52-1-47.  Limitations on compensation benefits.

Amendment Notes.

Notes to Decisions

      Generally.

Payments of benefits to an employee for a subsequent injury did not create a double recovery disqualifying him for workers’ compensation benefits for a prior injury; former 59-10-18.8D, 1953 Comp. did not apply to a situation where benefits were received from a subsequent injury and not a prior injury. Maes v. John C. Cornell, Inc., 1974-NMCA-061, 86 N.M. 393, 524 P.2d 1009, 1974 N.M. App. LEXIS 672 (N.M. Ct. App. 1974).

      Aggravation of previous injury.

This section is operative where an employer or insurer has paid or must pay a worker for medical benefits or disability compensation for a prior accidental injury when the worker has suffered an aggravation or later injury to the same member or function and the compensation benefits payable on account of the subsequent injury would, in whole or in part, duplicate the benefits paid or payable on account of such prior injury. Tom Growney Equip. Co. v. Jouett, 2005-NMSC-015, 137 N.M. 497, 113 P.3d 320, 2005 N.M. LEXIS 292 (N.M. 2005).

      Applicability.

      Burden of proof.

Where a reduction is sought under 52-1-47D NMSA 1978, the burden of proof to establish a right to a deduction is ordinarily shared by the second employer and the New Mexico Subsequent Injury Fund (Fund). Where the second employer withdraws its request for credit at the beginning of trial, the Fund had the burden to establish both its right to a reduction and the amount of the reduction. Lea County Good Samaritan Village v. Wojcik, 1988-NMCA-102, 108 N.M. 76, 766 P.2d 920, 1988 N.M. App. LEXIS 107 (N.M. Ct. App. 1988).

      Compensation.

      Construction.

      Construction with other law.

Pursuant to former 52-2-11A NMSA 1978, an employer or its insurer is solely responsible for the payment of workmen’s compensation benefits for the first eight weeks of a worker’s disability, and is not entitled to reimbursement from the New Mexico Subsequent Injury Fund for that period; thereafter, liability between the Fund and the employer is controlled by the apportionment ordered by a court, and the employer is entitled to reimbursement to the extent that it paid in excess of its apportioned liability, pursuant to former 52-2-11B NMSA 1978. Mares v. Valencia County Sheriff's Dep't, 1988-NMCA-003, 106 N.M. 744, 749 P.2d 1123, 1988 N.M. App. LEXIS 2 (N.M. Ct. App. 1988).

      Contribution.

Where an employee was injured but not disabled while working for a first employer, then his injury was aggravated while working for the second and third employers, there could not be contribution from the three employers based on theories outside workers’ compensation law because workers’ compensation is an exclusive remedy under 52-1-6E NMSA 1978, although this section allowed a subsequent employer to reduce its payments to avoid overlap of an initial employer’s payments. The liability of the employer(s) depended on when the employee’s disability began, and whether there was proper notice under 52-1-29A NMSA 1978. Tom Growney Equip. Co. v. Jouett, 2005-NMSC-015, 137 N.M. 497, 113 P.3d 320, 2005 N.M. LEXIS 292 (N.M. 2005).

      Credit/reduction amount.

      Death.

Under the clear language of 52-1-47C NMSA 1978, disability compensation benefits terminate upon the death of an injured workman; therefore, in a widow’s action against the compensation carrier for her husband’s employer, alleging that a settlement agreement had been reached between the carrier and her husband’s attorney for a lump-sum payment of weekly payments of total permanent disability compensation, the carrier’s obligation to pay benefits ceased and the attorney’s agency terminated when the husband died from an unrelated disease during the negotiations. Brazfield v. Mountain States Mut. Casualty Co., 1979-NMCA-100, 93 N.M. 417, 600 P.2d 1207, 1979 N.M. App. LEXIS 705 (N.M. Ct. App.), cert. denied, 93 N.M. 205, 598 P.2d 1165, 1979 N.M. LEXIS 1379 (N.M. 1979).

      Double recovery.

      Error.

Workers’ compensation judge (WCJ) erred when she assessed all liability for future medical expenses against a worker’s current employer in light of the WCJ’s finding that the worker’s disability was caused by both a prior accident at the worker’s previous employer and by the subsequent accident at the worker’s current employer. McMains v. Aztec Well Serv., 1994-NMCA-126, 119 N.M. 22, 888 P.2d 468, 1994 N.M. App. LEXIS 162 (N.M. Ct. App. 1994).

