Last Employer Rule in Occupational DiseaseOn May 17, 2017, the United States Court of Appeals for the Fifth Circuit rendered a decision affirming an Administrative Law Judge’s decision in Bollinger Shipyards, Inc., et al. v. Director, OWCP, et al., No. 16-60370.  This matter arose as a claim filed under the Longshore and Harbor Workers’ Compensation Act, 33 USC § 901 et. seq.  The plaintiff, Kenneth Worthy, filed a claim against his past employer, Bollinger Shipyards, Inc., for an occupational illness as a result of exposures to hazardous substances, including welding fumes, sandblasting dust, industrial cleaning solvents and other fumes and chemicals resulting in a diagnosis of chronic, obstructive pulmonary disease (COPD).

After a number of years working as a welding supervisor occasioning his exposure to the above-noted fumes, Mr. Worthy was examined by a physician in 2008, who indicated that he could no longer wear a respirator, as required by his job, due to airway obstruction. Mr. Worthy had been out of work due to other injuries at that time, and upon his attempt to return to work after recovering from these injuries, Bollinger required him to be again examined with regard to his pulmonary condition. On March 22, 2010, the company physician, Dr. Bourgeois, diagnosed Mr. Worthy with COPD based upon the results of a pulmonary function test. At that time, Mr. Worthy was told by the physician that he could not return to work and was advised to see a pulmonologist. It was also recommended that he apply for Social Security Disability.  Instead of doing this, Mr. Worthy applied for work with a separate employer and worked as a welding supervisor from March 29 – May 18, 2010, when he was fired for sleeping on the job.

After Mr. Worthy filed his claims against Bollinger for his respiratory condition, he was seen by yet another physician that performed a further pulmonary function test which gave similar results as were obtained in March 2010. This doctor also indicated to Mr. Worthy that he could not return to any job that exposed him to fumes or dust.

At the trial of the matter before an Administrative Law Judge, Bollinger asserted that it was not liable for Mr. Worthy’s occupational disease due to the fact that Mr. Worthy was exposed to further lung irritants while in the employ, however short-lived, of a later maritime employer. The issue presented addressed the application of the “last employer rule” as defined by the Second Circuit’s widely-adopted rule in Travelers Insurance v. Cardillo, 225 F.2d 137 (2nd Cir. 1955).  Under this rule, the responsible employer in occupational disease cases is the last employer during whose employment the claimant was exposed to injurious stimuli, prior to becoming aware that he was suffering from an occupational disease.

The application of this rule usually arises in the situation where the individual has terminated his employment as a result of a diagnosis identifying a disability and limitations precluding the claimant’s continued work. In the instant, however, after Mr. Worthy was diagnosed with COPD, he sought and obtained further employment for several months performing similar duties as he had for Bollinger. Under these facts, Bollinger argued that the ALJ should have focused solely on the date of disability (last date of employment) to determine the last responsible employer, citing Liberty Mutual Insurance v. Commercial Union Insurance, 978 F.2d 750, 756 (1st Cir. 1992). The Fifth Circuit determined that it did not need to address the situation when diagnosis and disability dates were different because the Administrative Law Judge found that both of these events occurred on March 22, 2010, and this issue was not truly raised by Bollinger before the Benefits Review Board, and was therefore forfeited.

Bollinger also attempted to avoid liability by asserting that Mr. Worthy’s pulmonary condition was made worse after his brief stint of work with the subsequent employer based upon a post-employment pulmonary function test indicating a decline in pulmonary functioning. The Fifth Circuit, noting the standard discretion applied to fact finding of an ALJ, refused to accept this prong of Bollinger’s appeal and indicated that the ALJ was not convinced by the evidence submitted by Bollinger supporting this conclusion.

2017 Longshore Conference

The 2017 Annual Longshore Conference was held last week at the Intercontinental Hotel in New Orleans. The annual conference, which is presented by Loyola University New Orleans College of Law in conjunction with the U.S. Department of Labor, is a two-day program/CLE for maritime practitioners and industry professionals handling claims arising under the Longshore and Harbor Workers’ Compensation Act (LHWCA), Defense Base Act (DBA) and other extension acts.

