Director, Office of Workers' Compensation Programs, United States Department of Labor v. Cooper Associates, Inc.
Director, Office of Workers' Compensation Programs, United States Department of Labor v. Cooper Associates, Inc.
Opinion of the Court
Opinion for the Court per curiam.
Three questions are presented in this workmen’s compensation case. First, is the
I
At the time of his death, Jacob Cooper (hereinafter Cooper) was an officer and director of a closely held corporation registered as Cooper Associates, Inc., t/a Raymond’s Liquors. His wife was the president and sole shareholder of the corporation. In 1969, Cooper acquired for the corporation a small retail liquor store called Raymond’s Liquors. For the first two years the business prospered. But beginning in 1971 it began to decline. Cooper became very depressed. He underwent psychiatric treatment and took medication. The business continued to decline and Cooper’s psychological problems continued as well. In March, 1974, Cooper was found dead at Raymond’s Liquor store of self-inflicted gunshot wounds.
Mrs. Cooper filed a claim for compensation death benefits on behalf of herself and her daughter Lois. 33 U.S.C. § 909, 36 D.C.Code § 501 et seq. The corporation’s insurer, Hartford Accident and Indemnity Company (hereinafter insurer), opposed the claim. After a hearing, an Administrative Law Judge (ALJ) held that (1) the Cooper family was entitled to the death benefits claimed; (2) the insurer controverted the claim in a timely fashion, and therefore was not required to pay an additional ten percent penalty; and (3) the insurer was not entitled to contribution from the “special fund,” and therefore had to shoulder the full cost of the compensation payments itself.
The insurer appealed to the Benefits Review Board for review of the ALJ’s first and third findings. The Director of the Office of Workers’ Compensation Programs, United States Department of Labor (Director) appealed with respect to the second finding. The Board affirmed the ALJ’s conclusion that the family was entitled to death benefits. But it reversed the ALJ and imposed the ten percent penalty. And the Board also reversed the ALJ on the “special fund” question, holding that the insurer is entitled to contribution under section 8(f).
Both the insurer and the Director petition for review of the Benefits Review Board decision. The insurer argues that the Cooper family is not entitled to death benefits, and that even if they are entitled, the Board erred when it imposed the ten percent penalty. The Director contends that the insurer has no right to contribution from the “special fund.”
II
1. The insurer argues that the Cooper family is not entitled to receive death benefits for three reasons. First Cooper was not an “employee,” and therefore was not covered by the Compensation Act.
2. An employer must pay a ten percent penalty on all late compensation payments unless he controverted claimant’s right to compensation “[within] fourtee[n] day[s] after he [employer] ha[d] knowledge of the alleged injury or death . . . .” 33 U.S.C. § 914(d), (e) (1977). In the instant case, the employer knew of Cooper’s death on March 25, 1974, but the insurer did not controvert the family’s right to compensation until March 12, 1975, almost one year later. Initially therefore, the ALJ ordered the insurer to “pay a ten percent penalty on all installments of compensation not paid when due. . . . ”
The Benefits Review Board reversed. First, it pointed out that
[u]nder the Act, the fourteen day period within which notice of controversion must be filed begins on the date the employer first has knowledge of the injury or death, not the day of receipt of notice that the death was reported to have occurred in the course of employment.9
Second, the Board stated that under section 35 of the Compensation Act, 33 U.S.C. § 935 (1977), “notice to or knowledge of an employer of the occurrence of the injury shall be notice to or knowledge of the carrier [insurer] . . .
The insurer argues that the Board’s decision should be reversed for three reasons. As a threshold matter, the insurer contends that the Director lacked standing to appeal the section 14(e) issue to the Benefits Review Board. This argument is wholly without merit. The Board’s regulations provide that an appeal may be taken by the “Secretary or his designee.”
the Section 14(e) issue is a substantial legal issue which affects the proper administration of the Act. The determination of whether or not to access the penalty under a particular set of circumstances impacts the Act’s underlying policy of encouraging voluntary payment of compensation to the injured employees. Therefore, this issue is properly raised on appeal by the Director.
Berger v. Cork ‘n’ Bottle, 4 BRBS 339, 341 (1976).
