CA - 1st DCA Upholds Firing of DIR Workers Who Violated Gift Policy
| 26 min read
Three California Department of Industrial Relations workers received a fair hearing before they were fired for violating the agency’s prohibition on accepting gifts from vendors doing business with the state, and for falsifying financial interest statements and time sheets, a California appellate court ruled.
The 1st District Court of Appeal said there was substantial evidence to uphold the firing of Tess Viceral, Christina Cornell and Imelda Canovas for dishonesty. However, the court also noted in its opinion that the timing of the investigation into the gift violations provides s...
VA - Inflation Adjustment for Fee Schedule Pleases Few
| 53 min read
A year into Virginia’s new workers’ compensation medical fee schedules, regulators are in the middle of a required review process. The first set of revisions, announced last week, don’t seem to please stakeholders on either side of the issue.
The state Workers’ Compensation Commission released a policy statement Jan. 15 that appears to split the baby on how medical fees will be adjusted for inflation. In the short term, for 2019 adjustments, the commission will consider only the 2018 inflation factor, as reported by the U.S. Department of Labor’s Consume...
NATL. - Asbestos Claims an Ongoing Drag on Insurer Profits
| 22 min read
Even though asbestos has become highly regulated by the federal government, it’s still having an impact on property and casualty insurers’ balance sheets, and continues to be a source of workers’ comp claims.
A report from A.M. Best declares there’s been “no slowdown” in asbestos claims, which have cost the property and casualty industry an additional $1.9 billion a year on average from 2013 through 2017.
Travelers, Chubb, American International Group and The Hartford have had the largest losses from asbestos and environmental claims from 2013 to 2017, the...
NJ - Medical Provider Claims for Payment Aren't Subject to Comp Act's Statute of Limitations
| 102 min read
The New Jersey Superior Court’s Appellate Division last week ruled that a group of medical providers who treated injured workers were not time-barred from receiving payment for their services.
Although the Legislature decided to shift jurisdiction for such claims to the Division of Workers' Compensation for adjudication, the court said the move didn’t make the payment claims subject to the two-year statute of limitations contained in the Workers' Compensation Act.
“We conclude that subjecting medical provider claims to the two-year time bar would be like jamming a s...
Press - Sedgwick highlights industry trends for 2019
MEMPHIS, Tenn., Jan. 15, 2019 — Sedgwick, a leading global provider of technology-enabled risk, benefits and integrated business solutions, today published its “Forward thinking 2019” list, which includes major industry trends employers and risk management professiona...
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CA - Grinberg: Absent Evidence of Causation, At-Work Collapse Not AOE/COE
Pop quiz: A worker collapses on the job and ultimately expires. No witnesses appear with an explanation of what happened — no trauma, no blows, no anything. He just collapses and dies.
Does his widow receive death benefits through the workers’ comp system?
As everything in law, it depends.
Such were the facts, or fairly close thereto, in the matter of Perez v. Deardorff Jackson Co. a recent writ-denied panel decision.
The decedent worked as a harvester for defendant and, on the alleged date of injury, collapsed in the field and f...
PA - Court Awards Ongoing Benefits for Bricklayer's Skin Condition, Reverses Penalties on Employer
| 9 min read
The Commonwealth Court ruled that a bricklayer was entitled to ongoing benefits for a skin condition caused by his exposure to the materials found on his job, but it overturned an order imposing penalties on his employer for failing to timely contest his claim.
Case: Kurpiewski v. WCAB (Caretti) and Caretti v. WCAB (Kurpiewski), Nos. 158 C.D. 2018 and 194 C.D. 2018, 01/18/2019, published.
Facts: Thomas Kurpiewski worked for Caretti Inc. as a bricklayer. In April 2012, Kurpiewski broke out in a rash.
Dr. Joel Laury diagnosed contact dermatitis arising from Kurpiewski’s long-term w...
IA - Attorney's Filing Flub Didn't Allow for Review of Claim for Penalties
| 2 min read
The Iowa Supreme Court ruled that an attorney’s failure to timely file a notice of appeal on all the necessary parties was fatal to the court’s ability to consider the merits of an injured worker’s claim for penalties.
Case: Evenson v. Winnebago Industries, No. 17–1419, 01/18/2019, published.
Facts and procedural history: David Lowell Evenson worked for Winnebago Industries. He injured his left elbow while at work in May 2010.
During the course of his workers’ compensation claim, Evenson made a demand for an award for penalties. A district court judge denied hi...
TN - Panel Overturns Denial of Claim for Worker With Fungal Infection in Lungs
| 18 min read
The Tennessee Supreme Court’s Special Workers’ Compensation Appeals Panel overturned a denial of benefits to a worker who developed a fungal infection in his lungs after digging a trench at a landfill.
Case: Butler v. Tennessee Municipal League Risk Management Pool, No. E2017-01981-SC-R3-WC, 01/16/2019, published.
Facts: Joe Butler worked as a laborer for the Oneida Water Department. In February 2013, Butler helped install a water line at the county landfill.
Two days later, Butler fell ill. After he was hospitalized and underwent a lung biopsy, doctors diagnosed invasive pulmon...
