Justia Government & Administrative Law Opinion Summaries

The issue before the Supreme Court in this case centered on whether a Workers' Compensation employer's insurance carrier should be reimbursed from the Supersedeas Fund for specific payments made to a claimant prior to the ultimate grant of supersedeas. The question turned on whether the relevant payments constituted payments of "compensation" within the meaning of Section 443 of the Workers' Compensation Act (WCA), 77 P.S. 999(a), or, as argued by Appellant Bureau of Workers' Compensation, whether the payments are not reimbursable because they constitute payment of legal costs associated with obtaining a claimant's third-party tort settlement under Section 319 of the WCA, 77 P.S. 671. After review, the Court found no language in either Section 443 or Section 319 that would transform the relevant payments into something other than compensation merely because the amounts of the payments were calculated to compensate the claimant for the costs of recovering the third-party settlement. Accordingly, the Court affirmed the decision of the Commonwealth Court. View "Bureau of Workers' Comp, Aplt v. WCAB(Excelsior Ins.)" on Justia Law

Appellant was injured in an accident that occurred during the course of her employment. After receiving a permanent partial impairment award from the Wyoming Worker's Compensation Division, Appellant sought permanent partial disability benefits. The Division denied Appellant's application, stating that she had not complied with the statutory work search requirements. After a contested case hearing, the Office of Administrative Hearings granted summary judgment for the Division, concluding that Appellant had not timely submitted documentation showing she had sought work. The district court affirmed. The Supreme Court reversed, holding (1) Appellant's work search submission was timely; and (2) Appellant was entitled to a hearing and the opportunity to present evidence showing that she actively sought work. View "Stallman v. State ex rel. Wyo. Workers' Safety & Comp. Div." on Justia Law

Following the trial court's grant of summary judgment to the Georgia Insurers Insolvency Pool (GIIP), Lumpkin County appealed, contending that following the insolvency of the County's regular insurer, GIIP was required to step in and cover the pending workers' compensation claims against the County. Specifically, the County argued that the trial court erred in finding that it was not entitled to coverage under the GIIP because the County's net worth exceeded $25 million. Alternatively, the County argued OCGA 33-36-3 unconstitutionally violated the County's due process rights. Upon review, the Supreme Court affirmed: "The County contend[ed] that this ruling was erroneous because the term 'net worth' is inapplicable to government entities, and, instead, the applicability of the twenty-five million dollar exemption under the Act should be assessed based on the County's 'net assets.' The County argue[d] that the bulk of its assets, including land, roads, bridges, and government buildings are restricted from use and are thus unavailable to meet its obligations or satisfy liabilities. Based on the County's calculation of its own net assets, it only has $5.6 million dollars with which to meet these obligations. As a result, the County maintain[ed] that it should receive coverage for its claims from the GIIP. This argument is misplaced." Therefore, the Court held that the trial court did not err in excluding the County from GIIP protection based on the net worth exemption. Furthermore, the County does not possess due process rights by which to challenge the constitutionality of the Act, and its argument premised on any such right necessarily failed. View "Lumpkin Co. v. Georgia Insurers Insolvency Pool" on Justia Law

Petitioner appealed an order of the West Virginia Workers' Compensation Board of Review through which Petitioner's permanent total disability (PTD) award previously granted was suspended and vacated. Petitioner challenged the Board's determination, upon a reopening of his PTD claim, that he was capable of gainful employment. Petitioner argued that his former employer, Lowe's, violated the statute that authorized the claim reopening because Lowe's was involved in the reevaluation process, and therefore, the order vacating his PTD award was invalid. The Supreme Court affirmed, holding that notwithstanding statutory language that suggests otherwise, an order issued by the Board that modifies or vacates a previous award of PTD is not subject to challenge based on the involvement of a self-insured former employer in the reevaluation process, given that the participation of the self-insured former employer is clearly anticipated and authorized by the provisions of W. Va. Cod 23-4-16(d). View "Justice v. W. Va. Office Ins. Comm'n" on Justia Law

Respondent injured his back while working, and his employer's workers' compensation insurer, Texas Mutual Insurance Company (TMIC), accepted the injury as compensable. Three years later when it was discovered that Respondent had herniated lumbar intervertebral discs, TMIC disputed whether they were causally related to the original injury. The Texas Department of Insurance Division of Workers' Compensation determined that the disc herniations were related to the original injury and ordered TMIC to pay medical benefits, which it did. Respondent later sued TMIC for damages caused by its delay in paying benefits. The trial court rendered judgment for Respondent, and the court of appeals affirmed. Based on the Court's recent decision in Texas Mutual Insurance Co. v. Ruttiger, the Supreme Court reversed and rendered judgment for TMIC. View "Tex. Mut. Ins. Co. v. Morris" on Justia Law

Appellant appealed from an opinion of the court of appeals which affirmed an order of the circuit court dismissing Appellant's petition for review of a decision of the Kentucky Unemployment Insurance Commission (KUIC). In addition to denying Appellant unemployment benefits, the KUIC ordered Appellant to reimburse $12,785 in benefit payments he had already received. The circuit court dismissed Appellant's petition for review because it did not comply with the verification requirement contained in Ky. Rev. Stat. 341.450(1), and thus the court concluded that its jurisdiction was not invoked within the twenty-day limitations period provided for filing such an action. The Supreme Court affirmed, holding (1) because Appellant failed to comply with the verification provision of section 341.450(1), the circuit court lacked jurisdiction over the controversy; and (2) Appellant did not comply with the verification requirement, as his attorney's signature on the petition did not constitute "certification." View "Taylor v. Ky. Unemployment Ins. Comm'n" on Justia Law

