FL - CFO Asks Court to Revisit Definition of Heart Disease for Presumptive Claims
10/17/2024 | 0
Florida's Chief Financial Officer is asking the state's 1st District Court of Appeal to revisit its definition of heart disease under a 2023 decision dealing with presumptive claims by first responders.
The CFO, who also serves as the state's fire marshal, said in an amicus brief that the appellate court's definition of heart disease in North Collier Fire Control and Rescue District v. Harlem is judicially constructed and contrary to legislative intent; improperly removes medical science and expert testimony from compensability determinations; usurps the factfinding functi...
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The Arkansas Court of Appeals upheld an award of benefits for a man with a rapid-repetitive-motion injury and that he did not forfeit his entitlement to benefits by lying about his medical history.
Case: International Paper Co. v. Steward, No. H109777, 10/02/204, published.
Facts: Ronald Steward began working for International Paper Co. in February 2021.
Before this, Steward suffered neck and back injuries in a May 2019 car accident. His treating physician said he was “unlikely to fully recover,” and at Steward’s last appointment in October 2019, the doctor ...
A New York appellate court ruled that an injured worker was not entitled to summary judgment on his Labor Law claims because there were triable issues as to whether his own conduct was the sole proximate cause of his accident.
Case: Ballard v. 300 Eastern Blvd. Canandaigua LLC, No. 589 CA 23-01329, 09/27/2024, published.
Facts: Keith Ballard allegedly suffered injuries when he fell to the ground while working on the roof of a building being constructed on property owned by 300 Eastern Blvd. Canandaigua LLC.
Ballard and his co-workers were installing plywood sheets to form the base layer of ...
A New York appellate court upheld a grant of summary judgment on a worker’s Labor Law claim for his injuries from being struck by a falling object.
Case: Tejada-Rodriguez v. 76 Eleventh Avenue Property Owner LLC, No. 29502/18, 10/01/2024, published.
Facts: Omnibuild Construction Inc. allegedly served as the general contractor for a construction project on property owned by 76 Eleventh Avenue Property Owner LLC.
Omnibuild allegedly hired Danny Tejada-Rodriguez’s employer as a concrete subcontractor.
Tejada-Rodriguez claimed that he suffered injuries while working on the pro...
Now that the 2024 California legislative session is over, what did we learn this year about workers’ comp at the Capitol? What follows are some takeaways and references to some of the bills that were passed and others that died.
Applicants' attorneys and labor advocates received legislative support for some of their proposals. But the employer/insurer coalition continues to be powerful, so most applicant-side workers’ comp efforts were rebuffed in 2024.
Bills passed by the Legislature but vetoed by Gov. Gavin Newsom included the following:
SB 1299, a bill to ...
West Virginia’s Intermediate Court of Appeals upheld a determination that an injured worker was entitled to a 0% permanent partial disability award.
Case: Gibson v. Greenbrier Valley Medical Center, No. 24-ICA-160, 10/01/2024, published.
Facts: Tara Lockwood Gibson worked for Greenbrier Valley Medical Center. She suffered injuries at work in February 2018 while assisting a patient out of bed.
Gibson was diagnosed with cervical and lumbar radiculopathy.
Procedural history: In May 2021, the Office of Judges found that Gibson had a 10% permanent partial disability. The Office of Ju...
Goldberg Segalla announced the addition of Angela G. DiSanti to the firm’s workers' compensation defense group in Philadelphia.
DiSanti has more than 10 years of experience counseling and defending employers, insurance carriers and third-party administrators from Pittsburgh to Philadelphia, the firm said.
She has extensive experience litigating cases before Pennsylvania workers’ compensation judges, the Workers’ Compensation Appeal Board and the Commonwealth Court of Pennsylvania.
DiSanti earned her bachelor's degree from Allegheny College and her law degree fr...
The California Division of Workers' Compensation announced standards it will use for profile audit review of adjusting locations next year.
The DWC said the PAR performance standard for 2025 audits is 1.57376. Audit subjects that score 1.57376 or lower will be required to pay any unpaid compensation but will not be assessed administrative penalties. Claims shops with a higher score are subject to an expanded full compliance audit.
The full compliance audit standard for 2025 is 2.14192. Shops that receive a lower score will be ordered to pay unpaid compensation as well as administrative p...
