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Workers' Compensation

Flor v. Holguin, 9 P.3d 404 (Haw. 2000)

Outcome:    Somewhat favorable

Also under Abusive litigation against physicians

Issue

The issue in this case was whether an employer should be charged under the “last injurious exposure rule” if an employee was unable to determine when and where she contracted a disease.

AMA interest

The AMA strives to avoid the expansion of liability theories against physicians, which can lead to abusive litigation. 

Case summary

A dental hygienist contracted Hepatitis C and sued three dentists to recover workers compensation damages.  She had worked for these dentists over a roughly ten year period.  She was unable to identify when she contracted the disease or which dentist, if any, had employed her when she had contracted it.

On appeal from a denial of workers compensation benefits, the Hawaii Supreme Court recognized Hepatitis C as a compensable occupational disease under the Hawaii workers compensation statute.  The court also ruled that, because of the difficulty of determining when Hepatitis C is contracted and because each exposure “contributes to the progression of the disease,” the court would employ the “last injurious exposure rule” and charge the employer for whom the plaintiff worked at the time of diagnosis with liability for all of plaintiff’s charges.

The defendants petitioned the Hawaii Supreme Court for rehearing.  The court granted in part and denied in part the defendants’ request for rehearing.  The court held that on rehearing the employers would be allowed to present evidence on whether the employee’s continued exposure to the conditions that initially precipitated her hepatitis C infection contributed to or otherwise aggravated the progression of her disease.

Litigation Center involvement

The Litigation Center and the Hawaii Medical Association filed an amicus brief to support the petition for rehearing.  The brief argued that the basic medical assumption underlying the Hawaii Supreme Court’s prior ruling was questionable.  The brief requested that, on remand, the parties be permitted to submit additional evidence on issues concerning aggravation of a preexisting disease.

Maryland Workers' Compensation Fee Schedule (Montgomery Cty., Md. Cir. Ct.)

Also under Payment issues (for physicians)

Issue
The issue in this case was whether the Maryland Workers’ Compensation Commission ("WCC") should award payment for medical services according to the fee schedule established in the Maryland Medical Fee Guide, or whether and under what circumstances it had discretion to pay according to a lower rate if the health care provider has agreed to accept the lower rate under a managed care contract.

AMA interest
The AMA supports fair policies and practices regarding payment for physician services.

Case summary
Two claims, adjudicated by the WCC with apparently conflicting results, were appealed to the circuit court. The Maryland physicians believed that the WCC should have required that the health care providers be awarded the amount specified in the Maryland Medical Fee Guide fee schedule. However, the court entered summary judgment against the physicians on both claims.

Litigation Center involvement
The case was supported by MedChi, the Maryland State Medical Society, and by several groups of Maryland physicians. The Litigation Center also contributed to the defraying of these expenses.