6 Recent WC Legal Rulings You Should Know About

Murder in the workplace, PTSD, softball injuries and other workers' comp litigation disputes are being brought before judges across the country.
By: | November 15, 2018 • 10 min read

Comp Doesn’t Cover Worker’s Murder by Coworker

Williams v. Park Family Health Care PC, 32 MIWCLR 70 (Mich. C.A.C. 2018)

Ruling: The Michigan Compensation Appellate Commission held that sufficient evidence supported the magistrate’s finding that the worker’s death, when she was killed by a coworker she was previously dating, was not work-related.

What it means: In Michigan, an employee’s death caused by the intentional act of a coworker motivated by private reasons is not work-related.

Summary: The commission held that sufficient evidence supported the magistrate’s finding that the worker’s death, when she was killed by a coworker she was previously dating, was not work-related.

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Prior to the murder, the worker broke up with the coworker and began dating another man. The coworker let himself into the employer’s premises, killed the worker, set the building on fire, and then killed himself.

The commission found that although the worker’s death occurred in the course of employment, as she was at work on the employer’s premises at the time of her death, her death did not arise out of her employment.

The friction between the worker and the coworker developed from the failure of their personal, off-duty relationship when she found out that the coworker was married and not seeking a divorce, which was followed by several incidents involving the worker’s new boyfriend.

The fact that the coworker used his keys to the employer’s premises on the day of the shooting was merely incidental to the fact pattern.

His possession of the keys did not impute any exacerbation of the worker’s personal situation to the employer nor did it mean that the employer contributed to facilitating her death.

Further, nothing in the record indicated that the feud between the worker and the coworker was in any way connected with the employment.

Worker Proves Compensable Claim for PTSD After Restaurant Shooting

Dickey v. Delphi Automotive Systems LLC, 32 MIWCLR 57 (Mich. C.A.C. 2018)

Ruling: The Michigan Compensation Appellate Commission held that the requisite evidence supported the magistrate’s decision awarding benefits to the worker for post-traumatic stress disorder from a work-related incident.

What it means: In Michigan, an employee’s experience of taking cover in a restaurant during a business meeting while several people near him are killed by gunmen constitutes a compensable claim for post-traumatic stress disorder.

Summary: The Commission held that the requisite evidence supported the magistrate’s decision awarding benefits to the worker for post-traumatic stress disorder from a work-related incident.

Evidence indicated that the worker was on a business trip and while at a restaurant in Mexico with clients and workers, witnessed gunmen kill several people in the restaurant. The worker and his party took cover beneath their table and then fled the restaurant.

After returning to Detroit, he became symptomatic and was subsequently diagnosed with PTSD. The commission noted that there was an actual employment event — a business dinner in which the worker witnessed the murders at the restaurant.

The commission also said that an objective analysis of a similar generic situation leads to a conclusion that a normal and healthy individual would view having people being murdered right in front of him as horrific, stressful, and traumatizing.

Further, it was logical to conclude that one who witnesses a horrific, stressful, and traumatizing event such as a multiple murder could possibly be afflicted with PTSD.

Also, the commission rejected the employer’s argument that the worker’s own actions were the cause for his continuing disability.

Although the employer’s examining doctor found the worker’s ongoing symptoms were from side effects of medication and the worker should be weaned off such medications, the magistrate reasonably relied on the contrary opinion of the treating doctors, who were actually increasing the worker’s medications.

Worker Scores Benefits for Injury Sustained in Softball Tournament

New York City Department of Corrections, 118 NYWCLR 125 (N.Y. W.C.B., Panel 2018)

Ruling: The New York Workers’ Compensation Board held that a worker’s knee injury, sustained while participating in an off-duty softball tournament, arose out of and in the course of his employment.

What it means: In New York, a worker’s injuries sustained in an off-duty softball tournament may be compensable where the employer actively encourages its employees to participate.

Summary: A worker injured his knee while participating in an off-duty softball tournament. He testified that his supervisor sent him a personal invitation to the event suggesting that he participate.

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Also, his supervisor’s secretary emailed him and encouraged him to participate in the event. He was not paid to participate in the event.

