Notice: Passwords are now case-sensitive

Remember Me
Register a new account
Forgot your password?

Top Stories

NATL. - Industry Must Work Harder to Attract, Retain Diverse Employees, Panelists Say

By Mark Powell (Reporter)
07/10/2020 | 5 | 0

If the workers’ compensation industry is going to continue to thrive, businesses nationwide must be more proactive about recruiting and promoting minority employees, a group of panelists said Thursday during a racial inequality webinar hosted by WorkCompCentral. But first, industry leaders will need to start having some uncomfortable, but necessary, conversations. “I don't see that this discussion is happening in our industry,” Margaret Spence, CEO of consulting firm C. Douglas & Associates in West Palm Beach, Florida. Spence — joined Thursday by Ametros ... Read More

NY - Widow's Failure to Comply With Regulatory Requirements Results in Denial of Claim

07/10/2020 | 6 | 0

A New York appellate court upheld the denial of a widow’s claim for death benefits because she failed to comply with regulatory requirements for submitting medical evidence to support a finding of causation. Case: In the Matter of the Claim of Johnson v. Consolidated Edison Co. of New York, No. 528775, 07/02/2020, published. Facts and procedural history: Catherine Johnson’s husband worked as a mechanic in an industrial plant for many years where he was exposed to asbestos and other toxic substances. He was diagnosed with metastatic lung cancer in 2014 and died in February 20... Read More

MI - Federal Appeals Court Rejects RICO Claim Based on Alleged Fraud

07/10/2020 | 6 | 0

A federal appellate court rejected a worker’s racketeering claim against her employer for the alleged practice of underpaying employees for overtime and underreporting payroll to the company’s workers’ compensation insurance carrier. Case: Collier v. LoGiudice, No. 19-1829, 06/26/2020, unpublished. Facts: Monica Collier worked at Vitale's Pizzeria from 2011 until 2017. Collier logged all hours that she worked in Vitale's point of service system, but the general manager reported to the payroll company only the first 40 hours employees worked each week. Collier w... Read More

MO - Commission Wrongly Sets Worker's MMI Date

07/10/2020 | 3 | 0

The Missouri Court of Appeals ruled that the Labor and Industrial Relations Commission erroneously deprived a worker of three years of permanent total disability benefits by ignoring uncontradicted and unimpeached evidence as to when he reached maximum medical improvement. Case: Williams v. Treasurer of the State of Missouri, No. ED108319, 06/30/2020, published. Facts: Thomas Williams began working for the Hussmann Corp. in 1992. His job required pumping a pedal with his foot to raise equipment on an assembly line, and then stepping up to and down from a 1.5-foot-tall platform ... Read More

Sponsored Content

Press - Athens Administrators - COVID-19 CA Legislative Update

07/08/2020 | 50 | 0

  FOR IMMEDIATE RELEASE July 7, 2020 Contact:      Michael Landa, Executive Vice President Business Development Athens Administrators (909) 451-1710 mlanda@athensadmin.com   Athens Administrators - COVID-19 CA Legislative Update California Executive Order N-62-20 One month has passed since California Governor, Gavin Newsom issued Executive Order N-62-20, creating the rebuttable presumption of compensability for COVID-19 clams that meet specific criteria. The Order extends from May 6 through July 5 of this year and applies to COVID-19 claims for dates of... Read More

Post Your Press Release Here!
Industry Insights

NATL. - Nichols: Survey of State Laws Regarding COVID-19 Compensability Published

By Steve W. Nichols
07/09/2020 | 202 | 0

The National Council on Compensation Insurance and American Academy of Actuaries have each released a survey of state laws regarding the compensability of the COVID-19 virus. NCCI’s survey provides a snapshot of all 37 NCCI-rated states. AAA’s report analyzes presumption laws around the country, how they vary by state and the challenges in estimating overall costs of COVID claims. NCCI reported that several states have begun introducing legislation and regulatory measures to expand compensability for workers on the front line in the fight against COVID-19, such as those ... Read More

NY - No Summary Judgment for Worker Who Fell From Balcony

07/10/2020 | 6 | 0

A New York appellate court ruled that a construction worker is not entitled to summary judgment on his Labor Law claim for an alleged fall from a balcony. Case: Yaguachi v. Park City 3 & 4 Apartments Inc., No. 2018-04982, 07/01/2020, published. Facts: Park City 3 & 4 Apartments Inc. hired Phoenix Building Restorers Inc. to renovate the external balconies of an apartment complex it owned in Queens. Luis Yaguachi allegedly fell approximately 30 feet from a balcony while working on the project when the hook that held his safety cable to the wall became dislodged. Procedural ... Read More

