Justia Government & Administrative Law Opinion Summaries

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

Sonya Chaffee, on behalf of her minor child, Fredrick Latham, Jr., sued the Jackson Public School District; Lonnie J. Edwards, the School District superintendent in his official capacity; and Jackson Public Schools Board of Trustees (collectively, “the School District”) alleging negligence and res ipsa loquitur. Fredrick was a student in Tracy Scott’s first grade class at Woodville Heights Elementary School. While Scott was standing at the front of the classroom readying the students for lunch, Fredrick and another boy got out of line and ran to the back of the classroom to use the single restroom. Bernice Anderson, Scott’s teaching assistant, was present at her desk in the back of the classroom nearer the restroom. Fredrick was injured when his hand slipped off the door and his finger got caught in the crack of the door as the other boy was closing it. After hearing a student scream that Fredrick had smashed his finger, Scott went to the back of the classroom, wrapped Fredrick’s finger in papers towels, and took him to the principal’s office. Fredrick’s mother was called, and he was taken by ambulance to the University of Mississippi Medical Center. Surgery was performed to reattach Fredrick’s fingertip using a skin graft. The School District defended on sovereign immunity grounds pursuant to the Mississippi Tort Claims Act (“MTCA”). After engaging in discovery, the School District moved for summary judgment which was granted. Aggrieved, Chaffee appealed, but finding no reversible error, the Mississippi Supreme Court affirmed. View "Chaffee v. Jackson Public School District" on Justia Law

Miranda Moser dislocated her right shoulder when she lifted a 24-pack of soda while working as a cashier for Rosauers Supermarkets, Inc. (“Rosauers”). Rosauers accepted the claim even though Moser had a pre-existing history of recurrent instability of her right shoulder. Moser underwent shoulder surgery. Afterward, she continued to suffer from “pseudosubluxation” and her surgeon, Dr. Adam Jelenek, recommended she receive a second opinion from a physician in Seattle. Rather than authorizing the request for referral, Rosauers arranged for Moser to be evaluated by Dr. Michael Ludwig who opined that Moser’s shoulder dislocation likely resulted from her pre-existing condition. Dr. Ludwig concluded that Moser had returned to her pre-injury baseline and that she did not require any further medical care. Rosauers filed a notice of medical exam to be performed by Dr. Joseph Lynch on February 5, 2018. Moser responded with a letter conveying she would not be attending the medical exam. Moser filed a Judicial Rule of Practice and Procedure (“J.R.P.”) 15 petition for a declaratory ruling, seeking an order on whether an employer could compel a claimant to attend an Idaho Code section 72-433 examination without first establishing the claimant was within her “period of disability,” which she argued was limited to a period when she was actually receiving benefits. Thereafter, Moser filed a notice that she would not attend the medical examination Rosauers had scheduled for April 2, 2018. The Commission held that following the claim of an accident, injury, or occupational disease, an employer may require a claimant’s attendance at such a medical examination. Moser appeals the Commission’s order. Finding no reversible error in the Commission’s judgment, the Idaho Supreme Court affirmed. View "Moser v. Rosauers" on Justia Law

The Supreme Court affirmed the district court's denial of the City of Reno's petition for judicial review of an appeals officer's decision that the City was not entitled to reduce Respondent's lump sum permanent partial disability (PPD) payment, holding that there is no legal basis to justify a workers' compensation insurer's reduction of the twenty-five-percent lump sum payment limit for an employee's PPD award.An injured employee may elect to receive a lump sum payment for a PPD award, but if the employee's PPD rating exceeds a twenty-five percent whole person impairment (WPI), the employee may only elect to receive a lump sum payment for up to twenty-five percent of the rating. Respondent suffered three industrial injuries. With respect to Respondent's third PPD payment, the City offered Respondent an eighteen-percent lump sum payment, believing it could deduct Respondent's two previous PPD lump sum payments from the twenty-five percent limit. A hearing officer found that the City erred. An appeals officer affirmed and district court affirmed. The Supreme Court affirmed, holding that the appeals officer correctly determined that Respondent was entitled to a lump sum payment for the first twenty-five percent of her most recent WPI rating and PPD award with the remaining eight percent to be paid in installments. View "City of Reno v. Yturbide" on Justia Law

