Articles Posted in Workers’ Compensation Benefits

Smiley v. Vermont, a workers’ compensation appeal from the Supreme Court of Vermont, involved claimant who injured his left ankle during his employment as a state game warden in January of 1996.

In July of 1996, claimant’s doctor documented it had been six months since claimant had surgery on his ankle, and claimant was back at work without physical limitations, though he did have trouble walking up stairs. Claimant’s doctor also found progress and limitations to be normal given it was only six months following surgery, as it generally takes a full year to recover from this type of ankle injury.

Doctor also noted claimant was offered psychical therapy, but declined. Doctor further expressed his opinion that claimant reached an end of his medical improvement around that time and any disability was likely to be permanent.

During this same time, the state department of labor had created a new rule that required employers or employers’ insurance companies to take necessary steps to determine if an employee has permanent impairment as a result a work-related injury or illness at the time claimant reaches maximum medical improvement (MMI).
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Provo City v. Utah Labor Commission, an appeal from the Utah Supreme Court, involves a claimant who worked for the city as a facility service technician. He was injured in an automobile accident while driving his truck for a work-related purpose. Claimant alleged the accident caused further injury to an existing congenital spine consider. The accident caused claimant to suffer chronic pain and other disabilities, according to his claim for workers’ compensation benefits.

Claimant continued working for city, but after four years, he claimed his pain and other symptoms were no longer manageable and requested reassignment to a job with less physically demanding responsibilities. After city told claimant such a position did not exist, he left his job and filed a claim for permanent total disability (PTD) benefits through employer’s workers’ compensation insurance carrier.
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Armstrong v. State, an appeal from the Supreme Court of Nebraska, involved claimant who injured herself while working as a staff nurse at a veteran’s hospital. Both claimant and her employer stipulated (formally agreed) she tore a hole in the rotator cuff of her right shoulder to a severity entitling her to compensation for her on-the-job injury.

Her employer paid her temporary total disability (TTD) workers’ compensation benefits from May 2010 to April 2010. At this point, doctors opined she had reached her maximum medical improvement (MMI).

MMI means doctors have done all they can feasibly do to improve a patient’s condition, and there is nothing else worth doing to improve his or her condition. Essentially, a doctor is saying he or she has done everything that could be done, and it’s not worth trying anything else in terms of cost and patient discomfort.
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Central Flying Serv. Inc. v. Circuit Court, an appeal from the Supreme Court of Arkansas, involved claimant who was killed in a plane crash. Claimant was a licensed pilot employed by an airline. He was to fly from Little Rock, Arkansas to Monroe, Louisiana, pick up passengers, and fly them to Beaumont, Texas.

On his flight from Louisiana to Texas, his plane crashed, and claimant and all three passengers were killed. Claimant’s estate filed a wrongful death civil action against employer on grounds he was not trained or certified to fly the particular aircraft he was flying the day of his crash. The aircraft involved in the deadly crash was a Beechcraft “Bonanza” A 36.
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The concept of workers’ compensation benefits is most often associated with work-related injuries. But occupational illness are equally as pervasive and can be just as serious.

The Centers for Disease Control and Prevention estimates between 26,000 and 72,000 deaths occur annually in the U.S. as the result of occupational diseases. The U.S. Bureau of Labor Statistics estimates approximately 300,000 new work-related illnesses occur annually. These run the gamut, from occupational cancers like mesothelioma to work-related heart disease to negative impacts on reproductive health.

Establishing a link between a worker’s condition and his or her job can be challenging, particularly when there is a period of latency between the exposure to illness-causing agents and development of the disease. But making this connection is critical to ensuring the person affected can obtain workers’ compensation benefits.
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Moreau v. Transp. Ins. Co., a workers’ compensation appeal from Supreme Court of Montana, involved claimant who work at an asbestos mine from 1963 until 1992. Claimant died as a result of asbestos-related lung cancer in 2009. Claimant’s surviving spouse, in her capacity as personal representative of claimant’s estate, filed a claim with employer’s workers’ compensation insurance carrier for benefits due to an occupational disease. Insurance carrier denied her claim.

In 2012, she filed a claim before the workers’ compensation commission requesting insurance company be found liable for claimant’s medical expenses. The following year, insurance company agreed to liability and entered into a settlement agreement to pay for medical expenses.

Employer paid providers who had already paid for claimant’s medical expenses and also reimbursed his estate for money it spent prior to his death. One provider, which had already paid $95,000, was a fund set up by claimant’s employer (asbestos mine owner) to compensate employees who developed asbestos-related injuries. Both the fund and employer refused to accept any reimbursement from insurance company. Claimant demanded any money declined by employer or fund be given to the estate.
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Schultz v. Workers’ Compensation Appeals Bd., a case from the Court of Appeal of the State of California, involved claimant who filed an application for workers’ compensation benefits after being injured in a traffic accident. He was driving his personal vehicle at the time of the crash, which occurred on an Air Force base. He worked for employer in a facility located on base.
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City of Danville v. Tate, a workers’ compensation case from the Supreme Court of Virginia, involved claimant who was employed by the city as a firefighter for 39 years. In March of 2009, claimant suffered a major heart attack and did not return to work. He retired six months after his heart attack.

Prior to becoming ill, claimant had accrued around 6,000 hours of paid sick leave. His employer paid out his sick leave prior to retirement in the amount of approximately $40,000. This sick leave payout was roughly equivalent to his annual salary. He used the balance of his sick leave, as permitted, to earn another year of employment credit with respect to his retirement plan.

However, before he retired, he filed a workers’ compensation claim seeking a rating of two-thirds impairment from the heart attack-related disability. The city first denied his claim, but it accepted liability the following year. He was paid for his six months of disability prior to retirement. The city did not ask to be given an offset credit with respect to money it had already paid out in sick leave.
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Duarte v. CA. State Teachers’ Ret. Sys., a case from the Court of Appeal for California, First Division, involved claimant who was a teacher for the state’s unified school district. He worked as a teacher there from 1993 to 1995. Claimant took personal leave in 1995 that was authorized but unpaid and then took educational leave until 1999. During his leave, claimant worked for one season as a firefighter for the state forestry department. He also completed law school, but, after failing to pass the state bar exam, began working as a paralegal.

In 2003, claimant returned to the school system, and his second day back on the job, two students he refused to let into the classroom due their disruptive behavior assaulted him. His specific claim was that one student injured his shoulder when he pushed claimant into the doorframe to get past him. He also alleged one student continued to the threaten him and told claimant “[he] was going to put a put a cap in his ass.” The other students repeatedly mocked claimant for the remainder of the day, making teaching virtually impossible. Claimant never returned to teach at the school.
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