Supreme Court says tribes must be fully reimbursed
Recent Cases
The Supreme Court says the government must fully reimburse Native American tribes for money they spent on federal programs.
The federal government had agreed to fully reimburse money tribes spent on programs like law enforcement, environmental protection and agricultural assistance, but Congress capped the amount of money earmarked for that reimbursement. The tribes sued, and the 10th U.S. Circuit Court of Appeals in Denver said the money must be fully reimbursed.
The high court on Monday said the Ramah Navajo Chapter and other Native American tribes must get their money back.
Justice Sonia Sotomayor wrote the majority opinion for Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Elena Kagan. Chief Justice John Roberts, and Justices Ruth Bader Ginsburg, Stephen Breyer and Samuel Alito dissented.
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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.