Alabama Workers Comp Blawg

Fish Nelson :: Attorneys at Law

Wednesday, May 15, 2013

Bipartisan Medicare Legislation Introduced to the House of Representatives

Reps. Dave Reichert (R-WA) and Mike Thompson (D-CA) introduced the Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act (H.R. 1982) into the House of Representatives May 15, 2013. 

The bill establishes clear and consistent standards for the administrative process which provides for reasonable protection of the injured worker and Medicare. Supporters indicate that it will benefit injured workers, employers and insurers by creating certainty as well as allowing the settlement process to move forward without the delays that parties are currently presented with.

The legislation is supported by the American Insurance Association, the American Bar Association, the National Council of Self-Insurers, Property Casualty, Insurers Association of America, UWC- Strategic Services and the Workers Injury Law and Advocacy Group (WILG).

The bill will likely be referred to the Ways & Means Committee for consideration.

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ABOUT THE AUTHOR

The article was written by Joshua G. Holden, Esq. a Member of Fish Nelson, LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation and related liability matters. Mr. Holden is AV rated by Martindale-Hubbell, which is the highest rating an attorney can receive. He is Chair of the ABA/ TIPS Workers’ Compensation and Employers’ Liability Committee. He is also on the board of the Alabama Workers Compensation Organization and a member of numerous other associations and organizations. Holden has been selected as a "Rising Star" by Super Lawyers.

Holden and his firm are members of The National Workers’ Compensation Defense Network (NWCDN). The NWCDN is a national and Canadian network of reputable law firms organized to provide employers and insurers access to the highest quality representation in workers’ compensation and related employer liability fields. 

If you have questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at jholden@fishnelson.com or 205-332-1428.

Sunday, April 21, 2013

Alabama Court of Civil Appeals Addresses Several Issues in Affirming Permanent and Total Award

On April 19, 2013, the Alabama Court of Civil Appeals released its opinion in McAbee Construction, Inc. v. Elvin Allday. At trial, the employee presented evidence that he had worked as a boilermaker since 1986. During that time, he had sustained multiple work related injuries to his back and shoulders. However, the evidence revealed that the employee had fully recovered from those injuries and was working without restriction. During a temporary shutdown of the mill operated by his regular employer, the employee took a job with McAbee Construction and claimed a work accident resulting in injury after only 5 days with his new employer. Initially, the employee claimed only arm and shoulder problems but, a few days later, also claimed back pain. Eventually, the employee underwent a two-level lumbar fusion and a decompressive laminectomy. At trial, the judge considered medical testimony stating that the employee could have experienced the same problems even without a new accident based on his medical history. There was also evidence that the FCE was rendered invalid by symptom magnification. Ultimately, the judge determined that the back injury was compensable and awarded permanent and total benefits for the lifetime of the employee. 

On appeal, the Court of Civil Appeals determined that there existed substantial evidence to support the permanent and total verdict and, therefore, affirmed that aspect of the judgment. In doing so, it addressed a few issues of interest.  

Notice

On appeal, the employer asserted that the employee did not provide proper notice of his back injury. The Court of Civil Appeals noted that only notice of the accident is required and that notice of the exact nature of the injury that flows from the accident is not required.   

Depression

The employer also asserted that the judge improperly related the employee’s claims of depression to the accident because the employee had failed to allege depression in his complaint. The Court of Civil Appeals noted that, while the judge’s order made reference to the testimony of a psychologist, it was for the purpose of explaining the symptom magnification referenced in the FCE. Specifically, it was the opinion of the psychologist that depression can cause or contribute to symptom magnification.  

AWW

At trial, the employee testified that he chose to work only 40 weeks a year in order to spend more time with his family. As a result, the judge elected not to use one of the three predesignated methods set forth in the Alabama Workers’ Compensation Act for computing AWW. Rather, the judge took the amount earned by the employee in the one week he worked for his employer, multiplied it times 40 weeks, and then divided it by 52 weeks. The Court of Civil Appeals agreed that the judge’s method was equitable to both parties and was an acceptable deviation from the standard three methods.  

