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NATL. - Judge Sanctions Applied Underwriters, Orders Attorney to Submit to Deposition

By Emily Brill (Reporter)
08/18/2017 | 613 | 0 | 0 min read

A federal judge in Nebraska has approved sanctions against the embattled Berkshire Hathaway affiliate Applied Underwriters for failing to produce documents, fully answer questions and make its attorney available for a deposition during litigation against New Jersey employment agency Tops Personnel. U.S. Magistrate Judge Cheryl Zwart ordered Applied to answer Tops' questions fully, give Tops access to emails it requested and, in an unusual move, allow Tops' attorneys to depose Applied's attorney, Jeffrey Silver, who is also an executive at the company.  Applied Underwriters s. Read More

NATL. - Drones Currently Impractical to Uncover Workers' Compensation Fraud, Investigators Say

By J. Todd Foster (Reporter)
08/18/2017 | 394 | 0 | 0 min read

Drones were predicted years ago to become a key tool in the fight against workers’ compensation fraud, but strict federal regulations and privacy concerns have all but halted their use, investigators say. Employers and their workers’ compensation carriers generally have the right to conduct workplace surveillance with hidden cameras or those in plain sight. But drones, or UAS (unmanned aircraft systems), aren't practical for fighting workers’ compensation fraud by surveilling workers who might be feigning or exaggerating their injuries, said Tim Wilcox, chief executive o. Read More

CA - WCIRB: State's Loss Adjustment Expenses Are 'Off the Charts'

By Elaine Goodman (medical/business Reporter)
08/18/2017 | 838 | 0 | 0 min read

California’s workers’ compensation system stands out in many ways from systems in other states, but the most dramatic difference may be seen in one measure: the Golden State’s 34.2% ratio of loss adjustment expenses to losses. Dave Bellusci That figure is more than 10 percentage points higher than the second-highest state — Hawaii, where the ratio is 23.6% — and nearly double the national median of 18.3%, according to the California Workers’ Compensation Insurance Rating Bureau. “This is the one where we’re off the charts,” said Tony M. Read More

CA - High Court Won't Review Decision Sending Doctor's RFA Through UR/IMR

By WorkCompCentral
08/18/2017 | 1079 | 0 | 0 min read

The California Supreme Court will not be reviewing a decision by the Workers’ Compensation Appeals Board finding that a request for authorization for treatment by a doctor within an employer’s medical provider network is subject to the Labor Code’s utilization review and independent medical review processes. The case is Willoughby v. WCAB, No. S242193. Pamela Willoughby had worked for the northern California-based law firm of Hoge, Fenton, Jones & Appel as a legal secretary. While playing in a softball game sponsored by her employer, a ball struck Willoughby on the lef. Read More


TX - Court Rejects Wrongful Termination Claim by Father Who Witnessed Son's Accident

By WorkCompCentral
08/18/2017 | 422 | 0 | 0 min read

A divided Texas appellate court ruled that a worker failed to assert a viable claim for wrongful termination after he saw his son get hurt in the course of their employment with their mutual employer. Case: In re Odebrecht Construction, No. 13-17-00289-CV, 08/15/2017, published. Facts and procedural history: Rodolfo Mora filed suit against his former employer, Odebrecht Construction, asserting he had been wrongfully terminated after his son, a fellow Odebrecht employee, filed a workers’ compensation claim against the company. Mora claimed that Odebrecht had fired all but one of the wi. Read More

Column

CA - Young: WCIRB Releases 2017 State of the System Report

By Julius Young
08/18/2017 | 417 | 0 | min read

The Workers' Compensation Insurance Rating Bureau has now issued its 2017 report on the state of the California workers’ comp system. Julius Young If you’re headed to a desert island and want to take along one resource for understanding California workers’ comp now, this is probably the best choice. As with so many studies, different stakeholders will read the report from their own perspective, seeing success or problems as the case may be. This year’s report is a great improvement in terms of format and ease of use. Most of the charts come with an “Insi. Read More

NY - Contractor Should Have Been Granted Partial Dismissal of Labor Law Claim

By WorkCompCentral
08/18/2017 | 307 | 0 | 0 min read

A New York appellate court ruled that a contractor was entitled to partial summary judgment dismissing a worker’s Labor Law claim to the extent it was predicated on two safety regulations that were inapplicable to the facts of his case. Case: Zaino v. Rogers, No. 2015-12211, 08/16/2017, published. Facts: A property owner hired The Laurel Group to remove and replace a residential driveway. Laurel then subcontracted the job to M&A Asphalt. Giuseppe Zaino worked for M&A. Zaino claimed he was struck by a crawler-mounted excavator operated by his supervisor during removal. Read More

Sulivan On Comp

CA - 9th Circuit Upholds Award of Benefits for Worker Who Attempted Suicide

By WorkCompCentral
08/18/2017 | 764 | 0 | 0 min read

The U.S. 9th Circuit Court of Appeals upheld an award of benefits to a longshoreman for his injuries from a failed suicide attempt. Case: Leeward Marine v. Director of the Office of Workers’ Compensation Program, No. 16-72242, 08/16/2017, unpublished. Facts: William Kealoha suffered an industrial injury in September 2001 when he fell a distance of 25 to 50 feet from the deck of a barge while working for Leeward Marine. He suffered a broken rib and a broken shoulder blade in the fall but returned to full duty less than three weeks after the accident. Kealoha filed a claim fo. Read More

