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AZ - Worker's COVID Death Held Compensable Under AOE/COE Analysis

09/25/2023 | 0

The Arizona Court of Appeals ruled that a worker’s death or injury from COVID-19 is compensable where the statutory requirements for compensability are met. Kenneth Zerby worked for Western Millwork as a design engineer. When the COVID-19 pandemic began, Western kept its employees working at the office regularly but established safety protocols based on Centers for Disease Control and Prevention guidance. Zerby had undergone a kidney transplant in 2003 and took immunosuppressants. He was also diagnosed as pre-diabetic. Zerby was nervous about contracting COVID-19, so he took pre... Read More

WV - Worker Fails to Prove Entitlement to Benefits for Knee Injury

09/25/2023 | 0

The West Virginia Supreme Court upheld a denial of benefits for a worker’s alleged knee injury. Case: Lambert v. Contura Energy Inc., No. 21-0868, 09/14/2023, published. Facts: Tracey Lambert allegedly injured his left knee in July 2020 while working for Contura Energy Inc. Lambert’s medical records indicate he previously reported a left knee injury from a fall in September 2019. He also reported a left knee injury from a misstep in June 2020. Lambert had an orthopedic surgical consultation with Dr. John E. Traynham in August 2020. Traynham diagnosed Lambert with suspected inte... Read More

WV - Supreme Court Upholds Denial of Claim Expansion, Additional Treatment

09/25/2023 | 0

The West Virginia Supreme Court upheld the denial of a worker’s request to expand the scope of her claim and for additional treatment. Case: Lambert v. American Bottling Co., No. 21-0996, 09/14/2023, published. Facts: Tara Lambert worked for American Bottling Co. as a truck driver. She filed a report of injury, claiming she was “kicked on the back of a two-wheeler” in April 2018. Lambert was seen at MedExpress for right calf pain and swelling, and she was advised to go to the emergency room for a venous duplex study. Dr. John Tabit saw Lambert in July 2018. His asses... Read More

NY - Court Overturns Summary Judgment for Insurance Carrier on Claims for Payment

09/25/2023 | 0

A New York appellate court overturned a grant of summary judgment to an insurance carrier on its claims for payment under its workers' compensation and employers' liability policies. Case: Alliance National Insurance Co. v. Hagler, No. 2019-09344, 09/20/2023, published. Facts and procedural history: Alliance National Insurance Co. filed suit against Bridge Healthcare LLC, Church Healthcare LLC and White Horse Healthcare LLC for failing to make certain payments due under their workers' compensation and employers' liability policies. Alliance then move... Read More

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Press - CEO Debra Livingston to Join Panelists at LASIE

09/21/2023 | 0

Brandon, FL (September 21st, 2023)- ReEmployAbility, a leading innovator in Return-to-Work services, is pleased to announce that Debra Livingston, the company's esteemed CEO, has been invited to join as a panelist at the upcoming LASIE Annual Conference. LCI Workers' Comp and The Louisiana Construction & Industry Association (LCIA) are presenting this year's conference. The panel, entitled "The Continuing Battle for Evidence-Based Guidelines," will focus on Louisiana adopting national guidelines to achieve the best outcome for injured workers and their employers. Liv... Read More

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Industry Insights

NV - Paduda: Leaving Las Vegas

By Joe Paduda
09/25/2023 | 0

Here are a few quick takeaways from the National Comp event in Las Vegas: Don’t know what total attendance was, but seemed somewhat lower than in pre-COVID years. Exhibit hall corridors were pretty empty despite sessions located around the exhibits. The newest thing du jour: artificial intelligence. Sessions on AI, vendors promoting various applications, attendees mentioning AI in conversations about claims, data interpretation, claim intake, you name it. Nurse triage: Just stop. Far too many are touting nurse triage, almost all withou... Read More

FL - Contractor Cited After Worker's Fatal Fall

09/25/2023 | 0

The U.S. Occupational Safety and Health Administration said Friday that it cited a Florida contractor following the fatal fall of a worker through a roof in March. OSHA cited Hialeah-based Sealed Tight Roofing Inc. for one willful violation and two serious violations and proposed $84,379 in fines. The worker was killed in a 40-foot fall while working on a commercial property in Miami Gardens. OSHA said Sealed Tight Roofing failed to provide employees with adequate fall protection or personal fall arrest systems and also failed to install covers or guardrails around holes in the roof. The c... Read More

CT - NCCI Proposes 9.8% Loss Cost Reduction

09/25/2023 | 0

The National Council on Compensation Insurance is proposing an average 9.8% reduction in voluntary loss costs for Connecticut, effective Jan. 1. At the same time, NCCI is proposing an average decrease of 10.5% to the assigned risk rate level. The filing is based on premium and loss experience for policy years 2020-2022 and excludes claims for COVID-19. NCCI said the primary driver of the proposal is improved experience. Lost-time claim frequency has generally been declining in the state. Although claims increased in policy years 2020 and 2021, frequency declined a cumulative 5% over the pe... Read More

CA - Governing Committee Meets Wednesday

09/25/2023 | 0

The Workers’ Compensation Insurance Rating Bureau of California Governing Committee will hear reports on legislative, regulatory and judicial issues during a Wednesday meeting. Committee members will hear a report on the regulatory and pure premium rate filings approved earlier this year. Insurance Commissioner Ricardo Lara in July adopted an advisory rate of $1.46 per $100 of payroll, a 2.6% reduction. The WCIRB had recommended a 3.4% increase, while the actuary for public members of the Governing Committee recommended a 7.3% cut. In May, Lara approved the WCIRB’s annual regula... Read More

