On July 1, 2006, Commissioner
Tarr concluded his three year term as the Chairman of the Virginia Workers’
Compensation Commission.Commissioner
Diamond will act as the Chairperson for the next three years.
As
of July 1, 2006, the new maximum compensation rate is $773.00 and the new
minimum compensation rate is $193.25.As
of October 1, 2006, the COLA rate is 3.45%.
The
Commission is also beginning a program in which it will provide foreign
language interpreters at no cost, provided the parties make a request for
interpreter at least 30 days prior to a hearing.
LEGISLATIVE UPDATE
As
of July 1, 2006, a new system for calculation of temporary partial disability
benefits has been incorporated into the Workers’ Compensation Act.For self-employed employees, salesmen who
work on commission, or individuals who are closely related to their employer,
temporary partial disability will now be calculated as follows:
a.
if the disability lasts less than 13 weeks, the partial disability rate is set
by taking the average of the claimant’s first two weeks of post injury
income.This rate is then subject to
retroactive adjustment at the conclusion of the 13 weeks, or the end of the
period of disability.
b.
if the disability lasts longer than 13 weeks, the temporary partial rate is
calculated by averaging the claimant’s total post injury wages from the current
period of disability to date.Adjustments are to be made quarterly.Underpayments are to be paid at the time of the adjustment, while
underpayments are to result in a dollar for dollar credit against future
benefits, which can be taken out of ongoing disability up to one-fourth of each
payment.
The
Commission is also authorized to use this formula for all other employees at
its own discretion.
RECENT CASE DECISIONS
CREDIT – VOLUNTARY
OVERPAYMENT
John
A. Killen v. Westvaco Corporation, VWC File No. 205-29-00 (November 14, 2006)
John
Killen was had an accepted claim for benefits related to a left knee injury of
November 16, 2000.The Commission
entered various awards of benefits, most recently entering an Award for
temporary total disability benefits from November 12, 2002 and continuing.
The
employer filed an application on January 24, 2006, seeking to have a credit in
the amount of $2,032.66, representing overpayments made by the employer based
on the employer’s incorrect calculations during 2004.The Commission awarded the credit, but
reduced the amount of the credit to $1,759.13 to account for COLA payments that
the employer had failed to make.The
claimant appealed, contending that he believed that the employer’s payments
were all correct when they were made, and he should not now be punished for the
employer’s mathematical errors.
The
Full Commission affirmed the Deputy Commissioner, and allowed the credit.The Commission said that calculation errors
constitute “voluntary” overpayments, even when the mistakes are made trying to
pay pursuant to an award.The Commission
stated that allowing this credit prevents unjust enrichment to the claimant.
Editor’s Note:This represents a change in philosophy for
the Full Commission.Previous decisions
have held that the employer could not claim overpayment for payments made to
satisfy an Award, even if the payment was a miscalculation.Under prior decisions, the employer would
have had to prove fraud, mutual mistake, or imposition.
SUSPENSION OF BENEFITS -
REFUSAL OF MEDICALCARE – FCE
Terry
B. Carter v. City of Portsmouth
School Board,
VWC File No. 200-28-21 (November 8, 2006).
The
claimant sustained a compensable occupational injury to her right knee, neck
and back on March 13, 2000.The
Commission entered an open Award for temporary total on May 7, 2003.On July 30, 2004 and April 28, 2005, the
employer filed applications to terminate benefits based on the claimant’s
failure to cooperate with employer-requested medical treatment.Specifically, the claimant had attended an
IME with Dr. Barnum, who also requested that the claimant undergo an FCE.The claimant attended the FCE, but did not
complete it.She testified that she
stopped the FCE because it was causing her pain in her knee.
The
FCE report indicated that the claimant had demonstrated symptom magnification
and poor effort during the FCE, noting 3 out of 5 Waddell’s signs and a score
of 3 out of 22 on the validity scale, suggesting “very poor” effort.When the FCE examiner told the claimant that
the computer was indicating that she was not giving her maximum effort, the
claimant began to cry and left the FCE without completing the tests.The FCE concluded that the claimant was unable
to return to work because of lack of strength.Dr. Barnum had also indicated some suspicion of symptom magnification,
stating that the claimant was attempting to falsely portray weakness in her
extremities.
On
this evidence the Deputy Commissioner held that the claimant had refused
medical treatment and suspended benefits.On appeal, the Full Commission found that the claimant had refused
medical treatment by failing to put forth maximum effort in the FCE, and in so
doing had frustrated the employer’s legitimate interest in speeding up the
claimant’s recovery.
Editors Note: Again, this appears to be a
deviation from the norm.In this case,
the claimant’s treating physician continued to opine that the claimant was not
faking or magnifying her symptoms, and opined that is was reasonable for her to
cut short the FCE if she was experiencing pain.In many other instances, the Commission has deferred to the treating
physician.In this case the IME and the
FCE report both offered very strong specific opinions as to the claimant’s
submaximal effort and symptom magnification.
SUSPENSION OF BENEFITS –
REFUSAL OF VOCATIONAL REHABILITATION – CHANGE OF ADDRESS
Joseph
Mendes v. Philip Chan t/a Yuan Ho Carry Out, VWC File No. 191-42-35 (October 20, 2006).
The
claimant sustained a compensable occupational injury on May 1, 1998, which
resulted in an open Award, which was suspended on two occasions because the
claimant relocated to India
for a period of several months without leaving an updated forwarding address.
On
this occasion, the employer attempted to place the claimant with a vocational
rehabilitation counselor.As the
claimant’s attorney indicated that the claimant would be in India “indefinitely,” the counselor set a
meeting with the claimant several weeks out for an initial assessment at his
permanent address in the United
States.When the claimant failed to appear, the Uninsured Employer’s Fund filed
an application for hearing based on refusal of vocational rehabilitation.
The
Deputy Commissioner suspended benefits, and the claimant appealed.On review, the Full Commission affirmed the
suspension, noting that by taking the position that the claimant was in India “indefinitely,” the claimant had put
himself in a situation that left the carrier with no ability to seek vocational
rehabilitation either here or in India.
Editor’s Note:This is a useful opinion for many situations
involving foreign born injured workers.It is not uncommon for foreign born injured workers to return to their
native country for several weeks or months at a time.If they leave a forwarding address, the
employer cannot suspend benefits for failure to provide an updated
address.However, unless the claimant
indicates an intention for his change of address to be permanent, he or she is
still subject to vocational rehabilitation in the United States at their permanent
address.
For more information, please
contact Lynn Fitzpatrick at (703) 793-1800 or lfitzpatrick@fandpnet.com.