Opinion ID: 2570294
Heading Depth: 3
Heading Rank: 2

Heading: Worker's Compensation Liability

Text: {21} [T]he question of apportionment ordinarily arises only after the determination of initial liability is made. Garcia, 112 N.M. at 600, 817 P.2d at 1242. Thus, we first determine, as a preliminary matter, which employer has potential liability for Jouett's 2001 disability. {22} The right to the compensation provided for in [the Act], in lieu of any other liability whatsoever, . . . shall obtain in all cases where ... at the time of the accident, the employee is performing service arising out of and in the course of [the worker's] employment, and the injury or death is proximately caused by [an] accident arising out of and in the course of [the worker's] employment. NMSA 1978, § 52-1-9 (1973) (emphasis added). `Claims for workers' compensation shall be allowed only ... when the accident was reasonably incident to [the worker's] employment ... and ... when the disability is a natural and direct result of the accident. NMSA 1978, § 52-1-28(A) (1987). Thus, Jouett is entitled to compensation for a work-related injury from the employer at the time of the accident. For purposes of defining an accident with regard to a disability, [c]ompensation is paid only when a work-related accidental injury becomes disabling. Salinas-Kendrick, 118 N.M. at 166, 879 P.2d at 798. {23} It is undisputed that Jouett suffered a compensable, work-related accident while employed with Growney Equipment in January of 1999, meeting the requirements of Section 52-1-9. However, Growney Equipment satisfied its obligation for Jouett's 1999 accidental injury at that time by providing medical treatment; because he was not disabled in 1999, Jouett was not entitled to a disability claim under Section 52-1-28 at that time. [1] The WCJ found that Jouett aggravated his initial injury sustained during his employment with Growney Equipment while working for his subsequent employers, Patterson Drilling and Big Dog. We therefore must determine which employer is potentially liable for Jouett's 2001 disability, based on the fact that Jouett aggravated his initial injury sustained at Growney Equipment during his employment with Patterson Drilling and Big Dog, eventually becoming disabled while in the employ of Big Dog. {24} Salinas-Kendrick addressed a situation in which the worker suffered a work-related accident, continued to work for the same employer, but became disabled due to aggravation of the earlier accident over a year later. 118 N.M. at 165, 879 P.2d at 797. [W]here there is evidence that [the worker's] continued work-related activities have contributed to [the worker's] disability, the insurance company insuring Employer at the time of the disability is responsible for payment of the disability benefits. Id. [D]isability arising from an accident is the event that triggers the obligation for payment. Id. at 165-66, 879 P.2d at 797-98. [T]he date that the injury became compensable due to further work-related causes is the determinative factor. Id. at 166, 879 P.2d at 798. `When a disability develops gradually, or when it comes as the result of a succession of accidents, the insurance carrier covering the risk at the time of the most recent injury or exposure bearing a causal relation to the disability is usually liable for the entire compensation.' Id. (quoted authority omitted). {25} In Gonzales v. Stanke-Brown & Associates, Inc., 98 N.M. 379, 381, 648 P.2d 1192, 1194 (Ct.App.1982), the Court of Appeals addressed a situation in which the worker suffered successive compensable disabilities where there were successive compensation insurers but a single employer. Compensation is paid, under New Mexico law, for disability. For an accidental injury to be compensable, the disability must be a natural and direct result of the accident and where such a result is denied, causation must be established as a medical probability by expert medical testimony. Id. at 382, 648 P.2d at 1195 (citation omitted). In Stanke-Brown, the worker had a preexisting condition caused by an initial accident, that had resulted in a forty-five percent permanent partial disability, when a second accident occurred, resulting in injury and an additional ten percent permanent partial disability. Id. at 381, 648 P.2d at 1194. The Court of Appeals concluded that, under New Mexico law, disability resulting from the second accident, regardless of the pre-existing condition, is compensable by the employer and compensation insurer at the time of the second accident. Id. at 383, 648 P.2d at 1196. The Court relied on an opinion from this Court which held that where there is a direct relationship or causal connection between the accidental injury and the resulting disability the employee is entitled to compensation to the full extent of the disability even though attributable in part to a pre-existing condition, notwithstanding acceleration or aggravation may be absent. It must be clear that there must be some causal connection. . . . Reynolds v. Ruidoso Racing Ass'n, Inc., 69 N.M. 248, 258, 365 P.2d 671, 678 (1961). A causal connection between work done and an injury is insufficient; an accident is required. Unless an accidental injury resulting in disability occurred during the time the second compensation carrier insured the employer, the second carrier had no compensation liability. Stanke-Brown, 98 N.M. at 384, 648 P.2d at 1197. {26} The Court of Appeals concluded that [t]he employer and compensation carrier at the time of the first accidental injury remain liable for compensation benefits payable for disability resulting therefrom. Id. at 386, 648 P.2d at 1199. However, the worker's preexisting condition in Stanke-Brown was a work-related accidental injury that resulted in disability prior to the successive work injury. Id. at 383, 648 P.2d at 1196. Stanke-Brown was addressing [t]he problem [of] whether a prior employer, liable for disability from an accidental injury, is relieved of liability by a subsequent accidental injury causing disability. Id. at 384, 648 P.2d at 1197 (emphasis added). By contrast, in the present matter, Jouett suffered a work-related injury but no disability at the time of his initial accident. Thus, the question for this Court is not whether Growney Equipment, the employer at the time of the first accidental injury[,] remain[s] liable for compensation benefits payable for disability resulting therefrom. Id. at 386, 648 P.2d at 1199 (emphasis added). Rather, the question is which employer is liable when the worker suffered an initial non-disabling injury, aggravated the injury through later employment, and became disabled