Is There a Time Limit on When a Medical Provider Can Seek Payment?

Within the last few years, the answer is yes. In October 2017, the Maryland legislature established a one-year bill submission period for Maryland medical providers. Previously, there was no submission period outlined by state statute. The Maryland General Assembly amended § 9-660 of the Workers’ Compensation Act to add time restraints for providers seeking payment of medical bills for treatment related to an employee’s work-related injury. Specifically, the code under section (d) states that a provider who provides medical service or treatment to a covered employee shall submit to the employer or the employer’s insurer a bill for the service within 12 months from the later of the date that:

1) the medical service was provided;

2) the employer or insurer accepted the claim for compensation; or

3) the claim for compensation was determined to be compensable by the Workers’ Compensation Commission. Md. Lab. & Empl. Code Ann. § 9-660(d).

Providers have more leniency with timely submission than the payers of the medical bills generally. Maryland regulation COMAR 14.09.08.06 requires insurers to reimburse providers or to deny in full or in part or within 45 days of receipt of the provider’s bill.

Does that mean the insurer is completely off the hook if the provider submits nothing within that 12-month period?   As we know, nothing in the law is that black and white. The statute goes on to state that the employer or insurer may not be required to pay a bill that was submitted after the 12 months outlined above unless the provider files an application for payment within the Commission (also known as the C-51) within three years of the later:

(1) the date of the medical treatment or service;

(2) the date the employee’s claim was accepted by the employer or the insurer; or

(3) the date the employee’s workers’ compensation claim was found to be compensable by the Commission; and

The Commission excuses the untimely submission for good cause. Id. At this point, the Commission decides what constitutes “good cause” on a case-by-case basis. The statute is still considered to be new; we can anticipate in the future that we will have a clearer definition as to what instances will establish good cause as required by the Act.

Written by associate Stephanie Broznowicz.

 

 

 

 

 

New Year, Same Problem: Commercial Trucker Shortage

The lobbying organization for the nation’s big trucking employers, the American Trucking Associations (ATA), has long touted a nationwide shortage of truck drivers due in part to its older workforce entering retirement. However, it was undeniably exacerbated by the constraints of the COVID-19 epidemic, much as the already constrained supply chain to move goods across the country was exacerbated as retirements were accelerated faster than new commercial truck drivers could be trained. According to the ATA, a record 80,000 additional truck drivers are currently needed to meet the nation’s freight demand, while the driver shortage is expected to exceed 160,000 by 2028. Not only does a trucker shortage clog the country’s supply chain, which increases consumer pricing, but it also adversely impacts the bottom lines of commercial trucking companies, whose trucks sit for days, unused, while costs continue to accumulate.

Various reasons for the driver shortage have been proposed. According to the ATA, age restrictions on drivers, gender issues, and schooling issues are lead amongst them; while nearly every state permit drivers under the age of 21 to obtain their commercial driver’s licenses (CDL), federal law prevents drivers who are younger than 21 from hauling freight across state lines. The public health crisis limited trucking opportunities to experienced drivers, as most schools closed since they could not teach truck driving via Zoom. As for gender, the stereotype of a trucker is male-dominated. The industry has struggled to attract women to commercial truck driving; while women comprise 47% of America’s workforce, they only account for 6% of commercial truck drivers. Interwoven within these issues is the “trucker lifestyle,” which is not appealing to many: unhealthy diet and sedentary lifestyle due to being on the road, long-distance travel with long hours and sometimes weeks away from home, and separation from families. Moreover, implementation of vaccine mandates or weekly COVID-19 testing, while arguably a vital part of the fight to quell the surge of COVID-19, has another negative impact on the industry. The companies already stretched thin struggle to implement the government-mandated policies, and not all commercial truck drivers are willing to participate.

