Supreme courts in several states have handed down workers'compensation-related rulings lately that, depending on where yousit at the table, are either brilliant or disastrous.

The Supreme Court of Ohio unanimously ruled against workers'compensation claimant Karen Jordan this month in a case focusing onpayments for brand-name prescription drugs.

Jordan had been receiving workers' compensation benefits,including full payment for prescription drugs, since 1984. However,a 2005 administrative rule change set the maximum allowable paymentfor a brand-name drug at the cost of a pharmaceutically equivalentgeneric drug. When Jordan's prescription payments were reduced, shebegan her rounds of appeals to various commissions and courts. Shewas seeking a writ ordering Ohio's Industrial Commission tocontinue paying the cost of her brand-name prescription drugsdespite the change, arguing that the rule violates the stateconstitution by retroactively infringing on a claimant's "vestedright."

After the 10th District ruled against Jordan, she sought relieffrom the Supreme Court, which affirmed the lower court's ruling.While the court agreed that state law has "consistently givenclaimants the right to treatment for their allowed conditions ...it has never given them the right to dictate the terms of thattreatment or the conditions of payment. R.C. 4123.66 has alwaysgiven that right to the administrative agency."

The court further declared: "The court of appeals correctly heldthat Jordan has no vested right to full payment for brand-namemedication. Without such a right, there can be no credible claim ofimpermissible retroactivity."

A Louisiana Supreme Court decision has sent a case involvingseveral entities back to the lower courts. According to courtdocuments released recently, the facts of the case are this: OnJan. 12, 2007, Broussard Physical Therapy filed a disputed claimfor compensation against an employer, Family Dollar Stores, Inc.,and its workers' compensation insurer, Ace American Insurance.Broussard had provided health care to an injured employee of FamilyDollar. But when underpayment and/or late payment of medical billsfor the employee became an issue, Broussard said that thedefendants -- not Broussard -- were liable under the Louisianaworkers' compensation act. Broussard also sought penalties andattorneys' fees for "arbitrary and capricious handling" of itsclaims.

Family Dollar and Ace then filed a third-party demand againstthe PPO involved, FOCUS Healthcare Management, Inc. They soughtdefense and indemnification from a workers' compensation judgebased on the PPO contracts with FOCUS, alleging that theunderpayments claimed by Broussard were discounts associated withthe PPO contracts, making FOCUS responsible, not them.

FOCUS filed an exception of lack of subject matter jurisdiction,arguing that the workers' compensation judge lacked jurisdiction todecide the claim. The workers' compensation judge denied theexception of subject matter jurisdiction. FOCUS then went to theThird Circuit Court of Appeal to request a stay, which wasgranted.

The case slowly worked it way up to the Louisiana Supreme Court,which ruled and bounced it back down.

The court determined that the dispute between Family Dollar/Aceand FOCUS was a contract dispute involving indemnity under PPOagreements. The court said that the general rule is that districtcourts are vested with original jurisdiction of all civil matters.Although the original, exclusive jurisdiction granted to workers'compensation judges is often an exception to this general rule, itis limited to explicit terms. State law does not expressly grantworkers' compensation judges jurisdiction over contract disputes ofthis type, the justices said.

Stating that the workers' compensation judge involved lackedjurisdiction to adjudicate the third-party demand, the courtreversed the court of appeal's ruling, dismissed the third-partydemand, and remanded the original case back to the workers'compensation judge.

In Florida, the Supreme Court's October decision in Murrayv. Mariner Health and Ace USA was widely viewed as a setbackfor the workers' compensation reforms enacted in 2003 by the statelegislature.

Emma Murray had filed a petition for benefits for injuries shesaid occurred on the job in 2003. Her employer challenged theclaim, and lost; Murray was awarded $3,224. Because a 2003 workers'compensation reform statute limited claimant attorneys' fees to apercentage of the benefits obtained, her lawyer received less than$700 for his work. It was the case claimant attorneys had beenwaiting for since the 2003 changes.

Because the 2003 legislation did not delete an existingreference to "recovery of a reasonable attorney's fee from thecarrier or employer" contained in another subsection of theworkers' compensation act, the court ruled that, "based upon theplain language of the statute, when a claimant is entitled torecover attorneys' fees from a carrier or employer ... the claimantis entitled to recover 'a reasonable attorney's fee,'" and that thestatutory formula that limits attorneys' fees to a percentage ofbenefits obtained should not be applied if it results in aninadequate fee.

The court ultimately determined that Murray's attorney should beawarded some $16,000, using a 40-year-old case to define"reasonable," including standards such as time and labor required,the skill and experience of the lawyer, and the certainty of afee.

The more far-reaching result is the reinstatement of hourlyclaimant attorney fees in all workers' compensation cases, at leastfor now. Business and insurance industry coalitions are busilycrafting legislative remedies to put before lawmakers.