Lifetime Benefits

The employer asserted and the employee conceded that it was improper for the order to state that benefits were owed for the employee’s lifetime. Therefore, the case was remanded to the judge to revise the order to state that benefits were only owed for the duration of the employee’s permanent disability.

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About the Author  

This article was written by Michael I. Fish, Esq. of Fish Nelson LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation matters. Fish Nelson is a member of The National Workers’ Compensation Network (NWCDN). If you have any questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at mfish@fishnelson.com or any firm member at 205-332-3430.

Monday, March 11, 2013

Unexplained Falls are not Compensable in Alabama

On March 1, 2013, the Alabama Court of Civil Appeals released its opinion in Ex Parte Russell Threadgill wherein it denied in part and granted in part the employee’s petition for mandamus relief.

At trial, the employee claimed that he had two accidents. His first accident allegedly resulted in injuries to his back, left leg, right arm, and right shoulder. His second accident allegedly resulted in injuries to his left ankle and right shoulder. The employee testified that his second accident was the direct and natural consequence of injuries resulting from the first accident. Specifically, he claimed that the tingling and numbness in his left leg from the first accident caused him to fall. The employer presented medical evidence that rebutted the employee’s claims by demonstrating that the employee had not been experiencing those problems prior to the second accident. The judge ultimately held that the employee’s second accident was not a direct and natural consequence of his previous injuries. Additionally, the judge found that the second accident was not compensable because the employee could not show that his employment caused him to roll his ankle and fall.

The Court of Civil Appeals agreed that substantial evidence supported the trial judge’s finding that the employee’s job did not cause the second accident and that the second accident was not a direct and natural consequence of his previous injuries.  However, the Court found that the trial judge erred  in denying benefits for the right shoulder injury solely on the grounds that the second accident was not compensable. The Court stated that evidence indicated the shoulder injury may have been the result of the first accident and that the trial judge failed to resolve that dispute. The trial judge was therefore directed to determine whether or not the right shoulder injury was the result of the first accident.

My Two Cents:


Because the Court granted the employee’s petition in part, the trial judge will likely do one of two things: Either find the shoulder injury was the result of the first accident and award benefits or find that the shoulder injury was not the result of the first accident and deny benefits.

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About the Author   
 
This blog post was written by Trey Cotney, Esq. of Fish Nelson LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation matters. Fish Nelson is a member of The National Workers’ Compensation Network (NWCDN). If you have any questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at tcotney@fishnelson.com or any firm member at 205-332-3430.

Wednesday, February 20, 2013

Alabama’s Judicial Estoppel Defense in Workers’ Compensation Matters... Use it or Lose it!

On February 15, 2013, the Alabama Court of Civil Appeals released its opinion in CVS/Caremark Corp. v. Gloria Washington wherein it addressed  the affirmative defense of judicial estoppel in the workers’ compensation context.  Specifically, the Court noted the availability of the defense but only when properly pled. 
The Court of Appeals had previously addressed the issue in White Tiger, Inc. v. Paul Clemons (released January 13, 2012).   In that case, the Court ruled that a claimant’s assertion that he was available and able to do some work at his unemployment hearing, did not prevent him from being awarded permanent and total disability benefits in his workers’ compensation case.  The Court noted that being willing and able to do some work does not necessarily mean that you are able to secure employment that you are physically able and qualified to do. In the workers’ compensation case the plaintiff testified that he could not secure work because of his disability but he would give it a shot if someone hired him for a job he was qualified to do. For this reason the Court held that the two statements, in separate judicial proceedings, did not contradict one another in order to satisfy the necessary criteria for judicial estoppel to apply. 
In the more recently decided Washington case, the Court held that the employer waived its right to assert judicial estoppel as a defense by not affirmatively asserting or pleading it.  The Court further noted that the employee would have been judicially estopped from prevailing on a claim for permanent and total disability benefits based on the Court’s rationale in Clemons.  The Court distinguished the two cases because the employee in Washington testified in her workers’ compensation case that she could not work at all because of her pain and she had not sought employment.  The employee further admitted that she misrepresented her condition and ability to work in her claim for unemployment benefits.  Unlike the Clemons case, in which the plaintiff testified he would give it a shot if he was hired in a position he was qualified for in the workers’ compensation case, the employee in Washington testified that she could not work and had not sought work because her injury/pain prevented her from working at all. Therefore, the two statements were in direct conflict of one another.  
Practice Pointer: Judicial estoppel is a viable defense in workers’ compensation cases but only if it is affirmatively pled.   
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ABOUT THE AUTHOR 
The article was written by Joshua G. Holden, Esq. of Fish Nelson, LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation matters. Fish Nelson is a member of The National Workers’ Compensation Defense Network (NWCDN). If you have questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at jholden@fishnelson.com, 205-332-1428 or any firm member at 205-332-3430. 