As we approach the two-year anniversary of the COVID-19 epidemic, we can reflect upon what creative solutions to the commercial trucker shortage are proving effective for various companies. The most obvious answers are financial ones, in line with the general concept of supply and demand: increasing driver pay, providing sign-on bonuses, and offering pay increases, along with better benefits and 401(k) or tuition reimbursement programs. The area of trucking with the most significantly seen shortage is “long-haul trucking,” which refers to truck drivers who must travel long distances across state lines, adversely affected by the above-referenced lifestyle issues. To address this, companies are offering options for part-time drivers, decreasing time on the road by offering weekend or local routes with steady and reliable hours and increasing the number of available distribution centers. Some companies have targeted minorities, women, and military veterans with focused advertising on social media or financial incentives. There has been a cry through initiatives such as the ATA’s DRIVE-Safe Act to lower the age minimum for a commercial driver from 21 to 18 so that the younger commercial driver force is not prohibited from transporting goods nationally. It may be that the improvement of and likely entry of autonomously operated vehicles into the workforce may decrease the adverse effects of product distribution caused by the trucker shortage.

What is clear, is that the effects of COVID-19 are ongoing, with no clear end in sight for either the epidemic or its impact upon the commercial trucker shortage. However, just as there is no singular cause of the commercial trucker shortage, there is no singular solution. But we know now, more than ever, that commercial truckers are vital to the economy in our society, and we need to keep working to support commercial truck drivers and attract them to the industry.

For more information contact Tamara B. Goorevitz.

Can the Opposition’s Expert Make Their Closing Argument?

A crucial part of many lawsuits is presenting and contesting expert witnesses. However, an expert’s persuasive role should be limited. As you prepare for experts in your case, beware of the opposition trying to disguise its closing argument within an expert’s “opinion” on the stand.

Expert assistance is wise for all sides whenever a case involves concepts or standards outside an ordinary jury’s knowledge. Such wisdom rises to the level of legal necessity in some matters, including medical malpractice actions in Virginia, which generally require a plaintiff to obtain an opinion from an expert on the applicable standard of care and breach of the same. Va. Code Ann. §8.01-20.1. But in cases where a theory of liability lies within the range of the jury’s common knowledge and experience, then expert testimony is unnecessary – and arguably irrelevant. See, e.g., Lake v. Adams, 2020 WL 1016352 (W.D. Va. 2020) (expert testimony regarding pedestrian or ordinary traffic movement excludable); Hot Springs Lumber & Mfg. Co. v. Revercomb, 110 Va. 240, 267 (1909) (“The ordinary affairs of life cannot be the subject of expert testimony”).

So when can we prevent a witness from giving an improper expert-stamp-of-approval on the opposition’s ultimate theory of liability?

The need to defeat this overreaching testimony may be enhanced in negligence per se cases arising from violations of safety statutes. See, e.g., McGuire v. Hodges, 273 Va. 199 (2007). A party’s violation of the statute alone (e.g., pool-fence height requirements, speed limits) creates an inference of negligence, challenging the defense from the start.

For the inference to apply, the court must find the statute was 1) enacted for public safety, 2) the plaintiff belongs to a class of persons for whose benefit the statute was enacted, and 3) the harm is of the type the statute is designed to protect against. This is a purely legal inquiry conducted by the court. See, e.g., France v. Southern Equip. Co., 225 W.Va. 1 (2010); McGuire, 273 Va. at 14. In these cases, experts must not be permitted to opine on conclusions of law or legality of conduct. Va. R. Sup. Ct. 2:704 (“in no event may such [expert] witness . . . express any opinion which constitutes a conclusion of law”); France at Syl. Pt. 10. Since expert testimony on breach of the applicable standard of care is not required, what is the remaining role of an expert, if any, in the negligence per se context?

Some plaintiffs have attempted to use asserted safety experts to opine on whether a statute “covers” a particular act, procedure, or protocol, often in realms where industry standards are implicated. However, this tactical testimony should be impermissible if the expert’s opinion concerns questions of law. Va. Code Ann. § 8.01-401.3; Va. R. Sup. Ct. 2:704; France, 225 W.Va. at 14. The application of the underlying statute in a negligence per se claim is an inquiry reserved for the court alone. Id. As such, in the context of negligence per se, an expert’s role at trial must be limited. Id. Importantly, a plaintiff cannot use an expert’s testimony to make it seem more likely to a judge or jury that a statute applies for the purpose of negligence per se. Id.