      Evidence.

           —Insufficient.

Facts recited by an employer and its insurer in the memorandum they presented at a hearing did not constitute valid evidence to support the granting of an offset of workers’ compensation benefits under 52-1-47D NMSA 1978. Munoz v. Deming Truck Terminal, 1990-NMCA-084, 110 N.M. 537, 797 P.2d 987, 1990 N.M. App. LEXIS 84 (N.M. Ct. App. 1990).

Employer and insurer failed to prove that they were entitled under 52-1-47D NMSA 1978 to deduct from a permanent disability award prior payments made to a workers’ compensation claimant because there was no overlap with the first of these awards and the employer and insurer failed to demonstrate the specific basis for any compensation payments which were then being received by the claimant pursuant to prior settlement awards, did not present evidence indicating the total amount of any weekly payments then being received by the claimant, and failed to establish the extent to which payments for the last disability duplicated payments being received by the claimant under prior awards of disability. Munoz v. Deming Truck Terminal, 1990-NMCA-084, 110 N.M. 537, 797 P.2d 987, 1990 N.M. App. LEXIS 84 (N.M. Ct. App. 1990).

           —Sufficient.

Apportionment ruling in a workers’ compensation action after the worker suffered two injuries to her back was appropriate because a doctor’s testimony that surgery would not have been necessary had the worker not suffered her second injury was evidence that a reasonable mind could have accepted as adequate to support the workers’ compensation judge’s decision. Leonard v. Payday Prof'l, 2007-NMCA-128, 142 N.M. 605, 168 P.3d 177, 2007 N.M. App. LEXIS 103 (N.M. Ct. App. 2007).

In a workers’ compensation action, an award of permanent partial, partial temporary, and temporary total disability under 52-1-47D NMSA 1978 was granted because the evidence was substantial to support the finding that the injury was a result of a work-related accident. Smith v. Trailways Bus Sys., 1981-NMCA-041, 96 N.M. 79, 628 P.2d 324, 1981 N.M. App. LEXIS 717 (N.M. Ct. App. 1981).

      Findings.

There was substantial evidence in the record as a whole to support the determination of a workers’ compensation judge that a worker’s disability was materially and substantially greater as a result of the combination of an earlier impairment and a second accident than it would have been as a result of the later accident alone. Kennecott Copper Corp. v. Chavez, 1990-NMCA-133, 111 N.M. 366, 805 P.2d 633, 1990 N.M. App. LEXIS 146 (N.M. Ct. App. 1990).

      Future medical benefits.

Pursuant to 52-1-47D NMSA 1978, future medical benefits cannot be denied in a workers’ compensation proceeding based solely on a prediction regarding future medical needs. McMains v. Aztec Well Serv., 1994-NMCA-126, 119 N.M. 22, 888 P.2d 468, 1994 N.M. App. LEXIS 162 (N.M. Ct. App. 1994).

      Jurisdiction.

      Legislative intent.

Manifest intent of 52-1-47C NMSA 1978 providing that compensation benefits shall cease when the disability ends prevails over any contradictory statutory provision because it is a later declaration of legislative intent and effectively repeals by implication the earlier conflicting legislative language. Jaramillo v. Kaufman Plumbing & Heating Co., 1985-NMSC-089, 103 N.M. 400, 708 P.2d 312, 1985 N.M. LEXIS 2004 (N.M. 1985).

      Liability.

Workers’ compensation judge erred in ordering a current employer to pay for all future medical care required as a result of one of its employee’s work injuries, without any contribution from the employee’s previous employer, because the current employer was entitled to a reduction in its liability under 52-1-47D NMSA 1978, to the extent that future medical expenses were necessary as a result of the employee’s accident at the previous employer’s. McMains v. Aztec Well Serv., 1994-NMCA-126, 119 N.M. 22, 888 P.2d 468, 1994 N.M. App. LEXIS 162 (N.M. Ct. App. 1994).

Under 52-1-47D NMSA 1978, to the extent that future medical expenses were necessary as a result of a worker’s accident with a previous employer, the worker’s current employer was entitled to a reduction in its liability. McMains v. Aztec Well Serv., 1994-NMCA-126, 119 N.M. 22, 888 P.2d 468, 1994 N.M. App. LEXIS 162 (N.M. Ct. App. 1994).

      Multiple payees.

      Payee classes.

      Reduction in benefits for subsequent disability.

