DE - Worker Not Prejudiced by Doctor's Late Production of Medical Records
03/19/2024 |
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The Delaware Superior Court ruled that a worker was not unfairly prejudiced or surprised when her employer’s expert testified about the content of her medical records.
Joan Trincia worked for Dick's Sporting Goods. She allegedly injured herself at work in September 2020 while lifting a heavy box.
Trincia filed a workers’ compensation claim, and a hearing took place in January 2023.
Four days before the hearing, Trincia’s primary care physician turned over copies of her medical records to Dick's. The medical expert hired by the company then testified at the hea...
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WA - Court Upholds Worker's Award for Aggravation of Preexisting Shoulder Injury
03/19/2024 |
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The Washington Court of Appeals upheld an award of benefits to a worker for the aggravation of a preexisting right shoulder injury.
Case: PCL Construction Services Inc. v. Green, No. 85089-0-I, 03/11/2024, unpublished.
Facts: PCL Construction Services Inc. hired Kenneth Green to work on a high-rise condominium construction project in October 2019.
Green had a history of right shoulder acromioclavicular joint separation.
After 10 days on the job, Green was informed that he was being terminated. During this conversation, Green mentioned that he had pain in his right shoulder. PCL called a pa...
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NY - Court: Worker Acted Unreasonably in Refusing Exams
03/19/2024 |
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A New York appellate court ruled that an injured worker unreasonably refused to attend two independent medical examinations scheduled by his employer.
Case: Matter of Mina v. New York City Transit Authority, No. CV-22-2040, 03/14/2024, published.
Facts: George Mina worked for the New York City Transit Authority. He injured his back at work in December 2020 and received various awards of benefits at various rates.
In November 2021, the Transit Authority scheduled an independent medical examination for Mina in Manhattan. He failed to appear for the exam.
The Transit Authority then sched...
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NY - Worker's Misrepresentations Result in Disqualification From Future Benefits
03/19/2024 |
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A New York appellate court upheld the disqualification of an injured worker from receiving future benefits because of his misrepresentations as to his limitations.
Case: Matter of Deliso v. New York City Transit Authority, No. CV-22-2032, 03/14/2024, published.
Facts and procedural history: John Deliso worked for the New York City Transit Authority as a maintenance supervisor. His job required regularly using various hand tools and a computer keyboard.
Deliso filed a claim for workers' compensation benefits, alleging that he sustained work-related injuries from the repetitive use of his...
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Press - Centre for Neuro Skills Promotes Nicholas Ashley to Chief Governance Officer
03/13/2024 |
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Centre for Neuro Skills Promotes Nicholas Ashley to Chief Governance Officer
Bakersfield, Calif. (March 13, 2024) - Centre for Neuro Skills (CNS), a leader in traumatic brain injury and stroke rehabilitation services, today announced the promotion of Nicholas Ashley, J.D., M.D.R., to chief governance officer.
Nick has been instrumental to the growth and expansion of CNS, says David Harrington, president and chief executive officer of Centre for Neuro Skills. Im excited to continue working closely with him to advance patient care.
During his 11-year tenure at CNS, Ashley serve...
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Industry Insights
NATL. - Moore: Basic AI Claims Adjuster Assistant Works Well
By James Moore
03/19/2024 |
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A basic artificial intelligence claims adjuster assistant works well for insurance companies. Think very basic.
If one looks at this article that I wrote many years ago on the workers' comp claims adjuster job duties, a few of the tasks can be removed by a basic AI claims adjuster assistant where the benefit heavily outweighs the cost.
Phone and email AI assistant
No, it is not having an AI assistant that answers and directs phone calls. Partially removing phone calls from the adjusters’ workloads will help the injured workers, employers and the w...
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NATL. - Harford Mutual Insurance Group Announces Three Officer Promotions
03/19/2024 |
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Harford Mutual Insurance Group announced the promotions of three officers.
Jeffery J. Bischoff was promoted to vice president of information technology from assistant vice president of information technology; Patrick J. Gagen was promoted to vice president of human resources from assistant vice president of human resources; and Stacey A. Rebbert was promoted to vice president and chief marketing officer from assistant vice president of marketing and corporate communications.
Bischoff will continue to oversee the information technology department and be responsible for developin...
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CA - WCIRB Actuarial Committee Meets Thursday
03/19/2024 |
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The Workers’ Compensation Insurance Rating Bureau of California Actuarial Committee is meeting virtually on Thursday to discuss claims experience and economic impacts on work comp issues.
The committee will discuss its indemnity claim frequency model as well as the impact of the economic downturn on pure premium rate indications.
Committee members will also discuss insurer experience through Dec. 31, 2023, and diagnostics that will be used to evaluate data from the first fiscal quarter of 2024.
Members will discuss how COVID-19 claims should be treated for ratemaking in light of ...
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VA - WCC Commissioner Marshall Reappointed for Third Term
03/19/2024 |
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The Virginia Workers’ Compensation Commission announced that Wesley G. Marshall was reappointed to a third term.
Marshall represented plaintiffs in workers’ compensation, employment and other civil cases as an attorney in private practice for 25 years before joining the WCC in 2012.
He serves on boards of directors for the International Association of Industrial Accident Boards and Commissions, the National Association of Workers’ Compensation Judiciary and Kids Chance of Virginia.
Marshall was inducted as a fellow in the College of Workers' Compensation Lawyers in...
