Workers' compensation subrogation continues to change and adapt, as
trial lawyers prod its weak points and capitalize on confusing areas of
the law. There have been numerous changes in workers' compensation
statutes and case law in many states since the last edition. This
edition includes an exhausting survey and detailed explanation of the
crazy status of employer contribution in Illinois, which includes a
step-by-step exposition of how contractual indemnity and the "Kotecki
cap" play a role in expanded employer liability in Illinois workers'
compensation subrogation cases. It covers the many nuances of Naig and
Reverse-Naig settlements under Minnesota law, including an analysis of
who has what burdens of proof and the effect such a settlement has on
the remaining third-party case tried to a jury. In light of the landmark
Missouri Court of Appeals decision in Robinson v. Hooker, the liability
of co-employees in Missouri and surrounding states have been covered in
greater detail. The concept of co-employee liability for acts which are
intentional or committed outside of the course and scope of employment
has been added in several states. New case law and explanations were
added to the Texas chapter with regard to subrogating against UM/UIM
policies, including arguments with regard to the efficacy of UM/UIM
exclusionary policy language and the ability to subrogate against a
UM/UIM policy actually issued by the same carrier insuring for workers'
compensation coverage. West Virginia completely revised their
subrogation statute and created a new statute relating to the "statutory
employer" status of primary contractors and subcontractors on
construction sites, limiting when and how primary contractors can become
legitimate third parties for purposes of subrogation. Chapter 7,
"Contractual Limitations to Subrogation" has been completely overhauled
to include new statutes and case law for every state to assist
practitioners in determining the law applicable when there is an alleged
applicable waiver of subrogation which might otherwise destroy
subrogation. A new Chapter 12 has been added, which focuses on
jurisdiction of workers' compensation third-party actions taking a broad
look at 28 U.S.C. § 1441, which prohibits removal of cases "arising
under" state workers' compensation laws. A carrier now has the ability
to prevent cases from being removed from favorable venues in state court
to less favorable federal court venues - an attractive option for
plaintiffs' attorneys with whom subrogated carriers can negotiate with
for stipulations and concessions on their subrogation interests in
exchange for maintaining a case in state court. This edition also
expands on which states do and do not hold workers' compensation to be
primary. Combined with more than 100 new case decisions, this Fifth
Edition is the most complete and up-to-date edition yet.
Workers' Compensation Subrogation is the most complete and thorough
treatise covering workers' compensation subrogation ever published.
There are very few areas in which the laws of each state vary more and
are applied as differently, then in the area of workers' compensation
subrogation. This book is intended to introduce the workers'
compensation claims handler, in-house counsel, and subrogation
professionals to some of the more esoteric and complex subrogation
issues encountered in today's workers' compensation insurance
subrogation marketplace. It covers the following issues in all 50
states:
• Allocating Third Party Recoveries
• Attorney's Fees
• Borrowed Servant Doctrine
• Conversion of Workers' Compensation Liens
• Costs and Expenses
• Dual Capacity Doctrine
• Equitable Subrogation/Contribution
• Exclusivity Rule Barring Action Against Employer
• How To Calculate Your Credit/Advance and How It Is Applied In Each State
• Intentional Acts
• Joint Ventures
• Made Whole Doctrine As Applied To Workers' Compensation Subrogation
• Necessity of Intervention
• Lien Reduction Statutes
• Staff Leasing Services and Temporary Employment Agencies
• Statutory Subrogation Rights
• Subrogating Against UM/UIM Benefits
• Subrogating In Medical Malpractice Cases
• Subrogating In Legal Malpractice Cases
• Waivers of Subrogation
• Who Qualifies As A Third Party
• Other Workers' Compensation Subrogation-Related Issues
In addition to being an excellent primer on workers' compensation
subrogation, suitable for both the new subrogation professional and the
seasoned veteran, the book also contains a detailed synopsis of the
workers' compensation subrogation laws in each of the 50 states. It is a
must for anyone with multi-state subrogation responsibilities. Complete
with diagrams, references and thousands of footnotes, this is the most
ambitious workers' compensation subrogation project ever undertaken.
The following issues and topics are covered in detail for each of the 50 states:
Statutory Subrogation Rights
• Identifies the statutory authority for workers' compensation subrogation in that state.
• Discusses the purpose/legislative intent of the statute.
• Is an election necessary by the worker?
• Who can bring a third party action (plaintiff, carrier, employer, or all of the above)?
• When and must a third party action be brought?
• What are the rights of a carrier to intervene in an existing third party action filed by a worker?
• Will a worker's compensation carrier's subrogation interest be barred if not brought timely?
Third Parties
• Who can be sued as third parties in a third party action?
• Can a co-employee be sued and under what circumstances?
• Can an uninsured/underinsured carrier be a "third party" under the laws of that state?
• Is there a dual capacity or borrowed servant doctrine which somehow
affects the ability of a worker's compensation carrier to effectively
subrogate?
• What is the state's workers' compensation bar?
• Are there any specific restrictions regarding subrogation against a
subcontractor or an employee of a subcontractor in a construction
situation?
• Under what circumstances can the employer be sued?
• Can a carrier subrogate to the benefits of a recovery in a legal or medical malpractice action?
Allocation of Third Party Recovery
• How and when does the carrier recover its subrogated interest?
• Does the carrier recover past benefits only or also the present value
of future benefits which it owes under the Workers' Compensation Act of
that state?
• Is there a formula used to determine how a third party recovery is allocated?
• What happens to the total recovery and how is it applied?
• Can a carrier recover benefits paid by a third party or recovered in a
third party action which relate to loss of consortium, or non-economic
damages such as pain and suffering, mental anguish, or punitive damages?
• Does the employer's negligence reduce the recovery by the worker or carrier?
Attorneys' Fees/Costs
• Can the plaintiff's attorney recover attorneys' fees and/or costs out
of the carrier's subrogated recovery and under what circumstances?
• How are attorneys' fees and costs handled if the carrier is also
represented by subrogation counsel, intervenes into the third party
action and actively represents its interest?
• What if the carrier isn't represented?
• Can a plaintiff's attorney recover attorneys' fees based on the value
of past benefits only or will he be able to recover attorneys' fees
based on the future benefits/credit recovered by the carrier?
• Must a carrier bear its proportionate share of expenses as many states require, and what does that really mean?
Credit/Advance
• Can a carrier take a vacation from paying workers' compensation benefits once a worker makes a third party recovery?
• How is the credit calculated under state law?
• Does the carrier have to do anything special to obtain the credit, such as filing with the Workers' Compensation Commission?
• Does the carrier get a credit toward future compensation benefits it
owes or does it actually get to collect the present value of the future
benefits it owes and still be obligated to pay the scheduled benefits in
the future?
Statutes of Limitation
• What are the applicable statutes of limitation or statutes of repose
that may be applicable to third party subrogation actions?
Related Subrogation Issues
• Are there any other issues or statutes which affect a worker's
compensation carrier's right of subrogation, such as the made whole
doctrine, common fund doctrine, or anti-subrogation statutes?
• Are there any lien reduction statutes, such as those existing in
Indiana, which affect a worker's compensation carrier's right of
recovery?
• Does the state have any no-fault laws which complicate workers'
compensation subrogation involving an automobile accident, such as exist
in Michigan and Colorado?
• What are the carrier's options if the worker and his attorney simply
refuse to repay a worker's compensation carrier's lien after settling a
third party action?
• If the worker fails to repay the carrier, is there a cause of action
for conversion of a carrier's subrogation interest or may the carrier
still proceed against the third party tortfeasor to recover its
subrogation interest?