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CA - Plaintiff Can't Amend Lawsuit Against Contractors to Allege Comp Violations

02/14/2025 | 0

A California appellate affirmed a determination that a plaintiff could not amend his complaint against contractors for unfinished work to add allegations that they were uninsured and unlicensed. Joseph Soaris hired Tony Aikhionbare and Ota Enterprises to remodel his house in May 2019. He agreed to pay $164,000 for materials and labor. Soaris alleged that the contractors failed to perform the work as agreed upon. He later testified that he had paid the contractors $57,000 before terminating the relationship. In February 2020, he filed a complaint against Aikhionbare and Ota Enterprises for b... Read More

OH - Surgical Removal of Lens Doesn't Entitle Worker to Award for Total Loss of Vision

02/14/2025 | 0

An Ohio appellate court ruled that a worker was not entitled to an award for the total loss of vision in his right eye after the surgical removal of the lens. Case: State ex rel. Kreitzer v. Industrial Commission, No. 22AP-601, 01/30/2025, published. Facts and procedural history: Rodney Kreitzer worked for Henny Penny Corp. He suffered an injury to his right eye at work in December 1982. In 1983, Kreitzer received a schedule award based on a finding of a 25.8% loss of vision in his right eye. In 2008, Dr. Michael E. Snyder surgically removed the lens from Kreitzer’s right eye. A... Read More

NY - Court Partially Overturns Summary Judgment on Worker's Labor Law Claim

02/14/2025 | 0

A New York appellate court overturned a partial grant of summary judgment to a worker on his Labor Law claim and granted partial summary judgment to the defendant. Case: Martinez v. Nader Enterprises LLC, No. 2021-08414, 02/05/2025, published. Facts: Wuilmer Martinez worked for Sunfar Contracting Corp. Sunfar was the general contractor for a construction project at a property owned by Nader Enterprises LLC. Martinez allegedly suffered injuries while using a grinder without a blade guard in place. Sunfar owned the grinder and provided it to Martinez. Procedural history: Martinez filed suit ... Read More

LA - Worker Gets TTD for Aggravation of Compensable Leg Injury

02/14/2025 | 0

A Louisiana appellate court upheld a worker’s award of temporary total disability benefits after he aggravated a compensable leg injury. Case: Brunner v. NAES Corp., No. 24-294, 01/29/2025, published. Facts: William Brunner worked as a welder for NAES Corp. He suffered injuries to his right arm and leg in August 2022 when a beam fell from an overhead crane and struck him. Brunner received workers’ compensation benefits and underwent surgery by Dr. Brett Cascio. Cascio released Brunner to return to work on April 19, 2023. In May 2023, Brunner allegedly aggravated his leg injury... Read More

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Press - Sumit Raghuvanshi Joins Albert and Mackenzie's Leadership as Managing Partner

12/20/2024 | 0

Agoura Hills, CA - Albert and Mackenzie is proud to announce Sumit Raghuvanshi's promotion to Managing Partner, recognizing his dedication to our team, clients, and the professional growth of those around him. More than a talented attorney, Sumit is a mentor, collaborator, and leader whose guidance and expertise have made a lasting impact on our firm. His ability to navigate complex cases with care and professionalism has earned the trust and respect of clients and colleagues alike. At Albert and Mackenzie, growth, learning, and collaboration are the pillars that define our tea... Read More

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Industry Insights

NATL. - Stith: States With the Most Opportunity to Improve Care for Injured Workers

By Jay Stith
02/14/2025 | 0

We’ve been getting many questions about the Health Strategy Associates Workers’ Comp Facility Assessment Tool. One that’s come up a few times is how big a “lift” payers and injured workers can realistically expect by changing facilities. So, I put together a list of the top 10 states with the “most opportunity” to improve patient outcomes and reduce costs by making informed facility decisions. Our definition of “most opportunity” refers to the difference between facilities in the bottom quarter of the ratings and those ... Read More

WV - Supreme Court Denies Worker's Claim for Leg Amputation

02/14/2025 | 0

The West Virginia Supreme Court ruled that a worker who suffered the loss of a leg while working out-of-state was not entitled to benefits in West Virginia. Case: Heavener v. J.F. Allen Co., No. 24-210, 01/22/2025, published. Facts: Jason Heavener worked for J.F. Allen Co. He suffered the amputation of his right leg while working for J.F. Allen on a project in Pennsylvania in 2023. According to J.F. Allen’s president, the company was based in West Virginia, but it had been awarded a job in Greencastle, Pennsylvania, and work had begun on the site in May 2022. Heavener had been permane... Read More

WA - U-Haul Facility Fined $231,000 for Exposing Mechanics to Asbestos

02/14/2025 | 0

The Washington State Department of Labor and Industries said it fined a U-Haul facility in Spokane $231,000 for knowingly exposing mechanics to asbestos. U-Haul of Spokane purchased an abandoned K-Mart in 2019 and started renovating the building without getting it tested for asbestos. L&I said the Spokane Regional Clean Air Agency subsequently inspected the building and found that 90,000 square feet of vinyl floor tiles and glue contained asbestos. U-Haul coated some of the tiles with epoxy and had others removed by a certified asbestos company. L&I said about 7,400 square feet of t... Read More

NJ - NJCRIB Announces New Quarterly Reporting Elements

02/14/2025 | 0

The New Jersey Compensation Rating and Inspection Bureau announced that it is expanding the elements that must be reported as part of its quarterly indemnity data calls. The rating bureau said it is adding fields for carriers to report a classification code, return-to-work date and the ZIP code for the injury site. The bureau is also requesting that carriers report the number of dependents an injured worker has at the time of injury, an exposure state code that identifies the state in which coverage has been provided, and an indemnity claim code that the bureau said can aid in identifying an... Read More