Tuesday, February 19, 2013

Alabama Judge Addresses Link Between Manual Labor and Cumulative Trauma Injuries

On February 8, 2013, the Alabama Court of Civil Appeals released its opinion in Ex Parte Johns & Kirksey, Inc. wherein it denied an employer’s petition for a writ of mandamus.  In its petition, the employer had sought relief from an interlocutory order finding that alleged cumulative trauma back and leg injuries were compensable.   

At trial, the employee presented evidence that he sustained a work related back injury and underwent surgery in November 1996. The employee returned to work, performing at full-duty after his recovery. In 2008, the employee began to have trouble with his back and right leg and claimed the new problems were the result of repetitive manual labor resulting in a cumulative-trauma injury. In particular, the employee presented evidence that he spent 60% to 80% of his time at work performing manual labor such as heavy lifting and installing roofs which required repetitive bending, stooping, squatting and kneeling. Additionally, a physician stated that the employee’s job duties were at least a contributing cause of his injuries.   
The employer offered testimony that the employee only spent 50% of his time performing manual labor, with half of that falling in the light or medium-duty range. 
In denying the employer’s petition, the Court of Appeals noted that the evidence presented at trial supported a finding that the employee proved both medical and legal causation by clear and convincing evidence.  As such, the employer could not establish a clear legal right to the relief sought.   
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About the Author  
This blog post was written by Trey Cotney, Esq. of Fish Nelson LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation matters. Fish Nelson is a member of The National Workers’ Compensation Network (NWCDN). If you have any questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at tcotney@fishnelson.com or any firm member at 205-332-3430.
 
 

Friday, January 18, 2013

SMART Act Improves Medicare Conditional Payment System

On January 10, 2013, President Obama signed the SMART Act (the Strengthening Medicare and Re-Paying Tax Payers Act) into law. The Act reforms certain aspects of Medicare’s requirements for conditional payments, which affect workers’ compensation claims. The various sections under the SMART Act will go into effect at different times throughout the next 18 months.

Section 201 deals with the approval of conditional payments. This section creates reform in the following areas: 1) The U.S. Secretary of Health and Human Services (the Secretary) can be notified within 120 days, prior to settlement, judgment and award of the expected date and amount of the settlement, judgment or award; 2) Upon the Secretary receiving notice, the conditional payment information can be provided through a website and the information will be updated no later than 15 days after a payment; 3) Subject to certain conditions, the last statement downloaded from the website will be considered the final demand for conditional payment; 4) If the conditional payment amount is disputed, the Secretary is required to respond to resolve any dispute within 11 days. If not, the proposed resolution by the claimant, plaintiff, or applicable plan will be deemed accepted. These procedures will go into effect on April 9, 2013.

Section 202 will not take effect until 2014 but will obligate the Secretary to publish a reporting threshold by November 15th of every year.

Section 203 has an enactment date of March 10, 2013 and applies to fines for noncompliance. The fines will now be discretionary.

Section 204 states that the Centers for Medicare and Medicaid Services (CMS) has 18 months from the date of enactment to publish rules that phase out the use of Social Security numbers and health ID claims numbers in the reporting process.