This year’s programming kicked off with a session dedicated to recent decisions under the LHWCA, including a discussion of Bis Salamis Inc, v. Dir. Office of Workers’ Comp. Programs, 819 F. 3d 116 (5th Cir. 2016), a Fifth Circuit case regarding the effect of a claimant’s credibility (or, more accurately, lack thereof) on establishing causation. The Bis Salamis case was the subject of an earlier Offshore Winds blog post by Doug Matthews. Day One’s programming continued with a question and answer session with the Office of Administrative Law Judges, who discussed case assignments and allotments, how the various district offices operate, and provided guidance in practicing before the OALJ. The ALJs took questions from audience members, several of which were directed to what lawyers can do to help speed up the process of judicial decision-making in claims before the Department of Labor. The (not-so-helpful) response of the ALJs in a nutshell? Write better and more concise briefs.

Following the ALJs were presentations on the interplay between other benefits schemes (such as state workers’ compensation statutes) and the LHWCA; trends and forecasts in DBA claims and the business of military contracting in general; and an eye-opening presentation regarding pain management and the opioid crisis in America. Day Two included presentations addressing several other timely topics of interest to Longshore and DBA practitioners, including Section 22 modifications and trends, professionalism in settlement negotiations, and a panel of District Directors of the Office of Workers’ Compensation Programs, who discussed practicing before the OWCP.

Some takeaways from the Conference:

  • The issue of whether a particular claimant was injured on a covered situs under 33 U.S.C. § 903(a) continues to be frequently litigated, and often turns on whether the claimant’s injury occurred in an “adjoining area” within the meaning of the Act;
  • Similarly, while the issue of whether a structure is a vessel under the LHWCA continues to be frequently litigated, it is becoming more well-settled that a very large tension leg platform is not a vessel, due to the lack of self-propulsion, steering mechanism, and rudder, and its dedicated time on site; and
  • Under the LHWCA, traumatic injuries get a one year statute of limitations; but occupational diseases get a two year statute of limitations. With respect to claimants experiencing delayed expression PTSD, it can be difficult determining which limitations period applies.

The Loyola Longshore Conference is held annually in New Orleans.

LHWCA Psychological InjuryOn January 27, 2017, the Fourth Circuit Court of Appeals in Ceres Marine Terminals, Inc. v. Director, OWCP, (Samuel Jackson), No. 15-1041, affirmed the decisions of an Administrative Law Judge and the Benefits Review Board holding that a defense founded upon the precept of “zone of danger” was not applicable under the LHWCA. It further agreed with the courts below that the opinion of an independent medical examiner appointed by the District Director’s Office carries no greater weight than do other medical opinions.

This case arises out of a tragic work-related accident where Samuel Jackson, a longshoreman, was operating a fork lift when it accidentally struck and killed a co-worker. The accident was very gruesome in nature. Subsequently Mr. Jackson sought psychological care and was diagnosed with post-traumatic stress disorder (PTSD). After seeing several medical care providers for his psychological condition, the employer requested that the claimant be examined by a medical care provider of its own choosing. That provider, a psychiatrist, also diagnosed the claimant with PTSD and felt that he was being under medicated. As a result of this opinion with regard to the appropriate level of medication, the District Director’s Office appointed an independent medical examiner who, after reviewing the claimant’s injuries, felt that since the claimant did not experience a threat to himself and was never in danger of injury that PTSD was an inappropriate diagnosis. He further felt that the claimant showed significant evidence of malingering. Based upon this opinion, the employer terminated compensation, after which Mr. Jackson filed a claim under the LHWCA.

