When You Read Case Law:
Do You Ask Questions?  Do You Get Answers?
If Not, How Can You Really Understand What You Read?

Whenever I read new case law, questions always come to mind. These questions may just be factual, or they may have to do with the evidence put forth in the case or the strategies employed by the parties.  Regardless, unless those questions are answered, my understanding of the significance of the case and the impact it may have on future cases is incomplete.

Now for me, I call my good friend and renowned expert in workers’ compensation, John Dubreuil.  He can usually get me the answers I need, and from there I can evaluate the meaning and significance of the holdings.

But what about you?  Your resources may be different (i.e. one or more favorite attorneys or firms that you or your company uses), but the process should be the same...

For instance, since January 1, 2008, five new cases of significance have been reported and are contained on the WCCP’s Case Law Update webpage.  Several of those cases raise questions that must be answered if one is to truly understand the holdings:

• Roberson v. St. Johns County School Bd - Re: Statute of Limitations & Estoppel
  2008 FL App. LEXIS 708 (FL 1st DCA Jan 23, 2008).
  
  A number of questions are left unanswered in this case, and one would have to read the claim file or the trial transcript to get some answers. First, was the initial acceptance and subsequent “denial” properly done (i.e. the 120-Day Rule)?  If so, what, if any, obligation does the E/C have to do anything after denial? If none, then the “wrong” done here was sending the DWC-4 reflecting the zero percent rating.  But would this not be harmless error? If the case was not compensable, and the claimant was properly advised of the denial, then the rating should not have been an issue.  For this reason, it would not be wise to use a case like this to support any position without answers to those questions.
• AMS Staff Leasing, Inc./Andrews Roofing, LLC/Aspen Administrators/Providence Property & Casualty Insurance Company, Appellants, V. Jesus Infante Arreola, Appellee - Re: Medical Care Outside the United States
  2008 FL App. LEXIS 993 (FL 1st DCA 2008).
  
  The big question here is the forum for this issue. Should not this fight have been waged before AHCA? Would the result have been different?
• Wal-Mart v. Thompson, 2008 FL App. LEXIS 1433 - Re: PTD Under the New Law
  (FL 1st DCA, February 6, 2008).
  
  OK, people.  I know this is not politically correct, but what the heck happened here?  Who fell asleep at the switch? 
  
  The case deals with PTD under the new law, but really points out the terrible things that can happen when the defense just sits on its hands and allows the claimant to present unrebutted evidence. It brings out presumption and burden of proof issues, and it strikes right to the heart of what to do and what NOT to allow to happen when handling a potential PTD claim, i.e. I wonder about the claimant’s voc expert’s testimony that “claimant was "ruled out on all jobs within a 50-mile radius of her home."  I strongly suspect that if the E/C had utilized an effective reemployment strategy, this testimony could have easily been rebutted. I wonder who was driving this case, the defense attorney or the E/C? Whoever it was, they clearly missed the boat.

If you’re not asking these questions, you’re in trouble...

• Rodas v. Commercial Forming Corp. - Re: Change of Venue
  2008 FL App. LEXIS 1806 (FL 1st DCA February 2008).
  
  Granted, this is probably not the most significant of cases, but the question that needs to be asked here is “why”? If the main case had already been settled, what standing would the claimant have to appeal the JCC’s order? And why would the E/C stipulate to this? There may be good reasons, but without more information, it looks like someone may have gotten duped here and a lot of extra and unnecessary costs were ultimately incurred in this case.

One characteristic of a seasoned and expert claims professional is the look at a case, or a factual situation, and dissect the central issues that must be addressed. Can you do that? Do you do that?

It’s a question only you can answer.

James W. Greer, CPCU
President, PCCP Association
AE21 Incorporated & AE21 Online
Educational & Professional Development Services