Justia Government & Administrative Law Opinion Summaries

The Supreme Court granted allowance of appeal in this case to determine whether the immunity provisions of Section 23 of the Workers' Compensation Act (Act 44) applied to "subrogation and/or reimbursement claims sought against an employee who has entered into a third[-]party settlement with a Commonwealth [p]arty such as Southeastern Pennsylvania Transportation Authority ('SEPTA')." Upon review of this matter, the Supreme Court held that the portion of Act 44 at issue in this case barred any claim made by the employer for the recoupment of workers' compensation benefits it paid. View "Fraizer v. W.C.A.B." on Justia Law

Frank Hutson was working as a crane operator for the State Ports Authority when he suffered an injury to his lower back and legs while attempting to remove a container from a ship. He was diagnosed with a disc bulge for which he was treated with steroid injections, physical therapy, and used a back brace. After reaching maximum medical improvement, he filed a Form 50 with the workers' compensation commission for continued benefits alleging permanent and total disability pursuant to Sections 42-9-10 and 42-9-30 South Carolina Code (1976 & Supp. 2011) or, alternatively, a wage loss under Section 42-9-20. He also asked to receive the award in lump sum. Although the Ports Authority and its insurance carrier, the State Accident Fund (collectively, Respondents), admitted the accident and the back injury, they disputed the claims to his legs and argued he should receive only permanent partial disability benefits. They also objected to Hutson's request that his benefits be paid in a lump sum. The issue before the Supreme Court centered on whether speculative testimony by the claimant concerning his possible future work as a restaurateur qualified as substantial evidence to establish he did not sustain a wage loss pursuant to Section 42-9-20 of the South Carolina Code (1976). The Court held it did not, and therefore reversed and remanded the case for further proceedings. View "Hutson v. SC State Ports Authority" on Justia Law

Zaloudek Grain Company held a workers' compensation policy with CompSource Oklahoma for approximately ten years prior to 2011. Zaloudek was required each year to provide payroll audit information to CompSource. The audit information was used to determine the proper premium for each year. CompSource sent a notice in late 2010 to Zaloudek requesting audit information. In January, 2011, Zaloudek's policy was renewed for all of 2011 through January 1, 2012. On January 18, 2011, CompSource sent another letter requesting Zaloudek provide the necessary payroll audit information, but Zaloudek was unresponsive. Subsequently, CompSource sent Zaloudek a notification to inform the company that the process of canceling its policy would begin if CompSource did not receive the audit information. The audit information was not provided; CompSource ultimately canceled the policy when Zaloudek ignored several subsequent requests. CompSource issued a refund for payments made under the policy. Later that summer, two teenage workers were seriously injured in the grain auger at Zaloudek's facility. CompSource did not accept the company's new insurance application because it was incomplete and was not signed by an owner of Zaloudek. Zaloudek sued a few weeks following the rejection of its application, asking for a judgment against CompSource for breach of contract and bad faith and further requested declaratory relief in the form of an order requiring CompSource to provide workers' compensation coverage. Zaloudek filed a motion for summary judgment claiming CompSource lacked legal justification for terminating its policy and requested orders to establish there was no lapse in coverage and requiring CompSource to provide coverage for its two injured employees. Zaloudek further requested a finding that CompSource was in breach of contract. CompSource moved for summary judgment, arguing Zaloudek was not covered at the time of the incident and its policy was properly canceled. Zaloudek filed a counter-motion for summary judgment asserting CompSource should be estopped from denying coverage because it retained premiums and acted in a manner toward Zaloudek consistent with continued coverage. The trial court issued an order dismissing Zaloudek's bad faith claim but left pending its claims for breach of contract and declaratory relief. CompSource appealed. After its review, the Supreme Court concluded that CompSource was authorized to cancel a policy for an insured's failure to participate in the audit. The Court remanded the case for further proceedings on the other contract issues raised. View "Zaloudek Grain Co. v. CompSource Oklahoma" on Justia Law

The issue before the Supreme Court was whether an employee who filed an injury claim against his employer under the State Workers' Compensation Act and receives compensation in exchange for a "no liability" settlement with his employer that is approved by the State Board of Workers' Compensation may then turn around and sue the co-employee who caused the injury in a tort action. Ten years ago, the Court of Appeals answered this question no, holding that the Act's exclusive remedy provision bars such a lawsuit based on the same injury for which the employee has already received a remedy. In this appeal, however, the Court of Appeals was equally divided as to whether the underlying case law should be overruled, and the case was sent to the Supreme Court for resolution. Upon review, the Supreme Court held that "Ridley" was correctly decided. Thus, appellant Joseph Smith, having previously entered a Board-approved settlement with his employer in exchange for compensation, would be barred from suing appellee John Ellis for the same injury in tort if Ellis qualified as an "employee of the same employer" as Smith, rather than a "third-party tort-feasor," as those phrases are used in the applicable statutory authority. However, the evidence did not establish that Ellis was acting as "an employee of the same employer" in the course of his employment, at the time he injured Smith. The trial court therefore erred in granting summary judgment to Ellis, and that judgment was reversed. View "Smith v. Ellis" on Justia Law