CA - DWC Proposes Update to MPN, Medical Billing Rules

02/14/2025 | 0

The California Division of Workers' Compensation on Thursday opened a public comment period on proposed changes to its medical provider network rules and those that govern bills for medical treatment. The division said proposed updates to the MPN regulations would streamline the process of reviewing networks and provide transparency by removing passcodes and requiring documentation of additional information to providers. The update also provides clarity on telehealth and remote service as well as access standards. The division also said it proposed updates to its rules for medical t... Read More

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Press - COMP-X MEDICAL Announces New Leadership Structure with Promotion of Ashley Palkewick as President and Co-Owner

02/05/2025 | 0

Matawan, N.J. – Feb 4, 2025 - Comp-X Medical, a leading provider of workers compensation ancillary services, today announced the promotion of Ashley Palkewick to president and co-owner. This strategic move reinforces the commitment of Comp-X Medical to expand its presence in the workers compensation ancillary services market while enhancing its comprehensive suite of clinical and non-clinical healthcare services. Palkewick, who is an integral part of the Comp-X Medical leadership team, brings 20 years of industry experience to her new role. Her proven track record includ... Read More

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NY - Defendant Not Liable for Worker's Electric Shock Claim

02/13/2025 | 0

A New York appellate court upheld a finding of no liability for the defendant on a worker’s claim for alleged injuries from a static electrical shock. Mario Saraiva allegedly suffered injuries from a static electrical shock by touching a PVC vacuum pipe while sandblasting paint on an overpass on the New York State Thruway. Saraiva filed suit against the New York State Thruway Authority. He asserted that the authority was negligent in permitting him to work near a known defective PVC vacuum pipe that had previously caused similar static electrical shocks to other workers on the sit... Read More

HI - Supreme Court Says Statute of Limitations Governs Requests to Reopen

02/13/2025 | 0

The Hawaii Supreme Court ruled that the eight-year period for reopening a workers’ compensation claim is a statute of limitations, and an employer bears the burden of proof that an application to reopen was untimely. Case: Webb v. OSF International Inc., No. SCWC-19-0000618, 02/11/2025, published. Facts: Richard Webb worked for OSF International Inc. He suffered injuries to his back and hip at work in April 1999. Webb settled his workers’ compensation claim with OSF in May 2002. The director of the Department of Labor and Industrial Relations Disability Compensation Division sig... Read More

NATL. - U.S. Virgin Islands Supreme Court Explains Proper Disbursement of 3rd-Party Recoveries

02/13/2025 | 0

The U.S. Virgin Islands Supreme Court clarified the appropriate disbursement of an injured worker’s third-party recovery when the amount recovered is less than his legal expenses and the employer’s lien. Case: Government of the Virgin Islands v. George, No. 2022-0110, 02/10/2025, published. Facts and procedural history: Elvis George worked for the territorial Government of the Virgin Islands. He suffered injuries when he was struck by a commercial vehicle driven by Mark Lonski in July 2020. George filed a claim for workers’ compensation benefits and received payments for m... Read More

WV - Court Upholds Denial of Authorization for Worker's Knee Surgery

02/13/2025 | 0

West Virginia’s Intermediate Court of Appeals upheld a denial of authorization for knee surgery for a worker who was injured in a workplace fall. Case: Stone v. CCBCC Inc., No. 24-ICA-298, 01/29/2025, published. Facts: Deana L. Stone worked for CCBCC Inc. She tripped and fell while at work in June 2019. Stone went to the Charleston Area Medical Center for treatment. She reported that she recently had right knee surgery and that her meniscus was removed. X-rays revealed no evidence of acute bone or joint abnormality but did show mild osteoarthritis. A claims administrator for CCB... Read More

NY - SWCB Reports Small Reduction in Hearings

02/13/2025 | 0

The New York State Workers' Compensation Board said in its 2024 annual report that hearings were down slightly in 2024 compared to 2023. The board held 239,760 hearings last year, compared to 244,458 in 2023. "The slight reduction in hearings compared to last year was due to efforts to reserve hearings for disputed issues and by issuing informal claims resolutions on claims that have no disputes," according to the report. "This enables the board to reduce the time it takes to receive a hearing." The WCB said roughly two-thirds of all issues presented during hear... Read More

NV - WCS to Use Graduated Fine Structure for Provider List Violation

02/13/2025 | 0

The Nevada Workers' Compensation Section announced that its Medical Unit will start assessing fines using a graduated schedule implemented last year when carriers fail to submit treating provider lists as required. Nevada Revised Statutes Section 616C.087(6) requires carriers to update their list of treating physicians and chiropractors annually and file the updated list with the Division of Industrial Relations by Oct. 1 of each year. The WCS announced on Tuesday that it will penalize carriers that fail to submit treating provider lists, using a graduated fine structure for subsequent v... Read More

VA - General Assembly Passes Bill to Clarify Throat Cancer Presumption

02/13/2025 | 0

Virginia lawmakers passed a bill clarifying conditions that are included in the presumption that throat cancer is compensable for first responders. The House voted 94-0 Tuesday to pass SB 920, by Sen. Azlan Salim, D-Merrifield. The Senate voted 40-0 to pass the bill Jan. 30. SB 920 would clarify that the throat cancer presumption includes cancer that forms in the tissues of the pharynx, larynx, adenoid, tonsil, esophagus, trachea, nasopharynx, oropharynx or hypopharynx. If enacted, the bill would take effect July 1. SB 920 can be presented to Gov. Glenn Youngkin, who can sign it, veto it, ... Read More