In cases involving alleged violations of ordinary traffic safety statutes, the opposition may also attempt to bolster its case with a safety expert’s “opinion” not only on the uncontroversial applicability of a statute, but also on the general causative effects of code violations. This broad testimony often simply amounts to a closing argument on duty, breach, causation, and damages. Will the trier of fact actually be assisted by a safety expert’s belief that speed limit violations cause accidents? Or is opposing counsel simply trying to distract the jury from the fact that their client swerved across the centerline and struck your client, who was traveling a mere mile per hour over the speed limit?

Luckily, there is a process in all jurisdictions whereby a litigant can challenge the admissibility of the opposing side’s experts and their opinions, including federal court. Although the Federal Rules of Evidence provide that an “opinion” is not objectionable just because it embraces an ultimate issue,” the Advisory Committee Notes clarify that Fed. R. Evid. 702 and 403 are designed to prevent “admission of opinions which would merely tell the jury what result to reach”. Courts recognize that “expert witnesses have the potential to be both powerful and quite misleading”. Westberry v. Gislaved Gummi AB, 178 F.3d 257, 261 (4th Cir. 1999). If the testimony has a “greater potential to mislead than to enlighten”, it should be excluded. Id. Many states’ evidentiary rules closely track this federal standard.

If the issues are too ordinary, straightforward, or ‘common-sense” for an expert to be necessary, a litigant should challenge the opposition’s expert testimony on those issues. If an issue is uncontestable, strategic stipulations may be useful to prevent unnecessary piling on testimony. Furthermore, if the expert’s proffered testimony sounds more like opposing counsel’s closing argument, a litigant should be on the alert for conclusions of law. By utilizing motions in limine to contest the opposing side’s attempt to offer expert testimony on the legality of conduct,  a litigant can mitigate the danger of opposing counsel clothing their closing in the mantle of expert testimony.

For more information contact Stephen J. Marshall.

Credit for IME No-Show Fees Increase

Prior to October 18, 2021, COMAR 14.09.03.08B(6) placed a cap of $125.00 reimbursement of reasonable expenses and costs incurred when a claimant in a Workers’ Compensation matter missed an independent medical examination appointment. The cap of $125.00 was arbitrary and not an accurate reflection of the fees that result from a claimant failing to attend a scheduled medical examination appointment.

Effective October 18, 2021, COMAR 14.09.03.08B(6) was revised to remove the $125.00 cap on the reimbursement of expenses and costs incurred due to a missed medical examination appointment. The controlling version of COMAR 14.09.03.08B(6) now reads: “If a Claimant fails to appear at, refuses to submit to, or fails to cooperate with the medical examination, without good cause, the Commission may order the claimant to attend a medical examination and order reimbursement of reasonable expenses and costs actually incurred because of the missed exam (emphasis added). Md. Code Regs. 14.09.03.08. The amendment now allows the penalized party to seek credit for the entire amount of the no-show fee.

The reimbursement amount ordered will be at the commissioner’s discretion presiding over the matter. If either party believes that the decided reimbursement amount inaccurately reflects the costs incurred, a motion for a rehearing may be submitted to the Commission within fifteen of the days after the decision. Additionally, another avenue to further litigate the issue of the reimbursement amount ordered is to appeal the matter to one of the state’s circuit courts for the matter to be litigated before a judge or jury.

Written by associate Marleigh Davis.

Party On, Wayne or Stairway Denied? Litigants Seek to Clarify the Maryland Court of Appeals’ Administrative Orders Tolling And/or Suspending the Statutes of Limitations

In the 1992 film “Wayne’s World,” the titular character, newly flush with cash, goes to a music store to purchase “Excalibur,” a ’64 Fender Stratocaster “in classic white, with triple single-coil pickups and a whammy bar.”  He tests out the guitar, playing a few notes before the store clerk stops him and sternly points to a sign reading “NO Stairway to Heaven.”  Wayne, stopped in his tracks, incredulously remarks, “No Stairway?  Denied!”  The music store, caring nothing for the musician’s skill or quality of the instrument, made the policy decision to impose an absolute bar on the playing of Led Zeppelin’s 1971 song, “Stairway to Heaven,” on the premises.

