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CA - Jury Convicts Radiologist on 39 Counts in Kickback Case

By Greg Jones (Deputy Editor)
12/15/2017 | 1434 | 0 | 0 min read

Beverly Hills radiologist Ronald Grusd will return to court in March to learn his sentence after a federal jury convicted him on 39 counts relating to a kickback scheme that prosecutors say generated $25 million in fraudulent bills for services provided to injured workers in California. Ronald Grusd (Yelp photo) A U.S. District Court for Southern California jury on Tuesday convicted Grusd and two companies he owns, California Imaging Network Medical Group and Willows Consulting Co., on 18 counts of honest services mail and wire fraud, 14 counts of health care fraud, six counts of violating. Read More

NATL. - Fla. PEO Under Fire for Denying Undocumented Workers' Claims Tried Same Tactics in Calif.

By Emily Brill (Reporter)
12/15/2017 | 433 | 0 | 0 min read

When representatives of Southern California firm Kamran Staffing Inc. learned from an insurance broker that a Florida professional employer organization could handle their workers’ compensation for cheap, they thought they’d found a pretty good deal. What they didn’t know when they signed a contract with SouthEast Personnel Leasing was that the company had a history of denying workers’ compensation benefits to undocumented immigrants — and that it wasn’t licensed to sell insurance in California. When Kamran Staffing learned these facts last year, it s. Read More

PA - Bill Would Permit Fund of Last Resort to Sell Health Insurance

By J. Todd Foster (Reporter)
12/15/2017 | 222 | 0 | 0 min read

Four Democrats and a Republican in the Pennsylvania House of Representatives have introduced for the third time a bill that would allow State Workers’ Insurance Fund to sell health insurance. Rep. Robert Freeman Rep. Robert Freeman, D-Northampton County, said Thursday he is optimistic that House Bill 1966 will pass when lawmakers reconvene in 2018 because it has a Republican co-sponsor and because President Donald Trump has “undercut” the Affordable Care Act. “They’ve made numerous efforts to try to weaken the act. The most recent example is shorten. Read More

CA - Prosecutors: More Than 14,500 Pacific Hospital Procedures Tied to Kickbacks

12/15/2017 | 944 | 1 | 0 min read

More than 14,500 patients had surgeries or other procedures performed at Pacific Hospital of Long Beach that were “likely the result of a kickback payment,” according to recently filed court documents. The disclosure in a proposed order regarding restitution and forfeiture for Dr. Philip Sobol suggests only a fraction of those patients had spinal surgeries performed at the hospital as a result of the kickback scheme. The FBI also has a spreadsheet specific to defendant Sobol, detailing “cases in which he performed the surgery or referred the patient to Pacific Hospital at t. Read More


NH - High Court Upholds Termination of Worker for Failing to Provide Medical Documentation

By WorkCompCentral
12/15/2017 | 289 | 0 | 0 min read

The New Hampshire Supreme Court ruled that a worker did not comply with his employer’s demand to provide medical documentation to a workers’ compensation carrier. Case: In re Appeal of Cover, No. 2016-0594, 12/13/2017, unpublished. Facts: Raymond Cover worked part time for the New Hampshire Liquor Commission. After he suffered an on-the-job injury in May 2013, the commission provided him with paperwork to initiate a workers’ compensation claim. The commission also warned him that he faced termination if he did not provide medical documentation to justify his absence f. Read More

Column

NJ - Gelman: Unpaid Volunteer Firefighter not Entitled to Temporary Benefits

By Jon L. Gelman
12/15/2017 | 231 | 0 | min read

The New Jersey Appellate Division held, in an unreported opinion, that an unpaid and unemployed volunteered firefighter was not entitled to temporary workers’ compensation benefits. Jon L. Gelman The court affirmed the compensation judge’s finding that without the receipt of any wages, temporary benefits were not payable. The trial court ruled: The workers' compensation judge denied [Jennifer] Kocanowski's application for temporary benefits. Although finding that “petitioner's volunteer work is laudable and certainly entitles her to both medical treatm. Read More

OH - Court Upholds Denial of Additional TTD for Worker's Hernia Injury

By WorkCompCentral
12/15/2017 | 184 | 0 | 0 min read

An Ohio appellate court ruled that the report of the doctor who performed a physician review constituted “some evidence” to support a denial of a worker’s claim for temporary total disability benefits. Case: State ex rel. Coseno v. Industrial Commission, No. 16AP-151, 12/12/2017, published. Facts: Joseph Coseno suffered a hernia while at work in August 2013. The Bureau of Workers’ Compensation accepted the injury as compensable. The BWC also accepted his claim for nerve damage and depression. In November 2014, Dr. Todd Hochman examined Coseno and determined that he h. Read More

Sullivan On Comp

MD - Court Rebukes Doctor for Unprofessional Conduct

By WorkCompCentral
12/15/2017 | 200 | 0 | 0 min read

The Court of Special Appeals on Wednesday rebuked a doctor who treated injured workers, for his practice of writing prescriptions for oxycodone for patients in bars, restaurants and parking lots in exchange for payment. The court found Dr. Walter Kozachuk guilty of unprofessional conduct in the practice of medicine and ordered that he be placed on probation for a minimum of two years. Kozachuk became a licensed physician in Maryland in 1988 and began working for Maryland Physician Associates as a neurology consultant. In 2012, a waitress at the Daniels Restaurant an. Read More

