UT - High Court: Underinsured Motorist Exclusion Hinges on Availability of Comp Benefits
03/24/2025 | 0
A district court erred in concluding that statutory limitations on underinsured motorist insurance that excludes coverage for benefits available through workers' compensation applied without regard to whether the benefits were available for a specific claimant, the Utah Supreme Court ruled.
"The better reading of the statute, in light of what motivates the statutory schemes, is that by excluding benefits that are 'paid or payable,' the Legislature intended that a claimant who wants to seek the type of benefits workers’ compensation provides attempt[s] to recover from wo...
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A New York appellate court revived a general contractor’s claim against a subcontractor for indemnification from liability to an allegedly injured worker.
Case: Freas v. John W. Danforth Co., No. 134 CA 23-01921, 03/14/2025, published.
Facts: Christopher M. Freas worked for Rochester Davis-Fetch Corp., a subcontractor for a construction project overseen by John W. Danforth Co.
Freas allegedly slipped and fell while working on the project.
Procedural history: Freas filed suit against Danforth, which in turn filed a third-party action against Davis-Fetch.
Danforth asserted c...
The Commonwealth Court of Pennsylvania vacated a decision of the Workers’ Compensation Appeal Board that reinstated a worker’s total disability status, finding additional proceedings were necessary for a judge to determine whether the worker’s status should be modified.
Case: Del Val Home Improvements v. Gaw (WCAB), No. 1117 C.D. 2022, 03/19/2025, published.
Facts and procedural history: John Gaw worked for Del Val Home Improvements. He suffered multiple injuries in August 2002 by falling from the roof of a building. Del Val issued a notice of compensation payable...
The Missouri Court of Appeals now has a split among its districts, with the Southern District ruling that a prior enhanced permanent partial disability award cannot be used to add weeks of compensation to an otherwise nonqualifying injury to trigger the liability of the Second Injury Fund.
Case: Walton v. Treasurer, No. SD38504, 03/20/2025, published.
Facts: Mark Walton worked as a diesel mechanic. He injured his left shoulder at work in 1992, and he received an award for a 20% permanent partial disability.
Walton injured his back at work in 2005. He received a PPD award for a 30% disabilit...
I recently had a chance to review how things are going with the Florida Office of Judges of Compensation Claims. There is a lot of interest in government efficiency.
The governor issued Executive Order 25-44 on Feb. 24, 2025. There are broad requirements and instructions there. Florida's government will emerge more efficient and effective in the coming months. There are going to be difficult questions asked, perspectives analyzed and changes made.
I strove to put the efficiency idea into perspective. From the OJCC standpoint, efficiency has been our hallmark...
The West Virginia Supreme Court upheld an award of benefits to a lineman after he unsuccessfully attempted to return to duty after suffering an electric shock injury.
Case: Quanta Services Inc. v. Bolling, No. 24-414, 03/19/2025, published.
Facts: Zachary Bolling worked for Quanta Services Inc. as a lineman. He suffered an electric shock injury in March 2021.
Bolling received temporary total disability benefits from the date of his injury through April 6, 2021.
He returned to work on April 7, 2022, and then was removed from work again on April 15, 2021, by a physician assistant who noted t...
The California Division of Occupational Safety and Health fined a construction company $157,500 after a fatal trench collapse.
Joel Olea Gomez, 27, was killed on Aug. 28, 2024, when a portion of the 17-foot-deep trench he was working in collapsed. He was pinned under a large concrete pipe he was helping install as part of a sewer project at Hoyt Park Drive and Scripps Ranch Boulevard north of San Diego, according to a report by a CBS affiliate.
Another worker who was in the trench at the time was able to avoid being buried.
The agency commonly referred to as Cal/OSHA said it cited W.A....
The Pennsylvania Supreme Court on Thursday ordered a law firm that represents injured workers to reimburse one of its partners for cannabinoid oil he was prescribed for a back injury, holding that any item that is part of a health care provider's plan to treat a work-related injury falls under the definition of medicines and supplies.
"In sum, we conclude that any item that is part of a health care provider’s treatment plan for a work-related injury falls within the purview of the broad-encompassing phrase 'medicines and supplies' as provided in Section 306(f.1)(1)(i) o...
