Court Opinion

ID: 9851158
Source: CourtListenerOpinion
Date Created: 2023-09-24 05:08:15.165729+00
Date Added: 2024-06-11T09:20:50.124498
License: Public Domain

HALL, Chief Justice
(dissenting):
I do not join the main opinion because it sanctions the payment of compensation for preexisting incapacities by indulging in a theory of second injury fund liability not within the contemplation of U.C.A., 1953, § 35-1-69. It does so by simply combining the percentage of preexisting incapacity (33%) with the percentage of incapacity attributable to the current industrial injury (2%), and drawing the conclusion that since Chavez’s total incapacity has increased, the “substantially greater” language of section 35-1-69 is met. I disagree.
Section 35-1-69, as it provided at the time of the accident, stated in pertinent part:
If any employee who has previously incurred a permanent incapacity ... sustains an industrial injury ... that results in permanent incapacity which is substantially greater than he would have incurred if he had not had the pre-exist-ing incapacity, compensation ... shall be awarded on the basis of the combined injuries, but the liability of the employer ... shall be for the industrial injury only and the remainder shall be paid out of the special fund....
It is thus to be seen that second injury fund liability is not premised simply upon whether one’s total incapacity is increased by the industrial injury. Rather, it is prem*1172ised upon whether the incapacity which stems from the industrial injury is in and of itself substantially greater than it would have been had there been no preexisting incapacity. This Court has consistently so held.1
Section 35-1-69(1) makes no provision for the payment of compensation for preexisting incapacities, per se.
An award of compensation for preexisting incapacities is only to be made to the extent that said incapacities combine with and thereby enhance the incapacity attributable to the industrial injury. In that event, the employer has liability for the industrial injury only, the remainder to be paid out of the special fund.2
The legislature’s use of the term “remainder” is of particular significance. In the context of section 35-1-69(1), the term “remainder” refers to that portion of the incapacity attributable to the industrial injury that is substantially greater than it would have been in the absence of any preexisting incapacities. If the theory of second injury fund liability advanced in the main opinion is to be followed, the term “remainder” must necessarily be equated with “preexisting incapacities.” The result is a strained and unwarranted interpretation of the statutory language. Had the legislature intended that payment of compensation for preexisting incapacities be triggered simply by the occurrence of an industrial injury, certainly it would have set forth that language in the statute rather than the “remainder” language which is inconsistent therewith.
The acknowledged purpose of the Worker’s Compensation Act3 is to compensate for the incapacities attributable to industrial injuries. However, it is not the purpose of the Act to provide a general health insurance plan covering and providing for compensation for any and all preexisting incapacities an employee may suffer from, and this Court has never so indicated.
The main opinion cites Ortega, Northwest Carriers, Paoli, and McPhie as supportive, by implication, of its conclusion. However, neither these cases, nor any others, reach that conclusion. Instead, the cases follow the explicit language of the statute and award compensation for preexisting incapacities only to the extent that the preexisting incapacities combine with and enhance the incapacity attributable to the industrial injury. The Ortega case is a classic example of the Court's prior reasoning.
In Ortega, the worker, Ortega, strained her back while lifting laundry bags. Due to the pain in her back, accompanied by psychosomatic pain, she was unable to continue work for a period of time. Based on a medical panel report, the Commission found that Ortega had a preexisting psychological condition relating to pain in her back which, combined with the industrial injury, resulted in a permanent partial disability of 30%, 10% of which was attributable to the preexisting condition and the other 20% to the industrial injury. Nevertheless, the Commission denied second injury fund compensation. In reversing the Commission on that point, the Court said:
The major difficulty in this case stems from the fact that the Commission found that the claimant had a pre-existing psychological condition relating to pain in her back, which combined with this accident resulted in permanent partial disability of 30 per cent, 10 per cent attributable to the pre-existing condition and the other 20 per cent to this accident. The claimant’s testimony and the medical *1173report provide support for that finding; and, since the latter also indicates that continued psychiatric treatment may lead to further significant improvement in the claimant’s condition, the Commission reserved its final determination of the plaintiffs liability for total disability benefits until the treatment is completed.

The requirement that the pre-existing condition combines with the later injury to cause a “substantially greater” permanent incapacity does not mean that the former must be greater than the latter. It simply means that it be some definite and measurable portion of the causation of the disability. It surely cannot be doubted that 30 per cent is substantially greater than 20 per cent, nor that 10 per cent disability is itself substantial in that it is definite and measurable. Consequently, inasmuch as it appears that the pre-existing condition increased the resulting disability by one third, it follows that under the requirements of the statute, the medical expenses as well as the compensation award should have been apportioned two thirds from the employer and one third from the special fund.

