Justia Public Benefits Opinion Summaries

Claimant Claud Sloan appealed a district court judgment that affirmed a Workforce Safety & Insurance (WSI) order awarding him additional permanent impairment benefits. In December 1985, Sloan sustained a compensable work-related injury while employed at a coal gasification plant in Beulah, North Dakota. WSI awarded Sloan permanent impairment benefits for his injury and has issued several permanent partial impairment orders since his original injury. Effective April 1, 2009, WSI promulgated N.D. Admin. Code 92-01-02-25(4) to address pain impairment ratings. Based on the newly adopted rule, WSI reviewed Sloan's pain rating and determined he had sustained an eight percent impairment for pain which, when combined with his prior impairment ratings, totaled a whole body impairment rating of 38 percent. On June 11, 2009, WSI issued an order awarding Sloan additional permanent impairment benefits, based on his combined whole body impairment of 38 percent for his cervical spine, depression, dysphagia, and chronic pain. Sloan requested a rehearing. At a November 2009, hearing before an administrative law judge, a staff attorney for WSI appeared as the only witness and testified regarding the WSI's promulgation of N.D. Admin. Code 92-01-02-25. The ALJ subsequently issued an order affirming WSI's June 2009 order awarding Sloan additional permanent impairment benefits. Sloan appealed to the district court, which affirmed the order. Upon review, the Supreme Court concluded WSI's promulgation of administrative rules for assessing pain impairment did not conflict with its statutory authority and was not arbitrary, capricious, or unreasonable.

Petitioner Toni Weeks appealed a district court judgment that affirmed a decision by Workforce Safety and Insurance (WSI) that reduced her disability benefits. Petitioner was injured at work after being exposed to anhydrous ammonia while employed by Dakota Gasification Company, in Beulah, North Dakota. In 2009, WSI received confirmation that on November 1, 2009, Weeks' social security disability benefits would convert to social security retirement benefits. WSI issued a notice of intention to discontinue or reduce benefits, in which Petitioner was informed that her permanent total disability benefits would end on October 31, 2009, and she would receive an "additional benefit payable" beginning November 1, 2009. Petitioner requested reconsideration. In November 2009, WSI issued an order denying Petitioner further disability benefits after October 31, 2009. Upon review, the Supreme Court found that because Petitioner failed to adequately brief her argument that WSI's reduction of her wage loss benefits violated equal protection under the federal and state constitutions, the Supreme Court declined to address her argument and otherwise affirmed the judgment.

Petitioner married in 2001. Her husband had retired unmarried under the Civil Service Retirement System and elected to receive an annuity payable during his lifetime with no survivor benefits. He died in 2003, and petitioner's application for survivor annuity benefits was denied. After considering evidence about a conversation that husband purportedly had with one of its employees, the Office of Personnel Management affirmed, stating that husband could have elected to receive a reduced lifetime annuity with survivor benefits for a new wife only by notifying OPM of his intentions in a signed writing within two years of his marriage, 5 U.S.C. 8339(k)(2)(A). An administrative judge upheld the decision, stating that the decision would become final on June 21, 2004, unless a petition for review was filed. Petitioner did not file until 2010, claiming disability made her unable to attend to the matter. The Board denied her petition for review as untimely filed, finding no credible medical evidence regarding her condition. The Federal Circuit affirmed.

This case was a direct appeal in a workers' compensation matter from a master's order reversing the Full Commission and finding respondent's decedent was totally disabled as the result of an occupational disease. On appeal, Appellant W. L. Gore & Associates contended this matter should have been dismissed because Respondent's admittedly untimely appeal to the Commission deprived the Commission of jurisdiction. Upon review of the Commission's record, the Supreme Court agreed that the untimely appeal to the Commission required it to vacate both the master's order and the decision of the Full Commission.

Plaintiff Jerry Elliott sought workers' compensation benefits from his employer, International Paper Company, Inc. (IP). He petitioned the Supreme Court for a writ of mandamus to quash a Court of Civil Appeals' writ of mandamus directed to the Conecuh Circuit Court. Plaintiff lived in Conecuh County for over 15 years and for 21 years worked as a machine operator at the plywood-manufacturing plant owned by IP located in Butler County. In 2007, he allegedly sustained an injury to his shoulder while at work. He filed an action at the Conecuh Circuit Court seeking workers' compensation benefits. IP filed motions to dismiss Plaintiff's action or, in the alternative, to transfer the case to Butler County. After a hearing, the trial court denied the motions to dismiss or to transfer. IP then filed a petition for the writ of mandamus at the Court of Civil Appeals to review the trial court's denial of its motion. The Court of Appeals granted the writ directing the Conecuh Court to transfer the case to Butler County. Upon review, the Supreme Court concluded the appellate court's decision was in error, and quashed the writ that was issued transferring venue to Butler County.

