Lockridge v. State Farm Mutual Automobile Insurance
Lockridge v. State Farm Mutual Automobile Insurance
Opinion of the Court
I. NATURE OF THE CASE
While plaintiff was off work because of a work-related disabling injury, and while he was accepting wage-loss benefits from General Motors Corporation (gm) under worker’s compensation laws, plaintiff was injured in an automobile accident on April 3, 1995. For more than a year after his automobile accident, plaintiff continued to accept worker’s compensation wage-loss benefits from GM and, by doing so, represented to GM that he was entitled to those benefits because his work-related injury continued to prevent
by continuing to receive worker’s comp, Plaintiff, regardless of the reason that he continued to stay out on comp for several more months, Plaintiff is saying to General Motors that he has a work related injury which doesn’t allow him to return.[1 ]
The question before us is: Does plaintiff’s acceptance of worker’s compensation wage-loss benefits from April 1995 to May 1996 constitute a binding representation that his work loss for this period was attributable to his work-related injury rather than the injury received in the automobile accident, thereby preclud
n. FACTS AND PROCEEDINGS
In July 1991, plaintiff suffered a neck injury after falling from a platform at the GM assembly plant where he was employed. After missing several months of work, plaintiff returned to his job on an intermittent basis until July 1993, when he began experiencing problems related to his fall. On July 12, 1993, as a result of the disabling injuries received in the fall, plaintiff began receiving worker’s compensation benefits in the amount of $350.83 a week.
On April 3, 1995, while he was still on leave from work and receiving worker’s compensation wage-loss benefits, plaintiff was a passenger in an automobile that struck a curb and rolled over. As a result of the automobile accident, plaintiff suffered a “hangman’s fracture” of his neck and was placed in a halo ring and vest. Plaintiff continued to accept worker’s compensation benefits until his return to work in May 1996.
On December 12, 1995, plaintiff brought this action against defendant for work-loss benefits pursuant to the no-fault act, MCL 500.3107(l)(b); MSA 24.13107(l)(b). While the action was pending, plaintiff returned to work in May 1996. Plaintiff alleged that the injury he sustained in the automobile accident, and not the previous work-related injury, prevented
Defendant moved for summary disposition of plaintiff’s lost-wages claim. Defendant maintained that plaintiff’s receipt of worker’s compensation benefits on the date the accident occurred, and his continued acceptance of such benefits until his return to work in May 1996, precluded plaintiff’s claim for wage-loss benefits for the automobile accident under the no-fault act. The trial court agreed and granted summary disposition of plaintiff’s claim for income loss.
m. ANALYSIS
This Court reviews decisions regarding motions for summary disposition de novo. Spiek v Dep’t of Transportation, 456 Mich 331, 337; 572 NW2d 201 (1998). Motions under MCR 2.116(C)(10) test the factual support of the plaintiff’s claim. Id. The court considers the affidavits, pleadings, depositions, admissions, and other evidence submitted to determine whether a genuine issue of any material fact exists to warrant a trial. Id. Both this Court and the trial court must resolve all reasonable inferences in the nonmoving party’s favor. Bertrand v Alan Ford, Inc, 449 Mich 606, 618; 537 NW2d 185 (1995).
Subsection 3107(l)(b) provides that a no-fault insurer is liable to pay benefits for
[w]ork loss consisting of loss of income from work an injured person would have performed during the first 3 years after the date of the accident if he or she had not been injured. [Emphasis added.]
In MacDonald v State Farm Mut Ins Co, 419 Mich 146; 350 NW2d 233 (1984), our Supreme Court explained this provision. The Court held that the ben
[W]ork-loss benefits are available to compensate only for that amount that the injured person would have received had his automobile accident not occurred. Stated otherwise, work-loss benefits compensate the injured person for income he would have received but for the accident. In the present case, plaintiff would have worked and earned wages for two weeks, until the date of his heart attack. After that date plaintiff would have earned no wage even had the accident not occurred and, therefore, is ineligible for work-loss benefits after that date under § 3107(b). [Id., 152.]
