Insurance Dispute Lawyer Blog

Are Mental Injuries Covered By Workers’ Compensation?

Published on: November 2, 2023 | By Berniard Law Firm

alzheimer_s_man_portrait_0-scaled Employees are often exposed to stressful situations while at work, whether from unhelpful coworkers or understaffing. Under what circumstances are resulting mental injuries entitled to workers’ compensation?

Diedre Emerson worked for Willis Knighton Medical Center as a certified nurse assistant on the cancer floor. One day, she arrived at work for her regular night shift. She found the prior shift had not completed a lot of their work, so she would have to do additional work. When she learned this, she became upset and mad. She said this was more of the same old behavior.

While working that day, she indicated that she felt something pop in her head but admitted nothing physically happened to cause the pop. After completing her shift, she went to the emergency room. The medical records from the visit did not show she complained about weakness on one side of her body or other neurological symptoms. Her primary complaint was hyperventilation and nervousness. Emerson was subsequently late in calling Willis Knighton to tell them she would not be able to work her shift. She was fired.

When Doctors Disagree: What Happens When There Is Conflicting Testimony In A Workers’ Compensation Case?

Published on: November 1, 2023 | By Berniard Law Firm

feet_girl_fingers_parts-scaled Medical testimony is an essential part of determining whether an injured worker has a valid claim. What happens if the doctors’ diagnoses conflict and they reach different conclusions about whether an injured worker can return to work?

Maxine Hall worked as a housekeeper for Global Solution Services. While working for Global at a hotel, a door closed on her foot. She went to the emergency room, where a doctor told her she did not have any broken bones. However, another doctor subsequently diagnosed her with a fractured toe.

Despite receiving medical treatment, Hall continue to suffer from pain in her foot. Hall received workers’ compensation benefits, but the benefits terminated approximately two years after the accident occurred. She then filed a Disputed Claim for Compensation against Global and Illinois National Insurance Company, its insurer. Hall sought to get her benefits reinstated. The Workers’ Compensation Judge dismissed Hall’s claims. Hall filed an appeal.

Who Is Responsible For Damages In Accident Involving Borrowed Car And Inadequate Maintenance?

Published on: October 31, 2023 | By Berniard Law Firm

driving_camera_in_mirror-scaled It is common to borrow a car from a family member or friend. If you are unfortunately involved in an accident while driving a borrowed car, who is liable for damages if the accident results from inadequate maintenance?

While Holly Fontenot was driving a car owned by Patricia Neil and her husband, the parents of Fontenot’s fiancé, she was involved in a single-car accident when she lost control and hit a utility pole. Fontenot had the Neils’ permission to drive their car. There were also two minors in the car with her.

Fontenot and the mother of the two minor children passengers filed a lawsuit against Safeway Insurance, who insured the Neils’ car. Fontenot claimed the accident occurred because of a lack of maintenance. She claimed the car went off the road because it had a broken tie road, which caused the car’s steering mechanism to fail.

Is An Unmarried Romantic Partner Entitled to Death Benefits in Workers’ Compensation?

Published on: October 30, 2023 | By Berniard Law Firm

marriage_rings_wedding_hands-scaled It is always tragic when a loved one passes away, especially when there are children are involved. Death benefits are part of the workers’ compensation system intended to help the surviving family members when someone passes away as a result of an on-the-job accident. However, with the evolving definition of a family, there can sometimes be complicated legal issues about who is entitled to recover death benefits. This case involves a claim from a supposedly unmarried romantic partner who had a child with the worker who died in an accident at work.

Travis Chiokai died as a result of an accident at work. When he died, Chiokai was unmarried. However, Chiokai had been in a romantic relationship with Latashia Perez. Perez filed a Disputed Claim for Compensation against Chiokai’s employer, Irby Construction, as well as their insurer, Old Republic. Perez sought death benefits for herself, as well as for her unborn child. Once the child was born, DNA testing was conducted that confirmed the child’s father was Chiokai. The child subsequently received death benefits.

Irby Construction and its insurer argued Perez should not received benefits under La. R.S. 23:1253, which defines dependents who are entitled to receive death benefits. The statute explicitly states that a concubine, such as Perez, is not entitled to receive death benefits. Irby Construction and its insurer filed an exception of no right or cause of action. The Workers’ Compensation Judge denied the motion.

How Is Coverage Divided When Multiple Insurance Policies Are Involved?

Published on: October 29, 2023 | By Berniard Law Firm

coins_currency_investment_insurance_0-scaled If you are involved in an automobile accident, it can be difficult to navigate insurance claims and coverage. The situation becomes even more complicated when there are multiple insurance policies involved. How is coverage allocated between multiple relevant insurance policies?

Sonya Theriot was unfortunately in an automobile accident in Lafayette, Louisiana. The other driver involved in the accident, Todd Sparks, was working for Thermal Technologies at the time of the accident. He was driving a rental car Thermal Technologies had paid for when he rear-ended Theriot while she was making a right-hand turn.

