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CA - WCIRB Actuarial Committee OKs Methodology for Setting New Pure Premium Rate

By Mark Powell (Reporter)
08/11/2020 | 317 | 0 | 42 min read

Claims for COVID-19 would add about 6 cents per $100 of payroll to California’s advisory pure premium rate, under a methodology the Workers’ Compensation Insurance Rating Bureau’s Actuarial Committee approved Monday. The actual rate for 2021 won’t be known until Wednesday at the earliest when the WCIRB’s Governing Committee meets to discuss the annual filing. Employers were already looking at a penny increase earlier this year. But the Governing Committee in April voted against a midyear rate filing that would have increased the advisory rate 0.7% to $1.53 ... Read More

NE - Legislature Moves Ahead on PTSD Bill, Enhanced Leave Time for Assaulted Teachers

By William Rabb (Reporter)
08/11/2020 | 106 | 0 | 2 min read

While many states' lawmakers have been focused on pandemic relief legislation, Nebraska's unicameral Legislature has moved ahead with workers' compensation bills that have nothing to do with COVID-19. As early as Wednesday, the Legislature is set to give final approval to LB 963, making post-traumatic stress disorder a compensable condition for first responders. The bill, introduced by Sen. Tom Brewer, a Republican from Gordon and a former Army helicopter pilot, gained support in January, when the 2020 legislative session began. But when the pandemic hit, the session was suspende... Read More

LA - Court Tosses Verdict for Carrier on Coverage of Car Accident

08/11/2020 | 105 | 0 | 28 min read

A Louisiana appellate court overturned a verdict in favor of an insurance carrier as to its obligation to cover an insured who was in an accident with an underinsured motorist. Case: Baack v. McIntosh, No. 19-657, 07/29/2020, published. Facts: Martin Baack worked for the Pilgrim's Pride Corp. He was driving his work vehicle on Louisiana Highway 6 near Natchitoches when another vehicle pulled out from the shoulder and attempted to make a U-turn. That vehicle, being driven by Michael McIntosh, collided with Baack’s vehicle. McInotsh was determined to be solely at fault in causi... Read More

TX - TCPA Doesn't Apply to Employer's Alleged Communications

08/11/2020 | 138 | 0 | 37 min read

A Texas appellate court ruled that an employer’s alleged communications regarding the termination of an injured employee did not implicate the protections of the Texas Citizens Participation Act. Case: Clinical Pathology Laboratories Inc. v. Polo, No. 08-19-00067-CV, 08/06/2020, published. Facts: Juan Polo worked for Clinical Pathology Laboratories Inc. as a phlebotomist. CPL is a "reference laboratory" that performs testing for clients, which include physicians, clinics and hospitals. On Aug. 22, 2016, Polo suffered injuries in a car accident while driving a ... Read More

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Press - Jopari Solutions Enables Medical Providers to Electronically Submit Medical Claim Attachments to Anthem Health Care Plans.

08/06/2020 | 72 | 0

CONCORD, Calif., August 6, 2020 - Jopari Solutions, in collaboration with their industry trading partners, has successfully deployed Jopari's Attach technology to enable medical providers to electronically submit claim attachments and medical records to over 50 Anthem Health Plans that span across Commercial, Medicare, Medicaid, and Federal Employ... Read More

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NATL. - Moore: Telecommuting Employee Accidents: Risk Management and Claims Nightmare?

By James Moore
08/11/2020 | 135 | 0

The coronavirus pandemic grew what was a “cottage industry” type job to one of the most popular jobs in existence today. Most telecommuting employee accidents will involve in-home hazards. Let us look at the previous telecommuter articles I wrote over the last few months on telecommuting employees since the beginning of the pandemic: Class Code 8871 popular now.  Premium refunds from COVID crisis.  California adds telecommuter class code. Furloughed employees. And, below: Definition of a telecommuting employee. In-home hazards that may cause accident... Read More

NY - Property Owner, Tenant Get Summary Judgment Dismissing Worker's Claim for Injury

08/11/2020 | 72 | 0 | 10 min read

The Appellate Division’s 2nd Department ruled that a property owner and tenant were entitled to summary judgment dismissing a worker’s claim for injuries from a fall during a power outage. Case: Reynoso v. Ahava 750 LLC, No. 2017-12424, 07/29/2020, published. Facts: Inez Reynoso allegedly was injured when she fell during a power outage while working in a building in Long Beach. Ahava 750 LLC owned the building, which was leased to Chem Rx Pharmacy Services LLC. Procedural history: Reynoso filed suit against Chem Rx and Ahava. The defendants separately moved for summary judgment... Read More

NY - Worker Can't Assert Viable Labor Law Claim for Injuries From Truck Tipping Over

08/11/2020 | 119 | 0 | 32 min read

A New York appellate court ruled that a worker could not assert a viable Labor Law claim for his injuries from a truck that tipped over as he operated it. Case: Kickler v. Dove-Tree Greenery Inc., No. 2018-13432, 07/29/2020. Facts: Vito and Josephine Rastelli hired Dove-Tree Greenery Inc. and PA Lupinacci to install a pool in the backyard of their property. After the pool was installed, the contractors were tasked with building a retaining wall and adding fill to level the yard. The contractors hired White Wolf Industries Inc. to procure and deliver several loads of fill material to th... Read More

