Workers’ Compensation Conditions

Workers’ compensation is a system of insurance that is there to protect injured employees when they, literally or figuratively, fall. It acts as a safety net to stop employees from experiencing financial ruin after an on-the job injury. Employers are required to carry workers’ compensation insurance and payments are given out once an employee proves their case. Payments are not given out unconditionally, however, and they will cease once an employee is able to return to work. One such condition of payment is often that an employee takes their prescription medication as directed and offers proof, such as a urine test, of that usage. Recently a New York appellate court held that this condition is not always enforceable in a court of law.

Mr. Harper’s Painkillers

Dan Harper of New York is a former employee of Public Energy Fuel Service Inc., a Hicksville, New York corporation. Harper suffered a debilitating back injury at work in 2002 and was placed on disability. Shortly after this finding Harper began receiving permanent total disability workers’ compensation payments. Harper’s workers’ compensation physician prescribed him a painkiller in an attempt to help Harper cope with his back pain. The opioid painkiller Kadian was included among his benefits. Public Energy required that Harper take this medication as directed. If he did not, his benefits would be revoked. A physician appointed by Public Energy to treat Harper’s back pain found that he was not taking the medication as often as the doctor recommended. Once Public Energy, and their insurance agents, discovered this, they sought to have Harper’s benefits revoked.

The Ruling

In our state workers’ compensation complaints are handled by the none other than the New York State Workers’ Compensation Board. The Board rejected the company’s claims. Once agency remedies are exhausted, a party who wishes to appeal has the right to take their case to the appellate courts. Here, that is precisely what Public Energy did. They sought relief in the three-judge panel of New York State’s Supreme Court. The court explained in the ruling that the law allows revocation of benefits where a recipient makes false statements to receive or increase their benefits. The court agreed that the Board correctly “noted the lack of evidence that the claimant was selling the excess Kadian or attempting to profit from it and, accordingly, found that the record did not establish that his misrepresentations were made for the purposes of obtaining compensation.” Thus, the appellate court determined that Public Energy did not have the right to revoke the benefits allocated to Harper.

Unfortunately, a situation such as this is not uncommon. Insurance agencies are for-profit corporations that are primarily concerned with the bottom line. Contacting an experienced and knowledgeable workers’ compensation attorney will help you protect your rights and your health. If you have struggled to obtain your workers’ compensation benefits, contact our team at Napoli Law today.