Workers' Compensation

Five Recent Cases You Should Know About (9/3/2010)

Larson's Spotlight on Death Benefits, Statute of Limitations, Physician Negligence, Independent Medical Examination, and Fraud. 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.

TX: State Supreme Court Construes "Producing Cause" Factor in Workers' Compensation Death Benefits Case

Utilizing the definition of "producing cause" approved in Ford Motor Co. v. Ledesma, 242 S.W.3d 32 (Tex. 2007), the Supreme Court of Texas recently reversed the judgment of the state's Court of Appeals that had earlier affirmed an award of death benefits to the wife of a worker who died from complications associated with a compensable knee injury.  The worker had received a kidney transplant in 1975, began a lifelong regimen of immunosuppressant drug therapy to ensure that his body would not reject the new kidney, began working for the employer in the mid-1980s, and sustained a knee injury in May 2000. He applied for and received workers' compensation benefits for the work-related injury. After a series of increasingly serious health complications which required repeated, lengthy hospitalizations, he died in January 2001.  The high court held that the Ledesma standard applied in workers' compensation cases, that the widow was required to show that the work-related injury was the "producing cause" of the worker's death, that is to say was a substantial factor in bringing about the injury or death and without which the injury or death would not have occurred [emphasis added]. Because the definition submitted to the jury lacked the but-for component, and because its omission constituted harmful error, the court remanded the case for new trial.

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: 2010 Tex. LEXIS 616. 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, § 10.04.

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FL: Claimant's Knee Replacement Effectively Tolls Statute of Limitations for the Indefinite Future

Most states have a provision similar to § 440.19(2), Fla. Stat., that tolls the ordinary statute of limitations for workers' compensation petitions for benefits for a period of time (one year in the case of the Florida statute) from the payment of compensation or furnishing of remedial treatment to the injured worker.  In a case that could have significant implications, a Florida appellate court has held that as long as a claimant can establish that an employer or carrier has actual knowledge of his or her continued use of a medical apparatus prescribed by an authorized doctor, the statute of limitations is tolled during such use.  The "apparatus" in question was a metal prosthesis that had been surgically implanted in the claimant's knee during knee replacement surgery.  Since the prosthesis has a life of 7-10 years and could be replaced, if necessary, one wonders if the statute of limitations will ever run in this claimant's workers' compensation case.

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: 2010 Fla. App. LEXIS 12702. 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, § 126.07.

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AK: Claimant May Not Sue Physician Who Performs Independent Medical Exam for Negligence

A physician performing an independent medical examination to assess a workers' compensation claimant's condition may not be sued in tort by the claimant where the physician reported that the worker had no physical injury and a later MRI reveal several spinal problems, including a Tarlov cyst, held the Supreme Court of Alaska recently; the claimant's civil action was dependent upon the establishment of a physician-patient relationship and there was no such relationship under the facts.

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: 2010 Alas. LEXIS 92. 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, § 112.02.

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FL: Employer May Not Compel Independent Medical Exam Where There is No "Dispute" Over Claimant's Condition

Where the worker's claim was resolved in a mediation conference, with the only remaining issue that of attorneys fees and costs, and where the employer/carrier had agreed to treat the worker's psychological injuries, the employer/carrier could not subsequently require that the worker attend an independent medical examination, held an appellate court recently in Florida; there was no "dispute" between the parties for purposes of § 440.13(5)(a), Fla. Stat.

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: 2010 Fla. App. LEXIS 12703. 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, § 10.10.

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MD: Commission's Decision Not to Refer Claimant to Insurance Fraud Unit Is Not Appealable

The refusal, by the state Workers' Compensation Commission, to refer a person to the Maryland Insurance Fraud Division is not a final administrative decision that is subject to a petition for judicial review, held the Court of Appeals of Maryland recently.  The refusal was interlocutory as it did not dispose of the claim.  The employer could seek reimbursement for improperly paid benefits or litigate the request for total temporary disability benefits.

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: 2010 Md. LEXIS 344. 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, § 130.02.

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

   Offer good through December 2010.