The insurer also asserts that the section 14(e) issue was waived by both the family and the Director because neither contested the insurer’s motion for reconsideration before the ALJ. We disagree. The Board’s regulations do not require a response to request for reconsideration,
Finally, the insurer argues that the Board erred in imposing the penalty. The insurer’s contention has three strands. First, the insurer asserts that the Board “fail[ed] to specifically address Judge Edward’s findings that the circumstances presented were such as to excuse the employer’s failure to file a timely notice of controversion. . . ”
Second, the insurer asserts that it would be unfair to impute the employer’s knowledge to the insurer in this case. While normally the employer’s interest would converge with those of its insurer, in this case the employer (Mrs. Cooper) would benefit from the imposition of the section 14(e) penalty. This argument is reasonable, and if it were necessary to the outcome of this case we would seriously consider making an exception to the statutory rule that an employer’s knowledge is always imputed to his insurer.
Third, the insurer suggests that it would be unfair to impose the penalty because “there was a substantial and serious question as to the circumstances surrounding Mr. Cooper’s death . . . and its possible attribution to his employment.”
In short, since the insurer did not controvert the claim within fourteen days of when it had actual knowledge of Cooper’s death, we hold that the Board properly imposed the penalty under section 14(e).
3. Section 8(f) of the Workers’ Compensation Act, 33 U.S.C. § 908(f) (1977), provides that when the consequences of an employee’s work-related injury are exacerbated because of that employee’s pre-existing permanent partial disability, the employer’s compensation liability is limited. The employer is responsible for compensation payments for only 104 weeks; thereafter a “special fund,” created pursuant to section 44 of the Act, 33 U.S.C. § 944 (1977), is liable for the payments.
The AU held that the insurer was not entitled to contribution from the special fund. He noted that section 8(f) does not apply unless the employee suffered two injuries, and he found only one continuing injury here.
[Ujnder C & P Telephone [Company v. Director, Office of Workers’ Compensation Programs [184 U.S.App.D.C. 18], 564 F.2d 503 (D.C.Cir. 1977)] the holding that Section 8(f) is inapplicable is incorrect. The Court in that case concluded that a work-related aggravation of a pre-exist-, ing condition may constitute a second injury for the purposes of Section 8(f). The overwhelming exacerbation of the decedent’s pre-existing mental condition which the administrative law judge found resulted in the decedent’s demise constituted sufficient injury to make applicable Section 8(f). See also Brannon v. Potomac Electric Power Co., 6 BRBS 527 . . . (Aug. 26, 1977).25
In effect, the Board held that each day Cooper went to work constituted a discrete, identifiable injury.
We are not persuaded by the Board’s rather metaphysical analysis. It is apparent from the record that “the suicide resulted from a single injury or disability, namely, distress over the continuing failure of the corporate business enterprise. . ,”
Brannon, supra, which we decide today,
The record here establishes that Cooper’s suicide was the result of his depression over his continuing business failure. C & P Telephone and Brannon are distinguishable because in each of those cases it was conceded that there were two separate injuries. The Board erred, therefore, when it held that section 8(f) was applicable here because it was applicable in those cases. Accordingly, we reverse the Board and hold that the insurer is not entitled to the limited liability provisions of section 8(f).
Ill
In summary, we affirm the Board’s determination that Cooper’s family is entitled to compensation benefits, and that the insurer is liable for the ten percent penalty under section 14(e). We reverse the Board’s conclusion that the insurer is entitled to contribution from the “special fund,” however; since there was only one continuing injury in this case, the insurer must shoulder the entire cost of Cooper’s family’s claim.
Judgment accordingly.
. 36 D.C.Code § 501 (1973) provides that the provisions of 33 U.S.C. § 901 et seq. “shall apply in respect to the injury or death of an employee of an employer carrying on any employment in the District of Columbia.”
. Death benefits are only payable to the family of an “employee.” E. g., 36 D.C.Code § 501; 33 U.S.C. § 909.
