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Schell v Farmers Insurance Exchange; (COA-UNP, 3/8/1995; RB #1770)

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Michigan Court of Appeals; Docket No. 163778; Unpublished  
Judges Fitzgerald, MacKenzie, and Glazer; 2-1(with Judge Fitzgerald, Dissenting); Per Curiam  
Official Michigan Reporter Citation:  Not Applicable; Link to Opinion alt   


STATUTORY INDEXING:  
Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)]  
Social Security Disability Benefits [§3109(1)]

TOPICAL INDEXING:  
Social Security Disability and Death Benefits   


CASE SUMMARY:  
In this unpublished per curiam Opinion, the Court of Appeals reversed the trial court's grant of summary judgment to plaintiff, and held that the defendant insurer was entitled to a setoff from plaintiffs wage loss benefits the amount plaintiff received in social security disability benefits.  

On March 10,1989, plaintiff sustained multiple hip and leg injuries in a motor vehicle accident and was disabled from his employment. Defendant no-fault insurer paid wage loss benefits. Plaintiff also applied for social security disability benefits, but was initially denied. However, plaintiff appealed and was awarded social security disability benefits on June 10, 1991, retroactive to March 10, 1989, the date of the automobile accident. In the award of social security disability benefits, the Administrative Law Judge found that plaintiff was disabled from his employment because of three psychological disorders.   

The trial court found that since plaintiffs social security disability benefits were based upon psychological impairments, and not his physical problems arising from the automobile accident, defendant insurer was not entitled to offset the wage loss benefits by the amounts received by the plaintiff from social security.

In reversing the trial court, the Court of Appeals applied the two-prong test set forth in Jarosz v Detroit Automobile Inter-Insurance Exchange, 418 Mich 565 (1984) (Item No. 702), which provides that social security disability benefits will be deducted from no-fault wage loss benefits pursuant to §3109(1), provided the social security benefits:

1.      serve the same purpose as the no-fault benefits; and

2.      are provided or required to be provided as a result of the same accident. 

With regard to the second criteria, the focus of the inquiry is whether the triggering event for payment of the collateral benefits is the same automobile accident. Applying this test to the case at bar, the Court of Appeals found that the Administrative Law Judge's decision was limited to the determination of whether plaintiff was disabled under the Social Security Act, and if so, when such disability commenced. In reaching his determinations, the Administrative Law Judge relied upon the reports of plaintiff s physicians and, the Court of Appeals agreed that based upon these reports, the reason for plaintiffs disability from employment was "his physical disabilities caused by the accident, combined with pre-existing mental and emotional impairments," which rendered him totally disabled after the accident. Therefore, the court found that both criteria under Jarosz had been met, thereby entitling the defendant insurer to offset the social security benefits from plaintiffs wage loss coverage. Accordingly, the Court of Appeals reversed the trial court's grant of summary disposition in favor of plaintiff, along with an award of attorney fees for plaintiff.  

Judge Fitzgerald dissented and wrote that he would affirm the trial court. Judge Fitzgerald found that a plain reading of the Administrative Law Judge's opinion revealed that plaintiff’s psychological impairments entitled him to social security benefits, and since the cause of the disability was not related to the automobile accident, the defendant insurer should not be entitled to receive an offset from the amount of wage loss benefits. Judge Fitzgerald would have also affirmed the award of attorney fees made by the trial court, granted under §3148(1) because of defendant insurer's delay in making payments of no-fault benefits after the order granting summary disposition had been granted.


Michigan auto accident attorney Stephen Sinas is the lead editor of the appellate case summaries published on this site regarding the Michigan auto insurance law. To learn more about how Stephen Sinas and how the Sinas Dramis Law Firm can help you if you have been injured in a Michigan auto accident, visit SinasDramis.com.

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