Opinion
W.C. No. 2-896-485
July 12, 1995
FINAL ORDER
The claimant seeks review of a final order of Administrative Law Judge Gandy (ALJ) which reopened the claim for workers' compensation death benefits, and permitted the respondents to offset benefits based on the claimant's receipt of social security disability "widow's benefits." We affirm.
The essential facts are not in dispute. The decedent died as a result of an industrial accident in August 1977. The claimant, the decedent's spouse, became entitled to workers' compensation death benefits under former § 8-50-103, C.R.S. (1986 Repl. Vol. 3B) [currently codified with changes at § 8-42-114, C.R.S. (1994 Cum. Supp.)].
Eventually, the claimant became entitled to the "widow's benefit" payable under the Social Security Act. A dispute then arose concerning whether or not § 8-50-103 authorized the respondents to offset the widow's benefit against the workers' compensation death benefits. In an order dated June 26, 1984, the ALJ held that the respondents were entitled to claim an offset. The Industrial Commission reversed the ALJ's order, holding that the widow's benefit was not a "periodic death benefit" within the meaning of § 8-50-103.
The decision of the Industrial Commission was affirmed by the Court of Appeals in Larimer County School District Poudre R-1 v. Industrial Commission, 727 P.2d 401(Colo.App. 1986). Although the Supreme Court initially granted the respondents' petition for writ of certiorari, the petition was subsequently dismissed as improvidently granted.
On January 31, 1994, our Supreme Court announced its decision in L.E.L. Construction v. Goode, 867 P.2d 875, (Colo.App. 1994). The precise holding in Goode was that the social security "mother's benefit" constitutes a "periodic death benefit" for purposes of § 8-50-103 and § 8-42-114. However, in a footnote, the court "disapproved" of the decision in Larimer County School District Poudre R-1 v. Industrial Commission, supra. It is apparent from the footnote and text of the Goode decision that the Supreme Court considers the "widow's benefit" to be a form of "periodic death benefit" within the meaning of § 8-50-103. 867 P.2d at 878, n. 5.
On July 14, 1994, the respondents filed an admission of liability claiming the right to offset the widow's benefits against the claimant's death benefits. The respondents also filed a petition to reopen claiming entitlement to the offset.
In an order dated January 4, 1995, the ALJ granted the petition to reopen on the ground that the initial denial of the offset constituted a "mistake of law." Consequently, the ALJ granted the respondents an offset from the date of the hearing, December 9, 1994.
In reaching this result, the ALJ indicated that he believed the claimant's testimony that allowing the offset would work a "financial hardship" on her. However, the ALJ stated that § 8-50-103 does not permit him to consider this factor.
I.
On review, the claimant's first contention is that the ALJ lacked jurisdiction to reopen the claim. Specifically, the claimant asserts that the decision in Larimer County School District Poudre R-1 v. Industrial Commission, supra, is " res judicata" or "law of the case," and the ALJ exceeded his jurisdiction by purporting to modify a final judgment of the Court of Appeals. We reject this argument.
Under the statute currently codified at § 8-43-303(1), C.R.S. (1994 Cum. Supp.), an ALJ may "reopen any award on the ground of an error, a mistake, or a change in condition." The term "mistake" includes a mistake of fact or law. Gregorich v. Industrial Commission, 117 Colo. 423, 188 P.2d 886 (1948).
It is true that principles including res judicata and "law of the case" apply in administrative proceedings. However, the statutory power to reopen is indicative of a legislative policy that, in workers' compensation cases, the goal of "achieving a just result overrides the interest of litigants in obtaining final resolution of their dispute." Standard Metals Corp. v. Gallegos, 781 P.2d 142, 145 (Colo.App. 1989). Thus, an award of benefits in a workers' compensation case is final only to the extent that the matter has been concluded, and not reopened. Padilla v. Industrial Commission, 696 P.2d 273 (Colo. 1985).
The fact that an initial award of benefits has been approved by an appellate court, as opposed to a final administrative ruling, is of no significance when an ALJ is asked to reopen a claim based on mistake of law. In Gregorich v. Industrial Commission, supra, our Supreme Court upheld the reopening of a claim which had been denied based on a mistaken application of the statute of limitations. The reopening was approved despite the fact that the initial denial of the claim was upheld by a District Court, and the Supreme Court itself. The following language from the Gregorich decision is pertinent:
"In the instant case, the commission and trial court not only were mistaken in assuming that the commission had no authority to reopen the proceedings because of our opinion in the Gregorich case, supra, but the commission was further mistaken when it said in its supplemental order that the claimant was `not paid compensation on account of the said injury.'"
It follows that the ALJ did not lack jurisdiction to reopen the claim based upon mistake of law. The ALJ had express statutory authority to determine whether the prior decision denying the offset was mistaken as a matter of law. The mere fact that the Court of Appeals, and indirectly the Supreme Court, previously denied the offset did not abrogate the ALJ's statutory authority. Gregorich v. Industrial Commission, supra; Berkley Moving and Storage Co. v. Eubank, 37 Colo. App. 299, 546 P.2d 961 (1976), aff'd., 193 Colo. 334, 566 P.2d 359 (1977).
II.
