WORKER'S COMPENSATION
3 Injury
3(1) Date of Injury
3(2) Type of Injury
4(1) General Provisions
4(2) Wages
4(3) Exclusive Remedy
§ 5 Burden of Proof
6(1) General Provisions
6(2) Employer Subrogation
6(4) Release
§ 7 Medical Care
§ 8 Judicial Review
§ 9 Beneficiaries
§ 10 Costs in a Worker’s Compensation Proceeding
§ 1 Purpose and Origin
The central policy behind workers' compensation statutes is that compensation should replace what the employee would actually have earned had it not been for the accident, rather than take into account the "deserving" or "undeserving" status of the employer or employee. Enekosi v. Tu'ufuli, 3 A.S.R.2d 81.
The aim of workmen's compensation statutes is to place an employee injured on the job in the position he would have been in had he not lost the wages through injury, rather than to test the fairness of the underlying employment contract. Enekosi v. Moaali'itele, 6 A.S.R.2d 49.
Workmen's Compensation Act of American Samoa is highly similar to, and seems to have been drawn largely from, the federal Longshoremen's and Harbor Workers' Compensation Act. A.S.C.A. §§ 32.0501 et seq; 33 U.S.C. §901 et seq. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
American Samoa's Workmen's Compensation Act seems to have been drawn largely from the federal Longshoremen's and Harbor Workers' Compensation Act. 33 U.S.C. § 933; A.S.C.A. §§ 32.0501 et seq. Patau v. Rosendahl Corp., 19 A.S.R.2d 80.
American Samoa's Workmen's Compensation Act was essentially modeled on the federal Longshoremen and Harbor Workers Compensation Act. 33 U.S.C. §§ 901 et seq.; A.S.C.A. §§ 32.0501 et seq. Vaeao v. Samoa Air, 20 A.S.R.2d 37.
American Samoa's Workmen's Compensation Act is similar to and appears to have been based on the federal Longshoremen and Harbor Workers' Compensation Act. 33 U.S.C. §§ 901 et seq.; A.S.C.A. §§ 32.0501 et seq. Harris v. Commissioner of the American Samoa Government Workmen's Compensation Commission, 24 A.S.R.2d 158.
§2 Commission Procedure
24 A.S.C. 458 is statute of limitations which precludes interference with Workmen’s Compensation order after expiration of thirty days from entry. Haleck v. Scanlan, 4 A.S.R. 841.
Workmen's Compensation statute does not require the Commission to order an examination, but instead requires the claimant to submit to any examination, which the Commission does order. A.S.C.A. § 32.0638. Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
When the medical officer of the Workmen's Compensation Commission was removed on the plaintiff's own motion and in accordance with statute because the physician was an employee of ASG and ASG was a party to the proceedings, there is nonetheless substantial compliance with the statute. A.S.C.A. § 32.0505. Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
The Workmen's Compensation Commissioner shall order a compensation-order hearing upon application of any interested party. A.S.C.A. § 32.0636(b). Harris v. Commissioner of the American Samoa Government Workmen's Compensation Commission, 24 A.S.R.2d 158.
Although a Workmen's Compensation order is "effective" when filed in the Commissioner's office, it does not become "final" until after 30 days; during this period of time, the Commissioner may reconsider his order. A.S.C.A. § 32.0651. Harris v. Commissioner of the American Samoa Government Workmen's Compensation Commission, 24 A.S.R.2d 158.
§3 Injury
§ 3(1) Date of Injury
In occupational disease cases, the best estimate of the "date of injury" will ordinarily be the date on which the progress of the disease made it impossible for the claimant to continue working. A.S.C.A. § 32.0621. Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
Even if the "last injurious exposure" rule were not the law in American Samoa, employers and insurers may contractually adopt this rule, which places full liability on the insurer providing coverage at the time of the most recent injury causally related to the disability. Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
§ 3(2) Type of Injury
Although occupational diseases differ from "typical" injuries in that they generally do not have a discrete and readily identifiable instant of occurrence, and although this may give rise to difficulties in the proof of causation, such diseases are injuries under the American Samoa Workmen's Compensation statute. A.S.C.A. § 32.0502(i). Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
§ 4 Compensation Award
§ 4(1) In General
Trial court properly upheld workmen's compensation commission award to injured employee based on that employee's actual earnings, even though the employee earned less than the statutory minimum hourly wage. Enekosi v. Moaali'itele, 6 A.S.R.2d 49.
