Liberty Mutual Ins. v. Larry Brinton, Jr.

This workers' compensation appeal has been referred to the Special Workers' Compensation Appeals Panel of the Supreme Court in accordance with Tenn. Code Ann. _ 5-6-225(e)(3) for hearing and reporting to the Supreme Court of findings of fact and conclusions of law. This appeal presents a novel issue arising from the provisions of T.C.A. _ 5- 6-238(b), which is one of the 1992 amendments to the Workers' Compensation Act. The appeal was perfected by the defendant, The Tennessee Department of Labor Second Injury Fund, from a ruling of the trial court awarding plaintiff, Liberty Mutual Insurance Company, a judgment in the sum of $6,526.52. The complaint alleged plaintiff was the workers' compensation insurance carrier for Macawber Engineering, Inc. and one of their employees, Lonnie D. Roberts, contended he sustained a work-related injury (heart attack) on July 19, 1993, as a result of stress due to overtime work and excessive heat at his workplace; that upon reviewing the claim plaintiff denied the heart attack was work- related and declined to pay benefits and medical expenses; that the claim was reviewed by a workers' compensation specialist who ordered plaintiff to pay temporary total disability benefits of $6,526.52 for a period beginning July 2, 1993 to January 17, 1994, and plaintiff complied with this order; that sometime after February 14, 1994, the Department of Labor determined the claim was not compensable as the heart attack was not work-related; that plaintiff made a demand upon the state Second Injury Fund for a refund which was declined. The complaint alleges that a copy of the state department's order to pay, drafts issued by plaintiff in satisfaction of the order and a copy of the department's order denying plaintiff's claim were attached to the complaint as exhibits but the certified record does not contain any of these documents. Defendant answered the complaint by alleging it was without sufficient information or knowledge to form a belief as to the allegations and strict proof of same was demanded. For further answer it was alleged that T.C.A. _ 5-6-238 allowed a workers' compensation insurance carrier to receive a refund under circumstances as alleged in the complaint when the Defendant was furnished a copy of a court order finding the claim was not compensable and since no such order had been submitted to it, the claim for a refund was premature. 2