Sole proprietor failed to timely notify comp insurer of work injury: Appeals court


A sole proprietor contractor serving as both employee and employer who was injured on the job wasn’t entitled to workers compensation because he failed to timely notify his insurer of the workplace injury, a Pennsylvania appellate court ruled Wednesday.

The Pennsylvania Commonwealth Court reversed a Workers’ Compensation Appeal Board decision affirming a comp judge’s granting benefits to David Heater.

Mr. Heater claimed he sustained a fractured neck vertebrae when he tripped while coming off a ladder during a roofing repair project. Mr. Heater’s business was subcontractor on the job.

The insurer denied the injury claim, challenging both the cause of the injury and the untimeliness of the claim filing.

The workers comp judge agreed with the insurer that the claim was untimely, but the board reversed, ruling that because Mr. Heater was his own employer, “notice of the work injury was instantaneous.”

In reversing, the Commonwealth Court distinguished between employer and insurer, saying that while notice given to an employer by a sole proprietor is instantaneous, the injured party still must give timely notice of a claim to the workers comp insurer, which the appeals court found was not done in this case.

The court said that a sole proprietor notifying only himself of the claim and not the insurer deprives the insurer from fully investigating the case and enables sole proprietor claimants to delay notice to insurers until “sometimes years after the injury.” 

 

 

 



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Comp combined ratio deteriorates slightly in 2023


The combined ratio for the U.S. workers compensation market worsened slightly in 2023 even as premiums increased year over year, according to an S&P Global Market Intelligence analysis released Tuesday.

The workers comp combined ratio increased to 84.9% from 84.5% this year, as direct premiums written and net premiums written also grew to $56.69 billion and $48.02 billion, respectively, according to the report.

Although higher than the previous year, 2023’s combined ratio remained stronger than the five-year peak of 88.1% in 2021, S&P said, with analysts stating that 2025 will likely be another profitable year for the industry “short of an unexpected turn in the domestic economy, judicial environment or other underlying cost drivers.” 

 



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Nurse’s firing for refusing COVID vaccine not illegal: Appeals court


A Pennsylvania hospital was within its right to terminate the employment of a nurse who refused to get an employer-mandated COVID-19 vaccination, a state appeals court ruled Tuesday.

The Pennsylvania Superior Court, in affirming a trial court decision, found that Holy Redeemer Health System Inc. didn’t violate any state laws when it fired nurse practitioner Cynthia Deasey in October 2021, one month after the employer mandated the vaccination of all employees.

Ms. Deasey requested a religious exemption, but it was denied.

Holy Redeemer claimed it was permitted to terminate Ms. Deasey because she was an at-will employee.

Ms. Deasey’s lawsuit contained counts of wrongful termination and employment discrimination.

Holy Redeemer argued the matter should have been under the jurisdiction of the U.S. Equal Employment Opportunity Commission and also that the suit was barred by workers compensation exclusive remedy.

A trial judge dismissed the wrongful termination claim and other counts in the lawsuit. Ms. Deasey appealed, reiterating her contention that her firing conflicted with various state laws and the Pennsylvania constitution.

The Superior Court, in upholding the suit’s dismissal, said the legislature never “sought to curb the ability of a private employer from requiring an at-will employee to receive a vaccination,” and that Holy Redeemer did nothing illegal in terminating Ms. Deasey.  

  

 



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OSHA’s revised Hazard Communication Standard tackles unresolved issues


The Occupational Safety and Health Administration on May 20 published a sweeping revision of its Hazard Communication Standard, mostly to better align it with the United Nations’ Globally Harmonized System of Classification and to clarify issues left unresolved by the last set of revisions in 2012.

“Most stakeholders would say (this) is a good thing as it provides a consistent and common approach to classifying chemicals and communicating hazard information,” John Ho, New York-based co-chair of the OSHA Workplace Safety Practice at Cozen O’Connor P.C., wrote in an email.  

The new regulations, which go into effect July 20, will mostly affect chemical manufacturers, importers, distributors and, to some degree, “downstream users,” which will need to revise employee training protocols for storing and handling such substances, according to experts. 

