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Can I Lose Workers’ Compensation Benefits If I Fail to Provide a Complete Medical History?

Workers’ compensation is designed to protect employees who are injured on the job. But employers—and their insurance companies—often look for any angle they can to avoid paying what are supposed to be no-fault benefits. And while there are legitimate exceptions under Tennessee workers’ compensation law, as an injured employee you should not back down when you are wrongfully denied medical benefits.

Panel Orders New Hearing for Trucker Injured in Accident

In a recent Knoxville case, the Tennessee Supreme Court’s Special Workers’ Compensation Appeals Panel ordered a lower court to reconsider a claim brought by a truck driver injured in an accident. The trial judge had incorrectly granted summary judgment to the employer. The issue in dispute was whether the employee—actually, an independent contractor—failed to disclose certain pre-existing medical conditions to the employer.

Normally, an independent contractor would not be considered an employee covered by Tennessee workers’ compensation law. The contractor in this case owned a tractor trailer that he drove under an agreement to transport the employer’s goods. In this situation—a motor vehicle owner transporting goods for a common carrier—the contractor may elect to be covered by the employer’s workers’ compensation insurance.

That is what the plaintiff in this case did. The parties signed an “employment agreement” and a separate agreement providing for workers’ compensation coverage. While acting under these agreements, the contractor was injured in a truck accident that occurred in Nevada. The agreement nevertheless specified any workers’ compensation disputes would be heard in Knox County, Tennessee.

The employer refused to pay benefits, arguing the contractor “made material misrepresentations regarding his physical condition during his pre-employment medical assessment.” The employer maintained had it known about the contractor’s true physical condition, it would not have certified him to drive or offered an employment agreement. The trial court agreed with the employer, holding the contractor “obtained employment by fraudulent means” and was therefore not entitled to collect workers’ compensation benefits.

But the Workers’ Compensation Panel disagreed. The panel said there was “no authority for the proposition that the Tennessee Workers’ Compensation Act is not applicable when an independent contractor, who receives workers’ compensation coverage by way of contract, is alleged to have misrepresented his or her physical condition in the employment agreement.” And while an employer may deny coverage based on “misrepresentation of physical condition at the time of hiring,” there must be evidence that “there was a causal relationship between the subject matter of the false representation and the injuries later suffered by the employee.” In this case, the Panel said the employer “offered no proof” on this point and there was no reason to believe any of the contractor’s undisclosed medical conditions contributed to his accident injuries.

Get Help from a Tennessee Workers’ Compensation Lawyer

Workers’ compensation is supposed to make things easier for injured employees. But far too often, employers use the court system to drag out the process. That is why if you have been injured on the job, you need to speak with an experienced Knoxville workers’ compensation attorney as soon as possible. Contact the offices of Fox & Farley, Attorneys at Law, if you need immediate legal assistance.

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