The North Carolina Court of Appeals upheld the calculation of a union pipe fitter’s average weekly wage from a project where he was injured.
Merck Pharmaceutical contracted with Jacobs Project Management Co. to serve as the general contractor on a construction project in Durham. Jacobs hired Southland Industries Inc. as a subcontractor. Southland was a signatory contractor with Local 421 in Durham, which required it to hire union members.
Travis Taylor is a journeyman pipe fitter and union member assigned to Southland for work on the Merck project. Taylor received an email from the uni...
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...
An Ohio appellate court upheld the denial of a worker’s claim for permanent total disability benefits, finding that she had some residual work capacity.
Case: Lee v. Industrial Commission, No. 22AP-446, 09/26/2024, published.
Facts and procedural history: Ruby Lee worked for New Delphi Automotive Systems LLC. She suffered injuries at work in May 2011 when she fell backward and struck a metal bar while lifting a box.
Lee filed a workers’ compensation claim, which was allowed for lumbar sprain, sacroiliac sprain, substantial aggravation of preexisting L5-S1 disc bulge wi...
The U.S. 10th Circuit Court of Appeals ruled that an employer was entitled to more than $541,000 in damages for its insurance carrier’s breach of contract.
Case: MVT Services LLC v. Great West Casualty Co., No. 23-2070, 10/02/2024, published.
Facts: MVT Services LLC purchased a workers’ compensation and employers’ liability policy from Great West Casualty Co. for coverage from January 2013 through January 2014. The policy had a limit of $1 million per accident.
MVT also purchased a nonsubscriber insurance policy from Crum & Forster Specialty Insurance Co. for...
A New York appellate court upheld a finding that a worker was entitled to benefits for his injuries from being struck by two motorized bicycles after he left a happy hour event.
Case: Matter of Matter v. Google Inc., No. CV-23-0719, 09/16/2024, published.
Facts: Bruce Matter worked for Google Inc. as an account executive. He sustained serious injuries, including a traumatic brain injury, in October 2021 when he was struck by two motorized bicycles while crossing a street en route to a bus stop.
The accident happened shortly after Matter had attended an invitation-only event called a &q...
Delaware Insurance Commissioner Trinidad Navarro on Wednesday announced that voluntary market loss costs will decrease by an average of 8.4% on Dec. 1.
At the same time, the commissioner announced an average rate reduction of 9.21% for the residual market.
The commissioner's office said this marks the eighth consecutive decrease in workers’ compensation rates.
“This year’s decrease in workers' compensation insurance rates continues the reversal of voluntary and residual market trends,” the commissioner’s office said. “With the residual market expe...
The California Workers' Compensation Institute said certain benefits will increase by about 3.8% next year because of an increase in the state's average weekly wage.
The average wage in California increased 3.776% to $1,704 from $1,642 for the 12-month period ending March 31.
As a result, the maximum temporary total disability and permanent total disability benefits will both increase to $1,680.29 per week from $1,619.15. Minimum TTD and PTD benefits will also increase to $252.03 per week from $242.86.
CWCI also said other benefits will increase, including TTD paid two years or...
A man convicted of fraud in two separate cases 15 years apart and who was kicked out of California's workers' compensation system seven years ago is facing new fraud charges for a scheme that allegedly started in 2020.
The Orange County District Attorney's Office on Friday said David W. Fish, 55, and three co-defendants each face 13 felony charges, including illegal referrals for compensation, conspiracy, filing false or fraudulent claims and insurance fraud. Prosecutors allege that the three-year scheme generated nearly $100 million in fraudulent fees.
Fish allegedly formed a ma...
A federal appellate court ruled that an injured longshoreman who has hearing loss in one ear and bilateral tinnitus is properly compensated at the statutory rate.
Case: Total Terminals International LLC v. OWCP, No. 23-179, 10/11/2024 published.
Facts: Robert Tower worked for Total Terminals International LLC. His job involved frequent exposure to loud marine operations.
In June 2019, Tower’s otolaryngologist diagnosed him with a 9.375% left monaural hearing loss and bilateral tinnitus.
Procedural history: Tower filed a hearing loss claim under the Longshore and Harbor Workers’...