Maryland’s statutes of limitations, set forth at Md.  Code Ann., Cts. & Jud.  Proc.  §5-101, et seq., impose a similar bar upon would-be litigants.  No matter the sufficiency of their case, the sympathy of their cause, or entitlement to relief, the law prevents them from bringing an action outside the applicable time period.  Maryland’s general limitations period affords a litigant three years from the date a cause of action accrued to file suit (although other limitations periods apply depending on the cause of action).  See Md.  Code Ann., Cts. & Jud.  Proc.  §5-101.  By way of example, if Wayne tripped over a guitar cable in the music store and sustained damages on December 1, 2017, he would have until December 1, 2020, to file suit.

While the general limitations period is easy enough for lawyers and lay-people to understand, the COVID-19 pandemic resulted in a flurry of orders across the United States, modifying the rules and operating procedures of the courts (including orders from Maryland’s highest court, the Court of Appeals), tolling and/or suspending the statutes limitations.

In its COVID-19 administrative orders, Maryland’s Court of Appeals ordered, among other things: a judicial state of emergency; a period from March 16, 2020, through July 20, 2020, during which the courts were closed to the public; and the tolling and/or suspension of deadlines relating to the initiation of matters (including statutes of limitations).  These orders have sparked vigorous debates amongst attorneys because some interpret the orders as applying only to those matters whose limitations period would have expired from March 16, 2020, through July 20, 2020 (the “narrow interpretation”), whereas other attorneys interpret the Court of Appeals’ orders as tolling and/or suspending the limitations period for all matters during the time the Courts were closed (the “broad interpretation”).

Those who support the narrow interpretation look to the following language:

For the purposes of tolling of statutes of limitations and other deadlines related to the initiation of matters, in this Order, “tolled or suspended by the number of days that the courts were closed” means that the days that the offices of the clerks of court were closed to the public (from March 16, 2020 through July 20, 2020) do not count against the time remaining for the initiation of that matter; and

For the purposes of tolling the statutes of limitations and other deadlines related to the initiation of matters, in this Order, “matters” are nunc pro tunc to March 16, 2020, those matters for which the statute of limitations and other deadlines and other deadlines related to the initiation would have expired between March 16, 2020, through the termination date of the COVID-19 emergency operations in the Judiciary as determined by the Chief Judge of the Court of Appeals.

Tenth Revised Administrative Order (August 6, 2021).  The inclusion of “nunc pro tunc” (Latin meaning “now for then”) in the administrative orders is significant because it allows the court to retroactively change the date of an order, deadline, or filing to a past date.  A narrow interpretation of the administrative orders views this language as limiting tolling to matters that would have expired from March 16, 2020, through July 20, 2020, and tolling those matters by 141 days from March 16, 2020 (the administrative orders also provide a 15 day grace period after the expiration of the tolling period).  Under their interpretation, Wayne’s deadline for filing would remain unchanged because it falls outside of the March 16, 2020, through July 20, 2020 time period during which the courts were closed to the general public.

But those who support the broad interpretation look to the following language:

. . . all statutory and rules deadlines related to the initiation of matters required to be filed in a Maryland state trial or appellate court, including statutes of limitations, shall be tolled or suspended, as applicable, effective March 16, 2020 by the number of days that the courts are closed to the public . . .

. . .  For example, if two days remained for the filing of a new matter on March 15, 2020, then two days would have remained upon the reopening of the offices of the clerks of court to the public on July 20, 2020.  With the additional fifteen days, seventeen days would be left for a timely filing, beginning July 20, 2020.

Tenth Revised Administrative Order (August 6, 2021).  The argument in favor of the broad interpretation is that the scope of the tolling is not limited to matters falling within the March 16, 2020, through July 20, 2020 time period because the tolling applies to “those matters for which the statute of limitations  . . . would have expired between March 16, 2020, through the termination date of the COVID-19 emergency operations in the Judiciary . . .”.  Id.  To date, the COVID-19 emergency operations in the Judiciary have not ended.  Accordingly, under the broad interpretation, Wayne had 261 days to bring suit as of March 15, 2020, and, following the time during which the courts were closed to the general public, would have 276 days from July 20, 2020, to bring suit.

