Williamson v. USA
Filing
75
MEMORANDUM OPINION & ORDER: The Gvt's motion for s/j, 55 , is GRANTED IN PART and DENIED IN PART. 1. Any damages award under the Federal Tort Claims act shall be offset by the following: the value of Pla's medical benefits under TRICARE$6,446,07 and the value of Pla's FECA benefits$127,155.09. 2. The US' motion for s/j is denied with respect to Pla's retirement disability benefits. Signed by Judge Joseph M. Hood on 6/15/2015.(LC)cc: COR
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF KENTUCKY
CENTRAL DIVISION at LEXINGTON
GARY EDWARD WILLIAMSON,
)
)
)
)
)
)
)
)
)
Plaintiff,
v.
UNITED STATES OF AMERICA,
Defendant.
Civil Case No.
5:12-CV-334-JMH-REW
MEMORANDUM ORDER AND OPINION
***
This
matter
is
before
the
Court
upon
the
motion for partial summary judgment, [DE 55].
government’s
Plaintiff has
responded, [DE 58], and the government has filed a reply, [DE
62].
For the following reasons, the motion will be granted in
part and denied in part.
Plaintiff seeks $750,000 in damages from the United States
in this Federal Tort Claims Action based on alleged medical
malpractice
during
the
treatment
of
Plaintiff’s
Lexington, Kentucky VA Medical Center.
foot
at
the
It is undisputed that,
in connection to injuries to his foot, Plaintiff has already
received various government benefits, including medical benefits
under TRICARE, workers compensation benefits under the Federal
Employees
administered
Compensation
government
by
the
contends
Act,
Office
that
any
and
of
disability
Personnel
monetary
retirement
Management.
award
that
The
Plaintiff
receives
under
the
FTCA
should
be
offset
by
the
amount
of
government benefits already received.
DISCUSSION
Summary judgment is appropriate “if the movant shows that
there is no genuine dispute as to any material fact and the
movant is entitled to judgment as a matter of law.”
Civ. P. 56(a).
Fed. R.
In considering a motion for summary judgment the
court must construe the facts in the light most favorable to the
nonmoving party.
Anderson v. Liberty Lobby, Inc., 477 U.S. 242,
255 (1986).
In
determining
whether
the
government’s
request
is
appropriate, the Court looks to Kentucky’s “collateral source
rule.”
See Douglas v. United States, 658 F.2d 445, 449 (6th
Cir. 1981).
This rule provides that “benefits received by an
injured party for his injuries from a source wholly independent
of, and collateral to, the tortfeasor will not be deducted from
or
diminish
tortfeasor.”
App. 2005).
tortfeasor
injured
the
damages
otherwise
recoverable
the
Schwartz v. Hasty, 175 S.W.3d 621, 626 (Ky. Ct.
Various rationales support this rule.
should
party
from
had
not
the
receive
a
foresight
benefit
to
simply
obtain
First, the
because
insurance.
O’Bryan v. Hedgespeth, 892 S.W.2d 571, 576 (Ky. 1995).
the
See
Second,
as between the tortfeasor and the injured party, any windfall
2
should inure to the benefit of the injured party.
S.W.3d at 626.
the
full
Schwartz, 175
Third, unless the tortfeasor is required to pay
amount
of
damages,
liability will be compromised.
the
deterrent
purpose
of
tort
Id.
The Court previously ruled that the dual capacity doctrine
applies in this case, allowing Plaintiff to bring his claim
under the FTCA despite the fact that the claim would ordinarily
be barred due to Plaintiff’s receipt of benefits under FECA.
See DE 19.
Accordingly, in determining whether the collateral
source doctrine applies to the benefits already received, the
Court must determine whether the source of those benefits is
“wholly independent of, and collateral to” the government in its
capacity as a healthcare provider.
To make this determination,
the Court must examine the character of each type of benefits
received, as well as the government’s dual capacity with respect
thereto.
In addition to Kentucky’s collateral source rule, federal
case law provides some guidance for such matters in which the
United States is the defendant.
While there appears to be no
Sixth Circuit authority addressing the issue, several circuits
have
differentiated
“unfunded
general
revenues
of
the
United
States (from which FTCA awards are made) and those (revenues)
which
come
from
a
special
fund
3
supplied
in
part
by
the
beneficiary
or
a
relative
upon
whom
the
beneficiary
is
dependent.”
Overton v. United States, 619 F.2d 1299, 1308 (8th
Cir. 1980) (internal quotation marks and citation omitted); see
also McLean v. Runyon, 222 F.3d 1150, 1156 (9th Cir. 2000);
Smith v. United States, 587 F.2d 1013, 1015–1016 (3d Cir. 1978);
United States v. Price, 288 F.2d 448, 450–51 (4th Cir. 1961);
Amlotte v. United States, 292 F. Supp. 2d 922, (E.D. Mich. 2003)
(holding that future Medicare payments should not offset FTCA
award,
since
characterized
future
as
Medicare
coming
from
a
payments
are
collateral
more
properly
source).
Another
approach makes “a distinction between those proceeds that are in
the nature of insurance to the plaintiff and those proceeds that
are not.”
Overton, 619 F.2d at 1308.
Whether the plaintiff has
contributed to the ostensible collateral source is particularly
relevant.
See Amlotte, 292 F. Supp. 2d at 930.
If a plaintiff
has paid insurance premiums or taxes to contribute to a benefit,
the benefit is less likely to be considered a collateral source.
See e.g., Berg v. United States, 806 F.2d 978, 985–86 (10th Cir.
1986) (holding that “when a plaintiff has paid Social Security
taxes
while
employed,
any
Medicare
benefits
subsequently received are a collateral source.”).
