Justia Government & Administrative Law Opinion Summaries

In a workers’ compensation matter, the Louisiana Supreme Court was presented with the question of whether an employee’s motion to compel her employer to choose a pharmacy other than the pharmacy at its retail stores to fill her prescriptions was premature in the absence of any claim that she has not been furnished proper medical attention or that there have been delays or deficiencies in filling prescriptions. Elizabeth Soileau filed a disputed claim for workers’ compensation benefits alleging she injured her right arm and hand in the course and scope of her employment with Wal-Mart Stores, Inc. (“Wal-Mart”). Pursuant to a 2012 consent judgment, Soileau received medical treatment, including prescriptions, some of which she filled at a Wal-Mart pharmacy. In 2016, Soileau obtained a judgment against Wal-Mart ordering that she was entitled to receive certain prescriptions, as prescribed by her physician. Soileau began filling her prescriptions at Falcon Pharmacy. Following the Louisiana Supreme Court's opinion in Burgess v. Sewerage & Water Board of New Orleans, 225 So.3d 1020, which held the choice of pharmacy belonged to the employer, Wal-Mart notified Soileau in writing that she could only use “a Wal-Mart or Sam’s Club Pharmacy” for her future prescriptions needs. Wal-Mart further advised Soileau it would not issue reimbursement for medications dispensed to Wal-Mart workers’ compensation patients from any pharmacy other than a Wal-Mart or Sam’s Club Pharmacy. Soileau moved to compel, arguing she “should not be forced to obtain medications from her employer directly and cannot go without her medication.” The motion proceeded to a hearing before the Office of Workers’ Compensation (“OWC”). At the hearing, Soileau testified that in September 2017 (after she filed her motion), Wal-Mart’s pharmacy denied two of her workers’ compensation prescriptions, but admitted she had no written documentation of the denial. The workers’ compensation judge explained that in the event Soileau experienced any delays or deficiencies in the filling of her prescriptions, she “has a remedy under Louisiana Revised Statute 23:1201E.” Soileau appealed. A divided panel of the court of appeal reversed, finding that a conflict of interest would be created if Wal-Mart were permitted to designate its own pharmacy as the only pharmacy Soileau could use for her workers’ compensation prescriptions. The Supreme Court found the matter was indeed premature and did not present a justiciable controversy. It therefore vacated the judgment of the court of appeal. View "Soileau v. Wal-Mart Stores, Inc." on Justia Law

On December 11, 2008, the Baton Rouge area experienced a snowstorm. The storm was of sufficient magnitude to result in the issuance of a winter weather advisory and closure of area schools. The schools reopened the next day as the weather improved. At approximately 8:00 a.m. on the morning of December 12, Sherry Boothe was operating her vehicle eastbound on Greenwell Springs Road, after bringing her daughter to school. As Boothe crossed the Comite River Bridge to return home, she lost control of her vehicle. Her vehicle crossed the median, flipped, and came to rest in the opposite lane of oncoming traffic. According to Boothe, after exiting her vehicle, she believed she had hit either ice or oil because the road was slippery. Boothe ultimately sued the Department of Transportation and Development (“DOTD”), seeking personal injury damages arising from the accident, for not adequately sanding the bridge following the snowstorm. The Louisiana Supreme Court found the uncontroverted evidence in the record revealed there was ice on the roadway at the time of the accident, and DOTD failed to take proper measures to address this condition. This evidence pointed "so strongly in favor of the moving party that reasonable persons could not reach different conclusions." Accordingly, the Court found the district court did not err in granting the motion for judgment notwithstanding the verdict in favor of plaintiffs. View "Boothe v. Louisiana Dept. of Transportation & Development" on Justia Law