At the trial of the case, the employer asserted that the claimant could not recover for psychological injury unless he sustained a physical injury or was placed in immediate risk of harm. In so many words, the claimant did not meet the “zone of danger” test for compensability that was first enunciated in Consolidated Rail Corporation v. Gottshall, 114 S.Ct. 2396 (1994). After trial, the Administrative Law Judge rejected this test indicating that Longshore Act case law had established that a claimant can obtain benefits for a work-related psychological injury, and to carve out a negligence law-based exception would be inappropriate. The judge also rejected the employer’s assertion that the Department of Labor-appointed IME psychiatrist opinion should carry more weight than the opinions of medical care providers holding contrary opinions.

The employer appealed to the Benefit Review Board which affirmed the two findings of the Administrative Law Judge and a petition was filed with the Fourth Circuit seeking review. The Fourth Circuit affirmed the two courts below on both issues. The Court rejected the employer’s assertion that Mr. Jackson could not, under the LHWCA, recover for psychological injury unless he sustained a physical injury or was placed in immediate risk of physical harm. It considered that the employer was misapplying the holding of the Consolidated Rail case, which involved a claim that arose under the Federal Employer’s Liability Act (FELA) and addressed principles of negligence. It further explained that the LHWCA did not distinguish between psychological and physical injuries, and simply used the word injury when addressing compensability. The Court found that nowhere in the statute was there a requirement, as suggested by the employer, that psychological injuries be accompanied by actual or threatened physical harm. It felt that Congress could have easily written the statute to contain such a requirement, but did not. On review of other case law, the Court also found that actual or threatened physical harm had never been mandated as a prerequisite for coverage of a psychological injury.

In affirming that decisions of the Administrative Law Judge and BRB insofar as the weighing of an independent medical examiner’s opinion, the Court stated that the specific portion of the LHWCA, 907(e), did not address the weight to be applied to the opinion of an independent medical examiner appointed by the Department of Labor, and therefore, determined that the independent medical examiner’s opinion must be weighed along with the other medical opinions of record without added weight.

canstockphoto24924390In Seaboard Spirit LTD, et al. v. Antwon Hyman, et al., No. 15-12953, an unpublished opinion issued by the Eleventh Circuit on December 5, 2016, the Court of Appeals reversed a District Court’s opinion that had expanded a vessel owner’s liability to a longshoreman that has traditionally existed under 33 USC § 905(b) to also include a separate cause of action under 33 U.S.C. § 933. This decision fosters the precept that when a vessel is involved with an injury with one covered by the Longshore and Harbor Workers’ Compensation Act, 33 USC § 901 et seq. (LHWCA) the injured plaintiff’s cause of action is solely governed by 33 USC § 905(b).

When injured in the course and scope of his employment a longshoreman is provided compensation benefits pursuant to the LHCWA from his employer. The liability of the employer is one that is set by statute without a determination of fault. Where the longshoreman’s injury is brought about due to the negligence related to the operation of a vessel, he can additionally sue the owner of the vessel pursuant to 33 USC § 905(b), whether the vessel is owned by his employer or another party. Furthermore, if a non-vessel owner/third party’s negligence has caused his injury, the longshoreman is provided a right to sue for damages under 33 U.S.C. § 933.

In the instant case, the longshoreman in question, Mr. Hyman, was killed while involved in unloading operations aboard the M/V SEABOARD SPIRIT in the Port of Miami on May 4, 2011. The M/V SEABOARD SPIRIT was a RO/RO vessel that allowed for containers on chassis to be rolled on and off the vessel in the loading operations. The M/V SEABOARD SPIRIT had been loaded with cargo containers on chassis in the Bahamas on May 3, 2011. Once the containers were aboard the vessel, the vessel crew proceeded to attach lashing chains to secure the cargo for its sea voyage. The securing of containers was a job that would normally be performed by stevedores/longshoremen.

During the unloading operation of the M/V SEABOARD SPIRIT in the Port of Miami, Mr. Hyman was killed while working for the unloading stevedore when a chassis shifted during unloading and caught Mr. Hyman in a pinch point between the container and the side of the vessel.