Section 205 sets forth a statute of limitations for conditional payment recovery of 3 years after the receipt of notice of settlement, judgment, award or other payment. As of January 1, 2014 certain liability claims will be exempt from reporting and reimbursement. The exemption will be based on whether or not the claim falls below the annual threshold, which is calculated by the Secretary. This section also states that the discretionary (see Section 203) civil noncompliance penalties can be up to $1,000.00 for each day of noncompliance, with respect to each plaintiff or claimant.

ABOUT THE AUTHOR

This article was written by Joshua G. Holden, Esq. of Fish Nelson, LLC, a law firm dedicated to representing employers, self-insured employers, and insurance carriers in workers’ compensation matters. Fish Nelson is a member of the National Workers’ Compensation Defense Network (NWCDN). If you have any questions about this article or Alabama Workers’ Compensation Issues in general, please feel free to contact the author at jholden@fishnelson.com or any firm member at 205-332-3430.

Thursday, January 17, 2013

Experiencing Temporary Symptoms does not Constitute a Permanent Aggravation

In Alabama, an aggravation of a preexisting condition can be treated as a new injury if the claimant was working without restriction prior to the accident date or date of last exposure to cumulative trauma. This is similar to the law in Iowa. Recently, an Iowa workers’ compensation matter (McQuown v. Brecht Trucking, Inc.) was initially decided in favor of the employer based, in large part, on medical testimony distinguishing between aggravation and symptoms. According to the testifying doctor, an aggravation means that an underlying situation was made to be medically worse, which is different than merely experiencing symptoms of a preexisting condition while performing work duties.

Iowa Workers' Compensation cases can go through several levels of appeal. The above case was first tried before a Deputy Workers Compensation Commissioner who issued an arbitration decision in favor of the employer. The case was then appealed to the Iowa Workers Compensation Commissioner which reversed the arbitration decision. The employer now has the option of appealing the matter to the Iowa District Court.

My Two Cents: 

Although this is an Iowa case, it is a must read for anyone that handles Alabama workers’ compensation matters. It presents an interesting argument which employers and treating physicians should consider when presented with an aggravation claim.

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About the Author  

 

This article was written by Michael I. Fish, Esq. of Fish Nelson LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation matters. Fish Nelson is a member of The National Workers’ Compensation Network (NWCDN). If you have any questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at mfish@fishnelson.com or any firm member at 205-332-3430.

Wednesday, January 09, 2013

Alabama Workers Compensation Organization 2013 Dues and Spring Conference

Membership in the Alabama Workers’ Compensation Organization offers a number of professional and social opportunities. Among these is the popular 3 day Annual Spring Conference usually held in early May. If you pay your dues by January 31st the 2013 Spring Conference is FREE.

A link to the application is below.

http://awcotoday.com/tyfoon/site/fckeditor/file/2013AWCOMembershipApplication.pdf

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About the Author

This blog post was written by Michael I. Fish, Esq. of Fish Nelson LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation matters. Fish Nelson is a member of The National Workers’ Compensation Network (NWCDN). If you have any questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at mfish@fishnelson.com or any firm member at 205-332-3430.

Monday, January 07, 2013

2013 Alabama Mileage Reimbursement Rate Update

Effective January 1, 2013, the standard mileage reimbursement rate for Alabama was increased to 56.5 cents per mile.

 

Monday, December 17, 2012

Alabama Court of Civil Appeals Reverses Order Requiring Employer to Pay Medical on Twenty Five Year Old Injury

On December 14, 2012, the Alabama Court of Civil Appeals released its opinion in Goodyear Tire & Rubber Company v. Marvin Wilson. On appeal, was the trial court’s holding that the employee’s current complaints of back pain were caused, at least in part, by a 1986 lumbar back strain. The 1986 claim resulted in a 1987 lawsuit which was subsequently settled with future medical benefits remaining open. Per the authorized treating physician, he had been treating the employee from time to time from 1987 until the present. However, it was his opinion that the employee’s current complaints were likely due to his degenerative arthritis rather than the original compensable lumbar strain. In holding the employer to be responsible for the current care, the trial judge noted that the physician could not rule out with certainty that the lumbar strain did not, at least, contribute to the employee’s degenerative arthritis. In reversing the trial court, the Court of Appeals noted that the physician’s testimony only provided a mere possibility that the current back pain and the 1986 injury were related. As such, the trial judge’s holding was not considered to be supported by substantial evidence.