The State of North Dakota, by and through the Department of Human Services and its Child Support Enforcement Division ("the Department"), appealed a district court order denying its application for an order to enforce an administrative subpoena. In July 2010, the Department issued an administrative subpoena to the North Dakota Insurance Reserve Fund ("NDIRF") directing it to provide information on all claims submitted to the Fund. NDIRF objected to the subpoena, contending that the Department was not statutorily authorized to issue an administrative subpoena to NDIRF and that the subpoena was vague, ambiguous, and unduly burdensome. The Department filed an application for an order enforcing the administrative subpoena in district court. The district court determined that the Department was not statutorily authorized to issue an administrative subpoena to NDIRF and denied the application. The district court did not address NDIRF's arguments that the subpoena was vague, ambiguous, and unduly burdensome. Upon review, the Supreme Court concluded that the district court erred in holding the Department was not statutorily authorized to issue an administrative subpoena to NDIRF. Accordingly, the Court reversed the order denying the Department's application for an order enforcing the administrative subpoena. Because the district court did not address NDIRF's contentions that the subpoena was vague, ambiguous, and unduly burdensome, the case was remanded to the district court for further proceedings to properly consider these issues under the limited four-factor review of enforcement of an administrative subpoena. View "North Dakota v. No. Dakota Ins. Reserve Fund" on Justia Law

Employer terminated Employee's employment after receiving complaints regarding poor service and use of inappropriate language by Employee. The Department of Labor & Industry concluded Employee was not qualified for unemployment insurance benefits because she had been discharged for misconduct. A hearing officer awarded unemployment benefits to Employee, concluding that Employee had not been deliberately rude and thus had not engaged in misconduct. The Board of Labor Appeals affirmed. Employer petitioned for judicial review. The Department and Board filed a notice of non-participation indicating they would not participate in the proceeding but reserved the right to intervene if issues arose pertaining to them. The district court reversed, holding that Employee's conduct as established by the hearing officer's findings of fact constituted misconduct as a matter of law under the carelessness standard of Admin. R. M 24.11.460(1)(d). The Department appealed. The Supreme Court affirmed, holding (1) the Department did not preserve its evidentiary arguments for appeal; and (2) the district court did not err by determining that the evidence found by the Department constituted misconduct as a matter of law under the carelessness standard. View "Gary & Leo's Fresh Foods v. Dep't of Labor & Indus." on Justia Law

In 1994, while en route to the scene of a fire, volunteer fireman James Hingle collided with a vehicle occupied by Sam and Ruby Anderson. Hingle was driving his personal vehicle at the time of the accident. The Andersons filed suit against Hingle, Marshall County, the volunteer fire department, and the Marshall County Board of Supervisors. The Andersons claimed that their injuries and damages amounted to $4,150,000. At the time of the accident, Hingle had two insurance policies with Guidant: personal automobile liability policy with limits of $250,000 per person and $500,000 per accident, and an umbrella protection policy with a $1,000,000 limit. Marshall County had a business automobile liability policy with a $300,000 limit through INA, which covered non-owned automobiles and provided coverage to the volunteer fire department. A dispute arose regarding which insurance company should defend the litigation and which provided primary coverage. INA filed a declaratory-judgment action against Guidant in the Circuit Court of Marshall County. INA asked for a judgment declaring, inter alia, that Guidant had a duty to defend all the defendants and INA did not have any duty to defend, and that Guidant's policies afforded primary coverage for all defendants, while INA provided excess coverage only. INA moved for summary judgment in the declaratory-judgment action, but the trial court held the motion in abeyance pending a final determination on the merits of the underlying lawsuit. Following that ruling, INA provided defense counsel to Marshall County and the fire department in the Anderson lawsuit. Guidant defended Hingle. INA appealed the trial court's decision on remand. Upon review, the Supreme Court affirmed in part, reversed in part, and remanded the case back to the trial court. The Court affirmed the trial court's denial of INA's Rule 56(f) motion for continuance and the denial of INA's request for prejudgment interest. The Court found that INA's claims of procedural errors warranting reversal were without merit. While the Court agreed with the trial court's finding that INA was required to contribute to the settlement, the Court reversed the trial court's determination that INA was required to contribute its policy limit. The Court held that Guidant was required to exhaust its $500,000 per-accident limit before INA's insurance was to be applied. View "Indemnity Insurance Company of North America v. Guidant Mutual Insurance Company" on Justia Law

Merwin Carlson appealed a judgment affirming a Workforce Safety and Insurance ("WSI") decision that denied his claim for workers' compensation benefits after remand. Under the law of the underlying case, the Supreme Court held that the administrative law judge ("ALJ") erred in concluding WSI properly exercised its continuing jurisdiction under N.D.C.C.65-05-04 to deny Carlson benefits on remand. The Court reversed and remanded for WSI to award Carlson benefits based on the ALJ's calculation that Carlson's average weekly wage was $722. View "Carlson v. Workforce Safety & Ins." on Justia Law