Justia Government & Administrative Law Opinion Summaries

The Pennsylvania Workers’ Compensation Act (“WCA”) makes an employer liable for paying the disability benefits and medical expenses of an employee who sustains an injury in the course of his or her employment. In January 1993, Craig Whitmoyer suffered a work-related injury that resulted in the amputation of part of his arm. Starting at that time, his employer, Mountain Country Meats (“MCM”), or MCM’s insurance carrier, Selective Insurance (“Selective”), paid all of Whitmoyer’s medical expenses related to this injury. A few months later, the parties reached an agreement related to Whitmoyer’s disability benefits – he was entitled “to a 20 week healing period and 370 weeks of specific loss benefits [at $237.50 per week after May 22, 1993].” Whitmoyer subsequently petitioned for a commutation of these weekly payments. In December 1994, the Workers’ Compensation Judge (“WCJ”) granted his petition and directed MCM or Selective to pay Whitmoyer a lump sum payment of $69,994.64. While this commutation resolved his entitlement to disability benefits entirely, MCM remained responsible for Whitmoyer’s ongoing medical bills. Several years later, Whitmoyer obtained a $300,000 settlement from third parties related to his injury and, in April 1999, he entered a third-party settlement agreement (the “TPSA”) with Selective providing that as to past-paid compensation, Selective was entitled to a net subrogation lien of $81,627.87. Selective continued to pay Whitmoyer’s work-related medical expenses in full (without taking credit under the TPSA) for approximately thirteen years, until September 2012. At that time, Selective filed a modification petition requesting an adjustment to the TPSA to reflect the medical expenses incurred since the parties entered the agreement. The WCJ found, per the parties’ stipulation, that Selective had paid $206,670.88 for Whitmoyer’s work injury as of February 2013.The WCJ ordered that Selective’s percentage credit be reduced to 26.09% of future medical expenses, up to Whitmoyer’s balance of recovery amount of $189,416.27. Whitmoyer appealed to the Workers’ Compensation Appeal Board (the “Board”), arguing that the TPSA was unenforceable because neither he nor his counsel had signed it. The Pennsylvania Supreme Court granted allowance of appeal to determine whether the Commonwealth Court erred in concluding that the term “instalments of compensation” in section 319 of the WCA encompassed both disability benefits and payment of medical expenses. Under the WCA, disability benefits were required to be paid “in periodical installments, as the wages of the employee were payable before the injury.” Medical expenses are not. Accordingly, when a workers’ compensation claimant recovers proceeds from a third-party settlement (following repayment of compensation paid to date) as prescribed by section 319, the employer (or insurance carrier) is limited to drawing down against that recovery only to the extent that future disability benefits are payable to the claimant. The Supreme Court reversed the Commonwealth Court and remanded for further proceedings. View "Whitmoyer v. Workers' Compensation App. Bd." on Justia Law

The Supreme Judicial Court vacated the decision of the Appellate Division affirming the order of the Workers’ Compensation Board (Board) requiring Plaintiff’s former employer (Defendant) to pay for medical marijuana used to treat Plaintiff’s chronic back pain.Plaintiff was issued a certification to use medical marijuana to treat his pain after sustaining a work-related injury. Plaintiff filed a “petition for payment of medical and related services” with the Board seeking payment from Defendant for the cost of the medical marijuana. Defendant opposed the petition, arguing that an order requiring it to pay for Plaintiff’s medical marijuana was barred by the federal Controlled Substances Act (CSA) even if his use of medical marijuana were permitted by the Maine Medical Use of Marijuana Act (MMUMA). A hearing officer granted Plaintiff’s petition, and the Appellate Division affirmed. The Supreme Court vacated the decision of the Appellate Division, holding (1) in the narrow circumstances of this case, there was a positive conflict between federal and state law; and (2) consequently, the CSA preempts the MUUMA as applied here. View "Bourgoin v. Twin Rivers Paper Co., LLC" on Justia Law

