Employer Liable for Attorney's Fees if it Pays Some, But Not All, Benefits

An Employer faces payment of an attorney’s fee if it pays some, but not all, benefits sought by a claimant.
 
The Benefits Review Board reached this conclusion in Taylor v. SSA Cooper, LLC, BRB No. 16-0174 (6/30/17).  At issue in this case was the meaning of the phrase “any compensation” in Section 28(a), which provides, in part, “[i]f the employer or carrier declines to pay any compensation on or before the thirtieth day after receiving written notice of a claim for compensation … on the ground that there is no liability for compensation … and the person seeking benefits shall thereafter have utilized the services of an attorney at law in the successful prosecution of his claim, there shall be awarded, in addition to the award of compensation, in a compensation order, a reasonable attorney’s fee against the employer or carrier.”
 
The employer paid the claimant medical benefits, but not the one-week of compensation benefits the administrative law judge ultimately awarded the claimant.  The claimant’s attorney sought a fee of $11,136.28 for successfully prosecuting the claim by obtaining the week of benefits.  The employer refused to pay the attorney’s fee, relying on precedent that an employer is not liable for an attorney’s fee under Section 28(a) if, within 30 days of notice of the claim, it “admits liability for the claim by paying some compensation to the claimant.”  (Emphasis added.)  The employer further argued that, for purposes of Section 28(a), “compensation” has been held to include medical benefits.  Therefore, the employer maintained it was not liable for an attorney’s fee because it paid “some compensation,” in this case, medical benefits.  The ALJ agreed and denied an attorney’s fee.
 
The Board ruled in favor of the claimant, awarding attorney’s fees.  The Board determined that the term “compensation” in Section 28(a) must be interpreted as “disability and/or medical benefits.”  As the Board further explained, “a claim may be made up of parts, i.e., disability benefits, death benefits, medical benefits. If any type of benefit is denied and legal services are necessary to obtain the denied benefit, the claimant is entitled to an employer-paid fee because the employer’s denial caused the need for attorney involvement. Specifically, if both medical and disability benefits are claimed, and the employer pays one but not the other type of benefit, the employer is liable for an attorney’s fee if the claimant is later successful in obtaining the denied benefit.  To hold otherwise is to reduce the claimant’s successfully-obtained benefits, which the employer had denied, by the amount of his attorney’s fee.”  (Citations omitted.)

Taylor v. SSA Cooper, LLC, BRB No. 16-0174 (6/30/17)