Misrepresentation in Writing Prohibits Receipt of Workers' Compensation Benefits

Recently, the Alabama Court of Civil Appeals issued its opinion in the case of Cascaden v. Winn-Dixie Montgomery, LLC.  Cascaden began working for Winn-Dixie in 1999, and in 2001 he was injured in an automobile accident on his way home from a holiday party hosted by some of the store managers.  He suffered injuries to his lower back and neck, and underwent medical treatment and physical therapy.  He voluntarily left Winn-Dixie in 2002, and in 2007 was rehired as a meat cutter.  During the hiring process, Cascaden completed a written medical questionnaire, in which he answered "no" to several questions inquiring into whether he had experienced prior back injuries or had undergone medical treatment for prior back and neck injuries.  He testified in his deposition that he answered no because he needed the job and was afraid if he answered truthfully he would not be hired.  In 2009, he re-injured his back lifting a heavy box, and filed suit seeking Workers' Compensation benefits in 2010. 

Winn-Dixie argued that Cascaden was barred from receiving benefits due to his written misrepresentation of his pre-existing medical condition.  The Statute provides, in pertinent part, that "No compensation shall be allowed, if at the time of or in the course of entering into employment....the employee knowingly and falsely misrepresents in writing his or her physical or mental condition and the condition is aggravated or reinjured in an accident arising out of and in the course of his employment."  In order to receive the protection of this statutory defense, the document must contain the following language, in bold print:  "Misrepresentation as to preexisting physical or mental conditions may void your workers' compensation benefits". 

Cascaden argued that since Winn-Dixie know about his prior back injury that occurred during his employment with Winn-Dixie, they could not have relied upon the misrepresentation.

The Court concluded that reliance is not a factor in determining whether or not workers compensation benefits can be denied if there is a written misrepresentation as to an applicant's physical or mental condition, and that physical or mental condition is aggravated in a work related accident. 

Practice pointers.  If an employer is using a medical questionnaire, in order to take advantage of the misrepresentation defense, it must contain, in bold print, the language set forth in the statute:  "Misrepresentation as to preexisting physical or mental conditions may void your workers' compensation benefits".  Applicants are obligated to respond truthfully, or risk being denied workers' compensation benefits if they reinjure or aggravate a pre-existing condition.  It must be pointed out that this case does not address any of the potential problems the Americans With Disabilities Act may cause in dealing with workers' compensation issues, including the circumstances when medical questionnaires are allowed under the ADA. 

Alabama Supreme Court Addresses Unexplained Fall At Work

Last week, the Alabama Supreme Court issued it's opinion in the case of Ex Parte Patsy Patton d/b/a Korner Store (In re Lana T. Brown v. Patsy Patton d/b/a Korner Store).  Ms. Brown worked as a cashier at the Korner Store, which is a gas station/convenience store.  She walked to the deli counter to refill her coffee cup, and when she began walking back to the front of the store, she "inexplicably fell, breaking her wrist".  She filed a workers' compensation claim, which was denied by Korner Store, contending that the fall was attributable to an idiopathic characteristic or was due to some unexplained, but not work related, cause.  The trial court granted summary judgment in favor of Korner Store, but the Alabama Court of Civil Appeals reversed.  The Supreme Court reversed the Court of Civil Appeals, finding that in order to be a compensable injury, causation requires the injury to be the result of an accident arising out of and in the course of employment.  The Court went through a lengthy analysis of many cases, and specifically rejected a "but for" standard in determining whether an on the job injury is compensable under the workers compensation statute.  Although "courts must liberally construe the workers' compensation law to effectuate its beneficent purposes... such a construction must be one that the language of the statute fairly and reasonably supports."  SInce the statute allows for benefits only in the "case of personal injury or death...caused by an accident arising out of and in the course of [the employee's] employment", and Ms. Brown could not demonstrate what caused her fall, she was not entitled to workers compensation benefits.

POINTING A GUN AT MANAGEMENT LEGITIMATE GROUNDS FOR DISCHARGE

I have written in the past about violence in the workplace and the problems associated with the presence of firearms in the workplace. Last week, in the case of M&J Materials v. Isbell, the Alabama Court of Civil Appeals found that summary judgment in favor of the employer was appropriate when a worker, who had suffered a compensable on the job injury, was discharged for pointing a gun at a manager.  Thanks to one of my associates from my Huntsville office, Michael Pillsbury, for the summary of the case:

 

Stanford D. Isbell (Employee) injured his right wrist on June 15, 2006 while working for M & J Materials, Inc. (Employer). Sometime between April 2006 and June 2006, Employee, while still employed by Employer, brought a firearm to Employer's place of business. While showing the firearm to his co-workers (but not management), Employee aimed the firearm at a member of the management team while the manager's back was to Employee. The firearm did not discharge but this conduct made several co-workers uncomfortable and was soon reported to management who terminated Employee. Upon his termination, Employee filed suit against Employer for retaliatory discharge. Employer's motion for judgment as a matter of law was twice denied and Employer appealed. In order to prove a prima facie case of retaliatory discharge, the employee must show: 1) an employment relationship, 2) an on-the-job injury, 3) knowledge on the part of the employer of the on-the-job injury, and 4) subsequent termination of employment based solely upon the injury and the filing of a worker's compensation claim. The Court focused on the fourth element as Employee had provided evidence that the first three elements had been satisfied. Failure by the Employee to prove any of the four elements listed above was grounds for judgment as a matter of law in favor of Employer.