While Maryland Appellate Courts have yet to clarify this particular issue in an opinion, the Supreme Court of Massachusetts analyzed a similar tolling order, compared it with COVID-19 tolling orders in other jurisdictions, and noted that Maryland was among the jurisdictions that imposed a broad, blanket extension on the initiation of all matters (not just those that would have expired within a specified period).  See Shaw’s Supermarkets, Inc. v. Melendez (Slip Op. SJC-13054, 2021).  Additionally, at least one plaintiff has appeared to have prevailed in arguing for the broad interpretation of the administrative orders in defending against a motion for summary judgment before a Maryland trial court.  See e.g., Reed v. One Call Concepts, Inc., et al. (2021).

Ultimately, it will fall upon the Maryland Court of Appeals to determine whether its “party on, Wayne” or “stairway denied” for plaintiffs relying upon the administrative orders to file outside of the general limitations period.  Still, an answer may be coming soon.  Recently, the United States District Court for the District of Maryland presented a certified question to the Maryland Court of Appeals, asking Maryland’s high court to determine whether it had the authority to modify the applicability of the statutes ofl limitations.  See Jesse J. Murphy, et al. v. Liberty Mutual Insurance Co., (Misc. No. 5, September Term, 2021) (argued December 3, 2021).  Based upon the questions asked by the Court of  Appeals at oral argument, it would be surprising if the high court determines that it did not, in fact, have the authority to toll and/or suspend the statutes limitations.  Attorneys are optimistic that the court of appeals will also clarify the application of its administrative orders when addressing the certified question, but if the high court does not, there will surely be an appeal on the issue in the near future.  Until Maryland’s high court explicitly addresses the issue, plaintiffs should err on the side of caution and comply with the legislatively-established statutes of limitations, while defendants may continue to challenge matters filed outside of the March 16, 2020, through July 20, 2020 tolling period that have potential timeliness issues under the Statues of Limitations.

For more information contact Stephen J. Marshall.

Summary Denial of a Motion to Reopen or Modify Is Not Appealable or Subject to Judicial Review

Labor & Employment § 9-736(b) grants the Workers’ Compensation Commission (hereinafter the “Commission”) the authority to modify its findings or orders, where justified, so long as the application for modification is made within five years after the later of the date of accident; date of disablement; or date of last compensation paid. Upon receiving such a request, the Commission may summarily deny the request without conducting a hearing.  Alternatively, it may hold an evidentiary hearing on the issue, after which it can either deny or grant the request.  While any new decision reached after an evidentiary hearing is reviewable on appeal by the Circuit Court, a summary denial is not.

In the case of Linda A. Sanders v. Board of Education for Harford County, et al., the Commission’s authority to summarily deny a modification request was reviewed in the appellate courts of Maryland. Specifically, the Court of Appeals considered whether the Commission’s summary denial of a motion to reopen or modify under Labor & Employment § 9-736(b) was subject to judicial review or appeal. The employer, Board of Education for Harford County, and insurer, Maryland Association of Board of Education (“MABE”), hereinafter “Respondents” were represented by Franklin & Prokopik’s own Angela Garcia Kozlowski, Esq. and David A. Skomba, Esq. As a result of Ms. Kozlowski’s and Mr. Skomba’s tireless efforts in representing the Respondents before the Commission, the Circuit Court for Harford County, the Court of Special Appeals, and finally the Court of Appeals, we received a favorable decision from the Court of Appeals. The court held that a summary denial of a motion to reopen or modify under Labor & Employment §9-736 (b) is not subject to judicial review or appeal.

Linda A. Sanders, (hereinafter referred to as “Claimant”) was employed by the Board of Education for Harford County as a bus driver. On October 7, 2014, the Claimant was involved in a work accident involving a special needs student wherein she sustained injuries to her head, neck, spine, and left arm. The Claimant subsequently filed a claim with the Commission and sought authorization for physical therapy and surgery directed at the left shoulder. Following a hearing on the merits, the Commission denied authorization for surgery but granted authorization for physical therapy. The Claimant did not file a petition for judicial review (“appeal”), nor did she file a request for rehearing. Instead, she underwent surgery through her private health insurer.

Over three years later, the Claimant filed a request for modification of the earlier order, wherein surgery was denied. She sought authorization for the surgery and payment of surgery bills in her request. The Commission summarily denied the request, and the Claimant filed a petition for judicial review in the Circuit Court for Harford County. The Respondents filed a motion to dismiss, asserting that the Commission’s summary denial was not subject to judicial review. The motion to dismiss was granted in favor of the Respondents.

