February 10, 2009

Annals of Compensability: Arthur Pierce's Work-Related Fall

Arthur Pierce worked for a trucking company in Virginia. In September 2006 he was found lying beside his dump truck. He had suffered a severe brain injury and was unable to communicate any details about what had happened. Physicians speculated that he had fallen from the truck (falls are the number one cause of injuries to drivers), but there was no proof and no witnesses. The unfortunate driver required constant care until his death in January 2008.

Due to the uncertainty of the circumstances surrounding the injury, Pierce was denied workers comp benefits. (This would have been a very large claim.) Ironically, if he had been found dead, the death would have been deemed compensable: when an employee is found dead at work, the fatal injuries are presumed to arise out of employment, unless there is a "preponderance of evidence" to the contrary.

Legal Remedy Fails
Lawmakers in Virginia, sympathizing with the plight of Pierce and his widow, proposed changes to the state's comp statute. Senate Bill 821 was aimed specifically at employees who suffer severe brain injuries and are unable to recall the relevant circumstances of the accident. (How many of these cases would there be in a year - or even a decade?)

Alas, SB 821 died in committee. Opponents feared that the bill would increase the likelihood of workers' comp fraud. They were actually concerned that employees would fake severe brain injuries to secure benefits. To be sure, fraud can be a real problem, but how can you possibly fake a brain injury?

SB 821 would have come too late to help Pierce, and was so specific in nature, it would probably never have been helpful to severely injured workers. It was a mostly a symbolic gesture toward a family that was not served well by the Virginia comp system. Arthur Pierce's work-related fall simply fell through the cracks.



It is possible to fake a brain injury. You can get all the information needed on the internet. You did not indicate if any CT Scans were done to rule out trauma. If trauma showed up on the CT Scan I'd say the claim was compensable.

Since he was denied workers comp benefits I suggest the faamily hire a very good personal injury attorney and remind the company and their liability insurer why workers compensation is an exclusive remedy.

I agree with Charles. Although, I suspect it isn't the employer that denied the injury. By denying the claim, the carrier transfered their work comp liability onto the employer. The employer should pro-actively sue the carrier for breach of contract and bad faith.

Gee, maybe he could have faked his death as well!

There's no reason why the presupmtion of work-relatedness should not be extended to this case - and others like it. He was found at the bottom of his work vehicle! Enough of these apologies for rapacious insurance companies!

This is just another example of insurers' abuse of power and the propensity of the poltical class to represent their business 'clients'.



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This page contains a single entry by Jon Coppelman published on February 10, 2009 4:27 PM.

News roundup: Letters of credit, nuclear workers, NY construction, collaborative whiteboard, and more was the previous entry in this blog.

Cavalcade of Risk Issue #71 is the next entry in this blog.

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