California Compensation Insurance v. Industrial Accident Commission
California Compensation Insurance v. Industrial Accident Commission
Opinion of the Court
Petitioner seeks a review and annulment of an award by respondent commission of maximum temporary partial disability benefits.
On July 2, 1953, Badge Moore, while in the course of his employment as a brick tender, sustained an injury to his back, resulting in temporary total disability. At a hearing on February 16, 1954, respondent commission found that the period of temporary total disability ran from July 3, 1953, to and including October 16, 1953, and entered its award in Moore's favor for the sum of $35 per week for that period. No dispute exists as to the validity of this phase of the matter.
Evidence was taken at the same hearing relative to Moore’s condition following the cessation of his total disability. Moore testified that he had been released to light work by his physician, Dr. Ferguson, on October 15, 1953. A report prepared by Dr. Ferguson under that date read in part: ‘1 Badge Moore is now ready to do light work. He- should not perform any job that requires lifting more than 10 or 15 pounds. I am certain that six weeks from now he will be able to do regular full time work.” Another report from Dr. Ferguson, dated February 9, 1954, was received subsequent to the hearing. The following language appears therein: “He [Moore] is partially disabled and I believe that he will not be able to do heavy physical work for at least another three months. I also believe that he should obtain some active physical therapy treatment for the next two months, on a three times weekly basis. At the present time he is capable only of sitting jobs or jobs requiring very light lifting.”
Moore testified that even before Dr. Ferguson notified him
Moore acknowledged the receipt of a letter from petitioner dated October 27, 1953, which read in part: “Dr. Ferguson has advised us that you are now ready to do light work. If you have not returned to work may we suggest you contact your employer to determine whether or not there is any work available for you.” Moore testified he had made no inquiry of his former employer because the work of a brick tender, which entails pitching, picking up and carrying bricks, was not light work and, to the best of his knowledge, his old employer had no light work available to him. Petitioner’s counsel thereupon informed Moore, for the record, that the Lesher Company, his employer, had work of a nature which he could perform and would make such work available to him. Moore stated he would apply for such work on the day following the hearing. On March 11, 1954, the referee denied a request by petitioner for an additional hearing on the ground that Moore had failed to report to Lesher for work.
On March 17,1954, respondent commission issued a Findings and Award, the pertinent part of which reads as follows: “3. Said injury further caused temporary partial disability beginning October 17, 1953, to and including February 16, 1954, and thereafter, entitling the applicant to compensation on a wage loss basis . . . [H]e is and shall be entitled to compensation consisting of 65% of the difference between $53.85 and the amount earned in said week or weeks. ...”
On March 25, 1954, petitioner filed with the commission a “Notice of Cessation of Payments of Compensation and Request for Termination of Liability,” advising that it had discontinued compensation payments under the last order of the
On April 5, 1954, petitioner filed a petition for reconsideration of the findings and award, incorporating therein substantially the same contentions on which it has based its petition for the writ of review herein. Petitioner seeks a review of the commissioner’s order of May 5, 1954, denying its petition for reconsideration.
Petitioner contends that it was improper to enter a maximum award of temporary partial disability indemnity in favor of Moore for the same period during which he received unemployment insurance benefits. The commission replies that in determining Moore’s eligibility for temporary partial disability benefits under the Workmen’s Compensation Act it is wholly immaterial that during the period in question he has qualified for and received unemployment compensation insurance payments.
The precise issue here posed appears to have received little judicial scrutiny. The factors crucial to its determination must be sought not only in the limited confines of statutory language, but also in the broader areas of principle and policy, and by an analytic examination of the history, background and legislative purpose underlying the enactment of social insurance legislation.
It is a matter of common knowledge that the pattern of wage-loss legislation in this state, as indeed throughout the country, did not evolve full-blown in accordance with a master blueprint but emerged piecemeal in response to society’s awakening acceptance of the need for an enlightened
The general economic conditions prevailing in the 1930’s, characterized by the spectacle of widespread unemployment, promoted the enactment of the Unemployment Insurance Act (3 Deering’s Gen. Laws, Act 8780d.)