The State of Delaware appealed a superior court order that affirmed a determination by the Industrial Accident Board (the Board) that Nicholas Gates was working within the course and scope of his employment when he was injured in a motor vehicle collision. At the time of the collision, Gates was employed by the State as a road-maintenance equipment operator for the Department of Transportation (DelDOT). The collision occurred while he was responding to a “call-back” after his normal work hours. He was called back to attend to a roadside accident. Gates sought workers’ compensation benefits from the State for his injury. At the hearing before the Board, the State argued that State of Delaware Merit Rule 4.16 1 and a document titled “Call-Back Pay Guidelines and Recommended Procedure” (the Call-Back Pay Guidelines) were part of Gates’s employment contract. According to these provisions, Gates was not to be paid for a call-back until he arrived at the DelDOT yard. Because Gates’s collision occurred before he arrived at the yard, the State argued, his injury occurred outside the course and scope of his employment and was, therefore, not compensable under Delaware’s Workers’ Compensation Act (the Act).3 The Board looked to the parties’ prior course of conduct to determine the terms of the employment contract and found that Gates’s injury was compensable under the Act because, based on the parties’ prior course of conduct, he “was working within the course and scope of his employment contract when the motor vehicle accident occurred.” The Superior Court affirmed the Board’s decision. The Delaware Supreme Court affirmed the Superior Court, and therefore the Board. Specifically, the Court determined the Board applied the correct legal standard and acted within its discretion in finding, based on Gates’s unrebutted testimony as to the parties’ course of conduct prior to the collision, that the terms of Gates’s employment contract established he was to be paid for a callback from the time he received the call and that, at the time of the collision, he was working within the course and scope of this contract. These factual findings were supported by substantial evidence; the Board did not err in determining that Gates’s injury was compensable under the Act. View "Delaware v. Gates" on Justia Law

The Supreme Court reversed the decision of the Court of Special Appeals reversing the decision of the circuit court affirming the decision of the Workers' Compensation Commission modifying an order that provided Officer Peter Gang, who was injured working as a correctional officer for Montgomery County, a compensation award for a permanent partial disability resulting from his injury, holding that the Commission was authorized to retroactively modify the compensation award.Specifically, the Commission retroactively adjusted the rate of compensation because, as a public safety employee, Officer Gang had been entitled to a higher rate of compensation than that which he initially received. The Court of Appeals concluded that the Commission was not statutorily authorized to retroactively modify Officer Gang's rate of compensation. The Supreme Court affirmed, holding (1) under section 9-736(b) of the Workers' Compensation Act, the Commission may modify the compensation award within five years from the date of the last compensation payment; and (2) because Officer Gang applied for the correction before the statutory five-year period expired the Commission properly exercised its continuing jurisdiction to retroactively correct the rate of compensation in Officer Gang's award for permanent partial disability based on an error of law. View "Gang v. Montgomery County" on Justia Law

Mercer University sought immunity from liability for claims by the estate and family of Sally Stofer, who was fatally injured when she fell at a free concert hosted by the university at Washington Park in Macon, Georgia in July 2014. The park was owned by Macon-Bibb County, but Mercer had a permit to use the park for its concert series. The concert series was planned, promoted, and hosted by Mercer’s College Hill Alliance, a division of Mercer whose stated mission is to foster neighborhood revitalization for Macon’s College Hill Corridor. The trial court concluded, and the Court of Appeals agreed, that defendant was not entitled to summary judgment on its claim of immunity under Georgia’s Recreational Property Act, given evidence that Mercer hosted the concert and it might (at least indirectly) benefit financially from the event. In arriving at this conclusion, the Georgia Supreme Court surmised the Court of Appeals was led astray by language in the Supreme Court’s most recent relevant decision that was inconsistent with previous case law. After careful consideration of the statutory text and a thorough review of the case law, the Georgia Supreme Court concluded that whether immunity was available under this provision requires a determination of the true scope and nature of the landowner’s invitation to use its property, and this determination properly is informed by two related considerations: (1) the nature of the activity that constitutes the use of the property in which people have been invited to engage, and (2) the nature of the property that people have been invited to use. Clarifying that considerations of evidence of Mercer’s subjective motivations in hosting the concert and some speculation of the indirect benefits Mercer might have received as a result of the concert were generally improper, the Supreme Court vacated the Court of Appeals’ decision and remanded the case with direction that the court revisit its analysis consistent with the standard that was clarified here. View "Mercer University v. Stofer" on Justia Law

Kevin Smith appealed an Idaho Industrial Commission order that concluded the Idaho Industrial Special Indemnity Fund (ISIF) was not liable to him for worker’s compensation benefits. The Commission determined that Smith failed to prove he was totally and permanently disabled under both the 100% method and the odd-lot worker method. He also appealed a denied motion for reconsideration that was denied by the Commission, where he alleged that the Commission determined disability at a future date rather than the date of the hearing, that it improperly interpreted a report, and that it improperly considered an excluded exhibit. Finding no reversible error, the Idaho Supreme Court affirmed the Commission’s order. View "Smith v. Idaho, Industrial Special Indemnity Fund" on Justia Law

