Maintenance And Cure Denied Where Plaintiff Willfully Concealed Pre-Existing Back Trouble
December, 2005
by Kimbley A. Kearney and
In Rickey Brown v. Parker Drilling Offshore Cor., 2005 A.M.C. 827 (5th Cir. 2005), the U.S. Fifth Circuit Court of Appeals held that a Jones Act employer may deny maintenance and cure benefits to an injured seaman when the employer can establish that the seaman intentionally concealed a preexisting medical condition.
Facts
Plaintiff Rickey Brown was hired by Parker to work as a floorhand. On a medical questionnaire, Brown was asked whether he had “Past or Present Back and Neck Trouble.” Brown answered "no." Based partly on this representation, Brown was hired by Parker in August, 2000.
Actually, Brown had injured his back in 1998 as a result of a lifting accident. About ten months later, Brown applied to work for LeTourneau, Inc. as a seaman. When filling out LeTourneau’s medical questionnaire, Mr. Brown checked “no” when asked whether he had ever suffered from back trouble. In May of 2000, Brown alleged that he injured his back while at work for LeTourneau. After the alleged accident, Brown was terminated for “falsely reporting an on-the-job accident, filing a false accident claim and failing to disclose his 1998 back injury on LeTourneau’s medical questionnaire.” Approximately two months after being fired by LeTourneau, Brown was hired by Parker.
On April 20, 2001, Brown reported that he experienced back pain while pulling slips out of the master bushings of the rotary table aboard Parker’s ship. While investigating the accident, Parker came to believe that Brown’s alleged back injury was not sustained aboard Parker’s ship and that Brown had intentionally concealed his prior back injuries. Parker subsequently withheld payment of Brown’s maintenance and cure benefits. Brown filed suit against Parker, seeking maintenance and cure and personal injury damages. The jury returned a verdict in favor of Brown awarding him benefits and damages.
Analysis
On appeal, the Fifth Circuit vacated the jury’s verdict. The court found that the jury clearly erred when it found that plaintiff had not willfully concealed his medical condition. A Jones Act employer is also allowed to rely on certain legal defenses to deny these claims, such as an injured seaman willfully concealing a preexisting medical condition from his employer. The court stated that in order to establish “willful concealment” by an employee, an employer must show that: 1) the claimant intentionally misrepresented or concealed medical facts; 2) the non-disclosed facts were material to the employer’s decision to hire the claimant; and 3) a connection exists between the withheld information and the injury complained of in the lawsuit. The court found that Parker was able to make this three-pronged showing.
First, Parker established that Brown had been treated for back injuries on two prior occasions before he completed the medical questionnaire for Parker. Moreover, Brown had been fired from LeTourneau for filing a false accident report, falsely reporting an on-the-job injury and denying that he had suffered from prior “back trouble” on LeTourneau’s medical questionnaire and misstated during his deposition that he did not seek medical care while working for LeTourneau. On appeal, Brown offered two explanations for failure to disclose his prior medical condition. He first contended that the question at issue on Parker’s medical questionnaire was a compound and, therefore, unfair question. He further contended that he did not understand the meaning of “trouble.” The Fifth Circuit rejected both of Brown’s excuses.
Parker also established materiality and causality at trial, the other two elements of the willful concealment test. The court found that Parker based its decision to hire Brown in part on whether he had past or present back and neck trouble. Therefore, the information was material.
Next, the court concluded that “the requisite causal link is established if the preexisting injury and the new injury are located in the same part of the body.” 2005 AMC at 834. Because Brown’s injuries were both in part of the lumbar spine, “the causal link between the allegedly concealed information and the new injury was established at trial.” Id.
The Fifth Circuit ultimately held that the jury’s finding that plaintiff did not intentionally conceal his prior back injuries was a clear error. The court vacated the jury’s verdict and dismissed the matter with prejudice.
Learning Point:
A Jones Act employer has the right to deny maintenance and cure benefits to an employee when the employer can establish that the employee willfully concealed prior medical conditions. In order to do so, the employer must be able to satisfy all three elements of the “willful concealment test.” •
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