Roughly three months later, the Claimant filed a second request for modification wherein she sought the same relief as in the earlier modification request. The Commission again summarily denied the request, and the Claimant again filed a petition for judicial review in the Circuit Court for Harford County. The Respondents again filed a motion to dismiss, which was denied by the circuit court. The Claimant and Respondents then filed cross-motions for summary judgment. The circuit court ultimately ruled in favor of the Claimant and remanded the case to the Commission for further action on the second request for modification. The Respondents appealed this decision to the Court of Special Appeals.

The Court of Special Appeals eventually ruled in favor of the Respondents and held that the circuit erred in denying the Respondents’ Motion to Dismiss. The court explained that the Commission has broad discretion to deny a request to reopen summarily, and the summary denial is not subject to judicial review the Court of Appeals appealed the case.

After a thorough review and discussion of the applicable authorities, the Court of Appeals held that “where a party requests that the Commission reopen or modify a claim under LE Section 9-736(b) and the Commission summarily denied the request without a hearing and does not consider new evidence or the merits of the request to reopen/modify or make findings with respect to the merits of the request or of the earlier order in a new or amended order denying the request, the Commission’s denial is not subject to judicial review.”

The Court of Appeals explained that pursuant to the plain language of Labor and Employment § 9-736 (b), the Commission is vested with “wide discretion to either modify a finding or order that has previously issued or not to do so under LE 9-736(b), provided that a request to modify is made within the statutory limitations period of five years outlined under LE 9-736(b)(3).”  Following an application of a party for modification of an order under LE 9-736(b), the Commission may either grant the request, hold a hearing at which evidence is considered, and afterward issue a decision granting or denying the requested relief. Conversely, the Commission may also deny the request to reopen or modify the order without reopening the case for receipt of additional evidence or a hearing and without considering the merits of the request or earlier order and making new findings. This later course of action, the Court of Appeals explained, “is generally called a summary denial.”

In reaching this decision, the Court of Appeals explained that although Labor & Employment § 9-737 generally provides for judicial review of a decision by the Commission where a petition for judicial review is filed within thirty days after the date of the mailing of the Commission’s order that, “nevertheless, our case law makes clear that the summary denial of a request to modify under Labor & Employment § 9-736(b) is not subject to judicial review.” The court further explained that consistent with more than a century of developing case law, a refusal to reopen a claim constitutes a decision of the Commission, but concluded that such a decision is merely one “not to interfere with a previous decision settling the merits of the instant claim” and that such a decision “is not one intended to be included under a general statutory allowance of an appeal from any decision.” Since, in the instant case, the Claimant filed a request for modification of the Commission’s initial order, which was summarily denied, without reopening, and without addressing the merits of the underlying claim or veracity of the initial order, the Court of Appeals held that the Claimant was not entitled to judicial review of said denial.

Written by associate Kara Parker.

 

ATRI’s White Paper: Understanding the Impact of Nuclear Verdicts on the Trucking Industry

In June 2020, the American Transportation Research Institute (“ATRI”) released an 80-page report summarizing its comprehensive research into large “nuclear verdicts” over the past 15 years. The study, “Understanding the Impact of Nuclear Verdicts on the Trucking Industry,” analyzes litigation data from over 600 cases between 2006 and 2019.   The data was collected from multiple sources in the industry, including a litigation database firm. In sum, the data reveals that jury verdicts against trucking companies are increasing at an alarming rate.

According to the study, in the first five years of the data (i.e., 2006-2009), there were only 26 cases with jury verdicts over $1M. From 2012 to 2019, there were nearly 300 cases with jury verdicts over $1M – a 335% increase. The number of verdicts greater than $1M but less than $2M increased by 300% in the same period. Further, the number of verdicts over $10M doubled in the last five years of the data.

ATRI’s research revealed that the average verdict between 2006 and 2019 was $3.16M, with a large standard deviation of $7.19M.  However, the average size of verdicts from 2010 to 2018 increased from $2,305,736 to $22,288,000 – a 967% increase.