CA - Business Owner Ordered to Pay Nearly $3k in Premium Fraud Case

07/10/2020 | 6 | 0

A Northern California business owner was ordered to pay nearly $3,000 in restitution after pleading no contest to defrauding his insurance carrier by paying an employee off the books, the Monterey County District Attorney’s Office announced. The court accepted the no-contest plea by John Bresciani, owner and CEO of Pacific Coast Battery Service Inc., on Wednesday. Bresciani was ordered to pay $2,943.44 in restitution for premiums that would have been owed had he reported his employee. He was also ordered to pay a $5,000 fine and placed on probation for three years. Prosecutors sai... Read More

CA - Cannabis Cultivator Pleads Guilty to Comp Fraud

07/10/2020 | 7 | 0

The owner of a licensed cannabis company pleaded no contest to payroll tax and workers’ compensation insurance fraud charges, the Monterey County District Attorney’s Office announced. Monica Herrera, 43, owned and operated Holistic Farms LLC from August 2017 to June 2018, prosecutors said. While executing a search warrant in an unrelated investigation, investigators with the District Attorney’s Office reportedly discovered Herrera violated her license and permit by relocating her company. “During that search, investigators interviewed multiple individuals wh... Read More

FL - DWC Amps Up Portal for Coverage Verification, Exemptions, Claims Data

07/10/2020 | 5 | 0

The Florida Division of Workers' Compensation has revamped its data portal, allowing more information on proof of coverage, claims data and accident characteristics, the division announced Thursday. The new portal supplants the previous policy search page and automatically shows the last five years of coverage information received by the DWC, as well as the 10-year coverage history for an employer's federal employer identification number. Employers can also be searched by name, policy number, policy dates and county. The site also includes an exemption search, which allows users to s... Read More

NATL. - Puerto Rico SIF Extends Payroll Info Deadline, Adds Telecommuting Classifications

07/10/2020 | 6 | 0

Employers in Puerto Rico have an extra two weeks — until Aug. 4 — to file payroll information with the State Insurance Fund Corp., the SIF announced last week. Employers also have more options for classifying employees who are working from home during the pandemic and beyond. “Acknowledging that remote work will now be the 'new normal' for most employees, the SIF modified approximately 20 risk classifications to cover teleworking,” attorneys at the Littler Mendelson law firm explained in a blog post. Workers such as auditors, accountants, lawyer... Read More

CA - DWC Posts Adjustments to Hospital, ASC Sections of Fee Schedule

07/10/2020 | 5 | 0

The California Division of Workers’ Compensation on Thursday posted an order incorporating into the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule changes made by the Centers for Medicare and Medicaid Services. The replacement to the April 2020 “Approved Healthcare Common Procedure Coding System Code and Payment Rates” for ambulatory surgery centers is retroactive to April 1, the division said in a statement. At the same time, the division’s order adopts the July 2020 “Approved HCPCS Code and Payment ... Read More

FL - 10 Indicted in Alleged Plan to Use Rural Hospitals to Bilk Insurers Out of $1.4 Billion

By William Rabb (Reporter)
07/09/2020 | 619 | 1 | 28 min read

An X-ray technician at a rural hospital in North Carolina said she knew trouble was brewing when the surgery for her work-related back injury suddenly wasn't covered by the hospital's workers' comp insurance. It turns out that the premiums had gone unpaid for some time, leaving Melva Lilley with a surgery bill of $68,000, according to a Kaiser Health News report. Lilley's story is one of many that have emerged in the investigation into Jorge Perez, a south Florida health care entrepreneur who federal prosecutors said masterminded a scheme to fraudulently bill insurers out of ... Read More

NATL. - Study: Workers' Comp Drug Spending Fell 6.1%, Opioid Use Continued Decline in 2019​

By Mark Powell (Reporter)
07/09/2020 | 201 | 0 | 55 min read

Prescription drug spending on workers’ compensation plans fell 6.1% last year, and the total number of prescriptions fell by 4.3%, according to new data released Wednesday. In 2019, spending on opioids also dropped by 10.7% compared with the previous year, according to myMatrixx’s Workers’ Compensation Drug Trend Report. The report also states that injured workers who are using opioids are doing so for shorter periods of time. About 14.7% of injured employees used opioids for 30 days or more in 2019, down from 17% the previous year, according to the report. “Helping... Read More

KS - Court Rejects Defendant's Challenge to Restitution Order

07/09/2020 | 86 | 0 | 10 min read

The Kansas Court of Appeals rejected a criminal defendant’s constitutional challenges to an order requiring him to pay restitution to a workers’ compensation insurance carrier. Case: State v. Robison, No. 120,903, 06/26/2020, published. Facts and procedural history: In January 2018, prosecutors charged Robert James Robison III with two counts of battery on a law enforcement officer. The charges stemmed from an incident at the Lyon County Jail in which Robison hit Officer Zachary Nance and Cpl. Bobby Cutright several times.   Cutright suffered an injury to his eye and a... Read More