Thermal Technologies had a business automobile insurance policy with State Farm, a commercial general liability policy, and an umbrella insurance policy with Owners Insurance. Sparks had a personal automobile insurance policy with Travels Home Insurance Company. Theriot filed a lawsuit against State Farm, Sparks, and Thermal Technologies. She later added Travelers and Owners to the lawsuit.

Car Accident Case Dismissed For Improper Venue

Published on: October 28, 2023 | By Berniard Law Firm

car_wrecked_accident_collision-scaled If you are considering filing a lawsuit, it is essential that you file it in the correct venue. Otherwise, the court may lack authority to hear your claim and will not be able to consider the merits of your case.

While driving in Terrobonne Parish, Louisiana, Joanna Gilbert had a single car accident on Highway 3011. The accident occurred where the road ended. When she went onto the unpaved pat of the road, she ran off the unpaved area and went into the water.

Gilbert filed a lawsuit in Iberia Parish, where she lived, against the State of Louisiana Department of Transportation and Development (“DOTD”). She alleged the car accident had occurred because of DOTD’s negligence, which resulted in her injuries. Gilbert later added her uninsured/underinsured motorist insurance carrier as a defendant.

1010 Form Required For Company To Cover Medical Expenses in Workers Compensation

Published on: October 27, 2023 | By Berniard Law Firm

photo_old_old_recording_0-scaled While workers’ compensation is intended to compensate injured workers, there are a number of procedural requirements with which an injured worker must comply in order for his or her company to cover the medical treatments. This case illustrates the importance of complying with procedural requirements and submitting all required paperwork.

While working for Circle K Stores, Melody Smith went to a Capitol One bank located in Lafayette, Louisiana. Before Smith reached the bank to make the night deposit, she was robbed by a person who crashed his truck into the rear end of Smith’s car and shot at her two times. He then smashed her window and took the deposit bag from her.

Smith injured her knee, back, and neck in the incident. Circle K paid Smith workers’ compensation benefits following the incident. However, the parties disagreed about treatment for Smith’s injured knee. Smith filed a Form 1008 under La. R.S. 23:1034.2(F)(1) against Circle K, claiming it had failed to pre-authorize her evaluation for her knee injury with her selected physician.

Worker Entitled To Unpaid Compensation Owed Him Under Contract

Published on: October 26, 2023 | By Berniard Law Firm

business_signature_contract_962355-scaled One frequent use of contracts is to establish how much someone will be paid for specified work. Clear contractual language can help prevent disputes down the road. What happens if you do not receive all the compensation to which you are entitled under your contract?

Clifton Franklin and Fountain Group Adjusters signed a contract where Franklin would provide Fountain with insurance adjusting services related to claims from Superstorm Sandy. The contract outlined how Franklin would be compensated by Fountain. Franklin claimed Fountain wanted him to sign a second contract because it could not find the first contract. While the second contract set Franklin’s compensation at 75% rather than the 65% in the initial contract, Franklin only asserted claims for the original 65% commission.

Claims One employed Franklin during this time. Fountain also signed a contract with Claims One. Although Franklin received some compensation from Fountain, he filed a lawsuit against Fountain, claiming he had not been fully compensation.

Injured Worker Who Hid Injuries Still Entitled To Workers’ Compensation

Published on: October 25, 2023 | By Berniard Law Firm

emergency_rescue_stretcher_injured-scaled If you are injured on the job, it is best practice to inform your employer and supervisor about your injuries. They will likely inform you about possible workers’ compensation to which you might be entitled. Are you still eligible to receive workers’ compensation benefits if you tried to hide your injury from your employer?

Gary Jeansonne worked as a maintenance worker at a youth center located in Bunkie, Louisiana. Over two months after Jeansonne stopped working at the center, he filed a claim for workers’ compensation, claiming he had hurt his back while working at the center. He claimed the accident had occurred while he was working in the kitchen. Jeansonne claimed to have called his supervisor the next morning to tell him he would not be able to come in to work due to his back, but he did not tell his supervisor his back issues were from an injury at work.

Jeansonne started receiving medical treatment for his back injuries. His medical records indicate he told his doctor the accident that hurt his back occurred at home. Jeansonne subsequently claimed the report was not accurate and he had just said the incident occurred at home because he wanted to be able to go back to work.

Prior Mistake Does Not Waive Insurer’s Defense In Subsequent Claim

Published on: October 24, 2023 | By Berniard Law Firm

supreme_court_building_washington_3_9-scaled If you are in a car accident and your insurance pays your claim, you likely expect the same thing will happen if you are subsequently in a similar accident. What happens if your insurer paid your prior claim, but tries to deny a subsequent claim?

Brandon Forvendel was injured in a car accident. When the accident occurred, he was driving a car he owned and was insured by State Farm. Forvendel had uninsured motorist coverage. After the accident, Forvendel recovered under his uninsured motorist policy.

When the accident occurred, he was living with his mother, who also had insurance through State Farm. Forvendel also tried to recover under his mother’s uninsured motorist policy, which had higher policy limits. State Farm denied his attempt to recover under both his and his mother’s policies under the anti-stacking provisions in La. R.S. 22:1295(1)(c). Forvendel then filed a lawsuit against State Farm.