In this week’s Alabama Law Weekly Update, we report on two cases from the Alabama Court of Civil Appeals, both pertaining to the Alabama Workers’ Compensation Act. In the first case summarized below, the Alabama Court of Civil Appeals issued an opinion concerning the correct procedure for an employer to use when it seeks to terminate an employee’s established right to medical benefits under a settlement agreement. In the second case summarized below, the Court addressed the requirements a medical item or device must meet in order for an employer to be required to provide that device to an employee under the Act.
Total Fire Protection, Inc. v. Jean, No. 2130158 (Ala. Civ. App. August 22, 2014) (holding that an employer seeking to terminate an employee’s established right to medical benefits under a settlement agreement must file a new action for that purpose rather than merely filing a motion seeking to terminate a previously entered court judgment which had approved and implemented the settlement agreement).
An employee filed a claim seeking workers’ compensation benefits under the Alabama Workers’ Compensation Act following wrist injuries he received in a work-related accident. On September 29, 2005, the trial court approved a settlement agreement entered into by the employee and employer under which the employee received a lump-sum amount of compensation with medical benefits to remain open.
On June 5, 2006, while employed by a different employer, the employee visited his doctor to be treated for wrist pain. He was diagnosed with carpal tunnel syndrome which was attributed to his current employment. The former employer, which had been a party to the settlement agreement, filed a motion in the trial court to terminate the employee’s medical benefits on June 28, 2006. In its post-judgment motion, the employer sought to terminate its settled liability for future medical treatment on the substantive ground that the employee’s subsequent employer should bear that responsibility under the last-injurious-exposure rule. The trial court granted this motion to terminate medical benefits the following day, on June 29, 2006, without a hearing or waiting for any sort of response or opposition from the employee.
Approximately 22 months later, on April 29, 2008, the employee filed a motion with the trial court seeking relief from its previous order. The trial court granted the employee’s motion for relief, and on August 9, 2013, the trial court entered a judgment denying the employer’s motion to terminate medical benefits. The employer appealed.
On appeal, the employer first asserted that the trial court exceeded its discretion in granting the employee’s motion for relief from the June 29, 2006 court order which had granted the employer’s motion to terminate medical benefits. The employer argued that the trial court had no basis for setting aside the order. The Court of Civil Appeals affirmed the trial court’s decision. The Court ruled that under the Alabama Workers’ Compensation Act, it was improper for the employer to have sought to terminate its liability for the payment of medical benefits to the employee pursuant to its settlement agreement through the filing of a post-judgment motion. The employer instead should have filed a new petition, and any controversy as to the employee’s right to medical benefits should have been decided by trial and not by a motion.
In coming to this conclusion, the Court noted that this case was the first in which an employer had attempted to use the last-injurious-exposure rule offensively to terminate its agreed liability as part of a settlement agreement for future medical expenses via post-judgment practice rather than through filing a new legal action. Ordinarily, an employer raises the last-injurious-exposure rule as a defense to a claim for medical treatment filed by a former employee. The Court also pointed out that just as a circuit court cannot award an employee medical benefits based on a mere allegation in a motion that the employee requires medical treatment due to a work-related injury, likewise a circuit court cannot terminate an employee’s established right to receive medical benefits based on a mere allegation in a motion that the employee has sustained a new or aggravated injury for which his new employer bears exclusive responsibility.
The employer’s second argument on appeal was that the trial court had erred in how it applied the last-injurious-exposure rule. The rule provides that liability for medical treatment of an injury falls on the employer in whose employment the employee last experienced trauma that caused or contributed to the injury. Under the last-injurious-exposure rule, the employer would remain liable for medical treatment for the employee’s wrist pain only if that pain could be characterized as a “recurrent injury”, as opposed to a new injury or an aggravation of the employee’s original injury. The Alabama Court of Civil Appeals summarized the issue as follows: “[W]hen an employee experiences expected ongoing symptoms from an original compensable injury as a result of routine physical activities in subsequent employment, in the absence of evidence of some additional harmful change to the underlying anatomical condition of the employee, those expected ongoing symptoms will be treated under Alabama law as a recurrence of the symptoms from the original injury and not as an aggravation of the original injury.”
