Justia Government & Administrative Law Opinion Summaries
Articles Posted in Injury Law
Tudor’s Biscuit World of Am. v. Critchley
Defendant, Tudor's Biscuit World of America, appealed the circuit court's order denying its motion to alter or amend the court's order denying its motion to set aside the default judgment rendered against it in this workplace injury action. Tudor's asserted (1) the circuit court erred in its application of the "reasonable time" requirement set forth in W.V. R. Civ. P. 60(b) to its motion to set aside the default judgment, arguing that such timeliness requirement was inapplicable to void judgments; and (2) the circuit court improperly applied and weighed the factors set forth in Parsons v. Consolidated Gas Supply Corporation in denying its motion for relief from judgment. The Supreme Court reversed, holding that the circuit court should have properly set aside the default judgment, as (1) Tudor's motion to set aside the default judgment was filed within a reasonable period of time; and (2) the circuit court abused its discretion in its analysis of the Parsons factors to the extent that such analysis resulted in its denial of Plaintiff's motion for relief from default judgment, and therefore, to that extent, erred in denying Tudor's subsequent motion to alter or amend.
Heinzelman v. Sec’y Health & Human Servs.
Heinzelman, born in 1971, received a flu vaccine in 2003, and within 30 days, was hospitalized for Guillain-Barre syndrome, a disorder affecting the peripheral nervous system. She was previously employed full-time as a hairstylist earning $49,888 per year. Due to her injury, Heinzelman will never be able to work again and is eligible to receive SSDI benefits of approximately $20,000 per year. In 2007, she sought compensation under the National Childhood Vaccine Injury Act of 1986, 42 U.S.C. 300aa-1 to 300aa-34. A special master rejected the government’s argument that her eligibility for SSDI benefits should be considered in determining compensation under the Vaccine Act, finding that SSDI is not a "federal . . . health benefits program" within the meaning of section 300aa-15(g), and awarded $1,133,046.08, plus an annuity to cover future medical expenses. According to the government, Heinzelman's lost earnings award would have been roughly $316,000 less had the special master taken her anticipated SSDI benefits into account. The Claims Court and the Federal Circuit affirmed.
Lewis v. Gilmore
Lonnie Lewis died when the tractor trailer in which he was a passenger overturned. The driver of the truck, Nathan Gilmore, was employed by Buddy Freeman, and Freeman operated the tractor trailer pursuant to a contract with DOT Transportation. Neither Freedman nor DOT carried workers' compensation insurance. Lewis' dependents filed a claim for workers' compensation against Freeman and DOT and a wrongful death action against Freeman and Gilmore. An ALJ entered an award in favor of Lewis' dependents. After the entry of the workers' compensation award, DOT intervened in the Lewises' wrongful death action. The circuit court granted summary judgment in favor of Gilmore and Freeman, finding the wrongful death action was barred because the Lewises had made an election of remedies when they obtained a workers' compensation award against DOT. The Supreme Court reversed, holding that the Lewises' civil action against Freeman was not barred by their workers' compensation award from DOT, as Mo. Rev. Stat. 287.280 allowed the Lewises to proceed in a civil action against Freeman as a result of his failure to insure his liability under the Missouri workers' compensation laws even though the Lewises obtained a workers' compensation award against DOT.
Giordano v. McBar Indus., Inc.
Scott and Martha Giordano were married and later separated. Scott was subsequently killed while working as an insulator in a building. Martha filed a claim for benefits with the Workers' Compensation Commission. The deputy commissioner determined that Martha was not a dependent of Scott and, therefore, was not entitled to workers' compensation benefits. Subsequently, Martha, as personal representative Scott's estate, filed a wrongful death claim against Defendants, Scott's employer, the employer's subcontractors, and a supplier of a product used in the construction process (Builder's Supply). The circuit court sustained Defendants' pleas in bar, concluding that the exclusivity provision of the Workers' Compensation Act barred Martha's action. The Supreme Court affirmed in part and reversed in part, holding (1) the circuit court did not err in holding that the exclusivity provision barred a non-dependent individual who was not eligible to collect benefits under the Act from bringing an action in tort; but (2) the court erred in holding that this provision of the Act barred an action in tort against Builder's Supply, as mere delivery of product was not within the trade, business or occupation of Scott's employer.
LaFreniere v. Dutton
Plaintiff, Defendant's employee, was traveling as a passenger in a pickup truck owned and operated by Defendant when the truck collided with another vehicle, resulting in injuries to Plaintiff. Plaintiff sued Defendant and Defendant's Insurer, alleging negligence. The trial justice granted summary judgment in favor of Defendant, reasoning that because Plaintiff had collected workers' compensation benefits for injuries sustained while traveling with Defendant on work-related business, the exclusivity provision of the Workers' Compensation Act precluded double recovery. The Supreme Court affirmed, holding that Plaintiff relinquished his right to sue Defendant in tort after accepting workers' compensation benefits based on the exclusivity provision of the Act.
