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Docket Number

56611.

Attorney(S)

Patton Hoyt, Jack R. Hancock, for appellant. Hopkins Gresham, H. Lowell Hopkins, Patrick J. McKenna, for appellee.

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Smart Summary

Summary of Opinion: JAMES v. BROWN TRANSPORT CORPORATION (Ga. Ct. App. Oct. 23, 1978)

Factual and Procedural Background

On April 26, 1975, the claimant (James) was thrown from the sleeper of a truck cab and injured when the truck ran off the road. He experienced head and back pain and was hospitalized in St. Paul, Minnesota, from April 30 to May 8, 1975. After returning to Atlanta he was examined in June 1975 and diagnosed with neuritis and a probable lumbosacral sprain and "pinched nerve problem."

The employer, a self-insured corporation, paid the claimant's hospital bills and on June 13, 1975 tendered a check for $500 marked "Workmen's Compensation." An official of the employer also assured the claimant he would be sent for treatment to Johns Hopkins Hospital. In November 1975, while en route to Birmingham for treatment, the claimant suffered a second, unrelated injury in a train-car collision that caused a head injury and intermittent hospitalization through June 1976. The administrative law judge found the concussion resolved within 30 days, but the claimant's back injuries from the April 26, 1975 accident continued.

Procedurally, the administrative law judge found the employer estopped to insist on dismissal of the claim for failure to file within 12 months and awarded compensation. The State Board of Workmen's Compensation (the full board) adopted the law judge's findings of fact but concluded as a matter of law that the claim was not timely filed and dismissed it, citing prior Georgia cases. The case reached the Court of Appeals, which reviewed what legal conclusion should be drawn from the agreed facts. The Fulton Superior Court (before Judge Alverson) had been involved in the proceedings below; the Court of Appeals ultimately reversed the superior court's judgment and directed remand to the board for consideration of disability benefits, if any.

Legal Issues Presented

Whether the employer (or its agents) is estopped from asserting the one-year statute of limitations for filing a workers' compensation claim, based on the employer's payment of hospital bills, delivery of a check marked "Workmen's Compensation," and assurances to the claimant that his claim or treatment would be taken care of.
Whether the facts of this case fall within the court's prior precedents (as cited by the parties) that address when payments, assurances, or unapproved settlements will or will not toll the statutory filing period or give rise to estoppel.

Arguments of the Parties

Appellant's Arguments

The appellant cited prior authorities (including Hartford Acc. & Co. v. Snyder and U.S. Cas. Co. v. Owens) to argue that mere payment of medical bills, an unapproved settlement, or a statement by the employer that the employee would be "taken care of" do not, standing alone, toll the statute or provide a basis for estoppel.
The appellant relied on U.S. Cas. Co. v. Owens for the proposition that "a mere uncertain and indefinite understanding, based on no consideration, ... would not amount to fraud which would debar or deter [a claimant] from filing a claim within the one-year limitation" and urged that promises to send the employee to Johns Hopkins fell into that category.

Claimant's Arguments

The claimant testified that he did not file a claim within the statutory period because he believed the employer's vice president (Mr. Crane) when told that he would be sent to Johns Hopkins for treatment and that his claim was being taken care of.
The claimant relied on the combination of actions by the employer — payment of hospital bills, the $500 check marked "Workmen's Compensation," and assurances by employer representatives — to show that he was misled into postponing filing and that the employer should be estopped from asserting the statute of limitations.