Workmen's Compensation Commission has wide discretion in awarding medical and related travel expenses. A.S.C.A. § 32.0619. Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
A voluntary payment of workmen's compensation does not constitute an "award in a compensation order," which triggers an assignment of an injured worker's cause of action against a third party to his employer. A.S.C.A. § 32.0669. Patau v. Rosendahl Corp., 19 A.S.R.2d 80.
As a matter of law, a worker who lost his forearm was entitled to 244 weeks of compensation; in addition, the Workmen's Compensation Act also provides for up to 200 weeks of compensation in cases of serious bodily disfigurement. A.S.C.A. §§ 32.0609 (3), (15), 32.0609(20). Patau v. Rosendahl Corp., 19 A.S.R.2d 80.
§ 4(2) Wages
Bus driver who was paid a certain percentage of his total fares minus certain expenses of operating the bus was paid a wage "fixed by output" within the meaning of workers' compensation statute. A.S.C.A. § 32.0621. Enekosi v. Tu'ufuli, 3 A.S.R.2d 81.
That an employee's wage may have been less than required by the federal minimum wage laws did not make it improper for workmen's compensation commission to base his compensation award on his actual wage in accordance with territorial statute. A.S.C.A. § 32.0261. Enekosi v. Tu'ufuli, 3 A.S.R.2d 81.
Driver who was paid a percentage of bus fare receipts less fuel expenses was properly held to be an employee whose wages are "fixed by output" within the meaning of the workmen's compensation statutes, rather than one whose wages are neither "fixed" nor "ascertainable". A.S.C.A. § 32.0621 (d)(1),(3). Enekosi v. Moaali'itele, 6 A.S.R.2d 49.
Driver's "wage" for workmen's compensation purposes was a fixed percentage of the receipts from his work calculated after, rather than before, deduction by employer of his operating costs. Enekosi v. Moaali'itele, 6 A.S.R.2d 49.
§ 4(3) Exclusive Remedy
The "exclusive remedy" provision of the Workmen's Compensation Act extinguishes any tortious cause of action against an employer. A.S.C.A. § 32.0522(a). Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
Most jurisdictions recognize only one exception to the "exclusive remedy" provision of workmen's compensation acts--an indemnity action by a third party against an employer--because this is not an action for "damages" but for reimbursement. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
§ 5 Burden of Proof
Workmen's compensation claimant's proof of existence of injury and of employment relationship raises presumption that claim falls within coverage of workmen's compensation laws and shifts to employer the burden of proving by substantial evidence that employment did not cause the injury. A.S.C.A. § 32.0642. Star-Kist Samoa, Inc., v. Workmen's Compensation Commission, 7 A.S.R.2d 149.
In order to prevail on a workmen’s compensation claim, a claimant must show that her injury or illness “ar[ose] out of and in the course of employment.” A.S.C.A. § 32.0520. Once a claimant has shown the existence of an illness and an employment relationship, a presumption arises that the claim lies within the coverage of the workmen’s compensation laws. The employer then has the burden of showing by substantial evidence that the illness did not arise from employment. Harris v. Comm. Of the American Samoa Gov’t Workmen’s Comp., 29 A.S.R.2d 147.
Substantial evidence means more than a mere scintilla. It means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. Harris v. Comm. Of the American Samoa Gov’t Workmen’s Comp., 29 A.S.R.2d 147.
Although stress and hypertension can contribute to heart disease, a petitioner must submit evidence to show a casual relationship between his stress on the job and any asserted occupational disease. He must also show that the stress inherent in his job is greater than that which all workers are occasionally subjected. Felise v. Workmen’s Comp. Commissioner, 31 A.S.R.2d 96.