Rounding out and complementing the statutory system of social insurance are the provisions of the Unemployment Compensation Disability Act (Stats. 1946, eh. 81, §§ 150, 200 et seq., p. 101; 3 Deering’s Gen. Laws, 1949 Pocket Supp., Act 8780d, § 150 et seq.)
It is axiomatic that in analyzing statutes for the purpose of finding and effectuating the legislative intent, “regard is to be had not so much to the exact phraseology in which the intent has been expressed as to the general tenor and scope of the entire scheme embodied in the enactments.” (County of Los Angeles v. Frisbie, 19 Cal.2d 634, 639 [122 P.2d 526].) The statutes here under examination are part of a comprehensive, integrated program of social insurance which, operating in their respective spheres, are calculated to alleviate the burden of a loss of wages by a protected employee during a particular period of time. The contingencies foreseen are loss of wages through (1) involuntary unemployment ; (2) industrially caused disability; and (3) disability of a nonoccupational nature. The significant aspect of this legislation concerns the fact that wages have been lost; the cause of such wage loss is the touchstone which determines which category of remedial legislation is germane. The Workmen’s Compensation Act, which mitigates the hardships experienced where a worker is injured in the course of his employment, the Unemployment Insurance Act, which provides benefits to one unemployed because of lack of work, and the unemployment compensation disability insurance program, which protects the worker against nonoceupationad disability, though distinct, are all component elements of a general, coordinated plan of social insurance developed by the Legislature. (See Bryant v. Industrial Acc. Com., 37 Cal.2d 215, 218 [231 P.2d 32].) Though enacted at different times and thus lacking the more perfect meshing of' a uniform act, the tenor of the statutes and the recent cases construing them show that they are interrelated by the common principle implicit therein of permitting only a single recovery of benefits by an employee in a case involving temporary partial disability. (See Bryant v. Industrial Acc. Com., supra; Garcia v. Industrial Acc. Com., supra.)
The problem before us in the instant case points up the need for a harmonious construction of such statutes in order to obviate the payment of cumulative benefits to an employee and to avoid the imposition of a double burden upon the employer. Having suffered a particular weekly wage loss,
It cannot be gainsaid, as the commission argues, that there is no provision in the Labor Code which expressly prohibits the collection of both unemployment insurance and workmen’s compensation benefits for the same period. Nor do we so hold. What we do hold is that in the light of the manifest legislative intent to provide a correlated system of social insurance and to avoid dual benefits, the amount of the workmen’s compensation award for temporary partial disability should be diminished by the amount of benefits received as unemployment insurance. Such a procedure does not oust the commission of its jurisdiction to award an employee an amount it considers him entitled to, since the employee does receive such total amount. It merely restricts the employee’s benefits to that amount by giving due consideration to benefits already received by the employee from an agency charged with the administration of a coordinate part of the legislative scheme of wage-loss legislation.
This conclusion is fortified by the provision of Labor Code, section 4654, which reads: “Temporary partial disability. If the injury causes temporary partial disability, the disability payment is 65 per cent of the weekly loss in wages during the period of such disability.” (Italics added.) The legislative intent to relate the award to loss of wages in a particular week is clearly disclosed. If an employee’s loss of wages due to a temporary partial disability in a particular week is in part diminished by the receipt of unemployment insurance benefits for that week, to the extent of those benefits he has not suffered a wage loss. It would therefore be proper for the commission, in any realistic computation of his wage loss for that week, to consider those benefits provided by a parallel segment of the social insurance program. Attention is also directed to Labor Code, section 4657, which, so far as is here relevant, reads: “In case of temporary partial disability the weekly loss in wages shall consist of the difference between the average weekly earnings of the injured employee and the weekly amount which the injured
The commission argues that in section 4903 of the Labor Code the Legislature has expressly taken into consideration the possibility that unemployment insurance benefits might be erroneously paid to an employee who, in fact, was entitled to receive temporary total disability payments under the Workmen’s Compensation Act, and has provided for a lien against its award for the amount of such benefits.
