Gerlach vs Liberty Mutual
AWCB Decision No 16-0003
The Employee was injured while working at a fishing lodge in Yakutat. When he reported the injury, the Employer claimed he was not an employee but an independent contractor instead and therefore not entitled to Workers Compensation benefits. In analyzing the “relative nature of the work test”, the Alaska Workers Compensation Board ruled that the claimant was an employee therefore he was entitled to workers compensation benefits for his work-related injuries.
Williams vs McDonalds
AWCB Decision No 15-0116
In Williams v McDonalds the Board made several rulings, the most important is that the old "pre-existing condition" defense used by the Employer to refuse benefits was invalid. The Board ordered the Employer to pay all back temporary total disability benefits plus penalties and to immediately start paying medical benefits, including a needed back surgery. In this case, the Employee had an injury and back surgery in 1987. For the following 27 years, he worked hard and had absolutely no back pain other than normal strains. In 2014, he slipped on ice and fell, injuring his back again. The 2014 employer claimed that his injury was "preexisting" because of the 1987 injury. The Board ruled the 2014 injury was not preexisting because the Employee had no pain complaints in the 27 years before the 2014 injury and he had not seen a doctor from the time he recovered from the 1987 surgery until the 2014 fall.
Marquez v. Sunset Haven
AWCB Decision No 15-0086
On July 22, 2015, the Alaska Workers Compensation Board issued a decision in Marquez v Sunset Haven, AWCB Decision No. 15-0086 awarding the Employee all of the benefits she requested! The decision can be found at the Board's site: Alaska Workers Comp Case 15-0086
Marquez was working as a personal care attendant for Sunset Haven. She was paid a salary plus room and board plus cash under the table for working overtime. She fell in November of 2014 fracturing to vertebrae. On account of her injuries, she was unable to work as an attendant and was forced to move from the home. The Employer, whose workers compensation insurance had lapsed, disputed that the Ms. Marquez had been injured while working for him. The Board found that Ms. Marquez was injured while she was working, that she had reported her injury to him timely, that she was entitled to back benefits which compensated her for her lost wages plus room and board, medical benefits, plus 25% penalties for the Employer’s failure to pay her disability timely, plus interest, plus fees and costs. The Board ordered the Employer to pay Ms. Marquez what he owes her and if the does not pay within 30 days, the Alaska Workers Compensation Guaranty Fund will pay the judgment.
Baker vs Liberty Northwest
AWCB Decision No 15-0069
Liberty Northwest was represented by Holmes, Weddle & Barcott. The Employee had negotiated a settlement by which Liberty agreed to assume liability for paying medical bills in excess of $100,000 and for holding the Employee harmless on the bills. After the settlement was approved by the Board, Liberty refused to pay the Providence bill, demanding that Providence negotiate the amount. Providence refused and began pursuing the Employee again for payment. Keenan Powell filed a Claim against Liberty. Liberty’s response was that it was only responsible for reimbursing the Employee if he paid the bills. After a hearing, a Decision and Order was entered finding that the Employee was entitled to payment of the bills, the providers were entitled to payment of the bills, that Liberty had acted in bad faith when refusing to pay the bills and mandating Liberty pay the bills with 25% penalties.
King vs Liberty Northwest
AWCB Decision No 13-0010
Liberty Northwest was represented by Holmes, Weddle & Barcott. The insurance company had provided the Employee with a “prescription card” to use to fill his prescriptions. On at least four occasions, the pharmacy would not fill the prescriptions because it called the insurance company and the insurance company refused to authorize the specific prescription. The insurance company’s position is that it does not have a duty to pre-authorize prescriptions and instead is only obligated to reimburse for prescriptions paid by the Employee. At the hearing, Keenan Powell was successful in obtaining an order from the Board requiring the insurance company to arrange for filling the prescriptions when they are presented, plus a finding that the insurance company had acted in bad faith and would be reported to the Division of Insurance for an investigation, plus fees and costs. The order has subsequently been appealed and the appeal is on-going.
Carter vs Anchorage Daily News
AWCB Decision No 13-0050
The Employer’s adjuster controverted future benefits on the basis of its doctors opinion that the injury was not work-related. The Employer was represented by Holmes, Weddle and Barcott. Following a hearing, Keenan Powell was successful in obtaining an order for a Second Independent Medical Evaluation (SIME) and fees and costs.
Guinard vs Liberty Mutual/Liberty Northwest
AWCB Decision 13-0017
Liberty was defended by in-house counsel. Shortly after the Employee herniated a disc in his back at work, the Employer controverted all benefits claiming that surveillance videotapes did not show him being injured. It was proven at the hearing that the Employer had in fact destroyed the videotapes that would have shown the incident. Keenan Powell was successful in obtaining an award from the Board for past temporary total disability (TTD), past temporary partial disability (TPD), past medical bills, past transportation, fees and costs. After the hearing, the Employer subsequently agreed to a SIME and to a reemployment evaluation and paid , “41k” (stipend) payments during the rehabilitation process.
O'Hara vs Zurich American
AWCB Decision 12-0208
Zurich was defended by Holmes, Weddle and Barcott. The insurance company controverted all benefits based upon the opinion of his doctor that the Employee’s symptoms were not work-related and then refused to agree to a Second Independent Medical Evaluation (SIME). After a hearing before the Board, Keenan Powell was successful in obtaining a SIME on the issues of causation, compensability, medical treatment, disability, medical stability and PPI rating. The SIME took place and the case subsequently settled.
Weese vs Alaska National Insurance Co
AWCB Decision 12-0196
Alaska National was defended by Farley & Graves. The Employee injured her shoulder while working as a bus attendant for handicapped children. The insurance company sent her to Dr. Marilyn Yodlowski who claimed that her injury was not work-related and based upon Dr. Yodlowski’s opinion, the insurance company controverted all her benefits and additionally refused to agree to a Second Independent Medical Evaluation (SIME) because the Employee was unable to obtain medical opinions after the controversion which would dispute the controversion. Keenan Powell was successful in obtaining a decision from the Board ordering a SIME on the issues of causation, compensability, medical treatment, medical stability and whether there would be a PPI rating. The case settled shortly after the decision with the insurance company agreeing to pay for the surgery, total disability (TTD), PPI and fees and costs.
Torres-Soria vs Seabright Insurance Company
AWCB Decision 11-0008
Seabright was defended by Kara Heikkila. The Employer controverted all benefits six months after the Employee sustained a herniated disc in a lifting injury on the grounds that its physician stated that the injury was not work-related. During the course of the litigation, the Employer subsequently agreed to pay for medical treatment and temporary total disability (TTD). After several months of litigation, depositions and a hearing, Keenan Powell was successful in obtaining a decision from the Board awarding past medical benefits, interest on late paid TTD, “41k” (stipend) payments during the rehabilitation process, an order for a PPI rating evaluation, transportation benefits, fees and costs.
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