Employer's stated basis for Employee's termination was that Employee had brought a firearm into Employer's place of business. The Court noted that an employer's stated basis for a discharge is sufficient to defeat the fourth element listed above when the facts surrounding the stated basis are undisputed and the employee has not provided substantial evidence that a) the stated reason for termination has been applied in a discriminatory manner to employees who have filed worker's compensation claims, b) company policy does not support the termination, or c) the employer disavowed the stated reason or has otherwise admitted it is pretextual. The Court held that there was no dispute that Employee brought a firearm to Employer's place of business and aimed it at his supervisor. The Court further held that the Employer's policy against possession of weapons in Employer's place of employment was not being applied in a discriminatory manner against employees who had filed a worker's compensation claim. This matter was remanded to the trial court for proceedings consistent with the determinations of the Court of Civil Appeals.

Practice pointer.  Any time a weapon, be it a gun, knife, baseball bat or other type of weapon, is brandished in the workplace, whether as a joke or as a threat, it must be taken seriously.  There is no room for error in dealing with potentially violent employees.  In the Isbell case, termination was the correct course of action to take to protect all of the employees.

 

UNPAID SUMMER INTERNS

There is a great deal of discussion in the legal community about the legalities of unpaid summer interns.  It appears as if there will be a crackdown on employers who improperly use unpaid interns to take the place or supplement regular employees.  I have heard on at least 4 occasions in the last 2 weeks about my own relatives and friends who are working in unpaid positions this summer in jobs for which they should be paid.  Sirote & Permutt's next seminar is scheduled for Wednesday, May 19th from 11:30 a.m. to 1:00 p.m.  It will be presented live in the Birmingham office, and will be shown via video conferencing my Huntsville and Mobile offices.  if you are interested in attending, please feel free to contact me so we can plan accordingly.

WORKERS' COMPENSATION: SCHEDULED INJURIES AND DISABLING PAIN

The Alabama Court of Civil Appeals recently addressed the continuing attempt of workers injured on the job, with a scheduled member, trying to get around the schedule relying on disabling pain.  In Wehadkee Yarn Mills v. Harris, Deborah Harris was a long time employee at the mill, and at the time of her injury was a lab technician.  Her job required her to lift packages of yarn weighing 3 to 12 pounds.  On February 7, 2006, she was lifting a package of yarn when she felt pain in her right thumb.  She was treated by numerous doctors, and had surgery on her right hand.  She continued to have constant pain, rating it a 5 or 6 on a scale of 10, and that simple activities, such as washing dishes or putting on makeup increased her pain to an 8 on a scale of 1-10.  She testified that the pain did not go more than 2 inches above her wrist.  She returned to work at Wehadkee, but the plant shut down shortly thereafter.  She applied for and received unemployment compensation for about 5-6 months, and then took a job at Wal-Mart, where she worked for approximately 5 months, before quitting due to the pain in her right hand.  At the time of trial, she had been approved for Social Security Disability.  The trial court found her 100% permanently disabled as a result the disabling pain, and did not treat her injury as a scheduled injury.

On appeal, the Alabama Court of Civil Appeals remanded the case to the trial court since the trial court did not apply the test set forth in Norandal U.S.A. Inc, v. Graben, which held that "a worker who sustains a permanent injury to a scheduled member resulting in chronic pain in the scheduled member that is so severe that it virtually totally physically disables the worker would not be limited to the benefits set out in the schedule." 

Practice Pointer.  In a workers' compensation case, many times the injured worker who otherwise has a scheduled injury is claiming pain that results in a permanent total disability.  The court can find for such a claim, so long as the facts support it.  As I have frequently said, the 2 most important factors in a workers' compensation case are the judge and the demeanor of the injured worker.  The judge has the discretion to make almost any finding in a non-jury setting, so long as it is supported by a reasonable interpretation of the facts.  And the injured worker, when he/she makes a credible witness, has a much better chance of succeeding on the claim. 