My Two Cents:  At the trial of this case, it was assumed that the burden of proof was on the employer to prove that the current complaints of pain were not related to the previously accepted and compensable injury. However, it should be noted that it is always the burden of the employee to prove, be a preponderance of the evidence, that the complaint for which he or she seeks medical treatment arose out of and in the course of his or her employment.

Tuesday, November 13, 2012

Alabama Volunteers and the Right to Workers Compensation Benefits

Volunteers in Alabama who provide free or charitable services for organizations are generally not covered by the Alabama Workers’ Compensation Act. The idea being that someone who agrees to provide services without pay could not reasonably expect to lose wages as a result of an "on-the-job" injury. Basically, if you do not get paid to begin with, you cannot lose wages.

As with most rules, however, there is an exception. The Act allows for "voluntary coverage" for certified volunteer fire departments and some certified rescue squads. This means that volunteer fire departments and rescue squads have the option to purchase workers’ compensation insurance for their volunteers, but under no circumstances are they required to do so. This being said, it is important to keep the Exclusivity Doctrine in mind. In Alabama, if an employee’s on the job injury is subject to the Workers’ Compensation Act, the employee’s only recovery is through the benefits provided for in the Act. The employee cannot recover civil damages from the employer. In Thompson v. Town of Killen, 583 So.2d 1336 (Ala. 1991), the Alabama Supreme Court dealt with a volunteer fire fighter workers’ compensation claim. In that case, the Town of Killen had opted to purchase workers’ compensation insurance that included coverage for the town’s volunteer fire fighters. One of the volunteers was subsequently injured and attempted to sue the City for negligence. The Court dismissed the lawsuit because the employee had received workers’ compensation benefits as a result of his injuries.

Alabama Court of Civil Appeals Affirms Award of Death Benefits

On October 26, 2012, The Alabama Court of Civil Appeals released its opinion in the case of Hornady Transportation, LLC v. Gwendolyn Fluellen. In that case, the employer appealed the judgment of the Circuit Court of Monroe County, Alabama, which awarded death benefits to Charles Fluellen’s family as a result of an truck wreck in which Fluellen died. The primary issue in the case was whether Fluellen’s death arose out of his employment with Hornady, as there was conflicting testimony as to whether Fluellen died as the result of a heart attack, or died burned to death in the fire that followed the accident. Witnesses at the scene of the accident reported that Fluellen appeared to be moving inside the fire that engulfed the cab of his truck, which suggested that he died as a result of the fire. However, the forensic pathologist who performed Fluellen’s autopsy testified that in her opinion, Fluellen had not been alive when he burned in the fire. The pathologist testified that Fluellen’s heart showed signs of a recent heart attack, and that there was no evidence to indicate that he had inhaled smoke. Over a year later, at the request of Fluellen’s family, officials reopened an inquiry into the cause of his death, and a different forensic pathologist reviewed the first pathologist’s report, and determined that Fluellen had been killed by the fire. The first pathologist received the second pathologist’s report, and stated that she had not been aware of the eyewitness accounts that Fluellen appeared to be moving while his body was engulfed in flames. She further stated that had she been aware of those witnesses’ statements, she would have concluded that Fluellen died as a result of thermal injuries. Based on the evidence, the trial Court entered judgment for Fluellen’s family, finding that his death was due to thermal injuries, and therefore occurred in and arose out of his employment with Hornady.