The owners of the M/V SEABOARD SPIRIT filed a petition under the Limitation of Liability Act in which the heirs of Mr. Hyman made a claim under § 905(b) in addition to asserting a claim under § 933. In the latter assertion it was alleged that because the M/V SEABOARD SPIRIT’s crew secured cargo in the Bahamas, the owner of the M/V SEABOARD SPIRIT, in addition to being an owner, also acted as and assumed the duties of an on-loading stevedore. In this setting, the District Court ultimately determined that the heirs of Mr. Hyman had stated a claim against the vessel owners separate and apart from their status as owners of a vessel and one that could be recognized outside of the limitation proceeding and under § 933 due to their status as a loading stevedore.

The § 905(b) action was tried in the limitation proceeding after which the District Court ruled in favor of the ship owner, but it additionally found that the plaintiffs could proceed in a separate action against the vessel owner as on-loading stevedore under § 933.

This was appealed to the Eleventh Circuit. In review of prior precedent, the Eleventh Circuit found no case law that would allow a vessel owner to be sued separately in a different negligence action other than that provided for in 33 U.S.C. § 905(b) for any fault it may have had as an on-loading stevedore. It did note that a number of cases have found that the ship owner who participated in stevedoring operations would be held to a higher standard of negligence than that provided under the Supreme Court case of Scindia Steam Navigation Co. v. De Los Santos, 451 U.S. 156 (1981). It observed that the plaintiffs did not argue that the District Court should be reversed for not applying the higher standard of care to their § 905(b) claims as it applied to the ships stevedoring operations, and therefore, they had abandoned that argument.

collateral-source ruleThe Fifth Circuit issued an opinion on November 17, 2016, in Robert Deperrodil v. Bozovic Marine, Inc., (No. 16-30009). In a case involving the injury to a passenger aboard a crew boat in high seas, the District Court was called upon to determine whether under the collateral-source rule the plaintiff could recover $186,080.30, which was the amount billed for his medical care, rather than the amount that the insurer was eventually required to pay, $57,385.50, the balance having been written off. Generally the collateral-source rule bars a tortfeasor from reducing his liability by the amount the plaintiff recovers from independent sources. It is a substantive rule of law, as well as an evidentiary rule that disallows evidence of insurance or other collateral payments that may influence the fact finder.

The Fifth Circuit determined that there was no direct authority in the maritime tort context regarding the treatment of written off medical expenses for which liability existed under the Longshore and Harbor Workers’ Compensation Act (LHWCA) 33 USC 901 et. seq. It evaluated the law in its circuit and determined that Mississippi, Louisiana and Texas all had different approaches. The court then reviewed the Fifth Circuit decision in Manderson v. Chet Morrison Contractors, Inc., 666 F.3d 373, 381 (5th Cir. 2012), in which the question was whether the collateral-source rule allowed recovery of written off medical expenses when an employer paid the expenses as part of its maritime cure obligation.  In that case, about which Offshore Winds reported at the time, the Court held that it was error to award the amount charged rather than the amount that was paid.

The Court, in the instant case, while feeling that Manderson was not binding as it involved maritime cure and not a maritime tort or LHWCA insurance, the court considered that this was the most applicable of the various approaches to write-offs. It also felt that the rationale in Manderson was very persuasive because maritime cure and LHWCA insurance create similar obligations for employers. In so doing, it determined that LHWCA medical-expense payments are collateral to a third-party tortfeasor only to the extent paid; in other words, under those circumstances, the plaintiff may not recover for expenses billed, but not paid.

