Did injured worker deserve lifetime income benefits?
March 27, 2009 by Fred HosierPosted in: Bizarre Accident of the Week, new court decision, Special Report, Workers' comp
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What constitutes loss of use of feet and hands to qualify for permanent disability? A state court says it’s not necessary for employees to actually injure their feet or hands for that to be the case.
The case involves the award of lifetime income benefits (LIBS) to an employee by the Texas Workers’ Compensation Commission.
Carmen Muro was injured at work when she slipped and fell on a bathroom floor. She says she fell backwards and raised her right arm to prevent her head from hitting a toilet.
She injured her neck, right shoulder, lower back and hips, and underwent six surgeries on her back, hips and right shoulder.
The Insurance Company of the State of Pennsylvania denied her LIBS. If she didn’t receive LIBS, disability payments would run out after about eight years. The comp commission ruled in Muro’s favor.
The insurer appealed the case to a state trial court where a jury also decided for Muro. The case then went to the state appeals court.
The insurer argued Muro wasn’t entitled to LIBS because she didn’t suffer a direct injury to her feet and right hand.
The Texas labor code says LIBS are paid for permanent loss of both feet, or permanent loss of one foot and one hand, due to injury in the workplace.
The insurer said Muro’s injuries only affected her feet and right hand indirectly.
The appeals court rejected this argument, saying it was enough that Muro’s limitations on her use of her feet and right hand were due to her injuries and surgeries to her hips and shoulders. As one doctor stated, the hands rely on the shoulders to function and an injury to the hips affect the feet.
You can read the court’s full opinion here.
Have an opinion on this case? You can share it in the Comments Box below.
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Tags: hip injury, permanent disability payments, shoulder injury, slip and fall, workers' compensation
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March 30th, 2009 at 1:50 pm
Justice prevailed.
March 30th, 2009 at 8:03 pm
Sure injury event doesn’t deserve the bizzarre label - and the judge was right. Insurer’s come up with some “bizzarre” thinking to try to deny claims.
March 31st, 2009 at 9:26 am
I don’t know if justice prevailed or not. The story does not state weather Muro’s injuries happened because of her work environment being hazardous or if it was her not paying attention to her surroundings. Truth be told, I’m getting tired of hearing employers getting the short end of the stick. I’m not saying that is what is happening here but what ever happened to personal responsibility? I feel for Muro, but just because I empathize with her does not mean I think someone should pay for her standard of living for the rest of her life. I think too many people forget the only reason we have jobs is because our employer has invested time, money, and training into us. Resources they could have invested somewhere else. An employer hires employees so he or she can concentrate their time somewhere else. If this case was do to negligence on the employee’s part, this employer will think twice before filling this position again (if they can afford to after this). One less job to be had. Now I ask, is that justice?
March 31st, 2009 at 10:46 am
That is a tough one at best. I would like to look her up in about 3 years, follow her and see just how disabled she really is. Many times you will find people like her doing activities that would make work look like nothing. We had a supposedly “injured” worker than was unable to work and later our manager was at a soccer match and he was one of the players!!!
March 31st, 2009 at 11:18 am
Justice ? You wouldn’t be saying that if you were in her shoes, I’m sure her surgerie’s
weren’t painless and her quality of life probably won’t be that good for the rest of her life,
being in constant pain is no fun. All the company is worried about is $$$$. As far as her paying attention , it doesn’t matter, the co. has to provide a safe workplace for their employees.
I do some HR and have seen some pretty bad injuries, it all comes down to how much is this going to cost the co. So when it goes to a jury who do you think the regular people on the jury are going to feel sorry for ? the co ? Not even !!
March 31st, 2009 at 12:46 pm
I agree with Adam and Bonnie in that justice may not have been served. Why did she need 2 hip replacements? Did she actually break both hips in the fall? Also if there was a recall or bloched surgery, why should insurance company have to pay for that. That should be the manufacturer and/or surgeon. Yes, I’d like to see her in several years and see if she is still disabled. If she actually is, I also feel she should be compensated but I have seen too many cases of “the company has lots of $$$$ so let’s stick it to them”. That is what has gotten our rates for insurance, medical, etc. to go out of sight. We need to take some responsibility for our own actions. If someone fell at your home and went thru the same procedures, etc., and you had to pay either yourself or thru your homeowner’s insurance, would you feel same way?
