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NJ - Lawmaker Seeks to Forbid Providers From Sending Workers' Bills to Collections

By Emily Brill (Reporter)
12/12/2017 | 185 | 0 | 0 min read

New Jersey banned providers from invoicing workers for unpaid workers’ compensation medical bills five years ago. But when Ron Dancer’s constituent approached him recently with a ruined credit rating and a story, the assemblyman knew the balance-billing issue wasn’t over in the Garden State. Assemblyman Ron Dancer Balance billing is the practice of demanding from a patient the sum remaining on a provider's bill after an insurance company pays its share. Although balance billing was outlawed in New Jersey’s workers’ compensation system in 2012 with Gov. Read More

TX - Proposed Telemedicine Expansion Welcomed While Details Debated

By Elaine Goodman (medical/business Reporter)
12/12/2017 | 218 | 0 | 0 min read

An informal draft rule intended to expand injured workers’ access to telemedicine services in Texas received a warm reception from those who commented on the proposal, but also raised a number of questions. Will telemedicine providers be allowed to charge a facility fee? Could the use of content created during telemedicine examinations be used as evidence in contested case hearings? And what assurance do payers have that a patient treated by a telemedicine provider is actually an injured worker? The goal of the Texas Division of Workers’ Compensation’s propos. Read More

CA - Better ID of Suspended Providers, Process to Report Bad Actors Sought at Hearing

By Greg Jones (Deputy Editor)
12/12/2017 | 747 | 0 | 0 min read

OAKLAND, Calif. — A sparsely attended hearing on proposed permanent rules to suspend providers from California’s workers’ compensation system yielded a request for better ways to identify those no longer allowed to treat injured workers, a call for guidance on the retroactive effect of the suspension on outstanding bills, and a suggestion to create a process for system users to report suspected bad actors for investigation. Lisa Anne Bickford The Division of Workers’ Compensation is proposing to make permanent the emergency rules it has been using since the sta. Read More

LA - Treatment Guidelines Allow Radio-Frequency Ablation of Occipital Nerve Injuries

By WorkCompCentral
12/12/2017 | 124 | 0 | 0 min read

A Louisiana appellate court ruled that an injured worker was entitled to authorization for a radio-frequency ablation procedure to treat an occipital nerve injury. Case: Harper v. Boise Paper Holdings, No. WCA 17-602, 12/06/2017, published. Facts and procedural history: Lonnie Harper suffered injuries in the course of his employment with Boise Paper Holdings when he was struck in the face with a large pry bar. He was knocked unconscious and flown to Lake Charles for medical treatment. Harper began having severe headaches. After doctors diagnosed him with occipital neuralgia, Harper beg. Read More


IA - Court Rejects Worker's Claim for Carpal Tunnel Injury, Allows Remand of Claim for Back Injury

By WorkCompCentral
12/12/2017 | 104 | 0 | 0 min read

The Iowa Court of Appeals ruled that a worker was not entitled to benefits for his carpal tunnel syndrome, since he failed to provide his employer with timely notice of his condition, and that the workers’ compensation commissioner will have to evaluate the man's claim for a back injury. Case: Ruiz v. Revstone Casting Industries, No. 16-1728, 12/06/2017, published. Facts: Francisco Ruiz began working as a grinder for Revstone Casting in 1988. He regularly worked 10- to 12-hour shifts, picking up unfinished parts from a box on the right side of his workstation and placing finis. Read More

Column

NATL. - Paduda: Uncomfortable Truths at NWCDC

By Joe Paduda
12/12/2017 | 268 | 0 | min read

Frank Pennachio is one of those people every industry really needs. He’s blunt, outspoken, deeply insightful and completely unafraid to challenge established practices. Joe Paduda Especially when those practices need to be challenged. Thursday at the National Workers' Compensation and Disability Conference in Las Vegas, Frank and Denise Algire discussed the ways employers pay for managed care services and how those are often disconnected entirely from the quality of the care delivered to patients. Frank’s key question is this: Do managed care programs improve car. Read More

WV - Supreme Court Denies PTD Benefits to Veteran Coal Miner With History of Injuries

By Sherri Okamoto (Legal Reporter)
12/12/2017 | 108 | 0 | 0 min read

The West Virginia Supreme Court unanimously upheld a denial of permanent total disability benefits to a longtime coal miner with a 45% whole person impairment. Case: Farmer v. West Virginia Office of Insurance Commissioner, No. 17-0023, 12/07/2017, published. Facts and procedural history: Warren Farmer worked as a coal miner for 25 years. During that time, he sustained several work-related injuries. In 1972, Farmer suffered a severe electrical shock with a loss of consciousness. After the accident, Farmer experienced anxiety, insomnia and headaches. He was also diagnosed with post. Read More

Sullivan On Comp

NY - Dispute as to Worker's Involvement in Moving Equipment Didn't Foreclose Summary Judgment