Proposed LHWCA Maximum Compensation ChangeThe Office of Workers’ Compensation Programs, Department of Labor, posted proposed rules affecting section 906 of the Longshore and Harbor Workers’ Compensation Act 33 U.S.C. § 901 et seq., Federal Register, Volume 81, No. 166, August 26, 2016. The Department invited written comments on the proposed regulations from interested parties by October 25, 2016. The proposed change is designed to address how the provision in Section 906 related to “maximum” compensation is to be applied. These changes focus upon the interpretation of 906(c). For the purpose of this discussion, it should be understood that compensation benefits are capped at 200% of the national average weekly wage (906(b)(1)). Additionally, the national average weekly wage is recalculated every year pursuant to 906(b)(3). Historically an increase in this figure has always occurred. Section 906(c) provides that: determinations made of the national average weekly wage with respect to a period “shall apply to employees or survivors currently receiving compensation for permanent total benefits or death benefits during such period, as well as those newly-awarded compensation during such period.”

As noted in the proposed regulations, the terms “currently receiving compensation” and “newly-awarded compensation” have been the subject of certain litigation over the years. It appears that what the proposed regulations do is to place into a regulation a Benefit Review Board (BRB) ruling that has never been tested in the U.S. Circuit Courts of Appeals. The BRB ruling in Marko v. Morris Boney Company, 23 BRBS 353 (1990), held that 33 U.S.C. § 906(c) required that a claimant who is totally and permanently disabled is to be provided an increase in the maximum allowable benefit annually rather than being held to a fixed maximum that would be established by the date of his disability. So, if an employee’s initial benefit, due to his high average weekly wage (AWW), is limited by the cap of the maximum benefit provided in 906(b)(1), he will not receive a full two-thirds of his AWW as a weekly benefit. If later annual increases in the maximum allowable benefit reach a point where they exceed two-thirds of the claimant’s AWW, he will not then be so limited and will receive his full benefits.  If the maximum were fixed, as a number of employers have asserted, this would not occur.

Should an employer be concerned about this reformulated regulation, depends upon whether its employees fall into a category where their compensation rate would be limited by the maximum allowed under Section 906(b)(1). For present purposes, the maximum rate that will come into effect on October 1st, 2016, is $1,436.48. To max out at this rate, an individual would need to have an AWW of $2,154.72 or an annual income of $112,045.44. If employees receive wages in or around this level, then the potential effect of the application of this regulation may be of concern to employers.

The proposed regulations also establish a standard based upon the Ninth Circuit’s decision in Roberts v. Director, OWCP, 625 F.3d 1204, 1208-09 (9th Cir. 2010), aff’d sub nom Roberts v. Sea-Land Services, Inc., 132 S.Ct. 1350 (2012), and the Eleventh Circuit decision in Boroski v. Dyncorp. Int’l, 662 F.3d 1197 (11th Cir. 2011). Both of these courts interpreted Section 906(c)’s “currently receiving compensation” language for permanent and total disability or death benefits, and they have allowed a step-up in the maximum where the claimant’s disability category changed from temporary total disability (TTD) to permanent total disability (PTD). Rather than limit the employee to the maximum at the time of injury, the employee’s rate was subject to the maximum as of the date that his disability was classed as permanent and total. In one of these cases, the claimant, originally injured in 2012, went from TTD to PTD in 2005, and at that time his rate was found to be controlled by the maximum in the 2005 fiscal year. Later, when a wage-earning capacity was established, thereby changing the rate to one of permanent partial disability, the 2002 maximum rate for the date of injury was found to be applicable.

James Baker Jr. v. Director, OWCP; Gulf Island Marine Fabricators, LLCJames Baker, Jr. v. Director, OWCP; Gulf Island Marine Fabricators, LLC, U.S. Fifth Circuit No. 15-60634 (August 19, 2016). In this case the Court of Appeals affirmed the Administrative Law Judge’s (ALJ) determination that Mr. Baker, an employee of Gulf Island Marine Fabricators, LLC (Gulf Island) did not qualify for benefits under the Longshore & Harbor Workers Compensation Act (LHWCA), 33 U.S.C. § 901 et seq., either directly or by application of the Outer Continental Shelf Lands Act (OCSLA), 43 U.S.C. § 1331 et seq.

