AI Generated Opinion Summaries

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

• A worker filed a claim for workers' compensation benefits due to an injury sustained in a car accident while employed as a driver. The accident occurred within the scope and course of employment. Subsequently, the worker also pursued a tort action against a third party involved in the accident. After resolving the tort action with a judgment of $27,500 in favor of the worker, a dispute arose regarding the employer/insurer's entitlement to reimbursement for compensation benefits previously paid to the worker, including medical and indemnity benefits.

Procedural History

• Workers’ Compensation Administration, Gregory D. Griego, Workers’ Compensation Judge: The Workers' Compensation Judge (WCJ) issued a compensation order determining the employer's right to reimbursement, which was contested by the employer/insurer.

Parties' Submissions

• Worker-Appellee: Argued that the jury award from the tort action did not fully compensate for his damages, as it only covered pain and suffering, and after deducting costs and attorney’s fees, the recovery was insufficient.
• Employer/Insurer-Appellants: Contended that under Section 52-5-17 and Gutierrez, they were entitled to reimbursement for the compensation benefits paid to the worker, including medical and indemnity benefits, plus costs, minus the attorney fees the worker paid in the tort case.

Legal Issues

• Whether the Workers' Compensation Judge erred in the computation of the reimbursement owed to the employer/insurer under Section 52-5-17 and Gutierrez.

Disposition

• The compensation order of the Workers' Compensation Judge was reversed, and the case was remanded with instructions to reimburse the employer/insurer for compensation benefits paid to the worker for medical and indemnity benefits plus costs, minus attorney fees paid by the worker.

Reasons

• Per Michael E. Vigil, Judge (Linda M. Vanzi, Judge, Timothy L. Garcia, Judge concurring): The court found that the WCJ erred in the computation of reimbursement owed to the employer/insurer. The WCJ's decision was based on a complex calculation that did not fully reconcile with the jury verdict from the tort action. The court noted that the worker did not present evidence to rebut the presumption that the employer/insurer is entitled to full reimbursement for the compensation benefits paid. The evidence indicated that the jury verdict represented medical benefits, indemnity benefits, and a balance for pain and suffering. Without any arguments from the worker to distinguish or modify the application of Gutierrez to this case, the court was compelled to reverse the WCJ's compensation order and remand for proper reimbursement calculation according to the principles outlined in Gutierrez.