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Everything listed under: workers’ compensation

  • EMSA Filed Lien in Workers' Compensation Claim

    I have a Worker's Comp/3rdparty liability case arising out of an MVA. The 3rdparty auto insurance wants to settle with the standard 1/3 to WC subroation, 1/3 to the attorney, 1/3 to client agreement. EMSA filed a lien early on but WC has paid them about half of their bill. They won't release their lien. Is there any authority stating that EMSA has to release their lien and take the WC payment as payment in full?

    Answer:
    Your client doesn't owe the bill.Baptist Medical Center of Oklahoma, Inc. v. Aguirre, 1996 OK 133, 930 P.2d 213, 217-18:"The worker's statutory right to be relieved from the costs of medical treatment for a compensable injury is accommodated not so much by jurisdictional boundaries that separate the cognizance of the district court from that of the compensation tribunal as it is by the distinct concepts of legal obligation owed by the employer, the insurer and the worker. The interplay of these divergent liabilities is governed by the WC Act.Section 14of the Act makes the employer responsible for the injury-related medical treatment of a covered employee.The employer's liability extends to those claims for necessary medical services which have been presented and allowed by the WC court. Until the trial tribunal has ruled otherwise, the primary obligation of the employer is fully co-extensive with that of the injured worker. Before the WC court has either imposed upon orabsolvedthe employer from liability, the worker is to be regarded as immune from individual accountability that would be imposable in the district court for self-procured health care expense arising from treatment of a compensable injury."
    See also Thomas v. Okla. Orthopedic & Arthritis Foundation, Inc., 1995 OK 47, 903 P.2d 279, 286: "If a worker is injured by reason of a job-related accident, reimbursement for reasonable and necessary medical treatment may be awarded to the worker.The right to recover charges for medical care provided for personal injuries arising out of and in the course of covered employment lies solely within the Workers' Compensation Court."
    The ambulance lien does not attach to the bill covered by Workers' Comp. The ambulance lien statute, 85 O.S. Sec. 49, provides: "The lien shall not be applied or considered valid against any claim for amounts due pursuant to the provisions of Title 85 of the Oklahoma Statutes."
    If the ambulance service won't release the lien, sue them for a construction of the lien and that it does not apply to your third-party case. You should get an attorney fee in that suit. See: Luetkemeyer v. Magnusson, 2007 OK CIV APP 45, 162 P.3d 970: Physician liable for patient's attorney fee in removing lien as improper.

  • No Workers' Comp Claim Filed/Medical Providers Accept Write-Offs?

    I have a client who had a car accident while on the job who won’t let me file a workers’ compensation claim. Still the comp carrier has so far paid a portion of some of the med bills. Where there is no official comp claim, does the medical provider have to accept what the WC carrier pays as full payment? I'm concerned they'll return the WC money and demand full payment from my client.

    Answer: I don't think they can come after your client. Baptist Medical Center of Oklahoma, Inc. v. Aguirre, 1996 OK 133, 930 P.2d 213 holds that the District Court does not have jurisdiction over a medical bill arising from an on-the-job injury. I don't think it makes any difference whether a claim has been filed in comp court.

  • Coverage

    I have a client semi driver who was rear-ended by a co-employee. Can he access his own UM even though he can’t assert a claim against his co-employee?

    Answer: Yes. See:Barfield v. Barfield, 1987 OK 72, 742 P.2d 1107 andTorres v. Kansas City Fire and Marine Ins. Co.,1993 OK 32, 849 P.2d 407 (one whose claim against the tort-feasor is barred by the exclusive remedy of the Workers' Compensation Act can nevertheless recover UM benefits.)



  • UM Exclusion

    May a commercial UM policy exclude coverage for injury covered by workers' compensation?

    Answer: Check out these cases:

    Chambers v. Walker, 1982 OK 128, 653 P.2d 931, prohibits offset or credit against the insured's own UM policy for workers' compensation benefits, despite a policy provision to that effect. Bill Hodges Truck Company v. Humphrey, 1984 OK CIV APP 55, 704 P.2d 94. prohibits the converse: an offset of UM benefits paid under the worker's own policy against a workers' compensation recovery. Torres v. Kansas City Fire and Marine Ins. Co., 1993 OK 32, 849 P.2d 407, and Dennis v. Harding Glass Co., 1996 OK CIV APP 105, 929 P.2d 301. prohibit an employer and workers' compensation carrier from offsetting against workers' compensation benefits UM coverage payable under the employer's car policy.

