Opinion ID: 1897168
Heading Depth: 1
Heading Rank: 1

Heading: reimbursement for weekly compensation benefits

Text: La.R.S. 23:1103 provides that out of the damages awarded to the injured worker in an action against a third party tortfeasor, an employer must be reimbursed in whole or in part for the compensation benefits he has actually paid. [3] The intervenors argue they are entitled to be reimbursed not only out of the damages awarded to the tort claimant for lost wages, but also out of the sum awarded for pain and suffering. [4] Their argument stems largely from the peculiar facts of this case and the way in which weekly benefits are computed under the Worker's Compensation Law. In the usual compensation situation, an employee with year-round employment will receive two-thirds of his regular wages in weekly benefits. Later in a third party suit he may recover 100% of lost wages, reimbursing the compensation insurer or employer for the two-thirds already paid, and keeping the remaining one-third as the balance of his lost wages. However, in this case plaintiff, a part-time seasonal worker, was injured at the most productive time of his work year, thus entitling him to weekly benefits which exceeded his yearly earnings. Intervenors contend under these circumstances weekly benefits are paid both in lieu of lost wages and pain and suffering. The court of appeal adopted this position relying in part on Malone and Johnson's Civil Law Treatise on Workers' Compensation, quoting: When the employer or insurer does intervene, however, it is proper to assure that weekly benefits paid are reimbursed in the judgment out of the award to the employee for `pain and suffering,' wage loss, or out of `general damages ...' W. Malone and A. Johnson, Workers' Compensation Law and Practice, 14 La. Civil Law Treatise § 369, at 182-83 (2nd Ed.1980). With all due respect to the authors of this learned treatise, we cannot accept this statement of law. Worker's Compensation weekly benefits are paid to a worker merely in lieu of his lost wages and lost earning capacity during periods of disability resulting from job related accidents. [5] The intervenors' contention that compensation benefits include compensation both for lost wages and for such items of general damages as pain and suffering is at first glance a seemingly logical conclusion which is amply demonstrated by the facts of this case. Plaintiff, according to the jury, lost only $15,000.00 in wages for his 3 years of disability because he had been earning only $5,000.00 per year. The jury also awarded the plaintiff a sum for pain and suffering. Therefore, the intervenors assert, the $9,500.00 in yearly compensation benefits which they had been paying to the plaintiff must necessarily have included $4,500.00 for pain and suffering. Intervenors argue this is the only reasonable interpretation to be given to the workman's compensation benefit. As logical as this interpretation might appear at first glance, it is not the only reasonable interpretation of the Act. The intervenors' interpretation fails to account for the differences between compensation benefits as defined in the Louisiana Worker's Compensation Act and damages which are awarded in tort cases based on fault. It is true that tort damages can include compensation both for lost wages and for pain and suffering. Worker's compensation benefits, however, are different because compensation benefits include compensation for lost wages and for lost capacity to earn wages, but not for pain and suffering. This will be shown more fully below. For now, we postulate if compensation benefits may be said to compensate not only for actual wages lost from the worker's present job, but also for the diminished capacity to earn wages, then it is possible to interpret the Act differently than do the intervenors and conclude the $4,500.00 per year is a benefit paid to compensate for lost capacity to earn wages rather than to compensate for plaintiff's pain and suffering.