In the interest of completeness, we deem it advisable to discuss another aspect of the problem not raised in the
Petitioner also contends that in entering its award of maximum temporary partial disability payments for Moore, the commission failed to give effect to Labor Code, section 4657. We think this argument well taken. Section 4657 provides; “In case of temporary partial disability the weekly loss in wages shall consist of the difference between the average weekly earnings of the injured employee and the weekly amount which the injured employee will probably be able to earn during the disability, to be determined in view of the nature and extent of the injury. In computing such probable earnings, due regard shall be given to the ability of the injured employee to compete in an open labor market. If evidence of exact loss of earnings is lacking, such weekly loss in wages may be computed from the proportionate loss of physical ability or earning power caused by the injury.” Section 4654 of the Labor Code, which is correlated with section 4657, reads; “If the injury causes temporary partial disability, the disability payment is sixty-five per cent of the weekly loss in wages during the period of such disability. ’ ’
These sections taken together establish the standard by
In its brief, the commission acknowledges there “is no question that Moore was able to perform light work, that he was available for such light work and that he made a conscientious and sincere effort to seek such work on his own behalf.” The requirement of the statute before us is that an employer pay compensation to an injured employee during his temporary partial disability in an amount representing the difference between his earnings before injury and what he “will probably be able to earn during the disability,” giving “due regard ... to the ability of the injured employee to compete in an open labor market.”
It is the duty and function of the commission to weigh the evidence and make findings of fact. (Lab. Code, § 115.) The difference between the earnings of the employee before an injury and his probable ability to earn thereafter because of the nature of his injury is primarily a question of fact upon which findings must be made. (Tarascio v. S. C. Poriss Co., 116 Conn. 707 [164 A. 206, 207].) It is a matter to be established by proof, and cannot be arbitrarily fixed. (See Giovanniello v. Transit Dev. Co., 212 App.Div. 188 [208 N.Y.S. 581]; Vogler v. Ontario Knife Co., 223 App.Div. 550 [229 N.Y.S. 5].) Loss of wages due to an inability to secure work which has its origin merely in general business conditions or the slackness of the demand for labor furnishes no basis for an award of workmen’s compensation. (Johnson v. Cluett Peabody Co., 2 I.A.C. 10, 13; Jordan v. Decorative Co. 230 NY. 522 [130 N.E. 634, 635]; 1 Campbell, Workmen’s Compensation, § 839, pp. 746-747.) Though the workmen’s compensation act is to be liberally construed to extend its benefits for the protection of those coming within its provisions, it is not intended to provide unemployment insurance benefits. (Johnson v. Cluett Peabody Co., supra; McCormick S.s. Co. v. United States Employees’ C. Com., 64 F.2d 84, 85.) To sustain an award such as has been made herein, the evidence must show
In this case, the evidence was not such as to necessarily require a finding that Moore’s disability was of a type which rendered him unable to compete in the open market for some generally available line of work under the “odd-lot” doctrine enunciated in Meyers v. Industrial Acc. Com., 39 Cal.App.2d 665 [103 P.2d 1025],
Accordingly, the award is annulled and the cause remanded to respondent commission for further proceedings in consonance with the views herein expressed.
Moore, P. J., and MeComb, J., concurred.
A petition for a rehearing was denied December 17, 1954, and the following opinion was then rendered:
In its petition for rehearing, the commission has made two significant changes in its position: First, it
The commission’s new position serves also to buttress our conclusion that its findings, as made, were deficient in failing to find on material facts. If the commission’s theory that the Department of Employment is here entitled to a lien is to prevail (assuming, but without deciding, that it is tenable), findings would be necessary that Moore was, in fact, unavailable for work and that the unemployment insurance benefits paid him were consequently erroneous. But as has
The fallacy of the commission’s contention that the general finding it made necessarily implies that Moore was in the “odd-lot” category is apparent from an examination of that finding, which reads:
“3. Said injury further caused temporary partial disability beginning October 17, 1953, to and including February 16, 1954, and thereafter, entitling the applicant to compensation on a wage loss basis. For any week or weeks beginning on and after October 17, 1953, and until the termination of temporary partial disability herein or further order of the commission in which week or weeks applicant’s earnings fall below $53.85 per week, he is and shall be entitled to compensation consisting of 65 percent of the difference between $53.85 and the amount earned in said week or weeks. Jurisdiction is reserved to find thereon in the event the parties are unable to adjust said matter.”