WEATHER EMERGENCIES AND EMPLOYEE SAFETY

I was in Memphis yesterday to attend the finals of the Dizzy Dean World Series.  Fortunately, my son's team, the Alabama Rays, won the senior division. Unfortunately, in the 6th inning, the tornado sirens went off.  Heavy rain, lots of lightning, strong winds and word of a nearby tornado.  The park board had a weather emergency plan: all the players, parents and others in attendance were required to go into the only building available: either in the bathrooms or the concession storage closet.  Although a tight fit, everyone did as instructed.  After about 30 minutes, the all clear was given and we were allowed back outside.  Later, we learned that a tornado touched down about 5 miles away, causing damage to buildings, cars, etc.  I was impressed that the park board had a weather emergency plan, those in charge knew what it was, and it was implemented quickly and efficiently. 

Practice pointer.  It is important that companies have a weather emergency plan in place, all employees are trained as to what it is, and that it be implemented as necessary.  Training should take place on a regular basis, and supervisors need to  know what to do when the tornado sirens  sound.  Employees who are injured may be eligible for workers' compensation benefits.

RECENT COURT DECISIONS

Over the last several weeks, both the Alabama Court of Civil Appeals and the 11th Circuit Court of Appeals have issued a number of cases that impact the employment arena.  In my opinion, the most important ones are the following:

1.  Duran v. Goff Group:  Silva was working in Alabama for Jarman Construction when he died as the result of an on the job accident in 2003.  He was survived by a wife and two minor children, both of whom resided in Mexico at the time of his death.  The workers' compensation carrier, Goff Group, filed for a declaratory judgment that death benefits were not payable to Silva's dependents because they were nonresident aliens.  The Court of Civil Appeals found that since the dependents were neither citizens nor resident aliens in the United States, they were not afforded Constitutional guaranties to equal protection and due process.  The Court further found that the rights of dependents are separate and distinct from the rights of the deceased employee rather than derivative of the employee's rights.  As such, the non-resident alien dependents were not entitled to death benefits under Alabama's workers' compensation statute. 

2.  Allmond v. Akal Security Inc.:  Allmond applied for a job with Akal Security Inc. which, among other things, provided security officers at federal courthouses under contract with the U.S. Marshals Service.  Allmond was employed as a security officer in Columbus, Georgia.  One of the prerequisites of holding this job was to pass a hearing test, without the use of a hearing aid since the security officers must "be able to clearly understand directions in time of crisis....must be able to hear communication at a level of sound that does not inform persons causing an incident of the [officers'] response plans...[and] must be able to discern the direction of a disturbance or detect an approaching threat".  The hearing aid ban ensures that the officers can perform their job duties in the event the hearing aid fails or becomes dislodged.  Allmond failed the hearing test, and filed his lawsuit under the ADA and Rehabilitation Act.  The 11th Circuit, upholding the trial court's granting of summary judgment against Allmond, found that the hearing aid ban was job related and was consistent with a business necessity.  "When considered in the light of the tremendous harm that could result if a security officer could not perform the essential hearing functions of his job at a given moment, we accept this justification as legitimate and wholly consistent with business necessity".

3.  Gregory v. First Title of America Inc.:  Gregory worked as marketing representative for First Title, a title insurance company.  After she left her employment, she sued for overtime pay under the FLSA, seeking $10,000 in unpaid overtime compensation.  Her allegations included the fact that she never consummated a sale, that she was employed only to promote the company's services and to stimulate sales.  At her deposition, she testified that she did in fact obtain orders for title insurance and was paid a commission on her successful sales.  The 11th Circuit found that she was exempt under the FLSA as an oustside sales employee:  she was customarily and regularly performing her duties away from her employer's place of business, free from direct supervision,  that her primary duty was to obtain orders for title insurance, and her income was directed related to the number of orders she brought in or obtained. 

Seminar Update.  Due to an overwhelming response, my firm, Sirote & Permutt will conduct a second seminar addressing actual and anticipated changes in employment law on March 11, 2009 at Vulcan Park in Birmingham.  If you are interested in attending please contact ewilbourne@sirote.com or call 205.930.5494 to RSVP.

 

Determining Average Weekly Wages in Alabama For Workers' Compensation Purposes

In Ex parte Dolgencorp, Inc., the Alabama Supreme Court examined Ala. Code § 25-5-57(b) that defines how to compute compensation and determine average weekly wages. The statute provides for the calculation based on the employee's compensation for 52 weeks immediately preceding the injury. The statute further provides that if an employee has not worked for 52 weeks prior to the injury, the average weekly wage shall be calculated by dividing the employee's compensation by the number of weeks the employee earned wages immediately preceding the injury. Here, the plaintiff suffered an on-the-job injury after working 33 weeks for Dollar General. The Alabama Supreme Court, noting that the Workers' Compensation Act was passed to minimize litigation over work related injuries, found that the trial court's use of the second method of determining average weekly wages was accptable so long as the result is just and fair to both parties.

Practice Pointer    When an injured employee pursues a claim for workers' compensation benefits, it is important to work with the workers' compensation carrier and/or third party administrator to comply with the various provisions of the statute, including how to calculate average weekly wages.