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Defense Wins by Chesapeake Employers at the Workers’ Comp Commission

August 2015

Chesapeake’s thorough case preparation, investigation and defense help to keep premium costs fair by limiting unnecessary and excessive awards or claim payments. Here are a few summaries of recent hearing cases in which the Workers’ Comp Commission ruled in our favor.

Think Before You Drink 
 

Chesapeake Employers was successful in defending this claim tried before the Commission utilizing the intoxication defense. In this case, the claimant, a baker, alleged a slip and fall. The legal team did a comprehensive investigation and confirmed that the fall did occur, but learned that the claimant may have come to work intoxicated. A test administered by the employer after the accident indicated a .15% alcohol level. At the hearing we presented an employer witness who had successfully administered the same test in the past. The employer witness testified to overseeing the test administered to the claimant after the fall. After getting the initial .15% test result the claimant refused to take another test. The employer witness also stated that the claimant slurred words and slumped in a chair while being spoken to. On cross-examination the claimant admitted to drinking malt liquor the previous night. A Commissioner found that the evidence was sufficient to show that the claimant had been intoxicated on the date of the accident. The Commissioner also found that the intoxication was the sole cause of the injury.
The claim was disallowed. 

The Case of No Credibility

Our legal and claims team was successful in defending this claim before the Commission. In this case the claimant alleged injuries to the right wrist and right shoulder within the first weeks of employment. Originally, the claimant alleged a wrist injury but, when presented for treatment, complained of additional problems with the neck, back and shoulder. While investigating the claim, we went to meet with the employer. The manager on duty confirmed that the claimant reported an injury to the wrist from banging it against a metal shopping cart. When questioned, the manager offered that there was no observation of swelling of the claimant’s wrist. When claimant testified at the hearing, the claimant stated that the injury occurred while taking a bread pallet off a truck. The claimant denied making a prior statement of hitting the wrist on a metal shopping cart, and denied reporting an injury to the wrist only. Our legal team highlighted several inconsistent statements from the claimant on how the alleged injury occurred. An employer witness also confirmed that the claimant only reported an injury to the wrist. The Commissioner did not find the claimant to be credible and denied the claim.

The Coming and Going Rule

Our claims and legal professionals were successful in defending this claim by a worker who was injured in a motor vehicle accident while returning from a training session. After the session, the claimant got a ride home from a co-worker and they were in a motor vehicle accident. The claimant admitted that mileage reimbursement was never received for the training session on the date of the accident or at any time in the past. The claimant also admitted that the co-worker drove a personal vehicle on the date of the accident. The claimant’s attorney argued that the Special Errand or Mission Exception to the Going and Coming Rule applied. Our legal staff stressed the exceptions were not at all applicable in this case and argued that the claimant was furthering a routine part of the job and was not on a special mission. The Commission agreed and denied the claim.

The Case of Not Your Standard Deviation

The legal team was successful in defending a claim by a worker who sustained multiple injuries in a head-on motor vehicle accident. Chesapeake Employers did an investigation into the facts surrounding the claim and discovered that the claimant had given a co-worker a ride home on the date of the accident. The claimant argued that this claim was compensable because the claimant was required to attend supervisor training in Western Maryland and the claimant was paid mileage for the trip. The claimant testified that as part of the job, mileage roundtrip was entitled. When questioned, the claimant admitted to giving a co-worker a ride home to South Baltimore on that day and that, when the accident occurred, the co-worker was not dropped off at home yet. Our legal team argued that this was a textbook deviation. The Commission agreed and found that the claimant had deviated from the course of employment and was not in a place where the employer required the claimant to be. The claim was disallowed.

The Case of the Ambiguous Injury

Members of the legal team were successful in defending this unusual contested hernia case. The claimant asserted that on the date of the injury, the claimant was working overtime helping to clean up debris in the street following a storm. While working overtime, the claimant was using a chainsaw to cut various branches, estimated at fifty pounds, and then throwing the cut pieces over a guardrail. The supervisor was able to confirm that the claimant did not report any injury that day. After an investigation, we found that no work involvement had been mentioned when the claimant initially presented for treatment. Our team also found a history of a prior settled hernia case. As part of the defense preparation, Chesapeake Employers was able to secure an expert opinion from a doctor. In an evaluation, the doctor opined that the specific anatomical injury was not a direct result of the alleged workplace incident, but rather the result of a pre-existing condition. At the hearing, we also pointed out that the claimant’s expert only referred to lifting at work as a possible cause. Our legal team argued that an opinion with such ambiguous language was insufficient. The Commission agreed and denied the claim.


 

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Chesapeake Employers' Insurance Company •  Formerly the Injured Workers' Insurance Fund • 8722 Loch Raven Blvd. • Towson, MD 21286   410-494-2000  1-800-264-4943   Privacy Policy and Data Security