Subrogation

Subrogation is defined as “the substitution of one person in the place of another with reference to a lawful claim, demand or right, so that he who is substituted succeeds to the rights of the other in relation to the debt or claim, and its rights, remedies or securities”. For example, an insurance company may pay for damages incurred by the policyholder. These damages are those covered under a policy of insurance and include property damage, medical payments, and uninsured motorist coverage. Sometimes these damages and injury are caused by the negligence of another party. After payment of these damages, the insurance company is entitled to recover these payments from the responsible party and these recovery efforts may include litigation.

Health insurance companies also make payments for medical expenses which are actually the responsibility of another party. The insurance company is “subrogated” to the rights of the insured and can seek recovery for these costs from the wrongdoer. We also handle workers’ compensation subrogation.

The Business Division of Craft & Sheppard handles these cases, which range from auto accidents to significant business commercial losses, similarly to the way we handle a plaintiff case: aggressively. In these cases, we must establish a duty, a breach of duty, damages, and causation, just like we do in other plaintiff cases.

Our insurance and claims experience helps us to understand the priorities and expense control needs of the company. We are committed to improving their loss ratios and recovery rates. We work with companies to improve their investigation and claims handling so that we have the evidence we need to prevail on these complex cases.

Tennessee Workers’ Compensation Bulletin

Posted 12/18/2008

In Luther Roper, Sr. v. First Presbyterian Church et al, the Special Workers’ Compensation Appeals Panel of the Supreme Court ruled that the trial court erred in capping the employer’s liability at 260 weeks. The employee suffered a 70 percent vocational disability to the body as a whole as the result of an injury arising out of and in the course of employment. Since the employee was over sixty at the time of the injury, the trial court limited his award to 260 weeks pursuant to Tenn. Code Ann. section 50-6-207(4)(A)(I). The trial court concluded that the employer’s liability was likewise capped at 260 weeks, and, since the employer had already paid 152 weeks of compensation to the employee for previous injuries, the court allocated 108 weeks of the 260-week award to the employer, and the remaining 152 weeks to the Second Injury Fund. The Second Injury Fund appealed, arguing that the employer’s liability is not capped at 260 weeks, but rather remains 400 weeks.

Posted 11/11/2008

In Anthony Sircy and Anesthesiologists Professional Assurance Company v. Jerry Wilson, the Tennessee Court of Appeals affirmed the trial courts award of one-third of the settlement to counsel for the injured employee as attorney fees, despite the arguments of the intervening plaintiff workers compensation carrier.

Posted 11/02/2008

In Gerry G. Kinsler v. Berkline, LLC, the Tennessee Court of Appeals vacated the trial court’s judgment and remanded the case for further proceedings, ruling that genuine issues of material fact concerning the Employer’s explanation for termination precluded summary judgment where the Employee brought suit for retaliatory discharge after being terminated from his employment with Berkline, LLC, (“Employer”) three days after he backed out of a workers’ compensation settlement. The Employee argued that the Supreme Court’s holding in Allen v. McPhee, 240 S.W.3d 803 (Tenn. 2007) – that “proof of close temporal proximity alone can establish causation, . . .” and the Tennessee Court of Appeals agreed.

Posted 10/22/2008

In WHIRLPOOL CORPORATION v. SHERRY PRATT ,the Tennessee Court of Appeals ruled in favor of the employee, finding that she proved two required elements of her claim for retaliatory discharge: (1) that she made a claim for workers’ compensation benefits prior to her termination, and (2) that her workers’ compensation claim was a substantial factor in her termination.

Posted 10/22/2008

In JOHN W. KRANTZ, III, v. NISSAN NORTH AMERICA, INC. ET AL. , the Special Workers’ Compensation Appeals Panel of the Tennessee Supreme Court modified the lower court ruling by holding that the employee was limited to permanent disability benefits of 1.5 times the anatomical impairment because he was fired for failing to adhere to strict medical restrictions. Although he had sustained a compensable back injury, he nonetheless violated Nissan’s pre-existing written policy requiring adherence to medical restrictions by engaging in competitive horsemanship activities and the Court ruled he experienced a meaningful return to work, despite being fired, thereby triggering the 1.5 multiplier cap.

