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.