Case highlights flaws of work comp system
AN old joke about Oklahoma’s workers’ compensation system was that it was a constitutionally sanctioned system of fraud. A recent Oklahoma Supreme Court case shows why that line packed a punch.
On Feb. 12, 2014, Brandon Gibby fell off a pallet jack and injured his right wrist and left knee while working for Hobby Lobby. The employer provided him temporary total disability and medical benefits. The temporary total disability benefits ended April 29, 2014, when Gibby returned to work. When Gibby sought permanent partial disability benefits, Hobby Lobby resisted because he had missed multiple medical appointments without excuse. Under state law, this was grounds to deny further workers’ compensation benefits. In response, Gibby sued.
The Supreme Court sided with Gibby in a 5-3 decision, saying fault cannot be considered in a no-fault system. But the facts of the case show why so many Oklahomans view the state’s workers’ compensation system with skepticism.
State law allowed workers’ comp benefit recipients to miss medical appointments for “extraordinary circumstances beyond the employee’s control.” The majority opinion acknowledges, “A trial was held at which Claimant attempted to demonstrate extraordinary circumstances for missing three scheduled medical appointments. The administrative law judge found none …”
The three justices who dissented (on technical grounds) went into greater detail.
Gibby was injured Feb. 12, 2014. On June 2, 2014, he was scheduled to see a doctor for additional treatment “but did not show up for the appointment.” Medical notes showed the man didn’t call and was charged a no-show fee. Gibby claimed he overslept and rescheduled the appointment, but the dissenting opinion notes “the record does not include any medical notes reflecting the rescheduled visit.”
When the man saw another doctor on June 24, 2014, that doctor’s notes stated that Gibby “appears to be doing fine.” Gibby subsequently requested another physician.
On Aug. 11, 2014, Gibby’s new doctor recommended therapy, bracing, and anti-inflammatories and estimated Gibby would reach maximum medical improvement in two to three months. Gibby was scheduled for a follow-up appointment with that doctor on Sept. 12, 2014 “but did not attend the appointment.” Gibby testified he got lost in downtown Oklahoma City. He again claimed to have rescheduled the appointment, but the dissenting justices noted “nothing in the record substantiates that testimony.”
Gibby was scheduled to see that same doctor again on Oct. 20, 2014, but was again a no-show. The doctor’s notes for that visit stated, “Brandon was scheduled to be seen today. He has had multiple no-shows, a total of four. I last saw him in August. I am assuming his knee must be fine or he would be showing up for his appointments.”
Gibby’s attorney called the court ruling “a sweet victory for working people because that section of the 2013 law was absolutely punitive in nature.” Somehow, we doubt most Oklahomans who work for a living would agree.
Most Oklahomans would prefer to be able to work. In contrast, this plaintiff appears to have had less interest in medical treatment than in milking workers’ comp payments for all they were worth. The case highlights why Oklahomans have long supported reforming the system, and why additional reforms are still needed.