Table of Precedents Cited

Precedent	Rule or Principle Cited For	Application by the Court
Hartford Acc. c. Co. v. Snyder, 126 Ga. App. 31 (189 S.E.2d 919) (1972)	Held that assurances that medical bills would be paid and that a compromise settlement would be given "afforded no basis for tolling the statute" and that mere payment of medical bills, an unapproved settlement, or a statement that the employee would be taken care of are not separately sufficient to toll the statute.	The court acknowledged Snyder's holding but concluded that the combined actions in the present case (payment of bills, promises of hospitalization, and a check marked as compensation) required a different legal conclusion: they misled the claimant and supported estoppel.
Employers Ins. of Wausau v. Nolen, 137 Ga. App. 205 (223 S.E.2d 250) (1976)	Held that where parties were aware of the accident and claimed disability and the claimant was led to believe the employer had committed itself to liability (the question remaining one of amount), the board properly reversed a denial of compensation based on delay in filing.	The court noted Nolen as a case in which reversal was appropriate under facts showing the claimant was led to believe the employer had accepted liability; that authority supported the conclusion that estoppel can apply where the claimant is led to believe filing need not be pursued immediately.
U.S. Cas. Co. v. Owens, 109 Ga. App. 834 (137 S.E.2d 543) (1964)	Stated that a "mere uncertain and indefinite understanding, based on no consideration" would not amount to fraud sufficient to deter filing within the one-year limitation.	The appellant cited Owens to argue promises of treatment (e.g., to send claimant to Johns Hopkins) should not create estoppel. The court considered that argument but found the totality of acts here (payments, promises, and a check marked compensation) distinguished the case from Owens.

Court's Reasoning and Analysis

The court began with the premise that filing a workers' compensation claim within one year of the alleged accident is jurisdictional but that the time requirement may be waived or the employer may be estopped from asserting the statute of limitations.

The Court of Appeals framed the dispute as a question of what legal conclusion should be drawn from agreed facts. The court reviewed the cited precedents: Snyder for the proposition that isolated payments or assurances ordinarily do not toll the statute; Nolen as an example where the board properly reversed because the claimant had been led to believe the employer had accepted liability; and Owens for the principle that an uncertain, indefinite understanding unaccompanied by consideration may not constitute fraud or a deterrent to filing.

Turning to the facts, the court emphasized the contacts between the claimant and those with apparent authority (a union official and a corporate vice president), the payment of hospital bills by the employer, the issuance of a check labeled "Workmen's Compensation," and the vice president's assurance that the claimant would be sent for further treatment. The claimant testified credibly that he delayed filing because he believed the vice president's representations, and the vice president admitted discussing the matter.

The administrative law judge expressly found that the combination of paid hospital bills, promises of further hospitalization, and receipt of a check marked as workmen's compensation "caused the claimant in this case not to file a claim within one year" and that these actions misled the claimant "whether intentionally or not" and prevented his filing within the statutory period. The Court of Appeals concluded that this was a conclusion of law demanded by the evidence, distinguishing the present case from those where isolated acts were insufficient to toll the statute.

Holding and Implications

Holding: The Court of Appeals reversed the superior court's judgment and held that, on the facts presented, the employer was estopped from insisting the claimant's case be dismissed as untimely; the case was remanded to the State Board of Workmen's Compensation for consideration of disability benefits, if any.

Implications: The direct effect is reversal of the dismissal and remand to the board for adjudication of disability benefits. The opinion confines its action to the application of established principles of waiver and estoppel to the specific facts; it does not announce or rely upon a broader new rule of law beyond applying existing precedent to these facts.

Decision date: October 23, 1978. Rehearing denied November 7, 1978. Judgment reversed with direction.

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JAMES v. BROWN TRANSPORT CORPORATION.

While the filing of a workmen's compensation claim within one year of an alleged accident is jurisdictional, the time may be waived, or the employer may be estopped to urge the statute of limitations. Where the evidence demands a finding that the claimant has been injured by accident arising out of and in the course of his employment, where he is thereafter promised benefits by a vice president of the self-insured employer, his hospital bills are paid, and he receives a check marked for and admittedly paid as compensation benefits, and there is testimony that the claim was not filed because the claimant believed the statements of the company official, the evidence demands the conclusion that intentionally or not, the employer misled the claimant, thereby inducing him to postpone filing a claim until after the statutory period had run, and is in consequence estopped to insist upon its bar.

SUBMITTED SEPTEMBER 13, 1978 — DECIDED OCTOBER 23, 1978 — REHEARING DENIED NOVEMBER 7, 1978 — CERT. APPLIED FOR.

In this workmen's compensation case the administrative law judge, finding the employer estopped to insist on dismissal of the claim as not having been filed within 12 months of the injury, awarded compensation. The full board adopted the law judge's findings of fact but, disagreeing with the conclusions of law based thereon, dismissed the claim because not timely filed. We are thus presented with a decision as to what conclusion of law is to be drawn from certain agreed-on facts.