Hornady appealed, asserting that the trial court erred by improperly admitting hearsay eyewitness statements into evidence, and erred by admitting the second pathologist’s report into evidence because it was based on those eyewitness statements. Hornady further asserted that the trial court erred in finding that Fluellen’s death was proximately caused by an accident arising out of his employment because the only legal evidence demonstrated that Fluellen’s death was caused by an idiopathic heart attack prior to the wreck. The Alabama Court of Appeals found that the eyewitness statements and the second pathologist’s report were both admissible, and that evidence was sufficient to support the trial Court’s findings. The appellate court pointed out that while no one may ever know what caused Fluellen to crash, it is the cause of death, and not the cause of the accident, that was key in determining compensability, and that there was sufficient evidence upon which the trial Court could determine that his death was caused by the fire.

However, the Court of Appeals’ decision was not unanimous, as Judge Pittman did write a very interesting dissent. Pittman wrote that he did not believe that Fluellen’s family had met its burden of proving that the cause of death was thermal injury. He stated that even assuming that the eyewitness statements were admissible, the opinion of the second pathologist was unsupported by any evidence. Since the second pathologist did not perform another autopsy, but instead accepted the physical findings of the first pathologist’s report, his findings would have to be consistent with the data in the first report in order to be valid. Pittman further stated that Fluellen’s family failed to show that it was more likely that Fluellen’s death was caused by the fire than by a fatal heart attack prior to the fire. In his dissent, Pittman cited Ex parte Mobile Power & Light, 810 So.2d 756 (Ala. 2001), which held "Proof which goes no further than to show an injury could have occurred in an alleged way does not warrant the conclusion that it did so occur, where from the same proof the injury can with equal probability be attributed to some other cause." He also cited Ex parte Diversey Corp., 742 So.2d 1250 (Ala. 1999), which held that "There may be two or more plausible explanations as to how an event happened or what produced it; yet if the evidence is without selective application to any one of them, they remain conjectures only."

Friday, September 21, 2012

Scott Baio, Joan Jett, Bilbo Baggins, and Tommy Lasorda

What do all of these people have in common with the Alabama Workers’ Comp Blawg? They all celebrate birthdays on September 22nd. Many thanks to all of our readers who have helped to make http://www.alabamaworkerscompblawg.com a go to reference for Alabama workers’ compensation over the last 5 years. We look forward to another 5 years and beyond!

Wednesday, September 19, 2012

Once Bitten Twice Denied

On September 14, 2012, The Alabama Supreme Court released its decision in the case of Ex parte Johnnie L. Odom.  In Mercy Logging, LLC v. Johnnie L. Odom, the Alabama Court of Civil Appeals previously reversed the trial Court’s ruling that Odom’s snake bite injuries which he received while trying to catch a rattlesnake were compensable. (See July 27, 2012 article "Rattlesnake Roundup Gone Awry"). Odom petitioned the Supreme Court for a Writ of Certiorari and the Supreme Court declined to review, with no opinion. However, Justice Murdock did write a concurring opinion, in which he stated that Odom’s injuries were not causally connected to his employment because Odom had departed on his own personal enterprise when he decided to catch, rather than kill, the rattlesnake.

Court Looks at Totality of Circumstances and Determines Accident did not Arise out of or in the Course of Employment

On September 14, 2012, the Alabama Court of Civil Appeals released its opinion in McDuffie v. Medical Center Enterprise. Nancy McDuffie worked as a Patient Care Attendant at Medical Center Enterprise (MCE). Additionally, McDuffie attended Wallace Community College, where she was pursuing her nursing degree. As part of her course of study, McDuffie participated in clinicals at MCE under the supervision of a Wallace instructor.

On March 12, 2010, McDuffie clocked out from her job as a Patient Care Attendant at MCE, and reported to the lobby to meet her Wallace nursing instructor to begin clinicals. McDuffie realized she forgot her notebook in her car and secured permission from her instructor to retrieve it. On her way to her car, McDuffie walked down the same flight of stairs she always used to leave the hospital after work. McDuffie fell down the stairs, and broke her arm. McDuffie was not sure whether she slipped, tripped, or just fell for some other unknown reason. She then sued MCE for workers’ compensation benefits. MCE filed a Motion for Summary Judgment, asserting that McDuffie’s injury did not arise out of her employment, but instead arose out of her participation in the nursing program at Wallace. Additionally, MCE asserted that McDuffie could not explain what caused her to fall, and that her injuries were therefore idiopathic in nature. McDuffie contended that MCE owed workers’ compensation benefits because she fell on her employer’s premises while leaving work. The trial Court ruled in favor of MCE, and McDuffie appealed.

