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November 4, 2022

High courts largely rule for employees in slate of recent workers comp disputes

Dereck Mattson joined Christensen Group in 2017. Previously, Dereck held the position of Producer in the Senior Living Division of a prominent insurance company. Dereck has a specific focus in the following industries: Dereck graduated from the University of North Dakota with a Bachelor of Business Administration, Management. He holds an Associate in General Insurance (AINS) designation. Dereck is involved with several state associations including; LeadingAge Minnesota, Care Providers of Minnesota, and the Wisconsin Assisted Living Association (WALA).

Workers' compensation systems are creatures of statute, and state supreme courts throughout the country have recently addressed how to interpret laws relating to sovereign immunity, special circumstances warranting benefit increases, admissibility of medical reports, and the compensability of mental injury claims.

Missouri

The Missouri Supreme Court in a July 12 decision had to define “employer” in Poke v. Independence School District, a case involving the firing of a school custodian who tested positive for marijuana after being injured at work in December 2019.

After he was terminated, Travis Poke filed a lawsuit alleging the school district retaliated against him for filing a workers comp claim. The district filed a motion for summary judgment claiming sovereign immunity shielded it from retaliatory discharge claims.

A trial judge agreed with the district, but the state Supreme Court did not.

Missouri Revised Statutes Section 287.780 prohibits all employers from engaging in retaliatory conduct and creates a civil action for damages against all employers that ignore this prohibition. Another statute, Section 287.030, includes school districts in the definition of employer.

“Consequently, considered together, Sections 287.780 and 287.030 reflect an express showing of legislative intent to waive the school district’s sovereign immunity for Poke’s workers' compensation retaliation claim,” the high court said in reversing the trial court.

Kentucky

The Kentucky Supreme Court in a June 25 decision also addressed a case involving an injured worker who was terminated for cause.

The question in Tractor Supply v. Wells was whether Patricia Wells’ termination for allegedly filing false information on a company report prohibited her from receiving treble benefits.

Ms. Wells was on work restrictions for an August 2018 injury when she was fired in January 2019 for allegedly providing her employer false information in a matter not related to her claim.

Kentucky Revised Statutes Section 342.370(1) includes a mechanism to triple the permanent partial disability benefits owed to workers who are physically unable to return to their time-of-injury jobs.

The court found the statute does not include a provision allowing consideration of the reasons underlying a termination decision when determining whether the multiplier should be applied. In affirming the lower court’s decision, the high court said Ms. Wells was entitled to the benefit bump because she was incapable of meeting the physical demands of her old job.

By contrast, the court in a June 16 decision, Helton v. Rockhampton Energy LLC, ruled that a worker laid off for economic reasons in September 2019 wasn’t entitled to double benefits.

Section 342.730(1)(c)2 requires doubling permanent partial disability benefits owed to a person who returned to work after an injury only for the employment to subsequently end.

The high court said Jarvis Helton, by definition, could not “return” to work because he never missed any time for cumulative injuries he sustained while working for Rockhampton. Therefore, he wasn’t entitled to the benefit multiplier the high court said in a decision that affirmed the decisions of the Workers’ Compensation Board and the Court of Appeals.

The Kentucky Supreme Court on June 16 in Toler v. Oldham County Fiscal Court addressed the statutory definition of “physician” in a case finding a doctor not licensed in the state is not authorized to submit a report as evidence in a workers comp proceeding.

Section 342.0011(32) defines “physician” to include physicians, surgeons, psychologists, optometrists, dentists, podiatrists, osteopaths, and chiropractors acting within the scope of their state-issued license.

The Workers’ Compensation Board and the state Court of Appeals both allowed a report from an out-of-state doctor who opined on the impairment rating for Tracy Toler. Mr. Toler objected to the report.

The Court of Appeals said a statutory caveat in KRS 342.0011(32) — “unless the context otherwise requires” — allows the administrative law judge sufficient discretion to accept a report from an out-of-state doctor.

The high court disagreed, saying the General Assembly can widen the pool of physicians qualified to provide medical opinions in workers comp cases, but existing law “is limited so that only physicians licensed in Kentucky may provide such evidence.”

The “unless the context otherwise requires” language allows judges to consider medical opinions from specialists not recognized in statute, such as an audiologist, the court said. It does not require or allow admitting reports from physicians not licensed in the state, the court said.

Iowa

The compensability of mental injuries was before the Iowa Supreme Court in a June 3 decision in Tripp v. Scott Emergency Communication Center.

The case involved Mandy Tripp, a long-time emergency dispatcher who filed a claim for post-traumatic stress disorder after taking a call from a mother who had just come across her murdered child.

The split court overturned its precedent on mental injury claims, declining to continue enforcing a higher bar on emergency responders to be eligible for benefits for trauma-induced mental injuries suffered on the job than for workers in other roles with identical injuries.

Iowa Code Section 85.3(1) provides for the payment of compensation for “personal injuries sustained by an employee arising out of and in the course of the employment,” the court said.

Section 85.61(4) does not provide a precise definition of an “injury,” the court noted, but its case law has established that mental conditions qualify as injuries under the statute. The court’s case law has also established that causation of a mental injury at issue must be “based on a manifest happening of a sudden traumatic nature from an unexpected cause or unusual strain.”

Since nothing in the text of Section 85.3(1) makes the “unexpectedness” of the traumatic event dependent on the employee’s own job duties, the court ruled that Ms. Tripp was entitled to benefits for her trauma-induced mental injuries, even though dispatchers routinely take calls involving death and traumatic injury.

Utah

A case law-developed standard of what is “usual” and “ordinary” for workers was at the center of the June 4 decision in JBS Carriers v. Utah Labor Commission.

The Utah Supreme Court’s precedent had described an injury as compensable if it occurs because of “exertion required by the employment increases the risk of injury which the worker normally faces in his everyday life.”

In the JBS case, the court clarified it had not meant to narrow the circumstances relevant to legal causation to only those actions specifically required by the employer.

The court said it had meant to use the phrase “required by the employment” at a general level, meaning “conditions, exertions or activities that are employment-related as opposed to those activities that are not associated with work.”

Since David Hickey’s job as a truck driver required long drives that were an unusual activity when compared with nonwork life, the Supreme Court ruled he was entitled to benefits for his deep vein thrombosis that developed while he was making a three-day haul to California.

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