Mr. Baker filed a claim with the U.S. Department of Labor alleging an injury in the course and scope of his employment with Gulf Island for which he sought benefits under the LHWCA. Gulf Island was in the business of constructing and repairing vessels, and specialized in maritime oil and gas structures. One of Gulf Island’s projects was to fabricate the topside living quarters for the tension-legged platform, Big Foot. Mr. Baker had been hired by Gulf Island to work as a carpenter in the fabrication of the living quarters. His entire employment was spent on this project. His work was within 100 yards of the Houma Navigation Canal to which the employer’s property abutted, but he always worked on dry land. Mr. Baker never went offshore to participate in work duties on the Outer Continental Shelf. The parties had stipulated that the “situs” prong of the jurisdictional test under the LHWCA was met as Mr. Baker performed his duties in an area adjacent to navigable water, but the employer disputed whether under the “status” prong of the jurisdictional test Mr. Baker was involved in maritime employment.

In applying the recent decisions of the U.S. Supreme Court in Stewart v. Dutra Construction Company, 543 U.S. 481 (2005) and Lozman v. City of Riviera Beach, Fla., 133 S.Ct. 735 (2013), the ALJ determined that the tension-legged platform, Big Foot, was not a “vessel” in the context of the LHWCA as that term has been defined by decisional law, and Mr. Baker was therefore not involved in maritime employment.

Mr. Baker also sought coverage under the Act by application of the OCSLA, asserting that the Supreme Court’s decision in Pacific Operators Offshore, LLP v. Valladolid, 132 S.Ct. 680 (2012), extended OCSLA coverage to one who was injured on land. As noted by the ALJ, the Supreme Court decision applying OCSLA extra-territorially required the injured employee to establish a significant causal link between the injury that he suffered and his employer’s onsite OCS operations conducted for the purpose of extracting natural resources from the OCS. In this instance, the ALJ found that Mr. Baker never set foot on the OCS and his employer had no role in transporting the Big Foot to the OCS, installing it there or operating it, ergo OCSLA did not provide him with an avenue to LHWCA coverage.

The ALJ’s decision was affirmed by the Benefit Review Board and Mr. Baker appealed to the U.S. Fifth Circuit Court of Appeals. The Fifth Circuit’s decision likewise analyzed the Dutra and Lozman decisions of the Supreme Court and concluded that the Big Foot was not a “vessel” under the LHWCA. It felt that this comported with its cited precedent denying vessel status to structures that were not designed or engaged in maritime transportation noting that mere flotation on water does not constitute a structure a vessel.

The Fifth Circuit also addressed the Pacific Operators holding indicating that Mr. Baker’s injury occurred on dry land while he was building the living and dining quarters for the Big Foot, and therefore, he did not satisfy the fact-specific test enunciated by the Supreme Court. The Court reasoned that Mr. Baker’s job of constructing living and dining quarters was too attenuated from Big Foot’s future purpose of extracting natural resources from the OCS for the OCSLA to cover his injury. Mr. Baker’s employment was located solely on land, whereas the employee in Valladolid spent 98% of his time on an offshore drilling platform. Furthermore, Mr. Baker’s particular job did not require him to travel to the OCS at all, making his work geographically distant from the OCS. Likewise, his employer had no role in moving the Big Foot to and installing it on the OCS. Based upon these specific facts of Mr. Baker’s employment, the Fifth Circuit concluded that the ALJ appropriately denied Mr. Baker’s claim.

Surveillance and Section 20a PresumptionThe recent decision of the U.S. Court of Appeals for the Fifth Circuit in Bis Salamis, Inc. v. Director, OWCP (Joseph Meeks), No. 15-60148 (March 17, 2016), highlights how the defense to a claim under the Longshore and Harbor Workers’ Compensation Act, 33 USC 901 et.seq. (LHWCA), can have a tortured journey through the liberal Benefits Review Board (BRB) until a successful result is reached in at least some of the U.S. Courts of Appeals. This opinion also underscores the importance of surveillance evidence when facing a prevaricating claimant.