TX - Max Benefit, Discount Rate to Increase Oct. 1

09/25/2023 | 0

The Texas Division of Workers’ Compensation announced that the maximum temporary income benefit is increasing Oct. 1. At the same time, the division announced that the interest rate used to calculate the present value of lump-sum settlements will increase for the final quarter of the year. The maximum temporary income benefit is increasing to $1,174 from $1,112 for injuries occurring on or after Oct. 1. Maximum lifetime income benefits and death benefits are also increasing to $1,174. Maximum impairment income benefits and supplemental income benefits are both increasing to $822 ... Read More

CA - Worker Loses $12.6 Million Jury Verdict Due to Privette Doctrine

09/22/2023 | 0

A California appellate court overturned a jury’s $12.6 million verdict for an injured worker, finding the defendants’ liability was barred by the Privette doctrine. MAS Realty LLC owns a shopping center called Arlington Plaza, made up of one large building and three smaller buildings. In 2014, MAS hired defendant Athena Property Management Inc. to manage Arlington Plaza. Athena then hired The Roof Depot Inc. to inspect Arlington Plaza’s roofs and make any necessary repairs. Roof Depot advised Athena of two issues with one of the smaller buildings, specifically, that... Read More

AR - Injured Worker Fails to Prove Entitlement to Further Treatment, Benefits for Hip

09/22/2023 | 0

The Arkansas Court of Appeals ruled that a caregiver was not entitled to additional treatment or benefits for her injured hip. Case: Gant v. First Step Inc., No. CV-22-570, 09/20/2023, published. Facts: Kymira Gant worked for First Step Inc. as a caregiver. She injured her back in April 2020 while attempting to load a patient’s wheelchair into her car. She initially saw her family physician, Dr. Jenny Navarro, after the accident. Navarro noted that Gant complained of right hip pain. Gant also complained of unabated hip pain to Dr. Wayne Bruffett. Bruffett ordered a magnetic reso... Read More

WV - Worker Fails to Prove Compensability of Rotator Cuff Tear

09/22/2023 | 0

The West Virginia Supreme Court ruled that a worker failed to prove his torn rotator cuff had been caused by an on-the-job injury. Case: Clagg v. Constellium Rolled Products Ravenswood LLC, No. 21-0744, 09/14/2023, published. Facts: Bathan Cladd worked as a material expeditor for Constellium Rolled Products LLC. He allegedly felt a sharp, stabbing pain in the top of his shoulder while throwing a pan of debris at work in June 2019. Clagg sought treatment at Activate Healthcare. An X-ray of his left shoulder revealed moderate left glenohumeral and acromioclavicular joint arthritis. Clagg was ... Read More

WV - High Court Upholds Denial of Equipment Operator's Carpal Tunnel Claim

09/22/2023 | 0

The West Virginia Supreme Court upheld a denial of benefits for a heavy equipment operator’s carpal tunnel claim. Case: Trent v. Coronado Group LLC, No. 21-1047, 09/14/2023, published. Facts: Billy Trent worked for Coronado Group LLC as a heavy equipment operator. Neurological testing performed on Nov. 14, 2019, showed Trent had right carpal tunnel syndrome with no evidence of radiculopathy. Physician assistant Chris Tipton diagnosed Trent with a repetitive right wrist strain injury due to his work. Dr. Rebecca Thaxton performed a physician review in January 2020 and opined that the ... Read More

NATL. - Report: Social Security Clawing Back Overpayments From Injured Workers

09/22/2023 | 1

Injured workers are getting caught up in the federal government’s efforts to claw back billions of dollars in Social Security overpayments, according to a report by the Kaiser Family Foundation’s KFF Health News and Cox Media Group. The Social Security Administration in the fiscal year that ended in June 2022 collected about $4.7 billion in overpayments, according to the report. Another $22 billion was outstanding. One woman who was receiving workers’ compensation benefits and Social Security disability benefits said she received a letter from the Social Security Administra... Read More

WA - AWB 'Disappointed' With Proposed 4.9% Rate Increase

09/22/2023 | 0

The president of the Association of Washington Business said in a statement that the organization was “disappointed” with the Department of Labor and Industries proposal to increase workers’ compensation rates next year. L&I on Tuesday proposed increasing the average hourly rate employers and workers pay for comp coverage by 4.9%. The department said the rate increase is needed in part because of higher-than-normal wage growth in the state in recent years.  The agency said it tapped into its reserves to mitigate the rate hike. L&I said it would have needed ... Read More

CA - COEH, DWC Partner on Med-Legal Report Writing Classes

09/22/2023 | 0

The Center for Occupational and Environmental Health at the University of California, Berkeley, and the Division of Workers’ Compensation are partnering to present a four-part training course for medical-legal report writing. The program aims to teach qualified medical evaluators, clinicians and others involved in the work comp system about the intricacies of medical-legal report writing and what constitutes compelling evidence in legal proceedings. The first course on Oct. 6 will cover the statutory and regulatory requirements governing medical-legal reports. Instruction will cover th... Read More