West Virginia high court excludes inmates from workers' comp

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Inmates participating in work-release programs do not quality for workers' compensation benefits, the West Virginia Supreme Court ruled has ruled.

The court on Thursday unanimously affirmed a Workers' Compensation Board of Review's 2015 decision to not grant workers' compensation to a work release inmate named William F. Crawford, the Charleston Gazette-Mail reported. Crawford's hand was severely injured in a wood chipper in 2013 while he was working on a road crew for the state Division of Highways.

He was employed by the Charleston Work Release Center, now called the Charleston Correctional Center. Inmates live and work there as they prepare to re-enter society after leaving prison.

Crawford's injury required hospitalization and surgery, and his ring and pinky fingers were partially amputated. The state Department of Corrections covered his medical expenses, which exceeded $90,000. He was released on parole shortly after his hospitalization.

Court documents say Crawford sought workers' compensation benefits because "lack of treatment has put him at a significant disadvantage in re-entering society." He had appealed the board of review's decision, saying state law didn't clarify coverage exclusion for work-release inmates. He also said his equal protection rights had been violated, arguing that inmates working for private businesses would receive the benefits, while inmates working for a state agency would not.

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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.

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