Justin Rumbaugh v. DirectTV and American Zurich Insurance Company

Topeka, Kansas worekers compensation lawyer represented the Plaintiff for compensation for a work place injury.



After suffering a back injury at work in 2014, Justin Rumbaugh received treatment through his employer's workers compensation insurer in accordance with the Workers Compensation Act. In 2016, about eight months after Rumbaugh was released to return to work and two years after his original work injury, Rumbaugh presented to an emergency department with symptoms of cauda equina syndrome.



Unfortunately, he was not immediately diagnosed and later brought a third-party medical malpractice action alleging he suffered permanent, continuing urological conditions from the delayed diagnosis.



In 2018, Rumbaugh reached a settlement with his employer, DirecTV, and its workers compensation insurer, American Zurich Insurance Company (collectively Respondents), related to outstanding claims for his 2014 work injury, but that settlement excluded claims for future medical benefits. Then, in 2020, Rumbaugh also settled a third-party medical negligence claim related to damages for his delayed cauda equina syndrome diagnoses. After several communication attempts, to which Respondents did not reply, Rumbaugh sent Respondents a check and letter explaining that the check was intended to resolve any subrogation amount owed to Respondents.



* * *



Legal issue Can an employer claim a subrogation lien on an employee's entire third-party malpractice settlement when the damages covered are not duplicative of compensation payable under the Workers Compensation Act?

Headnote



WORKERS COMPENSATION LAW. SUBROGATION LIENS. The court examined whether an employer's subrogation lien extends to an entire third-party medical malpractice settlement award, determining that such a lien is applicable only to the extent the settlement duplicates damages addressed by a workers' compensation award, according to the Workers Compensation Act, K.S.A. 44-504(b).



CONTRACT LAW. ACCORD AND SATISFACTION. The court considered the timeliness of an accord and satisfaction claim, affirming the lower board's decision to reject the claim on procedural grounds due to the claimant's failure to provide necessary evidence, such as medical bills, to substantiate the claim under K.S.A. 84-3-311.



Key Phrases Workers Compensation Act. Subrogation lien. Cauda equina syndrome. Medical malpractice settlement. Accord and satisfaction claim.

Affirmed in part, reversed in part, and remanded with directions.