New Appellate Case – Overlap between Workers’ Comp and Medical Malpractice

Baltimore County v. Ulrich Deals with Comp and Med Mal

Claimant sustained work injury and was paid benefits by Baltimore County.   As a result of bad/late diagnosis, Claimant filed medical malpractice case against Concentra.  Case settled in federal court. County sent lien letter to recoup payments made.  Claimant agreed to repay the TTD paid as a result of the additional time missed due to malpractice, but refused to pay for any medical care.

Claimant’s argument was that (1) no additional medical care was needed as a result of the medical negligence, (2) no claim for medical expenses was made in the medical malpractice claim and (3) Concentra was not the “third party” who caused the work injury.

Decision —

This statutory lien arises only when the employee recovers damages from a third party who is liable for the compensable injury.  A third-party healthcare provider that merely treats an employee’s work-related injury is not liable for that injury, but only for the additional harm resulting from negligent treatment.  Accordingly, where an employer has paid for medical services exclusively to treat the compensable injury (not to treat the additional harm from medical negligence), the employer has no subrogation interest in the reimbursement of those medical expenses out of the damages recovered by an employee for the alleged negligent treatment.

In this case, the injured employee recovered a monetary settlement in a malpractice action against the third-party healthcare providers that treated his work-related injury.  The employee did not recover any sums for medical expenses in the malpractice action.  The employer was not entitled to be reimbursed for medical expenses that resulted solely from the work-related injury—expenses that the employer alone was obligated to pay and that the employee had no legal right to recover from the third-party healthcare providers.