The Court of Appeals acknowledged that in certain limited circumstances, an injury may still "arise out of" the employment when the employee sustains the injury when he or she is leaving the employer’s premises after work. Specifically, the appellate Court noted that an aneurysm sustained while an employee was taking a cold shower after a brisk walk out of the employer’s building was found compensable; as was an injury sustained by an employee who was struck by a car while crossing the street after leaving work. The Court also cited a case where an employee’s injuries from a fall he sustained when he climbed over his employer’s fence to retrieve his tools after work hours were compensable. However, the Court also noted that, in order to be compensable, the employee must show that the employment was the "source and cause" of the accident. The Court stated that there were many factors which must be considered when determining whether an activity arises out of the employment in such situations, including (1) the customary nature of the activity, (2) the employer’s encouragement or subsidization of the activity, (3) the extent to which the employer directed the activity, (4) the presence of pressure upon the employee to participate in the activity, and (5) whether the employer receives a benefit from the activity. The Court noted that none of these factors alone were necessarily determinative, and that the trial Court should evaluate each of these factors and their relative significance in relation to the employment. The Court noted that MCE did not contribute toward McDuffie’s education, did not direct the manner in which she obtained that education, and did not benefit from McDuffie’s participation in clinicals. As such, the Court of Appeals found that McDuffie’s injuries arose out of her pursuit of her education, and not her employment, and affirmed the trial Court’s decision.

MY TWO CENTS

It was unnecessary for the Court to address MCE’s argument that the injury was idiopathic in nature. However, unless there was evidence in the record that the employee’s job was somehow the source and cause of her fall (i.e. tripping over on object, slipping on a slippery substance, etc.), MCE would have likely prevailed on that argument as well.

Tuesday, September 11, 2012

Alabama Workers Compensation Organization 2012 Fall Conference

Just a reminder that the AWCO will be putting on its Fall Conference at the Westin Hotel in Huntsville, Alabama on October 29th and 30th. Along with a fantastic line up of speakers the conference provides numerous continuing education credits. The conference begins at 1:00 p.m. on October 29th and concludes at 12:30 p.m. on October 30th. To register on line, go to: http://www.awcotoday.com/seminars_events.php.

Friday, August 10, 2012

No Pain No Gain

On August 10, 2012, the Alabama Court of Civil Appeals released its opinion in Gold Kist, Inc. v. Delores Diane Smith wherein it reversed a permanent and total award. At trial, the parties stipulated that the employee’s right ankle fracture was compensable.  Her medical treatment included a surgery to insert 3 screws and a plate followed by a second surgery to remove the hardware. Eventually, the employee was returned to work without restriction. Due to continued complaints of pain in her ankle and new complaints of trouble with her back, the employee opted to see her own doctor who performed an EMG. The test reportedly revealed allodynia (extreme sensitivity to touch) and mechanical allodynia (a gait disorder). The employee testified that, as a result of her injuries, she had trouble performing daily activities and failed to meet the physical demands of four subsequent employers. Based on the foregoing, the trial court removed the injury from the schedule due to complaints of severe pain and awarded permanent and total disability benefits.

 
The Court of Appeals reversed the trial court because the employee did not present sufficient evidence to meet the exceedingly high standard to remove an injury based solely on complaints of pain. Specifically, the Court noted that the employee only took pain medications on an occasional basis and that she could walk and perform daily activities with the use of a cane and occasional breaks to sit as needed. In addition, the evidence revealed that the employee retained significant ability to perform physical activities. In reversing the trial court, the Court held that the employee’s complaints of pain did not rise to the level of totally or virtually disabling.
 