In this matter the Fifth Circuit reversed the BRB which had twice reversed an Administrative Law Judge’s (ALJ) finding that the claimant’s testimony, video surveillance and other evidence presented by the employer showed that the claimant’s assertions were so unworthy of belief that they were not adequate to invoke the Section 20(a) presumption. Without the presumption aiding the claimant, the ALJ concluded that the claimant had failed to prove that his disability was related to his work activities. Not only did the claimant relate several versions of how his alleged accident occurred, he was also heard to say shortly after the event that he had been “hurt before but … never got anything for it.” There was also conflicting evidence as to whether the personnel basket transfer that was used to transport the claimant from a platform to a vessel and that was alleged to have caused the injury, resulted in a small jostling of personnel or involved a six to ten foot fall.

In his original opinion the ALJ concluded that the claimant was such an unreliable witness and dishonest individual that his testimony and the supporting opinions and reports of the doctors who relied on what he told them had virtually no probative value or evidentiary weight. The ALJ found that the only relevant fact that was established, as more likely than not to have occurred, was that the claimant was involved in an incident where he was tossed about in a personnel basket.

Underlying the ALJ’s initial opinion was his evaluation of  surveillance video showing the claimant capable of performing many activities without exhibiting pain or limitation at the time he reported to doctors that he was in intense pain and incapable of performing even the lightest of activities. The video also refuted the claimant’s testimony that he spent most of his time in bed and could not lift anything heavier than 10 lbs.

The Benefit Review Board (BRB) reversed the ALJ’s first opinion faulting the ALJ for failing to place his findings within the LHWCA’s framework or explicitly discussing the presumption on causation in the claimant’s favor under Section 920(a). The BRB felt that the ALJ had shifted the burden onto the claimant to prove the work relatedness of his injuries.

After the first remand to the ALJ, he again found that any testimony, findings or opinions based on the claimant’s statements and complaints were entitled to virtually no weight because he found the claimant to be so dishonest and unreliable. The ALJ acknowledged that employers are liable for instances that aggravate pre-existing conditions, but found that the claimant failed to meet even the slight prima facie burden to establish a compensable harm. The only harm the ALJ found claimant incurred was a lumbar strain for which claimant was treated and released to full duty.

On the second appeal to the BRB, it again reversed the finding that the ALJ’s order indicating it was not supported by substantial evidence because objective medical evidence in the record established that the claimant required treatment for his injuries and was prevented from going back to his hard labor job. On the second remand, the parties stipulated to the claimant’s average weekly wage and the ALJ entered an order awarding temporary total disability in compliance with the direction of the BRB. This was then appealed to the Fifth Circuit.

Applying the accepted standard of review in determining whether the ALJ’s decision was supported by substantial evidence, the Fifth Circuit concluded that an ALJ may make credibility determinations in asserting whether a claimant has established the prima facie showing required to obtain the benefit of the presumption under 20(a). The Court indicated that the BRB had improperly reasoned that even if the claimant was not credible, some of the medical evidence was sufficiently objective, that the ALJ should have accounted for it and applied the Section 20(a) presumption. The Court noted that it is established law that the ALJ may choose between reasonable inferences and that he exclusively empowered to weigh the evidence. It reiterated that an ALJ may accept or reject the conclusions of experts and is not required to accept the opinion or theory of a medical expert that contradicts his findings based on common sense. It noted that there was plentiful evidence demonstrating that the claimant had a preexisting degenerative back condition that could reasonably cause the pain he alleged. The court, however, found that there was no definitive evidence showing that the claimant’s suffered a traumatic injury, and that there was no evidence showing a difference in his spine before and after the incident on the personnel basket. The Court further noted that although some of the doctor’s findings were based on what they viewed as objective tests, it was not irrational for the ALJ to conclude that the claimant probably faked assertions of pain and limited range of motion which was refuted by the video surveillance.

department of labor logoOn Thursday, March 12, 2015, the Department of Labor Office of Workers Compensation Program (OWCP) filed in the Federal Register (Volume 80, No. 48) a direct final rule and request for comments with regard to changes to OWCP regulations intended to broaden the acceptable methods by which claimants, employers and insurers can communicate with OWCP and each other. The direct final rule becomes effective on June 10, 2015, without further action unless OWCP receives significant adverse comment to the rule by May 11, 2015. The notice issued by the OWCP provides that the revisions are procedural in nature and that they will apply to all matters pending on the date the rule is effective. These revisions either codify current practice or broaden the methods by which documents and information may be transmitted under the LHWCA.

