Teresa Patrick v. Wal-Mart, Incorporated
681 F.3d 614
5th Cir.2012Background
- Patrick suffered a July 28, 1997 work injury at Wal-Mart and initially was denied coverage by the carrier.
- An Administrative Judge in 1999 found the injury compensable and awarded temporary total disability benefits of $187.01/week, with permanent issues reserved for later determination.
- Wal-Mart and the carrier paid a lump sum in October 1999 reflecting the temporary benefits awarded.
- A 2005 AJ later found Patrick totally and permanently disabled and awarded 450 weeks of benefits from 1997 plus medical expenses; the Commission affirmed on review.
- Patrick filed a bad-faith complaint in 2010 alleging continuing denial of benefits, arguing accrual started after the 1999 order and/or after appellate mandate in 2009.
- The district court dismissed the suit on statute-of-limitations grounds and for failure to plead plausible continuing bad-faith claims under Twombly/Iqbal.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| When does the statute begin for a bad-faith denial claim? | Accrual begins in 2009 after the Court of Appeals’ 2009 mandate. | Accrual began in 1999 when the AJ awarded benefits and the limitations period runs from that time. | Accrual began in 1999; initial bad-faith claim barred. |
| Do alleged continuing bad-faith acts after 1999 state a claim? | Second amended complaint pleads continuing bad faith after the 1999 order. | Allegations are conclusory and fail to plead plausible continuing bad-faith conduct under Twombly/Iqbal. | Second amended complaint failed; dismissal affirmed. |
| Is the exhaustion framework (Bullock) properly applied to determine when accrual starts? | Bullock limits on finality to monetary awards; exhaustion can delay accrual. | Bullock holds that an award is final when a monetary sum is awarded; initial non-monetary determinations are interlocutory. | Bullock and Walls guide exhaustion; the 1999 award was an award triggering exhaustion, but accrual was still in 1999. |
Key Cases Cited
- Bullock v. AIU Ins. Co., 995 So. 2d 717 (Miss. 2008) (interlocutory nature of some orders; exhaustion based on monetary award)
- Walls v. Franklin Corp., 797 So. 2d 973 (Miss. 2001) (exhaustion needed for bad-faith claim regarding medical services; awards required)
- Mississippi Dept. of Pub. Safety v. Stringer, 748 So. 2d 662 (Miss. 1999) (statutory time limitations purpose and prompt pursuit of claims)
- AmFed Cos., LLC v. Jordan, 34 So. 3d 1177 (Miss. Ct. App. 2009) (elements of bad-faith denial claim)
- Rogers v. Hartford Accident & Indem. Co., 133 F.3d 309 (5th Cir. 1998) (bad-faith denial framework referenced)