By WorkCompCentral
12/12/2017 | 107 | 0 | 0 min read

A New York appellate court ruled that questions as to whether a worker had actually been involved in moving a heavy reel of electrical wire at a constriction site did not prevent him from entitlement to summary judgment for injuries. Case: Gutierrez v. 451 Lexington Realty, No. 5124 305823/13 83954/14, 12/05/2017, published. Facts: Pedro Gutierrez suffered an injury to his foot while working at a construction site owned by 451 Lexington Realty. Workers at the site were rolling a reel of electrical wire up two wooden planks for loading onto a van when the reel fell and landed on Gu. Read More

CA - Investigation Into Double Electrocution Leads to Fraud Charges

12/12/2017 | 455 | 0 | 0 min read

Prosecutors in Southern California have filed workers’ compensation fraud charges against the employer of two men who were electrocuted on the job, alleging he underreported payroll and misclassified his employees to make it appear they were in less dangerous positions, according to a report by The Desert Sun.  The Riverside County District Attorney’s Office has asked for an arrest warrant against Carlos Valencia, owner of Valencia Trimming in La Quinta. Court papers allege that Valencia shortchanged State Compensation Insurance Fund out of $100,000 in premiums and cost the s. Read More

FL - Alleged Con Artist Charged With Failure to Secure Comp Coverage for Company

12/12/2017 | 144 | 0 | 0 min read

A woman who was arrested in July for allegedly posing as an engineer in an attempt to dupe the City of Homestead into awarding her a $33.3 million construction contract has been arrested again on charges of failure to secure workers' compensation coverage and running an organized scheme to defraud, the Miami Herald reports. Janet LeGrand (Miami-Dade photo) Online, Janet LeGrand posed as the CEO of a multinational engineering consulting firm she called the Bleu Network. She said the company had a robust portfolio of engineering projects and overseas offices in Spain and Argentina, the H. Read More

NC - Proposed Opioid Rules Draw Flurry of Feedback

12/12/2017 | 176 | 0 | 0 min read

The North Carolina Industrial Commission has released written public comments received in response to the draft opioid utilization rules developed by the state’s Workers’ Compensation Opioid Task Force. The proposed rules, released last month, would limit the daily dosage of opioids for acute pain to a 50 milligram morphine equivalent dose and would cap initial prescriptions for non-surgical patients at five days. The proposed rules state that before prescribing an opioid medication, a health care provider must document in the medical record that non-pharmacological and non-opioi. Read More

PA - Longshore, Coal Mine Rate Decreases Proposed

12/12/2017 | 114 | 0 | 0 min read

The Pennsylvania Compensation Rating Bureau has proposed a rate decrease of 9.97% for benefits under the Longshore and Harbor Workers' Compensation Act. And the Coal Mine Compensation Rating Bureau has filed for a 2.1% loss cost decrease for workers' compensation insurance, for new and renewal policies. In addition, the bureau has calculated an Employer Assessment Factor of 2.18%, as compared to the currently approved provision of 2.32%. The proposals, which are now under review by the Pennsylvania Insurance Department, would take effect on April 1. Comments on the proposals may be . Read More

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Press - Hallett Emerick Wells & Sareen

12/11/2017 | 186 | 0 | min read

Hallett Emerick Wells & Sareen is pleased to announce that H. Neal Wells IV has become the law firm's Corporate President in place of Bruce S. Emerick who has become Of Counsel. Additionally, Ilene M. Sheldon has been promoted to Managing Shareholder of the Calabasas Office and Brandon R. Lewis t. Read More

OH - 2 Plead Guilty to Working While Receiving Benefits

12/12/2017 | 118 | 0 | 0 min read

A carpenter convicted of workers' compensation fraud for working while collecting benefits must reimburse the Ohio Bureau of Workers' Compensation more than $23,000, the BWC announced Friday.  Ernest Shawn Baker (Ohio BWC photo) Ernest Shawn Baker, 45, of Pomeroy, must serve five years of probation as well. He pleaded guilty Nov. 29 to a fifth-degree felony count of workers' compensation fraud.  Jim Wernecke, the director of BWC's special investigations department, said Baker went back to work as a carpenter soon after his injury in 2014.  Another Ohio man . Read More

NJ - Rules Proposal Would Continue Horse Racing Injury Compensation Board

12/12/2017 | 150 | 0 | 0 min read

The New Jersey Horse Racing Injury Compensation Board has proposed rules to continue its existence, with changes to reflect an increase in the assessment rate authorized by the Legislature and to improve wording. A notice posted in Monday’s New Jersey Register states that the rules that authorize the board to provide coverage for jockeys and other horse racing industry employees expired on Nov. 24. However, by filing an amendment to continue the rules, the board has extended that expiration date for an additional six months, until May 23, 2018. The board is proposing readoption of New . Read More

TX - DWC Lifts Bulletin Extending Comp Deadlines in Disaster Area

12/12/2017 | 119 | 0 | 0 min read

The Texas Division of Workers’ Compensation has lifted a bulletin, effective Jan. 10, that that tolled deadlines for procedures in counties impacted by Hurricane Harvey. The division said lifting the tolling period means that the clock for completing a procedure or making a required filing will resume ticking on Jan. 1. “Although the tolling period is lifted effective Jan. 10, 2018, it is the continuing expectation of TDI-DWC that insurance carriers will continue to provide efficient and timely services to injured employees, health care providers, and policyholders and not extend. Read More