OH - Worker's Failure to Respond to Employer's Notice of Appeal Costs Him His Claim

By WorkCompCentral
08/18/2017 | 389 | 0 | 0 min read

An Ohio appellate court ruled that a worker’s case was properly dismissed because he failed to file a petition in response to his employer’s notice of appeal from an adverse Industrial Commission decision. Case: Smith v. Soci Petroleum, No. C-160477, 08/16/2017, published. Facts and procedural history: Brian Smith worked for Soci Petroleum. He filed a workers' compensation claim after sustaining injuries when he fell getting out of a truck. After the Industrial Commission determined that Smith was entitled to benefits for his injuries, Soci sought judicial review. Soci serv. Read More

OK - Supreme Court Gets Employer's Answer to Constitutional Challenge to TTD Cap

By WorkCompCentral
08/18/2017 | 404 | 0 | 0 min read

An Oklahoma employer on Wednesday filed its response to a worker’s constitutional challenge to the state’s statutory cap on the amounts payable as temporary total disability benefits, asserting that the issue isn’t anything the Oklahoma Supreme Court needs to address. Section 45(A)(1) of the Administrative Workers' Compensation Act sets the weekly TTD rate for a worker at the lesser of 70% of his average weekly wage, or 70% of the statewide average weekly wage. Attorneys Clyde Muchmore and Melanie Rughani of Crowe & Dunlevy assert that it was wit. Read More

NY - Comp Board Drops Queens Rehabilitation Physician Over Federal Arrest

08/18/2017 | 433 | 0 | 0 min read

The state Workers’ Compensation Board on Wednesday temporarily suspended Dr. Xiaoliang Zhang’s authorization to treat injured workers. Zhang’s last-known business address is 45-02 82nd St., first floor, Elmhurst. On July 11, federal prosecutors charged Zhang with a “scheme and artifice” to defraud Medicare and Medicaid. Board Chairman Kenneth J. Munnelly wrote in Subject No. 046-975 that Zhang “may be guilty of misconduct, and that such misconduct would detrimentally affect the quality of care provided to injured workers.” Reports submitted by Zhan. Read More

OH - BWC Wants Stakeholder Feedback on Proposed Fee Schedule Changes

08/18/2017 | 273 | 0 | 0 min read

The Bureau of Workers’ Compensation is seeking comments and feedback on two proposed fee schedule rules. The agency said Thursday that it has completed a review of the current Professional Provider Medical Services Fee Schedule, which will become effective Jan. 1, and the Hospital Inpatient Reimbursement Rule, which will become effective Feb. 1. The payment of hospital inpatient services under the Medicare Prospective Payment Center will be multiplied by a payment adjustment factor of 1.103, down from the current 1.127, the proposal states. Reimbursement for outliers will be multiplie. Read More

NATL. - Brian Allen Joins Mitchell's PBM Business

08/18/2017 | 295 | 0 | 0 min read

Brian Allen has joined Mitchell as vice president of governmental affairs for the company’s ScriptAdvisor pharmacy benefit management business. Brian Allen Allen was previously vice president of government affairs for more than five years for pharmacy benefit manager Helios, which was acquired by Optum in January 2016. Under Allen’s leadership, Mitchell will expand its advocacy role in the PBM industry, working with legislators and regulators, and providing customers with insights into regulatory changes that may affect them. Allen, a former Utah legislator, is a frequen. Read More

IL - IWCC Announces Death of Administrator Robert Falcioni

08/18/2017 | 604 | 0 | 0 min read

The Illinois Workers’ Compensation Commission announced that arbitrator Robert Falcioni died on Wednesday. Falcioni was one of the commission’s “Downstate” arbitrators, covering Zone 4 and conducting hearings in Kankakee, New Lenox and Ottawa. The commission said any contracts that need to be reviewed should be forwarded to Zone 4 arbitrators Christine Ory or Carolyn Doherty. Motions and other documents should be sent to Arbitration Manager Bob Devereaux in Chicago, the commission said. . Read More

OR - WCD Proposes Rules to Determine Number of Arbiters for Panels

08/18/2017 | 380 | 0 | 0 min read

Oregon’s Workers’ Compensation Division is proposing rules that would allow consideration of where an injured worker lives, specialties of providers needed to conduct exams, and general expediency when deciding whether to appoint two or three arbiters to panels. The rules proposed on Tuesday would implement House Bill 2335, which Gov. Kate Brown signed into law earlier this year. The bill gives the division the option of appointing two members to medical arbiter panels that were previously required to comprise  three providers. The measure also directed the division to p. Read More

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Press - For Immediate Release

08/02/2017 | 1876 | 0 | min read

An investigation conducted by the Georgia State Board of Workers’ Compensation’s Enforcement Division has led to the arrest of Laura A. Ditchkoff. According to Enforcement Division Director Stan BeXley, Laura A. Ditchkoff, age 42 and a resident of Alma, Georgia, was arrested on Monday,. Read More