Justia Government & Administrative Law Opinion Summaries

The issue before the Supreme Court in this case was one of first impression: whether the Louisiana Workers’ Compensation Law (specifically La. R.S. 23:1036) as the exclusive remedy for a volunteer firefighter in claims for personal injury against the "fire company," similarly applies to claims for personal injury against fellow volunteer members. After reviewing the record and the law, the Court found the defendant failed to establish that the Workers’ Compensation Law granted immunity to fellow volunteer members of a volunteer fire company from suits in tort. Accordingly, the Court affirmed the decisions of the lower courts in denying the defendants’ motion for summary judgment. View "Champagne v. American Alternative Ins. Corp." on Justia Law

KCC, Inc., d/b/a Vital Care of Meridian (Vital Care) filed a complaint against the Mississippi State and School Employees' Life and Health Plan ("the Plan") and the Plan’s pharmacy benefits manager, Catalyst Rx, alleging that the Plan and Catalyst had violated Mississippi Code Section 83-9-6 by designating Walgreens Pharmacy as the sole provider of specialty pharmacy services. Later, Vital Care moved for partial summary judgment on the question of whether Section 83-9-6 applied to the Plan. The Chancery Court granted Vital Care’s motion for partial summary judgment, and the Plan and Catalyst appealed. Upon review of the applicable statute, the Supreme Court found that Section 83-9-6 applied to the Plan because it applies to "all health benefit plans providing pharmaceutical services benefits, including prescription drugs, to any resident of Mississippi" and was not ambiguous. View "Mississippi State & School Employees' Life and Health Plan v. KCC, Inc." on Justia Law

K&D Enterprises, through its manager, Mid-America, contracted to purchase an apartment complex. Prior to the closing, K&D Enterprises created a new company, Euclid-Richmond Gardens, and assigned its rights under the purchase agreement to that new company. Euclid-Richmond Gardens hired K&D Group, Inc., a property-management company, to manage the apartment. K&D Group hired former employees of Mid-America and assumed the operations of the complex. The Bureau of Workers' Compensation later conducted an audit and determined K&D Group was the successor in interest to the business operations of Mid-America, a determination that authorized the Bureau to base K&D Group's experience rating, in part, on Mid-America's past experience, which included a large workers' compensation claim. After K&D Group's administrative appeal was denied, K&D Group unsuccessfully filed a mandamus action in the court of appeals. The Supreme Court reversed the judgment of the court of appeals and issued the writ of mandamus, holding that K&D Group was not a successor in interest for purposes of workers' compensation law, and thus, the Bureau abused its discretion when it transferred part of Mid-America's experience rating to K&D Group. View "State ex rel. K&D Group, Inc. v. Buehrer" on Justia Law

Petitioner Michael Crisp, Jr. worked for Employer SouthCo, Inc., seeding grass and performing odd construction jobs. In 2004, Petitioner and other workers were installing silt fencing to combat ground erosion. Petitioner held a pole while another worker operated the Bobcat. As Petitioner bent down to reach for a pole, the bucket of the Bobcat fell on Petitioner, covering him. Petitioner suffered injuries to his head and hands. At the emergency room, Petitioner was treated for abrasions and bruises to the back of the head and neck and a complex fracture in his right hand. There was no mention of a brain injury in Petitioner's hospital records. Nearly two years after his injury, Petitioner's doctor opined that Petitioner sustained physical brain injury as a result of his 2004 injury. Petitioner's eventual workers' compensation claim for the brain injury was denied, and he petitioned the Supreme Court for review of an appellate court's decision to reverse a circuit court's finding that he sustained a compensable brain injury. Upon review, the Supreme Court reversed the appellate court and remanded the case for further consideration of whether Petitioner sustained physical brain damage as contemplated under the Workers' Compensation Act which would entitle him to benefits for life. View "Crisp v. SouthCo." on Justia Law

Palmetto Hardwood, Inc. employed Petitioner Clifton Sparks as a saw operator. Petitioner suffered three work-related injuries during this employment, the first two of which injured Petitioner's lower back. In the third incident, Petitioner was required to remove a piece of metal from under a gang saw. In the process, the metal exploded and a three- to four-inch cubic piece struck him in the head. Petitioner subsequently sought workers' compensation for his injuries. Six doctors opined regarding whether Petitioner had suffered a physical brain injury. The Commission found that Petitioner had sustained a compensable injury to his head. It also found him to be totally and permanently disabled. The Commission ruled that Petitioner should receive only five hundred weeks of compensation as a result of his total and permanent disability and medical expenses causally related to the three compensable injuries. On appeal, the circuit court remanded to the Commission for it: (1) to explain whether the "physical brain injury" it found "border[ed] on the frivolous" was intended to be the same as or different from "physical brain damage" as used in section 42-9-10 (C); and (2) to reconcile the order's seemingly contradictory findings that Petitioner suffered a compensable injury to the head with its finding of no physical brain injury. On appeal, the circuit court affirmed the Commission's order. Petitioner subsequently appealed to the Court of Appeals, which affirmed in an unpublished opinion. On appeal to the Supreme Court, Petitioner argued that the Court of Appeals erred when it applied an improper definition of "physical brain damage" within the meaning of section 42-9-10(C). The Supreme Court disagreed and affirmed the circuit court. View "Sparks v. Palmetto Hardwood" on Justia Law