While it is often argued that nuclear verdicts reflect real-world cost increases, the data shows that the verdict’s size has far exceeded standard inflation and healthcare cost increases. From 2010 to 2018, mean verdict awards increased 51.7% per year, in contrast to inflation and healthcare costs, which on average grew 1.7% and 2.9% per year, respectively.

In addition to data analysis, ATRI interviewed defense attorneys, plaintiff attorneys, insurance agency brokers, insurance executives, and underwriters. The interview subjects identified six categories which they deemed to influence large verdicts: 1) prevention; 2) crash-related details; 3) post-crash/pre-litigation stage; 4) litigation strategies; 5) unfavorable practices; and 6) additional factors.  The data analysis confirmed that the type of injury, number and type of parties involved, and even vehicle types had a statistically significant impact on verdicts.

Ultimately, ATRI concluded that a “comprehensive and multifaceted program” is required to reign in the nuclear verdict trend. Such a program must address state and federal litigation landscapes, modified approaches to trial preparation, new safety compliance standards, broader fraud investigations, and expanded strategy and information-sharing among the defense bar.

COVID-19 Presumption Legislation Updates

COVID-19 Presumption Legislation Updates – Maryland

COVID-19 Presumption Legislation Updates – Virginia

COVID-19 Presumption Legislation Updates – D.C.

COVID-19 Presumption Legislation Updates – Delaware 

COVID-19 Presumption Legislation – District of Columbia

The DC Council has enrolled changes to various statutes relative to COVID-19 and workers’ compensation, and unemployment benefits will be discussed in further detail below.  These proposed changes were signed by Mayor Muriel Bowser on February 26, 2021. They will expire in 90 days, but more temporary legislation is likely pending. Information about the state of the proposed changes can be found here: https://lims.dccouncil.us/Legislation/B24-0058.

The major proposed changes so far relative to workers’ compensation benefits note an “injury” under public and private sector workers’ compensation law would now include the contracting of COVID-19 in the course of and within the scope of employment.  However, at this time, there is no specifically-tailored COVID-19 “presumption” legislation for workers’ compensation claims, such as those proposed or adopted in other jurisdictions.  D.C. proposals/laws relative to COVID-19 and workers’ compensation benefits appears to primarily ensure workers can file for workers’ compensation benefits if they suspect they contracted COVID-19 (defined in the statute as “the disease caused by the novel Coronavirus SARS-CoV-2 or any of its recognized mutant variations”) in the course of and within the scope of employment.  In layman’s terms: an employee could file a claim for workers’ compensation benefits after contracting COVID-19 and missing time from work, or if that person has to take unpaid time off from work because of exposure to COVID-19.  For those familiar with D.C. workers’ compensation law, this should come as no surprise; the burdens of proof and persuasion are heavily in the claimants’ favor when filing a claim.  The D.C. Department of Employment Services (DOES), which encompasses the workers’ compensation system as well as unemployment and other employment-related offices, has produced a chart of “COVID-19 Scenarios and Benefits Available” as well, found here: https://does.dc.gov/sites/default/files/dc/sites/does/publication/attachments/DOES-covid-19-scenarios-and-benefits_v13_0.pdf.   The chart states that if the employee is exposed to the virus during regular work duties and lost wages as a result of either becoming ill or having to quarantine due to exposure, he or she may be entitled to workers’ compensation benefits.  Of course, the chart is not the “law,” but it can give some insight into the current state of benefits available in different scenarios.

There are a few other portions of related laws that may eventually make their way into the workers’ compensation scheme in D.C., either through changes to the statutes or through caselaw.  For example, the Displaced Workers Right to Reinstatement and Retention Amendment Act of 2020 (passed January 13, 2021) provides that employers and contractors in retail, hospitality, or other covered industries must offer certain employees “displaced” by COVID-19 reinstatement to their previous positions or to a substantially similar position as positions become available.  This kind of scenario may spill over into the workers’ compensation field, but that is only this attorney’s conjecture at present.