Posted 10/15/2008

In MERRY LESHANE, as Next of Kin of WINNIE BRUMLEY, Deceased v. QUINCE NURSING AND REHABILITATION CENTER, LLC, the Tennessee Court of Appeals vacated and remanded the case for further proceedings with respect to the issue of whether the daughter had authority to sign admission papers on behalf of her mother and therefore bind the mother to certain arbitration provisions contained within those admission documents.

Posted 10/13/2008

In Opinion No. 08-161, the Tennessee Attorney General states that the prohibition in Overstreet v. TRW Commercial Steering Div., 256 S.W.3d 626 (Tenn. 2008), regarding ex parte communications between an employer and an employee’s physician does not apply to case managers operating under Tenn. Code Ann. § 50-6-123.

Posted 10/08/2008

In Ritescreen, Inc., et al v. Donald Campbell, the Special Workers’ Compensation Appeals Panel of the Supreme Court affirmed the trial court award of benefits to an Employee who alleged that he sustained an aggravation of pre-existing pulmonary disease as a result of exposure to a chemical in the workplace.

Posted 9/29/2008

The Special Workers’ Compensation Appeals Panel of the Supreme Court in Lisa Miller, et al v. M & R Constructors, Inc. a/k/a Millwrights & Riggers, disagreed with the Employer grounds for appeal, holding that the Employee’s death from cardiac arrest was work related and reaffirmed the payment of benefits to the survivors.

Posted 9/29/2008

In Michael Limbaugh v. Mueller Refrigeration Co., Inc. the Special Workers’ Compensation Appeals Panel of the Supreme Court upheld the trial court’s assignment of 15% permanent impairment to the body as a whole even though the AMA Guides did not provide for assigning an impairment for a condition known as “winging” of the scapula.

Posted 9/25/2008

In the Tennessee workers’ compensation case, Velma Lynn Saunders Manuel v. Davidson Transit Organization, the Special Workers’ Compensation Appeals Panel of the Supreme Court ruled that the additional injuries sustained by the employee in an automobile accident which occurred as she was returning to her home from receiving medical treatment for a compensable work injury, was also compensable.

Posted 9/08/2008

The Tennessee workers’ compensation case, Melissa A. Grayson v. Shaw Industries, Inc., was referred to the Special Workers’ Compensation Appeals Panel of the Supreme Court in accordance with Tennessee Code Annotated section 50-6-225(e)(3) for a hearing and a report of findings of fact and conclusions of law. While at work for the Employer, the Employee’s hair was caught in machinery, which violently pulled her head into the machine. Her scalp was pulled away from her skull. She received treatment at an emergency room. In the months that followed, she had three surgical procedures to repair the wound and her scalp. She was diagnosed with post traumatic stress syndrome, developed sleep problems, anxiety and headaches. She became fearful and anxious around machinery and was ultimately discharged by her Employer. Her physicians and vocational experts and the Employer’s vocational expert agreed that when a Social Security questionnaire was considered, she was 100% disabled. Nevertheless, the Employer contends that she is not 100% disabled. The court affirmed the trial court’s ruling.

Posted 9/03/2008

In the Tennessee workers’ compensation case, Fred Tharpe v. Emerson Electric Company, brought before the Special Workers’ Compensation Appeals Panel of the Tennessee Supreme Court, Employer, after entering into a court-approved settlement, requested an independent medical examination of Employee in which examining physician indicated the current medical treatment was not related to the original work injury. Employer then stopped paying for medical treatment. The trial court ordered the Employer to resume payments and the appellate court upheld that ruling.

Posted 8/20/2008

In the Tennessee workers’ compensation case, Billy Anderson v. Westfield Group, the Tennessee Supreme Court reversed the Special Workers’ Compensation Panel, finding that the employer was not liable for medical expenses for treatment of two injuries to the employee’s hand allegedly caused by a prior compensable injury to his elbow. The Court found that the hand injuries were due to his own negligence.

General Counsel

Craft & Sheppard serves as general counsel to a number of corporations, providing regulatory, contract, and risk management services. Additionally, the firm audits internal legal, collection, and operational policies and procedures, providing a proactive analysis designed to avoid litigation and penalties.

We partner with our corporate clients to analyze systems and procedures to diagnose legal issues before they occur.