NATL. - Comp Could Be Hit Hard by Virus-Related Fraud, and Regulators Hope to Get Creative
04/01/2020 | 850 | 0 | 30 min read
From new questions about home-based work injuries to an increase in fraud and litigation, workers' compensation may be affected more than most lines of insurance by the changes wrought by the coronavirus, fraud experts said Tuesday.
“The world of workers' comp may never be the same again. This may be where the most dramatic long-term effect comes, from COVID-19,” said Matt Smith, executive director of the Coalition Against Insurance Fraud, one of the speakers in a webinar that featured fraud fighters, state regulators and some 3,500 viewers from around the country.
And wi...
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California worker advocates are asking Gov. Gavin Newsom to create an emergency presumption stating that COVID-19 is compensable for essential employees who continue to work face-to-face with the public during the pandemic, according to a letter sent last month.
The California Labor Federation on March 19 sent a letter to Newsom’s office expressing concern over workers’ safety and requesting a workers’ compensation presumption that exposure to the coronavirus counts as job-related for essential employees. The letter was sent the same day the governor ordered all nonessential...
An Ohio appellate court upheld a jury’s findings that a worker was entitled to benefits for additional conditions that were caused by the repetitive motions of her job.
Case: Day v. Rochling-Glastic Composites L.P., No. 108532, 03/19/2020, published.
Facts: De'Carla Day worked for Rochling-Glastic Composites L.P. In 2006, RGC assigned her to work as a press operator. The job required that Day keep the presses supplied with spools of fibers known as "rovings,” and liquid resin.
The rovings weighed between 42 and 50 pounds each, and the resin came in 55-gal...
A New York appellate court said an employer’s failure to identify when it objected to a ruling warranted denial of its application for review.
Case: Matter of Barrett v. BSR LLC, No. 529535, 03/16/2020, published.
Facts and procedural history: Brendan Barrett worked for BSR LLC. He filed a workers’ compensation claim for an alleged back injury.
A workers’ compensation law judge found the claim compensable. BSR sought review by the Workers’ Compensation Board, which rejected the application as incomplete.
Analysis: The Appellate Division’s 3rd De...
Grants are being given to 40 nonprofits throughout the state
AUSTIN, Texas - Texas Mutual Insurance Company, the state's leading provider of workers' compensation insurance, today announced a donation of $2 million in grant funding for nonprofit organizations across the state that are vital to COVID-19 relief and recovery. The grants will go to 40 nonprofit organizations, including Meals on Wheels, United Way, local food banks, community ...
It is an anticipated, unfortunate consequence of the COVID-19 health crisis that many employers in California will soon lay off a significant quantity of their workforce. Layoffs in the range of 80% are estimated in the retail, hospitality and construction fields.
It can be expected that the layoffs will soon be followed by claims for continuous trauma injuries.
Set forth below are strategies and best practices that can be used by employers, claims administrators and defense attorneys to minimize the incidence and exposure from post-layoff CT claims.
By way of background, recall that ju...
A New York appellate court said a worker’s failure to identify the date she had made an objection to a ruling was fatal to her challenge.
Case: Matter of Martinez v. Family Care Services Inc., No. 529174, 03/16/2020, published.
Facts and procedural history: Martha Martinez worked for Family Care Services Inc. as a home attendant. She established a workers’ compensation claim for a back injury from 2012.
In June 2018, a workers’ compensation law judge found Martinez had not worked from January to April of that year. The judge further found Martinez did not remain attached t...
Self-insurers in Ohio could soon receive rebates on their assessments for the guaranty fund if they pay electronically, according to a rule change proposed this week.
The Bureau of Workers' Compensation is encouraging self-insured companies to utilize electronic payments and e-notifications for the Self-Insuring Employers' Guaranty Fund, the bureau said in a notice. All self-insurers are required to pay into the fund, and the assessment is 6% of premium for most self-insurers.
The bureau, which proposed the rebate idea last fall, said it considered requiring all self-insurers to...
Utah Gov. Gary Herbert enacted legislation that will lower the threshold for presuming intoxication was the major contributing cause of a workplace injury, as well as allow the appointment of alternate members to the Labor Commission Appeals Board.
The governor on Saturday signed House Bill 15, by Rep. James Dunnigan, R-Taylorsville, allowing two alternates — one representing employers and one representing labor — to fill in when regular members of the Appeals Board are unavailable.
Other provisions in the bill would allow the Senate and House of Representatives to each...
First responders in Wyoming will be allowed to file claims for mental stress without having an accompanying physical injury, under legislation enacted by Gov. Matt Mead.
Mead on Thursday signed SF 117, by Sen. Tara Nethercott, R-Laramie, exempting first responders from the prohibition on so-called “mental-mental” claims.
The bill would enable first responders to collect benefits for a mental stress claim for up to 36 months following diagnosis by a psychiatrist, psychologist or psychiatric mental health nurse practitioner.
The exemption to the prohibition on mental clai...
Tampa, FL (March 11, 2020) - ReEmployAbility is proud to announce it was recognized for the fourth year in a row by Florida State University on their 2020 Seminole 100 List.
ReEmployAbility, along with 99 other fastest-growing businesses owned or led by FSU alumni, were honored February 22, 2020 during a ceremony at FSU's University Center Club in Doak Campbell Stadium. ReEmployAbility rank...
SAIF Corp. announced a $10 million fund to help Oregon employers keep workers safe during the coronavirus pandemic.
“The fund will help businesses pay for expenses tied to making workplaces safer against the virus and dealing with the impact of the pandemic on workers,” the carrier said in a statement. “Eligible expenses could include work site cleaning and disinfection supplies; resources to reopen businesses safely after a coronavirus-related closure; resources to redesign or modify workspaces to encourage social distancing; and mental health and wellness initiatives.&rdqu...
The California Division of Workers' Compensation over the weekend said it may be beneficial for parties to allow telehealth for medical-legal evaluations during the COVID-19 outbreak when an in-person physical examination is not necessary.
The Saturday news release comes days before a law firm representing more than 100 qualified medical evaluators was set to ask a Los Angeles County Superior Court judge to order the division to allow telehealth evaluations during the pandemic.
Yet the division said it "strongly recommends" that five conditions be met before a telemedical or re...
With employers across the country facing unprecedented downtime, ergonomic experts suggest that this may be an opportunity to consider retooling workplaces with equipment that can reduce injuries and comp claims.
One holdup to that plan, however, may be that some products that have been shown to help reduce hazards have not found widespread acceptance in the U.S. marketplace.
“There are a lot of products out there that have great benefits but have not really taken off,” said Jack Dennerlein, a professor at Northeastern University's College of Engineering who special...
A divided Mississippi Court of Appeals ruled that an autoworker was not entitled to benefits for the second of his two alleged back injuries.
Case: Burton v. Nissan North America, No. 2018-WC-01490-COA, 03/17/2020, published.
Facts: Tremayne Burton began working for Nissan North America in 2003. On Dec. 8, 2008, he allegedly suffered a back injury while attempting to loosen a bolt with a wrench.
Burton went to the computer lab. He stayed there and worked, using a computer for the remainder of his shift.
When his direct supervisor asked him why he was in the lab, Burton allegedly ...
