Spencer v. Plumrose USA, Inc.

CourtDistrict Court, N.D. Mississippi
DecidedJuly 16, 2024
Docket1:23-cv-00091
StatusUnknown

This text of Spencer v. Plumrose USA, Inc. (Spencer v. Plumrose USA, Inc.) is published on Counsel Stack Legal Research, covering District Court, N.D. Mississippi primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Spencer v. Plumrose USA, Inc., (N.D. Miss. 2024).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF MISSISSIPPI ABERDEEN DIVISION

SAMUEL R. SPENCER PLAINTIFF

v. CIVIL ACTION NO. 1:23-CV-91-SA-DAS

PLUMROSE USA, INC.; AMERICAN ZURICH INSURANCE COMPANY; and SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. DEFENDANTS

ORDER AND MEMORANDUM OPINION On May 23, 2023, Spencer initiated this lawsuit when he filed his Complaint [2] in the Circuit Court of Prentiss County, Mississippi. The Defendants removed the case to this Court on the basis of diversity jurisdiction. The Defendants have since filed separate Motions for Summary Judgment [48, 50, 57], which are now ripe for review. Having considered the parties’ filings, along with the relevant authorities, the Court is prepared to rule. Relevant Background This case stems from an injury that Spencer sustained on April 25, 2019 within the course and scope of his employment with Plumrose USA. At all relevant times, American Zurich Insurance Company provided workers’ compensation insurance to Plumrose. Sedgwick Claims was the third-party administrator that handled Spencer’s claim. Plumrose is engaged in the business of slicing and packaging deli meats for distribution. Spencer was a longtime employee of Plumrose prior to the subject injury. The injury itself occurred when Spencer moved a stick of deli meat weighing approximately 40 pounds from an overhead drying rack to put it in a slicer. Spencer felt pain in his right shoulder at that time. He underwent relatively significant medical treatment and ultimately was diagnosed with a torn rotator cuff, among other things. He had surgery on June 17, 2019 and underwent a second surgical procedure on October 11, 2019. He was prescribed physical therapy treatment. He then participated in physical therapy at Performance Physical Therapy from October 14, 2019 through January 20, 2020. After Spencer underwent an MRI on February 13, 2020, Dr. Taylor Mathis determined that Spencer had attained Maximum Medical Improvement. In an Order dated November 2, 2020, the Administrative Law Judge ordered Plumrose and Zurich to pay workers’ compensation benefits to Spencer in pertinent part as follows:

1. Temporary total disability benefits at the rate of $360.02 a week for any time that Claimant missed from work do to [sic] his injury between April 25, 2019 and February 13, 2020, with credit for any payments made by the Employer/Carrier;

2. Permanent partial disability benefits at the rate of $360.02 a week beginning February 13, 2020, and continuing for 100 weeks, with credit for any such benefits already paid by the Employer/Carrier.

[2] at p. 32. On January 13, 2021, the Workers’ Compensation Commission approved and filed an Order Granting Application for Compromise Settlement, which was jointly presented by counsel for Spencer and counsel for the Employer/Carrier. That Order, in pertinent part, approved: It is, therefore, ordered that said compromise settlement should be, and the same is hereby approved and that JBS USA, LLC and America Zurich Insurance Company shall pay to Samuel R. Spencer, Claimant, the sum of $30,000.00, all inclusive, without discount, in addition to any compensation and medical benefits heretofore paid, in complete settlement of all claims of every kind and nature, arising out of or in any way related to this claim or those injuries or conditions alleged herein. The settlement amount includes any back temporary total disability benefits and permanent partial disability benefits owed to Claimant. Employer and Carrier will be responsible for payment of all outstanding medical expenses incurred as of December 30, 2020, that are in the proper chain of referral, causally related to Claimant’s injury of April 25, 2019, and reasonable and medically necessary . . . Claimant will be responsible for payment of all other outstanding and future medical expenses. [57], Ex. 1 at p. 1-2.1 The Order also authorized Spencer to enter into a settlement agreement. Consistent with that authorization, Spencer signed a receipt and release agreement, wherein he agreed as follows: FOR AND IN CONSIDERATION of the sum of Thirty Thousand and No/100 Dollars ($30,000.00), cash in hand paid, receipt of which is hereby acknowledged, I, Samuel R. Spencer, do hereby fully, completely and finally release, discharge, and acquit JBS USA, LLC and American Zurich Insurance Company from any and all claims which I may now or hereafter have under the terms of the Mississippi Workers’ Compensation Law, or otherwise, on account of, arising out of, or connected with my sustaining personal injuries on or about April 25, 2019.

It is further understood that this payment has heretofore been approved by the Mississippi Workers’ Compensation Commission in docket number 1903654-P-9748, and is accepted by me in full and complete settlement, compromise, accord and satisfaction of all claims that I may now or hereafter have because of, arising out of, or connected with said accidental injuries, against said Employer and Carrier, and their agents, servants and employees, and any other party in privity with any of them.

[57], Ex. 2 at p. 1. Spencer signed the receipt and release agreement (“release agreement”) on January 18, 2021. Nonetheless, as indicated above, on May 23, 2023, he initiated this lawsuit. In his Complaint [2], Spencer walks through in detail his medical treatment and the processing of his workers’ compensation claim. He also contends that after the execution of the release agreement, Plumrose and Zurich failed to timely pay the medical bills for Spencer’s treatment. He articulates the steps taken to obtain payment for those medical bills as follows: On March 16, 2021, Counsel for Claimant wrote to Attorney Robert Stacy, Counsel for the Employer and Carrier, advising of unpaid Performance Physical Therapy bills.

1 For the sake of clarity, “JBS USA, LLC” is one and the same as Plumrose. On April 20, 2021, Counsel for Claimant wrote to Attorney Robert Stacy, Counsel for the Employer and Carrier, advising of unpaid Performance Physical Therapy bills.

On July 20, 2021, Charlene with Performance Physical Therapy faxed the Performance Physical Therapy account ledger to the office of Daniel Coker pursuant to their request.

On July 28, 2021, Charlene with Performance Physical Therapy faxed another ledger to the office of Daniel Coker pursuant to their request.

On October 4, 2021, Claimant’s Attorney filed a Motion for Claimant to reopen the case because the Carrier had failed to pay medical bills that were submitted.

On October 6, 2021, Charlene with Performance Physical Therapy faxed unpaid claims to Anthony Toto with Sedgwick.

On October 8, 2021, Counsel for the Employer and Carrier filed a Response to Claimant’s Motion to Reopen.

On January 19, 2022, Performance Physical Therapy received an additional partial payment in the amount of $42.66 with the remaining charges again denied by the Carrier alleging that they were not timely filed and/or were duplicate claims.

On February 9, 2022, Performance Physical Therapy received payment in the amount of $831.07 as a partial payment for charges of Performance Physical Therapy and the remaining charges were again denied alleging that they were not timely filed and/or were duplicate claims.

On February 10, 2022, Performance Physical Therapy received another partial payment in the amount of $3,907.15 with the remaining charges again being denied alleging they were not timely filed.

On February 15, 2022, Charlene with Performance Physical Therapy faxed the ledger of charges for the Claimant to Anthony Toto and Attorney J. Miles Forks showing outstanding charges of Performance Physical Therapy remained unpaid.

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Bluebook (online)
Spencer v. Plumrose USA, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/spencer-v-plumrose-usa-inc-msnd-2024.