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CA - QMEs Allege Additional Underground Rules Limit Billing for Research Time

By Greg Jones (Deputy Editor)
02/23/2018 | 583 | 1 | 18 min read

California qualified medical evaluators have lodged another complaint about underground rule-making in their nearly two-year fight with the Division of Workers’ Compensation over how the agency is handling requests for recertification. Nicholas Roxborough Six former QMEs in an amended complaint filed Wednesday with the Los Angeles County Superior Court said the division is limiting their ability to cite time spent on medical research as a complexity factor as part of a “scorched-earth policy” to deny reappointment licenses. The providers claim the division adopted t... Read More

KY - Amendment Boosts Optimism Over Work Comp Reform Measure

By Elaine Goodman (medical/business Reporter)
02/23/2018 | 80 | 0 | 57 min read

A wide-ranging workers’ comp reform bill in the Kentucky legislature has cleared the House and is being taken up by the Senate, following a floor amendment by its sponsor to appease firefighters. Rep. Adam Koenig House Bill 2, by Rep. Adam Koenig, R-Erlanger, passed Wednesday on a 55-39 vote. The bill was received by the Senate on Thursday and is expected to be assigned to a committee today or Monday. HB 2 follows a failed attempt at workers’ comp reform legislation last session. HB 296 passed the House 58-40 last year but was pulled from a Senate committee due to lack of supp... Read More

CA - SB 1160 Author Resigns From Senate Amid Sexual Harassment Allegations

02/23/2018 | 419 | 0 | 14 min read

Tony Mendoza on Thursday resigned before lawmakers had an opportunity to vote on a resolution to expel him from the California Senate after an independent investigation determined he "more likely than not" engaged in “unwelcome flirtation and sexually suggestive behavior” with six women over the last decade. Tony Mendoza Mendoza, who authored a 2016 law that wiped out more than 290,000 liens with an estimated total claimed value of $2.7 billion, and stayed another 500,000 liens filed by or on behalf of criminally charged providers, reported called the investigation &l... Read More

AK - Committee Passes Gov's Reform Bill

02/23/2018 | 106 | 0 | 45 min read

The Finance Committee of the Alaska House of Representatives passed a wide-ranging reform bill requested by Gov. Bill Walker, projected to increase annual revenue for the state’s workers’ compensation administrative account by $1.8 million. The committee on Wednesday voted 3-2 to pass House Bill 79. The measure would eliminate the Second Injury Fund, revise how premium taxes are allocated, create a new definition of independent contractor, revise the penalty for employers that intentionally misclassify workers as contractors, and allow the Division of Workers’ Compensation t... Read More


TX - Injured Truck Driver Can't Proceed With Premises Liability Claim

By WorkCompCentral
02/23/2018 | 45 | 0 | 2 min read

A Texas appellate court ruled that an injured truck driver could not proceed with a premises liability claim against the owner of the property where he hurt his shoulder while making a delivery. Case: Martin v. ECO Services Operations, No. 01-17-00293-CV, 02/22/2018, published. Facts: Lewis Martin III worked for Dana Transport as a truck driver. During the course of his employment, he made deliveries of sulfuric acid to a facility in Houston that was owned by ECO Services Operations. Dana had provided him with training on the proper way to unload the acid at the ECO facility. The facil... Read More

Column

NATL. - Moore: Medical Networks Key to Employee Health and Savings

By James Moore
02/23/2018 | 103 | 0 | min read

Workers' compensation medical networks have always provided a large return on investment.  Injured employees receive the best medical treatment, and the employer cuts its workers comp costs. James Moore The insurance carrier or third-party administrator of claims staff being able to work with the treating physicians to obtain work statuses and medical information will always lower your workers comp reserves.    This is the first area in workers' comp that I realized benefits all parties. In fact, in the old days as an adjuster, I had built i... Read More

NY - State Had Jurisdiction Over Resident's Comp Claim for Out-of-State Injury

By WorkCompCentral
02/23/2018 | 58 | 0 | 9 min read

A New York appellate court ruled that the state workers’ compensation system had jurisdiction over a resident’s claim based on an out-of-state accident while working for an out-of-state employer. Case: Matter of Galster v. Keen Transport, No. 523202, 02/15/2018, published. Facts: Arthur Galster began working for Keen Transport in 2006. Galster was a resident of New York, and Keen was based in Pennsylvania. He testified that he was hired by Keen during a phone call while he was at home in New York, and that he went to Pennsylvania for a four-day orientation after he was hired. G... Read More

Sullivan On Comp

NY - Court Tosses Some of Worker's Labor Law Claims Over Ramp Mishap

02/23/2018 | 39 | 0 | 4 min read

A New York appellate court ruled that a worker was not entitled to summary judgment on all of his Labor Law claims based on injuries from an incident where a ramp slipped out from underneath a heavy cart he had been pulling. Case: Sawczyszyn v. New York University, No. 5702 158910/14, 02/15/2018, published. Facts: Krzysztof Sawczyszyn allegedly suffered injuries while working on a construction project at a property owned by New York University. He testified that he was rolling a four-wheeled plastic cart filled with 100 to 200 pounds of material over an unsecured, makeshift plywood ram... Read More

