SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-612-97T3
IN THE MATTER OF
CHARLES D. SCOTT
_________________________________________________________________
Argued March 17, 1999 - Decided April 27, 1999
Before Judges Stern, Landau and Wecker.
On appeal from the State of New Jersey,
Department of Labor, Board of Review.
Paul A. Schwartz argued the cause for appellant
Charles D. Scott (Goldstein, Ballen, O'Rourke &
Wildstein, attorneys; Mr. Schwartz, on the brief).
Rosalind E. Asch argued the cause for respondents
Konica Business Machines and Zurich-American
Insurance Group (Ms. Asch, on the brief).
The opinion of the court was delivered by
STERN, P.J.A.D.
This appeal presents a previously unresolved issue arising
out of the interplay between the Workers' Compensation Law,
N.J.S.A. 34:15-1 et seq., and the Temporary Disability Benefits
Law, N.J.S.A. 43:21-25 et seq. The claimant, Charles D. Scott,
held two jobs and, as a result of an injury "arising out of and
in the course of" (N.J.S.A. 34:15-7) his part-time employment,
seeks both workers' compensation from that employer and temporary
disability benefits under the full-time employer's private
disability plan. Recently, a divided Supreme Court, adopting the
majority opinion of a panel of this court, held that an
individual who obtains workers' compensation benefits by
settlement "may not obtain temporary disability benefits for the
same injury." Sperling v. Board of Review,
301 N.J. Super. 1, 5
(App. Div. 1997), aff'd o.b.,
156 N.J. 466 (1998). It was
explained that, by virtue of N.J.S.A. 34:15-20, even a settlement
"constitutes an implied acknowledgment that the claimant's
disability was work-related and compensable under the Workers'
Compensation Act," Sperling, supra, 301 N.J. Super. at 5; and
N.J.S.A. 43:21-29 and -30 prohibit the receipt of both temporary
disability and workers' compensation benefits for the same
accident. We must now decide if Scott's entitlement to workers'
compensation benefits for part-time work precludes his recovery
of temporary disability benefits for his full-time employment.
Scott appeals from an order of a private plan hearing
officer of the Board of Review determining that he is "ineligible
for disability benefits under the Employer's (employer #1)
[Konica Business Machines'] approved Private Plan from April 8,
1997 through July 15, 1997 as payment would be a duplication of
benefits under N.J.S.A. 43:21-30." Scott, who was injured during
work for a part-time employer, Holiday Bowl, Inc. ("employer
#2"), on October 28, 1995, claimed that he "should be entitled to
private plan disability benefits from his full-time job [as] he
is unable to work at that job."
The facts are not in dispute. Accordingly, we adopt them as
embodied in the decision of the private plan hearing officer:
The claimant was last employed as a
copier technician on a full-time basis for
employer #1 from April 2, 1988 through April
7, 1997 at a final weekly salary of $523.50.
The claimant was also employed on a
part-time basis for employer #2 from March
1994 though April 6, 1997 as a desk
attendant. He had an average weekly wage of
$208.25. He was injured on the job on
October 28, 1995 at which time he crushed his
hand while working with employer #2. The
claimant had reconstructive surgery in the
form of a tendon transplant performed on
April 8, 1997 and was unable to work at
either job through July 15, 1997. He has
been released to work by Dr. Wayne Altman on
July 16, 1997. The claimant has received
$145.77 per week as a temporary settlement
from employer #2's insurance carrier and will
receive 66.15 weeks at $125 per week as he
had permanent residuals as a result of his
injuries.
The Worker's Compensation claim was not
contested and the certification for contested
Worker's Compensation form was not submitted
by the claimant's attorney.See footnote 1
The private plan hearing officer concluded that because "claimant
suffered from a disabling injury in an accident arising out of
and in the course of his employment with employer #2 [Holiday
Bowl] which resulted in his total inability to perform the duties
of his employment," the claimant was "ineligible for disability
benefits" in light of N.J.S.A. 43:21-30. That statute, entitled
"nonduplication of benefits," provides:
No benefits shall be required or paid under
this act for any period with respect to which
benefits are paid or payable under any
unemployment compensation or similar law, or
under any disability or cash sickness benefit
or similar law, of this State or of any other
State or of the Federal Government. Nor
shall any benefits be required or paid under
this act for any period with respect to which
benefits, other than benefits for permanent
partial or permanent total disability
previously incurred, are paid or payable on
account of the disability of the covered
individual under any workmen's compensation
law, occupational disease law, or similar
legislation, of this State or of any other
State or the Federal Government. ...
Konica's disability carrier opposes the payment of any
temporary disability benefits from its private plan because such
benefits are payable only for injuries "not compensable under the
workers' compensation law," N.J.S.A. 43:21-29. As Scott obtained
workers' compensation (including "medical benefits and temporary
disability benefits") from Holiday Bowl, Konica argues that
N.J.S.A. 43:21-29 and -30 prohibit the payment of any temporary
disability benefits to Scott because he received benefits "under
the workers' compensation law."
While the argument has some literal appeal, we do not
interpret those provisions to reflect a legislative intention to
deny all temporary disability benefits to a disabled full-time
worker, merely because he receives a workers' compensation award
as a result of an accident "arising out and in the course of"
unrelated part-time employment, when the workers' compensation
benefits he receives are calculated solely on the basis of his
earnings with that employer and are far less than would have been
payable had the accident occurred on the full-time job. The
effect of the hearing officer's interpretation is to give Scott,
who was diligently working two jobs, less benefits than he would
have received had he worked only at Konica and incurred the same
injuries in a non-work related event. In this case there is no
dispute that even if Scott received temporary disability benefits
under Konica's plan, as well as the workers' compensation from
Holiday Bowl, the aggregate would still be less than his full-time salary, which is the maximum amount payable under N.J.S.A.
