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Workers' Compensation

Larson’s Spotlight on Recent Cases: Non-Dependent Spouse Precluded From Death Benefits and Barred From Bringing Death Claim

Larson's Spotlight on Non-Dependent Spouse and Death Benefits, Fraud and Surveillance Video, Tort Action Against Sole Proprietor, and Statute of Limitations for PTSD Claim. 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.

LexisNexis Workers’ Compensation eNewsletter

VA: Non-Dependent Spouse Precluded From Workers' Compensation Death Benefits and Also Barred From Maintaining Wrongful Death Claim Against Employer

Where an employee with no dependents suffers fatal work-related injuries, an apparent paradox faces any non-dependent relatives in the vast majority of jurisdictions.  On the one hand, the non-dependents are barred from recovery of statutory death benefits under the state Workers' Compensation Act.  On the other hand, they are also barred from tort recovery under the exclusive remedy provisions of that same Act.  Consider the recent decision by the Supreme Court of Virginia in which the high court held the Virginia Workers' Compensation Act barred the non-dependent spouse of the deceased worker from pursuing a wrongful death action against the employer.

The facts were a bit unusual.  At one time, the deceased worker and the spouse had lived as husband and wife.  They separated, however, and lived apart for a number of years, segregating their assets and their bank accounts.  When the worker sold the house in which he lived, he moved in with his spouse, but they continued the arrangement of separateness.  Following the worker's death in a construction accident, the spouse sought workers' compensation benefits. After hearing the evidence, a deputy commissioner determined that the worker's estate was entitled to statutory funeral expenses, but that the spouse was not a dependent of the deceased worker and, therefore, was not entitled to workers' compensation benefits.

The spouse then, as personal representative of her husband's estate, filed a wrongful death claim in the county circuit court against the employer and others, including a sheetrock supplier. The circuit court determined that, because the Commission had jurisdiction over the matter, the exclusivity provision applied. Accordingly, the circuit court sustained the pleas in bar.

The state supreme court held that the Act not only bound employers and employees, it also defined the categories of persons, in addition to the employee, who were bound by the agreement between the employer and employee. The court indicated that the clear and unambiguous language of Va. Code Ann. § 65.2-307(A) precluded "all other rights and remedies" available to the personal representative of an employee who has accepted the provisions of the Act. The widow's claim was, therefore, barred in spite of the fact that she could not recover under the Act.  The high court did, however, find that the cause of action could proceed against the sheetrock supplier, however.

See Giordano v. McBar Indus., Inc., 2012 Va. LEXIS 138 (June 7, 2012).

See generally Larson's Workers' Compensation Law, § 101.02.

US: 12 Hours of Surveillance Video Support Jury's Decision that Defendant Was Guilty of Workers' Comp Fraud

The Second Circuit Court of Appeals recently affirmed the conviction of a defendant on four counts of knowingly falsifying, concealing or covering up a material fact in connection with the application for, and the receipt of, federal workers' compensation benefits in violation of 18 U.S.C. § 1920, in spite of the fact that the government presented no medical testimony in the case.  The 6th Circuit observed, however, that the government presented more than 12 hours of video surveillance at trial showing defendant performing a variety of manual tasks, including lawn mowing and snow shoveling, while evidencing little sign of back pain.  The court noted that the defendant's doctor's evaluations of the defendant's abilities were primarily based on his self-reporting of pain levels.  The jury was, therefore, entitled to weigh those self-reports against the hours of video surveillance and reach its own conclusion as to whether defendant's condition had improved.

See United States v. Casey, 2012 U.S. App. LEXIS 11833 (2nd Cir., June 12, 2012).

See generally Larson's Workers' Compensation Law, § 39.03.

RI: Plaintiff's Tort Action Against Sole Proprietor Employer Barred Where He Had Already Received $41,000 in Workers' Compensation Benefits

The Supreme Court of Rhode Island recently affirmed summary judgment in favor of a defendant, based upon the exclusive remedy provisions of the Workers' Compensation Act where defendant operated a landscaping business as a sole proprietor, employed plaintiff to perform landscaping duties, and where plaintiff was injured in a vehicular accident during a multi-day trip which combined activities that were both related and unrelated to the work.  Plaintiff accompanied defendant to Columbus, Ohio, to a car show to see a vintage vehicle in which defendant was personally interested.  While traveling back to Rhode Island, with the intention of making a work-related stop in Somerset, PA, defendant rear-ended another vehicle.  Important to the decision was the fact that plaintiff received approximately $41,000 in workers' compensation benefits from defendant's comp carrier following the accident.  The state high court agreed that plaintiff could not have a double recovery.

See LaFreniere v. Dutton, 2012 R.I. LEXIS 73 (June 7, 2012).

See generally Larson's Workers' Compensation Law, § 100.01.

TN: Statute of Limitations for PTSD Claim Begins to Run at Diagnosis, Not at the Time of Traumatic Event

Applying the so-called "discovery" rule, the Supreme Court of Tennessee recently held that the statute of limitations regarding claimant's post-traumatic stress disorder claim did not begin to run until the diagnosis of the condition and not at the time of the original trauma. The employee viewed the bodies of co-workers who had died as a result of work accidents on two separate occasions in February and April 2008. On June 23, 2008, the employee was diagnosed with PTSD caused by the two incidents. On June 23, 2009, the employee requested a benefit review conference. Here, since the claim was filed within one-year of the diagnosis, but not within one year of the trauma, the trial court erred in finding that the claim was barred on statute of limitations grounds.

See Gerdau Ameristeel, Inc. v. Ratliff, 2012 Tenn. LEXIS 401 (June 7, 2012).

See generally Larson's Workers' Compensation Law, § 126.05.

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

Larson’s Workers’ Compensation Law

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