In general the rules now recognize email transmission of documents as a means for communication between parties as long as the parties have either in writing or by email provided confirmation that the receiving party agrees to accept electronic transmission if it is sent through a reliable method. The rules also provide for a replication of this agreement. The revisions also provide for the use of the OWCP SEAportal method for serving documents on a District Director’s office, but does not exclude the existing means for delivery of documentation whether by mail, facsimile or hand delivery.

As we all know, the devil is in the details. It is therefore recommended that the LHWCA employer, insurer and practitioner review these revisions to be in compliance by their effective date.

Global Management Enterprises v. Commerce & Industry Insurance Co. clarifies whether oil spill clean-up injuries are covered under LHWCA.

In an unpublished per curiam decision, Global Management Enterprises, LLC v. Commerce & Industry Insurance Company, No. 13-31249, filed June 23, 2014, Judges Davis, Benavides and Prado determined that a worker who was injured while assisting with Deepwater Horizon oil spill clean-up efforts on an island in the Gulf of Mexico was not covered under the Longshore and Harbor Workers’ Compensation Act (LHWCA). Mr. De La Cruz was allegedly injured on the beach of an unnamed Gulf island while lifting a bag of oil-contaminated sand that would later be loaded onto a truck and eventually transferred to a vessel for removal from the island. 

Mr. De La Cruz was employed by Global Management Enterprises (Global), a temporary employment agency that was insured for workmen’s compensation payments by Chartis under a policy that excluded coverage for claims under the LHWCA. Due to the fact that De La Cruz had filed, but later withdrew, a Longshore Act claim while receiving state workmen’s compensation benefits, Chartis ceased workers’ compensation payments citing their policy’s LHWCA exclusion. Global then sued Chartis seeking the state workmen’s compensation coverage that they had purchased. 

The determinative situs issue for coverage under the LHWCA was whether the site of injury was an “other adjoining area customarily used by an employer in loading, unloading, repairing, dismantling, or building a vessel” 33 U.S.C. § 903(a). According to the decision by the Fifth Circuit in Depot Services v. Workers’ Compensation Programs, 714 F.3d 384 (5th Cir. 2013)(en banc), a work site, to be covered by the LHWCA, must (1) adjoin navigable waters and (2) customarily be used by an employer to facilitate one of the listed maritime activities. There was no dispute that the incident occurred at a site adjoining navigable waters. The remaining question was whether the beach was a location customarily used by an employer for covered activity. The panel concluded that the site of the injury was not. There was no evidence that any loading or unloading of vessels or repair of vessels transpired at the site where the claimant was injured. 

Interestingly, Chartis argued that the beach and pier where the crew would load the oil-laden sand aboard a vessel should be considered a single area, asserting that under Coastal Production Services, Inc. v. Hudson, 555 F.3d 426 (5th Cir. 2009) the site should be seen as interconnected with the longshoring activities. The Court in examining the material facts rejected this argument, finding that the proximity of the site of injury to the vessel loading activities was not sufficient to establish it as a component of the general area used for the overall loading process. 

While some had thought that the en banc decision in Depot Services v. Workers’ Compensation Programs had completely overruled Winchester and Hudson, this panel of the Fifth Circuit indicated that Winchester and Hudson were only overruled where they are inconsistent with the adjacency standard established in Depot Services. Citing a discussion in Winchester of the functional “customary use” component of situs they indicated the previous discussion remained binding precedent.