Source: http://www.jeremywrichter.com/category/workers-compensation/
Timestamp: 2019-04-19 01:33:36+00:00

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Category Archive for "Workers’ Compensation"
A construction worker was killed while operating a dump truck. When his death occurred, he was on loan from his employer to my client, also a construction company. Due to his death, the worker’s family was entitled to death benefits under the Alabama workers’ compensation statute. But which company had to pay the benefits? My client or his day-to-day employer? The answer hinged on the answers to a couple of tests.
In Alabama an employer has different responsibilities for regular employees than it does for independent contractors or special employees. An employer may be held liable for the conduct of employers, where it may not be for the conduct of independent contractors. However, there are certain circumstances in which an independent contractor can become a “special employer” of the employee.
First, to determine whether a worker is an employee versus an independent contractor, Alabama has a statutory test. Alabama uses a reserved right of control test to determine whether a worker is an employee or an independent contractor. This is a common law right-to-control test. See Tuscaloosa Veneer Co. v. Martin, 172 So. 608 (Ala. 1937) (“If there is no evidence that defendant reserved no control, except an inference from the circumstances, the question was one for the jury.”); see also Hudson v. DuraWear Corp., 344 So.2d 182 (Ala. Civ. App. 1977); Birmingham Post Co. v. Sturgeon, 149 So. 74 (Ala. 1933); White v. Henshaw, 363 So.2d 986, 988 (Ala.Civ.App. 1978).
More recently, the Alabama Supreme Court has held, “The test for determining whether a person is an agent or employee of another, rather than an independent contractor with that other person, is whether that other person has reserved the right of control over the means and method by which the person’s work will be performed, whether or not the right of control is actually exercised.” Martin By & Through Martin v. Goodies Distrib., 695 So.2d 1175, 1177 (Ala. 1997).
“When a general employer lends an employee to a special employer, the special employer becomes liable for workman’s compensation…only if: (a) the employee has made a contract of hire, express or implied, with the special employer; (b) the work being done is essentially that of the special employer; and (c) the special employer has the right to control the details of the work. When all three of the above conditions are satisfied in relation to both employers, both employers are liable for workmans’ compensation.” See G.UB.MK Constructors v. Garner, 44 So. 3d 479 (Ala. 2010), quoting Terry v. Read Steel Products, 430 So. 2d 862, 865 (Ala. 1983). Notably, all three conditions must be present for a finding of a special employer.
Furthermore, the Alabama Court of Civil Appeals has held that in order for a person to be considered an employee, “the other party must retain the right to direct the manner in which the business shall be done, as well as the results to be accomplished, or, in other words, not only what shall be done, but how it shall be done.” Atchison v. Boone Newspapers, Inc., 981 So. 2d 427, 431 (Ala. Civ. App. 2007). The reserved right of control is the test of the relationship between the parties. Id.
If for purposes of liability or workers’ compensation you need to determine whether a business is a special employer or statutory employer, there are two applicable tests. Follow the analyses and you can determine the responsibilities the business owes to the employee and liabilities it may be subject to on his behalf.
My thoughts on the status of the Alabama Workers’ Compensation statute have been published in the “News and Updates” portion of the June 2017 issue of CLM Magazine (p. 57): “Trial Court Declares State Workers Compensation Statute Unconstitutional“.
Ex parte Austal USA, LLC considers the narrow exception to the exclusivity provision of the Workers’ Compensation Act and the standard for a plaintiff to survive a Rule 12(b)(6) motion to dismiss.
Austal moved to dismiss the claim under Alabama Rule of Civil Procedure 12(b)(6), arguing it was immune from the intentional misconduct claim via the exclusivity provisions of the Longshore & Harbor Workers’ Compensation Act (33 U.S.C. § 901 et seq., “the LHWCA”) and the Alabama Workers’ Compensation Act (Alabama Code § 25-5-1, et seq.). The trial court denied Austal’s motion to dismiss the intentional misconduct count.
