TX - Low Pay, More Vacancies for WC Judge Positions
| 12 min read
Last year, the Texas Legislature changed the title of workers’ compensation hearing officers to administrative law judges. That may have been an attempt to give the judges the honorific they deserve and smooth over some simmering frustrations, attorneys say.
But HB 2111 did not raise the judges’ salaries, and at $70,000 annually, the pay level remains lower than in many other states. With three vacancies at the court and others soon to open up, there’s growing concern that the bench won’t be able to keep up with the caseload or attract enough qualified candidates.
CA - Doctor Challenges Jury Instructions in Appeal of Fraud Conviction
| 7 min read
A doctor serving a 10-year prison sentence says the federal jury in Southern California that convicted him of 39 counts of fraud wasn’t properly instructed on how to interpret the law prohibiting kickbacks.
Dr. Ronald Grusd is asking the U.S. 9th Circuit Court of Appeals to release him from prison and stay all fines to preserve the status quo pending the outcome of his appeal. He said there are substantial questions about the jury’s understanding of the charged crimes and whether he would have been convicted had the jury received proper instructions.
He suffered h...
NATL. - Paradigm Deal Illustrates Interest in Catastrophic Care
| 35 min read
Paradigm Outcomes, a provider of medical management for catastrophically injured workers, has entered into an agreement to be acquired by OMERS Private Equity, the companies announced Thursday.
Terms of the deal were not disclosed. But Joe Paduda, principal of Health Strategy Associates, said the transaction values Paradigm at more than $1 billion. Paduda reported the Paradigm deal Wednesday on his Managed Care Matters blog.
“The price is even more remarkable, as there wasn’t an auction; the valuation continues what’s become the new normal pricing for work comp assets,&rdqu...
OR - Worker's Failure to Timely File Brief in Carrier-Initiated Appeal Didn't Preclude Award of Fees
| 2 min read
A unanimous Oregon Court of Appeals this week ruled that a worker was not precluded from receiving an award of fees for the services provided by his attorney to defend an administrative law judge’s finding of compensability.
While the board’s precedent has conditioned a worker’s entitlement to a fee award on his commencement of the review process and the timely filing of a review brief, the court said neither of these are prerequisites under Oregon law.
The case was In the Matter of the Compensation of Schommer.
Craig Schommer worked for AC Schommer & Sons. H...
LA - Worker Gets Benefits for Consequential Injuries but No Penalties, Attorney Fees
| 20 min read
A Louisiana appellate court upheld portions a worker’s award for consequential injuries following an injury to his right knee but overturned the assessment of fees and penalties against the employer.
Case: Loar v. LUBA Workers’ Comp, No. 17-CA-683, 09/19/2018, published.
Facts: Rodney Loar worked for the Terminix Service Co. While working in December 2011, he slipped in a muddy ditch and fell. Terminix accepted liability for an injury to Loar’s right knee and his head.
Loar initially received treatment for his knee injury from Dr. Gordon Nutik. Nutik recommended a tot...
CA - Weinmann: SB 790 Bites the Dust
Our decidedly negative story on Senate Bill 790 about gifts and benefits in medication prescribing and dispensing was published on May 15, 2017.
Dr. Robert Weinmann
We asserted that the bill actually showed how little the author knew about drug pricing and how physicians prescribe. Sen. Mike McGuire's press release at the time said that the "interaction with the pharmaceutical industry is associated with ... unnecessary drug prescriptions ... borne by the patient and less availability of generic drugs."
McGuire and crew didn't mention then that the markup or p...
TN - Panel Says Judge Improperly Capped Worker's PPD Award
| 25 min read
The Supreme Court of Tennessee’s Special Workers’ Compensation Appeals Panel ruled that a church employee’s permanent partial disability benefits were improperly capped, since the evidence did not support a finding that she had been fired for stealing.
Case: Gandee v. Zurich North America Insurance Co., No. W2017-01523-SC-WCM-WC, 09/19/2018, published.
Facts: Vicki Gandee injured her knee in April 2004 while working for the Christ United Methodist Church. She returned to work two weeks later but reinjured her knee in a workplace fall in August 2004.
Gandee came b...
NY - Worker Can't Renew Opposition to Summary Judgment on Labor Law Claim
| 3 min read
A New York appellate court ruled that a construction worker was not entitled to renew his opposition to a motion for summary judgment on his Labor Law claim based on a recent ruling from a different department.
Case: Opalinski v. City of New York, No. 2015-10766, 09/19/2018, published.
Facts and procedural history: Witold Opalinski allegedly cut his hand while using a grinder in 2008 while working on a renovation project at a New York City public school.
Opalinski filed a Labor Law claim against the city, then moved for summary judgment on his claim under Section 241(6). Section 241(6)...