Sapko v. State
Plaintiff Christine Sapko sought survivor's benefits following the death of her husband, an employee of the state of Connecticut. The workers' compensation commissioner denied Plaintiff's claim, determining that the decedent's ingestion of Oxycodone and Seroquel constituted a superseding cause of his death and, therefore, the decedent's compensable work injuries were not the proximate cause of his death. The workers' compensation review board upheld the commissioner's decision. The appellate court affirmed, concluding (1) the board incorrectly concluded that the superceding cause doctrine applied to the present case, but (2) this impropriety was harmless because the board correctly determined that the commissioner properly decided the issue of proximate cause. The Supreme Court affirmed but for different reasons, holding that the board correctly concluded that the commissioner's finding that superseding events broke the chain of proximate causation between the decedent's compensable work injuries and his death constituted a proper application of the law to the facts.
Gallagher v. Nat’l Grid USA/Narragansett Elec.
Dennis Gallagher was diagnosed with malignant mesothelioma, an occupational disease, and ultimately succumbed to the disease. A trial judge of the workers' compensation court entered decrees holding USGEN New England, Inc. (USGEN) liable to pay benefits to Dennis and to his wife, Maureen Gallagher, as Dennis's last employer under R.I. Gen. Laws 28-34-8. The appellate division of the workers' compensation court vacated those decrees and entered final decrees assessing liability against National Grid USA/Narragansett Electric (National Grid), USGEN's predecessor as owner of the plant where Dennis had worked and been exposed to asbestos. Maureen and National Grid each petitioned for a writ of certiorari to review the appellate division's final decrees. The Supreme Court issued both writs and consolidated the cases. The Court then affirmed, holding that the appellate division did not err in vacating the trial judge's decrees and in entering final decrees assessing liability against National Grid instead.
Ceres Gulf, Inc. v. DOWCP, et al
Petitioner, the former employer of a retired longshoreman, challenged a Benefits Review Board (BRB) decision that overruled an ALJ twice and held petitioner liable for the longshoreman's hearing loss. The court held that the BRB erred in rejecting expert evidence in part and in then rejecting the ALJ's first conclusion based on his evaluation of the evidence. Further, the court need not reach the aggravation rule issue raised by petitioner. Because the BRB initially applied the wrong legal test and standard of review to the ALJ's decision, the court reversed.
Weiner v City of New York
Plaintiff, an employee of the New York City Fire Department, applied for and received workers' compensation benefits from the city. Plaintiff subsequently commenced this action against the city and its Parks and Recreation Department, alleging both common law negligence and a cause of action under General Municipal Law 205-a. The city moved to dismiss the complaint pursuant to CPLR 3211, arguing that plaintiff's receipt of workers' compensation benefits barred his lawsuit. The court concluded that it was not the intent of the Legislature to allow recipients of workers' compensation benefits to sue their employers in tort under section 205-a. Accordingly, the court affirmed the judgment.
Yussen v. Med. Care Availability & Reduction of Error Fund
At issue in this direct appeal to the Supreme Court was a statutory prerequisite to the obligation of the Insurance Department to defend certain medical professional liability actions asserted against health care providers, and to the requirement for payment of claims asserted in such actions from the Medical Care Availability and Reduction of Error Fund. Specifically, resolution of the appeal turned on when, under the governing statute, a "claim" is "made" outside a specified four-year time period. On June 4, 2007, Joanna Ziv filed a praecipe for a writ of summons naming Appellant Phillip Yussen, M.D. and other medical providers as defendants. A complaint was filed on August 2, 2007, alleging medical negligence last occurring on July 7, 2003. Appellant’s primary insurer, Pennsylvania Healthcare Providers Insurance Exchange, requested that the claim be accorded Section 715 status by the Insurance Department. The Department denied such request, however, on the basis that the claim had been made less than four years after the alleged malpractice. Appellant initially challenged this determination in the administrative setting, and a hearing ensued. Before the examiner, Appellant argued that, consistent with the policy definition of a "claim," the date on which a claim is made for purposes of Section 715 cannot precede the date on which notice is provided to the insured. Appellee, on the other hand, contended that a claim is made when it is first asserted, instituted, or comes into existence - including upon the tender of a demand or the commencement of a legal action - and that notice to the insured or insurer is not a necessary prerequisite. In this regard, Appellee Medical Care Availability & Reduction of Error Fund highlighted that Section 715 does require "notice" of the claim to trigger the provider's obligation to report the claim to the Fund within 180 days, but the statute does not contain such an express notice component in delineating the four-year requirement. The Commonwealth Court sustained exceptions to the hearing examiner's recommendation lodged by Appellee and entered judgment in its favor. In its review, the Supreme Court found "claim" and "made" as used in Section 715 ambiguous. The Court determined that for purposes of Section 715, the mere filing of a praecipe for a writ of summons does not suffice to make a claim, at least in absence of some notice or demand communicated to those from whom damages are sought. The Court remanded the case for entry of judgment in Appellant's favor.