The plaintiffs later filed a fourth amended complaint, restating the intentional misconduct claim, and adding five more claims that alleged various intentional and/or fraudulent acts or omissions against Austal. Austal moved the court to dismiss the newly alleged claims, as well as the intentional misconduct claim first stated in the third amended complaint. Its grounds for dismissal remained the exclusivity provisions of the LHWCA and Alabama Workers’ Compensation Act. The trial court likewise denied this motion to dismiss. Austal petitioned the Alabama Court of Civil Appeals for a writ of mandamus. Ex parte Austal USA, LLC [Ms. 1151138 Mar. 3, 2017), ___ So.3d ___ (Ala. 2017).
“‘The LHWCA, at 33 U.S.C. § 905, precludes a personal injury action against any employer who complies with the LHWCA. Just as Ala. Code 1975, § 25-5-53, provides that workers’ compensation benefits are the exclusive remedy for injuries received in a work-related accident, the LHWCA provides, in 33 U.S.C. § 905(a), that an injured worker may not maintain a tort action against his employer for any negligence of the employer giving rise to the injury; the injured worker’s exclusive remedy is under the LHWCA.” Rodriguez-Flores v. U.S. Coatings, Inc., 133 So.3d 874, 880-81 (Ala. 2013).
Rodriguez-Flores recognized an “exceedingly narrow” exception in the exclusivity provision of the LHWCA for occasions in which the employer has committed an intentional tort. 133 So.3d at 881-82. The exception requires that the employer had a specific intent or desire that the injury occurred. Id.
Austal further argued that, on the whole, each plaintiff suffered accidental injury when a tool supplied to each by Austal to perform his/her work kicked back and made contact with their bodies. However, the plaintiffs specifically allege that Austal intended to cause them injury. Austal argues that these assertions by the plaintiffs are conclusory in nature and made only to invoke the narrowly-tailored intent-to-injure exception to the LHWCA exclusivity provision.
While the Alabama Supreme Court was skeptical of the plaintiffs’ claims and noted that the alleged intent-to-injure was inconsistent with the cost-saving motivation, the court held that for purposes of considering whether the complaint is sufficient to withstand the motion to dismiss, the court must take the allegations of the complaint as true. Ussery v. Terry, 201 So.3d 544, 546 (Ala. 2016). The test is not whether the plaintiff will ultimately prevail, but rather, whether he may possibly prevail. Daniel v. Moye [Ms. 1140819, No. 10, 2016], ___ So.3d ___ (Ala. 2016); Newman v. Savas, 878 So.2d 1147, 1149 (Ala. 2003). A dismissal pursuant to Rule 12(b)(6) is only appropriate “when it appears beyond doubt that the plaintiff can prove no set of facts in support of the claim that would entitle the plaintiff to relief.” Knox v. Western World Ins. Co., 893 So.2d 321, 322 (Ala. 2004) (quoting Nance v. Matthews, 622 So.2d 297, 299 (Ala. 1993)).
In light of the above caselaw, the Alabama Supreme Court could not deny there was some possibility the plaintiffs’ accusations were true. Austal had not shown a clear legal right to a Rule 12(b)(6) dismissal, and its petitions were denied.
Ex parte Hibbett Sporting Goods, Inc.: For venue purposes, pursuant to Alabama Code (1975) § 6-3-7(a)(3), proper venue is not established by the principal of an entity doing business in a particular county, rather than an agent.
Keith Cantrell was a commercial driver for Hibbett Sporting Goods, Inc (“Hibbett Sporting Goods”). During his employment, he was injured while in Indiana. Cantrell sued Hibbett Sporting Goods for workers’ compensation benefits, bringing his claim in Lamar County, Alabama. Cantrell lived in Lamar County. Hibbett Sporting Goods filed a motion to transfer venue to Jefferson County, arguing that Lamar County was an improper venue, and Jefferson County was a proper venue. Hibbett Sporting Goods is a Delaware corporation, whose principal place of business is in Jefferson County, Alabama. Cantrell argued that Lamar County was a proper venue because he resided there and alleged that Hibbett Sporting Goods did business by agent in Lamar County.
