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LA - Split Court Awards Non-Skilled Personal Care Service to Injured Worker

06/09/2023 | 0

A divided Louisiana appellate court ruled that a worker was entitled to an award of non-skilled personal care assistant services. Terry McCain worked for Lewis Cos. Inc. In February 2011, when he was 58, he fell from a ladder and landed headfirst on a concrete sidewalk. Lewis had workers’ compensation coverage through LUBA Casualty Insurance Co., which paid medical and indemnity benefits to McCain after the accident. McCain filed a request for non-skilled personal care attendant services, as recommended by his treating neuropsychologist. LUBA objected, contending that McCa... Read More

OR - No PPD Benefits for Worker Whose Impairment Isn't Caused by Compensable Back Injury

06/09/2023 | 0

The Oregon Court of Appeals ruled that a worker was not entitled to permanent partial disability benefits for a low back condition, since none of her impairment was caused by her compensable back injury. Case: In the Matter of Compensation of Gramada, Nos. 2005499 and A177672, 06/07/2023, published. Facts: Viorica Gramada worked for Community Vision Inc. In March 2020, she suffered sharp low back and lower abdominal pain after she helped a patient into a shower. Community had workers’ compensation coverage with SAIF Corp., which accepted liability for a lumbar strain. In August 2020,... Read More

NY - Court: Doctor's IME Report Properly Excluded From Evidence

06/09/2023 | 0

A New York appellate court upheld the exclusion of a doctor’s report on permanency and loss of use because his examination of a worker constituted an independent medical exam, and he did not comply with filing requirements. Case: Matter of Harris v. Department of Environmental Protection, No. 534963, 06/01/2023, published. Facts: Kevin Harris worked for the Department of Environmental Protection. In 2019, Harris filed a workers' compensation claim alleging that he sustained work-related injuries while removing a heavy box from a shelf.  The claim was ... Read More

NY - Worker Gets Benefits for Auto Accident Despite Drinking at Lunch

06/09/2023 | 0

A New York appellate court ruled that a worker was entitled to benefits for his injuries from a car accident that occurred when he and a co-worker were returning from a restaurant where they had consumed alcohol. Case: Matter of Pernice v. Harlan Electric Co., No. 534832, 06/01/2023, published. Facts: Cody Pernice worked for Harlan Electric Co. as a lineman. He suffered injuries in an automobile accident when a bucket truck owned by Harlan rolled over. A co-worker who had consumed alcohol during the lunch break was intoxicated and was driving. Procedural history: Pernice filed a w... Read More

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Press - ReEmployAbility and Work Comp Central Announce Free Webinar: Overcoming Jurisdictional Return-to-Work Challenges

05/10/2023 | 0

ReEmployAbility and Work Comp Central Announce Free Webinar: "Overcoming Jurisdictional Return-to-Work Challenges"  Brandon, FL (May 10, 2023)- ReEmployAbility CEO and Founder Debra Livingston will be hosting a second free, live Work Comp Central webinar in their continued series to educate the worker's ... Read More

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Industry Insights

CA - Kamin: Panel Decision Takes Aim at Inflated LC 5710 Fees

By John P. Kamin
06/09/2023 | 0

A new panel decision from the Workers’ Compensation Appeals Board affirmed a decision to reduce the Labor Code Section 5710 fees for an applicant's attorney for work performed in response to a deposition of the applicant. The board affirmed the reduced LC 5710 fees in its September 2022 panel decision of Cowens v. ABC Unified School District. In that case, the parties attended a videoconference deposition. What attorney wanted in first invoice Immediately after the deposition, the attorney issued an invoice for $950: Preparation time — one hou... Read More

NATL. - AmTrust: Compensable Injuries Among Food Workers Decrease

06/09/2023 | 0

The total number of compensable work injuries in the U.S. food manufacturing sector decreased post-pandemic, with a 13% decline in workers’ compensation claims from pre-COVID-19 levels, according to a report by AmTrust Financial Services Inc. The specialty insurer examined 15,000 comp claims in food manufacturing between 2018 and 2022, finding that general workplace injuries were down in 2020, 2021 and 2022, at the height of the global pandemic. In general, workplace injuries in the food industry were down post-pandemic compared with 2019, even as the sector dealt with labor shortages,... Read More

TX - DWC Requests Comments on Medical Quality Review Panel Rule Changes

06/09/2023 | 0

The Texas Division of Workers’ Compensation has proposed changes to its Medical Quality Review Panel rules. The proposed amendments to Rules 180.64, 180.66, 180.68, 180.72 and 180.76 are intended to conform with related rules and practices; to clarify the amount of notice to which a respondent is entitled before an informal settlement conference; to clarify that the DWC may conduct an ISC remotely or in person; and to make editorial changes for plain language and agency style. The DWC has also proposed repealing Rule 180.78 concerning the effective date of the rule ... Read More

IL - Goldberg Segalla Adds Calvin J. Brown to Chicago Group

06/09/2023 | 0

Goldberg Segalla added Calvin J. Brown to the firm’s workers’ compensation group in Chicago. Brown counsels and defends employers, insurers and third-party administrators in workers’ compensation matters throughout Illinois. Brown gained courtroom and trial experience as an assistant public defender in the Cook County public defender’s office, where he represented more than 100 clients on criminal charges. He also negotiated plea and sentencing agreements with assistant state’s attorneys and appeared before multiple judges in the 1st Municipal Division... Read More

