by Alissa C. Atkins, Esq.
Last week, Business Insurance reported that a Louisiana log truck driver had been receiving temporary total disability benefits for post-traumatic stress disorder that developed after two women died in an accident when the car in which they were passengers pulled in front of the claimant’s logging truck. The workers’ compensation insurer unilaterally terminated the claimant’s disability benefits when a local newspaper reported that the claimant fought with a police SWAT team that entered his home on a drug bust. The insurer argued that if the claimant was capable of assaulting a police officer and dealing drugs, as outlined in the article, then he was physically and mentally capable of driving a logging truck.
Eventually, the claim went before the Louisiana Court of Appeals, where the arresting officer testified that the claimant never struck him because he did not have the opportunity to do so. The claimant further testified that when the SWAT team arrived in the door, he thought someone was breaking into his home, and ran at the first door that he saw (unfortunately for him, he ran directly into a police officer). Therefore, the Court determined that the picture that had been painted of the claimant was inaccurate and ruled that “by relying solely on a factually unreliable newspaper article as the basis for the termination of benefits, [the insurer] did not make a reasonably reliable determination.” The Appeals Court also noted the lack of correlation between an ability to deal drugs and/or attack an officer with the ability to drive a logging truck. Therefore, the claimant’s benefits were reinstated and the insurer was found liable for attorney fees and penalties.
However, the claimant eventually pled guilty to simple possession of marijuana, for which he received a one year probation sentence. In Georgia, benefits cannot be suspended strictly because of an arrest. However, if the claimant either pleads or is found guilty and is sentenced to jail time, benefits can be suspended on the grounds that the incarceration, rather than the injury for which benefits were previously received, is the cause of the claimant’s unavailability to work. Also, in Georgia, post-traumatic stress disorder in and of itself as a psychological condition is insufficient to secure the receipt of temporary total disability benefits without a physical injury. Even though this is not a Georgia case, the ruling makes a helpful point: do not unilaterally suspend benefits because of a newspaper story. However, definitely use any information you receive as a stepping point for further investigation.