4
that
are
To
determine
government
is
whether
an
appropriate,
offset
it
is
as
requested
necessary
to
by
examine
the
each
benefit individually.
A. TRICARE Benefits
TRICARE
civilian
families.
is
a
health
managed
benefits
health
for
care
program
military
See 32 C.F.R. § 199.17.
that
personnel
provides
and
their
The government seeks an
offset of $6,446.07 against any judgment in Plaintiff’s favor,
based on medical bills paid that were paid under TRICARE.
The
government bases its argument, in large part, on its assertion
that
TRICARE
benefits
come
from
the
unfunded treasury, as would an FTCA award.
government’s
general
See Mays v. United
States, 806 F.2d 976 (10th Cir. 1986) (CHAMPUS benefits are not
collateral, as payments come from the general revenues of the
United States); see also Harvey v. United States, No. 3:09-cv122, 2013 WL 2898785 (W.D. Ky. June 13, 2013) (TRICARE benefits
for
past
medical
expenses
are
not
collateral
to
the
United
States).
Applying Kentucky’s definition of “collateral source,” it
is clear that the TRICARE benefits are not “wholly independent
of” the United States in its capacity as a healthcare provider.
As the government contends, both the TRICARE benefits and any
FTCA damages would come from the government’s general unfunded
5
treasury and, so, the TRICARE benefits are not collateral under
Kentucky law.
The
Court
is
mindful
of
the
general
rule
government should not pay twice for the same injury.
v. United States, 337 U.S. 49, 53 (1949).
that
the
See Brooks
In Molzof v. United
States, 6 F.3d 461, 465 (7th Cir. 1993), the court stated that,
in
determining
whether
the
collateral
source
rule
applies,
courts look “to the source and nature of the payments received
by the plaintiff, even though both payments were made by the
government.”
Though Plaintiff did not pay premiums for his
TRICARE insurance, he contends that he “earned” the benefits
through
benefits
his
military
cannot
be
service
offset
and,
against
thus,
a
FTCA
the
value
award.
of
the
While
a
plaintiff’s contribution to the benefit is a factor to consider
in determining whether a source is collateral, see Phillips v.
Western Company of North America, 953 F.2d 923, 931 (5th Cir.
1992), Plaintiff’s suggested application of the rule would be
inconsistent with Kentucky law and, therefore, is inappropriate.
For the reasons stated, Plaintiff’s TRICARE benefits are not
collateral to any FTCA damages.
B.
FECA Benefits
The Federal Employees Compensation Act (FECA), 5 U.S.C. §
8101, et seq., provides “a comprehensive system of compensation
6
for
federal
employees
who
sustain
work-related
injuries.”
United States v. Lorenzetti, 467 U.S. 167, 168 (1984).
funded by the Employees’ Compensation Fund.
Employees do not contribute to this fund.
222
F.3d
1150,
1156
(9th
Cir.
2000)
FECA is
5 U.S.C. § 8147.
See McLean v. Runyon,
(workers’
compensation
payments under FECA were paid entirely by USPS and, therefore,
not derived from a collateral source).
FECA
benefits
generally
is
required
An employee who receives
to
reimburse
the
United
States for those benefits when he obtains a damages award or
settlement from a third party who is liable to the plaintiff for
his injuries.
§ 8132.
reimbursement
“that
employee’s
Further, FECA creates a general right of
obtains
third-party
without
recovery
excluded from FECA coverage.”
regard
includes
to
whether
losses
that
Lorenzetti, 467 U.S. at 174.
the
are
It
is logical to apply the Act’s compensation-shifting scheme when
the “third-party recovery” comes from the United States in an
alternate capacity.
Accordingly, the Court finds that any FTCA
award should be offset by the amount of FECA benefits Plaintiff
has received.
Based on the offset, however, the government is
barred from seeking repayment of FECA benefits, should Plaintiff
recover under the FTCA.
7
C.
Disability Retirement Benefits
The United States seeks an offset for disability retirement
payments that Plaintiff has already received, as well as for the
present
value
of
future
payments.
These
payments
are
administered by the Office of Personnel Management and paid for
out of the Civil Service Retirement and Disability Fund.
U.S.C. § 8348.
5
It is undisputed that Plaintiff made financial
contributions to his retirement fund throughout his employment
with the U.S. Postal Service.
capacity
in
this
case
is
Further, the government’s dual
of
particular
relevance
here.
Plaintiff made a decision to seek treatment at the VA Medical
Center,
but
elsewhere.
action
he
just
as
easily
could
have
sought
treatment
Had he done so, been injured, and brought a tort
against
a
private
healthcare
provider,
his
retirement
benefits would, without question, remain undisturbed.
To offset
the amount of Plaintiff’s retirement benefits would allow the
United States to benefit from Plaintiff’s fortuitous choice in
selecting the VA Medical Center and would present the government
with a windfall.
As the Court has stated, “a benefit that is
directed to the injured party should not be shifted so as to
become a windfall for the tortfeasor.”
Baptist Healthcare Sys.,
Inc., 177 S.W.3d at 683 (citation omitted).
Accordingly, the
Court finds that the retirement benefits meet the definition of
8
“collateral source” under the applicable law and offset will be
denied.
Accordingly, IT IS ORDERED that the government’s motion for
summary judgment, [DE 55], is hereby GRANTED IN PART and DENIED
IN PART.
(1)
shall
Any damages award under the Federal Tort Claims act
be
medical
offset
benefits
by
the
under
following:
the
value
TRICARE—$6,446,07
and
of
Plaintiff’s
the
value
of
judgment
is
Plaintiff’s FECA benefits—$127,155.09.
(2)
denied
The
with
United
respect
States’
to
motion
Plaintiff’s
benefits.
This the 15th day of June, 2015.
9
for
summary
retirement
disability
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