The question of whether Lamar County is a proper venue is controlled by Alabama Code (1975) § 6-3-7(a)(3), which provides (in part) that a suit against a corporation may be brought in the county in which the plaintiff resides if the corporation does business by agent in that county. Because this arises out of a workers’ compensation action, it is important to note that the Alabama Workers’ Compensation Act provides the venue statutes apply to workers’ compensation cases just as they would in other civil actions involving claims for injuries. See Alabama Code (1975) § 25-5-1(18); see also Ex parte Adams, 11 So.3d 243, 247 (Ala.Civ.App. 2008).
In order to establish Lamar County as a proper venue, Cantrell alleged that Hibbett Team Sales, Inc. (a separate corporation) acted as an agent for Hibbett Sporting Goods. It is undisputed that Hibbett Team Sales did work in Lamar County selling athletic equipment and merchandise. However, Hibbett Sporting Goods contends that no agency relationship exists between itself and Hibbett Team Sales.
The trial court denied Hibbett Sporting Goods’ motion to transfer venue. Hibbett Sporting Goods filed a petition for a writ of mandamus. Ex parte Hibbett Sporting Goods, Inc. [Ms. 2160069, Jan. 27, 2017], — So.3d — (Ala.Civ.App. 2017).
The question before the Alabama Court of Civil Appeals, for the purpose of establishing proper venue, was whether Hibbett Team Sales was an agent for Hibbett Sporting Goods in Lamar County. The standard for testing agency for venue purposes is different than the agency testing standard for the purpose of liability. See Ex parte Peabody Galion Co., 497 So.2d 1126 (Ala. 1986). For the purpose of venue, the element of control (or lack of control) of the principal over its agent is not determinative. The measure rather is as follows: if the entity is the means by which the principal is able to do business in a particular county, then the entity is the agent of the principal for venue purposes. Ex parte Charter Retreat Hosp., Inc., 538 So.2d 787, 789-90 (Ala. 1989).
The facts before the court in this matter revealed that both Hibbett Sporting Goods and Hibbett Team Sales were subsidiaries of Hibbett Sports. Therefore, Hibbett Sports is the principal of both Hibbett Sporting Goods and Hibbett Team Sales. Therefore, Hibbett Teams Sales is not and cannot be the agent of Hibbett Sporting Goods. And Alabama Code (1975) § 6-3-7(a)(3) requires that the defendant have an agent, not a principal, that does business in the county. Because Hibbett Sporting Goods then does not have an agent that does business in Lamar County, it is an improper venue. As a result, the Alabama Court of Civil Appeals issued the writ, instructing that trial court remove the case to Jefferson County.
Augmentation, Inc. v. Debra Harris – Before refusing to pay for prescribed medical treatment, pursuant to a court order in a workers’ compensation case, the employer must implement the utilization-review process or seek judicial review.
While working in the line and scope of her employment at Augmentation, Inc., Debra Harris injured her neck, left shoulder, and back, on April 3, 2011. Two years later Harris sued Augmentation, Inc. for worker’s compensation benefits. The parties reached a settlement agreement that was approved by the trial court on April 3, 2014, with medical benefits to remain open and Augmentation to pay for Harris’ future medical expenses.
In March 2015, Harris brought claims that Augmentation had failed to authorize, approve, and pay for medical treatment that had been prescribed by her treating physician. Specifically, her physician had ordered epidural steroid injections for Harris’ lower back injury. She also alleged that Augmentation had failed to reimburse her for mileage costs to and from appointments. Augmentation sought to and did take Harris’ physician’s deposition to determine whether the treatment, including the epidural injections, he was prescribing were related to Harris’ 2011 injury. Dr. Bailey testified that although Harris’ lumbar symptoms waxed and waned, she had never completely recovered from her 2011 injury. Nevertheless, there was testimony in the record from other physicians that Harris’ symptoms were consistent with an acute lumbar strain rather than a chronic injury.
