On January 31, 2017 the Missouri Labor and Industrial
Relations Commission (“LIRC”) affirmed the Award of an Administrative Law Judge
(“ALJ) in Casey v. E. J. Cody Co., a
case involving the application of the “occupational diseases due to toxic
exposure” amendments to the Missouri Workers’ Compensation Law, which became
effective on January 1, 2014. The ALJ found that the employer’s insurer on the
date that the employee’s mesothelioma was diagnosed was liable for the enhanced
mesothelioma benefit, even though the employee was last employed by that
employer, and last exposed to asbestos, in 1990.
{The ALJ’s Award was discussed in an alert posted to this
website on April 11, 2016. Please refer to that here.}
In the Final Award, the LIRC affirmed the ALJ’s findings that:
- The
employee (now deceased) contracted mesothelioma, an occupational disease.
- The
mesothelioma arose out of and in the course of his employment.
- The
employee was last exposed to asbestos when he worked for Cody Co., his last
employer.
- The
employer had notice of the occupational disease or was not prejudiced by any
lack of notice.
- The
employee’s exposure to asbestos was the prevailing factor in causing the
employee’s mesothelioma and resulting death.
- The
insurer’s mesothelioma endorsement applied to the Claim, since the date of
diagnosis (October 26, 2014) was after January 1, 2014 and the disease was
diagnosed during the policy period.
- The
mesothelioma endorsement superseded the policy language, which provides that in
order for the policy to apply to an occupational disease, the exposure must
take place during the policy period.
- [The
ALJ’s award was only modified to correct the rate of compensation utilized by
the ALJ to calculate the enhanced benefit, the maximum rate of compensation in
effect on the date of diagnosis for permanent total disability and death
benefits (105% of the State Average Weekly Wage – “SAWW”), to 100% of the
then SAWW - as required by Sec. 287.200.4.]
Although the LIRC generally approved
and adopted the ALJ’s rulings on the coverage issue, they added some additional
reasoning of their own:
- The LIRC rejected the insurer’s argument
that Sec. 287.063.2, the section which shifts all liability to the last
employer in whose employment the employee was last exposed to the hazard of the
disease at issue, should also then shift the liability to the last insurer for
that last employer.
- That argument was rejected since
there isn’t sufficient legal authority to find that Sec. 287.063.2 applies
equally to successive insurers as well as successive employers.
- In addition, the LIRC pointed out
that the historical insurer (here the insurer for the employer in 1990) could
not have calculated and charged a premium to cover a risk that didn’t exist in
the law when that insurer’s policy was written [but mesothelioma has been a
recognized occupational disease for decades].
- However, the current insurer wrote
the policy, and added the mesothelioma endorsement, fully aware of the exposure
that insurer was accepting and for which that insurer could collect an appropriate
premium [really?].
- The LIRC also questioned whether Sec.
287.063.2, given the current “rule of strict construction”, even applies to
cases being pursued under Sec. 287.200.4 due to the lack of guidance in the
latter section concerning the successive insurers issue.
- Whereas the new law clearly applies
to the insurer which added a mesothelioma endorsement after January 1, 2014.
- Lastly, the LIRC emphasized that
under Sec. 287.280 an insurer must insure the employer’s “entire liability”
under the workers’ compensation law, ergo, including the liability now created
by the new occupational disease provisions.
You need to know:
- The
LIRC’s decision is likely to be appealed.
- The
constitutionality issues which the defendants raised have not yet been addressed
(since neither the ALJ nor the LIRC have the power to decide those issues).
- Only
the enhanced benefit is at issue (no “traditional” occupational disease
benefits were being sought).
- The
date of diagnosis was after January 1, 2014 (in some cases which had been filed,
only the Claim filing date is after January 1, 2014).
- We
don’t know to what extent this decision applies to claims for one of the other
ten “occupational diseases due to toxic exposure”, those where neither an
election nor an endorsement is required.
STAY TUNED!
COPYRIGHT
Evans & Dixon L.L.C. 2017