Big Horn Coal Company petitioned the Tenth Circuit Court of Appeals for review of a Department of Labor Benefits Review Board (“Board”) decision awarding benefits to Edgar Sadler, a then-living miner, under the Black Lung Benefits Act (BLBA or “the Act”). The BLBA’s statute of limitations required miners to file claims for benefits within three years of receiving a medical determination of total disability due to pneumoconiosis. In interpreting this statute of limitations, the Secretary of the Department of Labor issued 20 C.F.R. 725.308(c) (2010), which provided that the time limits in section 932(f) “are mandatory and may not be waived or tolled except upon a showing of extraordinary circumstances.” The issue this appeal presented turned on the validity of the Secretary’s regulation in section 725.308(c) and the interpretation and application of the “extraordinary circumstances” test contained therein. Sadler received a total disability diagnosis in 2005, but he did not file the claim at issue here until 2010. Despite that delay, an administrative law judge (ALJ) awarded benefits to Sadler upon finding that “extraordinary circumstances” existed to warrant tolling the statute of limitations. Big Horn Coal argued there were no "extraordinary circumstances" sufficient here to justify tolling the statute of limitations. The Tenth Circuit concluded it lacked jurisdiction because Big Horn Coal failed to exhaust that issue before the Board. View "Big Horn Coal Company v. Sadler" on Justia Law

Claimant Elvia Garcia-Solis was injured in a work-related accident. Farmers Insurance Company and Yeaun Corporation (collectively, “Insurer”) accepted a workers’ compensation claim and certain specified medical conditions associated with the accident. Because claimant also showed psychological symptoms, her doctor recommended a psychological referral to diagnose her for possible post-traumatic stress disorder (PTSD). Insurer argued, and the Court of Appeals agreed, that the cost of the psychological referral was not covered by workers’ compensation because claimant had failed to prove that it was related to any of the medical conditions that insurer had accepted. The Oregon Supreme Court reversed both the Court of Appeals and the Workers’ Compensation Board: “’injury’ means work accident is context-specific to exactly two uses in the first and second sentences of ORS 656.245(1)(a). It does not apply to the second use in the first sentence of ORS 656.245(1)(a). We do not decide or suggest that it applies to any other statute in the workers’ compensation system.” View "Garcia-Solis v. Farmers Ins. Co." on Justia Law

Tiffany Greenfield appealed after the lawsuit she filed on behalf of minor Ethan Ford, was dismissed. Greenfield alleged that the defendants, who worked for the Delaware Division of Family Services (“DFS”), contributed in some way (as case workers, others as managers and supervisors) to four faulty investigations of reports that Ford and his half-sister, Autumn Milligan, were being abused and neglected by their mother, Tanasia Milligan. According to Greenfield’s complaint, the defendants’ dereliction of duty resulted in the tragic death of Autumn and permanent and irreversible damage to Ford that she averred necessitated long-term physical care and psychological services. The Delaware Supreme Court determined that Ford’s guardian sought redress from individuals who were charged with protecting him but who were unable to do so. "Those same individuals, however, are also required to preserve and foster the family unit, which creates an obvious tension between their duties that requires the exercise of judgment. Under such circumstances, our law requires that complaints against such individuals be written to a higher standard. We agree with the Superior Court that Greenfield’s complaint did not satisfy that standard and therefore affirm." View "Greenfield v. DFS Director Miles, et al." on Justia Law

Claimant Catherine Sheldon injured her shoulder after falling in the lobby of the office building where she worked. Claimant contended she suffered a compensable injury that arose out of employment because her fall was unexplained and occurred at work. Employer, US Bank, contended the injury was not unexplained because claimant failed to eliminate idiopathic factors related to her personal medical conditions that might have caused her fall. The Workers’ Compensation Board (the board) concluded claimant failed to establish that her fall was unexplained. The Court of Appeals held that the board applied the wrong standard, vacated the board’s decision, and remanded the case to the board to apply the standard in the manner directed by that court. Although the Oregon Supreme Court disagreed with the standard expressed by the Court of Appeals, it nevertheless reached the same result, therefore affirming the Court of Appeals, vacating the board’s decision, and remanding the case to the board. View "Sheldon v. US Bank" on Justia Law