Destiny Schoon v. Farmington Casualty Company; Gallagher Bassett Services, Inc.; Examworks, LLC

CourtDistrict Court, D. South Dakota
DecidedDecember 4, 2025
Docket5:24-cv-05002
StatusUnknown

This text of Destiny Schoon v. Farmington Casualty Company; Gallagher Bassett Services, Inc.; Examworks, LLC (Destiny Schoon v. Farmington Casualty Company; Gallagher Bassett Services, Inc.; Examworks, LLC) is published on Counsel Stack Legal Research, covering District Court, D. South Dakota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Destiny Schoon v. Farmington Casualty Company; Gallagher Bassett Services, Inc.; Examworks, LLC, (D.S.D. 2025).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF SOUTH DAKOTA WESTERN DIVISION

DESTINY SCHOON, 5:24-CV-05002-ECS Plaintiff, Vs. ORDER GRANTING EXAMWORKS AND DEFENDANTS’ REQUESTS TO PREVENT FARMINGTON CASUALTY COMPANY; THE PRODUCTION OF CONFIDENTIAL GALLAGHER BASSETT SERVICES, INC., AND SENSITIVE MEDICAL INFORMATION OF INDIVIDUALS Defendants, UNRELATED TO THIS LAWSUIT EXAMWORKS, LLC, Intervenor.

Plaintiff, Destiny Schoon, filed a lawsuit in this Court pursuant to 28 U.S.C. § 1332 alleging state-law claims related to her workers’ compensation injury. Doc. 1. She sues her employer’s insurer, Farmington Casualty Company (Farmington), and Farmington’s third-party

administrator for its claims management program, Gallagher Bassett Services, Inc. (Gallagher Bassett). Id. 1 2-5. Currently pending before this Court is Intervenor Exam Works, LLC’s (Exam Works) and Defendants’ requests to prevent the production of confidential and sensitive medical information. Docs..37, 41. I. Factual Background’ On May 7, 2015, Schoon injured herself while hanging advertisements for her job at News America Marketing. Doc. 1 | 8. On May 8 and 12, 2015, | Schoon had chiropractic

1 This Court recites a brief factual background as alleged in Schoon’s Complaint and the submitted briefs. This inclusion is solely to provide context for the pending requests and is not intended to adopt the facts as true.

adjustments to alleviate her neck and shoulder pain, and she was referred to an orthopedic center to determine whether more serious treatment was required. Id. ff 9-11. A physician’s assistant at the orthopedic center prescribed physical therapy, and Schoon attended multiple physical therapy appointments until she was referred to Dr. Lawlor for treatment. Id. {J 13, 15. After learning about Schoon’s injury and symptoms, Dr. Lawlor ordered a cervical MRI and prescribed more physical therapy. Id. {| 16-17. “The MRI results showed a broad-based disc herniation at C5-6 which impinged on the right ventral hemicord.” Id. {J 18, 20, 22. Around that time, Schoon’s employer indicated that her work injury claim was accepted for her right shoulder only and asked Dr. Lawlor to send records about the need for more physical therapy for her shoulder and treatment for her neck. Id. § 19. The next day, Dr. Lawlor sent a fax to Gallagher Bassett Senior Claim Representative Jorna Chapple informing her about the MRI results and opining that “these findings are consistent with [Schoon’s] stated onset of pain and consistent with her need for ongoing physical therapy to specifically address the neck as it relates to her shoulder pain.” Id. § 21; Doc. 44-1 at 5:12. Dr. Lawlor referred Schoon to Dr. Johnathan Wilson at Black Hills Neurosurgery and Spine, and “Dr. Wilson recommended a C5-6 cervical disc arthroplasty.” Doc. 1 (23-24. But the insurer refused to authorize surgery until Schoon attended an independent medical examination (IME). Id. 425. Gallagher Bassett sought an IME through IME vendor ExamWorks. Doc. 41 at 3. Exam Works advised Chapple “that the closest available provider who would conduct an examination was Dr. [Jeffrey] Nipper.” Id. On January 21, 2016, Dr. Nipper conducted the IME on Schoon. Doc. 1 § 26. On February 17, 2016, Dr. Nipper issued his IME report, in which he opined that (1) Schoon’s shoulder strain was resolved by approximately six weeks following the injury, (2) Schoon was at maximum medical improvement, (3) Schoon “was entitled to no impairment,” and (4) Schoon