The First Circuit vacated in part the district court’s grant of summary judgment in Defendants’ favor on Plaintiffs’ claims seeking compensatory damages, declaratory relief, a permanent injunction, and expungement of disciplinary proceedings from a student’s university records.John Doe was accused of sexually assaulting a fellow Boston College student. In 2012, Boston College held disciplinary proceedings against Doe, and an Administrative Hearing Board found Doe responsible for the lesser offense of indecent assault and battery. In 2014, Boston College conducted an independent review of the disciplinary proceedings and determined that the Board’s finding was proper. Doe and his parents filed a lawsuit against Trustees of Boston College and several university officials. The district court granted summary judgment in favor of Defendants on all counts. The First Circuit (1) affirmed the district court’s grant of summary judgment as to Plaintiffs’ breach of contract claim for the 2014 review and Title IX, negligence, and negligent infliction of emotional distress claims; and (2) vacated the grant of summary judgment as to Plaintiffs’ breach of contract claim for the 2012 disciplinary proceedings, where there were genuine issues of material fact on this claim, and basic fairness claim, where the grant of summary judgment on this claim rested on the court’s analysis as to Plaintiffs’ breach of contract claim. View "Doe v. Trustees of Boston College" on Justia Law

Substantial evidence supported the Workers Compensation Board’s decision to deny workers compensation benefits to Appellant, who was severely injured when he was hit by a drunk driver while walking from a bar to his hotel.At the time of the accident, Appellant was a laborer working an out-of-town roofing job. The Board found that Defendant’s injuries did not arise out of and in the course of his employment. The court of appeals affirmed. The Supreme Court affirmed, holding that Appellant’s injuries did not arise out of and in the course of his employment as defined by the Kansas Workers Compensation Act (KWCA). View "Atkins v. Webcon" on Justia Law

The Supreme Court affirmed the judgment of the court of appeals granting a writ of mandamus ordering the Industrial Commission to vacate its order allocating the cost of a permanent-total-disability award between two different employers and issue an amended order.Appellee filed an application for permanent-total-disability compensation based on three workers’ compensation claims for work-related injuries she received while working for two different employers. A staff hearing officer granted the application. Appellant, one of Appellee’s employers, filed this mandamus action challenging the Commission’s allocation of the cost of the award among the three claims. The court of appeals ordered the Commission to vacate the portion of the hearing officer’s order allocating the cost of the award. The Supreme Court affirmed, holding that the Commission abused its discretion by failing to explain the basis for the specific allocations of the award among the three claims. View "State ex rel. Penske Truck Leasing Co. v. Industrial Commission" on Justia Law

Workers’ compensation dependents’ death benefits awarded under West Virginia law are payable as long as the benefits awarded under the laws of another state for the same injury remain suspended due to a related third-party settlement.Petitioner received awards of dependents’ benefits in both Rhode Island and West Virginia. The West Virginia award was subject to W. Va. Code 23-2-1c(d), which provides for a credit of workers’ compensation benefits “awarded or recovered” under laws of another state. No benefits were paid out in connection to the West Virginia award because the weekly benefits paid in relation to the Rhode Island claim were greater than, and credited against, the West Virginia benefits awarded. After Petitioner reached a confidential settlement with defendants in a civil action she filed in relation to the decedent’s death her Rhode Island dependents’ benefits were suspended. Petitioner then requested payment of West Virginia dependents’ benefits. Petitioner’s request was denied. The Supreme Court reversed, holding that because the dependents’ benefits awarded under Rhode Island law were suspended, Petitioner was entitled to receive payments of dependents’ benefits awarded to her under West Virginia law. View "Moran v. Rosciti Construction Co., LLC" on Justia Law

Claimant Joanne Perrault appealed the Commissioner of Labor’s decision on summary judgment denying her workers’ compensation benefits. On appeal, claimant argued she was an employee of defendant Chittenden County Transportation Authority (CCTA) for the purposes of workers’ compensation and, therefore, was entitled to benefits. Claimant applied to be a driver in CCTA’s volunteer program in 2014. Once through the application process, a volunteer driver was governed by CCTA’s volunteer manual. This manual, in addition to explaining certain restrictions and requirements, also stated that the manual should not be understood to mean that any employment contract existed between CCTA and the volunteer driver. Drivers received money from CCTA based on the miles driven in a given period and calculated at the federal mileage rate. The CCTA manual referred to this monetary payment as reimbursement, and stated that CCTA would perform random checks to verify the accuracy of mileage submissions. This was the only monetary or other exchange between CCTA and drivers in the volunteer program. CCTA provided insurance on drivers’ vehicles on a secondary basis and encouraged drivers to carry more than the minimum required insurance and to name CCTA as an additional insured on their personal vehicle insurance policies. Drivers in the program were required to meet standards set by CCTA and were subject to certain restrictions, which were similar to the restrictions governing CCTA’s regular drivers. On December 1, 2015, claimant had an automobile accident. At the time of the accident, she was driving a CCTA rider to an appointment. Claimant sustained significant injuries in the accident, including a broken neck at the third and fourth vertebrae, a fractured spine, and broken ribs. She subsequently sought workers’ compensation benefits. The Vermont Supreme Court held that, because claimant did not receive wages, she could not be considered a statutory employee as that term was defined for the application of workers’ compensation. View "Perrault v. Chittenden County Transportation Authority" on Justia Law