Employee-Petitioner Melenia Trotter was awarded workers' compensation benefits for a back injury by the South Carolina Workers' Compensation Commission ("Commission").  Petitioner worked at "the turb and trim station," which consisted of using an "air driver" (a screwdriver with a blade) to trim down tubes to the same length, and then "turbulating" the tubes by putting a spring into each tube. According to Petitioner, she began having spasms and some lower back pain that extended down her legs in December 2004, which she mentioned to her Team Leader and Trane's Safety Coordinator.  Petitioner continued to work with increasing discomfort in December 2004 and January 2005. An MRI revealed Petitioner had a herniated disc at L5-S1 with marked compression of the right S1 nerve root.  Following a doctor's recommendation, Petitioner underwent surgery in early 2005. In May 2005, Petitioner filed a claim alleging a job-related injury to her back. Trane denied the claim, maintaining it did not receive notice of the injury until after her surgery and that there was insufficient proof of a work-related injury. An Appellate Panel of the Commission unanimously upheld the commissioner's order finding Petitioner's injury was work related and granted her benefits.  The circuit court affirmed.  Trane appealed, and the appellate court reversed. Upon review, the Supreme Court concluded the Court of Appeals erred in finding the Commission abused its discretion in denying Trane's motions for a continuance or to keep the record open for depositions to be taken.  Consequently, the Court reversed the opinion of the Court of Appeals and reinstated the order of the Commission. 

In this case, the court construed Labor Code section 4659(c), which provided for the annual indexing of two categories of workers' compensation benefits, total permanent disability and life pension payments, to yearly increases in the state's average weekly wage (SAWW), so that lifetime disability payments made to the most seriously injured workers would keep pace with inflation. The indexing procedure was sometimes referred to as an "escalator," or one providing for "cost of living adjustments" (COLA's). At issue was whether the operative language of section 4659(c) required the annual COLA's for total permanent disability and life pension payments to be calculated (1) prospectively from the January 1 following the year in which the worker became "entitled to receive a life pension or total disability indemnity," (when the payments actually commenced); (2) retroactively to January 1 following the year in which the worker sustained the industrial injury; or (3) retroactively to January 2004, in every case involving a qualifying industrial injury, regardless of the date of injury or the date the first benefit payment became due. Applying fundamental rules of statutory construction, the court held that the Legislature intended that COLA's be calculated and applied prospectively commencing on the January 1 following the date on which the injured worker first became entitled to receive, and actually began receiving, such benefits payments, i.e., the permanent and stationary date in the case of total permanent disability benefits, and the date on which partial permanent disability benefits became exhausted in the case of life pension payments.

Linda Thompson appealed from a Superior Court judgment reversing the determination of the Unemployment Appeals Board (UIAB) that good cause existed for Thompson's voluntary resignation and granting her unemployment benefits. Thompson contended that good cause existed for voluntarily terminating her employment, that she exhausted her administrative remedies, and that substantial evidence in the record supported the UIAB's decision. The court affirmed the judgment of the Superior Court and held that substantial evidence did not support the UIAB's decision and the UIAB erred as a matter of law by concluding that Thompson was entitled to benefits pursuant to 19 Del. C. 3314(1).

Petitioner's claim for Social Security disability insurance benefits (42 U.S.C. 423(a)(1)(E)) and supplemental security income payments after suffering serious injuries in a motorcycle crash were denied by the Social Security Administration. An ALJ also denied the claim after conducting a hearing, finding that petitioner could perform a significant number of jobs. The district court the denial. The Seventh Circuit affirmed the denial as supported by substantial evidence that petitioner is qualified to work in positions that are available in substantial numbers.

Claimant Katrina Blue appealed an Employment Security Board decision that denied her claim for unemployment compensation benefits.  Claimant contended the Board erred in: (1) finding that she was disqualified from receiving benefits because she left her employment voluntarily; and (2) assigning her the burden of proof.  Claimant worked for about four years for Hickok & Boardman Realty.  In the early summer of 2010, claimant left her employment to participate in a three-month cross-country bicycle ride for multiple sclerosis. Claimant acknowledged that she did not submit a written request for leave, as required in the company's personnel policy, which stated that employees who apply for unpaid personal leave, "must apply in writing" and that, "reinstatement is not guaranteed" but rather, "at the Company's sole discretion."  While conceding that her leave arrangement "was not typical," Claimant maintained that her supervisor had agreed, "that an exception would be made in this instance." In its ruling, the ALJ's findings indicated that Claimant "requested a three-month leave of absence" but do not state whether the request was granted or, if so, on what terms.   Its key conclusion, however, was that, "[w]hile the claimant maintain[ed] that she was fired when the employer would not allow her to come back from a personal leave of absence, it was the claimant who initiated the separation from employment by requesting the leave of absence . . . thus making this a voluntary separation from employment."  Since there was no claim that the separation was for "good cause attributable" to the employer, the ALJ concluded that claimant was disqualified from receiving benefits. In a divided ruling, the Employment Security Board adopted the ALJ's findings and conclusions and sustained its decision.  The dissenting member of the Board would have found that claimant's "departure for her cross-country ride was . . . not a voluntary abandonment of her employment, but a temporary unpaid leave of absence," that claimant was let go upon her return in late August, and therefore that she was entitled to unemployment compensation benefits from that time forward.  This appeal followed. Upon review of the record, the Supreme Court reversed and remanded the case to the Department of Labor's ALJ: "[m]indful that our unemployment compensation scheme must be broadly construed so that no claimant is "excluded unless the law clearly intends" it … we direct the ALJ on remand to enter additional findings and conclusions on the material issues presented, and to award unemployment compensation benefits to claimant in the event it is determined that she  did not leave her employment voluntarily."