Therefore, in order to claim work-loss benefits for the period following the automobile accident, plaintiff here must show that it was the automobile accident, and not the prior workplace accident, that prevented him from working and earning wages. See Williams v
Here, plaintiff asserts that the automobile accident occurred just days before he would have returned to work. However, plaintiff continued to accept worker’s compensation benefits for the industrial accident in the period following the April 1995 automobile accident through the date he returned to work in May 1996. If plaintiff had recovered from the industrial accident, his worker’s compensation benefits should have terminated the day he would have returned to work but for the automobile accident. However, plaintiff continued to accept the benefits for over a year. By continuing to receive the worker’s compensation benefits during this period, plaintiff effectively admitted that his disability was attributable to the industrial accident rather than to the automobile accident. Plaintiff cannot represent to his employer that he is entitled to worker’s compensation disability benefits because of the industrial accident, and simultaneously represent to his no-fault insurer that he is entitled to no-fault wage-loss benefits because of an automobile accident. Consequently, as a matter of law plaintiff cannot demonstrate the expectation of any income he would have received but for the automobile accident.
Plaintiff’s reliance on Brashear v DAIIE, 144 Mich App 667; 375 NW2d 785 (1985), is misplaced. In Brashear, the plaintiff was unable to work full-time for five months after receiving disabling injuries in an automobile accident. Id., 668. Nonetheless, his employer continued to pay his full salary out of the company’s good will. Id. When the plaintiff applied
Neither Brashear nor Spencer is relevant here. In both of those cases, the plaintiffs were able to support their assertions that they were not earning wages because injuries from an automobile accident pre
Plaintiff places undue emphasis on his argument that worker’s compensation benefits are not properly considered wages. In the context of this case, it makes no difference whether the worker’s compensation benefits are characterized as substitute wages or collateral source payments. Either way, plaintiff remains ineligible for no-fault work-loss benefits because he cannot show any loss of wages because of the automobile accident.
Plaintiff also attempts to argue that he is entitled to the no-fault work-loss benefits equal to the differential between his worker’s compensation benefits and his predisability wage. See Popma v Auto Club Ins Ass’n, 446 Mich 460; 521 NW2d 831 (1994), and Kirksey v Manitoba Public Ins Corp, 191 Mich App 12; 477 NW2d 442 (1991). Again, plaintiff’s argument misses the mark. Because plaintiff is precluded from showing that the automobile accident resulted in a total or partial loss of wages, plaintiff is not entitled to any amount of no-fault work-loss benefits.
As an alternative theory for granting defendant’s motion, the trial court found that plaintiff had not actually lost any wages because he received worker’s compensation in lieu of wages.
According to plaintiff, at the time of the fall he had been receiving a weekly wage in excess of $1,400.
In any event, plaintiff’s bare allegation that he would have returned to work is not supported by evidence as required by MCR 2.116(C)(10). At the time of the automobile accident, plaintiff had been unable to work regularly for nearly four years because of the 1991 industrial accident. Plaintiff maintains that he intended to return to work, but he does not support this allegation with anything more than a statement of his subjec
Quoting 14 ULA, Civil Procedural and Remedial Laws, Accident Reparations, Uniform Motor Vehicle Accident Reparations Act, § l(a)(5)(ii),
Dissenting Opinion
(dissenting). I respectfully dissent and would reverse the trial court’s ruling.
Defendant moved for partial summary disposition regarding the work-loss benefits claim, contending that plaintiff’s continued acceptance of worker’s compensation disability benefits until May 1996, well after the automobile accident, constituted an admission on his behalf that he continued to be disabled because of his work-related injury. The trial court granted the motion, essentially ruling that plaintiff had suffered no wage loss because he was collecting worker’s compensation disability benefits and had not attempted to return to work at the time of the automobile accident, and because he continued to receive worker’s compensation disability benefits after the accident.
