Court Opinion

ID: 9785256
Source: CourtListenerOpinion
Date Created: 2023-08-30 21:12:21.998947+00
Date Added: 2024-06-11T07:36:13.750205
License: Public Domain

JABAR, J.,
concurring.
[¶ 25] I agree with the Court that we must vacate the Superior Court’s judgment, but write separately for two reasons. First, because of the certainty involved in calculating the Trust’s lien for benefits already paid, I believe we should provide the parties with a final ruling regarding the court’s finding on this issue. Second, obtaining a decision in the pending matter before the Workers’ Compensation Board will not assist the court in determining the amount of the Trust’s future hen. Because of the inherently speculative nature of the Trust’s future lien, I believe a different approach is warranted.
A. Lien for Benefits Paid
[¶ 26] Calculating the portion of the Trust’s lien attributable to benefits paid is a relatively straightforward task. Upon settlement with a third party, 89-A M.R.S. § 107 (2009) entitles the employer to a lien for the “value of compensation paid,” and requires the employee to “repay to the employer, out of the recovery against the 3rd person, the benefits paid by the employer under this Act, less the employer’s proportionate share of cost of collection, including reasonable attorney’s fees.” In this case, the Superior Court correctly determined that the Trust was entitled to a lien in the amount of $210,746.22 for benefits paid. Prior to discontinuing payments on August 11, 2006, the Trust had paid Dennis $340,404.86 in workers’ compensation benefits.8 After reducing this amount by the Trust’s proportionate share of costs ($16,190.36) and attorney fees ($113,-468.28), the court correctly arrived at the $210,746.22 figure.
[¶ 27] In accordance with section 107’s clear mandate, this amount should have been paid to the Trust “out of the recovery against the 3rd person.” The law firm failed to do this. After the court determined the amount of the Trust’s lien for benefits paid, it should have ordered that amount immediately payable pursuant to section 107. The court erred in attaching the Trust’s lien to the escrowed funds and Dennis’s annuity payments.
B. Lien for Future Benefits9
[¶ 28] Determining the amount of the Trust’s hen for future benefits is a sepa*697rate and distinct process. It is well established that, in addition to a hen on benefits already paid, an employer is entitled “to offset any future liability against the settlement amount netted by the employee.” McKeeman v. Cianbro Corp., 2002 ME 144, ¶ 10, 804 A.2d 406, 409 (citing Liberty Mut. Ins. Co. v. Weeks, 404 A.2d 1006 (Me.1979)); accord Overend v. Elan I Corp., 441 A.2d 311, 314 (Me.1982). The offset applies to the remaining portion of the settlement, after the Trust’s hen for past benefits has been deducted.10 Absent this offset, the employee would receive both the settlement proceeds and workers’ compensation benefits, resulting in a double recovery. See McKeeman, 2002 ME 144, ¶ 10, 804 A.2d at 409.
[¶29] In return for its right to offset any future liability against the settlement, the employer is responsible for its “proportionate share of cost of collection, including reasonable attorney’s fees.” 39-A M.R.S. § 107. Although the statute is silent on the method for calculating the employer’s proportionate share, we directly addressed this issue in McKeeman, reasoning that, “[b]ecause the employer’s rights in the settlement include not only past amounts paid, but also future benefits relieved, the employer also has a duty to pay the corresponding proportionate share of attorney fees for the present value of the entire benefit it receives.” 2002 ME 144, ¶ 13, 804 A.2d at 410. Thus, we held: “[A]n employer’s proportionate share of fees and costs upon an employee’s settlement with a third party should be calculated with reference both to past benefits paid and future liability relieved, to the extent that it can be determined.” Id. ¶ 17, 804 A.2d at 411 (emphasis added).
[¶ 30] Significantly, the trial court in McKeeman was able to easily establish the employee’s future benefits: the employee had died from a work-related accident, and death benefits available to surviving dependents are statutorily fixed. Id. ¶ 2, 804 A.2d at 407; see also 39-A M.R.S. § 215(1) (2009). In that sense, the factual situation we faced in McKeeman was distinct; courts will not always be presented with a relatively simple calculation of future benefits. Workers’ compensation benefits may fluctuate over an employee’s life, presenting the potentially difficult task of determining future benefits and corresponding costs of recovery. We explicitly recognized this distinction in McKeeman, noting that, “unlike the definite nature of death benefits payments as in this case, the determination of future liability to employers will often be a difficult process requiring a significant factual inquiry.” McKeeman, 2002 ME 144, ¶ 17 n. 5, 804 A.2d at 411.
[¶ 31] As the Court’s opinion today acknowledges, the Superior Court here was faced with the difficult task we anticipated in McKeeman. Recognizing that the Trust’s future liability relieved could not be determined, the court fashioned a solution:
The evidence presented at trial was not sufficient to permit the Court to make this determination because it is not know[n] at this time whether the defendant will be eligible to receive future benefits, and if eligible, what the eligibility period will be. Consequently, the only way that the court can determine [the Trust’s] proportionate share of costs and attorney fees related to future liability relieved is to require that [the *698Trust] pay its share as the benefit accrues periodically.
This approach was not mentioned in McKeeman, but our opinions in both Over-end and Weeks — where the employees’ future benefits were not fixed — implicitly recognized the need to determine an employer’s proportionate share of costs as the employer receives each credit against its compensation liability. See Overend, 441 A.2d at 814; Weeks, 404 A.2d at 1013. Although not referred to by name in Over-end and Weeks, this method of reimbursement is commonly called “pari passu.” See Franges v. Gen. Motors Corp., 404 Mich. 590, 274 N.W.2d 392, 397 (1979); see also DiVirgilio v. Norton Co., 344 F.Supp. 552, 554 (W.D.Pa.1972).
