MD - Insolvency Threatens Uninsured Employers' Fund
02/21/2019 | 180 | 0 | 30 min read
Maryland’s Uninsured Employers' Fund could become insolvent as early as next year after suffering gravely due to bankruptcies by two major employers, managerial neglect and a rash of serious problems detailed in a legislative audit and other reports.
Many in Maryland’s workers’ comp community were unaware of the gravity of the problems until a legislative hearing Tuesday, when UEF Executive Director Michael Burns detailed the challenges he’s facing while urging passage of bills he said are needed to keep the fund afloat.
“I’m a ...
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A New Jersey volunteer firefighter is now due almost $120,000 in wage benefits, even though she wasn't working and had no wages at the time of her injury.
That was the decision handed down this week by the New Jersey Supreme Court in Kocanowski v. Township of Bridgewater. Municipalities are now bracing for potentially higher workers' compensation costs in the future, but claimants consider the ruling a major victory for volunteers in New Jersey, where most towns and smaller cities rely exclusively on volunteer firefighters.
A municipal insurance official said the ruling may not ...
The Illinois Appellate Court last week ruled that a municipal employer was not entitled to the entirety of an injured employee’s recovery from a third-party tortfeasor to satisfy its workers’ compensation lien.
Although Illinois law recognizes an employer’s subrogation interest if a worker obtains damages from a civil defendant who is responsible for the injury, the court said the employer is not entitled to a lien merely because it paid workers’ compensation benefits.
The court said the employer needs to prove the payments were connected to the injury for which the e...
In a case of first impression, the Tennessee Court of Appeals ruled that nurse case management fees are not recoverable as part of an employer’s workers’ compensation subrogation lien.
Case: Memphis Light, Gas and Water Division v. Watson, No. W2018-00218-COA-R3-CV, 02/13/2019, published.
Facts and procedural history: Tykena Watson worked for the Memphis Light, Gas and Water Division as a meter reader. She suffered injuries when she was attacked by a dog in June 2013.
MLGW provided workers' compensation benefits to Watson after the attack and eventually settled wit...
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If you ask an applicants' attorney about the “going and coming rule,” nine out of 10 will tell you, “Oh yeah, it means you’re going to find this claim compensable, and I’m coming for your money.”
Well, probably not, but, maybe after this blog post, they’ll start saying that.
The going and coming rule stands for the premise that employees engaged in their commute to or from work are not “working” yet, and so injuries sustained during the commute are not industrial (nor is harm to third parties the liability of the employer via...
A divided Arkansas Court of Appeals upheld an award of benefits to a bus driver for a shoulder injury, finding the Workers' Compensation Commission had not arbitrarily disregarded the opinion of the only medical expert to testify as to causation.
Case: Lonoke Exceptional School v. Coffman, No. CV-18-534, 02/13/2019, published.
Facts: Don Coffman worked for the Lonoke Exceptional School as a bus driver. In April 2017, he fell in a gravel parking lot and injured his left shoulder.
Coffman underwent a magnetic resonance imaging scan that revealed a tear in the shoulder.
Coffman later...
A New York appellate court ruled that a worker was not entitled to an increase in his schedule loss of use award for a shoulder injury, given the authority of the Workers’ Compensation Board to resolve the conflicting medical evidence.
Case: Matter of Napoli v. Edison, No. 524823, 02/07/2019, published.
Facts and procedural history: John Napoli injured both shoulders in 2003 while operating a jackhammer at the World Trade Center site. He established a workers’ compensation claim and received an award for a 20% schedule loss of use of each shoulder in 2006.
Napoli retired in 2011...
A New York appellate court upheld the dismissal of a worker’s claim that he had been terminated in retaliation for pursuit of benefits for his on-the-job injuries.
Case: Matter of Romero v. DHL Holdings (USA) Inc., No. 525195, 02/07/2019, published.