We observe that compensation is not necessarily awardable simply because it is desirable or advisable for her to continue psychiatric therapy, but it is properly awardable only during actual inability to work which is found to have been caused by and is properly attributable to the industrial accident. Under the circumstances here shown the Commission was justified in ordering that temporary total disability compensation continue during the time she is disabled and until she is released for work by her doctor.
We are not insensitive to plaintiff’s apprehensions about what it terms a “blank check” award. There is no doubt but that such an uncertain situation as the Commission has found to exist here should be dealt with in the most satisfactory manner that can be achieved by making the award as definite as is reasonably possible. The objective should be to reach some equitable and reasonable balancing between affording fair and proper coverage for an employee who suffers injury and has bonafide residual disability, as compared to the imposing of uncertain, and sometimes extensive and long continuing burdens upon the employer.4
(Emphasis added.)
The Court followed the same reasoning in Northwest Carriers. In that case, the Commission concluded that the worker, Merz, sustained a substantial whole-man physical impairment. The Commission also found that Merz was permanently disabled because his physical impairment and his advanced age and poor education made rehabilitation unlikely. Nevertheless, the Commission declined an award of compensation for incapacity attributable to the nonphysical unemployability factors. In reversing the order of the Commission, the Court said:
[W]e hold that ... the Second Injury Fund should bear the cost of disability payments to the extent that the 15% preexisting impairment, acting in combination with Merz’s age, mental abilities and lack of rehabilitative prospects, contributed to his total disability. Thus a proper assessment of responsibility for non-physical factors should be determined by the proportion which the preexisting physical impairment bears to the additional physical impairment resulting from the instant industrial accident... ,5
(Emphasis added.)
The Paoli case does not significantly bear upon the case at hand because the issue presented in Paoli was whether the second injury fund was liable for the preexisting incapacity which had already been *1174compensated. The Court answered in the negative, but, since the record suggested that the incapacity attributable to the loss of Paoli’s leg may have been augmented by a subsequent degenerative condition which might bear upon the extent of the incapacity attributable to the current industrial injury, the case was remanded for further proceedings.
In McPhie, the worker, McPhie, struck his head on the window frame of a locomotive he was operating. The resultant injury necessitated a spinal fusion following which he returned to his duties. Subsequently, a second industrial accident resulted in further injuries which necessitated a spinal cervical fusion. Application was made for benefits. The medical panel concluded that McPhie had suffered a 100% permanent impairment, and the Commission so found. The Commission further found that a 15% permanent partial loss of function was attributable to the current industrial injury, but declined to award second injury fund compensation. In reversing the Commission’s order, the Court espoused the same reasoning followed in Ortega and Northwest Carriers:
The Utah statute uses the language “any employee who has previously incurred a permanent incapacity by accidental injury, disease, or congenital causes, sustains an industrial injury for which compensation and medical care is provided by this title that results in permanent incapacity which is substantially greater than he would have incurred if he had not had the preexisting incapacity....” In this case the plaintiff was able to return to his regular employment but thereafter became totally unable to work. It is unrealistic to say that his resulting incapacity is not substantially greater.6
(Emphasis added.)
All of the remaining cases that bear upon the issue of second injury fund liability are of the same import.
In Day’s Market v. Muir, the Court concluded that:
The Fund’s only application is where the ... incapacity [attributable to the industrial injury] “is substantially greater than [the employee] would have incurred if he had not had the pre-existing incapacity.” This language requires a finding as to the effect the pre-existing incapacity has upon the current incapacity. ... [F]ull responsibility falls upon the current employer (or its insurer) unless it can be said that the current incapacity is substantially greater than it would have been “but for” the pre-existing incapacity.7
(Emphasis added.)
In Muir, the Commission failed to fulfill its statutory obligation to determine whether the incapacity attributable to the industrial injury was substantially greater than it would have been in the absence of preexisting incapacity. The Court remanded for the purpose of determining the effect the pre-existing incapacity had upon the industrial injury.
In United States Fidelity & Guaranty Co. v. Industrial Commission, the Court firmly recited the basis for second injury fund liability as follows:
Explicit statutory authority exists to apportion compensation awards and medical costs between employers and the Second Injury Fund, provided pertinent conditions are met. Basically, those conditions are three in number: 1) permanent incapacity occasioned by accidental injury, disease or congenital causes, followed by 2) subsequent injury resulting in further permanent incapacity which is 3) substantially greater than that which would have been incurred had there been no pre-existing incapacity. Those conditions having been met, the liability of the employer is assessed “on the basis of the percentage of permanent physical impairment attributable to the *1175industrial injury only and the remainder shall be payable out of the said special [second injury] fund.”8
(Emphasis added.)
In Kincheloe v. Coca-Cola Bottling Co., Kincheloe suffered a herniated disc while lifting a case of soda pop at his place of employment. The disc was surgically removed. Kincheloe had previously suffered an industrial injury to his back while employed in Nebraska. For the previous injury, he received a disability rating of 15% and was fully compensated therefor. In disallowing reimbursement from the second injury fund for the disc injury, the Commission found that the assessment of 15% permanent incapacity in the current medical evaluation was merely a restatement of the disability rating given in Nebraska.
In affirming the order of the Commission, the Court stated:
Based on the evidence before him, it was reasonable for the law judge to conclude that plaintiff did not sustain “permanent incapacity which is substantially greater than he would have incurred if he had not had the pre-existing incapacity”', hence, the second injury fund has no application.9
(Emphasis added.)
The factual scenario of Intermountain Smelting Corp. v. Capitano, like that of Ortega, is classically demonstrative of an industrial injury which was substantially greater because of its enhancement by a preexisting incapacity. Capitano had been shot in his left leg while in the military service in Korea and was given a 30% disability rating for life. His subsequent industrial injury resulted in a 30% loss of use of his right foot. To compensate, he partially shifted his weight to his left foot, which adversely affected that foot. The Commission found, based upon a medical panel report, that the combined effects of both injuries amounted to a loss of bodily function of 25%, 16 ¥2% of which was attributable to the preexisting incapacity and 8V2 % to the industrial injury. However, the Commission refused to order proportional contribution from the second injury fund because the preexisting injury was not causally connected to the industrial injury.
In reversing the Commission’s decision, the Court recounted the provisions of section 35-1-69, cited its recent decision in Ortega and concluded that there was no requirement that a causal connection exist between the preexisting injury and the industrial injury. It was undisputed that the combined effects of both injuries caused the industrial injury to be substantially greater than it would have been had there been no prior incapacity. The Court awarded compensation accordingly.
In Hafer’s, Inc. v. Industrial Commission, the Court expressly declined to compensate for a preexisting incapacity by simply adding it to the incapacity attributable to the industrial injury. In that case, the Commission awarded compensation for injuries sustained when a “spring-loaded” shock absorber slipped, causing a blow to the head of the worker. The Commission concluded that the blow to the head was the sole cause of the worker’s disability and declined to compensate for a 25% preexisting incapacity. In affirming the order of the Commission, this Court held:
The proposition plaintiff asserts is that there is medical evidence that the applicant had a prior disability which could fairly be rated at 25 per cent. The obstacles to the plaintiff’s position are (1), that the Commission expressly found that the injury complained of herein was the sole cause of Mr. Reid’s disability for which this award was made; and (2), that there is also a reasonable basis in the evidence to justify that finding.
In accordance with what we have said herein, we are not persuaded that the Commission acted capriciously, arbitrari*1176ly or unreasonably, or in excess of its authority.10
(Emphasis added.)
Each of the foregoing cases stands for the proposition that an award of compensation for preexisting incapacities is only to be made to the extent the said incapacities combine with and enhance the incapacity which results from the industrial injury. I have found no cases to the contrary. If the law should be different, the subject should be addressed by the legislature, whose function and prerogative it is to make changes or clarifications in the law.11
In the instant case, the record contains substantial evidence to support the conclusion reached by the Commission that the industrial injury was trivial in nature and not enhanced or made substantially greater than it would have been in the absence of preexisting incapacities. Furthermore, the facts do not in any way indicate that any of the worker’s problems subsequent to the industrial injury, including his present severe arthritis in his hands, are in any way a consequence of his industrial injury.
I would affirm the order of the Commission.
ZIMMERMAN, J., does not participate herein.