MT - Carrier Held Liable for Shoulder Injury From Overuse
| 27 min read
The Montana Workers' Compensation Court ruled that a carrier was liable for a worker’s condition caused by overuse of the left shoulder after a compensable right shoulder injury.
Case: York v. MACo Workers’ Comp Trust, No. 2016-3724, 01/15/2019, published.
Facts: Jenny York worked for Lewis and Clark County as a licensed practical nurse at the Cooney Nursing Home. York injured her right shoulder in July 2007 while lifting a resident who had fallen.
At the time, MACo provided workers’ compensation insurance coverage to the county and accepted liability for York&rsq...
Press - Beecher Carlson taps ACM to handle claims for national client
San Diego, CA, 1/8/2019 – DS Services of America, in partnership with their broker Beecher Carlson, recently selected American Claims Management (ACM) to handle claims management in a portion of the states in which they operate.
“In our selection process, we looked at the technology innovations, claims records and service standards of a number of claims administrators to handle the workers’ compensation and auto liability claims for our client, and ACM exceeded our standards,” said Christian Florence, managing director of Beecher Carlson.
“We are delighted to co...
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ND - Bill Would Change Definition of Health Care Provider
| 19 min read
A bill that would substitute the term “health care provider” for “doctor” and add a definition for "allied health care professional" has been introduced in the North Dakota legislature.
Senate Bill 2184, by Sens. Judy Lee, Kathy Hogan and Jerry Klein, was introduced on Jan. 8 and referred to the Industry, Business and Labor Committee. A committee hearing is scheduled for 9:15 a.m. Wednesday.
The bill would strike the definition of “doctor” in regard to workers' compensation claims and benefits. The definition of a health care provid...
CA - Bill Proposes Dynamex Exemption for Insurance Companies
| 33 min read
Insurance companies in California would be exempt from a three-part employment test for contractors if certain conditions are met, under terms of a bill introduced last week.
Assembly Bill 233, by Assemblyman Ken Cooley, D- Rancho Cordova, would declare the term “employee” doesn’t apply to a person licensed by the Department of Insurance who enters into a written agreement with a carrier when:
The agreement is voluntary.
The worker is classified as an independent contractor.
Each party has the right to terminate the contract.
The worker is allowed to work outs...
OK - Bill Introduced to Boost Revenues for Multiple Injury Trust Fund
| 16 min read
An Oklahoma state lawmaker has introduced a bill aimed at shoring up the state’s struggling second injury fund, which may soon default on benefit payments as it grapples with a $500 million shortfall.
House Bill 2410, by Rep. Chris Kannady, R-Oklahoma City, would increase the employer assessment that supports the Multiple Injury Trust Fund, to 7% from 6%, and would limit the scope of claims that can be made against it.
Kannady is assistant floor manager in the state House.
HB 2410 would bar any Multiple Injury Trust Fund claims for workers whose disabilities to the body as a ...
MT - Lawmaker Proposes Solvency Law for Public Self-Insureds
| 121 min read
Public self-insured employers in Montana could be forced to prepare written plans for improving their financial situations, under a bill scheduled for a hearing Thursday.
Senate Bill 126, by Sen. Fred Thomas, R-Stevensville, would require solvency for public self-insured entities to be determined using a discounted reserve estimate.
“The department shall calculate available funds as total assets minus 80% of property and equipment assets minus accounts payable,” the bill says. “If available funds fall below an 85% confidence level using a discounted reserve estimate, th...
NE - Bills Would Modify Death, Burial Benefits
| 8 min read
Death benefits of $25,000 could be paid to a representative of a worker’s estate, under a bill introduced in the Nebraska Legislature.
Legislative Bill 408 was introduced by Sen. Dan Quick, of Lincoln, and read for the first time on Friday.
The representative of the estate would be eligible for the $25,000 payment in cases where there is no spouse, child or other dependent entitled to workers’ comp death benefits.
Another measure would increase burial benefits by nearly 20%.
LB 448, by Sen. Mike McDonnell, of Omaha, would increase the burial benefit by setting the...
AZ - ICA Postpones Launch of New Claims System
| 27 min read
The Industrial Commission of Arizona postponed the planned Feb. 19 launch of a new claims system.
“Barring any further setbacks, the commission expects to launch the new claims system in March 2019,” the ICA said in a statement released Friday.
The statement does not explain why the rollout was delayed.
The new claims system will allow carriers, employers, claimants and attorneys the option of receiving claims and case communications through the mail, via fax or using secured file transfer protocol. Mail will be the default option and encrypted email will not be a...
NATL. - Scott Mugno Re-Nominated as OSHA Head
| 4 min read
Scott Mugno’s nomination to head the U.S. Occupational Safety and Health Administration was resubmitted to the Senate a second time on Thursday, as the agency goes for a record length of time without a permanent leader.
President Donald Trump on Wednesday submitted the nomination of Mugno, the former vice president for safety at FedEx Ground. Trump first nominated Mugno to become assistant secretary of labor, occupational safety and health in November 2017; and renominated him in January 2018.
Mugno retired from FedEx in February 2018.
It’s the first time in history that OSH...