The trial court granted the Lincoln County Board of Supervisors’ and the City of Brookhaven, Mississippi’s motions to dismiss Samuel Wilcher, Jr.’s personal injury suit, finding both governmental entities enjoyed discretionary-function immunity. In doing so, the judge employed the Mississsippi Supreme Court’s recently created test announced in Brantley v. City of Horn Lake, 152 So.3d 1106 (Miss. 2014). On appeal, the Court faced "head on one of the unintended but predicted consequences of Brantley—that the test forces parties and judges to wade through an ever-deepening quagmire of regulations and ordinances to locate 'ministerial' or 'discretionary' duties, overcomplicating the process of litigating and deciding claims involving governmental entities." Unfortunately, this methodology had proved unworkable. "Instead of trying to retool the Brantley test to somehow make it workable, we concede this short-lived idea, which was meant to be a course correction, has ultimately led this Court even farther adrift." The Court found it best to return to its original course of applying the widely recognized public-policy function test—the original Mississippi Tort Claims Act (MTCA) test first adopted by the Court in 1999. Applying the latter test to this case, the Supreme Court held that Wilcher’s claim that County and City employees negligently left an unfinished culvert installation overnight, without warning drivers they had removed but not yet replaced a bridge, was not barred by discretionary-function immunity. "Wilcher is not trying to second-guess a policy decision through tort. He is seeking to recover for injuries caused by run-of-the-mill negligence." Because, from the face of the complaint, the County and City were not immune, the Court reversed the grant of their motions to dismiss. View "Wilcher, Jr. v. Lincoln County Board of Supervisors" on Justia Law

The intermediate court of appeals (ICA) did not err in ruling that an injury suffered by Plaintiff that arose while she worked as a Public Health Educator IV for the State Department of Health (DOH) resulted from an “accident occurring while in the actual performance of duty at some definite time and place” and was therefore a covered injury under Haw. Rev. Stat. 88-336.Section 88-336 provides service-connected disability retirement benefits under the Employees’ Retirement System’s (ERS) Hybrid Plan to Class H public officers and employees, such as Petitioner. Petitioner submitted an application for service-connected disability retirement in connection with permanent incapacitating injuries she suffered to her elbow, arm, and hand. A hearing officer concluded that Petitioner’s excessive keyboarding over a period of time did not constitute an “accident” because it did not occur at a “specific time and place.” The ERS denied Petitioner’s application. The circuit court affirmed. The ICA vacated the circuit court’s decision and remanded to the circuit court with directions to vacate the ERS Board’s denial of disability retirement to Petitioner. The Supreme Court affirmed, holding that Petitioner’s injury occurred “while in the actual performance of duty at some definite time and place.” View "Pasco v. Board of Trustees of the Employees’ Retirement System" on Justia Law

The Supreme Court affirmed the decision of the Labor and Industrial Relations Commission (Commission) declining to approve the agreement entered into Employer and Employee that Employer would make a lump sum payment to fully satisfy Employee’s award of permanent total disability benefits.Employee received a work-related injury and filed a workers’ compensation claim against Employer. A final award granted Employee permanent total disability benefits to be paid weekly. The parties later agreed that Employee would make a lump sum benefit to fully satisfy the award. The Commission declined to approve the agreement, concluding that the Commission had no authority to approve the agreement either as a settlement under Mo. Rev. Stat. 287.390 or as an application for a “commutation” under Mo. Rev. Stat. 287.530. The Supreme Court affirmed, holding (1) the Commission did not have the authority to consider or approve the agreement under section 287.390; and (2) the Commission properly refused to approve a commutation pursuant to the agreement. View "Dickemann v. Costco Wholesale Corp." on Justia Law