“Probably new training will be the biggest impact on downstream users,” said Valerie Butera, Detroit based senior counsel in the OSHA Workplace Safety Practice Group at Conn Maciel Carey LLP.

For larger enterprises involved in importing and distributing, many of the changes focus on updated labeling requirements and adjustments to safety data sheets that must accompany chemicals, according to Andrew C. Brought, a Kansas City, Missouri-based partner with Spencer Fane LLP, who said importers would be most affected.

The revised standard has been accompanied by controversy, as larger manufacturers have argued that greater disclosures on chemical makeup, such as concentration levels, would reveal trade secrets, experts said.

OSHA has long argued that disclosures are necessary to protect workers who could be harmed by exposure to chemicals and that emergency health care workers should know about the concentrations of the substances involved, Ms. Butera said.

“OSHA tried to balance the need for information with those trade secret protections by also adding to the rule that if there’s an emergency that a health care provider thinks involves a chemical, the manufacturer needs to disclose that information to the health care provider immediately so that they can try to provide better medical assistance,” she said.

Another issue has been adherence to the existing rules regarding chemicals, Mr. Brought said.

“OSHA believes most employers already have inadequate hazard communication programs, and that concept is supported by the enforcement statistics which routinely reflect HazCom violations as one of the highest penalized areas by the agency, usually only behind fall protection violations,” Mr. Brought said.

OSHA did not respond to a request for comment regarding any changes to enforcement of the revised standard.

 



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Stanley Black + Decker cited in electrical arc blast severely injuring worker


The U.S. Occupational Safety and Health Administration said Tuesday that it cited tool manufacturer Stanley Black + Decker after a maintenance electrician suffered severe burns during an electrical arc blast at a company facility.

OSHA cited the company for one “willful” violation and four “serious” violations after a December 2023 inspection at MTD Products Inc. in Willard, Ohio. The agency proposed $222,392 in penalties.

Stanley Black + Decker, headquartered in New Britain, Connecticut, lacked safe work practices and training for electrical maintenance employees, OSHA said. It also exposed workers to fall hazards and failed to enforce lockout/tagout procedures for energized equipment.

The electrical arc blast occurred as the maintenance electrician was replacing fuses during the repair of an industrial oven, according to OSHA.

The worker was hospitalized and treated for severe burns.

Stanley Black + Decker, which has 56,000 employees in more than 60 countries, has 15 business days to contest the citation and proposed penalties. 

 

 



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Asbestos remediation company fined for exposing workers


The Washington State Department of Labor & Industries said last week it had cited and fined an asbestos removal contractor after two investigations found the company exposed workers to hazardous conditions.

The department cited Lynnwood-based Seattle Asbestos of Washington for 35 “willful” health and safety violations and issued more than $790,000 in fines after inspectors found that the company “knowingly and repeatedly” exposed workers and homeowners to unsafe conditions.

During the first inspection, investigators discovered plastic barriers used to block off an area from asbestos had developed large holes rendering the sheathing useless.

In the second inspection, employees were seen leaving the regulated work area without protective clothing or respirators. In addition, they did not use onsite showers, which is a requirement during asbestos removal work, the department said.

The department issued stop work orders at both locations until the problems are addressed.

Seattle Asbestos of Washington has filed appeals in both cases, the department said

 

 



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Second Injury Fund not liable for worker’s mental injury


The Missouri Court of Appeals upheld a determination that the state-run Second Injury Fund was not liable for a worker’s permanent total disability benefits for a psychological injury she reported following a physical injury.

A worker for wire manufacturer WireCo World Group for 28 years, the woman had injured her shoulder at work in 2015 and later claimed she suffered from diabetes, hypertension, anxiety and depression, two preexisting mental conditions once connected to a car accident and her mother dying but later attached to her work injury, according to No. WD86436, filed May 21.

In 2018, she settled her claim with WireCo for her shoulder injury.