CT - Governor Signs Captives Bill

06/09/2023 | 0

Connecticut Gov. Ned Lamont signed a bill modifying provisions relating to captive insurers. Lamont on Wednesday signed Senate Bill 1038, which will allow captive insurers — insurance companies formed to insure or reinsure the risks of its owner — to accept or transfer risk through parametric contracts that condition payment on specified triggering events rather than the value of the loss.  SB 1038 additionally modifies provisions governing sponsored captives, where sponsors provide the minimum paid-in capital and surplus; participants are insured through separate contracts;... Read More

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Press - Rising Medical Solutions Adds Two Strategic Hires to Ancillary Services Team

05/25/2023 | 0

May 25, 2023 - Chicago, IL - Rising Medical Solutions recently announced that two seasoned ancillary services professionals have joined the company, strengthening the company's Marketplace offering for national ancillary solutions. Carolyn Tsourakis and Kelsey Murphy, both formerly operations leaders at ancillary service provider CentralComp, bring significant experience delivering durable medical equipment, diagnostic, physical therapy, prosthetic, hearing aid, home health, transportation, and translation services to the insurer, third party administer, and employer markets. Ts... Read More

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WA - Appeals Court Says Pet Service App Not Employer, Doesn't Need Comp

06/08/2023 | 0

An online platform that connects pet owners to people providing services such as dog walking or grooming and pockets a percentage of any payments as compensation for the matchmaking is not an employer required to pay for workers’ compensation insurance, an appellate court in Washington state ruled. Although there were some indications that A Place for Rover, more commonly known as Rover.com, exercised control through its unfettered discretion over who could use its app to offer or solicit services — and by using GPS to monitor the location of dog walkers — the... Read More

MT - Supreme Court Says Time for Worker to File Claim Was Tolled While He Had No Guardian

06/08/2023 | 0

The Montana Supreme Court ruled that the statute of limitations for a worker’s claim was tolled during the time he had no appointed guardian, and that substantial evidence supported an assessment of attorney fees and penalties against the carrier that contested the claim. Case: Bryer v. Accident Fund General Insurance Co., No. DA 22-0590, 06/06/2023, published. Facts: In July 2017, a plant manager of American Welding & Gas Inc. discovered technician Johnny Lee Sheldon, unconscious and bleeding from a head wound, lying on the floor near a high-pressure cylinder that was releasi... Read More

TX - Self-Represented Worker Waives Arguments He Failed to Raise in Administrative Process

06/08/2023 | 0

A Texas appellate court ruled that a self-represented litigant’s failure to present arguments during the administrative process for his workers’ compensation claim waived his ability to assert them on appeal. Case: Whitehurst v. New Hampshire Insurance Co., No. 14-21-00153-CV, 06/06/2023, published. Facts and procedural history: Anthony Whitehurst was injured in the course and scope of his employment in a motor vehicle accident. His employer’s insurance carrier, New Hampshire Insurance Co., accepted liability for a right wrist contusion, right wrist strain, right wrist... Read More

NY - No Additional Benefits for Injured Court Reporter Whose Disability Didn't Cause Unemployment

06/08/2023 | 0

A New York appellate court upheld a denial of additional benefits to an injured court reporter whose disability had not caused her to leave her job. Case: Matter of Saporito v. Office of Court Administration, No. 534851, 06/01/2023, published. Facts: Barbara Saporito worked as a court reporter. She suffered injuries in a fall from a chair at work in March 2004. The fall disturbed hardware from lumbar fusion surgery performed the prior year to address a non-work-related injury. The hardware was removed in November 2005. Saporito returned to work, but she was terminated in December 2006. Afte... Read More

NY - Worker's Failure to Mention Prior Neck Injury Doesn't Result in Forfeiture of Benefits

06/08/2023 | 0

A New York appellate court ruled that a worker who failed to mention to his doctors a prior compensable neck injury after a second industrial accident did not commit fraud. Case: Matter of Updike v. Synthes, No. CV-22-1920, 06/01/2023, published. Facts and procedural history: Lawrence Updike worked as an automotive mechanic. He established a claim for an injury to his low back and a consequential injury to his neck.  After the Workers’ Compensation Board classified Updike as permanently partially disabled, he settled his claim for the neck and back injuries. In 2006, Updike... Read More

TX - TDI Corrects Commissioner's Order

06/08/2023 | 0

The Texas Department of Insurance has corrected language related to the effective date of the recently adopted Commissioner’s Order No. 2023-7932 for NCCI Item E-1410. TDI reported that the order should have included the language “and any in-force policy in effect on and after July 1” in Finding of Fact No. 4, Conclusion of Law No. 4 and the ordering paragraph, but the language was left out by mistake.  DWC announced that the order has been amended nunc pro tunc to add the correct language related to the effective date. The order can be viewed here. ... Read More

NY - IMEs Would Face New Requirements Under Bill

06/08/2023 | 0

A New York lawmaker filed legislation that would amend sections of the state’s workers' compensation law that deal with physicians authorized to conduct independent medical examinations. Assembly Bill 7730, which was introduced Tuesday, would require doctors conducting independent medical exams to do so in an “objective and impartial manner.” The bill would additionally require that IMEs agree to audits to ensure they are complying with state law. If regulators determine that three or more of the five audited records are deficient, the bill would authorize additional au... Read More