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NATL. - Report: USPS Lagging in Reducing Injured Worker Opioid Use

By Elaine Goodman (medical/business Reporter)
06/19/2019 | 299 | 0 | 43 min read

U.S. Postal Service workers who got hurt on the job were receiving 9% fewer opioid prescriptions in 2017 compared to 2013 — a much smaller drop than the 21% decrease seen among the national population overall, according to a report from the USPS Office of Inspector General. Opioid costs for injured USPS workers fell 18% from 2016 to 2018, the OIG found. The cost of opioids for other federal agency employees decreased 26%. In addition, the average number of opioid prescriptions per injured USPS worker increased from 2014 to 2017 — from 6.2 prescriptions per employee to 6.8. For pa... Read More

ID - No Timeliness Defense for Employer

06/19/2019 | 91 | 0 | 37 min read

The Idaho Supreme Court ruled that a worker filed a timely claim for additional benefits because his employer failed to provide a mandatory notice of claim status when his entitlement to permanent partial impairment compensation would end. Idaho law requires workers to file a claim for additional benefits within one year from the date of the last payment. Although Brent Austin missed the deadline, the high court said the one-year statute of limitations was tolled because the employer did not send a notice of claim status with the final payment. The case was Austin v. Bio Tech Nutrients. Bio... Read More

CT - Employer's Failure to Timely File Response Bars Liability Contest

06/19/2019 | 87 | 0 | 1 min read

The Connecticut Appellate Court ruled that an employer should have been barred from contesting liability for a worker’s claim. Case: Woodbury-Correa v. Reflexite Corp., No. AC 39397, 06/18/2019, published. Facts and procedural history: Marcella Woodbury-Correa worked for the Reflexite Corp. In April 2009, she filed a notice of workers’ compensation claim with her employer and the Workers’ Compensation Commission. Woodbury-Correa alleged she had suffered repetitive trauma injuries, and she asserted that they had become symptomatic in 2003. Both the commission and... Read More

KY - Worker's Fall at Home Constituted Accident in Course of Employment

06/19/2019 | 136 | 0 | 16 min read

The Kentucky Court of Appeals ruled that a worker who fell while working from home suffered an injury in the course of her employment, but a triable question remains as to the cause of the accident. Case: Bluegrass.org v. Higgins, No. 2018-CA-001262-WC, 06/07/2019, unpublished. Facts: Lisa Higgins worked for Bluegrass.org. as a case manager and sometimes did her job from home or in the field. While speaking to a client by phone, Higgins fell and was injured. Procedural History: Higgins filed a workers’ compensation claim. An administrative law judge denied it, finding Higgins did not ... Read More


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Press - Coventry and Kids' Chance Partner to Create Referral Program

06/17/2019 | 68 | 0

Downers Grove, IL. (June 17, 2019) - Coventry, a leading provider of care and cost management solutions for workers' compensation, has created a first of its kind Catastrophic Care Referral Program to benefit children affected by a parent's work-related injury or death and to provide the ability to pursue their education without financial burden. The program will refer affected parties to Kids' Chance, a provider of educational opportunities and scholarships for the children of workers seriously injured or killed on the job. Coventry's Catastrophic Case Management program, whi... Read More

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CA - Burns: Telecommuters and the Home as Second Workplace

By Michael P. Burns
06/18/2019 | 161 | 1

The cost of living in California has resulted in many employees choosing to move to remote parts of the state, but retaining their local jobs. Telecommuting is also a growing trend across the country. According to a 2017 study, 20%-25% of the U.S. workforce telecommutes at least part-time. Since 2005, there has been a 115% increase in regular remote work arrangements. Working from home presents challenges for workers' compensation insurers. When the home becomes a workplace, what injuries are covered on an industrial basis? First, let’s examine the commute. Generally, injuries... Read More

NY - Worker Gets Partial Summary Judgment on Fall Claim

06/19/2019 | 71 | 0 | 3 min read

A New York appellate court ruled that a worker was entitled to partial summary judgment on his Labor Law claim for a fall through a duct. Case: Zhou v. 828 Hamilton, No. 2017-08985, 06/12/2019, published. Facts: Yiming Zhou was a salesman at a kitchen plumbing supply center owned by Bright Way Cabinets and Home Centers Inc. In August 2014, he was instructed to run thermostat wiring through a wall on the second floor of a building owned by 828 Hamilton Inc. Zhou claimed that he stepped on a thin, unsecured piece of styrofoam covering an opening in the floor. The styrofoam broke, and he ... Read More

NY - Property Owner Gets Summary Judgment on Claims

06/19/2019 | 78 | 0 | 11 min read

A New York appellate court ruled that a property owner should have been granted summary judgment dismissing a worker’s claims for negligence and violation of the Labor Law. Case: Chavez-Lezama v. Gao, No. 2017-04446, 06/12/2019, published. Facts and procedural history: Kun Gao hired Miguel Chavez-Lezama to convert his single-family home into a duplex. Chavez-Lezama suffered injuries when he fell from a ladder. Chavez-Lezama filed suit against Gao, asserting claims for negligence and violation of the Labor Law. Queens County Supreme Court Justice Ernest F. Hart denied the motion Gao f... Read More

NJ - Governor Signs COLA and Return-to-Work Bills

06/19/2019 | 97 | 0 | 55 min read

Gov. Phil Murphy signed into law a bill authorizing cost-of-living adjustments to death benefits for public safety workers. The Democrat governor on Monday also signed a bill creating a so-called “partial return-to-work” program for those receiving temporary disability benefits. Murphy in May vetoed Senate Bill 1967, saying the proposal to apply a cost of living adjustment to all benefits paid to first responders could cost New Jersey its “reverse offset” designation. The Garden State is one of 15 jurisdictions in which comp benefits are reduced for workers collec... Read More