§ 6 Employer Liability
§ 6(1) In General
The workmen's compensation statute limits an employer's liability to pay compensation to the amount which the commissioner determines is payable over the amount the employee recovered against a third person, and an employer may maintain an action against the employee for any overpayment. A.S.C.A. § 32.0669(c). Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
§ 6(2) Employer Subrogation
American Samoa's Workmen's Compensation Act does not explicitly provide for a right of subrogation where an employee receives compensation without a formal award and then recovers from a third party; however, an employer has an equitable right of subrogation and is entitled to be reimbursed from an employee's net recovery, whether by judgment or settlement, from a third party. A.S.C.A. §§ 32.0501 et seq. Vaeao v. Samoa Air, 20 A.S.R.2d 37.
Accepting a workmen's compensation award in a compensation order assigns to the employer all rights to recover damages against a third person, unless the workman commences an action against the third person within six months after such award. A.S.C.A. § 32.0669. Patau v. Rosendahl Corp., 19 A.S.R.2d 80.
§ 6(3) Settlement Agreement
Disallowing compromise contracts between the employer and employee, the Workmen's Compensation Act bars an agreement to prevent the employee from receiving or altering the amount of compensation fixed and guaranteed to him by statute. A.S.C.A. §§ 32.0554(b), 32.0672. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
A settlement agreement, which has been approved by the Workmen’s Compensation Commission effectively discharges an employer's liabilities under the Act. A.S.C.A. § 32.0668. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
Because American Samoa's Workmen's Compensation Act disallows compromise contracts between the employer and employee, the employer's liability for workmen's compensation benefits, fixed and guaranteed under the Act, may not be altered by way of contract. A.S.C.A. §§ 32.0554(b), 32.0672. Patau v. Rosendahl Corp., 19 A.S.R.2d 80.
Only those settlements between the parties that have been approved by the Workmen's Compensation Commission have the effect of discharging an employer's liability for compensation. A.S.C.A. § 32.0668. Patau v. Rosendahl Corp., 19 A.S.R.2d 80.
§ 6(4) Release
A court will not presume that an injured worker settling a workmen's compensation claim clearly intended to release all his future claims against a third party who did not participate in negotiating the contract and apparently paid no consideration for such release. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
When a defendant has provided no showing regarding the context in which a release was signed--the negotiations preceding its execution; the circumstances under which it was signed; whether the underlying payment was a settlement under A.S.C.A. § 32.0668, commuted per A.S.C.A. § 32.0666; or whether the Commissioner had approved such settlement or issued a formal compensation order--an inference of invalidity must be drawn in plaintiff's favor for purposes of summary judgment. A.S.C.A. §§ 32.0668, 32.0666; T.C.R.C.P. 56. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
The old common-law rule that the release of one tortfeasor releases all tortfeasors does not apply to workmen's compensation claims because an employer is not a joint tortfeasor and the policy reasons behind a general release are inapplicable. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.
Since no release is valid except as otherwise provided for by the Workmen's Compensation Act, summary judgment was not available when the record was unclear on whether the release agreement was approved by the Workmen's Compensation Commission. A.S.C.A. § 32.0672; T.C.R.C.P. 56. Patau v. Rosendahl Corp., 19 A.S.R.2d 80.
§ 7 Medical Care
Nothing requires that insured persons go through the process of off-island medical referral; the primary concern of the referral process is the government's expenditure of funds. A.S.C.A. §§ 11.0311(b), 11.0318. National Pacific Insurance Co. v. Commissioner of the American Samoa Government's Workmen's Compensation Commission, 22 A.S.R.2d 15.
§ 8 Judicial Review
24 A.S.C. 459 provides that exclusive appellate remedy for review of Workmen’s Compensation Board decision is injunctive proceedings in High Court—hence, the Administrative Procedure Act appeal provisions are inapplicable. In re Westerlund v. Scanlan, 4 A.S.R. 998.
Workmen's compensation award based on injured employee's actual contractual wage did not preclude employee from attacking the legality of his contract in a separate proceeding. Enekosi v. Moaali'itele, 6 A.S.R.2d 49.
Territorial workmen's compensation statute, under which reviewing court could set aside decision of workmen's compensation commission only if it was "not in accordance with the law," precluded court from reversing a finding of fact by the commission for which there was substantial evidence in the record of the commission's proceeding. A.S.C.A. § 32.0652. Continental Insurance Co. v. Workmen's Compensation Commission, 7 A.S.R.2d 105.