while working for a successive employer. The employer and compensation carrier at the time of the second accidental injury are initially liable for disability resulting from the second accidental injury, to the full extent of the disability. Id. As discussed further below, this liability on the part of the successive employer may be reduced under Section 52-1-47(D) if the initial injury resulted in disability prior to the subsequent injury. See id. {27} Thus, under both Salinas-Kendrick and Stanke-Brown, Big Dog is potentially responsible for Jouett's disability claim because disability resulting from the subsequent accident, regardless of the preexisting condition, that is, Jouett's initial 1999 injury, is compensable by the employer and compensation insurer at the time of the subsequent accident. It is undisputed that Jouett suffered a work-related accident while employed with Growney Equipment. It is also undisputed that Jouett was not disabled at the time of his initial injury. Perhaps the confusion in this case is partially the result of whether or not Jouett suffered an accidental injury resulting in his 2001 disability while working for Patterson Drilling or Big Dog. The WCJ found that Jouett suffered work-related accidents that resulted in injury while working for his subsequent employers, Patterson Drilling and Big Dog. Further, our precedent does not require a discrete accident, in the traditional sense, if employment activity itself aggravates a preexisting injury and results in disability, which is also consistent with the WCJ's finding that Jouett's work with Patterson Drilling and Big Dog aggravated his initial shoulder injury. {28} The Court of Appeals, in an earlier case, described the rule in New Mexico for what constitutes an accident: [I]f the stress of labor aggravates or accelerates the development of a preexisting infirmity causing an internal breakdown of that part of the structure, a personal injury by accident does occur. Herndon v. Albuquerque Pub. Sch., 92 N.M. 635, 640, 593 P.2d 470, 475 (Ct.App.1978). In Herndon, the worker had a preexisting back condition caused by non-industrial accidents. Id. at 637, 593 P.2d at 472. The worker suffered an employment-related accident resulting in severe back pain in June; she continued to work for several weeks before becoming disabled in September as a result of the severe pain. Id. at 637-38, 593 P.2d at 472-73. The Court of Appeals summarized that a worker has suffered an accidental injury if he or she has preexisting pain from a previous work-related accident, continues normal employment under pain, and subsequently suffers a disability that was caused or accelerated while working. Id., at 640, 593 P.2d at 475. [A] malfunction of the body itself ... caused or accelerated by doing work required or expected in employment is an accidental injury within the meaning and intent of the compensation act. Id. (emphasis omitted) (quoted authority omitted). Under these circumstances, where a work-related accidental injury is aggravated by continued employment activities but the worker continues normal employment under pain resulting in later disability, the Court concluded that the time and place of the accident, for purposes of definiteness and certainty of the Act, is the date the worker became disabled. Id. at 639, 642, 593 P.2d at 474, 477. {29} Jouett's aggravation of his 1999 non-disabling injury through his employment duties at Patterson Drilling and Big Dog, where he performed his work, albeit in pain, resulting in his 2001 disability, thus constitutes an accidental injury within the meaning and intent of the Workers' Compensation Act regardless of whether Jouett had other discrete work-related accidents while employed with Patterson Drilling and Big Dog. See Herndon, 92 N.M. at 640, 593 P.2d at 475 (The `accident' was the subsequent and continued strain on plaintiff's back that resulted in an accidental injury on September 2, 1975 [when she terminated her employment because of disability due to severe pain].). Despite any pain he may have suffered due to accidents or aggravation of his injury, Jouett did not become disabled during the two weeks he worked for Patterson Drilling, so this employer is not liable for disability compensation. Big Dog is potentially responsible for Jouett's 2001 disability claim because it was his employer at the time of the second accident or aggravation of his injury resulting in disability, if Jouett complied with other requirements of the Act. See Salinas-Kendrick, 118 N.M. at 166, 879 P.2d at 798, Stanke-Brown, 98 N.M. at 383, 648 P.2d at 1196. {30} The WCJ did not determine a date of disability for Jouett. The WCJ may have decided that a specific determination was unnecessary because, under the facts of this case, Jouett became disabled in 2001 while employed by Big Dog, either in May, when he was told by Dr. Maldonado that he was temporarily totally disabled and should not continue his work with Big Dog, or as of December 14, 2001, when he quit work with Big Dog because he could no longer perform his duties due to his injury. We do not fault the WCJ; we agree with the WCJ that this is a complex case, both factually and substantively, as also demonstrated by the efforts of the Court of Appeals. However, we believe that the date of disability is an ultimate fact necessary for a determination of liability. See Torres v. Plastech Corp., 1997-NMSC-053, ¶ 13, 124 N.M. 197, 947 P.2d 154. Conclusions of law must be supported by findings of ultimate fact. Id. We assume that Jouett became disabled as of December 14, 2001. This fact appears to be consistent with both the record and the definition of temporary total disability as the inability of the worker, by reason of accidental injury arising out of and in the course of [the worker's] employment, to perform [the worker's] duties prior to the date of [the worker's] maximum medical improvement. NMSA 1978, § 52-1-25.1(A) (1991). Although the medical expert may not have been able to give an opinion as to what percentage of Jouett's disability was the result of work performed at Growney Equipment, Patterson Drilling, and Big Dog, it appears that Jouett became disabled as of December 14, 2001, when he could no longer perform his employment duties. For purposes of this analysis, December 14, 2001, is therefore the operative date for determining liability for Jouett's disability compensation. We recognize that there continues to be argument by some of the employers that Jouett became disabled earlier. Notwithstanding our assumption, on remand we direct the WCJ to determine the date of disability and consider arguments contrary to our assumption.