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CA - Second Large Consolidation Voids $2M in Liens

By Greg Jones (Deputy Editor)
11/16/2018 | 907 | 0 | 16 min read

Steven Howser was convicted of conspiring to pay $8,000 in kickbacks to a Southern California doctor who ordered durable medical equipment from his company. As a result, the Division of Workers’ Compensation is wiping out about 1,000 liens with a claimed value of at least $1.9 million. Howser's liens became officially null and void on Oct. 29 when he and his attorney signed a stipulation “that any and all bills and liens that currently exist, or date of service that has yet to be billed, but could be billed by or on behalf of Steve Howser or Post-... Read More

MT - State Auditor Adopts Proposed Revisions to Classification Manual

11/16/2018 | 87 | 0 | 19 min read

The Montana State Auditor announced that it has adopted revisions to classification codes for retirement living centers, limousine and taxi companies, digital photography, manufacturing and repairing drones, and auto body shops. The auditor’s Classification Review Committee recommended that the state revise the codes to align definitions with those used by the National Council on Compensation Insurance. The committee did not receive any written comments about the proposed changes, and no one testified regarding the proposal during an Oct. 3 hearing. A notice in the current edition of ... Read More

TX - Federal Appeals Court Revives Injured Worker's Retaliatory Discharge Claim

By WorkCompCentral
11/16/2018 | 89 | 0 | 25 min read

A federal appellate court revived an injured worker’s claim that he had been fired in violation of Texas law because of his pursuit of workers’ compensation benefits.   Case: Cristain v. Hunter Buildings & Manufacturing, No. 17-20667, 11/14/2018, published. Facts: Hunter Buildings & Manufacturing hired Luis Enrique Cristain in August 2014 as a helper. His job duties included painting, maintenance and cleaning. Kevin Edmonds also worked for Hunter as its environmental health and safety manager. He did not directly supervise Cristain and had seen him only a ... Read More

NY - Award of Benefits at PPD Rate Didn't Constitute Classification of Disability

By WorkCompCentral
11/16/2018 | 91 | 0 | 10 min read

A New York appellate court ruled that an injured worker was never classified as having a permanent partial disability even though she had received multiple awards of benefits at a PPD rate. Case: Matter of Murray v. South Glens Falls School District, No. 526052, 11/15/2018, published. Facts and procedural history: Bonnie Murray worked for the South Glens Falls School District. She suffered injuries while at work in December 2007. Murray established a workers’ compensation claim for injuries to her back and trapezius. In June 2010, a workers’ compensation law judge entered a... Read More


Column

NATL. - Furtado: Quest for the Holy Grail in Workers' Comp

By Karen Furtado
11/15/2018 | 211 | 0

Quotes from only five data points, or even fewer? Name your number, and you can find an insurer looking to transform the sales experience to match. Karen Furtado We have seen a great deal of this momentum in personal lines with increasing attention in small commercial lines. And the line of business delivering today is workers’ comp. Insurers writing workers’ comp — including insurtech startups — are innovating in many areas, including quoting, servicing, claims and the overall customer experience. There is high potential for emerging technologies, includ... Read More

NY - Board Did Not Err in Rejecting Sole Medical Opinion on Worker's Lost Use of Arms

By WorkCompCentral
11/16/2018 | 71 | 0 | 12 min read

A New York appellate court ruled that the Workers’ Compensation Board properly rejected a treating doctor’s opinion as to a worker’s loss of use of her arms, even in the absence of any contrary medical opinion. Case: Matter of Maunder v. B&B Lumber Co., No. 526034, 11/15/2018, published. Facts and procedural history: Elizabeth Maunder has an established case for occupational disease to her bilateral wrists and for bilateral cubital tunnel syndrome stemming from a work-related accident in 2002. Liability for her claim was transferred to the Special Fund for Reopened Cas... Read More

SC - High Court Maintains View That Self-Insurance Fund Members Can Pursue Suit Against Board

By WorkCompCentral
11/16/2018 | 55 | 0 | 141 min read

The South Carolina Supreme Court is standing by its decision that the disgruntled members of a self-insured workers’ compensation fund can proceed with their claims against the board of trustees for rerouting assets in a failed effort to start up a new insurance company. Case: Patterson v. Witter, No. 27841, 11/14/2018, published. Facts and procedural history: The South Carolina Home Builders Self Insurers Fund was created by the Home Builders Association of South Carolina for the purpose of fulfilling its members’ obligation to provide workers’ compensation coverage for th... Read More

IN - State Sues Purdue Pharma Over Alleged Opioid Misrepresentation

11/16/2018 | 91 | 0 | 50 min read

Indiana Attorney General Curtis Hill has filed a lawsuit against opioid manufacturer Purdue Pharma, alleging that the company’s misrepresentation of the risks and benefits of its painkillers played a key role in the state’s opioid crisis. Hill’s lawsuit, filed Wednesday in Marion County Court, alleges that Purdue Pharma violated Indiana’s Deceptive Consumer Sales Act; the Prescription Drug Discount and Benefit Cards Statute; the False Claims Act; and the Medicaid False Claims Act. The complaint seeks maximum penalties, damages, costs and an order directing Purdue Phar... Read More

