Legal Corner

ADA
Restriction-free RTW policy leads to $95,000 settlement with EEOC

Navitas Systems, LLC, an Ann Arbor, Michigan battery manufacturer, had a policy that required any employee returning from medical leave to be 100 percent free from restrictions. An employee who suffered severe injuries to his left arm was restricted from using his left arm but cleared to return to work using his other arm. It was determined that he could complete the essential functions of his job, however, the company applied its policy, refused to allow him to return, and fired him.

After failing to settle, the Equal Opportunity Commission (EEOC) filed suit under the ADA. Under the three-year consent decree, Navitas will pay $95,000 in monetary damages to the employee, provide annual training on the ADA to all managers, supervisors, and human resources personnel, and submit annual reports to the EEOC regarding reasonable accommodation requests and employees returning to work following medical leave.

Workers Compensation
Court says miner proves work, not smoking, caused lung condition - Federal

The United States Court of Appeals for the Fourth Circuit, which covers Maryland, North Carolina, South Carolina, Virginia, and W. Virginia, recently issued a decision in Extra Energy Inc. v. Glen K. Lawson et al. under the Black Lung Benefits Act (BLBA). The miner worked underground for 12 years and smoked one pack daily for 30 years. The key issue was whether his chronic obstructive pulmonary disease was attributable at least in part to his work in the mines.

Five physicians submitted medical opinions. While three opined that the disease was caused by a combination of his smoking and his employment, two disagreed and said his condition was due solely to his smoking history. The ALJ found that the medical evidence supported a finding of legal pneumoconiosis, and the Benefits Review Board concurred. The 4th Circuit Court of Appeals affirmed, noting that ALJ's have the discretion to evaluate medical evidence and the findings were credible.

The case demonstrates that employers must present robust evidence to avoid liability. Under the BLBA, miners are given certain presumptions and procedural protections (e.g., the 15-year presumption for long-term miners), which are difficult to rebut.

Date of injury determination necessary for claim related to 50-year-old injury - California

In Travelers Indemnity Company v. Workers' Compensation Appeals Board, a former New York Yankees player filed a work comp claim for cumulative injury sustained from 1968 to 1978. The WCJ determined the player did not become aware of his right to file a claim until 2017 or 2018. Therefore, the statute of limitations was tolled. The Workers' Compensation Appeals Board (WCAB) found he had a compensable injury but deferred any award pending further proceedings, including mandatory arbitration of the insurance coverage dispute.

The carrier appealed, arguing that mandatory arbitration applied only to injuries occurring on or after Jan. 1, 1994. The court noted that there was never a determination of the date of the injury, which was necessary for mandatory arbitration. It remanded the case for further proceedings, emphasizing that the "date of injury" for cumulative injuries should be determined under section 5412, which considers when the employee first suffered disability and knew or should have known it was work-related.

Employee can't sue employer for emotional distress without filing comp claim first - Florida

In Steak 'n Shake v. Amber N. Spears et al., an employee who had been held at gunpoint during a robbery filed her lawsuit claiming she had suffered severe emotional distress. A trial court allowed her lawsuit to proceed, arguing that the state's "framework" for workers comp does not allow compensability for a mental injury claim without a physical injury requiring medical treatment.

The appeals court reversed ruling she must file a workers compensation claim and have a carrier or a judge of compensation claims determine that the injury is not compensable before suing the employer. Interestingly, the Texas Supreme Court recently took the opposite position in University of Texas Rio Grande Valley v. Rita Oteka ruling that workers are not required to file comp claims before suing employers.

High court clarifies when retaliatory firing is illegal in comp cases - Indiana

In South Bend Community School Corp. v. Connie Grabowski, a jury concluded that the School Corp. illegally fired an employee in retaliation for a potential comp claim and awarded her $600,000 in damages. An appeals court agreed, but the state Supreme Court noted that there were limited exceptions to the state's employee-at-will doctrine, which stipulates an employee can be fired at any time for any reason. One of the exceptions is firing workers for filing a workers compensation claim to avoid the liability of paying the claim.

The teacher suffered a sprained wrist and ankle when a student bumped into her, causing her to fall against a wall. Although there had been a negative history between the teacher and student, it was agreed the incident was an accident. The family filed a bullying complaint, an investigation followed, and the teacher was given a "last chance agreement." She resigned and later sued for wrongful termination, charging the school with retaliating against her for expressing an intent to file a comp claim.

The Supreme Court found the evidence didn't show, nor did the teacher contend, that the school was trying to avoid workers' compensation liability. Therefore, the claim did not fit into the narrow exception to the state's at-will doctrine.

High court addresses statutory cap and excess attorney fees - Minnesota

In Jurgensen v. Dave Perkins Contracting, a worker suffered a shoulder injury in 2021 and underwent two surgeries. He was paid benefits, but a dispute arose over the correct permanent disability rating and ongoing restrictions needed. In mediation, the parties agreed to a lump sum settlement of $150,000, under which the contingency attorney fee recovery was limited to the statutory maximum (20 percent of the first $130,000) plus a $4,000 excess fee to be deducted from the settlement. Effective Oct. 2024, the Legislature increased the presumptive cap on attorney fees to 20 percent of the first $276,000.

