Justia Insurance Law Opinion Summaries

Employee was injured while working for Employer. Five years later, Employee was fired for violating the company's attendance policy. Employee's termination was later the basis for the Industrial Commission of Ohio's denial of his request for temporary total disability compensation (TTC). The Commission found that Employee's discharge amounted to a voluntary abandonment because it was consequence of behavior that Employee willingly undertook. The court of appeals reversed, holding that the deliberate misconduct necessary to support a finding of voluntary abandonment could not be imputed to Employee. The Supreme Court affirmed and issued a limited writ of mandamus that vacated the Commission's order and returned the cause to it for further consideration, as the hearing officer did not carefully examine the totality of the circumstances in finding that a simple allegation of misconduct existed to preclude temporary total disability compensation. View "State ex rel. Brown v. Hoover Universal, Inc." on Justia Law

A compensation judge found Respondent was barred from receiving workers' compensation benefits because his written notice of injury, given nearly two years after his last day of work, was not timely and because Respondent's employer did not have actual knowledge that Respondent's back problems were work-related. The workers' compensation court of appeals (WCCA) reversed, concluding that a reasonable person in Respondent's position would not have known his injury was compensable until Respondent's doctors provided written reports to Respondent's attorney establishing a relationship between Respondent's back problems and his job duties. The Supreme Court reversed the WCCA and affirmed the denial of benefits, holding (1) the WCCA erred in overturning the compensation judge's finding that Respondent failed to give timely notice to his employer of his work-related injury; and (2) the compensation judge did not err in finding that the employer did not have actual knowledge of such an injury. View "Anderson v. Frontier Commc'ns" on Justia Law

Respondent sustained six injuries while playing for the Washington Redskins on four separate occasions. Consequently, Respondent filed with the Maryland Workers Compensation Commission six separate claims against his employer, the Washington Redskins (Petitioner). The Commission denied five of Respondent's claims on the ground that he was not a "covered employee" because he was working for the Redskins outside of the State when he sustained the injuries underlying the claims. The circuit court affirmed. The court of special appeals reversed. The Court of Appeals affirmed, holding that a football player employed by the Washington Redskins is a "covered employee," and therefore entitled to avail himself of Maryland's workers' compensation laws, when injured while practicing and playing football outside of Maryland. View "Pro-Football, Inc. v. McCants" on Justia Law

Appellee was injured during the course of his employment. When his workers' compensation benefits ceased, Appellee applied for and received unemployment insurance benefits. The Kentucky Unemployment Insurance Commission determined that Kan. Rev. Stat. 341.090, which permits the use of an "extended base period" that captures earnings leading to equitable unemployment benefits, required that the extended base period may include only the four calendar quarters that immediately precede the base period. Pursuant to this extended base period, Appellee was awarded benefits of $149 per week. The circuit court reversed. The court of appeals affirmed, concluding that the extended base period need not be limited to the four quarters that immediately precede the base period. The Supreme Court reversed, holding that the Commission properly applied the statute in calculating Appellee's unemployment benefits. View "Unemployment Ins. Comm'n v. Hamilton" on Justia Law

This appeal concerned the method for excluding impairment from a non-compensable disability when calculating a worker's permanent disability benefit under the post-1996 version of Kan. Rev. Stat. 342.730(1)(b). The ALJ calculated a benefit based on the claimant's entire post-injury permanent impairment rating and then subtracted an amount equal to a benefit based on his pre-existing active impairment rating. The workers' compensation board reversed, determining that the present version of section 342.730(1)(b) requires the calculation of income benefits to be based only on the permanent impairment rating caused by the injury being compensated. The court of appeals affirmed. The Supreme Court affirmed, holding that pre-existing impairment must be excluded when calculating a total disability award under section 342.730(1)(b). View "Tudor v. Indus. Mold & Mach. Co." on Justia Law

Claimant sustained a work-related injury in 2003, for which he was awarded temporary total disability (TTD) benefits followed by 425 weeks of permanent partial disability benefits. In 2007 Claimant sustained another injury. After finding the effects of the 2003 injury caused Claimant's 2007 injury, an ALJ increased Claimant's partial disability benefit at reopening and tripled the entire income benefit awarded for his injury. The workers' compensation board and court of appeals affirmed. The Supreme Court affirmed, holding (1) substantial evidence supported the finding of increased impairment as well as the finding that Claimant lacked the physical capacity at reopening to perform the type of work performed at the time of his injury; and (2) the combined effects of the impairment present at the time of the initial award and the additional impairment present at reopening entitled Claimant to triple benefits based on the whole of his disability for the balance of the compensable period. View "James T. English Trucking v. Beeler" on Justia Law

This appeal concerned an ALJ's decision to award the claimant temporary total disability (TTD) benefits for his work-related shoulder injury from the date he left work, May 10, 2007, until May 8, 2009. The ALJ also awarded permanent income and medical benefits for the injury but denied claims for cervical and lumbar spine injuries. A court of appeals majority reversed, concluding that the opinion and award failed to contain findings adequate to make clear whether the ALJ considered and understood all of the evidence relevant to the date when TTD began. The Supreme Court (1) reversed to the extent that the ALJ made the finding of fact required by Kan. Rev. Stat. 342.0011(11)(a); but (2) affirmed to the extent the Court was unable to determine whether the ALJ simply misstated May 10, 2007 as being the date the claimant testified he stopped working due to the effects of his injury, misunderstood the evidence concerning his reason for missing work on May 10, 2007, or chose May 10, 2007 based on other evidence. Remanded to the ALJ to clarify that portion of the decision. View "Arnold v. Toyota Motor Mfg." on Justia Law

Strata Corporation and Liberty Mutual Fire Insurance Company appealed a partial summary judgment dismissing Liberty Mutual's subrogation claim against United Crane & Excavation, Inc., after the district court certified the partial summary judgment as final under N.D.R.Civ.P. 54(b). Because this case did not represent the "infrequent harsh case for immediate appeal and subsequent proceedings in the district court may moot the issue raised on appeal," the district court improvidently certified the partial summary judgment as final and the Supreme Court dismissed the appeal. View "City of Mandan v. Strata Corp." on Justia Law

James Mickelson appealed a judgment affirming a Workforce Safety and Insurance ("WSI") decision denying his claim for workers' compensation benefits. He argued WSI erred in deciding he did not suffer a compensable injury. Upon review, the Supreme Court concluded WSI misapplied the definition of a compensable injury, and the Court reversed and remanded for further proceedings. View "Mickelson v. Workforce Safety & Ins." on Justia Law

Perks applied for disability insurance benefits and supplemental security income under Titles II and XVI of the Social Security Act. An ALJ denied Perks's application. On appeal to the appeals council, Perks submitted additional evidence. The appeals council noted the receipt of the additional evidence but denied further review of Perks's claim. The district court affirmed. The Eighth Circuit Court of Appeals affirmed, holding (1) substantial evidence supported the ALJ's finding that Perks was not disabled; and (2) the additional evidence submitted to the appeals council did not undermine the ALJ's determination, as the ALJ would not have reached a different result with the additional evidence and the ALJ's decision was supported by substantial evidence in the record as a whole. View "Perks v. Astrue" on Justia Law