Facts: Mauricio Romero worked for DHL Holdings as a relief tractor-trailer courier/driver. He was also a member of the International Brotherhood of Teamsters Local 295, which had a collective bargaining agreement with DHL.
Romero injured his back and shoulder in June 2011 at work. He claimed he informed his station manager he had...
The Montana state Senate has sent two workers’ compensation bills to the House — one that would require insurers to give workers notice when closing their claim, and another that would require workers’ comp coverage for all volunteer firefighters.
The Senate on Tuesday voted 50-0 to approve Senate Bill 78, by Sen. Mary McNally, D-Billings. The measure would require insurers, if they are paying medical bills within 90 days of when benefits are due to terminate, to provide notification to the injured worker and the worker’s attorney. Insurers that fail to send t...
A bill requested by the Oregon Workers’ Compensation Division that would increase maximum aggregate penalties against insurers and employers that violate workers’ compensation laws has cleared its first committee vote.
The House Committee on Business and Labor on Tuesday approved House Bill 2087, by Rep. Paul Holvey, D-Eugene, in a 9-0 vote.
Under Holvey’s bill, the maximum civil penalty against employers that fail to pay assessments, induce a worker not to file a claim or violate other provisions of workers’ compensation law would remain at $2,000 for ...
Medical providers would no longer be able to submit a claim to Virginia's Workers' Compensation Commission if they've already accepted payment through the federal Longshore and Harbor Workers' Compensation system, according to a bill that was sent to the governor this week.
Senate Bill 1729, introduced by Sen. Thomas Norment, R-Williamsburg, was approved unanimously by the House and Senate last month. It applies only to medical services provided to an injured worker before July 1, 2014, and bars the Workers' Compensation Commission from considering the claim.
“...
The Utah state Senate is poised to give final approval to a bill that would appoint a task force to recommend ways of removing barriers to mental health treatment for first responders.
House Bill 154, by Rep. Karen Kwan, D-Murray, would create the Mental Health Protections for First Responders Workgroup, with representatives from the legislature, insurers, first responders and public and private employer groups.
Its mission would be to review barriers to mental health treatment for first responders, and statutory requirements for compensability of mental stress claims. The grou...
Pharmacy benefit managers, part of a multibillion-dollar niche industry that evolved to hold down medication costs in America's complex health care landscape, are now facing increasing criticism from state and federal regulators that they're not providing the cost savings they promised.
The latest jolt comes from the Ohio attorney general, who is demanding that OptumRx refund almost $16 million because of overcharges to the Ohio Bureau of Workers' Compensation. In a Feb. 11 letter to Optum, Attorney General Dave Yost said the PBM, one of the largest in the U.S., had overc...
Step aside, opioids. Non-steroidal anti-inflammatories are now the most common therapeutic drug group prescribed to injured workers in the state, according a new report by the California Workers’ Compensation Institute.
CWCI said efforts to curb inappropriate use of opioids, such as utilization review, treatment guidelines and restrictions by payers, are having a measurable impact on usage rates. Opioids made up 30.5% of all prescriptions filled in the California workers’ compensation system 10 years ago, but that fell, to 18%, in the first half of 2018. Opioids made up ...
An employee hurt on the job may be reluctant to file a workers’ comp claim, deciding to have the injury treated under his group health plan instead. But a high deductible on the group health plan could tilt the decision the other direction, according to a new study from the Workers Compensation Research Institute.
“As individuals increasingly become responsible for a greater share of their health care costs under GH (group health) coverage, our findings indicate that workers’ compensation will see a greater number of injuries shifting from group health,” WCRI...
A divided Kansas Court of Appeals last week overturned an award of benefits to the widow of worker who died in a fall from a catwalk, finding the Workers’ Compensation Appeals Board erred in refusing to consider evidence that he had tested positive for marijuana.
The court found no specific statute or regulation prevented the board from considering the test result, and that there was “ample evidence supporting the reliability of the test result.”
Admitting the test result into evidence would give rise to a conclusive presumption that 60-year old Gary Woessner had been impai...
