Court Opinion

ID: 9760162
Source: CourtListenerOpinion
Date Created: 2023-08-29 00:41:32.585617+00
Date Added: 2024-06-11T07:29:08.583287
License: Public Domain

OPINION BY
President Judge LEADBETTER.
Employer Good Tire Service petitions for review of the March 27, 2008 order of the Workers’ Compensation Appeal Board (Board) that reversed in part and modified in part the order of the Workers’ Compensation Judge (WCJ) granting Employer’s petition to review benefit offset. This case presents a novel issue under Section 319 of the Workers’ Compensation Act (Act), Act of June 2, 1915, P.L. 736, as amended, 77 P.S. § 671:1 whether an employer’s pro-rata *1045share of attorney’s fees from a third-party settlement arising out of a work injury should be calculated based upon counsel’s original contingent-fee agreement with the claimant or upon the actual amount ultimately paid, where counsel has reduced his fee. Characterizing the waived portion of the fee as a “gift,” the Board ruled that Employer’s share of the fee was to be calculated on the contractual amount rather than the amount actually retained by counsel from the settlement proceeds. Because we conclude that there is no principled or legal distinction between a fee that is refunded and one that is never taken in the first place, we reverse the Board’s order.
The facts as found by the WCJ are as follows. In April 2004, Timothy Wolfe (Claimant) suffered a broken right leg as a result of an automobile accident that occurred while he was in the course and scope of his employment. Employer’s insurer, Cincinnati Insurance Company, recognized the injury via the issuance of a notice of temporary compensation payable, which later converted to a notice of compensation payable. Based on an average weekly wage of $820.21, Claimant received weekly benefits of $547.21.
Claimant subsequently filed a third-party lawsuit arising out of the work injury. In September 2006, Claimant settled the lawsuit for a total of $75,000, having incurred litigation costs of $727.25. As of the date of the settlement, employer’s insurer had paid $13,289.39 in wage loss benefits2 and $34,969.93 in medical benefits, thereby bringing its total accrued lien against the third-party settlement recovery to $48,259.32.
Claimant and his counsel had entered into a contingent-fee agreement for forty percent of any amount recovered in the third-party lawsuit. Having received the settlement check at the conclusion of the lawsuit, Claimant’s counsel deposited the forty-percent fee, $30,000, and then remitted $9,205.92 of that fee to Claimant when the proceeds were distributed. The record contains the following Settlement Distribution Statement:
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Claimant’s counsel took the position that the forty-percent contingent fee applied to the calculation of Employer’s pro-rata recovery of its compensation lien, regardless of counsel’s voluntary decision to refund a waived portion of the fee to Claimant. Accordingly, Claimant’s counsel paid *1047$28,478-67 to Employer’s insurer from the $75,000 recovery.
The insurer, however, did not accept $28,478.67 as full payment. Instead, it calculated the recovery of its accrued lien and future grace period using an attorney’s fee of $20,974.08, what the attorney kept as a fee after deducting the refunded amount of $9,205.92. It also took into account the $725.25 in litigation costs. Employer filed the petition to review benefit offset at issue, alleging that the subro-gation claim had not been paid in full.
In granting Employer’s petition, the WCJ concluded that “[t]he waived and refunded fee amount is not a reasonable attorney fee incurred in obtaining the recovery from a third party, within the meaning of Section 319.... ” WCJ’s Conclusion of Law No. 1. Accordingly, the WCJ directed Claimant’s counsel to reimburse the insurer $34,485.67 in satisfaction of the subrogation lien, allowing credit for a previous payment of $28,478.67. Claimant appealed from the WCJ’s decision.
The Board reversed, characterizing the fee waiver as a “gratuity.” Specifically, the Board noted:
[Employer] who has received reimbursement of its subrogation lien now seeks to receive an additional benefit of a gratuity that counsel extended to its client in light of the severe injuries not to mention pain and suffering that the client sustained. We hold that to recalculate the subrogation amount to reduce the third party recovery to the Claimant under these facts would be contrary to the humanitarian purposes of the ... Act in addition to the contractual rights of the parties.
Board’s Decision at 6. Employer’s timely petition for review to this Court followed.
In support of its position, Employer contends that the Board’s determination that insurer’s subrogation lien should be reduced by the full forty-percent fee, regardless of the fact that the full amount was not retained by counsel, contradicts well-established law that the statutory right of subrogation is an absolute right that cannot be altered or made subject to equitable principles. Thompson v. Workers’ Comp. Appeal Bd. (USF &G Co.), 566 Pa. 420, 781 A.2d 1146 (2001); Stout v. Workers’ Comp. Appeal Bd. (Pennsbury Excavating, Inc.), 948 A.2d 926 (Pa.Cmwlth.), appeal denied 599 Pa. 684, 960 A.2d 457 (2008). Employer emphasizes that the only attorney’s fees actually paid in this matter were $20,794.08, almost $10,000 less than the amount set forth in the fee agreement. Employer, therefore, urges this Court to reject the Board’s erroneous acceptance of the proffered equitable reason for the refund, i.e., that it would have been inequitable for Claimant to receive less than his attorney’s fees. It asks us to enforce the statutory right of subrogation.
In response, Claimant maintains that the Board properly noted the principles of subrogation as set forth in Section 319 of the Act and explained how counsel complied with them consistent with the Supreme Court’s decision in Pennsylvania Manufacturers’ Association Insurance Company v. Wolfe, 534 Pa. 68, 626 A.2d 522 (1993). In that case, the Court determined that the attorney who creates the third-party settlement fund is entitled to get paid prior to the insurer’s receiving any benefit from that settlement, noting that “but for the attorney’s actions, there would be no fund for either the workers’ compensation carrier or for the client-injured employee.” Id. at 74, 626 A.2d at 525 (emphasis deleted).
We first note that Wolfe held that in a structured settlement situation in which the initial lump-sum payment was insufficient to cover both the counsel fee and the *1048subrogation lien, the fee was to be paid first and the lien satisfied out of subsequent proceeds. Here, the entire settlement was paid in a lump sum, so priority of payments did not come into play. Wolfe had nothing to do with calculating the amount of employer’s subrogation interest, nor the amounts anyone was to be paid, only the priority of payments. It simply affords no support for Claimant’s suggestion that counsel can deposit an agreed-upon fee, then calculate Employer’s pro-rata share on that deposit, then remit part of that fee to his client and refuse to recalculate Employer’s share because counsel has gone through the mechanical steps in a particular order. Moreover, while we do not impugn counsel’s motives here, were we to accept Claimant’s argument, we would open the door to sham fee agreements specifically calculated to avoid the law regarding employers’ subrogation rights.
Nonetheless, counsel maintains that once he deposited the fee into the firm’s general account, those monies became the property of the firm. As such, counsel argues that he was entitled to make a gift to Claimant out of those funds in order to prevent him from receiving less money than his counsel,3 and that such action should be viewed as furthering the humanitarian purposes of the Act.
Apparently, Claimant’s counsel agreed with the WCJ that under the circumstances, “[t]he waived and refunded fee amount is not a reasonable attorney fee incurred in obtaining the recovery” and so waived $9,205.92 of that fee and distributed that amount to Claimant along with Claimant’s share of the settlement proceeds. While we respect and commend counsel’s professionalism in reducing his fee, neither his motives nor the humanitarian purposes of the Act allow us to ignore the fact that the fee actually paid was $20,794.08, not $30,000. This is the amount upon which Employer’s pro-rata share of costs must be calculated under the Act. It is of no moment that a larger amount was originally agreed upon or whether that larger fee might have been found reasonable had it, in fact, been paid. As noted above, the statutory right of sub-rogation is “clear and unambiguous. It is written in mandatory terms and, by its terms, admits of no express exceptions, equitable or otherwise.” Thompson, 566 Pa. at 428, 781 A.2d at 1151. Employer is obligated under the Act to pay a pro-rata share of the fee paid to generate the fund subject to subrogation, not some hypothetical fee which might have been paid.
Accordingly, for the above reasons, we reverse the Board and reinstate the order of the WCJ.

