Bussen v. BE&K CONST. CO.
Bussen v. BE&K CONST. CO.
Opinion of the Court
Victor Bussen sued his employer, BE K, on June 28, 1994, seeking workers' compensation benefits for injuries he sustained on July 21, 1993, during the course of his employment. Following an ore tenus proceeding on September 28, 1995, the trial court stayed Bussen's workers' compensation claim, pending the outcome of Bussen's third-party action that also arose out of the workplace incident. The third-party action was subsequently settled for $160,000. BE K had previously paid temporary disability benefits and medical expenses totalling $16,000. BE K was repaid 2/3 of the $16,000 ($10,666.67) out of the $160,000, the amount to which it was subrogated.
The case action summary sheet indicates that the worker's compensation claim was settled on January 17, 1996, and that the issue of future medical expenses was submitted to the trial court on that same day. On January 18, 1996, BE K, in a letter brief to the trial court, stated that its position was "not that it has no further obligation to pay for future medicals. Rather, its obligation is merely suspended until [Bussen] exhausts his settlement proceeds, some $160,000." (Emphasis in original.) The trial court, on June 27, 1996, entered an order stating: "[Bussen's] claim for future medical benefits is denied." Bussen appeals, asking whether his recovery in a related third-party claim gives *Page 619 BEK a subrogation right for future, unpaid medical benefits.2
This appeal raises a question of first impression in this state: whether an employer is entitled to subrogation of future medical expenses not yet incurred by an employee, under §
Section
"(a) . . . If the injured employee . . . recovers damages against the other party, the amount of the damages recovered and collected shall be credited upon the liability of the employer for compensation. If the damages recovered and collected are in excess of the compensation payable under this chapter, there shall be no further liability on the employer to pay compensation on account of the injury or death. To the extent of the recovery of damages against the other party, the employer shall be entitled to reimbursement for the amount of compensation theretofore paid on account of injury or death. . . . For purposes of this amendatory act, the employer shall be entitled to subrogation for medical and vocational benefits expended by the employer on behalf of the employee."
For purposes of §
"(e) In a settlement made under this section with a third party by the employee . . . the employer shall be liable for that part of the attorney's fees incurred in the settlement with the third party . . . in the same proportion that the amount of the reduction in the employer's liability to pay compensation bears to the total recovery had from the third party. For purposes of the subrogation provisions of this subsection only, `compensation' includes medical expenses, as defined in Section
25-5-77 , if and only if the employer is entitled to subrogation for medical expenses under subsection (a) of this section."
The general rules of statutory construction have been stated as follows:
City of Montgomery v. Water Works Sanitary Sewer Bd. of theCity of Montgomery,"`The fundamental rule of statutory construction is to ascertain and give effect to the intent of the legislature in enacting the statute. Words used in a statute must be given their natural, plain, ordinary, and commonly understood meaning, and where plain language is used a court is bound to interpret that language to mean exactly what it says. If the language of the statute is unambiguous, then there is no room for judicial construction and the clearly expressed intent of the legislature must be given effect.'"
The 1992 amendments to the Act created a right of subrogation in the employer for medical and vocational benefits expended by the employer on behalf of the employee. §
Id.,"The statute speaks in terms of past payments only. . . . The state's authorization to pursue litigation asserting its subrogation rights is triggered only `[i]f a payment is made.' When the state does pursue litigation, it may not infringe upon the Medicaid claimant's right to `any part of the recovery beyond the costs expended on the person's behalf by the department.' DSS's reimbursement rights are premised upon benefits phrased solely with reference to the past tense. Nothing suggests that DSS may pursue recovery for benefits to be paid in the future. In fact, some of the statutory phrases just noted would appear to affirmatively prohibit what DSS seeks in this case."
We conclude that §
Our holding is also consistent with the recognized principles of subrogation. Subrogation is defined as the "right of one whohas paid an obligation which another should have paid to be indemnified by the other." Black's Law Dictionary 1279 (5th ed. 1979) (emphasis added). Subrogation is an equitable doctrine intended to prevent a double recovery by an insured and to reimburse the insurer for payments it made that should be borne by another. Int'l Underwriters/Brokers, Inc. v. Liao,
Accordingly, we reverse the judgment of the trial court and remand the case for the trial court to enter an order consistent with this opinion.
REVERSED AND REMANDED WITH INSTRUCTIONS.
THOMPSON, J., concurs specially.
ROBERTSON, P.J., and MONROE, J., concur in the result.
CRAWLEY, J., dissents.
Concurring Opinion
I agree with the majority opinion in its statutory interpretation. However, I do believe the statute as written allows for a double recovery by the employee at the expense of the employer.
For purposes of subrogation, I can see no reason for the distinction between past and future medical payments. In my opinion, the settlement proceeds should be treated as an advance payment of future compensation and include all future medical expenses. When the advance is exhausted, the employer would resume paying the worker's compensation benefits if warranted.
The legislature will have to address this problem as it sees fit.
Dissenting Opinion
I must respectfully dissent. When future expenses are paid by the workers' compensation insurer, Ala. Code 1975, §
Rather than require the insurer to risk the worker's possible inability to reimburse the insurer for future benefits after they are paid, many courts have allowed the insurer to withhold payment of benefits until the amount of such benefit payments equals the balance of the third-party recovery, at which time the insurer would resume payment of the appropriate benefits. See,e.g., Bilodeau v. Oliver Stores, Inc.,
Reference
- Full Case Name
- Victor Bussen v. Be K Construction Company. [Fn1]
- Cited By
- 4 cases
- Status
- Published