The employer paid for the permits while the participants paid a $45 fee. The workers’ compensation law judge found the employer sponsored the softball event, and therefore, the injury was compensable.

In affirming, the board noted that the worker distinguished his case from the facts of the cases relied on by the employer.

The employer argued that the instant case was similar to the facts of a prior decision, where the worker was participating in an athletic tournament, was required to pay a fee, and the commissioner of the Department of Corrections attended the games.

However, in that case, the evidence did not support a finding that the employer actively encouraged employees to participate.

In contrast, the evidence in the instant case demonstrated that the employer made sure that its employees were well-aware of the tournament and the worker’s supervisor’s secretary personally emailed him and encouraged him to participate.

Delay in Requesting Benefit Review Undermines Worker’s PTSD Claim

Lyles v. Titlemax of Tennessee, No. W2017-00873-SC-WCM-WC (Tenn. 09/14/18)

Ruling: The Tennessee Supreme Court held that a worker’s claim was barred when she failed to file a request for a benefit conference review within one year of the date of her treatment with the employer-provided counselor.

What it means: In Tennessee, the right to compensation is barred unless the required notice is given to the employer and a benefit review conference is requested within one year of the accident.

Summary: A worker for Titlemax of Tennessee was working when an armed robbery occurred where an individual entered the store, jumped over the desk, and brandished a gun while demanding money.

For several weeks after the incident, the worker experienced crying spells, nightmares, nervous, distress, and unable to focus.

Titlemax sent her to a counselor, who diagnosed her with post-traumatic stress disorder as a result of the robbery.

The worker eventually stopped seeing the counselor. More than one year later, she requested a benefit review conference. She subsequently filed a workers’ compensation claim.

The Tennessee Supreme Court held that the claim was barred by the statute of limitations.

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The court explained that the right to compensation is barred unless the required notice is given to the employer and a benefit review conference is requested within one year of the accident.

Here, the benefit review conference was requested more than one year after the armed robbery.

The worker asserted that although she knew she suffered an injury due to the armed robbery, she did not have knowledge that the injury she sustained was permanent at the time.

However, the court pointed out that she continuously experienced PTSD symptoms, and she did not initially believe that her symptoms resolved.

She said that she stopped treatment with the counselor provided by Titlemax because she “hoped she would be okay” even though she was still experiencing symptoms.

County Can’t Rebut Worker’s Showing of Total Disability

Harris v. Stone County Board of Supervisors, et al., No. 2017-WC-01396-COA (Miss. Ct. App. 09/25/18)

Ruling: The Mississippi Court of Appeals held that a worker was entitled to permanent total disability benefits.

What it means: In Mississippi, a worker can establish a prima facie case for total disability if, after reaching maximum medical improvement, he reports back to work for the employer and the employer refuses to reinstate or rehire him.

Once a worker makes a prima facie showing of total disability, the burden shifts to the employer to rebut or refute the worker’s evidence.

Summary: A worker for Stone County suffered a work-related injury to his left knee. He had worked for the county for 11 years cutting grass, keeping up the county buildings, and performing custodial duties.

After reaching maximum medical improvement, he asked the county about the possibility of employment that was less physically demanding. The county responded that there were no positions available within the worker’s restrictions.

The county’s vocational rehabilitation counselor said that he had the ability to be employed in a limited number of occupations in his geographic area.

The counselor identified employment opportunities, and the worker applied for the positions but he was unable to secure employment. The Mississippi Court of Appeals held that the worker was entitled to permanent total disability benefits.

The court rejected the county’s assertion that the worker was only entitled to permanent partial disability benefits.

The court found that the worker established a prima facie case of total disability because after he reached MMI and reached out to the county about employment that was less physically demanding, the county responded that there were no positions available within his physical limitations.

The court found that the county failed to rebut or refute the worker’s evidence. The worker was 50 years old with no vocational training past high school, and his entire employment history was limited to custodial and maintenance work.

He applied for all of the positions the counselor found but was not hired. The court pointed out that the range of pay for these positions, which the worker did not qualify for by education or training, was less than his preinjury earnings.

Also, the medical testimony showed that the worker sustained a permanent impairment and would not be able to be employed in a long-term job that required any significant physical demands.

