IN - Judge Miscalculates Insurance Provider's Lien Against Amputee's Tort Settlement
10/04/2024 | 0
The Indiana Court of Appeals ruled that a trial judge miscalculated an insurance provider’s lien against a truck driver’s third-party recovery for an accident that resulted in the loss of his legs.
Christopher Chadwick worked for Bama Truck Lines LLC, an Alabama-based trucking company. He suffered serious injuries, resulting in the amputation of his legs, while hauling a load of heavy steel bars through Indiana for the Niagara LaSalle Corp.
Chadwick sought workers’ compensation benefits from Bama, which had coverage with Alabama Trucking Association Workers’ Compensat...
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The Commonwealth Court of Pennsylvania rejected an employer’s challenges to orders reinstating a worker’s benefits, the expansion of his claim and the imposition of penalties.
Case: Pennsylvania Liquor Control Board v. Berardi (WCAB), No. 649 C.D. 2023, 09/20/2024, unpublished.
Facts: Amato Berardi worked for the Pennsylvania Liquor Control Board as a clerk at a Pennsylvania Fine Wine and Good Spirits store. He tripped and fell while returning to work from lunch on June 29, 2019.
Berardi continued to work through July 11, 2019, when the board placed him on mo...
The Alabama Court of Civil Appeals ruled that a circuit court lacked jurisdiction over a worker’s claim for compensation for a work-related injury and that an individual member of the limited liability company that employed her could not be held personally liable for her unpaid wages.
Case: Zackery v. Huntley, No. CL-2024-0127, 09/20/2024, published.
Facts: Fredrick Zackery is a member of Renaissance House LLC. Renaissance hired Lucretia Huntley in late July 2021 to work in a group home.
Huntley suffered injuries from a fire in the kitchen of the group home in August 2021. She stayed ...
The West Virginia Supreme Court upheld the denial of a worker’s request to reopen her claim for temporary total disability benefits, additional medications and a referral to a rheumatologist.
Case: Blevins v. Princeton Community Hospital Association, No. 23-614, 09/23/2024, published.
Facts: Brenda G. Blevins worked for Princeton Community Hospital Association.
In November 2016, she saw a physician assistant after being diagnosed with bronchitis. The physician assistant suspected that Blevins had underlying asthma and referred her to an allergy and asthma specialist.
In December...
One of the most nebulous, omnipresent topics that can loom over a workers’ compensation claim is the concept of whether an injured worker is being forthright and how that is to be assessed.
I had the opportunity to discuss this topic with noted psychologist Dr. Ronald C. Heredia of Good Mood Legal and summarized his thoughts below.
First and foremost, workers’ compensation practitioners should note that the AMA Guides to the Evaluation of Permanent Impairment, fifth edition, clearly states that medical evaluators should be aware of malingering. The guides say:
Malinger...
The Workers’ Compensation Insurance Rating Bureau of California announced that Andrea Coleman will succeed Bill Mudge as president and CEO next year.
Coleman’s promotion will take effect Feb. 1, the WCIRB said. Mudge will serve as CEO emeritus until his retirement April 1.
Coleman joined the WCIRB in May 2022 as executive vice president and chief operating officer. She served on the bureau’s senior leadership team, overseeing finance, human resources, customer experience, marketing and communications.
Before joining the WCIRB, Coleman most recently served as managing d...
The California Division of Workers’ Compensation Pharmacy and Therapeutics Committee is meeting virtually on Oct. 16.
The 2015 bill that directed the DWC to create a prescription drug formulary also created the P&T Committee to review available evidence of the relative safety, efficacy and effectiveness of drugs or a class of drugs in updating to the formulary.
Committee members are slated to discuss issues relating to the Medical Treatment Utilization Schedule drug list, which identifies medications that can be prescribed without utilization review. Members will discuss incorporat...
The Texas Division of Workers’ Compensation announced regulatory action to update employer forms and change the title of a rule.
The division said it revised employer notice forms to conform to agency standards, use plain language and remove references to outdated violation language.
Forms that the division updated include DWC Form-001, employer’s first report of injury or illness; DWC Form-002, employer’s report for reimbursement of voluntary payment; and DWC Form-006, supplemental report of injury.
The revised forms are effective Jan. 20.
The DWC said it also adopted an...
The Oklahoma Workers’ Compensation Commission announced personnel updates and changes in contact information within the Court of Existing Claims.
The commission said Katrina Stephenson, who will become judicial liaison and order writer, can be reached at kstephenson@cec.ok.gov.