The facts are as follows: James, the employee, was thrown from the sleeper of a truck cab and injured when it ran off the road on April 26, 1975. He suffered head and back pains, and was hospitalized in St. Paul, Minnesota, from April 30 to May 8. On return to Atlanta he was examined by various specialists in June, 1975, and received a diagnosis of neuritis along with probable lumbosacral sprain and "pinched nerve problem."

The self-insured employer paid the hospital bills incurred by the employee. In addition it tendered him a check in the sum of $500 on June 13, 1975, which was marked "Workmen's Compensation." In addition, when the employee's back continued to hurt him, an official of the employer assured him that he would be sent for treatment to Johns Hopkins Hospital.

In November the claimant was still having back trouble. He was en route to Birmingham for treatment when he sustained a second injury in a train-car collision which put him in the hospital off and on until June, 1976. This latter accident was responsible for a head injury which resulted in some amnesia concerning its immediate surrounding circumstances. The law judge found as a fact that the concussion resulting from the train wreck resolved itself within a 30-day period but that he back injuries from the prior accident continued.

Based on these accepted facts the full board denied compensation and dismissed the claim as not filed within the applicable twelve-month period, citing Hartford Acc. c. Co. v. Snyder, 126 Ga. App. 31 ( 189 S.E.2d 919) (1972) and Employers Ins. of Wausau v. Nolen, 137 Ga. App. 205 ( 223 S.E.2d 250) (1976).

DEEN, Presiding Judge.

In the Snyder case it was held (p. 37) that even if the claimant had been assured that medical bills would be paid and that he would be given a compromise settlement in addition thereto this "afforded no basis for tolling the statute as to the time for filing the claim, and could not have justified a different award. . ." and cases are cited holding that mere payment of medical bills, or the making of an unapproved settlement, or a statement by the employer that the employee would be taken care of, are not separately sufficient to toll the statute. In the Nolen case, however, it was held that the full board acted properly in reversing the administrative law judge who had denied compensation based on delay in filing the claim, where the facts showed the parties were aware of the accident and claimed disability and the claimant was led to believe that the employer had committed itself to liability, the question at issue being amount. The appellant further cites U.S. Cas. Co. v. Owens, 109 Ga. App. 834 ( 137 S.E.2d 543) (1964) to the effect that "a mere uncertain and indefinite understanding, based on no consideration, ... would not amount to fraud which would debar or deter him from filing a claim within the one-year limitation" and urges that this would apply to any promises to send the employee to Johns Hopkins for further treatment.

The record shows that the claimant's contacts with his employer were through a union official and a vice president of the corporation, that he was assured by both that his claim was being taken care of, that in the early stages bills were in fact paid, and that he received a check from the employer designated as workmen's compensation. It is simply unrealistic to contend that such actions and promises on the part of those who represent authority to a semi-skilled laborer and lull him into believing that no further affirmative action on his part is needed do not affect his actions in prosecuting his claim. The record shows that from November, 1975 on, the claimant was suffering both from a head injury (not employment connected, but sustained on his way to a hospital for back treatment) and in April, 1975, injury to his back which was indisputably employment connected. As to why he did not file a claim between April and November, 1975, he testified it was because he "kept thinking Mr. Crane (the vice president) was telling me the truth about going to the hospital, at Johns Hopkins Hospital." Nothing casts the least doubt on this explanation. Crane admitted having brought the matter up. The administrative law judge hearing the case made a finding that the payment of hospital bills, the promises of further hospitalization and the receipt of a check marked as workmen's compensation taken together "caused the claimant in this case not to file a claim within one year. . . it is apparent that the actions between the parties and the payment of some weekly compensation benefits misled the claimant, whether intentionally or not, and prevented his filing a claim within the statutory period, and therefore the claim is within the jurisdiction of the Board for adjudication." This is as denominated by the board a conclusion, but it is one demanded by the evidence.

The claimant, should not have been dismissed as barred by the statute of limitations. The judgment of the superior court is therefore reversed with direction to remand the case to the board for consideration of disability benefits, if any.

Judgment reversed with direction. Smith and Banke, JJ., concur.

JAMES v. BROWN TRANSPORT CORP