Tag: Workers Comp

An appeals court in New York upheld a denial of benefits to a bus driver who claimed in 2020 that he suffered “work-related stress and mental health injuries as a result of his exposure to COVID-19, the COVID-19-related death and illness of co-workers, the conditions of his employment and his treatment by co-workers and passengers, among other things.”

The driver, who in November 2020 quit his job with the Manhattan & Bronx Surface Transit Operating Authority, filed a workers comp claim for mental injuries his doctor classified as work-related, according to No. 535458, filed July 20 in the Appellate Division of the Supreme Court of New York, Third Department.

The driver, who did not test positive for COVID-19, claimed that “he was fearful of contracting and bringing it home to his family, as most passengers refused to wear masks when he instructed them that masks were required and some threatened him, half of his co-workers went unmasked and he was only provided with one mask per week at the outset of the pandemic,” according to the ruling.

In affirming the Workers’ Compensation Board’s denial of his claim, the court wrote that “mental injuries caused by work-related stress are compensable if the claimant can establish that the stress that caused the injury was greater than that which other similarly situated workers experienced in the normal work environment.”

The court wrote that all drivers were given the same allotment of masks, which were “scarce” at the time, and that all were subjected to the same risk of COVID-19.

The court said the driver failed to demonstrate that the stress he experienced at work was “greater than the stress normally experienced in the workplace by similarly situated bus operators, given that their job duties necessarily involved interacting with the general public and co-workers throughout the community where they are subjected to myriad illnesses, including COVID-19, and difficult passengers.”

 

 

 

West Virginia Gov. Jim Justice on Wednesday announced that the National Council on Compensation Insurance filed a proposed workers compensation loss cost decrease of 12.7%, effective Nov. 1.

This latest filing represents the 19th consecutive year of decreases, and a projected $20 million in savings to West Virginia employers as loss costs are factored in when calculating rates, according to a statement.

Since the state’s workers compensation program was privatized in 2006, the market has experienced approximately $466 million in premium savings, the governor’s office said.

 

A Virginia appellate court has reversed a lower court ruling involving a since-reinstated state police trooper who was fired after going out on workers compensation following a duty-related injury and was later embroiled in an insurance dispute with his employer.

The Virginia Court Appeals on Tuesday overturned a trial court decision upholding a hearing officer’s determination that the Department of State Police was required to reimburse Trooper Todd Brendel for substitute health insurance premiums he paid during a period of unemployment after he was fired following his work-related injuries.

Mr. Brendel was fired in May 2020, two years after sustaining double shoulder injuries requiring surgery. He was awarded temporary total disability comp benefits at the time.  

A hearing officer found the police department wrongfully fired Mr. Brendel and ordered his rehiring.

Mr. Brendel requested to be reimbursed for insurance premiums he paid through April 2021; the department challenged a portion of the reimbursement, saying the benefits reinstatement was retroactive. Mr. Brendel claimed he continued paying substitute insurance because he didn’t have proof he was covered.

A trial judge ordered the reimbursement, but the police department argued it wasn’t responsible for Mr. Brendel’s choice to continue paying the substitute premiums.

In finding the trial court erred, the appeals court remanded the matter so a lower judge could ascertain whether the insurance reimbursement should be offset by the amount Mr. Brendel paid in substitute premiums. 

 

 

 

A Missouri appellate court has ruled that health care providers who treat injured employees in workers compensation claims are also subject to comp exclusive remedy in fee disputes concerning partial payment by employers’ comp insurers.

The Court of Appeals of Missouri, Eastern District, in a Tuesday decision, found that health care providers seeking additional payment in comp claims may not pursue litigation to be paid for remaining treatment charges, but rather must plead their case in the comp system.  

The case, Orthopedic Ambulatory Surgery Center of Chesterfield LLC v. Sharpe Holdings Inc., concerned health care providers who sued numerous employers and comp insurers for payment of additional medical charges arising from injured worker treatment.

The plaintiffs sued for breach of contract, unjust enrichment, negligent misrepresentation and other claims.

The defendants argued that the matter belonged in the comp system, because the state Division of Workers’ Compensation has exclusive authority over fee disputes relating to charges incurred for medical care.

The appeals court agreed with the defendants, writing that the comp law provides health care providers the “exclusive procedures and remedies” for claims for unpaid medical bills in injured worker cases.

The court wrote that “we cannot ignore the legislature’s unequivocally mandatory language” requiring medical fee disputes to be handled in the comp system and not the tort system.

With their ruling, the appeals judges affirmed a similar conclusion reached at the trial court level. 

 

 

 

The U.S. Occupational Safety and Health Administration has cited an Illinois grain bin operator after an employee became trapped in a grain elevator for five hours in February.

OSHA on Wednesday said it cited Martinsville-based Littlejohn Grain Inc. for violating federal grain-handling safety standards by allowing workers to enter grain bins without appropriate protective equipment such as a safety harness or lanyard.