In affirming the trial court’s judgment that the employer remained liable for the employee’s medical treatment, the Court of Civil Appeals found that there was substantial evidence before the trial court to support the trial court’s finding that the employee’s wrist pain was recurrent in nature.
Flanagan Lumber Company, Inc. v. Tennison, No. 2120911 (Ala. Civ. App. August 22, 2014) (discussing the requirements for a device to qualify as an “other apparatus” to make it necessary for an employer to provide the device to the employee under the Alabama Workers’ Compensation Act).
An employee filed a claim seeking workers’ compensation benefits under the Alabama Workers’ Compensation Act following a lumbar back injury he received in a work-related accident. On May 22, 2011, the trial court entered an order approving a settlement agreement entered into by the employee and employer. Pursuant to the terms of the settlement agreement, the employer remained obligated to pay the employee’s future medical expenses resulting from the accident to the extent provided by the Alabama Workers’ Compensation Act.
Following the settlement, the employee continued to experience lower back pain and related symptoms from his work related injury. The employee inquired of his physician about obtaining a recommendation for a walk-in bathtub to be installed in the employee’s home. Although the physician wrote two letters of recommendation to the employer that a walk-in tub was “medically necessary” for the employee, the employee’s requests for a walk-in tub were denied on the basis that a walk-in tub (the cost of which would exceed $18,000) was not included in the future medical expenses for which the employer was obligated to pay under the settlement agreement and the Alabama Workers’ Compensation Act.
On August 28, 2012, the employee filed a “Motion for Determination of Workers’ Compensation Medical Benefits Issue”, requesting that the trial court rule on whether the employer would be required to provide the employee a walk-in bathtub. The trial court held a hearing on the issue and heard arguments from both sides before ruling that the walk-in tub was a “reasonably necessary medical apparatus”, thus requiring the employer to provide the employee with a walk-in bathtub pursuant to Section 25-5-77(a) the Alabama Workers’ Compensation Act. The employer appealed.
At issue in the appeal was whether the walk-in bathtub constitutes an “other apparatus” under Section 25-5-77(a) of the Act, which provides that an employer is required to pay for “reasonably necessary medical and surgical treatment and attention, physical rehabilitation, medicine, medical and surgical supplies, crutches, artificial members, and other apparatus as the result of an accident arising out of and in the course of the employment.”
The Alabama Court of Civil Appeals recognized that the definition for “other apparatus” under the Act is as follows: “[I]n order to constitute an ‘other apparatus’ and be compensable as a medical benefit under [Section 25-5-77(a)], the item must be (a) reasonably necessary and
(b) intended to improve the injured employee’s condition, to prevent the further deterioration of the employee’s condition, or to relieve the employee from the effect of his condition by restoring the employee to a basic level of appearance or functioning. The determination of what constitutes a reasonably necessary ‘other apparatus’ should be made on a case-by-case basis.”
The Alabama Court of Civil Appeals reversed the judgment of the trial court and held that the employer could not be required to provide a walk-in bathtub to the employer. It found that the evidence before the trial court (mostly in the form of deposition testimony of the employee’s physician) did not establish that the walk-in bathtub was reasonably necessary under the facts of the case. The Court found that the walk-in bathtub would not improve the employee’s condition because “potential temporary alleviation of certain symptoms does not constitute an improvement of one’s condition”. The Court also found that the walk-in bathtub would not prevent a deterioration of the employee’s condition. Finally, the Court reasoned that the mere potential for temporary symptom relief afforded by a walk-in bathtub was not sufficient to meet the requirement for an “other apparatus” that the walk-in bathtub must relieve the employee from the effect of his condition by restoring him to a basic level of appearance or functioning.