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Top Stories

SC - Stakeholders Miffed at Lack of Information on Troubled Claims Management System

By William Rabb (Reporter)
04/07/2020 | 133 | 0 | 10 min read

South Carolina's new web-based claims management and filing system was set to roll out in March, promising an end to a 30-year-old system that offered only limited access to files and required stakeholders to rely heavily on U.S. mail and hand delivery. Comp attorneys around the state said the new system was set to go live at the perfect time — just before the coronavirus outbreak forced workers to stay at home and use electronic filing when possible. But it wasn't meant to be. The state Workers' Compensation Commission in February announced that after months of ... Read More

CA - Shortages Underline Uneasy Conditions for Essential Workers During COVID-19 Pandemic

By Mark Powell (Reporter)
04/07/2020 | 148 | 0 | 4 min read

As California and other states attempt to mitigate the damage caused by the COVID-19 pandemic, a lack of personal protective equipment for health care professionals and essential workers has underscored the dangerous conditions in which they operate. But what can employers do when there are no masks or respirators to hand out? And should workers be forced to reuse safety equipment that’s meant to be thrown away? In times like these, the questions don’t always receive status quo answers, said Garrett Brown, former field compliance officer and special assistant to the chief of Cali... Read More

UT - Court Upholds Findings of Medical, Legal Causation for Truck Driver's Foot Injury

04/07/2020 | 57 | 0 | 8 min read

The Utah Court of Appeals upheld a finding that a truck driver’s foot injury was related to his employment and that his employer was not denied due process in the compensation proceedings. Case: Fastenal v. Labor Commission, No. 20180196-CA, 04/02/2020, published. Facts: Ronald Stone worked for Fastenal as a truck driver. Stone operated semi-trucks equipped with manual transmissions and more than 15 gears. His schedule included driving for 11 hours per day to make deliveries in various cities throughout the country. During one of his trips, Stone discovered a pressure ulcer on th... Read More

LA - Supreme Court Orders Suspension of Comp Attorney for Misconduct

04/07/2020 | 83 | 0 | 6 min read

The Louisiana Supreme Court last week ordered the suspension of a veteran workers’ compensation attorney for collecting an unreasonable fee, violating a judicial order and directing his secretary to forge the name of a client on a satisfaction of judgment. A majority of the court concluded that George Flournoy’s misconduct warranted a one-year suspension from the practice of law, with all but 30 days deferred, followed by a one-year period of unsupervised probation. Chief Justice Bernette Joshua Johnson dissented, contending a 90-day actual suspension would be more appropria... Read More

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Press - In response to the COVID-19 crisis, the California Division of Workers Compensation (DWC) issued Emergency Measures for Medical-Legal Evaluations during Governor Newsom's Stay-at-home-Order

03/31/2020 | 129 | 0

This measure encourages primary treating physicians to continue to manage injured workers' care through telehealth options whenever medically appropriate. Telehealth options include remote visits via video-conferencing, video-calling, or similar such technology that allows each party to see each other via a video connection. To better serve our customers during this global crisis, iLingo2.com, Inc. is launching Video Remote Interpreting (VRI) services, to manage cases using a viable alternative during state-mandated stay-at-home orders. As a leading language solutions provider, iLin... Read More

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NATL. - Geaney: Preventive Actions Do Not Trigger Temporary Disability Benefits

By John H. Geaney
04/07/2020 | 90 | 0

Let me begin with a correction to a prior blog.  A few weeks ago I wrote in a blog about a hypothetical scenario where an employer requires an employee to be quarantined because the employee was exposed to a fellow employee who tested positive for COVID-19. Several readers wrote to disagree that the period of lost time should be paid in workers’ compensation, even if the quarantined employee ultimately tested negative and no other workers’ compensation benefits were due. These comments led me to rethink the issue. Having reviewed case law in different states on... Read More

IA - Worker Partially Waives Claim for Penalties

04/07/2020 | 57 | 0 | 21 min read

The Iowa Court of Appeals ruled that an injured worker partially waived her claim for penalties against her employer by raising the issue and then failing to litigate it. Case: True v. Heritage Care and Rehabilitation, No. 19-0818, 04/01/2020, published. Facts: Debra True injured her right shoulder while working as a dietary aide at Heritage Care and Rehabilitation in 2010. Heritage provided medical benefits but True did not miss any work, so she did not receive any disability benefits. Procedural history: In March 2011, True filed a petition with the workers' compensation commissi... Read More

FL - DWC Sets Workshop in May on Medical Reimbursement and Utilization Review Changes

04/07/2020 | 66 | 0 | 10 min read

While many conferences, hearings and meetings around the country have been canceled through May because of the coronavirus outbreak, the Florida Division of Workers' Compensation announced it will hold a workshop May 27 on medical reimbursement and utilization review rules. The proposed changes affect the 69L-7 family of administrative rules and seek to clarify definitions and what is required of medical providers and insurers. The notice of rulemaking did not make clear what the proposed changes are, and a preliminary draft was not available, the division said in a notice this week. The... Read More

