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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. The appellate court just said doctors can be sued for reporting child abuse. The most dangerous form of child abuse with the highest mortality rate of any form of child abuse (between 6% and 9% according to the below listed studies). Now doctors will be far less likely to report this form of dangerous child abuse in Indiana. If you want to know what this is, google the names Lacey Spears, Julie Conley (and look at what happened when uninformed judges returned that child against medical advice), Hope Ybarra, and Dixie Blanchard. Here is some really good reporting on what this allegation was: http://media.star-telegram.com/Munchausenmoms/ Here are the two research papers: http://www.sciencedirect.com/science/article/pii/0145213487900810 http://www.sciencedirect.com/science/article/pii/S0145213403000309 25% of sibling are dead in that second study. 25%!!! Unbelievable ruling. Chilling. Wrong.

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  3. Mr. Levin says that the BMV engaged in misconduct--that the BMV (or, rather, someone in the BMV) knew Indiana motorists were being overcharged fees but did nothing to correct the situation. Such misconduct, whether engaged in by one individual or by a group, is called theft (defined as knowingly or intentionally exerting unauthorized control over the property of another person with the intent to deprive the other person of the property's value or use). Theft is a crime in Indiana (as it still is in most of the civilized world). One wonders, then, why there have been no criminal prosecutions of BMV officials for this theft? Government misconduct doesn't occur in a vacuum. An individual who works for or oversees a government agency is responsible for the misconduct. In this instance, somebody (or somebodies) with the BMV, at some time, knew Indiana motorists were being overcharged. What's more, this person (or these people), even after having the error of their ways pointed out to them, did nothing to fix the problem. Instead, the overcharges continued. Thus, the taxpayers of Indiana are also on the hook for the millions of dollars in attorneys fees (for both sides; the BMV didn't see fit to avail itself of the services of a lawyer employed by the state government) that had to be spent in order to finally convince the BMV that stealing money from Indiana motorists was a bad thing. Given that the BMV official(s) responsible for this crime continued their misconduct, covered it up, and never did anything until the agency reached an agreeable settlement, it seems the statute of limitations for prosecuting these folks has not yet run. I hope our Attorney General is paying attention to this fiasco and is seriously considering prosecution. Indiana, the state that works . . . for thieves.

  4. I'm glad that attorney Carl Hayes, who represented the BMV in this case, is able to say that his client "is pleased to have resolved the issue". Everyone makes mistakes, even bureaucratic behemoths like Indiana's BMV. So to some extent we need to be forgiving of such mistakes. But when those mistakes are going to cost Indiana taxpayers millions of dollars to rectify (because neither plaintiff's counsel nor Mr. Hayes gave freely of their services, and the BMV, being a state-funded agency, relies on taxpayer dollars to pay these attorneys their fees), the agency doesn't have a right to feel "pleased to have resolved the issue". One is left wondering why the BMV feels so pleased with this resolution? The magnitude of the agency's overcharges might suggest to some that, perhaps, these errors were more than mere oversight. Could this be why the agency is so "pleased" with this resolution? Will Indiana motorists ever be assured that the culture of incompetence (if not worse) that the BMV seems to have fostered is no longer the status quo? Or will even more "overcharges" and lawsuits result? It's fairly obvious who is really "pleased to have resolved the issue", and it's not Indiana's taxpayers who are on the hook for the legal fees generated in these cases.

  5. From the article's fourth paragraph: "Her work underscores the blurry lines in Russia between the government and businesses . . ." Obviously, the author of this piece doesn't pay much attention to the "blurry lines" between government and businesses that exist in the United States. And I'm not talking only about Trump's alleged conflicts of interest. When lobbyists for major industries (pharmaceutical, petroleum, insurance, etc) have greater access to this country's elected representatives than do everyday individuals (i.e., voters), then I would say that the lines between government and business in the United States are just as blurry, if not more so, than in Russia.

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