PPD benefits, NAC
616C.490(4), the appeals officer and the district court in this case

 

 

concluded that respondent’s prior impairment rating, which wa
calculated using an older version of the AMA Guides, should be deducted
from his current impairment rating, which was calculated using the
current edition of the AMA Guides. We disagree. The plain language of
the governing statute, NRS 616C.490(9), requires the rating physician to
reconcile the different editions of the AMA Guides by first recalculating
the percentage of the previous impairment rating using the current
edition and then subtracting that recalculated percentage from the
current level of impairment. Thus, we reverse.
PROCEDURAL HISTORY AND FACTS

Respondent Dale Blake injured his back on December 15,
2004, during the course and in the scope of his employment. Prior to this
accident, Blake had suffered four other industrial accidents, in 1982, 1983,
1993, and 1995, resulting in injuries to his lower back. As of his last PPD.
determination in 1995, Blake received a PPD compensation based on a 14-
percent whole person impairment rating using the second edition of the
AMA Guides.

 
on

 

In 2003, the Legislature mandated the use of the fifth edition
of the AMA Guides for calculating PPD awards. Blake’s most recent
injury was evaluated under the fifth edition of the AMA Guides. ‘That
evaluation found that Blake suffered a 40-percent whole person
impairment. Subtracting the 14-percent prior impairment rating from
Blake's current 40-percent impairment, the rating physician determined
that Blake's PPD award for the 2004 injury should be calculated using a
net 26-percent increase in impairment rating.

After receiving the rating physician's evaluation, appellant
Public Agency Compensation Trust (PACT), which was the insurer for
Blake’s employer when the 2004 accident occurred, expressed concern to
the rating physi

 

in that the impairment rating for the prior evaluations
were not comparable to the rating for the new evaluation because of the
change in editions of the AMA Guides. In response, the physician
submitted an addendum to his report indicating that he was unsure
whether Blake's condition before the 2004 injury could be established. He
stated that there was insufficient data to establish Blake's rating, but the
fifth edition of the AMA Guides permits an estimation of impairment. On
that basis, the doctor estimated that Blake's prior level of impairment was
equal to a 23-percent level of impairment under the fifth edition of the
AMA Guides. Subtracting the revised 23-percent impairment for the prior
injuries from the 40-percent current impairment rating, the doctor

'Sce NAIW v, Nevada SelfsInsurers Association, 126 Nev. _, __
225 P.3d 1265, 1267 (2010), for a general discussion of the use of ‘the fifl
edition of the AMA Guides to evaluate impairment percentage or rating
for injured workers.

 

 
determined that the PPD award should be apportioned to compensate him
for 17-percent impairment for the 2004 injury. PACT then offered an
award to Blake based on a net 17-percent rating of whole person
impairment.

Blake administratively appealed, and an appeals officer
ordered PACT to offer a PPD award to Blake based on the original net 26-
percent impairment rating. PACT petitioned for judicial review pursuant
to NRS 238.135, The district court upheld the appeals officer's finding
that the prior percentage of disability is deducted from the current
disability percentage regardless of the edition of the AMA Guides used to

 

calculate the prior disability determination. PACT now appeals,
DISCUSSION

We now determine the proper method of calculating PPD

compensation for a subsequent work-related injury when the impairment

rating for that injury is based on a different edition of the AMA Guides

than were prior injuries. We conclude that NRS 616C.490(9) is plain and

unambiguous and requires that the calculations for prior and subsequent

injuries be reconciled by first using the current edition of the AMA Guides

 

to determine both the percentage of the entire disability and the
percentage of the previous disability, and then subtracting the latter
number from the former to calculate the award for the current injury. We
further conclude that to the extent that NAC 616C.490 allows for
computation of PPD compensation without reconciliation of the different
editions of the AMA Guides, it impermissibly conflicts with NRS 616C.490
and is invalid.
Standard of review

‘This court applies de novo review to questions of law,

including issues of statutory interpretation. State, DMV _v.

 

 
Caldwell, 126 Nev. __, __, 229 P.3d 471, 472 (2010); State, Dep't of
‘Motor Vehicles v. Terracin, 125 Nev. 31, 34, 199 P.3d 835, 836-37 (2009).
When a statute is clear and unambiguous, this court gives effect to the
plain and ordinary meaning of the words and does not resort to the rules
of construction. Seput v. Lacayo, 122 Nev. 499, 502, 134 P.3d 733, 735
(2006), abrogated on other grounds by Buzz Stew, LLC v, City of N. Las
Vegas, 124 Nev. 224, 228 n.6, 181 P.8d 670, 672 n.6 (2008).

‘NRS 6160.490(9) is plain and unambiguous

NRS 616C.490(9) provides, in pertinent part, that

[where there is a previous disability, ... the
percentage of disability for 2 subsequent injury
must be determined by computing the percentage
of the entire disability and deducting therefrom
the percentage of the previous disability as_it

 

Blake interprets NRS 616C.490(9) to permit the deduction of
prior disability ratings without reconciling the calculation of the prior
rating with any new edition of the AMA Guides. More specifically, Blake

reads this provision as codifying a legislative determination that the

 

 

calculation should be made using the percentage of impairment as it
existed at the time of the subsequent injury. PACT, however, contends
that a proper apportionment of prior and subsequent injuries under the

statute requires the rating physician to recalculate the impairment rating
for the prior disability under the same edition of the AMA Guides used to
calculate the impairment rating for the current injury. The plain
language of NRS 616C.490(9) demonstrates that PACT is correct.

