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Workers' Compensation

Five Recent Workers’ Comp Cases You Should Know About (8/26/2011) – Claimant’s Degenerative Knee Injury Caused By Original Work Injury

Larson's Spotlight on Degenerative Condition, Attorney's Fees, Health Care Provider, Facial Disfigurement, and Life Care Plan. 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.

PA: Nothing Inherently Inconsistent Between Degenerative Condition and Industrial Causation

A Pennsylvania appellate court recently held that a workers' compensation judge erred in presupposing that the use of the term "degenerative" automatically ruled out a finding of causal connection to a prior work injury.  Observing that the diagnosis of "degenerative" merely described the condition, and did not, in itself, address the issue of causation, the court concluded that both the Board and WCJ failed to distinguish between degenerative disability produced by work-related trauma, and degenerative disability not related to the claimant's work. The WCJ misread the expert's testimony, in which the expert clearly opined that work-related trauma set the claimant's degenerative condition in motion.

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 404. 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, § 10.03.

FL: Both Employee and Employer Can Be "Prevailing Party" For Purposes of Attorney's Fees

Finding that workers' compensation proceedings have a unique nature, wherein "a sequence of (often non-competing) claims and defenses is normally consolidated into a single hearing," a Florida appellate court has held that the phenomenon creates the potential for a party to be both "prevailing and nonprevailing," relative to different claims in the same proceeding for purposes of awarding "prevailing party costs" under § 440.34(3), Fla. Stat. According to the court, "the different types of workers' compensation benefits resist comparison and distillation to determine an overall victor." Because the JCC's order regarding prevailing costs was inconsistent, the matter was reversed and remanded for further determination.

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 Fla. App. LEXIS 13245. 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, § 133.03.

MN: Medical Center-Not Spinal Cord Manufacturer-Is "Health Care Provider" For Purposes of Billing the Cost of the Equipment

The entity that provides a service, article, or supply directly to an employee in its final, usable form is the "health care provider actually furnishing" the service, article, or supply under Minn. R. 5221.0700, subp. 2A (2009), and is entitled to charge the payer directly for the service, article, or supply, held the Supreme Court of Minnesota recently.  This has important implications where complex and expensive medical paraphernalia is supplied in the treatment of the injured worker.  Here, the injured worker received surgical implantation of a spinal cord stimulator at a hospital.  The workers' compensation carrier contended that the hospital was not the actual medical provider, that the provider was the manufacturer of the implant device, and that the device manufacturer even had one or more representatives present during the surgery to answer questions.  The carrier contended, therefore, that the "markup" of price for the device was inappropriate and that the manufacturer should have filed its claim directly.  The high court disagreed, finding that the hospital rendered the supply to the patient in its final, usable form.

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 Minn. LEXIS 471. 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, § 94.01.

OH: No "Current Desire to Work" Must Be Shown to Support Facial-Disfigurement Claim

An Ohio appellate court, affirming an award to an injured employee, recently held that an employee need not demonstrate a current desire to work in order to obtain facial-disfigurement compensation under R.C. 4123.57(B). The appellate court held that the Commission's award was based on "some evidence" that the employee's facial disfigurement was of such a nature that it "may in the future impair" her opportunities to secure or retain employment. The Commission did not abuse its discretion in arriving at that conclusion merely because additional evidence indicated that the employee was receiving social security disability benefits and had removed herself from the workforce at the time of her application.

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 Ohio App. LEXIS 3516. 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, § 88.03.

NC: Appeal of Order Related to Life Care Plan Dismissed; Order Was Interlocutory

A North Carolina appellate court recently determined that an employer's appeal of an Order requiring a second life care plan-both the Deputy Commissioner and the Full Commission found the first was not credible-was interlocutory and since it was not a final award, it could not be appealed.  The injured worker had been rendered a quadriplegic as a result of an industrial injury.  Among the issues to be decided was whether the employer should provide modified housing-it was already providing care in a nursing facility. The Commission ordered the parties to confer and agree upon the selection of a qualified planner and for the planner to evaluate the specific circumstances surrounding the injured worker's need for adaptive care, transportation, and attendant care, as originally set forth in a pre-trial agreement.  Both the worker and the employer appealed, but the issues were not ripe for decision, according to the appellate court.

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 N.C. App. LEXIS 1860. 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.

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

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