Employer’s Decision to Fill Injured Worker’s Position Isn’t Discriminatory

In re BCI Coca-Cola Bottling Co. of Los Angeles, Inc., No. CAAP-14-0001135 (Hawaii Ct. App. 09/28/18, unpublished)

Ruling: In an unpublished decision, the Hawaii Intermediate Court of Appeals held that an employer did not discriminate against an injured worker when it refused to return her to her preinjury position.

What it means: In Hawaii, it is unlawful for an employer to discriminate against a worker solely because she suffered a work injury.

Summary: A worker for BCI Coca-Cola Bottling suffered a work-related injury and was placed on disability leave.

After she was on leave for 10 months, BCI hired a permanent replacement for her preinjury position.

The worker later sought to return to work in her preinjury position, but BCI refused to reinstate her to her former position because it had been filled.

The worker alleged that BCI subjected her to discrimination. The Hawaii Intermediate Court of Appeals held that BCI did not discriminate against the worker solely because she had a work injury.

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The court explained that the statute bars discrimination against a worker solely because she suffered a work injury.

BCI asserted that it refused to return her to her preinjury because the position was filled. BCI pointed out that the worker’s prolonged absence from work created a business hardship that required it to fill the position before she was able to return to work.

For nearly one year, two supervisors covered for the worker’s absence by learning her position and arriving to work two hours earlier than normal to perform her job in addition to their own duties.

The worker and her doctor could not determine when or if she would be able to return to work. Therefore, BCI replaced the worker with a permanent employee.

About 15 months after the injury, BCI learned that the worker was released to work. By that time, her preinjury position had been filled.

The court explained that the language of the statute did not suggest that employers were required to leave a vacated position open or hire temporary employees to replace an injured worker who may be unable to return to their previous employment for lengthy periods of time. &

Christina Lumbreras is a Legal Editor for Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

Exclusive | Hank Greenberg on China Trade, Starr’s Rapid Growth and 100th, Spitzer, Schneiderman and More

In a robust and frank conversation, the insurance legend provides unique insights into global trade, his past battles and what the future holds for the industry and his company.
By: | October 12, 2018 • 12 min read

In 1960, Maurice “Hank” Greenberg was hired as a vice president of C.V. Starr & Co. At age 35, he had already accomplished a great deal.

He served his country as part of the Allied Forces that stormed the beaches at Normandy and liberated the Nazi death camps. He fought again during the Korean War, earning a Bronze Star. He held a law degree from New York Law School.

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Now he was ready to make his mark on the business world.

Even C.V. Starr himself — who hired Mr. Greenberg and later hand-picked him as the successor to the company he founded in Shanghai in 1919 — could not have imagined what a mark it would be.

Mr. Greenberg began to build AIG as a Starr subsidiary, then in 1969, he took it public. The company would, at its peak, achieve a market cap of some $180 billion and cement its place as the largest insurance and financial services company in history.

This month, Mr. Greenberg travels to China to celebrate the 100th anniversary of C.V. Starr & Co. That visit occurs at a prickly time in U.S.-Sino relations, as the Trump administration levies tariffs on hundreds of billions of dollars in Chinese goods and China retaliates.

In September, Risk & Insurance® sat down with Mr. Greenberg in his Park Avenue office to hear his thoughts on the centennial of C.V. Starr, the dynamics of U.S. trade relationships with China and the future of the U.S. insurance industry as it faces the challenges of technology development and talent recruitment and retention, among many others. What follows is an edited transcript of that discussion.


R&I: One hundred years is quite an impressive milestone for any company. Celebrating the anniversary in China signifies the importance and longevity of that relationship. Can you tell us more about C.V. Starr’s history with China?

Hank Greenberg: We have a long history in China. I first went there in 1975. There was little there, but I had business throughout Asia, and I stopped there all the time. I’d stop there a couple of times a year and build relationships.

When I first started visiting China, there was only one state-owned insurance company there, PICC (the People’s Insurance Company of China); it was tiny at the time. We helped them to grow.

I also received the first foreign life insurance license in China, for AIA (The American International Assurance Co.). To date, there has been no other foreign life insurance company in China. It took me 20 years of hard work to get that license.

