NCCI's Legal Team provides an update on appellate court decisions issued in the last month of 2024 that may be of interest to the workers compensation (WC) industry. Below, grouped by geographic zone, is a summary of each of these decisions and a link to the court's opinion.
Northeastern Zone
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Connecticut, Cancellation of a WC Policy
Napolitano v. Ace American Insurance Co. (December 24, 2024)
The Connecticut Supreme Court concluded that insurers must strictly comply with the requirements of Connecticut statute § 31-348—which governs the cancellation of WC policies—as well as with contract law principles that notices of cancellation must be definite, certain and unambiguous.
For more detail, read the opinion
here. -
Connecticut, Entitlement to Total Incapacity Benefits After Retirement
Cochran v. Dept. of Transportation (December 24, 2024) and
Martinoli v. Stamford Police Dept. (December 24, 2024)
The Connecticut Supreme Court ruled on two separate cases, finding that pursuant to the plain and unambiguous language of Connecticut statute 31-307(a), workers who sustain compensable workplace injuries are eligible to receive total incapacity benefits when the total incapacity occurs after their voluntary retirement from the workforce.
For more detail, read the opinions
here (Cochran) and
here (Martinoli)
Southeastern Zone
-
Alabama, Constitutionality of the Workers' Compensation Act
Crenshaw v. Sonic Drive in of Greenville, Inc. (December 6, 2024)
The Supreme Court of Alabama considered a constitutional challenge to the entire state's Workers' Compensation Act on grounds that because the Act allows only employers and not employees to opt out of WC coverage, the Act violates Article I, Section 13 of the Alabama Constitution, which requires every person to have a remedy by due process of law. The court upheld the constitutionality of the Act, reasoning that the claimant had no vested rights in a cause of action because the injuries occurred after the Act was enacted and the legislature validly exercised its police powers.
For more detail, read the opinion
here. -
Florida, Timeliness of a Claim for Benefits
Ortiz v. Winn-Dixie Inc. (December 23, 2024)
The Florida First District Court of Appeal reconsidered a prior decision addressing issues related to what constitutes the furnishing of medical care for purposes of tolling the statute of limitation period for filing a claim for benefits. The court found that the Judge of Compensation Claims erred in holding that a claimant's three contested visits to a provider did not constitute the furnishing of medical care that would toll the statute of limitations. The court found that the evidence presented showed that all three visits were part of the care that the WC insurer had authorized, and there was nothing to indicate that the claimant’s medical issues no longer related to the compensable injury.
For more detail, read the opinion
here. -
Kentucky, Traveling Employee Exception to the Coming and Going Rule
W.G. Yates & Sons Construction Co. v. Harvey (December 19, 2024)
The Supreme Court of Kentucky analyzed the traveling employee exception to the coming and going rule and held that an employee's injuries sustained while traveling to the worksite before the beginning of the work shift were not compensable, as the employee was not required to travel to or from a remote site, nor was he traveling between different worksites when the accident occurred.
For more detail, read the opinion
here. -
Mississippi, Contractor's Tort Immunity for Injuries Suffered by Subcontractors
Harris v. Hemphill Construction Co. (December 12, 2024)
The Supreme Court of Mississippi held that a general contractor—that contractually required a company hired as a subcontractor to maintain WC insurance—was immune from liability in a negligence lawsuit filed by a corporate officer of the subcontracting company, where the corporate officer suffered injuries while performing on the contract and had personally elected to opt out of WC coverage.
For more detail, read the opinion
here. -
North Carolina, Total Loss of Wage-Earning Capacity
Sturvidant v. North Carolina Department of Public Safety (December 13, 2024)
The Supreme Court of North Carolina held that the term "total loss of wage-earning capacity," as it appears in the 2011 version of North Carolina statute 97-29(c)— which limits awards of total disability benefits to a maximum of 500 weeks unless the employee sustains a total loss of wage-earning capacity—means the total loss of the ability to earn wages in employment. This decision reversed an appellate court ruling, which found that the term was synonymous with "total disability."
For more detail, read the opinion
here. -
West Virginia, COVID-19 and Subsequent Medical Conditions
Stalnaker v. West Virginia University (December 6, 2024) The Intermediate Appellate Court of Appeals of West Virginia affirmed the Workers' Compensation Board of Review by holding that a WC claimant who received WC benefits for the work-related contraction of COVID-19 failed to establish that subsequent conditions—some of which included restrictive lung disease, PTSD, chronic fatigue, and other symptoms associated with "long COVID"—were not related to the claimant's initial COVID-19 diagnosis.
For more detail, read the opinion
here.
Midwestern Zone
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Iowa, Calculation of Average Weekly Wage (AWW)
Hermanstorfer v. Lennox Industries Inc. (December 4, 2024)
The Court of Appeals of Iowa found that the Workers' Compensation Commissioner miscalculated a worker's AWW by excluding a portion of the hours that the worker was on personal leave under the Family Medical Leave Act.
For more detail, read the opinion
here. -
Iowa, Liability of the Second Injury Fund
Second Injury Fund of Iowa v. Strable (December 13, 2024)
The Iowa Supreme Court clarified the analysis for determining the liability of the Second Injury Fund when a worker with preexisting disabilities suffers a second injury and sequela injuries. The court reviewed Iowa statute 85.64, which allocates liability to the Fund when an employee suffers a second injury, and noted that the Fund's liability is triggered when (1) the employee has lost the use of a hand, arm, foot, leg, or eye; (2) the employee sustains the loss of use of another such member or organ and; (3) there is some permanent injury from the injuries. The court reasoned that the statutory term "loss of use to another such member or organ" means a loss of use to another such member regardless if the second loss includes other injuries. With this decision, the court rejected the Fund’s position that it had no liability when the second qualifying injury causes a sequela injury that is then compensated as an unscheduled injury.
For more detail, read the opinion
here.
For more information on other cases monitored by NCCI's Legal Division, visit previous Court Case Updates and
Court Case Insights under the
Legal section of
INSIGHTS on
ncci.com.
This article is provided solely as a reference tool to be used for informational purposes only. The information in this article shall not be construed or interpreted as providing legal or any other advice. Use of this article for any purpose other than as set forth herein is strictly prohibited.
