Legal Corner

Workers Compensation
DOJ asks SCOTUS not to review Minnesota decision on reimbursing injured workers for medical cannabis - US

Recently Minnesota's high court ruled employers can't be compelled to reimburse injured workers for medical cannabis because it would force them to violate federal law. The Department of Justice (DOJ) filed a brief noting the cases do not warrant review by the U.S. Supreme Court "for the straightforward reason that when a federal law such as the (Controlled Substances Act) prohibits possession of a particular item, it preempts a state law requiring a private party to subsidize the purchase of that item."

WCAB's 'grant-for-study' practice under scrutiny - California

The Workers' Compensation Appeals Board (WCAB) has been ordered by an appeals court to explain the origin of its "grant-for-study" procedure and why it shouldn't be precluded from using the process in the future. The WCAB is required to issue decisions on appeals within 60 days, but by granting the petition for further study, the deadline for a final decision can be extended indefinitely. Five injured workers are challenging the constitutionality of the practice.

Appeals court overturns compensability for tetraplegia worker - Florida

In LFI Ft. Pierce v. Holmes, a Judge of Compensation Claims (JCC) awarded benefits to a worker left with incomplete tetraplegia from injuries in a car accident while carpooling with a coworker who fainted from dehydration while driving. They worked for Blue Goose Growers LLC as leased employees of Labor Finders Inc. (LFI). When the worker sued in tort, Blue Goose asserted workers' compensation immunity as a defense and the worker pursued comp benefits.

LFI argued that the claim was barred by the going-and-coming rule. The JCC determined the case was not barred from the going and coming rule, because Blue Goose had argued the contrary in circuit court and the two employers had a special relationship, the driver's dehydration was a 'special hazard,' and the injury arose directly out of employment in that the dehydration experienced by the driver was a "ticking time bomb."

In overturning the ruling, the Court of Appeals found the employers had adverse interests and that the special hazard exception only applies when there is both a "hazard at particular off-premises location" and "close association of the access route with the work premises." Further, the dehydration occurred in the scope of the driver's employment, not of the injured worker.

Department of Insurance (DOI) can resolve dispute over premium between employer and carrier - Illinois

In Prate Roofing and Installations LLC v. Liberty Mutual Insurance Corp., Prate sought workers' compensation coverage through the Assigned Risk Plan and Liberty Mutual was assigned as the carrier. During an audit, Liberty Mutual determined that one of Prate's subcontractors did not have workers' comp insurance, which created additional exposure and added $127,305 to the premium. The DOI agreed with Liberty, but upon review an appellate court relied on another recent decision, CAT Express Inc. v. Muriel, to declare the DOI order void.

On appeal, the state Supreme Court noted the cases differed. CAT had not disputed the application of an experience rating plan, classification system, or any NCCI manual rules, but centered on whether the carrier had applied the wrong classification code to certain workers and misclassified others. The Insurance Code specifically allows the DOI to review how the NCCI rating system has been applied in connection with a party's insurance, which was relevant in the Prate case.

Lump-sum settlement bars claim for later causally related injury - Massachusetts

In Lamport's case, a worker at an assisted living facility injured her right shoulder while lifting a resident out of a wheelchair. She underwent surgery to repair her rotator cuff, but before the surgery, also had pain in her left shoulder. The insurance carrier accepted liability and entered into a settlement agreement and agreed to remain liable for future medical payments for the specified injuries to her right shoulder.

A few months later, she was diagnosed with a left rotator cuff tear requiring arthroscopic surgery and applied for workers comp benefits. While an administrative judge found the injuries related to the earlier accident compensable, the Industrial Board disagreed. It noted that she was aware of the left shoulder injury but did not specifically reserve or exclude the left shoulder injuries from the scope of the settlement. The Appeals Court agreed and noted that a similar case was inapplicable because that considered whether the left shoulder injuries were causally related to the accident; the carrier had not raised the lump sum agreement as a bar to recovery.

How hearing loss is apportioned among employers - Minnesota

In Sershen vs. Metropolitan Council, the worker had been exposed to high levels of noise throughout his career, which included employment with five companies. His last place of employment was Metropolitan Council where he was not exposed to hazardous noise onsite but did go to noisy worksites. A WCJ found that he had suffered occupational hearing loss from exposure at all five companies and determined that the last significant exposure was at the employer before Metropolitan Council.

Although the judge found that employment with Metropolitan Council did not contribute significantly to the hearing loss, the company was ordered to pay medical benefits because he was last exposed there. Noting that state law stipulates the employer where the employee was last exposed to the hazard "shall" pay the medical expenses, the Supreme Court upheld the award. It also noted that the statute "provides that the last-exposure employer is entitled to reimbursement from the last-significant-exposure employer, but "only in the case of disablement."

Court overturns decision that twisting and turning injury not casually related to employment - Missouri

In Durr v. Clark's Mountain Nursing Center, a nursing assistant injured her knee while attempting to navigate a narrow space between a patient's bed and a wall. The Labor and Industrial Relations Commission denied benefits because she was exposed equally to twisting and turning injuries during normal daily activities and, therefore, the injury was not causally related to employment. A divided court disagreed, finding the injury arose out of the working conditions and work requirements of her job.

Worker loses benefits for failing to disclose prior medical treatment - New York

In Nappi v. Verizon New York, a technician obtained workers comp benefits for a right shoulder injury. However, he did not disclose that he had previously received treatment for the same shoulder and the carrier filed a request for action on the possible violation of the Workers Compensation law. The Workers' Compensation Board found misrepresentation and the court agreed. The benefits award was rescinded and a discretionary penalty, permanently disqualifying him from receiving wage replacement benefits for the claim, was imposed.

Remote worker cannot assert disability claim if not working in state - New York

In Shiber v. Centerview Partners LLC, a federal court held that an employee working remotely from New Jersey due to the COVID-19 pandemic cannot assert claims under the New York State and New York City anti-discrimination laws. Alleged discriminatory conduct must have an impact in New York City and New York State for the city and state's anti-discrimination laws to apply.

Direct line between compensable knee injury and need for bariatric surgery - North Carolina

Although initially denied by the Industrial Commission, a preschool owner and operator who needed a knee replacement surgery related to a workplace injury won approval for bariatric surgery, which was medically necessary to undergo the knee surgery. In Robin Kluttz-Ellison v. Noah's Playloft Preschool and Erie Insurance Group, the court accepted the opinion of her physician that she "could not lose weight fast enough due to her physical limitations for the knee surgery to be conducted safely and optimally without undergoing weight loss surgery".

Full Commission can reconsider and amend deputy commissioner's award - North Carolina

State statute empowers the Industrial Commission to reconsider the evidence before the deputy commissioner and to amend the deputy commissioner's award "if good ground be shown" to do so. However, it does not have to expressly state that it found good grounds to reconsider the decision, nor does it have to identify the grounds on which it relied.

In Forte v. Goodyear Tire & Rubber Co., a case of first impression heard by the state Supreme Court, a deputy commissioner awarded benefits for an injury to a roll changer for Goodyear. The employee had delayed reporting and presented inconsistent reports and the full Commission found that his testimony was not credible. Upon appeal, the Court said it would presume that the Full Commission found the necessary good grounds to reconsider the evidence and deny the benefits, therefore, its review was limited to examining whether the implied finding of good grounds was a manifest abuse of discretion. The Commission's decision was affirmed.