43:21-39(h).See footnote 2
Justice Jacobs reviewed the purpose of temporary disability
benefits in Janovsky v. American Motorists Ins. Co.,
11 N.J. 1,
4-5 (1952). As he explained, temporary disability benefits
compensate a worker whose income is lost because his accident is
not covered by workers' compensation or while that issue is being
litigated. Therefore, as there can be no duplication of
benefits, any temporary disability benefits received must be
reimbursed by any workers' compensation recovery for same:
Where an employee is disabled by accident or
illness he will generally be entitled to
benefits under either the compensation law or
the benefits law, but not under both. If
liability under the compensation law is
clear, payment will be made thereunder, and
if absence of liability under that statute is
clear, payment will be made under the
benefits law. If, however, as in the instant
matter, the occurrence is in a twilight zone,
with liability under the compensation law
doubtful and dependent on the outcome of
contested proceedings (Cf. Neylon v. Ford
Motor Co.,
10 N.J. 325 (1952)), immediate
payment to help tide the worker over during
his inability to work should be permissible
and, indeed, readily available, under the
benefits law, with full reimbursement from
any award subsequently rendered in the
compensation proceeding.
[Janovsky v. American Motorists Ins. Co.,
supra, 11 N.J. at 5.]See footnote 3
See also Sperling v. Board of Review, supra.
It is undisputed before us that deductions to cover benefits
under Konica's plan are taken from Scott's salary, and the amount
of benefits are based on the salary paid (and income lost).See footnote 4 In
this setting, we are not dealing, as in Janovsky and Sperling,
with the traditional situation of a worker who has one job and is
injured in circumstances not covered, or clearly covered, by
workers' compensation.
We can find neither logical support nor empirical evidence
that the Legislature intended to deprive a worker who pays
deductions for temporary disability benefits from obtaining those
benefits to compensate him for the loss of income at his full-time employment merely because his injury occurred at a second or
part-time job taken to supplement that income. See N.J.S.A.
43:21-26 (requiring liberal construction of the Temporary
Disability Benefits Law "as remedial legislation"); In re
Paterson,
298 N.J. Super. 333, 339 (App. Div. 1997) ("[t]he
purpose of the Temporary Disability Benefits Law is to protect
workers against loss of income caused by non-employment-related
accident or sickness"). The employee should not be worse off
because the accident, not related to his full-time or prime
employment and therefore otherwise entitling him to temporary
disability benefits through that employer, happened to occur at
an unrelated part-time work site.
The statutory interplay which divided the Supreme Court and
our colleagues in Sperling takes on a different significance when
multiple employment is involved. We must, therefore, reverse the
denial of temporary disability benefits.
A question arises, however, as to whether the disability
carrier should be entitled to a set-off "to the extent of the"
temporary workers' benefits obtained through workers'
compensation, Sperling v. Board of Review, 156 N.J. at 468
(Stein, J. concurring), or in some other amount. See N.J.S.A.
34:15-57; N.J.S.A. 43:21-30; see also Sperling v. Board of
Review, supra, 301 N.J. Super. at 5. Scott argues that, absent
any workers' compensation benefits received from Konica, there
can be no offsetSee footnote 5 and suggests, in effect, that Konica should not
benefit from his inability to work at either employment,
particularly at his expense given the deduction from his pay for
temporary disability benefits. We agree that the argument must
be examined in light of our conclusion that the statutory
interplay itself must be examined separately with respect to each
job. Moreover, as Justice O'Hern emphasized in his separate
opinion in Sperling, N.J.S.A. 43:21-30 (entitled "non-duplication
of benefits," not "election of benefits") "intends to avoid
double recovery, not full recovery." Id. at 473 (O'Hern, J.
concurring and dissenting). However, the record does not permit
us to resolve the issue.
Given his conclusion that the receipt of workers'
compensation benefits from Holiday Bowl precluded the award of
any temporary disability benefits under Konica's plan, the
hearing officer did not consider the issue of "offset" or
credits. In the absence of a record addressed to the question
and a decision by the agency with expertise in administering the
Temporary Disability Law (including the State plan to which
N.J.S.A. 41:21-29 and -30 apply), we decline to pass upon the
issue before it is decided by the agency below. Accordingly, the
final administrative determination under review is reversed, and
the matter is remanded to the Board of Review for further
proceedings consistent with this opinion.
Footnote: 1Scott's brief says "[h]is case for permanent partial disability benefits remains pending" in the Division of Workers' Compensation. Footnote: 2N.J.S.A. 43:21-39(h), relating to State plan benefits, is applicable to private plan benefits by virtue of N.J.S.A. 43:21-32(c). The private plan must provide for weekly benefits "at least equal to the weekly benefit amount payable by the State plan, taking into consideration any coverage with respect to concurrent employment by another employer...." N.J.S.A. 43:21-32(c). Footnote: 3N.J.S.A. 43:21-30 was amended by L. 1967, c. 306, § 1, after Janovsky was decided to provide for temporary disability while the contested workers' compensation proceedings are ongoing. Footnote: 4See Young v. Western Elec. Co., Inc., 189 N.J. Super. 1 (1982), aff'd as mod., 96 N.J. 220 (1984), regarding offsets under a private pension plan. Private plans are governed by N.J.S.A. 43:21-32 to -36. The State plan is governed by N.J.S.A. 43:21-37, -42. N.J.S.A. 43:21-30 is a provision of general application and applies to both. Footnote: 5The respondent did not develop the point, insisting that the workers' compensation award was dispositive of the issues before us.