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KY - Committee Seeks ALJ Applicants
03/19/2024 |
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The Kentucky Workers’ Compensation Nominating Committee seeks applications for a single administrative law judge position.
The applicant will serve a term running through Dec. 31, 2027.
Applicants must be licensed attorneys with at least five years of experience practicing workers’ compensation law or a related field in the state. Administrative law judges receive the same salary as circuit court judges.
Applications should include a cover letter, current resume and a completed application supplement and be sent to Derrick.Hill@ky.gov by noon on March 25.
...
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Press - Floyd Skeren Manukian Langevin announces George Krikes joins the Firm
03/12/2024 |
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Floyd Skeren Manukian Langevin, LLP is pleased to announce George A. Krikes has joined our Firm. Mr. Krikes joins us with over 42 years of workers' compensation experience throughout California, and is a perfect fit as we continue to serve large numbers of entities and companies. His extensive expertise, technical knowledge, managerial skills and formidable relationships forged over his impressive career, ideally suit him as he enters his role in the continued success and growth of our Firm. George Krikes will be working in our Complex Litigation and Special Projects Unit, based out o...
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CA - Court Overturns Nonsuit on Claims by Injured Dairy Worker, Comp Carrier
03/18/2024 |
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A California appellate court overturned a grant of nonsuit against a hay delivery company for a dairy employee who was injured when bales fell on him.
Ricardo Gonzalez worked for AC Enterprises, a dairy operation in Tipton.
On April 28, 2017, Hettinga Transportation Inc. delivered hay to the dairy. Hettinga employees unloaded and stacked the hay upon delivery.
The next morning, Gonzalez was at work, dislodging bales of hay from the stack to feed the cows when other bales toppled onto him, grievously injuring him.
Gonzalez received workers’ compensation benefits from the dairy’s...
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CA - Court Upholds Prison Employee's Conviction for Comp Fraud
03/18/2024 |
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A California appellate court upheld a prison employee’s conviction for insurance fraud.
Case: People v. Jones, No. F085205, 03/14/2024, unpublished.
Facts: Tiffinie Marvell Jones started working for a state prison in May 1995. She held various administrative positions in the years that followed, including a brief stint as the liaison between injured employees and the workers’ compensation insurance company for the prison.
In 2014, Jones filed a workers’ compensation claim for injuries caused when a shelf fell on her. She filed two claims in 2016 for lifting injuries and a ...
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NY - Defendant Not Entitled to Summary Judgment on Labor Law Claim
03/18/2024 |
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A New York appellate court ruled that a Labor Law defendant was not entitled to summary judgment because triable issues remained as to whether it was free from fault in causing a worker’s accident.
Case: Samperi v. City Safety Compliance Corp., No. 2021-06809, 03/13/2024, published.
Facts: Salvatore Samperi allegedly suffered injuries while working on a construction site at premises owned by Site 5 DSA LLC when a gate swung open and hit him, causing him to fall.
Site 5 hired Northeast Interior Specialists LLC to install the perimeter fencing and access gates at the construct...
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AR - Court Upholds Employee's Award of PPD Benefits for Carpal Tunnel
03/18/2024 |
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The Arkansas Court of Appeals upheld an award of permanent partial disability benefits to a worker for her carpal tunnel syndrome.
Case: Arkansas Department of Corrections v. Washington, No. CV-23-30, 03/13/2024, published.
Facts: Tereasa Washington began working for the Arkansas Department of Corrections in 2017 as a mental health adviser. Her job required her to type reports, and she began experiencing numbness and tingling in her arms in 2020.
She was diagnosed with carpal tunnel syndrome, and the ADC accepted the condition as compensable.
In October 2020, Dr. Sean M. Morell performed a...
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MT - Court Won't Reconsider Calculation of Benefits for Worker With 2 Jobs
03/18/2024 |
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The Montana Workers’ Compensation Court denied a request to reconsider a decision awarding temporary total disability benefits based on a worker missing time from one of his two jobs because he now says he missed time from both.
The court on Wednesday rejected the argument that it overlooked a material fact, saying that the parties themselves never raised the issue, even after reviewing a proposed order.
“For this court to have ‘overlooked’ the fact that Perea worked at Life in Bloom until just before his surgery, the parties would have had to introduce that fact...
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CA - Worker's Fraud Conviction Leads to Nearly $140k in Restitution
03/18/2024 |
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A Northern California court ordered a worker convicted of fraud to pay nearly $140,000 in restitution, the Sacramento County District Attorney’s Office announced.
Ahmad Z. Noori was convicted of work comp fraud in March 2023. He was charged with two counts of fraud in 2021 after officials said he misrepresented symptoms of a head injury.
The Insurance Department said Noori claimed to suffer from amnesia and difficulty with activities of daily living as a result of a head injury sustained in 2019. The department said surveillance footage showed Noori speaking, walking and driving as wel...
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MA - Owners of Roofing Company Charged With Fraud
03/18/2024 |
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The Internal Revenue Service announced that the owners of a Massachusetts roofing company were arrested and charged in connection with schemes to defraud workers’ compensation carriers, the Small Business Administration and their mortgage lender.
A federal grand jury in Boston indicted Ronaldo Solano and Adriana Solano on one count of conspiracy to commit mail and wire fraud and one count of conspiracy to commit wire and bank fraud.
The indictment alleges that Ronaldo Solano and Adriana Solano underreported payroll for their Framingham company that operates under names including H&...
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