OR - Gov. Names Andrew Stolfi Director of DCBS

04/07/2020 | 32 | 0

Oregon Gov. Kate Brown appointed Andrew Stolfi director of the Department of Consumer and Business Services. As director of DCBS, Stolfi will oversee the Workers’ Compensation Division, the Workers’ Compensation Board and the ombudsman for injured workers, as well as other agencies including Oregon OSHA, the Building Codes Division, Division of Financial Regulation and the Oregon Health Insurance Marketplace. He will also continue to serve in his role as the insurance commissioner. In March, as head of the agency's Division of Financial Regulation and as Oregon's ins... Read More

CA - WCAB Approves Emailed Submissions in Latest En Banc Decision

04/07/2020 | 190 | 0 | 6 min read

The Workers’ Compensation Appeals Board on Monday issued an en banc decision allowing some documents to be submitted by email while California is subject to a gubernatorial order directing residents to stay at home when possible. “To the extent that WCAB Rule 10940(b) prohibits sending documents directly to the appeals board by email, we order that documents may be emailed directly to the appeals board,” Monday’s decision reads. “Documents that may be emailed include, but are not limited to, correspondence relating to a petition for reconsideration that has been ... Read More

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Press - Longtime Industry Expert Joins Preferred Medical

04/06/2020 | 51 | 0

Company grows leadership team with addition of industry veteran as Chief Clinical Officer LOUISVILLE, Ky. (April 6, 2020) - Preferred Medical, a leading pharmacy benefit manager and ancillary service partner in workers' compensation, announced today that Jim Andrews has joined the company as chief clinical officer. Andrews has over 45 years' experience in pharmacy administration, operations and workers' compensation. He brings a proven ability to solve challenging problems and communicate effectively though all verticals. In his role as chief clinical offic... Read More

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CA - Report: Horse Trainers Face Retroactive Fee to Cover Shortage in Comp Fund

04/07/2020 | 85 | 0 | 2 min read

California horse trainers are facing a retroactive charge of $1,233 per horse for the first quarter of 2020 to cover a shortfall in funding for a self-insured workers’ compensation program, according to the Paulick Report. The board of directors for the Post Time Self-Insurance Group said the shortage is a result of the frequency and severity of claims and the indefinite suspension of racing, which reduced the subsidy for comp costs that comes from the amount of money being bet at tracks. “These are expenses that need to be covered, and as joint and several members, you are ... Read More

CA - Risico, AgSafe Webinar to Cover Comp Issues

04/07/2020 | 76 | 0 | 14 min read

Risico and AgSafe are partnering to provide a free educational webinar to the agriculture community, covering topics related to COVID-19. The webinar will discuss COVID-19's effects on various aspects of the workers' compensation system and the potential impact on employers and employees throughout the medical care and claim process. The webinar will also explore the health crisis's effects on other lines of insurance such as general liability, professional liability, health insurance and auto. The webinar is from 10-11 a.m. Wednesday. Registration information is here. ... Read More

CA - DWC Cancels P&T Committee Meeting

04/07/2020 | 64 | 0 | 9 min read

The California Division of Workers’ Compensation announced it is canceling the April 22 meeting of its Pharmacy and Therapeutics Committee to comply with the state’s stay-at-home order. The P&T Committee was created by Assembly Bill 1124 to advise the division on updates to the prescription drug formulary. Currently, the committee is scheduled to meet next on July 22. The DWC said it welcomes comments from the public on the formulary drug list at formulary@dir.ca.gov. Materials including agendas and minutes from the committee’s previous meetings are available her... Read More

NATL. - CMS Fails to Authorize Telemed for Physical Therapy, Leaving Reimbursement in Doubt

By William Rabb (Reporter)
04/06/2020 | 838 | 0 | 38 min read

Of all the medical treatments now available for injured workers, physical therapy and rehabilitation may be ideally suited for video-based telehealth sessions. But the Centers for Medicare and Medicaid Services, for reasons that have yet to be explained, has failed to authorize those services for reimbursement. For states whose workers' compensation reimbursement schedules are tied to Medicare, such as Texas, that means thousands of injured workers could be stuck at home, unable to tune into regular telehealth therapy and rehab instructors during the coronavirus lockdown. "We&#... Read More

NATL. - Study: Claims Above $1M Account for 10% of Losses; Vehicle Accidents No. 1 Cause

By Mark Powell (Reporter)
04/06/2020 | 215 | 0 | 34 min read

Motor vehicle accidents, along with slips and falls, are the cause of about half of all claims above $1 million, according to a National Council on Compensation Insurance study chronicling high-dollar payouts over the past 15 years. Claims that pay out $1 million or more account for 10% of losses, but they represent less than 0.2% of all lost-time claims, according to the study, which was released Tuesday. The figures reflect part of a long-term, overall decline in claims within the workers’ compensation system, according to the study’s authors, NCCI Executive Director Jim Davis ... Read More