MASC filed an action in the district court seeking a declaration that South Carolina municipalities were entitled to assess municipal business license taxes based on, or measured by, the total flood insurance premiums collected in the particular municipality by insurance companies under an arrangement with FEMA. The district court denied the insurance companies' motion for summary judgment on grounds of preemption and sovereign immunity. The flood insurance premiums were federal property that could not be taxed and the participating private insurance companies, in their operation of and participation with the National Flood Insurance Program, were federal instrumentalities so closely connected with the federal government that they were immune from taxation. The federal government did not consent to this tax, and it was therefore invalid. Accordingly, the court reversed the district court's grant of partial summary judgment to MASC and denial of summary judgment to the insurance companies. View "Municipal Assoc. of SC v. USAA General Indemnity Co." on Justia Law

Decedent worked as a firefighter for Baltimore City. After Decedent died, his widow, Petitioner, began receiving survivorship benefits from Decedent's pension. Petitioner later filed a dependent's claim for death benefits under the Maryland Workers' Compensation Act. The dispute at the hearing concerned what provision of the Act was applicable to Petitioner's claim. The City argued that Md. Code Lab. & Empl. 9-610, which reduces compensation death benefits by the amount of pension benefits, should apply. Petitioner argued that Md. Code Lab. & Empl. 9-503(e), which allows firefighters' dependents to collect both pension and workers' compensation up to the amount of what had been the firefighter's weekly salary, should apply. Petitioner's claim was pending when section 9-503(e) was amended to include dependents in its scope of coverage. The Workers' Compensation Commission determined that section 9-503(e) governed the claim and awarded Petitioner benefits. The circuit court granted summary judgment for the City, ruling that Petitioner had no preexisting right to dual benefits prior to the statute's amendment. The Court of Appeals affirmed, holding that the amendments involved a substantive change in the law that precluded it from applying retroactively to pending cases. View "Johnson v. Baltimore" on Justia Law

Appellant Altrua HealthShare appealed the district court's decision affirming the Idaho Department of Insurance's (Department) determination that Altrua transacted insurance without a certificate of authority. Altrua argued that both the Department and the Ada County district court erred in finding that Altrua was an insurer because Altrua never assumed the risk of paying its members' medical bills. The Department found, and the district court affirmed, that when members make their predetermined monthly payments into the escrow account Altrua operates, the risk of payment shifts from the individual members to the escrow account, and in turn to Altrua. Altrua also contended that the Department's determination that it is an insurer despite the disclaimers in its membership contract to the contrary is an unconstitutional interference with Altrua's right to contract. Upon review, the Supreme Court found that the Department's conclusion that Altrua's membership contract was an insurance contract was clearly erroneous, and reversed the findings. The case was remanded for further proceedings. View "Altrua Healthshare v. Deal" on Justia Law

The Wyoming Workers' Safety and Compensation Division determined that Appellant suffered a compensable injury while employed by Employer. The lodge filed an objection to that determination and requested a hearing with the Office of Administrative Hearings (OAH). Appellant filed a motion to dismiss that objection on the grounds that the objection was invalid because Employer was not a proper party to the action. The OAH denied Appellant's motion and concluded that Appellant had not suffered a compensable injury. The district court affirmed. At issue on appeal was whether Employer properly filed an objection to the Division's final determination of compensability. The Supreme Court affirmed, holding that Employer was a proper party to the action because it was the identified employer and paid the necessary contributions under Wyoming Worker's Compensation Act. View "Heikkila v. Signal Mountain Lodge" on Justia Law

Employee injured his back while working for Employer. Employee and the Department of Labor and Workforce Development (Department) agreed upon a settlement that provided for a lump sum payment to Employer for his injuries. The settlement and SD-1 form were signed by Employee and both parties' attorneys. Two years later, Employee filed a petition to set aside the settlement. The trial court granted Employee's petition. The Special Workers' Compensation Appeals Panel vacated the trial court's judgment on a procedural issue, finding the SD-1 form was not "fully completed." The Supreme Court reversed the judgments of the Panel and of the trial court and dismissed Employee's petition, holding (1) when the Department approves a settlement, it implicitly approves the accompanying SD-1 form, and a court has no authority to set the settlement aside based on its independent finding that the SD-1 form was not "fully completed"; and (2) the evidence preponderated against the trial court's finding that Employee was not represented by counsel, and the court erred in granting relief based on Tenn. R. Civ. P. 60.02(5) as well as its inherent authority. View "Furlough v. Spherion Atlantic Workforce, LLC" on Justia Law