High court won't review award to Calif. couple deputies shot

U.S. Court News

The Supreme Court is leaving in place a roughly $4 million judgment for an innocent couple shot while California deputies searched for a wanted man.

The high court on Monday declined to again take up the case involving Angel and Jennifer Mendez. Their case had previously been before the justices in 2017. At that time, the high court unanimously overturned the $4 million award and ordered a lower court to revisit the case. On second look, the appeals court again sided with the couple.

The pair were shot in 2010 when deputies searching for a parolee entered a backyard shack in Lancaster, north of Los Angeles, where the couple was living. Deputies fired shots after seeing Angel Mendez pick up what looked like a gun. It was a BB gun.

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Workers’ Compensation Subrogation of Administrative Fees and Costs

When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.

In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.

In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.