  • Temp Agency

    Is a company that hires from a temp agency immune from suit if the temporary employee gets injured on the job?

    Answer: As I read 40 O.S. Sec. 600.7E, both the leasing company (which the statute calls a PEO) and the leasing company’s client or customer are employers and protected by the exclusive remedy: “E. Workers' compensation. Both client and the PEO shall be considered the employer for the purpose of coverage under the Workers' Compensation Act [FN1] and both the PEO and its client shall be entitled to protection of the exclusive remedy provision of the Workers' Compensation Act irrespective of which coemployer obtains such workers' compensation coverage.”

  • Worker's Comp Exlusivity

    I have an on the job death case that appears to be the result of the negligence of a fellow employee. Since the decedent was not married and had no children, no claim for the death could be made under the worker's comp act, though the parents and siblings can make a claim under the wrongful death statute. Since there is no claimant under the Comp Act, does that lift the bar on district court claims? Can I file a lawsuit in district court based on the negligence (not intentional acts) of the employer?

    Answer: No. See: Hughes Drilling Co. v. Crawford, 1985 OK 16, 697 P.2d 525 :Parents of deceased minor whose death occurred accidentally in course of his employment filed wrongful death action against employer. The District Court, Logan County, overruled the employer's objection that any claim for the minor's death was exclusively under the provisions of the Workers' Compensation Act, but certified the ruling for interlocutory review. Certiorari was granted. The Supreme Court, Hodges, J., held that the fact that the parents were limited a recovery under the Workers' Compensation Act did not abrogate their right of action for wrongful death.

  • Workers Comp Subro in PI Case

    I have a minimal impact car wreck with significant cervical injury. Plaintiff was on the job at the time of the collision and workers’ comp ruled the injuries caused by the wreck. In third-party case, insurance company arguing the wreck did not cause the injury. Can I use the comp decision to bar the insurance company’s defense?

    Answer: You can’t bind the defendant in the district court case by the finding in the Work Comp case because the defendant in the district court case is not a party to the comp case. Attempting to bind the defendant by a decision in a case to which it was not a party would violate due process. See: State Mut. Life Assur. Co. v. Hampton, 1985 OK 19, 696 P.2d 1027: Acquittal of beneficiary of killing insured did not require payment to beneficiary, under “slayer” statute (84 O.S. 231): “Moreover, special administrator and children, who are entitled to take under § 231 if wife is barred, were not parties to the criminal case. Due process standards would preclude their being bound by the result of proceedings in which they did not participate. See, Parklane Hosiery Co., Inc. v. Shore, 439 U.S. 322, 326, n.7, 99 S.Ct. 645, 649, n.7, 58 L.Ed.2d 552 (1979); Blonder-Tongue Laboratories, Inc. v. University of Illinois Foundation, 402 U.S. 313, 329, 91 S.Ct. 1434, 1443, 28 L.Ed.2d 788 (1971); California-Western States Life Ins. Co. v. Sanford, 515 F.Supp. 524, 533 (E.D.La.1981).”
  • Denial of UM Coverage Based on Workers Comp Exclusion

    I have a case where my client was injured in auto accident on the job. Tortfeasor has limited coverage. My client has UM which says coverage may not apply due to exclusions in the policy relating to claims for bodily injury covered by WC.

    Answer: You may have a bad faith case. The work comp exclusion from UM is invalid, as a matter of law. See: Bill Hodges Truck Company v. Humphrey, 1984 OK CIV APP 55, 704 P.2d 94: no UM offset against workers' compensation recovery. And Thrasher v. Act-Fast Labor Pool, Inc., 1991 OK 12, 806 P.2d 640: No subrogation of Workers' Compensation against UM; suit against UM carrier does not require filing election in Workers' Compensation Court. The insurance company should have known that.