Legal Corner

Workers' Compensation
Appeals court publishes ruling on fees for missed hearings - California

In California Correctional Peace Officers Association Benefit Trust Fund vs WCAB, the 3rd Appellate District Court granted a motion by the Workers' Compensation Appeals Board (WCAB) and agreed to publish a decision that neither the Department of Industrial Relations nor the WCAB was required to notify a hearing representative or his client that a hearing was being held telephonically. Separately, the appellate court also said withdrawing a lien didn't excuse the failure to appear.

In the letter making the request, the WCAB wrote, "the Court's decision will provide needed clarification that publication of Newsline notices announcing changes in the method of appearance at workers' compensation proceedings during the COVID-19 pandemic, satisfy the due process right to notice of those change."

Sinkhole injury not compensable - Delaware

In Browning v. State, a judicial assistant for a state court parked her car on a public street and fell into a sinkhole that opened beneath her as she walked to the courthouse. When she filed a workers compensation claim, the eligibility revolved around the question of whether the injury occurred on her employer's premises. The street was owned by the state, her employer. However, the Industrial Accident Board found and the state Supreme Court confirmed that the street was not part of the state's premises because the city, not the state, exercised authority over parking on the street and she had not crossed the threshold of the courthouse when she fell. Therefore, the injury occurred while traveling to work and was not compensable.

Reimbursement for medically-necessary surgery denied - Florida

In Tejeda v. City of Hialeah, the city took responsibility for a firefighter's back injury, stipulating in an agreement that the city would authorize further surgical intervention if the city's designated doctor said it was necessary. Without an opinion from the city's doctor on medical necessity, the firefighter underwent spinal fusion surgery and sought reimbursement. While a judge found that the surgery was medically necessary, the stipulation agreement was binding and, therefore, reimbursement was denied.

High court clarifies exclusive remedy protection for general contractor - Illinois

In Munoz v. Bulley & Andrews, LLC, the state Supreme Court ruled that exclusive remedy does not depend on the payment of workers comp benefits and is only conferred upon immediate employers of the injured employee. An employee of a subcontractor filed for workers' comp benefits and sued the general contractor for personal injuries. The subcontractor was a wholly- owned subsidiary of the general contractor, but the companies operate as separate corporations, with separate tax ids, executives, and employees. The court found only the immediate employer of the injured worker was immune from the lawsuit under exclusive remedy, and it was undisputed that the general contractor was not the employee's immediate employer.

Benefits denied for employee who choked on breakfast - Missouri

In Boothe v. Dish Network Inc., a field service specialist choked on his breakfast while driving to an appointment, blacked out, and was injured when his van hit a pillar. An administrative law judge found the injuries to be compensable because the risk of driving on a rural road under time constraints was employment related. The Labor and Industrial Commission reversed the ruling and the Supreme Court agreed there was nothing about his employment that required him to eat breakfast while driving.

Knee injury when lifting patient not compensable - North Carolina

In an unpublished opinion, Vance v. Laurels Healthcare Holding, the Court of Appeals reversed a decision of the Industrial Commission that had found a knee injury sustained by a physical therapy assistant ("PTA") was compensable. Under the statute, injury is defined as "injury by accident" rising out of and in the course of employment. The injury occurred when the PTA was attempting to help a 6'4" 300-lb patient stand. She acknowledged that the patient was a two-person lift and that she had never lifted him before. Hence, there was no evidence that at the time of her injury the PTA was "performing her usual job duties in the usual manner."

Break injury compensable - Pennsylvania

In Henderson v. WP Ventures, an appellate court reversed the decision of the Workers' Compensation Appeal Board that had denied benefits to a worker who slipped on ice when he walked to a nearby sandwich shop to grab a sandwich and smoke a cigarette. Citing several earlier decisions, the court concluded breaks that allow the employee to administer to his or her personal comfort better enable the employee to perform the job. Therefore, they are compensable because they further the employer's business.

Statutory offset against Social Security upheld; post-injury limitations not a factor in earning power - Pennsylvania

In Sadler v. Philadelphia Coca-Cola, the Commonwealth Court upheld the constitutionality of an automatic 50% offset of Social Security retirement benefits received by an injured employee. While the court acknowledged that employers can only take offsets for severance and pension benefits to the extent that the employer paid them, it noted the Social Security offset was "a fair approximation of the employer's contribution" made to avoid "the burden to tailor the offset in each individual case to the actual Social Security tax contributions made by an employer for the employee subject to the offset."

In the same case, after the injury the employee was convicted of a Class II felony. The court ruled that non-work-related injury limitations that occurred after the work-related injury need not be considered as part of an injured employee's residual productive skill in determining whether a position identified by an employer is appropriate and/or open and available.

Summary of high court decisions on workers compensation published - Tennessee

The Advisory Council on Workers' Compensation published a summary of significant decisions the state's high court issued in 2021.