CA - Judge Orders Uber, Lyft to Classify Drivers as Employees

08/11/2020 | 435 | 0 | 25 min read

A Northern California judge on Monday issued an injunction ordering Uber and Lyft to reclassify their drivers after concluding there is no way the transportation network companies can rebut the presumption that the drivers are employees. San Francisco Superior Court Judge Ethan P. Schulman wrote in Monday’s decision that neither Uber nor Lyft can satisfy the second prong of a three-part test of employee status that took effect at the start of the year. The so-called ABC test presumes workers are employees unless the employer proves the workers are free from control and direction, perfor... Read More

CA - Sheriff Arrests Two Accused of Trying to Steal Death Benefits

08/11/2020 | 431 | 0 | 26 min read

Law enforcement officials in Northern California arrested two people who allegedly tried to steal workers’ compensation death benefits that had been mailed to the family of a sheriff’s deputy who was killed in the line of duty in 2008. The Yolo County Sheriff’s Office said the county’s insurance provider reported a possible attempt to fraudulently cash benefit checks that were mailed to family members of Deputy Tony Diaz. Detectives arrested Dawn Faulk, 50, and Jensen Faulk 61, on Thursday after executing a search warrant in Woodland. The search allegedly found t... Read More

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Press - Coventry Drug Trends Series Continues with an Evaluation of Opioids

08/06/2020 | 56 | 0

In part three of our workers' compensation drug trends series we're evaluating opioid trends, which continue to represent a decreasing proportion of overall scripts and costs with favorable trends seen in important markers such as morphine equivalent dose (MED), duration of use, and access to guideline-supported measures including medication-assisted treatment (MAT) and overdose rescue medication (naloxone). Some highlights from the series include: The number of injured workers using opioids has continued to decline for 6 consecutive years Opioid script utilization has fallen... Read More

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NV - Shops in Las Vegas Strip Mall Cited for COVID-19 Safety Violations

08/11/2020 | 90 | 0 | 63 min read

Nevada regulators cited three stores in the Fashion Show mall on the Las Vegas Strip for failing to comply with COVID-19 safety regulations. The Division of Industrial Relations announced that investigators observed noncompliance with one or more requirements of general and industry-specific guidance and directives at least twice at the stores. The employers were notified of violations and asked to comply with state directives intended to slow the spread of the new coronavirus. They were cited when investigators observed continued noncompliance during follow-up visits. Saks Fifth Avenue, Sh... Read More

TX - DWC to Hold Meeting on New Interrogatory Forms

08/11/2020 | 96 | 0 | 44 min read

The Texas Division of Workers' Compensation will host an online meeting next month to discuss proposed changes to the interrogatory forms used in discovery in contested case hearings. The DWC in January proposed changes to both forms — the claimants' interrogatories to insurer and the carrier's interrogatories to claimant. After receiving public comments, the agency made some revisions. The amended versions would ask for more information, including contact details of the persons answering the questions; the issues in dispute; recordings or video of the claimant since the inj... Read More

CA - DWC Sets Conference Call on Proposed Changes to MTUS

08/11/2020 | 169 | 0 | 37 min read

The California Division of Workers’ Compensation will hold a conference call Sept. 10 to gather testimony on a proposal to adopt guidelines governing the use of drugs that treat nausea and vomiting. The division is proposing to incorporate into the Medical Treatment Utilization Schedule guidance from the American College of Occupational and Environmental Medicine on the use of antiemetics. The ACOEM guideline covering the treatment of nausea was last updated in March. “The Antiemetics Guideline is applicable as a supplement to conditions addressed in the other MTUS guidelines tha... Read More

CA - WCIRB Committee: Telecommuter Rate Should Be Based on Golden State Data

By Mark Powell (Reporter)
08/10/2020 | 331 | 0 | 37 min read

A Workers' Compensation Insurance Rating Bureau committee says it is willing to wait for California-based data before settling on a specific pure premium rate for a proposed telecommuter classification.  WCIRB Classification and Rating Committee members on Friday opted not to rely on National Council on Compensation Insurance data culled from other states that already have telecommuter classifications separate from clerical worker codes. Instead, members agreed to advise the WCIRB’s Governing Committee to administer a rate of 23 cents per $100 of payroll — the current ra... Read More

TN - Worker Gets PPD Award With Uncapped Multiplier for Elbow Injury

08/10/2020 | 113 | 0 | 24 min read

The Supreme Court of Tennessee’s Special Workers' Compensation Appeals Panel upheld an award of benefits to a worker for his elbow injuries, finding his claim was timely filed and that he did not have a meaningful return to work. Case: Coates v. Tyson Foods, No. W2019-00904-SC-R3-WC, 07/28/2020, published. Facts: Kenneth Brian Coates worked as a feed mill supervisor for Tyson Foods Inc. He supervised five to six employees and also performed physical work himself. Coates experienced pain in his elbows while using a sledgehammer to help unload soybean meal from a rail car ... Read More