VERMONT WORKERS’ COMPENSATION UPDATE APRIL TO JUNE 2015 by Keith Kasper, Esq.

Florence Godin has retired after 23years in state service. She will be replaced by Paul Donovan former State Law Librarian.
Effective July 1, COLA increases for weekly indemnity benefits is effective in the amount of 2.3% with a new maximum compensation rate of $1,224 and a new minimum compensation rate of $408.
New WC Rules become effective on August 1.

DEPARTMENT DECISIONS

Wood v Fairpoint Communications, Opinion No.7-15WC (Apr.10 2015)
Attorney fees awarded following informal conference when initial denial based upon “‘lack of investigative evidence to determine causal relationship to employment.’” Treating physician altered initial treatment note to show causal connection to work but Defendant did not rescind denial.

Kurant v Sugarbush Soaring Association, Inc. (Kurant III), Opinion No. 8-15WC (April 13, 2015).
Attorney fees awarded without formal hearing when Carrier refused to pay ongoing medical treatment based upon an IME report stating that such ongoing treatment is not reasonable or necessary, but no Form 27 filed in support of the IME and no other medical records filed in support thereon. “Defendant’s failure to comply with the requirements of Rule 18.2100 amounted to misconduct or neglect under Rule 10.1330. It thus became necessary for Claimant to retain an attorney, whose efforts resulted in an interim order requiring Defendant to continue benefit payments. Notably, because the benefits at issue involve ongoing medical coverage rather than a cash award, under the circumstances of this case Claimant has no other workers’ compensation-related fund from which to pay his attorney for her work. If he is to be made whole, an award of attorney fees is necessary.”

Hoyt v Chittenden South Supervisory Union, Opinion No. 9-15WC (Apr. 28 2015)(HO Phillips)
“Claimant here relies on Rule 10.1370 as the basis for his request for an award of [attorney] fees. But for his ‘persistent efforts’ he asserts, Defendant would not have paid his medical bills, and instead would have allowed his group health insurer to retain the financial burden related to treating his work injury. Aside from the mere fact of the delay between the time when the Defendant agreed to accept Claimant’s claim and the time when it actually issued payment, I can find no evidence to support this assertion. Given both the inherently time-consuming nature of the medical bill audit and payment process and the inflammatory nature of Claimant’s accusation, I cannot accept it as substantiated.”

Conant v Entergy Corp., Opinion No. 10-15WC (Apr. 28, 2015)(HO Phillips)
“[I]n accordance with the Supreme Court’s ruling in Yustin [v. Department of Public Safety, 2011 VT20], I conclude as a matter of law that AIG may claim an offset for the sick leave benefits Claimant received against any future workers’ compensation indemnity benefits to which she may become entitled. However, I am unwilling to extend the Court’s ruling to allow for an offset of short-term disability benefits. As to those, I conclude that Defendant’s recourse lies not with the Commissioner, but rather with the grievance and dispute resolution provisions of the collective bargaining agreement.”

Siebanaler v. Chittenden County Transportation Authority, Opinion No. 11-15WC (June 3, 2015)(HO Woodruff)
IME doctor’s opinion found more persuasive than that of treating physician when treating physician’s “opinion was based upon an erroneous understanding of Claimant’s mechanism of injury, as well as a flawed understanding of her previous medical history.”

Lewis v Town of Stowe, Opinion No. 12-15WC (June 3, 2015)(HO Woodruff)
Pro se Claimant’s lack of expert medical opinion causally relating migraines to work environment results in summary judgment in favor of Defendant. Claimant’s “testimony and … belief that the fumes caused [his] headaches will not be enough to carry [his] burden.”

Boyd v. Kennametal, Inc., Opinion No. 13-15WC (June 17, 2015)(HO Woodruff)
Claimant wins summary judgment motion for COLA adjustments for intervening years when PTD benefits restart after a lump sum 330 week payment. “I emphasize the limited scope of this conclusion. Because an injured worker who is permanently and totally disabled is likely never to return to work, his or her ability to maintain the required relationship between the compensation rate and the state average weekly wage is completely dependent on the annual cost of living adjustments mandated by §650(d). In contrast, injured workers who are only partially disabled and therefore presumably able to return to work will have other avenues available to them to earn both current wages and periodic increases….. [T]his was the case in both Birchmore [v The McKernon Group, Opinion No. 40-11WC (Nov. 28, 2011)] and Bollhardt [v. Mace Security Intl, Inc. Opinion No. 51-014WC(Dec. 17, 2004)], and my conclusion here should not be read to overturn the holdings in those cases.”

Cushing v Control Technologies, Inc., Opinion No. 14-15WC (June 9, 2015)(HO Woodruff)
Grant of summary judgment in favor of Claimant when Hearing Officer “conclude[s] as a matter of law that no penalty can be imposed upon an injured worker for failing to attend a scheduled independent medical examination unless the employer can establish first, that it complied fully with the notice requirements of Workers’ compensation Rule 13000, and second, that the injured workers’ conduct was purposeful, negligent or otherwise inexcusable.”

ARBITRATION DECISIONS

Lachance v. Reliant Electric Works State File No. FF-00044 & CC-02624 (May 18, 2015)(Atty Kolter Arbitrator)
Subsequent work event resulted in a flare-up of pre-existing severe crushed knee injury resulting in liability resting with subsequent employer form June 7, 2013 until Claimant returns to baseline on December 3, 2013. “The ‘crux’ of the inquiry is whether there was a distinction between the April 2011 crushed knee injury and the June, 2013 [subsequent event] ‘and their respective effects on claimant’s overall condition so as to fairly apportion liability between the successive [insurers].’ Cehic [v. Mack Molding, Inc., 179 Vt. 602, 604 (2005)].”