OH - Bill Would Have WC Pay for Correctional Officers' Disease Testing

11/16/2018 | 85 | 0 | 3 min read

Corrections workers who are at risk of contracting infectious diseases because of contact with inmates would have their testing and diagnosis covered by workers' compensation, under a bill introduced in the Ohio legislature. House Bill 733, sponsored by state Rep. Rick Perales, R-Beavercreek, was assigned this week to the House Insurance Committee. It would extend the coverage, which is now afforded first responders, to corrections officers. The officers and emergency workers are exposed to bodily fluids during emergency calls and inmate disturbances, the bill explains, but prison worker... Read More


NATL. - Ambulatory Center Surgeries Not Always Cheaper, WCRI Finds

11/16/2018 | 105 | 0 | 128 min read

Knee and shoulder surgeries usually cost less at ambulatory surgery centers compared to hospital outpatient departments, but there are exceptions in some states, according to a new report from the Workers Compensation Research Institute. The WCRI report looks at payments to ASCs and hospital outpatient departments for knee and shoulder arthroscopies in 18 states. In 14 states, payments for knee surgeries performed at ASCs were at least 21% lower than payments for hospital outpatient surgeries in 2016. In three states, the payments were similar, and in Indiana, payments for ASC surgeries wer... Read More

NATL. - FDA: Unapproved Drugs Add to Intrathecal Pump Risk

By Elaine Goodman (medical/business Reporter)
11/16/2018 | 141 | 0 | 19 min read

Intrathecal pumps, drug-delivery systems that have been controversial in workers’ compensation, are the subject of a warning issued Thursday by the U.S. Food and Drug Administration. The FDA has cautioned against using the pumps to deliver drugs that aren’t approved specifically for use with the systems. Intrathecal pumps are surgically implanted devices, often intended for pain relief, that administer drugs directly into a patient’s spinal canal. “Pain medicines approved by FDA for delivery into the spinal fluid must meet additional safety standards because the ... Read More

CA - DWC Moves Satellite Office in Eureka

11/16/2018 | 266 | 0 | 44 min read

The California Division of Workers’ Compensation has moved its office in Eureka. The office is now located in the state office building at 409 K St., Room 201. The division said the office phone numbers are the same as from when the office was on H Street. The Eureka office is a satellite of the division’s district office in Santa Rosa. ... Read More

NATL. - AmTrust Posts Another Third-Quarter Loss

11/16/2018 | 178 | 0 | 46 min read

AmTrust Financial Services Inc. has reported a third quarter net loss of $84.5 million, compared to a net loss of $175 million in the third quarter of 2017. For the first nine months of the year, AmTrust posted a net profit of $461 million, reversing a $146 million net loss in the same period last year. AmTrust offers workers’ compensation and other lines of coverage through its small commercial and specialty program business segments. In small commercial, net earned premiums were $646 million in the third quarter, up from $529 million in the prior-year quarter. Workers’ compens... Read More

CA - Court Grants Pacific Hospital CFO Reprieve From Prison Sentence

11/16/2018 | 601 | 0 | 27 min read

The chief financial officer who tracked kickback payments to facilitate the spinal kickback scheme at Pacific Hospital of Long Beach will not serve time in prison, a reward for the substantial assistance he has provided prosecutors since sentencing. James L. Canedo was ordered to serve 366 days in federal prison in February under terms of a 2015 agreement to plead guilty to a single conspiracy charge. He was also ordered to forfeit $633,091 in criminal proceeds. He was ordered to start serving his sentenced Nov. 12 but scored a last-minute reprieve Nov. 8 when the U.S. Distric... Read More

MT - Rising Medical Taking Over Bill Review for Montana State Fund

11/16/2018 | 108 | 0 | 61 min read

Rising Medical Solutions will take over as Montana State Fund’s bill review and payment vendor on Jan. 1, the carrier said in a newsletter emailed on Thursday. “We believe this partnership will make the bill review process timelier and more accurate for our providers and claim examiners,” MSF said. “One major enhancement that RMS offers is the ability for electronic billing and the issuance of electronic funds transfer payments.” MSF said providers should continue to contact the current vendor, Conduet/ACS, about payment status or bill review questions unti... Read More

TX - Seaman Had 'Legal Remedy' for Injuries Even Though No Foreign Court Had Jurisdiction

By WorkCompCentral
11/16/2018 | 55 | 0 | 12 min read

A Texas appellate court on Thursday upheld the dismissal of a foreign seaman’s lawsuit against a Houston-based vessel owner, finding he had a legal remedy available even though no other country would take jurisdiction over his claims. The court said Texas remained an available forum for Andre Nazareth to pursue a remedy, and absent any evidence that he could not pursue a claim under the laws of his home country or the country with jurisdiction over the area where he was hurt, he was not subject to the protection of the Jones Act or America’s maritime jurisprudence. Nazareth ... Read More