Court reviewing findings of fact by workmen's compensation would not reverse a finding unless a reasonable person could not have concluded as the commission did from the evidence in the record. A.S.C.A. § 32.0652. Continental Insurance Co. v. Workmen's Compensation Commission, 7 A.S.R.2d 105.
Court would not reverse workmen's compensation commission finding that fatal heart attack "arose out of and in the course of" decedent's employment, even though the heart attack had occurred at home rather than at work, where the commission record reflected that (1) decedent had a history of heart trouble but medical treatment had brought his condition under control in the months preceding his heart attack; (2) decedent had recently been transferred from his job as a night watchman to a highway maintenance job involving physical labor; (3) the punitive and involuntary transfer had created emotional pressures that testifying physician cited as a possible factor in the heart attack; (4) after the transfer decedent's symptoms had taken a drastic turn for the worse; (5) the heart attack had occurred eleven days after decedent had begun work on the road crew. A.S.C.A. §§ 32.0520, 32.0652. Continental Insurance Co. v. Workmen's Compensation Commission, 7 A.S.R.2d 105.
Workmen's compensation commission decision should be overturned on appeal only if it is not in accordance with the law. A.S.C.A. § 32.0652. Star-Kist Samoa, Inc., v. Workmen's Compensation Commission, 7 A.S.R.2d 149.
Workmen's compensation commission decision should be upheld by reviewing court if supported by substantial evidence, whether or not the court would have reached the same conclusion from the evidence as the commission did. A.S.C.A. § 32.0652. Star-Kist Samoa, Inc., v. Workmen's Compensation Commission, 7 A.S.R.2d 149.
Court will not disturb workmen's compensation commission decision if record contains evidence from which a reasonable person could conclude that the injury and death were work-related and it does not appear that the commission arbitrarily and capriciously disregarded substantial evidence to the contrary. A.S.C.A. §§ 32.0642, 32.0652. Star-Kist Samoa, Inc., v. Workmen's Compensation Commission, 7 A.S.R.2d 149.
Appellant's claim that the trial court failed to apply certain evidentiary presumptions was without merit, as in administrative proceedings the agency rather than the court is to weigh the evidence and find facts; evidentiary presumptions used to facilitate fact-finding should be applied at the agency level and not at the level of judicial review. Continental Insurance Co. v. Workmen's Compensation Commission, 8 A.S.R.2d 152.
Decision of workmen's compensation commission may be set aside only if the decision was not made in accordance with law. A.S.C.A. § 32.0652. Continental Insurance Co. v. Workmen's Compensation Commission, 8 A.S.R.2d 152.
Finding by workmen's compensation commission that there was an "injury or death arising out of and in the course of employment" must be supported by substantial evidence. Continental Insurance Co. v. Workmen's Compensation Commission, 8 A.S.R.2d 152.
Trial court correctly applied the substantial evidence standard where it upheld a workmen's compensation commission decision "as long as reasonable people could differ on the facts presented to the Commission." Continental Insurance Co. v. Workmen's Compensation Commission, 8 A.S.R.2d 152.
Substantial evidence test in judicial review of administrative decision is limited to whether a reasoning mind could reasonably have reached the factual conclusion the agency reached, and reviewing court may neither find its own facts nor substitute its own judgment for that of the agency. Continental Insurance Co. v. Workmen's Compensation Commission, 8 A.S.R.2d 152.
Finding of fact based on no evidence is an error of law and thus a workmen's compensation commission award which is not supported by any evidence will be reversed, but where the commission has statutory power to find the facts its findings must be affirmed even if the reviewing court believes the evidence points the other way. Continental Insurance Co. v. Workmen's Compensation Commission, 8 A.S.R.2d 152.
Workmen's compensation commission order should be set aside only if it was based on "whimsy evidence"; order should be affirmed if reasonable people might differ as to the weight of the evidence. Continental Insurance Co. v. Workmen's Compensation Commission, 8 A.S.R.2d 152.
The Workmen's Compensation Commission's findings of fact and inferences derived there from are to be upheld by the High Court if supported by "substantial evidence," using a reasonableness standard. Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
That a different conclusion might also have been supported by the evidence is insufficient to warrant reversal of the Workmen's Compensation Commission's conclusions. Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130.