We also introduced an agency system in China. They had none. Their life company employees would get a salary whether they sold something or not. With the agency system of course you get paid a commission if you sell something. Once that agency system was installed, it went on to create more than a million jobs.

R&I: So Starr’s success has meant success for the Chinese insurance industry as well.

Hank Greenberg: That’s partly why we’re going to be celebrating that anniversary there next month. That celebration will occur alongside that of IBLAC (International Business Leaders’ Advisory Council), an international business advisory group that was put together when Zhu Rongji was the mayor of Shanghai [Zhu is since retired from public life]. He asked me to start that to attract foreign companies to invest in Shanghai.

“It turns out that it is harder [for China] to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.

Shanghai and China in general were just coming out of the doldrums then; there was a lack of foreign investment. Zhu asked me to chair IBLAC and to help get it started, which I did. I served as chairman of that group for a couple of terms. I am still a part of that board, and it will be celebrating its 30th anniversary along with our 100th anniversary.

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We have a good relationship with China, and we’re candid as you can tell from the op-ed I published in the Wall Street Journal. I’m told that my op-ed was received quite well in China, by both Chinese companies and foreign companies doing business there.

On August 29, Mr. Greenberg published an opinion piece in the WSJ reminding Chinese leaders of the productive history of U.S.-Sino relations and suggesting that Chinese leaders take pragmatic steps to ease trade tensions with the U.S.

R&I: What’s your outlook on current trade relations between the U.S. and China?

Hank Greenberg: As to the current environment, when you are in negotiations, every leader negotiates differently.

President Trump is negotiating based on his well-known approach. What’s different now is that President Xi (Jinping, General Secretary of the Communist Party of China) made himself the emperor. All the past presidents in China before the revolution had two terms. He’s there for life, which makes things much more difficult.

R&I: Sure does. You’ve got a one- or two-term president talking to somebody who can wait it out. It’s definitely unique.

Hank Greenberg: So, clearly a lot of change is going on in China. Some of it is good. But as I said in the op-ed, China needs to be treated like the second largest economy in the world, which it is. And it will be the number one economy in the world in not too many years. That means that you can’t use the same terms of trade that you did 25 or 30 years ago.

They want to have access to our market and other markets. Fine, but you have to have reciprocity, and they have not been very good at that.

R&I: What stands in the way of that happening?

Hank Greenberg: I think there are several substantial challenges. One, their structure makes it very difficult. They have a senior official, a regulator, who runs a division within the government for insurance. He keeps that job as long as he does what leadership wants him to do. He may not be sure what they want him to do.

For example, the president made a speech many months ago saying they are going to open up banking, insurance and a couple of additional sectors to foreign investment; nothing happened.

The reason was that the head of that division got changed. A new administrator came in who was not sure what the president wanted so he did nothing. Time went on and the international community said, “Wait a minute, you promised that you were going to do that and you didn’t do that.”

So the structure is such that it is very difficult. China can’t react as fast as it should. That will change, but it is going to take time.

R&I: That’s interesting, because during the financial crisis in 2008 there was talk that China, given their more centralized authority, could react more quickly, not less quickly.

Hank Greenberg: It turns out that it is harder to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.

R&I: Obviously, you have a very unique perspective and experience in China. For American companies coming to China, what are some of the current challenges?

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Hank Greenberg: Well, they very much want to do business in China. That’s due to the sheer size of the country, at 1.4 billion people. It’s a very big market and not just for insurance companies. It’s a whole range of companies that would like to have access to China as easily as Chinese companies have access to the United States. As I said previously, that has to be resolved.

It’s not going to be easy, because China has a history of not being treated well by other countries. The U.S. has been pretty good in that way. We haven’t taken advantage of China.

R&I: Your op-ed was very enlightening on that topic.

Hank Greenberg: President Xi wants to rebuild the “middle kingdom,” to what China was, a great country. Part of that was his takeover of the South China Sea rock islands during the Obama Administration; we did nothing. It’s a little late now to try and do something. They promised they would never militarize those islands. Then they did. That’s a real problem in Southern Asia. The other countries in that region are not happy about that.

R&I: One thing that has differentiated your company is that it is not a public company, and it is not a mutual company. We think you’re the only large insurance company with that structure at that scale. What advantages does that give you?