MCL 500.3107(l)(b); MSA 24.13107(l)(b) provides that work-loss benefits are available for “loss of income from work an injured person would have performed during the first 3 years after the date of the accident if he or she had not been injured.” Our Supreme Court has made clear that work-loss benefits compensate the injured person for income that person would have received but for the accident. Marquis v Hartford Accident & Indemnity (After Remand), 444 Mich 638, 645; 513 NW2d 799 (1994), citing MacDonald v State Farm Mut Ins Co, 419 Mich 146, 152; 350 NW2d 233 (1984); see also Popma v Auto Club Ins Ass’n, 446 Mich 460, 472; 521 NW2d 831 (1994) (work-loss benefits replace income that a claimant would have earned had the claimant not
The trial court erred in ruling that plaintiff suffered no “wage loss” because he was collecting worker’s compensation disability benefits. Receipt of worker’s compensation disability benefits does not preclude plaintiff from recovering work-loss benefits under subsection 3107(l)(b). In Brashear v DAIIE, 144 Mich App 667; 375 NW2d 785 (1985), this Court held that “work loss” as utilized in subsection 3107(l)(b) includes situations in which an injured employee loses time from work that the employee would have performed had he not been injured, even where the employer continues the employee’s wages under a formal wage-continuation plan or as a gratuity. In Brashear, the plaintiff was injured in an automobile accident, was completely off work for nearly four months, and then returned to work on a part-time basis for the following three months. During that period, however, the employer paid the plaintiff his salary because of “good will.” This Court determined that the plaintiff was still entitled to work-loss benefits under subsection 3107(l)(b) because.the statute defines work loss as “loss of income from work an injured person would have performed ... if he or she had not been injured.” (Emphasis added.) Similarly, in Spencer v Hartford Accident & Indemnity Co, 179 Mich App 389, 392; 445 NW2d 520 (1989), this Court held that the plaintiff was entitled to work-loss bene
Accordingly, the trial court’s ruling that plaintiff suffered no wage loss because he received, and continued to receive, worker’s compensation disability benefits is an error of law. Plaintiff is entitled to receive work-loss benefits under subsection 3107(l)(b), even where he received worker’s compensation disability benefits.
In a somewhat different twist, defendant also argues, and the trial court agreed, that plaintiff’s acceptance of worker’s compensation disability benefits after the automobile accident constitutes an admission on his part of a work-related disability that precludes a claim for work-loss benefits under § 3107. In this regard, the trial court ruled that “by continuing to receive worker’s comp, Plaintiff, regardless of the reason that he continued to stay out on comp for several more months, Plaintiff is saying to General Motors that he has a work related injury which doesn’t allow him to return.”
Defendant relies on Williams v DAIIE, 169 Mich App 301; 425 NW2d 534 (1988), to support its contention in this regard. In Williams, the plaintiff suffered an initial on-the-job injury in 1968, and suffered subsequent on-the-job injuries in 1980 and 1981. In July 1982, the plaintiff’s doctor released the plaintiff for return to work with certain restrictions. The plaintiff’s employer did not have a position available with the work restrictions. In August 1982, while on medical
I believe that, unlike the plaintiff in Williams, plaintiff in the present case has set forth sufficient documentary evidence to raise a material factual dispute regarding whether, but for the automobile accident, he would have returned to work. First, the injuries are different and can be attributable to their specific events. The medical records show that the work-related injury involved injury to and ultimately surgery (cervical spinal fusion) to C4, C5, and C6 of plaintiffs neck. The automobile accident involved a hangman’s fracture to C2 and C3 of plaintiff’s neck. A June 8, 1995, letter from John M. Commet, D.O., to Dr. William Moore indicates that shortly after plaintiff was evaluated by Dr. Moore, “it was felt that an evaluation by a work hardening program would be a bene
The patient’s primary clinical finding today is in relationship to a history of a[n] April, 1995 motor vehicle accident which has resulted in a nonwork related C2 fracture. The patient is at this point and time totally and functionally limited. I do not feel that he could resume his prior employment duties as described. His present level of disability is directly related to the motor vehicle accident and not to the July, 1991 work related incident. The patient does require appropriate medical follow-up given this C2 fracture as he has not yet reached the point of maximum medical improvement.
Finally, a letter from Richard J. Kovan, M.D., to Dr. Commet, dated February 14, 1996, states that plaintiff was due to return to work two days after he was involved in the automobile accident.
In the present case, because there is evidence that plaintiff would have returned to work two days after the automobile accident occurred but for the fact that the automobile accident did occur, plaintiff may be entitled to work-loss benefits under subsection 3107(l)(b) of the no-fault act. This is a factual dispute that a trier of fact will have to resolve. Accordingly,
I would reverse and remand for further proceedings.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.