Opinion
C.A. No.: 01C-07-008-FSS.
Submitted: March 21, 2003.
Decided: March 31, 2003.
Joseph W. Weik, Esquire, Weik, Nitsche Dougherty
Sean A. Dolan, Esquire, Marshall Dennehey Warner Coleman Goggi
Dear Counsel:
Viewing the evidence in the light most favorable to Sun Builders, it appears that Plaintiff was injured on the job in July 2000. He filed a claim for worker's compensation benefits, which were granted on March 15, 2001. The Industrial Accident Board's award of benefits is not explicit because the Board merely finds that Plaintiff was an employee. The Board's decision, however, also establishes that the only thing standing between Plaintiff and total disability benefits was the question as to whether he was an employee. Thus, it is beyond dispute that when the Board's March 15, 2001 decision is read as a whole, it granted ongoing, total disability benefits to Plaintiff.
It further appears, continuing to view the record in the light most favorable to the non-moving party, that Sun Builders had suspicions about whether Plaintiff had gone back to work and, therefore, from that point he would not be entitled to total disability benefits. Sun Builders still suspects Plaintiff. But Sun Builders only could prove that Plaintiff became re-employed on June 4, 2001. Thus, there was no reason why Plaintiff was not entitled to total disability benefits at least until June 4, 2001. This conclusion assumes without deciding that Sun Builders could legally have begun to deny benefits on June 4, 2001, without first filing a Petition to Terminate Benefits. That is a questionable assumption.
It further appears that Sun Builders was confused about Plaintiff's social security number. That was because Plaintiff was a documented alien, who did not have a permanent social security number. It took some months for Plaintiff's counsel to establish Plaintiff's permanent social security number to Sun Builders' satisfaction. There is nothing contemporaneous in the record, however, establishing that the reason why Sun Builders' failure to honor the Board's award of benefits was based on Sun Builders' confusion about Plaintiff's social security number. Again, in reaching this conclusion the court assumes that legitimate confusion about Plaintiff's social security number forms a basis for failure to pay benefits. That is another questionable assumption.
In summary, it is undisputed that Plaintiff was seriously injured on the job in July 2001, and he filed a claim for worker's compensation benefits. Despite the Board's March 15, 2001 decision in his favor, Plaintiff did not begin receiving benefits until July 18, 2001 and he did not receive his final disability payment until October 25, 2001. Meanwhile, Sun Builders' only justification for failing to pay benefits sooner was its confusion about Plaintiff's social security number and its suspicion that Plaintiff had rejoined the workforce. Sun Builders made no attempt to justify to Plaintiff, much less to the Board, its refusal to pay benefits as called for by the Board's March 15, 2001 decision.
Viewing all the circumstances presented here in the light most favorable to Sun Builders, the court holds that Sun Builders' failure to pay benefits after demand, until July 18, 2001 was unlawful and Plaintiff is entitled to benefits under Huffman. In reaching this conclusion, the court understands Sun Builders' concern that Plaintiff had gone back to work, that he was not entitled to benefits and that Sun Builders would not recover if it paid Plaintiff for benefits to which he was not entitled. The way Sun Builders acted, however, opens the door for employers to pick- and-choose which awards of benefits they will honor. The facts do not bear out Sun Builders' suspicions, much less the way they approached Plaintiff. Considering how he was treated, it is not surprising that Plaintiff went back to work on June 4, 2001 no matter how he felt. At that point, almost an entire year had gone by without his receiving benefits and he had no reason to believe that he would receive them any time soon.
Huffman v. C .C. Oliphant Son's, 432 A.2d 1207 (Del. 1981).
For the foregoing reasons, Plaintiff's Motion for Summary Judgment is GRANTED. The court will sign an order upon submission by Plaintiff, after approval as to form by Defendant.
Very truly yours,
FSS/lah oc: Prothonotary (Civil Division)