No. 81-1674.United States Court of Appeals, Fourth Circuit.Argued January 5, 1982.
Decided March 22, 1982.
Page 249
Lawrence P. Postol, Washington, D.C. (Junius C. McElveen, Jr., Clifford J. Zatz, Myra C. Selby, Seyfarth, Shaw, Fairweather
Geraldson, Washington, D.C., on brief), for petitioner.
Joshua T. Gillelan, II, U.S. Dept. of Labor, Washington, D.C. (T. Timothy Ryan, Jr., Sol. of Labor, Donald S. Shire, Associate Sol., Marianne Demetral Smith, U.S. Dept. of Labor, Washington, D.C., on brief), for Federal respondent, OWCP.
Richard B. Donaldson, Jr., Newport News, Va. (Jones, Blechman, Woltz Kelly, P. C., Newport News, Va., on brief), for respondent, Jasper J. Hall, Jr.
Petition for review from the Benefits Review Board.
Before INGRAHAM,[*] Senior Circuit Judge, and HALL and SPROUSE, Circuit Judges.
INGRAHAM, Senior Circuit Judge.
[1] Petitioner Newport News Shipbuilding and Dry Dock Company seeks review under 33 U.S.C. § 921(c) (1976) of an award of compensation benefits to Respondent Jasper Hall under the Longshoremen’s and Harbor Workers’ Compensation Act, 33 U.S.C.A. §§ 901–950 (1978 and Supp. 1981). The agency respondent is the Director of the Office of Workers’ Compensation Programs, United States Department of Labor. The sole question presented is whether an employee is barred from receiving compensation for an employment-related injury because he misrepresented his medical history on his initial employment application, the employer relied on such misrepresentation, and the subsequent injury was causally related to the concealed prior history. An administrative law judge found no provision in the Act relieving an employer of liability in such circumstances and awarded benefits. The Benefits Review Board, one member dissenting, upheld the award. We affirm. [2] I. FactsPage 250
on the ground that respondent had committed fraud on his employment application. At the hearing before the ALJ, the parties stipulated that the Act applied, that respondent Hall and the petitioner were in an employee-employer relationship at the time of the injuries, and that the injuries arose out of and in the course of employment. Therefore, in the absence of a misrepresentation defense, respondent Hall is concededly entitled to some compensation benefits.
[5] The administrative law judge found that respondent had knowingly and willfully made false representations as to his physical condition; that the petitioner relied on the misrepresentations and that this reliance was a substantial factor in its decision to hire respondent; and that respondent would not have injured his back had the misrepresentations not been made (in other words, that the injuries were causally related to the misrepresentations). Although respondents contend these findings are contrary to the evidence developed at the hearing, we will assume for the purposes of argument that they are true. Despite these findings, both the ALJ and the Benefits Review Board held, although with some reluctance, that the Act makes no provision for denial of benefits under these circumstances. Petitioner was therefore ordered to restore compensation payments based on temporary total disability. [6] II. Discussion[8] 33 U.S.C. § 903(b) (1976). Section 31 further provides:No compensation shall be payable if the injury was occasioned solely by the intoxication of the employee or by the willful intention of the employee to injure or kill himself or another.
[9] 33 U.S.C. § 931 (1976). [10] The misrepresentation exception urged upon us by petitioner is referred to as the Larsen test, inasmuch as Professor Larsen in his treatise on workers’ compensation describes the “emerging trend” in state workers’ compensation cases towards such a doctrine. IC A. Larsen, The Law of Workmen’s Compensation § 47.53 (1980). Professor Larsen describes the test as a “melange of contract, causation and estoppel elements.” Under the test, compensation benefits are barred where the three conditions found here by the ALJ are present: that is, misrepresentation, reliance and causation. [11] The Act plainly does not encompass such an exception by its express terms. Petitioner nevertheless makes a three-pronged argument for its adoption: first, the Larsen test has been accepted by several states despite the absence of explicit statutory provisions in the state compensation acts; second, that admiralty cases involving the doctrine of maintenance and cure have held that misrepresentation of medical historyAny person who willfully makes any false or misleading statement or representation for the purpose of obtaining any benefit or payment under this chapter shall be guilty of a misdemeanor and on conviction thereof shall be punished by a fine of not to exceed $1,000 or by imprisonment of not to exceed one year, or by both such fine and imprisonment.
Page 251
does bar maintenance and cure benefits; and third, that Section 3(b) should not be regarded as the exclusive exception to liability for compensation, but rather, together with Section 31, considered evidence of a general congressional intent to condemn fraud.[1]
[12] The short answer to petitioner’s arguments is that to engraft such an exception into the LHWCA would be to “amend a statute under the guise of `statutory interpretation,'” a task we are not at liberty to perform. Fedorenko v. United States, 449 U.S. 490, 513, 514 n. 35, 101 S.Ct. 737, 750, 751 n. 35, 66 L.Ed.2d 686Page 252
1927; we are not free to incorporate into those provisions subsequent state-law developments that we may consider sound as a matter of policy.”).
[14] Respondents contest the applicability of cases recognizing a misrepresentation defense in actions for maintenance and cure, and offer cases under the Federal Employer’s Liability Act, 45 U.S.C. § 51 et seq. (1976), as a better analogy. In Still, as noted above, the Supreme Court held such a misrepresentation defense will not normally be available in FELA cases. While it has been observed that maintenance and cure does bear some resemblance to workers’ compensation, at least to the extent that both doctrines impose liability on the employer without fault, commentators have also suggested that the analogy might properly end there. G. Gilmore C. Black, The Law of Admiralty § 6-6 (2d Ed. 1975). An employer’s potential liability for maintenance and cure is tremendously broad; in particular, liability is not restricted to injuries causally related to employment. The doctrine is “deep-rooted in maritime law” and its scope has traditionally been explored and defined by the courts. Evans v. Blidberg, Rothchild Co., 382 F.2d 637, 639 (4th Cir. 1967). Accordingly, adoption of an exception to liability in that area does not involve the concern of intruding into the legislative domain present in the case before us. [15] Although neither of the analogies provides authoritative guidance, we prefer the analogy to cases construing the FELA and Jones Act. In the face of specific legislative policy favoring compensation of injured employees, those courts have held that such policy overrides the general considerations surrounding an allegedly fraudulent formation of the employment relationship Still, supra, 368 U.S. at 44-45, 82 S.Ct. at 153-154; Compton v. Luckenbach Overseas Corp., 425 F.2d 1130 (2d Cir.), cert. denied, 400 U.S. 916, 91 S.Ct. 175, 27 L.Ed.2d 155 (1970). [16] Finally, petitioner would have us discern a general anti-fraud legislative intent from the provisions of Sections 3(b) and 31, arguing that Congress could not have intended to allow claimants to benefit from their fraud. As a plain reading of the sections demonstrates, however, the enumerated exceptions do not lend support to a general anti-fraud policy, and Section 31, the only section that expressly speaks to an instance of misrepresentation, applies only misdemeanor sanctions and says nothing regarding cessation or continuation of benefits. [17] Petitioner further argues that the result of affirmance in this case will be to place an intolerable and inequitable burden on employers, who, unable to rely on applicants’ representations, will be forced (theoretically) to perform more thorough examinations on all applicants. Although these policy arguments are forcefully and eloquently made, they are drawn neither from the statute nor the legislative history.[6] They require an evaluation of the distribution of risk between employer and employee, and subjective determinations of fairness. These are precisely the types of policy arguments that must be presented to and considered by Congress. [18] AFFIRMED.Page 253
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