“needed no further treatment.” Id. {J 26-28. On February 24, 2016, relying on Dr. Nipper’s IME opinion, the insurer denied further workers’ compensation benefits for Schoon, without petitioning the South Dakota Department of Labor (SDDOL) for approval. Id. {{] 29-31. However, on May 5, 2016, Schoon underwent surgery with Dr. Wilson and continued to have conservative treatment, which included physical therapy, medications, and injections. Id. {J □□□ 33. On November 28, 2016, Schoon filed a petition for hearing with the SDDOL. Id. { 34. On January 20, 2017, Schoon’s employer and the insurer responded, denying that Schoon’s 2015 work injury was a major contributing cause of her continuing neck injuries. Id. 35. On September 23, 2020, the SDDOL held a hearing on the merits. Id. In January 2021, Administrative Law Judge Michelle Faw issued a decision approving Schoon’s request for benefits, and later in March 2021, Judge Faw entered an order requiring Defendants to pay Schoon $101,797 for past medical expenses and prejudgment interest. Id. {{] 37-38. Schoon’s employer and insurer appealed the SDDOL’s decision to the Sixth Circuit of the South Dakota Unified Judicial System, and the circuit judge affirmed the administrative law judge’s decision. Id. 40-42. Schoon’s employer and insurer appealed to the South Dakota Supreme Court, which affirmed the Circuit Court’s order. Id. §§ 43-44; see generally News Am. Mktg. v. Schoon, 984 N.W.2d 127 (S.D. 2022). Schoon alleges Defendants have refused to comply with the court orders and failed to pay her the ordered amount. Doc. 1 § 48. Il. Procedural Background On January 12, 2024, Schoon filed her Complaint against Defendants Farmington and Gallagher Bassett alleging state-law claims for bad faith and unfair and deceptive practices, civil conspiracy, and intentional infliction of emotional distress, and requesting punitive damages.

See generally id. Relevant to Exam Works’ current request is Schoon’s claim that “Defendants selected and used Dr. Nipper knowing he is biased in favor of insurance companies, and the vast majority of the time he issues fully favorable opinions for insurance companies, which they use

as a pretense to deny valid worker’s compensation claims.” Jd. { 60(e). Due to the sensitive nature of the relevant documents and discovery for such claims, the parties jointly moved for a protective order limiting the use and disclosure of confidential information, including

information protected by the Health Insurance Portability and Accountability Act of 1996; this Court granted the joint motion. Docs. 14, 15. □

Schoon sought information about her IME and other IMEs conducted by Dr. Nipper. Gallagher Bassett allegedly was not able to programmatically search its files by doctor name due to limitations in its electronic data system. Doc. 25 at 3. Thus, Schoon served a subpoena on Works seeking information regarding her IME and more broadly about other IMEs conducted by Dr. Nipper along with additional information about other claims reviewed by Works for Farmington and Gallagher Bassett. Doc. 20-1. ExamWorks filed a non-party motion to quash subpoena and motion for a protective order, Doc. 20, and Schoon opposed the motion, Doc. 21. On May 9, 2025, this Court held a hearing. Doc. 35. Ultimately, this Court ordered Exam Works to: (1) produce a list identifying Gallagher Bassett claim numbers for all workers’ compensation files in which Dr. Nipper has prepared a written independent medical examination report or a written medical record review for Gallagher Bassett within Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin from 2015 through 2019.... (2) set forth by declaration Dr. Nipper’s financial compensation from Exam Works, LLC for independent medical examinations and record reviews on work undertaken for Gallagher Bassett’s worker’s compensation files in Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin between 2015 and 2019.... □

(3) set forth by declaration Dr. Nipper’s financial compensation for his work on Plaintiff Destiny Schoon’s individual file. . . . [and] ,

(4) produce its file for Plaintiff Destiny Schoon’s independent medical examination. Doe. 36 at 1-3 (numeration added).

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Bluebook (online)
Destiny Schoon v. Farmington Casualty Company; Gallagher Bassett Services, Inc.; Examworks, LLC, Counsel Stack Legal Research, https://law.counselstack.com/opinion/destiny-schoon-v-farmington-casualty-company-gallagher-bassett-services-sdd-2025.