Justia Government & Administrative Law Opinion Summaries

Petitioner suffered an injury while in the course and scope of his employment. The employer's workers' compensation insurance carrier paid medical benefits but contested the extent of Petitioner's entitlement to impairment income benefits. The Department of Insurance's Workers' Compensation Division determined that Petitioner had an impairment rating of twenty percent. The trial court reversed the agency's decision, ruling that Petitioner had no valid impairment rating. The court of appeals affirmed. While Petitioner's appeal to the Supreme Court was pending, the Court held in American Zurich Insurance Co. v. Samudio that the absence of a valid impairment rating that had been submitted to the agency did not deprive a reviewing court of subject matter jurisdiction. In light of its decision in Samudio, the Court then reversed and remanded to the trial court with instructions that the court remand the case to the Division in light of its determination that Petitioner had no valid impairment rating. View "DeLeon v. Royal Indem. Co." on Justia Law

The Supreme Court accepted the petition of Harleysville Mutual Insurance Company (Petitioner) in its Original Jurisdiction to assess constitutional challenges to Act No. 26 of the South Carolina Acts and Joint Resolutions, which regulates coverage provided by commercial general liability (CGL) insurance policies for construction-related work. Upon review, the Supreme Court held that the retroactivity clause of Act No. 261 violated the Contract Clauses of the state and federal Constitutions, and that the statute may only apply prospectively to CGL insurance contracts executed on or after its effective date of May 17, 2011. View "Harleysville Mutual v. South Carolina" on Justia Law

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