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NM - Ankle Condition Qualifies as Schedule Injury to Foot, Not Leg

12/08/2023 | 0

The New Mexico Court of Appeals ruled that an ankle injury is a schedule injury to the "foot at the ankle." Lynne Jaramillo worked for the New Mexico Taxation & Revenue Department. She injured her ankle at work, and a workers’ compensation judge awarded her 115 weeks of benefits for a schedule injury to "one foot at the ankle." Section 52-1-43 of the state Workers’ Compensation Act lists 43 "specific body members" and pairs each with a period, stated in weeks, that compensation will be provided for "the loss or loss of use.&... Read More

PA - Minor Fire Doesn't Constitute Abnormal Working Condition for Truck Driver With PTSD

12/08/2023 | 0

The Commonwealth Court of Pennsylvania ruled that a minor fire that was extinguished in two minutes without physical injury to anyone did not constitute an abnormal working condition for a truck driver. Case: Premium Transportation Staffing Inc. v. Welker, No. 1329 C.D. 2022, 11/30/2023, published. Facts: Robert L. Welker worked for Premium Transportation Staffing Inc. In February 2015, Premium sent Welker to York Haven to pick up a truck. His pre-trip safety inspection included making sure a fire extinguisher was on board. While Welker was driving the truck on the Pennsylvania Turnpike, t... Read More

NY - Court Partially Revives Claim for Worker Injured While Taking Cover in Explosion

12/08/2023 | 0

A New York appellate court partially revived a worker’s Labor Law claims for his injuries from taking cover from an alleged explosion that occurred while a work crew was replacing a damaged utility pole.   Case: Ricottone v. PSEG Long Island LLC, No. 2021-02524, 11/29/2023, published. Facts: Anthony Ricottone worked for Verizon Communications. He was part of a work crew that had been dispatched, along with crews for PSEG Long Island LLC, to replace a utility pole after it had been struck and damaged by a vehicle. According to Ricottone, he was standing approximately 150 feet... Read More

NY - Settlement of Third-Party Action Bars Receipt of Further Comp Benefits

12/08/2023 | 0

A New York appellate court ruled that an injured worker was barred from receiving further workers' compensation benefits because she had settled a third-party claim without the consent of her employer and its insurance provider, but that she had not made material misrepresentations. Case: Matter of Salvia v. Nutritional Frontiers LLC, No. 535150, 11/30/2023, published. Facts: Leonore Salvia worked for Nutritional Frontiers LLC. She suffered injuries in a work-related motor vehicle accident in August 2013. In January 2014, a third-party action was commenced on her behalf, seeking damages... Read More

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Press - Carisk Partners Recapitalizes with Lee Equity Partners and Elements Health Investors - Positioning the Company for Continued Growth and Expansion

12/04/2023 | 0

MIAMI - December 4, 2023 - Carisk Partners ("Carisk"), a specialty risk transfer and care coordination company, announced today the completion of a recapitalization led by Lee Equity Partners, LLC ("Lee Equity") and Elements Health Investors, LLC ("Elements"). The recapitalization will fund Carisk's continued expansion and position the company to invest in best-in-class products and services to benefit clients and beneficiaries across the workers' compensation claims value chain. Previously, an MBF Healthcare Partners portfolio company, Car... Read More

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Industry Insights

NATL. - Paduda: Another Deal Is Done in Work Comp Services

By Joe Paduda
12/08/2023 | 0

Private equity firms Lee Equity Partners and Elements Health Investors completed a recap of Carisk Partners last week, marking one of the very few deals to be done over the last many months. While this may be an indication that things may be moving, there are several reasons we aren’t likely to see a return to the halcyon days of a decade ago. First, over the last two years, Carisk is one of the very few companies to actually get a deal done. Several others tried and failed, mostly because: Sellers’ expectations were out of whack with what buyers would ... Read More

CA - Two Tractor Rollover Deaths in Two Months Lead to $290,000 Fine

12/08/2023 | 0

The Washington State Department of Labor and Industries fined a fruit grower and processor $290,000 after two orchard workers died in separate tractor rollover accidents in two consecutive months. L&I said Gilberto Padilla died May 7 after he drove over a tractor weight, causing the vehicle to roll. The department said the rollover protection structure was not up at the time and Padilla was not wearing a seat belt. The department said it directed Borton & Sons to ensure that tractor drivers wore seat belts and used rollover protection structures. On June 8, Oscar Rodriguez-Olivera w... Read More

CA - DWC Updates Ambulance Fee Schedule

12/08/2023 | 0

The California Division of Workers’ Compensation posted an order updating reimbursement rules and rates for ambulance services provided in 2024. For services rendered on or after Jan. 1, the maximum reasonable fee shall not exceed 120% of the applicable California fees established in the 2024 Medicare Ambulance Fee Schedule File, the DWC said. The division’s order adopts the Centers for Medicare and Medicaid Services calendar year 2024 ambulance fee schedule as well as CMS ZIP code files. The order notes that CMS adopted an ambulance inflation factor of 2.6% for 2024 as part of ... Read More

CA - WCIRB Governing Committee Meets Wednesday

12/08/2023 | 0

The Workers’ Compensation Insurance Rating Bureau of California Governing Committee is meeting at 9:30 a.m. Wednesday. The committee’s December meeting is typically short, and this year is no exception. The only new business for committee members to discuss are potential 2024 actuarial and research projects and the schedule for meetings next year. The meeting agenda is here. ... Read More

