Inability to show that alcohol caused accident nixes benefit reduction

To be entitled to the death benefit payment reduction under Wisconsin law, a carrier must present credible and substantial evidence that the employee was intoxicated at the time of his injury and that his injury was causally related to such intoxication.

Case name: Acuity Insurance Co. v. Labor & Industry Review Commission, No. 2008AP297 (Wis. Ct. App. 11/19/08).

Ruling: The Wisconsin Court of Appeals affirmed the Labor & Industry Review Commission's dismissal of the plaintiff's claim for decreased compensation.

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What it means: To be entitled to the death benefit payment reduction under Wisconsin law, a carrier must present credible and substantial evidence that the employee was intoxicated at the time of his injury and that his injury was causally related to such intoxication.

Summary: The claimant was a truck driver who was killed when his truck crossed a center line, crashed through a guardrail, plummeted down an embankment, and collided with a freight train. The workers' compensation carrier conceded liability but alleged it was entitled to decreased compensation payments under Wisconsin law. Under the relevant statute, if a fatal injury results from the employee's intoxication, the death benefit provided shall be reduced by 15 percent, but the total reduction may not exceed $15,000.

The Court of Appeals concluded that the commission was entitled to deny the claim for a decrease in compensation if it had legitimate doubts about whether the employee was intoxicated or whether a link existed between his intoxication and his fatal injury.

The analysis on the blood sample taken from the claimant detected no drugs but was declared invalid for ethanol alcohol due to contamination by diesel fuel. The carrier also submitted state lab reports and the report of an occupational medicine consultant. The administrative law judge noted a number of discrepancies which prevented the ALJ from conclusively establishing that the claimant's "alleged intoxication" was the reason for the accident. Further, there were questions regarding the methodology used by the expert and his qualifications to perform forensic analysis. The ALJ also reasoned that the validity and reliability of the testing methods may have affected the outcome of the tests.

January 29, 2009

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