ORDER

AND NOW, this 15th day of July, 2009, the order of the Workers’ Compensation Appeal Board in the above captioned matter is hereby REVERSED, and the order of the Worker’s Compensation Judge is REINSTATED.

. In pertinent part, Section 319 of the Act provides that where a claimant's compensable injury is caused in whole or in part by the act or omission of a third party, an employer shall be subrogated to the right of the claimant against the third party to the extent that the employer paid compensation to the claimant. Because the employer obtains a valuable benefit from the claimant’s third-party lawsuit, the employer must pay its pro-rata share of the reasonable attorney’s fees and litigation costs incurred in obtaining a recovery or ef*1045fectuating a settlement. Id. An employer's pro-rata share of reasonable attorney's fees is the proportion of attorney's fees and other costs that the amount of compensation paid or payable at the time of recovery or settlement bears to the total recovery or settlement. Id. An employer’s right to subrogation is automatic and absolute. Suburban Delivery v. Workers' Comp. Appeal Bd. (Fitzgerald), 858 A.2d 219 (Pa.Cmwlth.2004).

. On October 4, 2004, Claimant returned to work for Employer without an injury-related loss.

. Counsel also argues to this Court that, once it was deposited, the entire $30,000.00 constituted income upon which the firm was obligated to pay taxes, no matter what happened thereafter. He asserts no authority for this novel proposition, and no evidence was presented concerning die law firm's treatment of the money for tax purposes. Employer properly points out that a counsel's assertions and arguments do not constitute evidence. Jacquin v. Pennick, 68 Pa.Cmwlth. 327, 449 A.2d 769(1982).