Upon hearing, the trial court determined that Augmentation was in violation of the April 2014 order by “willfully and contumaciously” failing to provide for the medical treatment prescribed by Harris’ physician. The trial court further found that Augmentation both failed to implement the utilization-review process, set forth in Alabama Code (1975) § 25-5-293(g) that enables an employer to institute a utilization-review program to review claimed medical expenses for reasonable necessity, and failed to seek judicial review before refusing to pay for Harris’ treatment. The court ordered Augmentation to immediately pay for the prescribed medical treatment and awarded damages to Harris. Augmentation appealed to the Alabama Court of Civil Appeals. Augmentation, Inc. v. Debra Harris [Ms. 2150307], — So.3d — (Ala.Civ.App. Sept. 23, 2016).
Augmentation argued on appeal that the trial court erred in concluding that Augmentation had violated the April 2014 judgment; the trial court erred by finding Augmentation liable for Harris’ ongoing and future medical treatment; and the trial court erred by failing to allow meaningful discovery and by failing to conduct a trial on the merits to determine whether Augmentation was required by the April 2014 judgment to pay for Harris’ ongoing and future medical treatment.
The appellate court found that the trial court conducted four hearings, of which two were evidentiary hearings. It did not find any reversible error related to a failure to permit meaningful discovery.
Augmentation contended that the trial court improperly construed the April 2014 judgment to mean that Augmentation had accepted liability for Harris’ alleged injuries and agreed to authorize and pay for Harris’ medical treatment. Augmentation emphasized that the settlement agreement indicated that Augmentation contested Harris’ claim and that its agreement to pay for future medical treatment was subject to medical necessity, causation, and pre-authorization requirements as provided in the Alabama Workers’ Compensation Act. Regardless of any finding of liability, the trial court’s 2014 judgment specifically required Augmentation to provide for Harris reasonable and necessary medical treatment related to her compensable injury. The Alabama Court of Civil Appeals found that the trial court had not erred in construing the April 2014 judgment.
The Alabama Court of Civil Appeals, pulling no punches, stated: “We do not understand the trial court’s judgment to make such a blanket determination,” in obligating Augmentation to pay for all of Harris’ future medical treatment with Dr. Bailey. (Ms. 2150307, p. 21). Rather the appellate court read the judgment to understand that Augmentation was responsible for paying for Harris’ related future medical treatment, the necessity of which Augmentation could seek to challenge. The 2014 judgment was specifically understood to refer to the prescription to plaintiff of muscle relaxers and anti-inflammatory patches for her chronic lumbar back strain. Therefore, the appellate court found no error by the trial court for determining that Augmentation was required to pay for Harris’ medical treatment that was not specifically provided for in the April 2014 judgment.
The trial court based its finding of Augmentation’s willful refusal to pay on Augmentation’s failure to prove that it had a valid reason to believe that the treatment Dr. Bailey prescribed was not reasonable and necessary at the time Augmentation refused to pay for the treatment. The trial court found that Augmentation had not properly investigated or challenged its obligation to pay for the prescribed medical treatment before declining to pay, and as a result had no evidence whereby it could decline payment. The appellate court reflected that sanctions for contempt, such as those imposed against Augmentation, should not be implemented where there is a valid reason for the employer to question its liability to pay for medical expenses, but if the employer has willfully and contumaciously refused to provide medical expenses, such sanctions are warranted. See Travelers Indem. Co. of Illinois v. Griner, 809 So.2d 808, 814 (Ala. 2001); see also Ex parte Cowgill, 587 So.2d 1002, 1004 (Ala. 1991).
The Alabama Court of Civil Appeals found that Augmentation had immediately questioned Dr. Bailey about the necessity of the epidural steroid injection, and after Dr. Bailey responded with a note, Augmentation did not do any further investigation before refusing to pay for the injection. Augmentation had also refused to pay for muscle relaxers and anti-inflammatory patches for more than a year, without having sought information pertaining to the necessity of those prescribed treatments. The appellate court also noted Augmentation’s failure to implement the utilization-review process or seek judicial review. Thus, the trial court had not abused its discretion by finding that Augmentation’s failure to pay for Harris’ medical treatment was willful and contumacious.

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