. 33 U.S.C. § 902(2) (1977). In O’Leary v. Brown-Pacific-Maxon, 340 U.S. 504, 506-07, 71 S.Ct. 470, 471-72, 95 L.Ed. 483 (1951) the Court stated:
The test of recovery is not a causal relation between the nature of employment of the injured person and the accident. Nor is it necessary that the employee be engaged at the time of the injury in activity of benefit to his employer. All that is required is that the “obligations or conditions” of employment create the “zone of special danger” out of which the injury arose.
. 33 U.S.C. § 903(b) (1977) (“No compensation shall be payable if the injury was occasioned solely by the . . willful intention of the employee to injure or kill himself . . . .”).
. App. 98-101 (ALJ’s Decision and Order); App. 115-20 (Benefits Review Board Decision).
. Banks v. Chicago Grain Trimmers Ass’n, Inc., 390 U.S. 459, 467, 88 S.Ct. 1140, 1145, 20 L.Ed.2d 30 (1968) (“The Deputy Commissioner’s finding . . that there was a causal connection between the work-connected injury suffered by the petitioner’s husband . . and his fall at home some two hours later . . must be affirmed if supported by substantial evidence on the record considered as a whole.”); O’Keeffe v. Smith Associates, 380 U.S. 359, 363, 85 S.Ct. 1012, 1015, 13 L.Ed.2d 895 (1965) (“While this Court may not have reached the same conclusion as the Deputy Commissioner, it cannot be said that his holding that the decedent’s death arose out of and in the course of his employment is irrational or without substantial evidence on the record as a whole.”); O'Leary v. Brown-Pacific-Maxon, supra, 340 U.S. at 508, 71 S.Ct. at 472 (“the findings are to be accepted unless they are unsupported by substantial evidence on the record considered as a whole.”).
. App. 105.
. App. 107 (ALJ’s Supplemental Decision and Order).
. App. 123 (emphasis added).
. App. 123-24.
. Id. 124.
. “Any party in interest adversely affected or aggrieved by a decision or order issued pursuant to one of the Acts may appeal such decision or order to the Board. . . . ” 20 C.F.R. § 802.201(a). “ ‘Party’ or ‘Party in interest’ means the Secretary or his designee and any person or business entity aggrieved or directly
. 20 C.F.R. §§ 802.407-802.409.
. See, e. g., Fed.R.App.P. 40(a) (“No answer to a petition for rehearing will be received unless requested by the court . . .”).
. Harris v. Marine Terminals Corp., 8 BRBS 712, 714 (1978).
. Laber v. Sun Shipbuilding and Dry Dock Co., 7 BRBS 956, 957 (1978); Reed v. Sun Shipbuilding and Dry Dock Co., 4 BRBS 130, 134 (1976).
. Insurer’s Br. 50.
. App. 107-08 (ALJ’s Supplemental Decision and Order).
. 33 U.S.C. § 935 (1977).
. “As the record reflects, Jacob Cooper committed suicide on March 25, 1974. (J.A. 97) Three days later the decedent’s nephew, attorney Steven M. Cooper, wrote to Hartford Accident and Indemnity Company, the workmen’s compensation carrier for Cooper Associates, [and] advised that Jacob Cooper had died. .” Insurer’s Br. 45.
. Insurer’s Br. 51.
. See O’Leary v. Southeast Stevedore Co., 3 BRBS 419 (1976).
. The purpose of § 8(f) is explained in Director, Office of Workers’ Compensation Programs, U.S. Dept. of Labor v. PEPCO, 197 U.S.App.D.C. 193, 607 F.2d 1378 (D.C.Cir. 1979), which is decided today, and discussed infra page 206 of 197 U.S.App.D.C., page 1391 of 607 F.2d.
. App. 104.
. App. 121.
. App. 102.
. Director v. PEPCO, supra.
Reference
- Full Case Name
- DIRECTOR, OFFICE OF WORKERS' COMPENSATION PROGRAMS, UNITED STATES DEPARTMENT OF LABOR v. COOPER ASSOCIATES, INC. t/a Raymond's Liquors and Hartford Accident and Indemnity Company, Respondents COOPER ASSOCIATES, INC. t/a Raymond's Liquors and Hartford Accident and Indemnity Company v. Janet COOPER and Lois Cooper and Director, Office of Workers' Compensation Programs, United States Department of Labor
- Cited By
- 1 case
- Status
- Published