[¶ 32] In its opinion adopting the pari passu approach, the Michigan Supreme Court’s decision in Franges bears a close resemblance to our discussion of proportionate costs and attorney fees in McKee-man. Faced with the issue of “whether the future compensation credit should be included as an interest of the insurer when computing the apportionment of fees,” the court in Franges surveyed the various approaches taken in other jurisdictions. 274 N.W.2d at 397. Similar to our opinion in McKeeman, 2002 ME 144, ¶ 14, 804 A.2d at 410-11, the Franges court rejected the approach adopted in Missouri, which holds an employer responsible only for attorney fees based on the amount of compensation already paid. 274 N.W.2d at 397, 400-01. The Franges court also identified the dual interests to an employer in any given third-party action by an employee:
First, there is the reimbursement interest: the refunding of monies previously paid or payable as workers’ compensation benefits as of the date of judgment. Additionally, a second interest appears when the dollar amount of recovery exceeds the insurer’s reimbursement. That interest is a dollar amount obtained by the employee but treated by the employer or insurer as a future credit against payment of additional compensation benefits.
274 N.W.2d at 400. Again, this analysis parallels our recognition in McKeeman that, upon an employee’s settlement with a third party, the benefit inuring to the employer “includes both reimbursement of amounts paid and the relief of future amounts payable to the extent of the settlement amount netted by the employee.” 2002 ME 144, ¶ 13, 804 A.2d at 410.
[¶ 33] Unlike McKeeman, however, the employees in Franges were issued an “open-end” award of workers’ compensation benefits, in which compensation was granted “for an indefinite period of time or so long as the facts on which the award was predicated continue.” 274 N.W.2d at 394 n. 2.11 As the Franges court observed, in cases where an employee’s future benefits are not fixed, the future credit to the employer takes on a contingent quality. Id. at 400. An employer may not receive this credit for a variety of reasons, including the employee’s medical improvement, retirement, subsequent employment, or death. To properly balance the contingent quality of this interest with the employer’s responsibility for bearing the cost of the benefit, the Franges court embraced the pari passu approach, whereby an employer pays its share of costs and fees as it receives the benefit of the third-party recovery. Id. at 397, 400. As the court held, “payment of the apportionment per*699centage of total costs based upon gross recovery will be made as this interest of the insurer becomes dollars credited against compensation liability.” Id. at 400.
[¶34] This general approach mirrors the Superior Court’s solution and is consistent with Maine law. The Maine Workers’ Compensation Act reforms passed in 1992 were based in large part on the Michigan model, see Guiggey v. Great N. Paper, Inc., 1997 ME 232, ¶ 9, 704 A.2d 375, 378, and we have often explored Michigan precedent when our case law does not clearly resolve workers’ compensation issues, see, e.g., Bureau v. Staffing Network, Inc., 678 A.2d 583, 589-90 (Me.1996).12 Accordingly, I would hold that where an employee’s future benefits cannot be determined, an employer may pay its proportionate share of the costs and attorney fees attributable to its relief from payment of future benefits as those benefits accrue. McKeeman would continue to apply in situations where an employee’s future benefits are fixed.
[¶ 35] Adopting the pari passu approach in this case would resolve the problem the Superior Court will again struggle with on remand: calculating Dennis’s entitlement to future workers’ compensation benefits. To be sure, a portion of Dennis’s future benefits will be readily calculable. It is undisputed that Dennis was entitled to receive benefits between August 11, 2006, and May 15, 2007, the date the Trust’s petition alleges that Dennis refused a bona fide offer of reasonable employment. See 39-A M.R.S. § 214(1)(A) (2009). During this period, the benefits otherwise payable by the Trust stand as a credit against the settlement.
[¶ 36] With regard to Dennis’s entitlement to benefits after May 15, 2007, the Board’s decision on the Trust’s petition will provide the court with retroactive guidance. By statute, an employee who refuses a “bona fide offer of reasonable employment” is not entitled to receive benefits “during the period of the refusal.” 39-A M.R.S. § 214(1)(A). Although the Board’s decision will determine whether Dennis refused a reasonable employment offer, it will not fix Dennis’s entitlement to benefits going forward. In the future, Dennis could return to work or his medical condition could worsen, rendering him unable to physically perform the offered employment. Thus, regardless of the Board’s decision, there will be no finality with respect to Dennis’s entitlement to future benefits. Obtaining a decision by the Board, as the Court has instructed, will not aid the Superior Court in this regard.
[¶ 37] I think the better course would be to affirmatively adopt the pari passu approach. This would bring the litigation surrounding the declaratory judgment action to an end, leaving the parties to deal with Dennis’s responsibility for satisfying the Trust’s lien for past benefits.
[¶ 38] In sum, I would affirm the Superior Court’s determination that the Trust is entitled to a lien for benefits already paid in the amount of $210,746.22. This amount should have been paid to the Trust “out of the recovery against the 3rd person.” 39-A M.R.S. § 107. I would, however, vacate that portion of the court’s judgment attaching the lien to the es-*700crowed funds and Dennis’s annuity. Finally, I would affirm the court’s general approach regarding future benefits, allowing the Trust to pay its proportionate share of the costs and attorney fees attributable to its relief from payment of future benefits as those benefits accrue.13