Second insurance company, which insured an employee who was injured two times, was, under 52-1-47D NMSA 1978, entitled to a reduction in benefits payable for the employee’s second accidental work-related injury as the statute provided for a reduction in benefits payable for a second disability resulting from a prior accidental injury if the compensation benefits payable on account of the subsequent injury would wholly or partially duplicate the benefits paid or payable on account of such prior injury involving the same member or function or different parts of the same member or function. Gonzales v. Stanke-Brown & Assocs., 1982-NMCA-109, 98 N.M. 379, 648 P.2d 1192, 1982 N.M. App. LEXIS 901 (N.M. Ct. App. 1982).

      Right to credit/reduction.

      Settlements.

Failure of a settlement, or an order approving a settlement, to itemize the particular components of a workers’ compensation award will not foreclose the New Mexico Subsequent Injury Fund from presenting evidence in order to secure a reduction in appropriate cases and to prevent double recovery. A court-approved settlement is, in legal effect, a final award of compensation and may be used to determine the right of a party to a deduction. Lea County Good Samaritan Village v. Wojcik, 1988-NMCA-102, 108 N.M. 76, 766 P.2d 920, 1988 N.M. App. LEXIS 107 (N.M. Ct. App. 1988).

           —Intent of parties.

      Subsequent injury.

52-1-47D NMSA 1978 provides for a reduction in benefits payable for a second disability resulting from an accidental injury to the extent of benefits paid or payable for a disability resulting from a prior accidental injury. Thus, if an employee has previously sustained a compensable injury under the Workers’ Compensation Act and has been awarded benefits and thereafter suffers a subsequent injury involving the same members or functions, neither the employer at the time of the second accident nor the New Mexico Subsequent Injury Fund are liable for any impairment for which the worker has already been compensated. Lea County Good Samaritan Village v. Wojcik, 1988-NMCA-102, 108 N.M. 76, 766 P.2d 920, 1988 N.M. App. LEXIS 107 (N.M. Ct. App. 1988).

      Summary judgment.

Summary dismissal of a subsequent insurer in a workmen’s compensation case where an original insurer and the subsequent insurer were named was error because there was a genuine material issue of fact whether the worker’s initial injury was aggravated or accelerated by his continued work with the employer during a time when the employer was insured by the subsequent insurer. Pena v. New Mexico Highway Dep't, 1983-NMCA-111, 100 N.M. 408, 671 P.2d 656, 1983 N.M. App. LEXIS 778 (N.M. Ct. App. 1983).

      Workers’ compensation.

In awarding an employee workers’ compensation for an injury to her back, a trial court properly determined the proper amount offset under 52-1-47D NMSA 1978 with respect to the medical expenses awarded for her surgery when the trial court had the authority to consider evidence of the parties’ intent at the time the settlement agreement was approved regarding the allocation of specific benefits in the settlement. under 52-1-47D NMSA 1978 where the employee had received a prior settlement providing for the possibility of the surgery. Brewster v. Cooley & Assocs., 1993-NMCA-154, 116 N.M. 681, 866 P.2d 409, 1993 N.M. App. LEXIS 144 (N.M. Ct. App. 1993).

In awarding an employee workers’ compensation for an injury to her back, a trial court properly offset the medical expenses awarded for her surgery under 52-1-47D NMSA 1978 where the employee had received a prior settlement providing for the possibility of the surgery and where substantial evidence supported the trial court’s decision to offset the employee’s award. Brewster v. Cooley & Assocs., 1993-NMCA-154, 116 N.M. 681, 866 P.2d 409, 1993 N.M. App. LEXIS 144 (N.M. Ct. App. 1993).

Under 52-1-47D NMSA 1978, an order that authorized a deduction from the claimant’s prior workers’ compensation award was improper because the employer and the insurance company failed to prove that duplicative payments were made to the claimant. Munoz v. Deming Truck Terminal, 1990-NMCA-084, 110 N.M. 537, 797 P.2d 987, 1990 N.M. App. LEXIS 84 (N.M. Ct. App. 1990).

Where successive injuries to a workers’ compensation claimant were to different parts of his body, his employer and insurer were not entitled under 52-1-47D NMSA 1978 to offset payments made on account of the first injury against payments made for the second. Munoz v. Deming Truck Terminal, 1990-NMCA-084, 110 N.M. 537, 797 P.2d 987, 1990 N.M. App. LEXIS 84 (N.M. Ct. App. 1990).