Court Orders Plumbing Company to Cover Worker’s Care While Contesting Claim
- The Tennessee Court of Workers’ Compensation Claims ruled Aug. 5 that Alcoa-based BK Plumbing must continue to provide medical care to an injured worker, despite the employer contesting the claim.
- The case concerns a worker who reported a low-back injury on Jan. 28 after lifting a 45-pound box of insulation.
- BK Plumbing denied the claim without expert medical proof, instead relying on its own reading of the worker’s medical history, which included a prior back injury and surgery years earlier.
- The court ordered the company to provide a panel of three orthopedic physicians and cover reasonable, necessary treatment for a worker as the employee’s case seeking the care continues to wend its way through the claims system.
- Because this was an interim ruling, the worker only needed to show he was likely to prevail later, not prove his full case, and the court found his uncontradicted testimony and same-day emergency room records met that threshold.
- The court referred BK Plumbing and its insurance carrier to the state Bureau’s Compliance Program for investigation and potential penalty over its failure to timely offer a physician panel, though it denied the worker’s request for temporary disability benefits for now since he hadn’t shown he was off work or provided evidence of his average weekly wage.
Court Reinstates $1.9M Verdict for Dairy Worker Injured by Unguarded Equipment
- The Ohio Supreme Court reversed the Twelfth District Court of Appeals and reinstated a $1.9 million jury award to Jose Camara, a farm laborer severely injured in April 2019 when his clothing caught on an unguarded, rapidly rotating power take-off shaft on a sand spreader, throwing him across the tractor and causing permanent injuries to his legs and shoulder.
- Writing for the majority, Justice Jennifer Brunner held that under Ohio’s intentional tort statute, Camara only needed to prove the employer, South-Solon, Ohio-based Gill Dairy, “deliberately removed” the equipment’s safety guards — not that the company also made a considered decision never to replace them, as the appeals court had required.
- Trial evidence showed the sand spreader’s coupling guard had been missing since at least March 2018 after being removed during a 2016 pump repair, that Camara had raised concerns to a dairy co-owner, and that an OSHA investigator’s report found the missing guard caused the injury. Investigators also found the dairy had altered a purchase quote to falsely suggest it had bought a replacement shaft.
- The Supreme Court found this evidence sufficient for a reasonable jury to conclude the guards were deliberately removed and remanded the case back to the Twelfth District to consider Gill Dairy’s remaining objections to the trial court’s judgment.
Seven Accused of Running Workers’ Comp Fraud Ring Worth Nearly $100M
- Florida Attorney General James Uthmeier announced charges against seven Florida residents accused of running a workers’ compensation fraud and unlicensed money-service scheme that processed nearly $100 million.
- Prosecutors allege the defendants created and controlled shell construction companies that obtained workers’ compensation insurance by underreporting employee counts and payroll, then “rented” certificates of insurance to uninsured subcontractors for a fee.
- Investigators say the same network also operated an unlicensed money-service business to process and cash contractors’ payroll checks, distributing cash directly to some workers, with physical surveillance showing defendants working from the same location to handle payroll checks and cash distribution.
- Law enforcement seized more than $2.4 million in connection with the case, and the defendants face charges including organized scheme to defraud, operating an unlicensed money service business, money laundering and workers’ compensation fraud.
- The investigation was led by the Broward Sheriff’s Office Division of Covert Operations Money Laundering Task Force with assistance from the Palm Beach County Sheriff’s Office and the Office of Statewide Prosecution.