NY - Intervening High Court Ruling Entitled Injured Police Officer to Summary Judgment
| 2 min read
A New York appellate court ruled that a police officer was entitled to summary judgment on his personal injury claim against a motorist who had struck him as he was conducting an inspection of parked cars.
Case: Outar v. Sumner, No. 2017-10399, 09/19/2018, published.
Facts: Kenneth Outar worked for the New York City Police Department as a traffic enforcement agent. His job duties involved walking down a street to inspect vehicles in a parking lane.
A car being operated by Brandon Sumner struck Outar as he was inspecting the parked vehicles.
Procedural history: Outar filed a per...
CA - Governor Sings OSIP Data Reporting, CalOSHA Record-Keeping Bill
| 7 min read
California Gov. Jerry Brown signed into law a bill allowing the publication of some information related to the cost of public self-insured programs and clarifying the time frame during which employers can be penalized for failing to abide workplace safety record-keeping requirements
Assemblyman Tony Thurmond
Brown on Wednesday signed AB 2334, by Assemblyman Tony Thurmond, D-Richmond, which authorized the Office of Self-Insurance Plans to report on administrative costs, benefit payments, solvency and performance of public employers.
The bill also declares for the purpose of citations that ...
OK - Former Reserve National President Named Chief Actuary for Insurance Department
| 3 min read
The Oklahoma Insurance Department has hired the former president of Reserve National Insurance Co. to be chief actuary for the department.
Andrew Schallhorn's first day on the job will be Monday, Insurance Commissioner John Doak said in a statement.
“This position is extremely vital,” Doak said. “Monitoring the financial solvency of insurance companies is the number one thing we do to protect consumers. Andrew brings with him a wealth of actuarial experience and a unique perspective."
Reserve National is part of the Kemper companies, which offer mostly health...
OK - Chamber Wants Special Session on Medical Marijuana Law
| 4 min read
The Oklahoma Chamber of Commerce is asking lawmakers to delay implementation of a medical marijuana law or at least clarify employers' rights in a special session of the Legislature.
"If we could delay implementation, it will give this committee and the Legislature time to be able to put this regulatory scheme in place," Chamber President Fred Morgan said Wednesday, according to Tulsa Public Radio. "If not, we would like to see the Legislature move as quickly as possible to address the concerns we’ve raised."
Chamber officials said lawmakers should ma...
Press - Morse, Giesler, Callister, Karlin & Hiura is now Karlin, Hiura and LaSota
Morse, Giesler, Callister, Karlin & Hiura is now Kar...
NATL. - AmWins Promotes Kristin Downey to Chief Administrative Officer
| 19 min read
AmWins Group Inc., a global distributor of specialty insurance products and services, has named Kristin Downey as its chief administrative officer.
Downey has served as the company’s executive vice president of human resources since 2002, and recently took over responsibility for the group’s marketing and communications team.
In her new role, Downey will lead the firm’s human resources, training and development, marketing, and communications functions. She will also oversee the company’s philanthropic efforts, including the recently formed AmWin...
KY - Jeff Borkowski Named CEO at ClearPath Mutual
| 22 min read
The board of directors of ClearPath Mutual Insurance Co. has appointed Jeff Borkowski as the company’s chief executive officer.
Gregory Buie, the workers’ comp insurer’s previous CEO, will act as a consultant to the company until his retirement on Dec. 31.
Before joining ClearPath Mutual, Borkowski spent seven years with Brethren Mutual Insurance Co. in Hagerstown, Maryland. Borkowski was the commercial underwriting manager for four years, and most recently was vice president of underwriting and marketing.
While at Brethren Mutual, Borkowski...
WY - Department of Workforce Services Partners With Medata
| 54 min read
The Wyoming Department of Workforce Services announced that it is using Medata as its new vendor to process bills for medical treatment of injured workers.
The change will primarily affect the billing process for providers, the department said in a notice on its website.
Providers with questions about medical billing can contact Medata at email@example.com or at 877-879-3817.
Medata is a cost-containment and document management form in Irvine, California.
NATL. - NCCI: No Evidence That ACA Reduced Claims Filed on Mondays
| 30 min read
The National Council on Compensation Insurance said it found no evidence that the Affordable Care Act reduced the number of workers’ compensation claims filed on Mondays.
Slightly more workers’ compensation claims are filed on Monday than any other day of the week, and NCCI said it is hypothesized this is the result of workers filing claims for non-occupational injuries that occurred over the weekend.
NCCI said there has also been speculation that the Affordable Care Act could reduce the number of non-work-related claims covered by comp, which would reduce the share of claims wit...
Press - The Comp Laude® People’s Choice Awards speakers are here!
CAMARILLO, Calif.-- (Sept 13, 2018) The seventh annual Comp Laude® Awards & Gala celebrates the posit...