There are many ambiguities in the world of workers comp. (Without them, there might not be a need for this blog.) So today we find ourselves in Missouri, the “show me” state, where the state’s supreme court shows us how a dead man can be available for work.
The case involves Fred Schoemehl, a 62 year old man who suffered a work-related knee injury in 2001. He was eventually awarded permanent total disability, but unfortunately, one month after the award, he died of causes unrelated to the work injury. In most states, a deceased employee’s dependents will collect benefits if the death is work related. Otherwise, the benefits cease with the death of the employee. The assumption, even in the case of a permanent total disability, is that the dependents are entitled to benefits as long as the employee is at least theoretically “available for work.” Upon Mr. Schoemehl’s death, that availability ended. When Fred died, the dependent benefits to his wife, Annette, ceased.
She sued. Fred was dead, but Annette still was dependent upon his income. The court writes: “Until this case, no Missouri court had determined whether the right to compensation for the permanent total disability of an injured employee, who has died from causes unrelated to the work injury, survives to that injured employee’s dependents.” A majority of the state Supreme Court found in Annette’s favor. They determined that she is technically “an employee” – citing section 287.020.1 of the workers comp law, which provides that “any reference to any employee who has been injured shall, when the employee is dead, also include his dependents….”
So, Annette, who was not a disabled employee, continues to receive the indemnity benefits of a permanently disabled worker.
Judge Stith dissented from this finding:
The disability at issue here was an injury to Mr. Schoemehl’s knee. That injury necessarily discontinued upon his death. Even if the second prerequisite to payment under section 287.200.1 — continuance of the employee’s life — is met by reason of section 287.020.1’s inclusion of dependents in the definition of “employee,” the first prerequisite — continuance of the disability — is not satisfied. Therefore, upon Mr. Schoemehl’s death, neither he nor his dependents were entitled to continued permanent total disability payments. Accordingly, Mrs. Schoemehl is not entitled to receive compensation for permanent total disability benefits beyond that already accrued to Mr. Schoemehl at his death.
Predictably, insurers and business advocates are upset with this decision. Gary Marble, president of Associated Industries of Missouri, sees a troubling precedent, where any and all dependents of diseased disabled workers will now file for continuation of benefits. “Basically,” he says, “if not corrected, the workers compensation system has been relegated to a life insurance policy in addition to the legally mandated coverage for injured workers. The system simply cannot support this additional cost.” Needless to add, such benefits are not contemplated in current Missouri rates.
The ambiguities in the Schoemehl case disappear when a worker is killed on the job or dies from work-related causes. In these sad cases, the dependents are unambiguously entitled to benefits, as long as they meet the legal definition. Children lose eligibility when they become adults. Widows and spouses secure lifetime benefits, unless, of course, they choose to marry.
It will be interesting to track the impact of this ruling on Missouri claims. The state legislature may choose to respond to the business lobby and change the law to eliminate the ambiguous definition of “disabled employee.” Short of that, the “show me” state has opened the door to a new level of benefits. This approach is certainly humane, if not exactly what most people have in mind when they think of paying workers indemnity for the specific times they are at least theoretically available for work, but unable to do the job.