High court rules on workers comp fund

In a decision that could have far-reaching effects for Utah workers, the Utah Supreme Court has ruled that paying for medical costs for injuries or illnesses associated with a job now will only be paid in proportion to the amount directly connected to the job.

Traditionally the costs have been fully covered by the Workers Compensation Fund.

The ruling leaves employees responsible for the remaining costs.

An attorney for the Utah Labor Commission said he now worries that many workers who get such injuries or sickness may not seek medical treatment at all because they cannot afford their share of the expense. However, an attorney for the Workers Compensation Fund said the high court's decision reflects state law and appears to be what legislators intended.

The Supreme Court addressed two separate cases, one involving a woman with carpal-tunnel syndrome, and another involving a man who developed lower-back problems after working 20 years as a meat packer. In both cases, the Utah Court of Appeals had interpreted the state's Occupational Disease Act's reference to "compensation" as referring to medical costs as well as wages.

However, the Supreme Court's unanimous ruling, issued this week, reversed those Court of Appeals decisions involving both Jeffrey Smith, the man with back problems, and Tamara Edmonds, the woman with carpal-tunnel syndrome.

"This breaks my heart," said Phillip Shell, who represented both Smith and Edmonds and who has handled workers-compensation cases for 26 years. "It hurts my clients — people who are hurt and out of work."

Shell said the ruling may sound fair but will result in unfortunate outcomes for many working people.

"If you get sick at work because of some chemical and have some pre-existing condition, you have to pay part of that care, even though you didn't need treatment before," Shell said. "It's just a travesty for the injured worker."

Alan Hennebold, attorney for the Utah Labor Commission, said the decision will "change what we thought the law was, which was to require Workers Compensation insurance carriers to pay for all of the medical care necessary to treat work-related occupational diseases.

"Now, those expenses are going to be parsed out between the part that is directly attributable to the employee and the part that might relate to an individual's propensity to a disease, and the cost will (be) split according to those proportions," Hennebold said.

He said he fears some workers will lose out because they will never seek any medical care if they cannot pay their portion of the costs.

However, Floyd Holm, attorney for the Workers Compensation Fund, said the ruling is the correct one for the high court to make, and it is based on "common sense and fairness."