Hank Greenberg: Two things. First of all, we’re more than an insurance company. We have the traditional investment unit with the insurance company. Then we have a separate investment unit that we started, which is very successful. So we have a source of income that is diverse. We don’t have to underwrite business that is going to lose a lot of money. Not knowingly anyway.

R&I: And that’s because you are a private company?

Hank Greenberg: Yes. We attract a different type of person in a private company.

R&I: Do you think that enables you to react more quickly?

Hank Greenberg: Absolutely. When we left AIG there were three of us. Myself, Howie Smith and Ed Matthews. Howie used to run the internal financials and Ed Matthews was the investment guy coming out of Morgan Stanley when I was putting AIG together. We started with three people and now we have 3,500 and growing.

“I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.

R&I:  You being forced to leave AIG in 2005 really was an injustice, by the way. AIG wouldn’t have been in the position it was in 2008 if you had still been there.

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Hank Greenberg: Absolutely not. We had all the right things in place. We met with the financial services division once a day every day to make sure they stuck to what they were supposed to do. Even Hank Paulson, the Secretary of Treasury, sat on the stand during my trial and said that if I’d been at the company, it would not have imploded the way it did.

R&I: And that fateful decision the AIG board made really affected the course of the country.

Hank Greenberg: So many people lost all of their net worth. The new management was taking on billions of dollars’ worth of risk with no collateral. They had decimated the internal risk management controls. And the government takeover of the company when the financial crisis blew up was grossly unfair.

From the time it went public, AIG’s value had increased from $300 million to $180 billion. Thanks to Eliot Spitzer, it’s now worth a fraction of that. His was a gross misuse of the Martin Act. It gives the Attorney General the power to investigate without probable cause and bring fraud charges without having to prove intent. Only in New York does the law grant the AG that much power.

R&I: It’s especially frustrating when you consider the quality of his own character, and the scandal he was involved in.

In early 2008, Spitzer was caught on a federal wiretap arranging a meeting with a prostitute at a Washington Hotel and resigned shortly thereafter.

Hank Greenberg: Yes. And it’s been successive. Look at Eric Schneiderman. He resigned earlier this year when it came out that he had abused several women. And this was after he came out so strongly against other men accused of the same thing. To me it demonstrates hypocrisy and abuse of power.

Schneiderman followed in Spitzer’s footsteps in leveraging the Martin Act against numerous corporations to generate multi-billion dollar settlements.

R&I: Starr, however, continues to thrive. You said you’re at 3,500 people and still growing. As you continue to expand, how do you deal with the challenge of attracting talent?

Hank Greenberg: We did something last week.

On September 16th, St. John’s University announced the largest gift in its 148-year history. The Starr Foundation donated $15 million to the school, establishing the Maurice R. Greenberg Leadership Initiative at St. John’s School of Risk Management, Insurance and Actuarial Science.

Hank Greenberg: We have recruited from St. John’s for many, many years. These are young people who want to be in the insurance industry. They don’t get into it by accident. They study to become proficient in this and we have recruited some very qualified individuals from that school. But we also recruit from many other universities. On the investment side, outside of the insurance industry, we also recruit from Wall Street.

R&I: We’re very interested in how you and other leaders in this industry view technology and how they’re going to use it.

Hank Greenberg: I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.

R&I: So as the pre-eminent leader of the insurance industry, what do you see in terms of where insurance is now an where it’s going?

Hank Greenberg: The country and the world will always need insurance. That doesn’t mean that what we have today is what we’re going to have 25 years from now.

How quickly the change comes and how far it will go will depend on individual companies and individual countries. Some will be more brave than others. But change will take place, there is no doubt about it.

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More will go on in space, there is no question about that. We’re involved in it right now as an insurance company, and it will get broader.

One of the things you have to worry about is it’s now a nuclear world. It’s a more dangerous world. And again, we have to find some way to deal with that.

So, change is inevitable. You need people who can deal with change.

R&I:  Is there anything else, Mr. Greenberg, you want to comment on?

Hank Greenberg: I think I’ve covered it. &

The R&I Editorial Team can be reached at [email protected]