. The Trust also incurred $5990 in taxicab expenses to transport Dennis to Boston for medical treatment, which were properly included in the lien. See Me. W.C.B. Rule, ch. 5, § 13 (2008) (stating that an employer must pay "travel-related expenses” incurred for medical treatment, including "[m]ileage ... at the standard rate for business travel set by the Internal Revenue Service pursuant to 26 U.S.C.S. § 162(a)(1)” and ”[a]ctual charges for tolls”).

. The term "future benefits” refers to the benefits to which Dennis may be entitled after August 11, 2006, when the Trust discontinued *697its payment of workers’ compensation benefits.

. This offset stands as a credit against the settlement, and does not affect Dennis’s obligation to reimburse the Trust for benefits already paid.

. Of the three employees involved in the consolidated appeal in Franges, two were entitled to open-ended benefits. Franges v. Gen. Motors Corp., 404 Mich. 590, 274 N.W.2d 392, 395 n. 5 (1979). Because the third employee was deceased, that appeal involved survivor benefits with a fixed dollar amount. Id.

. Notably, in Weeks we cited Schalk v. Michigan Sewer Construction Co., 62 Mich.App. 658, 233 N.W.2d 825 (1975), as representative of the principle that, in dealing with future benefits, “the excess of third-party recovery over past compensation actually paid stands as a credit against future liability of the [workers' compensation] carrier.” Liberty Mut. Ins. Co. v. Weeks, 404 A.2d 1006, 1013 n. 10 (Me.1979) (quotation marks omitted). Schalk, along with two other cases from the Michigan Court of Appeals, were consolidated for purposes of appeal in Franges. See Franges, 274 N.W.2d at 394.

. Given the resolution of this appeal, I do not set forth a particular formula to be utilized in applying the pari passu approach, and therefore do not comment on the correctness of the Superior Court's actual calculation of the Trust’s proportionate share of costs and attorney fees.