It can hardly be said that this finding, even by implication, responds to the particular issues posed. It purports only to find that Moore’s injury caused a temporary partial disability and then indulges in a conclusion of law as to the amount of the award to which Moore shall be entitled in a week when his “earnings fall below $53.85 per week.” This language is the very opposite of an implication that Moore was an “odd-lot”; rather, the finding is pregnant with suggestion that Moore could obtain earnings, although of a fluctuating character. There is therefore no basis for an implication that in any week when Moore was not working or had no earnings it was purely ascribable to the fact that Moore’s physical condition was that of an “odd-lot” rather than to the vicissitudes of the industrial market. What the finding does indicate is that the commission was oblivious to its responsibilities under section 4657 of the Labor Code, which was patently ignored. While that section may be difficult to apply, administrative inconvenience does not excuse compliance with the legislative mandate. Petitioner was entitled to a finding as to the effect of Moore’s injury on his
Because of certain observations made by the commission in its petition for rehearing, we reiterate, as we have taken pains to emphasize heretofore, that upon remand the commission is, of course, free to exercise its independent judgment in evaluating the evidence as to the degree of Moore’s temporary partial disability and his probable earnings, if any, irrespective of any determination thereof which the Department of Employment may have made.
To insure clarity and to obviate possible confusion with compensation benefits awarded under the Workmen’s Compensation Act, payments under the Unemployment Insurance Act will be referred to in this opinion simply as unemployment insurance benefits.
The law relating to unemployment insurance and disability compensation was consolidated and revised and enacted as the Unemployment Insurance Code at the 1953 Regular Session of the Legislature, and became operative January 1, 1954 (Stats. 1953, eh. 308, p. 1457).
"See note 2, supra. Disability compensation is governed by div. 1, part 2, of the code, § 2601 et seq.
‘The commission may determine and allow as a lien against any amount to be paid as compensation: . . .
‘ ‘ (g) Unemployment Compensation Benefits. The amount of unemployment compensation benefits paid erroneously to the injured employee for a period for which he was unable to work and for which he received temporary total disability payments under this division. ’ ’ (Italics added,)
“Judicial recognition of the legislative objective of formulating a correlated scheme of protection against loss of wages appears in the following extract from Bryant v. Industrial Acc. Com., 37 Cal.2d 215, 218 [231 P.2d 32], where Mr. Justice Sehauer wrote: “Prior to the adoption of the unemployment compensation disability insurance program, the Senate Interim Committee on Unemployment Insurance reported that ‘In California where a worker is unemployed because of injury arising within the scope of his employment, some protection is offered by the Workmen’s Compensation Act. If an individual is unemployed because of lack of work, benefits are provided under the Unemployment Insurance Act. However, for the worker who is unemployed because of an injury not within the reach of the Workmen’s Compensation Act no protection whatever is granted. Tour committee feels it is an anomalous situation and a serious gap in providing economic security for the large working population of the state. ’ (Senate Journal, May 7, 1945, p. 85.) The committee recommended adoption of an insurance program ‘to pay benefits to individuals who are unemployed because of illness or injury for which no compensation is otherwise made’ (Id., p. 126; italics petitioners’) and further recommended ‘That no disability benefits be paid to an individual receiving unemployment insurance benefits or workmen’s compensation’ (Id., p. 89.) ”
"Broadly stated, the Odd-Lot Doctrine declares that if the effects of the accident have not been removed, it is not sufficient to entitle an employer to a reduction in the weekly compensation to show that the workman has the physical capacity to do some kind of work different from the general kind of work he was engaged in at the time of the accident. Since injury has made the workman’s service an “odd lot” in the labor market, it must also be shown that he can actually get such work. The burden is upon the employer, the moving party, to show that the workman can actually get a job within the scope of his limited capacity.” (1 Campbell, Workmen’s Compensation, 745-6.)
Reference
- Full Case Name
- CALIFORNIA COMPENSATION INSURANCE COMPANY (a Corporation) v. INDUSTRIAL ACCIDENT COMMISSION and BADGE MOORE
- Cited By
- 32 cases
- Status
- Published