Workers’ compensation decisions aren’t always clear-cut. Sometimes, they result in drawn out court battles, and these cases can have a major impact on workers’ compensation. From Washington to New York, here’s a look at some of the most important workers’ compensation rulings from the last half year or so.
Ohio First Responders Can Get Benefits for Mental Injuries
Some states allow workers’ compensation benefits for mental injuries. However, determining the cause of a mental injury and the validity of a workers’ compensation claim can lead to debate.
An emergency dispatch center worker in Ohio received a distressing 911 call from a woman who said her baby had died. The call involved more than two minutes of frantic screaming before the dispatch worker was able to get an address and transfer the call. The dispatch worker received counseling after the call and was diagnosed with post-traumatic stress disorder (PTSD). The worker filed a workers’ compensation claim, but it was denied on the grounds that the call did not meet the criteria for being “unusual” or “unexpected.”
However, the Iowa Supreme Court ruled that the PTSD diagnosis qualified as a personal injury that arose out of and in the course of employment. The ruling is seen as effectively lowering the bar for workers’ compensation claims filed by emergency responders for mental injury. You can read more about the case at SouthernMinn.com.
State Work Comp Laws Can’t Discriminate Against the Federal Government
It’s easy to see how a worksite with nuclear waste might lead to workers’ compensation claims, but a law designed to facilitate those claims came under fire. In 2018, Washington enacted a new law that applied to a site that used to manufacture nuclear weapons. Most of the workers at the site were federal contractors, but there were some federal employees. The new law made it easier for workers to file a successful workers’ compensation claim, but it only applied to federal contractors, not federal employees.
This resulted in a lawsuit filed by the United States against Washington. According to the lawsuit, the law discriminated against the federal government and therefore violated the Supremacy Clause. The Supreme Court ruled that the law was indeed in violation of the Supremacy Clause. You can read more about the ruling at SHRM.
Exclusive Remedy Provision Does Not Apply to Non-Work Comp Claims
Exclusive remedy provisions may bar certain lawsuits against employers. However, these provisions do not necessarily bar lawsuits for every type of injury or claim.
A company in Illinois scanned its employees’ fingers for timekeeping purpose. One employee filed a lawsuit claiming that the company had violated the Illinois Biometric Information Privacy Act (BIPA). The employer filed a motion to dismiss on the basis that the lawsuit was barred under an exclusive remedy provision in the Illinois Workers’ Compensation Act (IWCA). However, the exclusive remedy provision does not apply when the injury is not compensable under the IWCA, and the Illinois Supreme Court rule held the IWCA does not preempt BIPA claims. You can read more about the case in the National Law Review.
Debate over Coverage for Traveling Workers Continues
An electrician in Florida was driving from his home to his first remodeling job of the day when a drunk driver collided with his vehicle. Whether or not the incident was compensable under workers’ compensation became a matter of debate. On the one hand, the worker was communing from home to work. On the other hand, he was transporting some supplies and he received a gas allowance.
According to Business Insurance, the judge of compensation claims ruled that the claim was not precluded. An appeals court then reversed this, saying that the worker did not start work until arriving at the first job and clocking in. According to Claims Journal, the case may be appealed to the Florida Supreme Court.
Workers’ Compensation Laws May Not Preclude Take-Home COVID Claims
When a worker contracts COVID, the illness may be compensable under workers’ compensation. The NCCI says that 18 states adopted COVID presumptions in 2020 and 2021, and two states adopted more general infectious disease presumptions, making these claims easier to file. Another issue, however, is what happens when a worker contracts COVID and then passes it to someone in their household.
A woman says she contracted COVID while working at See’s Candies, and that she then passed the virus to her husband, who died. The woman has filed a lawsuit against See’s, and See’s tried to have it dismissed on the basis that the worker’s claims were covered by the state’s workers’ compensation law and the worker therefore could not sue in court. According to Reuters, an appeals court allowed the lawsuit to proceed, and the California Supreme Court declined to review the case, so the employer will have to face the lawsuit. A similar case is being considered in another California court, and additional lawsuits have been filed in other states.
New York Court Rules on Successive SLU Awards
A New York Court ruled on two cases involving schedule loss of use (SLU) awards for total or partial impairment of a body part. The cases involved successive injuries and raised the question of whether a prior injury and SLU award of the same body part should reduce subsequent SLU awards. For example, if a worker experiences a knee injury and received an SLU award and then experiences a hip injury on the same leg, should the SLU award for the hip injury be reduced because an SLU award has already been granted for the leg?
According to Law 360, the New York Court of Appeals concluded that separate SLU awards can be granted for the same body part if the claimant can show that the subsequent injury caused an increase in loss of use by itself, a ruling that may open the door to SLU awards that total more than 100%. You can read more about the rulings at Stockton, Barker & Mead, LLP.
Statute of Limitations Does Not Bar Timely Additional Claims
The full extent of injuries is not always known at the time of the incident. As a result, additional benefit claims may be filed a significant time after the incident. This raises the question of when the statute of limitations on claims applies.
An Arkansas worker fell from a ladder in 2015. His right shoulder was injured, and he underwent two surgeries. He was eventually released to light duty. In 2019, he filed for additional benefits, but a judge ruled that the claim was barred by the statute of limitations. The worker appealed, and the court ruled that the claim for additional benefits was filed within one year of the date of the last payment of compensation and was therefore permissible. The Arkansas Supreme Court then took up the case after the employer filed a petition for review, and the court held the ruling that the claim was timely and permissible. You can read more about the case in the Insurance Journal.
Are Your Overpaying for Workers’ Compensation?
As these cases show, many workers’ compensation issues are complicated. This doesn’t mean you have to get stuck with overpayments. A workers’ compensation premium audit can identify and recover overpayments. Learn more.
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