My Two Cents: The focus of the appeal was on the pain exception to the schedule. Although the employee complained of back problems which arguably could have been connected to her altered gait, the issue was not considered on appeal as a means of circumventing the schedule. 

Friday, July 27, 2012

Rattlesnake Roundup Gone Awry

On July 27, 2012, the Alabama Court of Civil Appeals released its opinion in Mercy Logging, LLC v. Johnnie L. Odom wherein it reversed the trial court’s finding that the employee was permanently and totally disabled.

At trial, the evidence revealed that the employee worked as a logger. On the day of the claimed accident, the employee had completed his job assignment and was riding back with three co-employees when the driver spotted a diamond back rattlesnake (later determined to be over 6 feet long) on the side of a paved road. The fateful foursome then decided to leave the safety of a perfectly good truck and catch the snake with their bare hands. In the process, the employee was repeatedly bitten on both hands. As a result of the bites, the employee was in a coma for two weeks and in the intensive care unit for 35 out of his 40 days in the hospital.

In finding the employee permanently and totally disabled, the trial judge pointed out that rattlesnakes are an occupational hazard to loggers and that the employee’s job as a logger materially increased his risk of exposure to a snake bite.

In reversing the trial court, the Court of Civil Appeals focused on the fact that the increased occupational risk had no causal relation to the snake bite that occurred when the employee and his buddies tried to catch a snake on the side of a road. The Court further noted that encountering snakes on the side of a road is not a hazard that is peculiar to loggers but one that would be shared by every passing motorist.

My Two Cents:

The Court of Civil Appeals reversed the trial court because it determined that the employee could not establish that the snake bites arose out of his employment. However, it could just have easily supported its reversal on the fact that the bites did not occur in the course of his employment. Although he was in a company truck on the way back from a job site, a substantial deviation occurred from that employment when the driver stopped the truck in order to catch a snake. Further, the act of trying to catch the snake was clearly "horseplay."

Another Two Cents:

Even Indiana Jones was afraid of snakes! It is a good rule of thumb that if Indiana Jones is afraid of something, you probably should be too!

Alabama Workers Compensation Organization 2012 Fall Conference

The AWCO will be putting on its Annual Fall Conference on October 29th and 30th at the Westin Hotel in Huntsville, Alabama. This conference always provides a fantastic line up of speakers from the legal and medical communities including the popular Workers’ Compensation 101 and 102 classes. This session provides the nuts and bolts of handling a workers’ compensation claim from the date of injury forward. Whether you are a new adjuster or are simply looking to brush up on certain aspects of Alabama workers’ compensation law, you are bound to learn something new.

The conference begins at 1:00 p.m. on October 29th and concludes at 12:30 pm on October 30th. If you are interested in attending or know someone that is, please contact the AWCO through their website at http://www.awcotoday.com/contact.php.

Friday, July 20, 2012

Alabama Supreme Court Reverses Court of Civil Appeals Holding in Ex parte Caldwell

On July 20, 2012, the Alabama Supreme Court released its opinion in Ex parte Caldwell (In re: West Fraser, Inc. v. Windell Caldwell, Sr.), reversing the earlier January 13, 2012 holding of the Alabama Court of Civil Appeals in that case. (See our January 23, 2012 blog post Finding of Compensability Reversed Where Burden of Proof not Satisfied for a summary of the earlier opinion). In its holding, the Supreme Court held that the lower court erred by re-weighing the evidence presented to the trial court. Citing Ex parte McInish, 47 So.3d 778, the Supreme Court stated that "in reviewing a decision of the trial court, an appellate court is not permitted to re-weigh the evidence, because weighing the evidence is solely a function of the trier of fact." The Supreme Court noted that the only function the appellate courts have in their review of workers’ compensation cases is to ascertain whether any substantial evidence existed that could support the trial court’s findings of facts. Since the trial court found Caldwell’s testimony credible, the Supreme Court held that Caldwell’s testimony constituted evidence of such weight and quality that fair-minded persons in the exercise of impartial judgment could reasonably infer that Caldwell’s injuries were work-related.