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CA - $11.25M Settlement for Construction Accident Could Be Record

By Mark Powell (Reporter)
08/07/2020 | 2196 | 0 | 37 min read

A former construction employee has been awarded what could be a record-setting workers’ compensation settlement more than two years after he fell four stories at a California work site. A Division of Workers’ Compensation administrative law judge on July 24 approved an $11.25 million settlement for Omar Ramirez, guardian of Salvador Ramirez Morales, 35, who suffered a traumatic brain injury and related complications following an accident in April 2018. The total settlement amount might be an unofficial record for California’s workers’ compensation system, which ha... Read More

NATL. - Wearable Ultrasound Promises Faster RTW; Claims Managers Not So Sure

By William Rabb (Reporter)
08/07/2020 | 202 | 0 | 13 min read

A wearable ultrasound system, often used by college and professional sports teams, is slowly making its way into workers' compensation as a way to speed recovery from injuries without extensive surgery or pain medications, the manufacturer said this week. Known as sustained acoustic medicine or SAM, the device utilizes ultrasonic waves to excite soft tissue, which can cut healing times, reduce inflammation and get some workers back in action in just a few weeks, officials with Connecticut-based ZetrOZ said in a news release. But claims managers said the system, also called therapeut... Read More

MO - Worker Can't Recover From Automobile Liability Carrier

08/07/2020 | 169 | 0 | 32 min read

The Missouri Court of Appeals ruled that a worker was not entitled to a recovery from his automobile liability insurance carrier for his injuries from an accident with an underinsured motorist. Case: Arnold v. Farm Bureau Town & Country Insurance Co. of Missouri, No. SD36253, 07/28/2020, published. Facts and procedural history: George Arnold worked as a Missouri Highway Patrol officer. In 2011, he was involved in a collision with a vehicle driven by Karen Chambers. Chambers was insured by an automobile liability policy that provided bodily injury coverage of $25,000 per person. Ar... Read More

NY - Court Tosses Worker's Claims for Injury From Fall

08/07/2020 | 183 | 0 | 26 min read

A New York appellate court threw out a worker’s Labor Law claim for his injuries for a fall at a single-family home, since he failed to show that the homeowner directed his work or was aware of the allegedly dangerous condition. Case: Casilari v. Condon, No. 2019-02200, 07/22/2020, published. Facts: Jose Casilari allegedly was injured when he fell 8 to 10 feet to the ground from a deck while removing a window at a single-family home owned by Zachary Condon. Condon was not living at the premises during the renovations, nor was he present on the date of the accident. Casilari... Read More

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Press - Kids' Chance of California announces record-breaking scholarship season for CA

08/07/2020 | 28 | 0

Soquel, CA August 7th, 2020 - Kids- Chance of California is a non-profit organization whose mission is to provide need-based educational scholarships to the children of California workers who have been fatally or seriously injured on the job. Every year, Kids' Chance of California does a push to high schools across the state and campaigns at... Read More

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Industry Insights

NATL. - Paduda: COVID Is Crushing Work Comp Claim Counts

By Joe Paduda
08/07/2020 | 353 | 0

Thank you, California Workers' Compensation Institute. Due to its diligence and foresight, we now know: Through June 30 there were 14,487 COVID claims reported to California’s Division of Workers' Compensation. This amounts to 6.3% of all confirmed COVID cases (data from Johns Hopkins). The vast majority of COVID claims reported have been accepted. And perhaps the most important data point: Total claims (COVID and non-COVID) dropped 36.4% from the first half of 2019 to the first half of 2020.  Kudos to the fine folks at CWCI. They have produced the ... Read More

WV - Worker Hit by Tree Branch Gets Award for Tooth Extractions, Dental Implants

08/07/2020 | 82 | 0 | 5 min read

The West Virginia Supreme Court unanimously upheld an award to a worker for tooth extractions and dental implants after he was hit in the face by a tree branch. Case: Liberty Excavation LLC v. Cornell, No. 19-0475, 07/31/2020, published. Facts and procedural history: William Cornell worked for Liberty Excavation LLC as a laborer. He was struck in the face by a tree branch while at work on Aug. 10, 2017. Cornell went to the hospital complaining of jaw pain, several broken teeth and right clavicle pain. Testing showed he had a comminuted right mandibular body and symphysis fracture. Cor... Read More

NY - No Additional SLU Award for Worker With Two Injuries Affecting Arm

08/07/2020 | 165 | 0 | 2 min read

A New York appellate court ruled that a worker was not entitled to a schedule loss of use award for an elbow injury after he had already received an SLU award for an impairment to his right arm from a prior injury. Case: Matter of Kleban v. Central New York Psychiatric Center, No. 530422, 07/23/2020, published. Facts and procedural history: Derek Kleban established a claim for workers' compensation benefits for an injury to his right shoulder in 2013. He received a 28.75% schedule loss of use for his right arm. In 2017, Kleban sustained a work-related injury to his right elbow, and his&... Read More

