CHARLOTTE, NC – In examining the elaborate relationship between employee rights and the maintenance of operational integrity, we often encounter situations where a claimant, or Plaintiff, is terminated for cause following the approval of a workers’ compensation claim. Such a termination raises critical inquiries regarding the responsibility of the insurance carrier in relation to the payment of Temporary Total Disability benefits. Should the carrier be obligated to initiate or continue these benefits, despite the termination? This question merits careful consideration, as it touches upon legal and practical aspects of workers’ compensation practices.
This very question was addressed in the case of Richards v. Harris Teeter, which was decided by the Court of Appeals in 2022. In this case, Plaintiff, who was employed as a truck driver by Harris Teeter, experienced an injury resulting from a single-vehicle accident. The incident occurred when Plaintiff lost control of his vehicle, leading to a crash in a grassy field.
Following the accident, medical documentation indicated a low back injury and Plaintiff’s physician to recommend a leave from work while he underwent necessary medical treatment. Subsequently, Plaintiff filed a claim for this injury. Defendants recognized their obligation by initiating payment of indemnity benefits and covering medical expenses associated with the claim. However, they did not challenge the validity of the claim within the statutory timeframe which resulted in the acceptance of compensability of the Plaintiff’s claim.
Shortly after the accident, Plaintiff was terminated for “Violation of Established Safety Procedures” with Defendants personnel records citing that the accident was preventable as the Defendants camera, in the cab of the truck, showed that Plaintiff closed his eyes for approximately seven to ten seconds which led to the accident, thus he was “not eligible for rehire”.
It’s important to note that Harris Teeter maintained a mandatory return-to-work program designed specifically for workers’ compensation claimants. Additionally, there were several temporary light-duty positions available that could have been suitable for Plaintiff. However, due to Plaintiff’s ineligibility for rehire, Harris Teeter did not extend an offer for reemployment. Defendants then contended that the Plaintiff constructively refused suitable employment, arguing that termination for cause prevented the possibility of reassignment. Their position was that, but for the termination, Plaintiff would have continued his employment at his pre-injury wages, as the Defendants were capable of accommodating his work restrictions with available light-duty roles.
Plaintiff’s attorney filed a Request that Claim be Assigned for Hearing, alleging that the Defendants failed to provide payment for past due Temporary Total Disability benefits. In their deciding this case, the Court of Appeals referenced the case of Seagraves v. Austin Co. of Greensboro, 123 N.C. App. 228, 472 S.E.2d 399 (1996). This case examined the conditions under which an employee could be considered to have refused suitable employment. Specifically, the determination focused on whether the employee’s loss of earning capacity could be traced back to a wrongful act that led to their dismissal, in which case benefits would be denied. On the contrary, if the loss was a direct result of a work-related disability, the employee would be entitled to the appropriate benefits available.
The Court of Appeals concluded that Plaintiff had indeed been terminated from his regular position due to his involvement in an accident that resulted in his work injury. They further established that the presence of “gross negligence” does not serve as a valid defense in a compensation claim. As highlighted in the case of Hartley v. N.C. Prison Dep’t, 258 N.C. 287, 289, 128 S.E.2d 598, 600 (1962), a claim can only be defeated by instances of intoxication or injuries that are intentionally inflicted.
Defendants argued that fault should have a place in the workers’ compensation system when it comes to determining whether an employer may terminate benefits. However, the Supreme Court considered similar concerns in the case of McRae v. Toastmaster where the court recognized the potential for abuse if employers were permitted to avoid their payment obligations simply because a claimant was terminated.
The key takeaway from this case is that while an employer may indeed terminate a claimant for valid reasons—such as violations of company policy—it remains essential that these violations cannot have occurred concurrently with the work-related injury. Should they happen simultaneously, it could expose Defendant’s to liability for Temporary Total Disability benefits that may be due to the claimant.
*****This article is for information purposes only and does not constitute legal advice. If you have specific question about properly suspending or terminating TTD, or if you need other legal assistance related to SC Workers’ Compensation Defense, reach out to Greg Seaborne at [email protected] or 704.247.9695*****