A court gives considerable deference to administrative decisions involving an agency's construction of its governing statute and regulations, unless the court deems the interpretation to be inconsistent with a statutory mandate or to frustrate legislative policy. National Pacific Insurance Co. v. Commissioner of the American Samoa Government's Workmen's Compensation Commission, 22 A.S.R.2d 15.
If a Workmen's Compensation Commission's statutory interpretation is permissible under the statutes and regulations, the court should defer to the Commission's decision; but if that construction is inconsistent with a statutory mandate, frustrates legislative policy, or renders the statutes ineffective, the court must set aside the decision. A.S.C.A. § 32.0652(a). National Pacific Insurance Co. v. Commissioner of the American Samoa Government's Workmen's Compensation Commission, 22 A.S.R.2d 15.
The Workmen's Compensation Commission's decision that the hospital's off-island medical-referral procedure does not apply to those covered by the workmen's compensation statute is a permissible interpretation of applicable statutes and regulations, so the court will defer to that decision. A.S.C.A. § 11.0312. National Pacific Insurance Co. v. Commissioner of the American Samoa Government's Workmen's Compensation Commission, 22 A.S.R.2d 15.
Though mislabeled with an appellate-division rather than a civil-division number and not specifically requesting statutorily-provided injunctive relief, a petition for judicial review of a Workmen's Compensation Commission order was sufficient to toll the statute of limitations and so avoid dismissal. Felise v. Workmen's Compensation Commissioner, 24 A.S.R.2d 95.
Statutory provision providing for judicial review of Workmen's Compensation Commission orders excludes other avenues of judicial review but does not preclude reconsideration proceedings at the administrative level. A.S.C.A. §§ 32.0652-32.0653. Harris v. Commissioner of the American Samoa Government Workmen's Compensation Commission, 24 A.S.R.2d 124.
A court utilizes a "clearly erroneous" standard of review in reviewing Workmen's Compensation Commission orders. Harris v. Commissioner of the American Samoa Government Workmen's Compensation Commission, 24 A.S.R.2d 124.
In reviewing the Commission's order, we are required to look for substantial evidence supporting the order. In this context, the substantial evidence test is limited to whether a reasoning mind reasonably could have reached the factual conclusion the agency reached. This need not and must not be either judicial fact-finding or a substitution of judicial judgment for agency judgment. Harris v. Comm. Of the American Samoa Gov’t Workmen’s Corp., 29 A.S.R.2d 147.
Where findings of fact are substantially supported by the record, and where those facts directly support the presumption that a worker’s injury has occurred as a result of employment, a conclusion by the Workmen’s Compensation Commission that the presumption has been overcome is plain error. Harris v. Comm. of the American Samoa Gov’t Workmen’s Corp., 29 A.S.R.2d 184.
Conclusions of law must follow from the facts which are developed at trial or before the Workmen’s Compensation Commission. It is for this reason that appellate courts review findings of fact for clear error but conclusions of law de novo. Harris v. Comm. of the American Samoa Gov’t Workmen’s Corp., 29 A.S.R.2d 184.
The court reviews a Workmen’s Compensation Commission's order to determine if it is "in accordance with the law." A.S.C.A. § 32.0652. Thus, the court will affirm the Commission's order if a "reasoning mind could have reached the factual conclusion the agency reached." Continental Insurance Co. v. Workmen's Compensation Commission, 15 A.S.R.2d 130, 133 (Trial Div. 1990). Felise v. Workmen’s Comp. Commissioner, 31 A.S.R.2d 96.
§ 9 Beneficiaries
Adoption of child subsequent to natural parent's injury and death does not affect child's right to receive death benefits under workmen's compensation laws, since legal relationship of natural parent and child existed at time of injury and death. Star-Kist Samoa, Inc., v. Workmen's Compensation Commission, 7 A.S.R.2d 149.
§ 10 Costs in a Worker’s Compensation Proceeding
A request for costs is properly denied in a negligence suit sounding in tort because it is not a proceeding "in respect to any claim or compensation order." A.S.C.A. § 32.0639. Etimani v. Samoa Packing Co., 19 A.S.R.2d 1.