Supreme Court Takes on Special Ed Case
National News
The Supreme Court is again trying to decide when taxpayers must footthe bill for private schooling for special education students.
The court will hear arguments Tuesday in an Oregon case in which alocal school district contends that students should at least givepublic special education programs a try before seeking reimbursementfor private school tuition.
Afederal appeals court sided with a high-school student identified incourt papers only as T.A. The student enrolled in a $5,200-a-monthprivate program and sought reimbursement from the Forest Grove SchoolDistrict.
The Supreme Court heard a similar case from New York in 2007, but split 4-4 on the outcome.
The case is Forest Grove School District v. T.A., 08-305.
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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.