That same year she underwent a psychological evaluation, of which an evaluator opined that her physically demanding, dangerous, third-shift work for WireCo was the direct, proximate and prevailing factor for her development of depression. The evaluator said her psychological disabilities were “complex, long-standing and taken as a whole are overwhelming.”

In 2019, she underwent a vocational assessment, which resulted in a report that she was totally disabled by the combined effects of her psychological issues, diabetes, migraine headaches and 2015 shoulder injury.

An administrative law judge found that she failed to meet her burden of proof to establish Second Injury Fund liability. The Labor and Industrial Relations Commission affirmed, as did The Missouri Court of Appeals, which explained that her claim did not meet the parameters that would trigger the fund’s liability.

The court noted that the woman suffered from a variety of ailments before September 2015, including anxiety and depression. At the psychological evaluation in January 2016, the death of her mother, her voluntary layoff as a result, fear that she may not be able to work up to her own standards, and fear of job loss were all noted as increased stressors that impacted her anxiety. The work injury from September 2015 was not mentioned as a stressor.

The court also said there was no evidence that the woman sought psychiatric treatment or addressed her anxiety and depression in any manner over the next two years other than how she had always addressed her anxiety and depression — via prescriptions of the same medications she had been taking before September 2015.

The court also said the timing of the post-settlement evidence was significant because (she) claimed to have suffered a psychological injury from the September 2015 work accident. But two years later, when she settled with her employer and after having undergone numerous consultations, treatment and surgery on her shoulder, there was no evidence to support a psychological work injury or disability specifically related to September 2015.

WorkCompCentral is a sister publication of Business Insurance. More stories here.

 

 

 

 



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11th Circuit dismisses coal worker widow’s claim denial review petition


The U.S. Court of Appeals for the 11th Circuit declined Thursday to take up an appeal in a case brought by the widow of a deceased coal worker who sought survivor benefits under the Black Lung Benefits Act.

The appeals court ruled that it has no jurisdiction to review a denial of survivor benefits for Doris Sloan, who said her husband, Gurstle Sloan, died from pneumoconiosis after working as a coal miner for Drummond Co. Inc. for 16 years.

An administrative law judge denied the claim, a decision subsequently upheld by a review board. Ms. Sloan argued that the judge improperly excluded evidence when she attempted to modify her claim. The judge found the evidence didn’t show the death was due to occupational pneumoconiosis.

The appellate court determined that it lacked jurisdiction to hear the appeal because the case fell under the jurisdiction of the review board. The court, citing U.S. Supreme Court case law, said certain administrative decisions denying rehearing requests are not reviewable by courts.

Another circuit court also held that a review board’s decision to deny a motion for reconsideration in a separate black-lung benefits claim isn’t reviewable, the 11th Circuit noted. The court dismissed Ms. Sloan’s petition for lack of jurisdiction.  

 

 



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Fired school custodian’s suit should have been dismissed: Texas appeals court


A trial court erred in failing to dismiss a lawsuit against a school district by a former custodian who claimed she was fired in retaliation for filing a workers compensation claim, a Texas appellate court ruled Thursday.

The state Court of Appeals said a trial judge should have dismissed a lawsuit against the Conroe Independent School District by Maria Osuna because the school system should have been protected against litigation due to governmental immunity for political subdivisions.

Ms. Osuna says she was sickened after being sprayed in the face with a chemical disinfectant in August 2020. She went out on workers comp.

After her doctor released her to return to work, Ms. Osuna claimed that the district threatened to fire her if she failed to have her physician modify her return-to-work note.

She claimed she was illegally fired in August 2020 over the incident.

During litigation, Ms. Osuna argued the state legislature waived a school district’s immunity from suit due to a section in the labor code that creates a $100,000 damages cap on a plaintiff’s recovery in retaliation claims. She argued it wouldn’t have made sense for the legislature to have created a damages cap unless it also intended to waive governmental immunity.

The appeals court said the suit should have been barred because the legislature has not waived the immunity of school districts in certain retaliatory firing claims. 

 

 

 



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