WA - L&I Cites Fitness Centers for Violating Safe Start Order

08/07/2020 | 203 | 0 | 2 min read

Operators of eight fitness centers in eastern Washington face fines totaling more than $77,000 for being open in violation of the state’s Safe Start order, the state Department of Labor and Industries announced. The department said most of the gyms are Anytime Fitness franchises owned by two separate entities. L&I said it cited the businesses after receiving multiple complaints that they were serving customers when they should not be open. L&I cited Bradshaw Development Inc. for allegedly opening gyms in Selah, Union Gap and Yakima on July 15. The three fines total $28,917. L&a... Read More

MT - Advisory Council Meets Tuesday

08/07/2020 | 62 | 0 | 94 min read

The Montana Labor-Management Advisory Council will hear an update on COVID-19 claims and discuss a proposal to change who is responsible for providing claimants with information about work comp benefits, during a meeting Tuesday. Council members will review draft legislation that would eliminate the requirement for carriers to provide injured workers who have filed a claim a written description of potential benefits and entitlements. The Department of Labor and Industry is already required to provide carriers with the informational brochures to send to injured workers. The draft bill would r... Read More

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Press - Jopari Solutions Enables Medical Providers to Electronically Submit Medical Claim Attachments to Anthem Health Care Plans.

08/06/2020 | 45 | 0

CONCORD, Calif., August 6, 2020 - Jopari Solutions, in collaboration with their industry trading partners, has successfully deployed Jopari's Attach technology to enable medical providers to electronically submit claim attachments and medical records to over 50 Anthem Health Plans that span across Commercial, Medicare, Medicaid, and Federal Employ... Read More

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CA - CAAA Webinars Focus on AMA Guides, Paralegal Issues

08/07/2020 | 336 | 0 | 48 min read

The California Applicants' Attorneys Association is hosting a webinar Aug. 14 to discuss impairment ratings, and a webinar on Sept. 18 to discuss issues for paralegals. The Aug. 14 webinar will explore how to obtain the most accurate impairment rating for conditions affecting the upper extremities under the American Medical Association’s Guides to the Evaluation of Permanent Impairment. The program will also cover questions to ask med-legal evaluators, when grip strength ratings are appropriate, as well as Guzman considerations for upper extremity injuries. The webinar runs f... Read More

TX - TDI Approves NCCI Filing on Excluding Furloughed Employees From Payroll

08/07/2020 | 163 | 0 | 80 min read

Employees who have been furloughed but were paid during the coronavirus pandemic shutdown should be excluded from payroll calculations, the Texas Insurance Commissioner said this week. The commissioner announced that he has approved changes to the National Council on Compensation Insurance manuals related to the pandemic, which recommended in April that furloughed workers not be counted on payroll and premiums. The Department of Insurance received no comments or hearing requests regarding the changes and announced the final approval on Tuesday. The changes will apply to new, renewal an... Read More

FL - Employers Can Be Served Electronically — If They Register With Comp Court System

08/07/2020 | 139 | 0 | 14 min read

Users of Florida's workers' compensation electronic filing system now have the option of choosing from a list of registered employers, which will serve a petition electronically and avoid the bother of certified mail. The change, however, is far from complete. It depends on employers registering their correct email address and other contact information in the e-filing system, said David Langham, chief deputy judge of the Florida Office of Judges of Workers' Compensation Claims. In a blog this week, Langham said it is unlikely that all 440,000 Florida employers will register. But ... Read More

CA - COVID-19 Claims Could Cost at Least $2.17B Over Next 3 Years, WCIRB Says

By Mark Powell (Reporter)
08/06/2020 | 1015 | 0 | 65 min read

Claims related to COVID-19 could cost California’s workers’ compensation system about $2.17 billion between now and 2022, according to projections from the Workers’ Compensation Insurance Rating Bureau. The total estimated cost could increase by roughly $500 million when accounting for self-insured employers. The WCIRB is projecting COVID-19 losses and loss adjustment expenses for 2020 of $1.3 billion, according to data presented during Tuesday's Actuarial Committee meeting. The WCIRB also assumed that the insured market will see about 63% of the COVID-19 claims this ye... Read More

NATL. - Trump Orders Permanency to Telemed Rules but Leaves Out Rehab, PT

By William Rabb (Reporter)
08/06/2020 | 376 | 0 | 65 min read

Telemedicine in workers' compensation received a shot in the arm this week from Washington and New York, another sign that remote health care will be around long after the coronavirus pandemic has subsided. President Trump on Monday issued an executive order that makes permanent what was a temporary plan by Medicare to reimburse many telemedicine services at the same rate as similar, in-person medical treatments. The Centers for Medicare and Medicaid Services proposed rules to that effect the same day. Trump's order was of particular interest to Texas and other states that ... Read More