Alex Watkins, who will schedule mediations for both the Court of Existing Claims and the Workers’ Compensation Commission, can be reached at alexander.watkins@wcc.ok.gov.
The commission said Valerie Rossiter-Reed will continue to receive prehearing announcements of moot only at cecadmin@cec.ok.gov. Partie...
Javier Vasquez, CEO of Miguel's Restaurants
FRESNO, CA, UNITED STATES, September 19, 2024 -- California Restaurant Mutual Benefit Corporation (CRMBC) is pleased to announce that Miguel's Jr. Restaurants, a long-standing family-owned enterprise in Southern California, has joined its self-insured group (SIG). This strategic move reflects Miguel's Jr.'s commitment t...
The Alabama Court of Civil Appeals revived an insurance provider's claim for reimbursement from a widow's wrongful death settlement.
Timothy Tumlin worked for L&C General Contractors Inc. He died as a result of a work-related accident in March 2019.
L&C filed a declaratory judgment action to determine the amount of benefits it was required to pay Tumlin's widow under the state Workers’ Compensation Act.
L&C settled with the widow for $65,000, and a trial judge entered a judgment accordingly in December 2020.
Meanwhile, the widow filed a wrongful...
The Iowa Court of Appeals dismissed an appeal from an order staying enforcement of a workers’ compensation award pending judicial review because the review process was completed.
Case: H.D. Supply Management Inc. v. Smith, No. 23-1656, 09/18/2024, published.
Facts and procedural history: In March 2023, a workers’ compensation commissioner awarded Kenneth Smith benefits for an injury he sustained while working for H.D. Supply Management Inc.
The commissioner found that Smith suffered a nonschedule work-related injury to his shoulder and arm that left him ...
A New York appellate court upheld summary judgment for the defendants in a Labor Law case involving a worker’s fall from the roof of a home undergoing renovations.
Case: Argueta v Hall & Wright LLC, No. 2022-03666, 09/18/2024, published.
Facts: Jose Daniel Santiago Argueta was a carpenter for MCJM Custom Builders of Long Island Inc. He allegedly sustained injuries while working on a home renovation project at a property owned by 520X Residential LLC.
MCJM was the general contractor for the project, and Hall & Wright LLC was the construction manager.
According to Argueta,...
The West Virginia Supreme Court upheld the denial of a request to expand the scope of a worker’s claim and for additional imaging.
Case: Cook v. Cecil I. Walker Machinery Co., No. 23-632, 09/23/2024, published.
Facts: Alvin Cook worked for the Cecil I. Walker Machinery Co. He injured his back at work in 2016. An administrator for CWMC’s insurance carrier accepted liability for a lumbar strain.
In June 2016, Cook underwent a magnetic resonance imaging scan, which revealed multilevel degenerative disc disease and spinal stenosis.
Dr. Rajesh Patel diagnosed Cook with a lumbar spra...
The California Workers’ Compensation Institute published a bulletin listing bills of interest that Gov. Gavin Newsom enacted this year.
The bulletin lists bills including AB 1239, which allows carriers to continue using prepaid debit cards to pay benefits through Jan. 1, 2027; AB 1870, which requires mandatory workplace posters that inform workers about their right to consult an attorney; AB 2337, allowing electronic signatures on work comp documents, subject to rules adopted by the Workers’ Compensation Appeals Board and Division of Workers’ Compensation; and SB 1455, ...
The Washington State Department of Labor and Industries fined Georgia Pacific $648,292 after a worker was crushed by an unguarded packing machine.
Georgia Pacific is appealing the citation.
Dakota A. Cline died March 8 at the age of 32 when he got stuck in the machine at a Georgia Pacific paper mill in Camas, according to media reports.
L&I said co-workers noticed boxes backing up on a conveyer belt and went to investigate when they found Cline had been crushed between the large metal arms that feed boxes through the machine.
The department reports that workers and managers told inspec...
The California Division of Workers’ Compensation posted an order adopting the latest quarterly update to the outpatient hospital and ambulatory surgery center section of the Official Medical Fee Schedule.
The division said the order updating the fee schedule adopts changes made by the Centers for Medicare and Medicaid Services, including:
The CMS Medicare Hospital Outpatient Prospective Payment System October 2024 “Addendum A” and “Addendum B.”
The CMS Ambulatory Surgical Center Payment System, October 2024 ASC Approved HCPCS Code and Payment Rates — co...