Excess fee awards can be rewarded if the compensation judge deems an attorney should recover more than the statutory cap allows. The judge applied the factors from an earlier case, Irwin, that should be considered for excess fees and denied the award. The attorney appealed and the Supreme Court heard the case. It ruled that the 2024 amendment does not apply retroactively, that the cap is constitutional, and that the administrative rules regarding judge's approval of excess fees did not mean that undisputed fees are entitled to automatic approval.

Recent Supreme Court decision could affect cases under appeal - Missouri

In Brian White v. Treasurer of Missouri as Custodian of the Second Injury Fund, a worker who sustained a chest injury had sustained a shoulder injury ten years earlier, received benefits, and applied for Second Injury Fund benefits (SIF). An ALJ found that the shoulder injury satisfied the requirement of a preexisting disability equal to at least 50 weeks and awarded benefits. The SIF appealed. While the appeal was pending, the Supreme Court ruled that occupational diseases are not compensable preexisting disabilities for SIF claims.

The court acknowledged the worker had relied on an occupational disease as his qualifying disability, but other claims that could qualify as compensable injuries may trigger SIF liability. Therefore, the case was remanded.

Attorney fees must reflect workers' increase in recovery, not gross amount - New York

In Cooper v. New York City Health & Hospital Corp., the Third Department addressed the issue of how attorney fees, awarded as a lien on reimbursements to the employer, should be calculated. The court clarified that the fees must be based on the actual increase in compensation the worker received because of the legal representation, not the gross amount of reimbursement.

20-day hearing rule on continuing benefits not mandated - New York

In Juncal v. Maspeth Remodeling Co., an appellate court clarified that when a worker is receiving continuing benefits at a temporary rate, the Workers' Compensation Board's regulations do not mandate that a hearing be held within 20 days, and they do not provide for the worker's benefits to be reduced or suspended after 20 days. Although the employer requested a reopening hearing, the Board proceeded at its own schedule, beyond the 20-day mark, and continued issuing temporary disability benefits.

Employers cannot rely on time delays alone to suspend or reduce ongoing temporary benefits. The 20-day time frame was a Board regulation that "was directory or aspirational rather than mandatory," according to the court.

Court rejects intentional misconduct claim after explosion death - North Carolina

In Tyson vs. ELG Utica Alloys LLC, the Court of Appeals rejected a "Woodson claim" in a case involving a fatal zirconium explosion at a metal processing plant. The Woodson exception, established in Woodson v. Rowland, allows an employee to sue their employer in civil court for workplace injuries if the employer's actions were "substantially certain" to cause death or serious injury. However, the courts have consistently emphasized that this is a narrow exception, requiring more than mere negligence or unsafe working conditions.

A trial court had denied a motion for summary judgment, but the Court of Appeals disagreed. The court found that the employer's conduct, while potentially negligent, did not meet the "substantial certainty" standard required for the Woodson exception to apply.

Supreme Court reverses long-standing case law on specific loss benefits - Pennsylvania

In Kristina Steets v. Celebration Fireworks Inc., the high court reversed an appellate court and ordered an employer to pay specific loss benefits to the estate of a worker who died before the final adjudication of her claim. In an explosion, the pyrotechnics worker suffered catastrophic injuries to her arms, losing use of them, and died while benefits beyond the disability and medical were being adjudicated.

In denying the award, lower courts relied on case law (Estate of Harris v. WCAB Sunoco Inc.), which found if a worker died from work-related injuries, her estate was not entitled to payment of specific loss benefits, only funeral expenses were awarded. However, the Supreme Court overturned the rulings, saying workers compensation law did "not categorially bar the recovery of specific loss benefits when a worker dies from her work-related injuries." The case was referred to a judge "to assess the amount of specific loss benefits due to the Estate."

Willful misconduct must be cause of injury to be basis for claim denial - Virginia

In Averett vs. City of Danville, an employee admitted to violating the employer's policies following an auto accident by not wearing a seatbelt and using his cellphone while driving. A Deputy Commissioner denied the claim based on his willful misconduct.

The worker maintained that the evidence did not support a finding that his injuries were caused by his willful misconduct or safety violations.The full Workers Compensation Commission (VWCC) agreed this finding was necessary and sent the claim back to the Deputy Commissioner to determine what injuries were suffered and whether the willful violations of the employer's safety rules were the proximate cause of any of the injuries. If they were, the claim can be denied.

Compensability dependent on whether injury involved horseplay or assault - Virginia

Although the opinion in Camping World RV Sales LLC v. Ocasio is unpublished (does not set legal precedent), it is a reminder for employers to investigate alleged horseplay incidents. An operations manager was hit by a golf cart driven by an employee, who claimed it was prank that went wrong. However, the manager, who suffered multiple injuries, felt it was intentional and sought a criminal warrant. The employee was charged with felony unlawful wounding, entered a no-contest plea, and was convicted of misdemeanor assault and battery.

The manager also filed a comp claim, which the Workers Compensation Commission approved but the Court of Appeals denied. The court said the record supported a finding that the manager's injuries were the result of a personal assault and battery, not related to the manager's status as an employee. It explained that when horseplay among co-workers causes an injury, it is automatically compensable. However, when a worker is injured from an assault and battery, there must be a nexus between the tort and the employment.