CA - 4th DCA Publishes Ruling on Scope of Carrier's Subrogation Rights

By WorkCompCentral
12/15/2017 | 663 | 0 | 0 min read

The 4th District Court of Appeal this week ordered publication of its decision establishing that an insurance carrier has the right to reimbursement of the benefits it paid to an injured worker from her recovery from a third party. The case was Duncan v. Walmart Stores (Hartford Accident & Indemnity Co.). Denise Duncan had worked for Acosta Inc., a Florida-based sales, marketing and service company. She fell and suffered injuries in August 2012 while working at a property owned by Walmart. Acosta had comp coverage with the Hartford Accident & Indemnity Co. After her accident, Hartfo. Read More

WV - Supreme Court Upholds Award to Drill Operator for Pneumoconiosis

By WorkCompCentral
12/15/2017 | 278 | 0 | 0 min read

The West Virginia Supreme Court unanimously ruled that a drill operator was entitled to benefits for pneumoconiosis based on his workplace exposure to coal and rock dust. Case: Vedco Holdings v. Hundley, No. 17-0018, 12/11/2017, published. Facts: Jeffrey Hundley worked as a drill operator with Vedco Holdings from 2008 through February 2013. In March 2013, he was diagnosed with pneumoconiosis and chronic obstructive pulmonary disease. In July 2013, Hundley filed a workers’ compensation claim, asserting he had been exposed to respirable dust hazards during the course of his employment w. Read More

NY - Comp Board Attorney Charged With Falsifying Time Sheets at Previous Job

12/15/2017 | 245 | 0 | 0 min read

A senior attorney for the New York State Workers’ Compensation Board has been charged with stealing nearly $12,700 in pay for which she was not entitled while working for another state agency. Laura Cail, 48, of Troy, is charged with grand larceny in the third degree and 36 counts of offering a false instrument for filing in the first degree, both felonies, the state Inspector General’s Office said in a press release. Inspector General Catherine Leahy Scott said that between June 2015 and October 2016, Cail allegedly filed false electronic time records while servin. Read More

AK - Reform Bill Coming Back Before Legislature in 2018

12/15/2017 | 208 | 0 | 0 min read

Alaska lawmakers will consider a proposal to adopt evidence-based treatment guidelines, and cap temporary total disability duration and attorney fees when they return to the State Capitol Building in Juneau on Jan. 16. Sen. Cathy Giessel Sen. Cathy Giessel, R-Anchorage, included the proposals in Senate Bill 112, a work comp reform bill she introduced in the waning days of the 2017 session. The Senate Labor and Commerce Committee did not take up the bill, and the measure was carried over to 2018, the second year of the two-year legislative session. The bill proposes a number of change. Read More

NJ - Woman Charged With Stealing Dead Father's Benefits

12/15/2017 | 188 | 0 | 0 min read

A Hudson County woman has been indicted on charges of stealing $272,223 by fraudulently collecting her father’s Social Security, permanent disability and pension benefits for more than 12 years after he died. Sylvia Wilkerson (New Jersey A.G.'s office) Sylvia Wilkerson, 67, of Jersey City, was charged with second-degree theft by deception, second-degree theft by unlawful taking and fourth-degree forgery. Investigators say Wilkerson’s father died in September 2004 and that she continued to collect his benefits, which were direct-deposited into a bank account bearing his nam. Read More

WV - Fired Governor's Aide Named to Appeals Board

12/15/2017 | 221 | 0 | 0 min read

Gov. Jim Justice has appointed his fired chief of staff to the Workers’ Compensation Board of Review, a three-member panel that hears appeals of comp claims. Nick Casey The Charleston Gazette-Mail reported that Nick Casey will replace W. Jack Stevens as a Democratic member of the board and will be paid nearly $104,000. Justice fired Casey on Aug. 14, 11 days after he announced at a President Donald Trump rally that he was switching his party affiliation from Democrat to Republican. After initially saying he would not make significant changes to his leadership team following the swi. Read More

MN - Assigned-Risk Premium Rates to Decrease 7.1% in April

12/15/2017 | 284 | 0 | 0 min read

The assigned-risk workers’ compensation premium level will decrease by 7.1% in Minnesota, effective April 1, the Minnesota Workers’ Compensation Insurers Association informed its members on Wednesday. Anne O'Connor The MWCIA summarized the changes to the assigned-risk rate level that had been outlined in an order issued by Deputy Commerce Commissioner Anne O’Connor last week. As of April 1, companies that buy their workers’ compensation insurance from the Minnesota Workers’ Compensation Assigned Risk Plan will: Have their industry’s pure pre. Read More

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Press - Hallett Emerick Wells & Sareen

12/11/2017 | 467 | 0 | min read

Hallett Emerick Wells & Sareen is pleased to announce that H. Neal Wells IV has become the law firm's Corporate President in place of Bruce S. Emerick who has become Of Counsel. Additionally, Ilene M. Sheldon has been promoted to Managing Shareholder of the Calabasas Office and Brandon R. Lewis t. Read More