The claimant next contends that the ALJ erred in determining that the Larimer County School District Poudre R-1 decision created a "mistake of law." In any event, the claimant asserts that the ALJ abused his discretion in reopening the claim considering the "hardship" the claimant will experience if the offset is allowed. We reject these arguments.
The reopening statute is "permissive" and gives the ALJ discretion to reopen a claim when he concludes that a prior decision was wrong because of a mistake. Industrial Commission v. Cutshall, 164 Colo. 240, 433 P.2d 765 (1967); State Compensation Insurance Fund v. Industrial Commission, 80 Colo. 130, 249 P. 653 (1926). When considering whether to reopen, the ALJ is required to determine "whether a mistake was made, and if so, whether it was the type of mistake which justifies reopening." Travelers Insurance Co. v. Industrial Commission, 646 P.2d 399, 400 (Colo.App. 1981). The ALJ's authority to reopen is broad, and we may not interfere with the decision unless there has been fraud or an abuse of discretion. Osborne v. Industrial Commission, 725 P.2d 63 (Colo.App. 1986).
Here, the ALJ did not abuse his discretion in determining that the Larimer County decision was "mistaken" with respect to the respondents' right to offset the widow's benefit against the claimant's death benefits. The Supreme Court's decision in Goode indicates, in no uncertain terms, that the Court of Appeals' decision in Larimer County was inconsistent with the express language of § 8-50-103, as well as the legislative history underlying the offset statute. Thus, the record amply supports the ALJ's determination that the prior denial of the offset was mistaken as a matter of law.
Further, the ALJ did not abuse his discretion in granting the petition to reopen. The ALJ conceded that allowing the offset will cause some financial hardship to the claimant. However, the ALJ was not required to conclude that this hardship outweighs the express statutory direction that death benefits be reduced on account of the claimant's receipt of the widow's benefit. This is particularly true in view of the strong legislative policies underlying enactment of the offset provision, and the fact that the claimant has already received more benefits than she is entitled to.
In reaching this result, we recognize that, under certain circumstances, equitable principles may abrogate the statutory right of offset. See Johnson v. Industrial Commission, 761 P.2d 1140 (Colo. 1988). However, the claimant has not cited any specific equitable principle, such as waiver or estoppel, which would operate to bar the respondents' right to an offset under the facts of this case. In fact, the respondents vigorously asserted their claim of offset prior to the Court of Appeals decision in Larimer County. Further, the respondents promptly asserted their right to an offset subsequent to the decision in L.E.L. Construction v. Goode. We agree with the ALJ that economic hardship, in and of itself, is an insufficient basis for granting equitable relief.
The claimant does argue that the respondents improperly claimed the offset by filing an admission of liability. However, the ALJ remedied any potential problem by granting the offset from the date of the hearing, not the date of the admission.
III.
The claimant's final condition is that the ALJ erred in "retroactively" applying L.E.L. Construction v. Goode. This contention is without merit.
A judicial opinion is applied "retroactively" when it is held to affect a transaction which occurred prior to the announcement of the decision. See Loffland Brothers Co. v. Industrial Claim Appeals Office, 754 P.2d 768 (Colo.App. 1988), aff'd., Loffland Brothers Co. v. Industrial Claim Appeals Office, 770 P.2d 1221 (Colo. 1989). A judicial decision is applied "prospectively" where it only affects rights and liabilities incurred after the date of the decision. See Marinez v. Industrial Commission, 746 P.2d 552 (Colo. 1987) .
Here, the ALJ's order does not purport to affect the claimant's entitlement to benefits prior to the date of the hearing on the respondents' petition to reopen. Thus, the ALJ has not attempted to apply L.E.L. Construction v. Goode so as to deprive the claimant of any benefits which she received prior to the date the Goode decision was announced. Rather, the ALJ's application of Goode is purely prospective, and raises no issue of retroactivity.
IT IS THEREFORE ORDERED that the ALJ's order, dated January 4, 1995, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
___________________________________ David Cain
___________________________________ Bill WhitacreNOTICE
This Order is final unless an action to modify or vacate the Order is commenced in the Colorado Court of Appeals, 2 East 14th Avenue, Denver, Colorado 80203, by filing a petition to review with the court, with service of a copy of the petition upon the Industrial Claim Appeals Office and all other parties, within twenty (20) days after the date the Order was mailed, pursuant to §§ 8-43-301(10) and 307, C.R.S. (1995 Cum. Supp.).
Copies of this decision were mailed July 12, 1995 to the following parties:
Gladys Renz, 613 Griffin Pl., Ft. Collins, CO 80521-1819
Larimer County School District Poudre R-1, 2407 Laporte Ave., Ft. Collins, CO 80521
Colorado Compensation Insurance Authority, Attn: P. Tochtrop, Esq. (Interagency Mail)
Timms R. Fowler, Esq. Alden T. Hill, Esq., 160 West Mountain Ave., P.O. Box 421, Ft. Collins, CO 80522 (For the Claimant)
Douglas P. Ruegsegger, Esq. and Michael Goodman, Esq., 1700 Broadway, Ste. 1700, Denver, CO 80290-8013 (For the Respondents)
John D. Baird, Esq., First Assistant Attorney General, 1525 Sherman St., 5th Flr., Denver, CO 80203
Mark W. Gerganoff, Esq., Assistant Attorney General, 1525 Sherman St., 5th Flr., Denver, CO 80203
By: _________________________