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DTCI: Workers' comp caselaw reviews

July 18, 2012

By Ann Stewart
By Karen Dutcher

dutcher-karen-dtci-mug Dutcher
stewart-ann-dtci-mug Stewart

What follows is a compilation of important workers’ compensation caselaw reviews and summaries from the last six months.

12/29/2011

Moorehead Electric Co., Inc. v. Jerry Payne, 962 N.E.2d 657 (Ind. Ct. App. 2011)

Issue: Did the Workers’ Compensation Board of Indiana err when it determined that plaintiff’s injury sustained outside the workplace arose from the prior compensable injury?

Payne injured his shoulder at work. The employer, Moorehead Electric Co., accepted the claim as compensable and provided benefits and medical treatment including two surgeries. Shortly after the second surgery and before Payne reached maximum medical improvement (MMI), he fell on the sidewalk while attending a wedding reception and reinjured the shoulder resulting in an additional surgery. At the time of the fall, Payne wore a very bulky arm brace apparatus, and the hearing member and full Workers’ Compensation Board found that the apparatus contributed to the fall. Moorehead Electric argued that the new injury resulted, at least in part, from Payne’s negligence. The board affirmed the hearing member’s finding that the new injury was causally related to the work injury and therefore, the employer had to provide treatment and benefits during the period of recovery from the fall that occurred outside of the workplace.

The Court of Appeals affirmed the board decision, stating that “because the original shoulder injury arose out of Payne’s employment, and there was no intervening, causal act of negligence, the subsequent injury is a consequence which flows from it, and therefore, likewise arises out of his employment with Moorehead.”

01/12/2012

Quinn v. Accurate Builders, 961 N.E.2d 70 (Ind. Ct. App. 2012)(unpub.)

Issue: Was evidence sufficient to support the Workers’ Compensation Board’s conclusion that plaintiff was not entitled to permanent and total disability benefits?

Quinn, a carpenter, suffered a severe back injury when a deck holding three workers collapsed and fell on him. His treatment included multiple back surgeries and, ultimately, implantation of a spinal cord stimulator (SCS) to treat ongoing pain. Quinn continued to suffer back pain although the evidence indicated that he received some benefit from the SCS. A functional capacity evaluation determined that Quinn could perform light duty work, although the record showed that his pain increased when he tried to work. Quinn applied for and received Social Security disability benefits. About three years after the injury date, Quinn reached MMI and obtained a PPI rating of 23 percent whole person. Quinn obtained a vocational evaluation concluding that he was permanently and totally disabled. The hearing member and full board concluded that Quinn was not entitled to permanent total disability benefits (PTD), but was entitled to the 23 percent whole person PPI rating. The board also found that Accurate Builders would have to provide continuing palliative care for an unspecified period.

The Court of Appeals affirmed the administrative decisions and concluded that based on the record, the board properly denied the claim for PTD benefits. The hearing member and board decisions relied heavily on very specific factual information from the medical records, and the court deferred to the factual determinations made at the lower levels weighing conflicting evidence.

01/19/2012

Meyers v. Rising Sun-Ohio County Community School Corp., 961 N.E.2d 541 (Ind. Ct. App. 2012)(unpub.)

Issues: Did the trial court err in granting summary judgment to the employer dismissing plaintiff’s Frampton claim of retaliatory discharge? Did the trial court err in granting summary judgment to defendant dismissing plaintiff’s claim of intentional infliction of emotional distress?

Meyers, a special education teacher, sought workers’ compensation benefits after she hit her head at work. After the injury, she missed several days of work because of migraine headaches resulting from the blow to her head. The injury occurred on Dec. 19, 2008. On Feb. 6, 2009, Rising Sun issued a suspension letter to Meyers citing several instances of misconduct, including inappropriate and dangerous handling of a student, inability to work with colleagues to develop behavior plans for students, failure to leave lessons plans on days when she was absent, failure to follow procedures outlined by administrators in dealing with students, and failure to teach academic skills to students during class time. Rising Sun provided Meyers with a hearing and then terminated her. Meyers sued, claiming retaliatory discharge and intentional infliction of emotional distress. The Court of Appeals granted summary judgment to Rising Sun on both claims. With regard to the Frampton claim, the court concluded that Meyers failed to produce evidence that Rising Sun’s proffered legitimate nondiscriminatory reasons for discharge were pretext for discrimination. Regarding the intentional infliction of emotional distress claim, the court held that Meyers abandoned her appeal as to that claim by failing to raise it in her initial brief and that raising it in her reply brief did not preserve the issue on appeal.

01/26/2012

Reeves v. Citizens Financial Services, 960 N.E.2d 860 (Ind. Ct. App. 2012)

Issue: Did the board err when it concluded that plaintiff was not entitled to additional palliative care?

Reeves injured his back and hip in a work-related automobile accident in 2003. After several years of ongoing back pain that radiated into Reeves’ leg and treatment and evaluation by several different physicians, a single hearing member determined that Reeves had reached MMI and that he was entitled to a 5 percent whole person PPI rating, but he was not entitled to additional medical or palliative care. The full board affirmed this decision, and Reeves appealed the determination that he was not entitled to palliative care. The Court of Appeals affirmed the board decision.

The court found that although some of the doctors mentioned that Reeves would need pain medication, therapy and exercise in the future, none of the records specify the treatment that would be needed, and the doctors failed to address whether palliative care would reduce the extent of Reeves’ impairment. The court stated that the board has authority to order payment for palliative care when the evidence supports the finding that the palliative care would limit the extent of the impairment.

01/26/2012

Bible v. St. Vincent Hospital, 961 N.E.2d 545 (Ind. Ct. App. 2012) (unpub.)

Issues: Did the Workers’ Compensation Board issue adequate findings of fact to support its decision affirming the denial of plaintiff’s claim? Did the single hearing member err in judging the credibility of plaintiff’s hearing testimony?

Bible filed an application for adjustment of claim on July 10, 2007, claiming that she injured her elbow at work when she banged it against a door on March 27, 2007. In mid-March, Bible had been off work on an unrelated medical leave related to an auto accident. Before she returned to work, on March 30, 2007, Bible told a nurse who examined her at St. Vincent’s that her elbow hurt and that she had not injured it at work. Bible obtained care for her elbow from her personal physicians and told them that she did not remember any specific injury to the elbow. In September 2007, St. Vincent denied Bible’s claim for benefits after investigating and concluding that the elbow pain did not arise from a work-related injury. The single hearing member denied the claim, finding that Bible was not a credible witness. The full board stated that “the Opinion issued by the Single Hearing Member should be affirmed.”

Bible appealed on the grounds that the full board decision was inadequate because it lacked independent factual findings. The Court of Appeals rejected this argument, finding that it is permissible for the board to adopt a hearing member’s decision and the factual findings accompanying that decision, and that is what the board did when it stated that it was affirming the single hearing member’s decision. The court also rejected Bible’s argument that the hearing member erred in judging the credibility of her testimony. The court stated that it would not second-guess the weighing of Bible’s credibility.

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