Co-workers and first responders worked for hours to remove hundreds of pounds of soybeans in an attempt to pull the injured employee out of the grain bin during the workplace incident.

Employees were working to unclog soybeans that were stacked as high as 30 feet on the bin’s inside walls at the time of the incident, which took place in the town of Westfield.

OSHA said the company failed to properly train workers on emergency procedures in such situations.

OSHA issued citations for two willful, 10 serious and three other-than-serious violations and proposed penalties of $272,957.

The company has 15 days to contest the citations and proposed fine.

While the employee in the February incident suffered only minor injuries, OSHA inspectors said they discovered a similar July incident led to another worker suffering injuries that required a foot amputation. That incident continues to be investigated.

 

 

 

The U.S. Occupational Safety and Health Administration cited the operator of a Boston area food plant for repeat violations after inspectors said the business failed to implement measures designed to protect workers from machine hazards.

OSHA on Monday announced it cited Chinese Spaghetti Factory Inc. and proposed an additional $82,500 in penalties on top of $108,031 in fines the company previously received relating to safety guards on a dumpling machine’s rotating shafts, a failure that OSHA said led to a worker’s serious injuries in 2022.

Regulators sent out to reinspect the food plant found several new and recurring hazards, according to OSHA.

The company was cited for willfully allowing the dumpling machine’s gears to remain unguarded, repeatedly exposing employees to the risk of electrical shock from unguarded electrical components, failing to implement procedures designed to prevent the unintended activation of machines, and failing to institute a hearing conservation program for workers who are exposed to high noise levels.

OSHA said it identified 10 serious, repeat and other-than-serious violations at the company’s Braintree, Massachusetts, location since 2017.

The company has 15 business days to contest the citations and proposed penalties.  

 

 

An Indiana appellate court ruled the state’s Worker’s Compensation Board erred in upholding a determination that an injured worker’s petition for additional workers comp benefits was untimely filed.

The Indiana Court of Appeals on Monday reversed a board ruling dismissing a claim adjustment application by Angela Santos, who injured her back in December 2019 while working for Franciscan Health, affiliated with the Franciscan Alliance Inc. health care system.

The claim was initially accepted as compensable. Ms. Santos filed a petition to adjust her claim in December 2021, but the application was denied because the paperwork was dated Dec. 6, one day after a two-year deadline.

The employer argued the claim was untimely filed and the comp board agreed.

Ms. Santos appealed, arguing her application was timely filed because the last day of the two-year period fell on a Sunday, and she sent the application by certified mail on Monday, the first business day.

The appeals court agreed with Ms. Santos, ruling the state’s work comp statute is silent as to how an application for claim adjustment must be filed, and that Ms. Santos timely filed her application under certain procedural rules.

The employer attempted to distinguish between an original application and a subsequent claim adjustment application, but the appeals judges said the rules provide no such distinction, and that the adjustment application was timely filed.

The court reversed the lower ruling and remanded the case to the comp board for further proceedings. 

 

 

The Kansas Supreme Court ruled that a multimillion-dollar arbitration award against an employer in a worker death case does not bar other defendants from facing a lawsuit stemming from the same workplace fatality.

The high court, in Hodges v. Walinga USA Inc., determined that the state’s “one-action” rule, which generally requires defendants in tort cases to be consolidated into a single lawsuit when facing similar allegations, doesn’t apply when plaintiffs recover damages through an arbitrator’s decision as opposed to a judicial outcome.

The case involved a worker who died from asphyxiation after being engulfed in a corn silo in 2019. The man’s estate sued the employer, Butts Farms LLC, as well as Walinga USA Inc., the manufacturer of the grain vacuum system that allegedly failed and contributed to the death.

An arbitrator awarded the estate $5 million for pain and suffering, $7 million for economic damages and wrongful death, and $250,000 for bereavement and loss of companionship. The award was solely against Butts.

Walinga sought dismissal from the litigation, asserting the suit against them was barred by the “one-action” rule. It argued the arbitration proceeding was a judicial action that barred further claims involving the same allegations.

The Supreme Court disagreed, ruling an arbitration award is “extrajudicial” and that the confirmation of an arbitration award by a state court also doesn’t qualify as a “judicial determination.”

 

 

 

The U.S. Occupational Safety and Health Administration cited a Wisconsin rendering plant after a worker was severely burned by steam and hot oil.

OSHA said Thursday it cited Green Bay-based Sanimax USA LLC for failing to develop and implement hazardous energy control procedures when clearing blocked pumps and piping at the facility.

The worker suffered serious burns when a pump seal released steam and hot oil as workers tried to clear a blockage in January.

OSHA proposed $296,668 in penalties. The company was issued citations for three repeat and 10 serious safety and health violations.

The company, a subsidiary of Montreal-based Sanimax of Canada, operates facilities in Green Bay and DeForest, Wisconsin, as well as in St. Paul, Minnesota.