Good luck to her and check in several years.
March 31st, 2009 at 1:14 pm
Actually, I would know. My Father was shot on the job. Was not expected to live so the surgeons never removed the bullets that rubbed against his spine for the last eighteen years of his life. I know about constant pain. I had to watch it for most of my childhood and into the beginning of my adult life. His hospital bills where paid for. We where on food stamps until he was well enough to work again and then he supported his family the best he could until he died. My Father would not take any handouts after that. Personal responsibility. Things happen in life. Instead of looking for someone to blame, pull yourself up by your bootstraps and move on. Like I said before. We don’t have the whole story. If the employer deliberately (or through negligence) created a hazardous work place. Then they bare some of the blame and liability. But if her actions are the major cause of the incident, then I don’t see why the employer should getting shafted. Like I said, I empathize with her.
April 1st, 2009 at 10:15 am
Not enough info here or on Lexis Nexus site to determine exactly what took place.
As Adam so pointedly states people need to take (some) responsibility for (their) actions and not always look for a scapegoat when something happens. Things do happen…all the time. This does not diminish the gravity of the situation.
For all we know this worker was cleaning the bathroom and slipped on a wet/slippery floor she created….or lost her balance due to intoxication or drug use or was changing her clothes - or whatever - who knows?
Maybe she failed to first report an unsafe condition or take other imediate action to remedy as per company policy…..if in fact there was any such company safety program or policy to begin with. Was there negligence involved? What bearing does it have on receiving LIBS?
How much of this condition was a result of improper or poor medical intervention?
If the statute clearly states that “loss of use” be interpreted as “loss of control” due to injury to other body part or corresponding function then the decision would appear to apply in my layman’s interpretation. (Refer to Larson’s Workers Compensation Law 87.05.)
Many people were under the impression that lack of use meant the limb/appendage had a condition or injury to itself directly causing the loss of use.
Lot of questions. Hope she recovers to a point she regains a majority (or all) of her functioning.
June 8th, 2009 at 1:22 pm
Like most of you, I get tired of all the whining, but it is the employers and employer reps. who I get tired of. Many employers think that since they are paying someone, they should be happy to have a job. The flip side is, if you have no employees you have no business either. However, most employers want their cake and eat it too.
A little understanding of the history of Work Comp, would eliminate most of this. WC laws were put in place to protect ‘employers’ from employee lawsuits. This arose from decades of abuse of employees by employers. Some well deserving employees (families) were able to sue their employers for death or serious injuries that could have been easily prevented had the employers invested some dollars. The employers, would rather get another employee. Once they found out they could be sued and lose, that was unacceptable.
Employers don’t want employees to be able to be sued for anything that happens during the course of employment over employer errors or mistakes, as a result is WC. Certain items are covered, a sort of no fault insurance. When on company property, which is the responsibility of the employer/owner; or will ‘on the clock’.
WC rates are based on accident/injury rates. They only go up when, the rates go up. If you have a lot of accidents, what are you doing about it. Sure there are individuals that game the system, but there are just as many employers do the same thing. When you talk about personal responsibility, it seems it only flows ‘one way’.
July 6th, 2009 at 5:02 pm
In this article, here again, we are not given all the facts. Too many what if’s to know excatly what happened.
If a person runs a red light and has an accident w/injuries, then that individuals auto insurance and medical would pay for it. (unless he/she don’t have either then the tax payers would pay for it! lol). If that same person on company time runs a red light and has an accident w/injuries the company pays for it. Either way someone else pays for it. That’s the society we live in!
December 17th, 2009 at 9:41 am
“…underwent six surgeries on her back, hips and right shoulder.” Who could say no to her? I mean jury or not, this woman was banged up BADLY. If she fell backwards, that is indicative of a slip. Maybe a puddle of water or piece of toilet paper on a slippery tile floor - highly probable. I believe compensation should be tied to your earning potential though. Yes cover medical bills by all means but if you work at MacDonalds earning minimum wage, your compensation should be in accordance to that earning potential and not 100 times over.