NRS 616C.490(9) applies in situations where a worker with a
prior permanent disability suffers a subsequent disability from an

 

 
employment-related accident. NRS 616C.490(9) requires the percentage of
prior impairment to be deducted from the percentage of current
impairment. However, there may be situations in which the prior
impairment was determined under one standard and the new impairment
under another because the American Medical Association periodically
publishes new editions of the AMA Guides, and our Legislature ha
frequently amended the statute with respect to applying the AMA Guides.
NRS 616C.110 (requiring adoption of the fifth edition of the AMA Guides);
see also 2009 Nev. Stat., ch. 600, § 9, at 3032-33; 2003 Nev. Stat., ch. 305,
§ 7, at 1671-72; 1999 Nev. Stat,, ch. 388, § 53, at 1777. In such situations,
the two determinations may not be comparable because updates to the
AMA Guides can, as they did in this case, create different percentages of

 

 

impairment rating for the prior disability.

However, the Legislature has made it clear that a previous
disability must be calculated “as it existed at the time of the subsequent
injury.” NRS 616C.490(9). This phrase refers to “previous disability,” not
“percentage,” because “previous disability” is the antecedent immediately
before it. See 2A Norman J. Singer and J.D. Shambie Singer, Sutherland
Statutory Construction § 47:33 (7th ed. 2007) (referential and qualifying
phrases generally apply to the last antecedent, meaning the last word to
which the phrase can apply without impairing the sentence’s meaning);
see also Thompsen v. Hancock, 49 Nev. 336, 341, 245 P. 941, 942 (1926)
(Tt is a rule of construction that relative and qualifying words and
phrases, grammatically and legally, where no contrary intention appears,
refer solely to the last antecedent.”). This interpretation is logical in light
of the purpose of the workers’ compensation scheme. Workers’

compensation is meant to compensate for the actual impairment to the

 

 
worker caused by an industrial injury. See NAC 616C.490. ‘The purpose
of each revision of the AMA Guides is to “update the diagnostic criteria
and evaluation process used in impairment assessment, incorporating
available scientific evidence and prevailing medical opinion.” American
Medical Association, Guides to the Evaluation of Permanent Impairment 1
(Linda Cocchiarella & Gunnar B.J. Anderson eds., 5th ed. 2000). Using a
consistent method of accounting for impairment ensures that workers are
fairly compensated for their disability.

Furthermore, this interpretation is consistent with the
legii
Bokelman, 113 Nev. 1116, 1123-24, 946 P.2d 179, 184 (1997) (explaining
that a similar statute regarding permanent total disability is intended to
avoid duplicate recoveries); see also Ransier v, SIIS, 104 Nev, 742, 744,
766 P.2d 274, 275 (1988) (‘When a worker's post-injury impairment is due
to both the immediate injury and a pre-existing injury, compensation may

 

ive intent of permitting only one award per injury. See SIS v,

only be paid for that portion of the impairment reasonably attributable to
the current injury."). Also, NRS 616C.425(1) states “(t]he amount of
compensation and benefits and the person or persons entitled thereto
must be determined as of the date of the accident or injury to the
employee, and their rights thereto become fixed as of that date.”
Reconciling the evaluation is necessary to prevent inconsistent accounting
of the level of impairment.

Although NRS 616C.490(9) is plain and unambiguous, the

appeals officer and the district court relied on the corresponding provision
in the Nevada Administrative Code, NAC 616C.490, in determining that
the impairment rating of Blake's prior disability should have been
calculated under a prior edition of the AMA Guides. Accordingly, we now

 

 
turn to a determination of whether NAC 616C.490(4) conflicts with its
governing statute, NRS 616C.490(9).

conflicts with NRS 616C.490(9)

‘To determine the meaning of an administrative regulation, we

NAC 61 ermi

 

will generally defer to the “agency's interpretation of a statute that the
agency is charged with enforcing,” State, Div, of Insurance v. State Farm,
116 Nev. 290, 293, 995 P.2d 482, 485 (2000). However, we will not defer to
the agency's interpretation if, for instance, a regulation “conflicts with
existing statutory provisions or exceeds the statutory authority of the
agency.” Id.; Jerry’s Nugget v. Keith, 111 Nev. 49, 54, 888 P.2d 921, 924
(1995) administrative regulations cannot contradict the statute they are
designed to implement’).
NAC 616C.490(4) provides:

Ifa rating evaluation was completed in this State
for a previous industrial injury or occupational
disease involving a condition, organ or anatomical
structure that is identical to the condition, organ
or anatomical structure being evaluated for the
present industrial injury or occupational disease,
an apportionment must be determined by
subtracting the percentage of impairment
established for the previous industrial injury or
occupational disease from the percentage of
impairment established for the present industrial
injury or occupational disease, regardless of the
edition of the [AMA Guides] used to determine the
percentage of impairment for the previous
industrial injury or occupational disease.

(Emphasis added.) NAC 616C.490(4) clearly contemplates the deduction
of a previous disability percentage from the current disability percentage

without requiring the prior disability percentage to be assessed “as it
existed at the time of the subsequent injury.” NRS 616C.490.

 

 
Because we conclude that NRS 616C.490(9) requires
recomputation of the previous injury’s percentage of disability, NAC
616C.490(4) is in direct conflict with the governing statute, Therefore, no
deference to the agency's interpretation is due, and we conclude that NAC
616C.490(4) is invalid,

Because we conclude that the district court and the appeals
officer erred in relying on NAC 616C.490(4) to determine the amount due
and, therefore, the PPD award based on the 17-percent whole person
impairment rating for the current injury was proper, we reverse the
district court's order denying the petition for judicial review and remand
this case to the district court with instructions to remand it to the appeals

officer so that Blake's PPD compensation can be calculated using the 17-

[Aunts

Hardesty

percent impairment difference?

 

Parraguirre

2We have considered the parties’ other arguments and conclude that
they are without merit.