CA - Supreme Court Won't Review Award to Worker for Disability After Self-Procured Treatment

By WorkCompCentral
02/23/2018 | 470 | 0 | 15 min read

The California Supreme Court will not review an employer’s challenge to an award of benefits to a worker for her temporary period of disability after she underwent surgery at her own expense. Belinda Go had injured her neck in 2013 while working for the Sutter Solano Medical Center. In May 2015, her doctor requested authorization for a cervical spine surgery. The hospital, which was self-insured, submitted the request for utilization review. The UR provider recommended that authorization be denied. Go sought review of the denial via independent medical review, but the IMR doctor ... Read More

WV - Worker Must Arbitrate Deliberate Intention Claim Against Employer

By WorkCompCentral
02/23/2018 | 37 | 0 | 7 min read

The West Virginia Supreme Court ruled that the terms of an injured worker’s arbitration agreement required that he arbitrate his claim that he had been hurt because of intentionally tortious conduct. Case: Hampden Coal v. Varney, No. 17-0088, 02/16/2018, published. Facts and procedural history: Michael Varney began working for the Hampden Coal Co. in 2000. In 2014, the assets of the Hampden Coal Co. were transferred to Hampden Coal LLC. Varney's employment with Hampden Coal, as well as that of all the Hampden Coal Co. employees, was conditioned upon the signing of an arbitrat... Read More

CA - QME Dies in Private Plane Crash in San Diego

02/23/2018 | 926 | 0 | 20 min read

A San Diego orthopedic surgeon who served as a qualified medical evaluator died when his private airplane crashed shortly after takeoff, according to news reports. Dr. John Seroki, 61, was embarking on a solitary flight to Yuma, Arizona, at 6:30 a.m. when his single-engine Cirrus SR22T crashed into a construction site in San Diego’s Kearny Mesa neighborhood. Seroki practiced at the Yuma Regional Medical Center and at Scripps Memorial Hospital in San Diego, the San Diego Union-Tribune reported. He had offices in University City, Chula Vista and Yuma, Arizona, the Fox 5 televis... Read More

IA - Fraud-Fighting Bill Estimated to Cost $1.2M Annually

02/23/2018 | 43 | 0 | 1 min read

A bill in the Iowa legislature that would give employers control of medical care and mandate a state workers’ compensation fraud enforcement unit would cost more than $1 million annually, with most of the money coming from penalty revenue and not general tax revenues, according to an analysis by the Fiscal Services Division. Senate File 2305 would establish a unit consisting of six investigators, an attorney and an analyst within the Insurance Fraud Bureau, according to the analysis. The $970,000 in annual costs would be paid out of the Workers’ Compensation Fraud Penalty Fund, fi... Read More

AL - House Passes Bill to Extend Benefits to Fallen Officers' Families

02/23/2018 | 37 | 0 | 18 min read

The Alabama House has passed a bill that would extend benefits to dependents of firefighters or police officers who die in the line of duty to age 18. Rep. Matt Fridy House Bill 192, by By Rep. Matt Fridy, R-Montevallo, was passed by a House vote of 80-3 on Tuesday. It now goes to the Senate. Under state law, benefits are paid to a dependent child of a law enforcement officer or firefighter killed in the line of duty for 500 weeks or until the child turns 18, whichever occurs first. HB 192 would allow the dependent child to keep receiving benefits until age 18, even if the 500-week m... Read More

AK - Governor Reportedly Appoints Labor Rep to Employer Seat on WCB

02/23/2018 | 68 | 0 | 4 min read

Alaska Gov. Bill Walker reportedly appointed a labor representative to fill a seat on the Workers’ Compensation Board that is reportedly required by law to be filled by a person representing employers, according to website mustreadalaska.com. Gov. Bill Walker Walker’s office has not released a statement announcing any appointments to the WCB. But mustreadalaska.com reports that the governor appointed Chad Bolduc to replace Chuck Collins, an employer representative whose term expires March 1. Bolduc, according to mustreadalaska.com, was a state employee and served on the b... Read More

TX - DWC Releases Proposed Performance Criteria for Designated Docs

02/23/2018 | 67 | 0 | 14 min read

The Texas Division of Workers’ Compensation wants input on how to evaluate the performance of designated doctors. The division posted notice Thursday that it has informally proposed performance review procedures for the evaluation process mandated by state law. The division has not started the formal rule-making process. According to the notice, Dr. Patrick Palmer, the division’s medical adviser, will review suggestions from the public when deciding whether to refine the draft before releasing an official proposal. The review procedures establish “performance factors&rdquo... Read More