.See Day’s Market, Inc. v. Muir, Utah, 669 P.2d 440 (1983); United States Fidelity & Guar. Co. v. Industrial Comm’n, Utah, 657 P.2d 764 (1983); Kincheloe v. Coca-Cola Bottling Co., Utah, 656 P.2d 440 (1982); Paoli v. Cottonwood Hosp., Utah, 656 P.2d 420 (1982); Northwest Carriers v. Industrial Comm’n, Utah, 639 P.2d 138 (1981); Intermountain Smelting Corp. v. Capitano, Utah, 610 P.2d 334 (1980); Intermountain Health Care, Inc. v. Ortega, Utah, 562 P.2d 617 (1977); McPhie v. United States Steel Corp., Utah, 551 P.2d 504 (1976); Hafer's, Inc. v. Industrial Comm’n, Utah, 526 P.2d 1188 (1974).

. See note 1 and cases cited therein.

. U.C.A., 1953, §§ 35-1-1 to -107.

. 562. P.2d at 619-20 (footnote omitted).

. 639 P.2d at 141-42.

. 551 P.2d at 505.

. 669 P.2d at 442 (footnote omitted).

. 657 P.2d at 767 (footnotes omitted).

. 656 P.2d at 442 (footnotes omitted).

. 526 P.2d at 1189 (footnote omitted).

. Intermountain Smelting Corp., 610 P.2d at 337.