At issue in this case was whether the workers' compensation courts had the authority to hear a petition filed by Insured to determine whether Insurer had a duty to defend and indemnify Insured under a policy for workers' compensation insurance. Insurer moved to dismiss Insured's petition, arguing that the compensation judge did not have subject matter jurisdiction to hear the petition because it asserted a breach of contract claim rather than one arising under the workers' compensation laws. The compensation judge disagreed and denied Insurer's motion to dismiss. The workers' compensation court of appeals (WCCA) affirmed, concluding that Insured was seeking a declaration that its insurance coverage with Insurer was still "in effect," a question within the compensation judge's authority to decide. The Supreme Court affirmed, holding that the workers' compensation courts had jurisdiction to decide the issues presented in Insured's petition for declaration of insurance coverage, as the real nature of the claim was whether Insured's insurance coverage was in effect, a question that was within the authority of the compensation judge to answer. View "Giersdorf v. A & M Constr., Inc." on Justia Law

Employee was injured while working for Employer. Five years later, Employee was fired for violating the company's attendance policy. Employee's termination was later the basis for the Industrial Commission of Ohio's denial of his request for temporary total disability compensation (TTC). The Commission found that Employee's discharge amounted to a voluntary abandonment because it was consequence of behavior that Employee willingly undertook. The court of appeals reversed, holding that the deliberate misconduct necessary to support a finding of voluntary abandonment could not be imputed to Employee. The Supreme Court affirmed and issued a limited writ of mandamus that vacated the Commission's order and returned the cause to it for further consideration, as the hearing officer did not carefully examine the totality of the circumstances in finding that a simple allegation of misconduct existed to preclude temporary total disability compensation. View "State ex rel. Brown v. Hoover Universal, Inc." on Justia Law

A compensation judge found Respondent was barred from receiving workers' compensation benefits because his written notice of injury, given nearly two years after his last day of work, was not timely and because Respondent's employer did not have actual knowledge that Respondent's back problems were work-related. The workers' compensation court of appeals (WCCA) reversed, concluding that a reasonable person in Respondent's position would not have known his injury was compensable until Respondent's doctors provided written reports to Respondent's attorney establishing a relationship between Respondent's back problems and his job duties. The Supreme Court reversed the WCCA and affirmed the denial of benefits, holding (1) the WCCA erred in overturning the compensation judge's finding that Respondent failed to give timely notice to his employer of his work-related injury; and (2) the compensation judge did not err in finding that the employer did not have actual knowledge of such an injury. View "Anderson v. Frontier Commc'ns" on Justia Law

Respondent sustained six injuries while playing for the Washington Redskins on four separate occasions. Consequently, Respondent filed with the Maryland Workers Compensation Commission six separate claims against his employer, the Washington Redskins (Petitioner). The Commission denied five of Respondent's claims on the ground that he was not a "covered employee" because he was working for the Redskins outside of the State when he sustained the injuries underlying the claims. The circuit court affirmed. The court of special appeals reversed. The Court of Appeals affirmed, holding that a football player employed by the Washington Redskins is a "covered employee," and therefore entitled to avail himself of Maryland's workers' compensation laws, when injured while practicing and playing football outside of Maryland. View "Pro-Football, Inc. v. McCants" on Justia Law

Appellee was injured during the course of his employment. When his workers' compensation benefits ceased, Appellee applied for and received unemployment insurance benefits. The Kentucky Unemployment Insurance Commission determined that Kan. Rev. Stat. 341.090, which permits the use of an "extended base period" that captures earnings leading to equitable unemployment benefits, required that the extended base period may include only the four calendar quarters that immediately precede the base period. Pursuant to this extended base period, Appellee was awarded benefits of $149 per week. The circuit court reversed. The court of appeals affirmed, concluding that the extended base period need not be limited to the four quarters that immediately precede the base period. The Supreme Court reversed, holding that the Commission properly applied the statute in calculating Appellee's unemployment benefits. View "Unemployment Ins. Comm'n v. Hamilton" on Justia Law

This appeal concerned the method for excluding impairment from a non-compensable disability when calculating a worker's permanent disability benefit under the post-1996 version of Kan. Rev. Stat. 342.730(1)(b). The ALJ calculated a benefit based on the claimant's entire post-injury permanent impairment rating and then subtracted an amount equal to a benefit based on his pre-existing active impairment rating. The workers' compensation board reversed, determining that the present version of section 342.730(1)(b) requires the calculation of income benefits to be based only on the permanent impairment rating caused by the injury being compensated. The court of appeals affirmed. The Supreme Court affirmed, holding that pre-existing impairment must be excluded when calculating a total disability award under section 342.730(1)(b). View "Tudor v. Indus. Mold & Mach. Co." on Justia Law