MO - Lawmakers to Consider Bill on Marijuana, Work Comp

12/08/2023 | 0

Missouri lawmakers will consider a bill that would add marijuana to current law that reduces or eliminates workers’ compensation benefits for those who are found to be under the influence of alcohol or nonprescribed controlled drugs. Workers’ compensation benefits are reduced by 50% when a worker disobeys an employer’s drug-free workplace rule and the “injury was sustained in conjunction” with the use of alcohol or nonprescribed drugs. The law forfeits all benefits when the use of alcohol or other drugs is the proximate cause of death or injury. SB 935, pr... Read More

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Press - Zack Craft: New MTI America VP of Complex Claims

12/05/2023 | 0

POMPANO BEACH, FL (December 5, 2023) - Zack Craft, ATP, CRTS, CAPS, CEAC joins MTI America as the newest member of MTIs Senior Leadership Team. Craft has over 24 years of experience in the complex care industry, working most recently for One Call as a VP National Product Leader. Craft said, I am thrilled to join the MTI team and contribute to our shared mission. My focus has been on building a dedicated team and developing programs designed to provide the workers' compensation industry with a comprehensive complex claims model of care, addressing the needs of both newly injured workers ... Read More

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NY - Bill Would Allow Survivors to Refile COVID Death Claims

12/08/2023 | 0

New York lawmakers on Wednesday introduced a bill that would allow survivors of those whose COVID-19 deaths were connected to work to refile workers' compensation death benefits claims that were previously denied due to timing. SB 7792, which was sent to the Senate Rules Committee, would allow the reopening of claims that were denied because they did not meet the provisions in current law that claims must be filed within two years of the death and/or within 30 days of the injury. If signed into law, the bill would immediately give families up to one year to refile claims. Business Insur... Read More

CA - Rehab Provider Doesn't Qualify as Probationer's 'Employer'

12/07/2023 | 0

A California appellate court ruled that a private, nonprofit organization providing a residential rehabilitation program to a probationer is statutorily excluded from being the probationer’s employer for workers’ compensation purposes. After Jose Velasquez pleaded guilty to a felony count of forgery, a Santa Barbara Superior Court judge placed him on supervised probation and required that he complete a residential treatment program. Velasquez entered the Salvation Army’s residential adult rehabilitation center in Santa Monica for substance abuse treatment. The Salva... Read More

NY - Court Overturns Summary Judgment to Worker on Labor Law Claims

12/07/2023 | 0

A New York appellate court overturned a grant of summary judgment to a worker on a Labor Law claim, finding one defendant should have had all the claims against it dismissed and that the worker had not established all the elements of his claims against another. Case: Hossain v. Condominium Board of Grand Professional Building, No. 2020-03010, 11/29/2023, published. Facts: Mohammed Iqbal Hossain allegedly suffered injuries while performing pointing work on the facade of a building. The building was owned by the Condominium Board of Grand Professional Building and managed by G Buddy Inc. ... Read More

NY - Defendant Gets Partial Summary Judgment in Cart Accident Case

12/07/2023 | 0

A New York appellate court ruled that a Labor Law defendant was entitled to partial summary judgment in its favor, but triable issues remained as to the rest of the worker’s claims. Case: Laliashvili v. Kadmia Tenth Avenue SPE LLC, No. 2021-03507, 11/29/2023, published. Facts: Zviadi Laliashvili worked for All City Glass and Mirror Co. In May 2017, he was on a crew of workers tasked with delivering large glass panels to a work site in Manhattan. The panels were each approximately 8 feet by 5½ feet long, a quarter-inch thick and weighed approximately 60 pounds. All Ci... Read More

DE - Supreme Court Upholds Additional Compensation to Law Firm Employee

12/07/2023 | 0

The Delaware Supreme Court upheld an award of additional compensation to a law firm employee, finding that her spinal injury was causally related to a prior shoulder injury and that her petition for benefits was timely filed. Case: Elzufon, Austin, Tarlov & Mondell PA v. Lewis, No. 47, 2023, 12/05/2023, published. Facts: DeLisa Lewis worked for the law firm of Elzufon, Austin, Tarlov & Mondell PA. After she began experiencing pain in her right shoulder in August 2016, she reported it to the firm. Dr. Eric Johnson diagnosed Lewis with bone spurs in the shoulder and performe... Read More

TX - DWC: Medical Costs Down Nearly 30% in Last Decade

12/07/2023 | 0

Payments for medical services declined nearly 30% to $812 million in 2022 from $1.15 billion in 2012, according to a new report on health care costs on utilization in the Texas workers’ compensation system. Overall, the Insurance Department’s Workers’ Compensation Research and Evaluation Group reports a general trend of reductions in the cost and use of medical services over the last decade. “These trends are most likely a result of a decrease in the total number of claims, as well as the implementation of evidence-based treatment guidelines, the pharmacy formula... Read More

CA - DWC District Office Moving From Stockton to Lodi

12/07/2023 | 0

The California Division of Workers’ Compensation is moving its Stockton office to Lodi next week. The division said the Stockton district office will operate on a virtual basis from Dec. 7-11 to facilitate the move. All in-person trials and expedited trials have already been rescheduled, and conferences will proceed as scheduled on teleconference lines. The division is encouraging parties to file documents electronically or through the mail. Anyone who needs to file a document in person Dec. 7-11 may do so in Sacramento, the division said. The new Lodi district office will be at 3021 ... Read More