Opinion ID: 852307
Heading Depth: 1
Heading Rank: 2

Heading: Effect of Board's Approval of Stipulation

Text: The worker alternatively argues that he is eligible for Second Injury Fund compensation because of the Board's express approval of the stipulation resolving his worker's compensation claims against his employer. As noted above, the agreed stipulation provided for the satisfaction of the worker's claims for worker's compensation disability benefits in coordination with social security benefits, Appellant's App'x. at 7; recognized that the agreed settlement was calculated to be coordinated with [the worker's] receipt of Social Security Disability benefits, id. at 8; and provided that the worker shall be eligible to petition the Worker's Compensation Board of Indiana for second injury funds, twice also expressly reserving the worker's right to apply for additional compensation from the Second Injury Fund. Id. at 9. The stipulation also declared that the worker is permanently totally disabled as a result of said work related injuries. Id. at 7. The Board, by action of a Single Hearing Member, expressly found that the stipulation should be approved and adopted. Id. at 11. The Fund acknowledges that the stipulation provided that the worker was permanently totally disabled but argues in response that the Board's approval of the stipulation was not a finding that [the worker] was eligible for Second Injury Fund benefits or that he is permanently totally disabled, but was only for the purpose of resolving their differences and avoiding the uncertainty and expense of litigation. Appellee's Br. at 6. On this issue, this case parallels Mayes v. Second Injury Fund, 888 N.E.2d 773 (Ind.2008). In Mayes, we found that the Worker's Compensation Board, by its approval of an agreement between the employer and employee, subjected the Second Injury Fund to liability that would not have existed absent such action by the Board. In Mayes, a worker's eligibility for Second Injury Fund benefits was disputed on grounds that a third party settlement had relieved the Fund of liability. We noted that [a]n employer acting outside the purview of the worker's compensation system does not have the unilateral authority to bind the Second Injury Fund to an agreement to assume liability where liability would otherwise terminate by statute, and that the Board would have the right to disapprove such agreement. Id. at 778. Because the Board approved the agreement,M however, we held that the Second Injury Fund has waived the right to claim non-liability due to a statutory provision. Id. As in Mayes, the Board here, in approving and adopting the parties' agreed stipulation and ordering its implementation, thereby accepted the stipulated facts and waived its right to disallow inclusion of the worker's Social Security Disability benefits in calculating whether the worker had met the exhaustion of benefits prerequisite. The Fund also argues that the the parties only agreed that [the worker] had the ` right to apply for additional compensation from the Second Injury Fund,' not that he would be eligible. Appellee's Br. at 6 (internal citation omitted). As can be seen in the previously quoted passages from the approved stipulation, there is language expressly reserving the worker's right to petition and to apply for additional compensation from the Second Injury Fund. Appellant's App'x at 9. To receive compensation from the Second Injury Fund, a worker must not only have exhausted the maximum benefits threshold but also must establish two additional statutory prerequisites: (1) that the employee is totally and permanently disabled from causes and conditions of which there are or have been objective conditions and symptoms proven that are not within the physical or mental control of the employee; and (2) that the employee is unable to support the employee in any gainful employment, not associated with rehabilitative or vocational therapy. Ind.Code § 22-3-3-13(i). While it may be argued that the first of these prerequisites is substantially established by the approved stipulation's declaration that the worker was permanently totally disabled as a result of said work related injuries, Appellant's App'x. at 7, the second prerequisite is not addressed in the factual stipulation, leaving it for determination at the time of Second Injury Fund application. It was thus reasonable for the language of the parties' agreed stipulation of April 2001 to speak of the worker's future right to apply for Second Injury Fund compensation. This is entirely consistent with language in paragraph 11 of the stipulation: The plaintiff acknowledges that the Board shall determine his eligibility for the second injury fund benefits at such time as he may make an application for benefits for the second injury fund. Id. at 9. In settling his dispute with his employer, the worker negotiated an agreement under which the employer avoided future medical expenses and the risk of full payment of the worker's claim for permanent and total disability benefits. In return, the worker received the employer's stipulation that the worker was totally and permanently disabled as a result of work related injuries and that, combining payments from the employer and Social Security Disability benefits, the worker had exhausted his maximum worker's compensation benefits from his employer and thus was entitled to seek compensation from the Second Injury Fund. As we observed in Mayes, where there is a plausible dispute about whether the Board's action constituted an approval, we conclude that its action should be treated as such in light of the fact that the worker's compensation scheme is designed for the benefit of employees, a benefit to be liberally construed. 888 N.E.2d at 777 (citing Hoffman v. Brooks Constr. Co., 220 Ind. 150, 157-58, 41 N.E.2d 613, 615-16 (1942)). We find that the Worker's Compensation Board, by approving the parties' stipulation, determined that the worker was permanently totally disabled from his work related injuries and that the employer-paid worker's compensation benefits could be combined with the worker's Social Security Disability benefits, thereby determining that the worker's combined benefits satisfied the $154,665 threshold prerequisite for eligibility for additional compensation by the Second Injury Fund.