The Supreme Court affirmed the decision of the Retirement Board of the Employee Retirement System of Providence (the Board) denying Petitioner's application for accidental disability retirement benefits and instead awarding her ordinary disability benefits, holding that there was legally competent evidence supporting the Board's decision to deny Petitioner accidental disability retirement benefits.Petitioner, who served as a bus monitor for the City of Providence, submitted an application for accidental-disability retirement benefits to Respondent, the Employees' Retirement System of Providence, alleging that she had suffered a work-related injury. The Board denied Petitioner's application and instead granted Petitioner ordinary disability benefits. The Supreme Court affirmed, holding that the Board based its decision on legally competent evidence that Petitioner's employment was not the natural and proximate cause of her disability. View "Trinidad v. Employees' Retirement System of Providence" on Justia Law

The Supreme Court affirmed the judgment of the court of appeals denying Appellant's request for a writ of mandamus against the State Highway Patrol Retirement System (HPRS), holding that Appellant was not entitled to an order compelling HPRS to vacate its finding that his disability was "not in the line of duty" and to grant disability retirement "in the line of duty."Appellant, a state trooper, applied to HPRS for permanent and total disability retirement benefits based on the diagnosis of an L5-S1 disk collapse and right-side disc bulge, as well as disintegration of L5-S1 vertebrae and arthritis. HPRS approved Appellant's disability but concluded that Appellant's condition did not occur in the line of duty. Appellant filed a complaint for a writ of mandamus, but the court of appeals denied the request. The Supreme Court affirmed, holding that Appellant failed to show that HPRS abused its discretion when it found that Appellant's injury did not occur in the line of duty. View "State ex rel. Seabolt v. State Highway Patrol Retirement System" on Justia Law

The Supreme Court affirmed the decision of the court of appeals reversing the decision of the Kansas Workers Compensation Board (Board) affirming an ALJ's denial of Helen Knoll's application for hearing with the Kansas Division of Workers Compensation (Division), holding that Kan. Stat. Ann. 44-523(f)(1) controlled Knoll's claim and required its dismissal.More than five years after Knoll filed her application with the Division, Employer moved to have Knoll's claim dismissed under section 44-523(f)(1) because the claim had not proceeded to a final hearing within three years of the filing of an application for hearing. The ALJ concluded that Knoll's motion for extension was timely and entered an award of compensation. The Board affirmed the ALJ's denial of the motion to dismiss. The Court of Appeals reversed, concluding that dismissal was appropriate because Knoll did not file a motion for extension within three years of filing her application for hearing. The Supreme Court affirmed, holding (1) if a workers compensation claimant filed an application for hearing under Kan. Stat. Ann. 44-534 after Kan. Stat. Ann. 44-523(f)(1) took effect in 2011, the 2011 statute governs the claim; and (2) because Knoll filed her application for hearing six months after the 2011 amendments became effective, section 44-523(f)(1) controlled her claim. View "Knoll v. Olathe School District No. 233" on Justia Law

Claimant Cozmin Gadalean, a commercial truck driver, was sent on a supervised delivery by and for employer as a pre-employment drive test. He was injured when he fell from employer’s truck. The Workers’ Compensation Board denied claimant coverage, concluding that he did not qualify as a worker at the time of the injury. The Court of Appeals reversed, holding that Oregon’s minimum wage laws would have entitled claimant to be paid for the delivery and that, therefore, he was a worker within the meaning of the workers’ compensation statute. The Oregon Supreme Court concluded the Court of Appeals erred, and affirmed the board’s denial of coverage. View "Gadalean v. SAIF" on Justia Law