Five Recent Workers’ Comp Cases You Should Know About (9/4/2011) – Employer Can’t Contractually Transfer Cost of Premiums to Employees

Larson's Spotlight on Insurance Premiums, Lifetime Income Benefits, Illegal Aliens, Death Benefits, and Unfair Settlement Claims. Larson's surveys the latest case developments that you need to know about. Thomas A. Robinson, the staff writer for Larson's Workers' Compensation Law, has compiled the list below.

MA: Employer May Not "Contractually" Transfer Cost of Workers' Compensation Insurance Premiums to Employees

Answering a series of questions certified by a federal district court judge: in relevant part, (a) whether an employer may use a system of customer accounts receivable financing to pay its employees at the time the customer pays the employer for the employee's work rather than when the work is performed; and (b) whether, under the Massachusetts Wage Act, G. L. c. 149, §§ 148, 150 (Wage Act), an employer and an employee may agree that the employee will pay the cost of workers' compensation and other work-related insurance coverage.  The court concluded that the accounts receivable financing system at issue improperly deferred payment of the employee's earned wages, and that an employer may not deduct the workers' compensation insurance costs from an employee's earned wages. The federal district court had already ruled that the employer had misclassified as independent contractors various workers who provided janitorial and custodial services to the employer's clients.  The Massachusetts state court held that to permit an employer to transfer to its employees the cost of workers' compensation insurance premiums would be inconsistent with both the general intent and the specific language of the Workers' Compensation Act.

FREE VERSION: Access the case on lexisONE free case law. Click on tab for Free Case Law. Click on the radio button for Search by Citation. Enter this citation: 2011 Mass. LEXIS 734. Then click on the red button Search for Free. Note: If you haven’t registered for free at lexisONE, you will be prompted to do so in order to access the free case law.

FULLY FEATURED VERSION: Lexis.com subscribers can read the fully featured case here. See generally Larson's Workers' Compensation Law, § 63.01.

TX: Award of Lifetime Income Benefits Limited to Injuries Specifically Enumerated in Statute

The Supreme Court of Texas, reversing a decision of the court of appeals, recently held that Texas Lab. Code § 408.161, which authorizes the award of lifetime income benefits to employees who lose certain body parts or suffer certain injuries in work-related accidents, cannot be broadly read so as to allow an award of such lifetime benefits to an employee who has not sustained one of the injuries enumerated within the statute. Here the employee injured her hips, an injury and body part not enumerated in § 408.161. Her hip injuries, however, affected the use of her feet—a body part mentioned in the statute—to the extent that she could no longer work. Although her feet were not injured, per se, the employee was awarded lifetime income benefits because her hip injuries prevented her from continuing to work.  The supreme court concluded that the occurrence of one of the injuries identified in § 408.161 is a prerequisite to the award of lifetime benefits. Since there was no evidence that the employee suffered one of the enumerated injuries, the court of appeals decision was reversed.

FREE VERSION: Access the case on lexisONE free case law. Click on tab for Free Case Law. Click on the radio button for Search by Citation. Enter this citation: 2011 Tex. LEXIS 601. Then click on the red button Search for Free. Note: If you haven’t registered for free at lexisONE, you will be prompted to do so in order to access the free case law.

FULLY FEATURED VERSION: Lexis.com subscribers can read the fully featured case here. See generally Larson's Workers' Compensation Law, §§ 86.04, 87.02, 87.05.

KY: Workers' Compensation Act Protects "Unauthorized" Aliens

Joining the growing number of federal and state courts that have concluded that the Immigration Reform and Control Act of 1986 (IRCA) does not preempt a workers' compensation law that otherwise covers unauthorized aliens, the Supreme Court of Kentucky recently affirmed a claim filed by a fifteen-year-old unauthorized alien for injuries sustained when he fell through a hole in the second floor of a home that the employer was constructing.  The worker sustained a severe head injury and other serious injuries. He lapsed into a coma and was hospitalized for two months.  The court indicated that eligibility for workers' compensation benefits was not a realistic incentive for an individual to enter the United States unlawfully and a decision to exclude unauthorized aliens from the application of the Kentucky Workers' Compensation Act worked to contravene the purpose of the IRCA by providing a financial incentive for unscrupulous employers to hire unauthorized workers and engage in unsafe practices, leaving the burden of caring for injured workers and their dependents to the residents of the Commonwealth.

FREE VERSION: Access the case on lexisONE free case law. Click on tab for Free Case Law. Click on the radio button for Search by Citation. Enter this citation: 2011 Ky. LEXIS 116. Then click on the red button Search for Free. Note: If you haven’t registered for free at lexisONE, you will be prompted to do so in order to access the free case law.

FULLY FEATURED VERSION: Lexis.com subscribers can read the fully featured case here. See generally Larson's Workers' Compensation Law, § 66.03.

PA: Death Benefits Denied to Spouse of Employee Found Slumped Over "Home Office" Desk

A Pennsylvania appellate court recently determined that the spouse of an employee who died several days after he was found unresponsive and slumped over his desk in what amounted to a office in his home was not entitled to workers' compensation death benefits; she failed to show an actual connection between her husband's death and his work.  Evidence that his blood was found near the front door and in other areas of the home, including a bathroom, did not necessarily support the widow's contention that the employee had been working and had perhaps slipped and fallen.  The court indicated that this was not a personal comfort case, that in order to show a brief departure from work, one had first to establish the actual work.  Here there was nothing in the record demonstrating what decedent was doing when he was injured.  The spouse's "proffered explanation that decedent slipped and hit his head while outside smoking a cigarette—attending to his personal comfort—or retrieving business mail [was] speculative at best."

FREE VERSION: Access the case on lexisONE free case law. Click on tab for Free Case Law. Click on the radio button for Search by Citation. Enter this citation: 2011 Pa. Commw. LEXIS 418. Then click on the red button Search for Free. Note: If you haven’t registered for free at lexisONE, you will be prompted to do so in order to access the free case law.

FULLY FEATURED VERSION: Lexis.com subscribers can read the fully featured case here. See generally Larson's Workers' Compensation Law, §§ 16.10, 21.01.

TX: Unfair Settlement Claims Against Workers' Compensation Carrier May Not Proceed

The Supreme Court of Texas recently held that that claims against workers' compensation carriers for unfair settlement practices could not be made under the Texas Insurance Code, that the provisions of the amended Texas Workers' Compensation Act [Tex. Lab. Code Ann. §§ 401.001-506.002] indicated legislative intent that its provisions for dispute resolution and remedies for failing to comply with those provisions in the workers' compensation context were exclusive of those in Tex. Ins. Code Ann. § 541.060. Thus, the employee could not assert a cause of action under § 541.060. The court also indicated that the legislature did not intend for workers' compensation claimants to have a cause of action against a carrier under the general provision of Tex. Ins. Code Ann. § 542.003. The court concluded that claims under the Insurance Code could be made against carriers for misrepresenting provisions of their policies. Because Tex. Ins. Code Ann. § 541.061 did not evidence intent that it be applied in regard to settling claims, it was not at odds with the dispute resolution process of the workers' compensation system. However, there was insufficient evidence in the instant case to support a finding that the carrier misrepresented its policy.

FREE VERSION: Access the case on lexisONE free case law. Click on tab for Free Case Law. Click on the radio button for Search by Citation. Enter this citation: 2011 Tex. LEXIS 600. Then click on the red button Search for Free. Note: If you haven’t registered for free at lexisONE, you will be prompted to do so in order to access the free case law.

FULLY FEATURED VERSION: Lexis.com subscribers can read the fully featured case here. See generally Larson's Workers' Compensation Law, § 114.04.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law

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