Additionally, the proposed changes expand an employer’s obligation to report the injury, illness, or death to include if an employer knows of an employee who has contracted COVID-19 in the course of and within the scope of employment or whose contact with others in the course of and within the scope of employment makes the contracting of COVID-19 probable.   This reporting obligation, if it becomes law, will most likely result in many employers filing more Employer’s First Reports (DCWC Form No. 8).  Form 8 filings do not constitute filing a claim, nor is it evidence of the truth of the claimant’s allegations, but it does start the timetable for the statute of limitation on indemnity benefits of filing if an employer learns of an employee’s potential exposure.

The attorneys at Franklin and Prokopik have been preparing for additional discovery in this regard and strategizing ways to limit a claimant’s allegation of contracting COVID-19 in the workplace (as opposed to elsewhere) because of the lack of presumption legislation to date.  Due to the current uncertainty in D.C. workers’ compensation law relative to COVID-19, it is strongly recommended one discusses the matter with counsel when dealing with a potential COVID-19 claim.

UPDATE: Enacted – signed by Mayor. Effective for 90 days; more temporary legislation is supposedly pending.

COVID-19 Presumption Legislation Updates – Maryland

COVID-19 Presumption Legislation Updates – Virginia

COVID-19 Presumption Legislation Updates – Delaware 

COVID-19 Presumption Legislation – Virginia

COVID-19 was declared a public health emergency on January 31, 2020, by the Virginia Department of Health and Human Services. The Coronavirus Aid Relief and Economic Security Act, 116 P.L. 136 (March 27, 2020) (“CARES Act”). COVID-19 remains a pandemic in the United States.

COVID-19 is a disease to which the general public is exposed outside of employment.  Presently, no case law in Virginia specifically addresses pandemic viruses as occupational diseases and workers’ compensation benefits.

Depending on the circumstances, a disease, such as COVID-19, may be compensable as an occupational disease.

To prove an occupational disease, an employee must establish that he suffers an illness arising out of and in the course of employment “but not an ordinary disease of life to which the general public is exposed outside of employment.” Va. Code § 65.2-400(A). To meet this burden, the employee must prove (1) a direct causal connection between the work conditions and the occupational disease; (2) that the disease can be seen to have followed as a natural incident of the work as a result of the exposure due to the nature of the employment; (3) that the employment proximately caused the disease; (4) that it was not a disease to which he would have had substantial exposure outside of employment; (5) it was incidental to the character of the business, and not independent of the employee/employer relationship; and (6) the disease originated in the risk of employment and flowed as a direct consequence of it. Virginia Code § 65.2-400(B).

A disease that is not compensable under Virginia Code § 65.2-400, because of the possibility of substantial exposure outside of employment, may still be compensable under Virginia Code § 65.2-401. For an ordinary disease of life to be compensable as an occupational disease, the employee must establish by clear and convincing evidence that the disease arose out of the employment and did not arise from causes outside the employment and that the disease either: (1) follows as an incident of occupational disease; (2) is an infectious or contagious disease contracted by workers in the health care industries; or (3) is characteristic of the employment and was caused by conditions peculiar to such employment. Virginia Code § 65.2-401. The elements required to prove an ordinary compensable disease of life must be established by clear and convincing evidence and not a mere probability.  The employee bears the burden to prove all elements of Virginia Code § 65.2-401, including that the disease did not result from causes outside his employment.

A bill has been sent to Governor Northam. If signed into law, it would provide first responders, including firefighters, law enforcement, EMS providers, and correctional officers exposed to COVID-19 while on the job.  The COVID-19 related illness would be compensable “unless such presumption is overcome by a preponderance of competent evidence to the contrary.”

According to the bill, the employee must have a diagnosis of COVID-19 from a licensed physician, after either a presumptive positive test or a laboratory-confirmed test for COVID-19, and presented with signs and symptoms of COVID-19 that required medical treatment.

The bill states that the presumption would apply to death or disability occurring on or after March 12, 2020, and before December 31, 2021.

I believe that COVID-19 claims that healthcare employees and emergency response personnel initiate are likely to be analyzed under Va. Code §65.2-401 covers employment in a hospital, healthcare, emergency rescue, and similar employment settings.   For all other individuals, COVID-19 claims could fall within the “ordinary disease of life” classification.

COVID-19 Presumption Legislation Updates – Maryland

COVID-19 Presumption Legislation Updates – D.C.

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