ME - Governor Signs Reform Bill Increasing Max Weekly Benefit

06/19/2019 | 93 | 0 | 15 min read

Maine Gov. Janet Mills signed into law a workers’ compensation reform bill that would, among other things, increase the maximum weekly benefit, to 125% of the state’s weekly average wage from 100%. Mills, a Democrat, on Monday signed LD 756, which also authorizes a cost-of-living adjustment of up to 5% for workers with a permanent partial disability. The bill also doubles the time to file a claim, to 60 days from 30. The bill caps attorney fees for lump-sum settlements, at 10% of the benefits left after deducting the costs incurred by the employee, including those for medical... Read More


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Press - NAMSAP Highlights Sessions for 2019 Annual Conference

06/14/2019 | 66 | 0

NAMSAP HIGHLIGHTS SESSIONS FOR 2019 ANNUAL CONFERENCE ALL IN, NAMSAP's 16th Annual Educational Conference, To Be Held Sept. 18-20 in Baltimore Baton Rouge, LA. (June 14, 2019) -- The National Alliance for Medicare Set-Aside Professionals announced that the 16th Annual NAMSAP Educational Conference, ALL IN, will be held September 18-20 in Baltimore. Designed for professionals who are involved in Medicare Secondary Payer compliance and Medicare Set-Aside allocation and preparation as well as insurance carriers, third-party administrators, employers, attorneys, and others who manage settle... Read More

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NATL. - Amtrust Report Looks at Return on Safety Investment

06/19/2019 | 141 | 0 | 17 min read

One dollar spent on workplace safety can save at least $3 on expenses related to worker injuries, according to some estimates — a statistic that’s included in a new report from Amtrust Financial Services. And employers that have safety programs in place can reduce expenses related to injuries and illness, by 40%, according to the Amtrust white paper, titled “The ROI of Safety: How to Create a Long-Term Profitable Workplace Safety Program.” The paper includes data from the Bureau of Labor Statistics, the National Safety Council, the Occupational Safety and He... Read More

NATL. - Lawmakers Urged to Renew TRIPRA

06/19/2019 | 97 | 0 | 46 min read

Insurance industry representatives testified before the U.S. Senate Committee on Banking, Housing and Urban Affairs on Tuesday to call for the renewal of the Terrorism Risk Insurance Program Reauthorization Act, or TRIPRA. The act, which provides a “backstop” for insurers’ losses in the case of a terrorist attack, is scheduled to expire on Dec. 31, 2020. Among those testifying was Tarique Nageer, property terrorism placement and advisory leader for Marsh, an insurance broker and risk advisory company. “Terrorism remains an evolving, expanding and ever-presen... Read More

NJ - House Committee Approves Presumption Bills

06/19/2019 | 97 | 0 | 56 min read

A generous cancer presumption bill, and a bill to extend supplemental benefits to corrections officers and some transit police, have passed key committees. Assembly Bill 1741, also known as the Thomas P. Canzanella 21st Century First Responders Protection Act, has been introduced every year since 2006 and was vetoed by Gov. Chris Christie in 2016. Firefighters have hoped this is the year it finally becomes law. It passed the Assembly Labor Committee last fall. Last week, the Assembly Appropriations Committee voted 10-1 to approve the bill, after a hearing and amendments that tightened t... Read More

KS - Max Weekly Benefit Rises

06/19/2019 | 68 | 0 | 38 min read

The maximum weekly benefit in Kansas has climbed, from $645 to $666, the state Department of Labor reported this week. The benefit level is set by law at three-fourths of the state's average weekly wage, and the department reported that the average wage for 2018 rose, to $888.29. The maximum will apply to occupational injuries incurred between July 1, 2019, and June 30, 2020, the department said. The minimum weekly rate for fatalities will be $444. ... Read More

IN - Lump-Sum Settlement Info Must Go Through EDI, Board Says

06/19/2019 | 83 | 0 | 16 min read

Lump-sum payment information must be recorded through the electronic data interchange (EDI) within 30 days after the Indiana Workers' Compensation Board approves a settlement, the board announced. The information can be conveyed through what the board calls a “PY” filing, followed by an “FN” filing, according to the board's website. More information is available on the updated settlement procedures on the site. The board also noted that no compliance measures regarding EDI 3.1 are being considered. The regulators will start tracking EDI transactions that were ... Read More

IL - Report on Chicago Comp Program Could Be Just the Start of More Investigations

By William Rabb (Reporter)
06/18/2019 | 399 | 0 | 46 min read

An examination of Chicago's workers' compensation program suggests that problems extend far and wide, from overpayments on claims, little attempt at subrogation, minimal fraud prevention efforts and a widespread lack of oversight. But watchdogs and fraud investigators say the report by the Grant Thornton accounting firm, released last week, may only scratch the surface, and more investigations and prosecutions are likely to follow in the months ahead. Chicago's new mayor, Lori Lightfoot, announced last week that the city had chosen internationally known Gallagh... Read More

NATL. - E-Scooter Popularity Creates Comp Concerns

By Elaine Goodman (medical/business Reporter)
06/18/2019 | 290 | 0 | 17 min read

As the popularity of electric scooters surges — as well as reports of accidents among riders — the workers’ comp industry is starting to pay closer attention to the devices. “As e-scooters continue to proliferate, expect the number of accidents involving them to increase,” Alice Strombom, a workers’ comp attorney in Sacramento, California, wrote on her firm’s website. Workers’ comp typically wouldn’t cover an injury an employee sustains while commuting to work, but might cover injuries that occur during work-related travel, Susan Schaeche... Read More