The Connecticut Supreme Court ruled that an administrative law judge has the discretion to award ongoing temporary disability benefits to a worker who has reached maximum medical improvement in lieu of permanent partial disability benefits and up to the statutory maximum of 520 weeks.
The high court said the appeals court erred when it looked beyond the text of the statutes themselves and analyzed the legislative intent of amendments adopted in 1993 to conclude that ALJs lack such discretion. The high court also rejected the contention that those amendments essentially nullified its 1943 deci...
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Centre For Neuro Skills to Open Clinic in Plano; Fifth in Texas
New 20,000+ square foot facility expands cutting-edge brain injury care in North Texas
PLANO, TX (March 19, 2025) — Centre for Neuro Skills (CNS), a premier provider of treatment for traumatic and acquired brain injury, today announced the opening of i...
The West Virginia Supreme Court upheld a determination that a worker was entitled to a 14% permanent partial disability award for his injuries from a fall.
Case: Horner v. Eastern Asphalt Products LLC, No. 24-279, 03/19/2025, published.
Facts: James Horner worked for Eastern Asphalt Products LLC. He fell off his truck at work in June 2020 due to a loose step.
A claims administrator for Eastern’s insurance provider accepted liability for a sprain of the forearm, elbow and shoulder.
In June 2021, Horner underwent a left shoulder arthroscopy with a rotator cuff repair, a subacromia...
The Nebraska Court of Appeals upheld a determination that a worker was entitled to a closed period of temporary total disability benefits for a back injury.
Case: Welchert v. Abe’s Trash Service, No. A-24-599, 03/18/2025, unpublished.
Facts: John A. Welchert worked for Abe’s Trash Service for more than 20 years. He typically worked about 45 hours over a five-and-a-half-day week.
Welchert’s primary duties included driving a skid loader, which had hard rubber tires, over rough terrain at a landfill.
According to Welchert, he began experiencing lower back pain in 2019 o...
The Virginia Court of Appeals upheld a determination that a worker’s functional capacity evaluation qualified as a compensable form of “necessary medical attention,” since it was not for the sole purpose of obtaining a permanency rating.
Case: Henrico County Public Schools v. Mack, No. 0635-24-2, 03/18/2025, unpublished.
Facts: Tonya Mack worked for Henrico County Public Schools. She suffered injuries to her right knee, left wrist and a finger in a workplace accident.
A deputy workers’ compensation commissioner granted Mack temporary total disability benefits an...
A New York appellate court overturned the denial of benefits to a crisis response worker for her toxic exposures at the World Trade Center after the Sept. 11, 2001, terrorist attacks.
Case: Matter of Goss v. WTC Volunteer, Nos. CV-23-2160 and CV-24-0333, 03/13/2025, published.
Facts: Cynthia Goss worked as a crisis response services provider. She was retained to provide crisis services to first responders after the terrorist attacks on the World Trade Center.
From Sept. 12 through Sept. 22, Goss was paid for her services. She mainly worked at a command center set up by her employer at ...
The Santa Monica Daily Press reported a nearly 30% increase in the city's work comp liabilities in the most recent fiscal year, as hospital fees increased 264% and nursing home care payments jumped 652%.
The newspaper said a report from the city finance director identifies three catastrophic claims — one from the police department and two from the fire department — as accounting for $7.9 million of the $8.2 million total increase in liabilities in the fiscal year that ended in June.
Overall liabilities for the city's work comp program increased to $36 million from $27.8 m...
The Alabama Daily News reports that a bill to provide workers' compensation benefits to the state's teachers has stalled in a House of Representatives committee.
Currently, teachers in Alabama must cover their own medical expenses for an on-the-job injury and seek reimbursement from the state.
Senate Bill 1, by Sen. Sam Givhan, R-Huntsville, would create the Public Education Employee Injury Compensation Program, the Public Education Employee Injury Compensation Trust Fund and the Public Education Employee Injury Compensation Board to provide workers' compensation benefits instead...
A California appeals court affirmed summary judgment dismissing a retaliation and age discrimination complaint after finding that the worker's allegations were based on activity outside the limitation period.
Because Steven Hernandez filed an administrative complaint with the Department of Fair Employment and Housing on Sept. 20, 2019, for alleged violations of the Fair Employment and Housing Act, any claim based on conduct before Sept. 20, 2018, was time-barred. Therefore, a trial court was correct when it determined that Hernandez was unable to establish any alleged discriminatory ...