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Court rules on workers' comp dispute

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The Indiana Court of Appeals reversed a finding that a company had acted in bad faith in denying workers' compensation benefits because there was a dispute over who should pay the benefits. The appellate court also encouraged employers to come to an early agreement to share treatment costs pending a liability determination to avoid a situation similar to the one in the instant case.

In Ag-One Co-Op and Trane v. James Andrew Scott, No. 93A02-0904-EX-298, James Andrew Scott, a former Trane employee who went to work for Ag-One, went without medical care or compensation from June 2004 until September 2006 because Trane and Ag-One Co-Op disputed who was responsible for his medical expenses. Scott hurt his shoulder in September 2002 while working for Trane and received workers' compensation benefits. He worked for Ag-One from March to May in 2004 and re-aggravated his shoulder injury. Scott filed an application for adjustment of claim against Trane; Trane asked that Ag-One be brought on as a party because it believed the company was liable for part of Scott's injuries.

In early 2006, a single hearing member of the Indiana Worker's Compensation Board and the full board found Trane, not Ag-One, to be responsible for Scott's medical care and expenses. The full board also allowed Scott 45 days to file a claim against Ag-One, which he did, alleging bad faith. The full board affirmed the single hearing member's decision that Ag-One acted in bad faith and should pay half the $5,000 in damages and $1,600 in attorney's fees.

The Court of Appeals found Borgman v. Sugar Creek Animal Hospital, 782 N.E.2d 993 (Ind. Ct. App. 2002), to be instructive in its finding that that there can be no bad faith in denying benefits if the employer didn't act improperly in denying benefits, wrote Judge Paul Mathias.

"While we share the Board's concern that Scott went without medical care while Trane and Ag-One disputed who was liable for Scott's worker's compensation benefits, we fail to see how Ag-One can be said to have acted in bad faith in denying Scott's claim for benefits when Ag-One was ultimately found not to be liable for such benefits," he wrote.

The appellate court cautioned that its decision shouldn't be interpreted as encouragement for multiple employers in disputes over liability to refuse payment while awaiting the Indiana Worker's Compensation Board's decision. It understood the board's frustration with Trane and Ag-One in refusing to cover Scott's benefits while awaiting the board's decision, and noted that if they had both paid something during the dispute, the company found not liable could be reimbursed from the other employer. The appellate court ordered the decision reversed and vacated.

"We encourage employers in like situations in the future to come to an early agreement to share treatment costs pending determination of which employer is fully or partially liable. Doing so could go far in facilitating settlement of the claim and will avoid liability for the type of bad faith determined by the Board in this case, a determination that will usually be upheld under our deferential standard of review," Judge Mathias wrote.

Judge Margret Robb concurred and wrote in a separate opinion in addition to vacating the order Ag-One pay damages to Scott, the board should enter an order determining Trane's responsibility for the entire $5,000 as bad faith damages.

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  1. It's a big fat black mark against the US that they radicalized a lot of these Afghan jihadis in the 80s to fight the soviets and then when they predictably got around to biting the hand that fed them, the US had to invade their homelands, install a bunch of corrupt drug kingpins and kleptocrats, take these guys and torture the hell out of them. Why for example did the US have to sodomize them? Dubya said "they hate us for our freedoms!" Here, try some of that freedom whether you like it or not!!! Now they got even more reasons to hate us-- lets just keep bombing the crap out of their populations, installing more puppet regimes, arming one faction against another, etc etc etc.... the US is becoming a monster. No wonder they hate us. Here's my modest recommendation. How about we follow "Just War" theory in the future. St Augustine had it right. How about we treat these obvious prisoners of war according to the Geneva convention instead of torturing them in sadistic and perverted ways.

  2. As usual, John is "spot-on." The subtle but poignant points he makes are numerous and warrant reflection by mediators and users. Oh but were it so simple.

  3. ACLU. Way to step up against the police state. I see a lot of things from the ACLU I don't like but this one is a gold star in its column.... instead of fighting it the authorities should apologize and back off.

  4. Duncan, It's called the RIGHT OF ASSOCIATION and in the old days people believed it did apply to contracts and employment. Then along came title vii.....that aside, I believe that I am free to work or not work for whomever I like regardless: I don't need a law to tell me I'm free. The day I really am compelled to ignore all the facts of social reality in my associations and I blithely go along with it, I'll be a slave of the state. That day is not today......... in the meantime this proposed bill would probably be violative of 18 usc sec 1981 that prohibits discrimination in contracts... a law violated regularly because who could ever really expect to enforce it along the millions of contracts made in the marketplace daily? Some of these so-called civil rights laws are unenforceable and unjust Utopian Social Engineering. Forcing people to love each other will never work.

  5. I am the father of a sweet little one-year-old named girl, who happens to have Down Syndrome. To anyone who reads this who may be considering the decision to terminate, please know that your child will absolutely light up your life as my daughter has the lives of everyone around her. There is no part of me that condones abortion of a child on the basis that he/she has or might have Down Syndrome. From an intellectual standpoint, however, I question the enforceability of this potential law. As it stands now, the bill reads in relevant part as follows: "A person may not intentionally perform or attempt to perform an abortion . . . if the person knows that the pregnant woman is seeking the abortion solely because the fetus has been diagnosed with Down syndrome or a potential diagnosis of Down syndrome." It includes similarly worded provisions abortion on "any other disability" or based on sex selection. It goes so far as to make the medical provider at least potentially liable for wrongful death. First, how does a medical provider "know" that "the pregnant woman is seeking the abortion SOLELY" because of anything? What if the woman says she just doesn't want the baby - not because of the diagnosis - she just doesn't want him/her? Further, how can the doctor be liable for wrongful death, when a Child Wrongful Death claim belongs to the parents? Is there any circumstance in which the mother's comparative fault will not exceed the doctor's alleged comparative fault, thereby barring the claim? If the State wants to discourage women from aborting their children because of a Down Syndrome diagnosis, I'm all for that. Purporting to ban it with an unenforceable law, however, is not the way to effectuate this policy.

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