By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board Just when you thought the right of “due process” was on the brink of destruction, the legislature...
By Hon. Susan V. Hamilton, Former Assistant Secretary and Deputy Commissioner, California Workers’ Compensation Appeals Board Over the past several decades California has implemented broad legislative...
CALIFORNIA COMPENSATION CASES Vol. 89, No. 9 September 2024 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions...
By Thomas A. Robinson, co-author, Larson’s Workers’ Compensation Law Editorial Note: All section references below are to Larson’s Workers’ Compensation Law, unless otherwise indicated...
By Hon. Colleen Casey, Former Commissioner, California Workers’ Compensation Appeals Board One of the most common reasons evaluating physicians flunk the apportionment validity test is due to their...
Do insurers gain the right to select a medical provider when the employer is no longer in business? In Lyman v Missouri Employer's Mutual Insurance Company, 2013 Mo. App. Lexis 970 (August 23, 2013) [version available to lexis.com subscribers], the court of appeals reversed a summary judgment against the worker which found the insurer had the right to direct care. Section 287.140 expressly grants that right to employers.
Claimant obtained a judgment for permanent and total disability with open medical flowing from a 2002 accident when he fell from a ladder. He claimed the carrier was responsible for unauthorized chiropractic treatment because the statute only provided the employer the right to direct care and the employer was no longer in business.
The issue was one of first impression. The court declined to decide it and found summary judgment was inappropriate because the issue was not ripe. The parties agreed that the employer was out of business,. The court noted that members of an LLC can still make some decisions even after dissolution, and summary judgment was inappropriate when there was an unresolved material fact if anyone with the employer was willing or able to make such a decision. The court noted the lack of evidence of articles of termination, even though that was not a disputed issue.
Missouri is unique among many states as the employer has the right to direct medical care. This case demonstrates a fascinating problem who manages medical decisions when the employer is no longer around. Practitioners trying permanent total cases or drafting settlement contracts with open medical should carefully consider whether to reserve the employer's right to direct medical care, and contingency plans if the employer is no longer around.
Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug’s Mo. Workers’ Comp Alerts.
For more information about LexisNexis products and solutions connect with us through our corporate site