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NATL. - Study Finds State Policies Reduce Opioids, but Worker Advocates Bemoan Lack of Alternatives

By Mark Powell (Reporter)
07/30/2021 | 0

A new study has found that drug monitoring programs and recently implemented policies limiting the period of initial prescriptions have reduced opioids in workers’ compensation, but injured worker advocates say the data doesn’t properly account for alternative treatments or workers who may require high-strength pain relief. Researchers from the Workers Compensation Research Institute found that in the first year of implementation, must-access prescription drug monitoring programs cut the morphine milligram equivalent amount for opioids prescribed by 12%. WCRI’s study al... Read More

CA - Fraud Conviction Results in Denial of Naturalization Application

07/30/2021 | 0

A federal appellate court ruled that a worker was properly denied naturalization based on an old conviction for concealing employment while collecting disability and workers’ compensation benefits. Case: Orellana v. Mayorkas, No. 20-16092, 07/28/2021, published. Facts and procedural history: Blanca Orellana is a citizen of El Salvador. She has resided in the United States since 1990 and has been a lawful permanent resident since February 2003. In February 2002, Orellana suffered injuries while working for Ocadian Care Center. Ocadian accepted liability for the injuries and began ... Read More

OH - Worker's Daughter Receives Award for Loss of Use

07/30/2021 | 0

An Ohio appellate court ruled that the daughter of a worker was entitled to an award for his loss of use of his limbs in an accident that resulted in death shortly after he was extricated from his truck. Case: State ex rel. Waste Management of Ohio Inc. v. Industrial Commission, No. 19AP-453, 07/20/2021, published. Facts: Travis Gelhausen worked for Waste Management of Ohio Inc. While driving a Waste Management truck on Oct. 18, 2017, Gelhausen approached a stop sign, failed to stop and attempted to make a right turn at a speed that caused the truck to overturn and slide into ... Read More

FL - Worker Shouldn't Have Been Denied Benefits for Psych Injury After MMI

07/30/2021 | 0

A Florida appellate court ruled that a worker should not have been denied temporary indemnity benefits for a mental injury even though more than six months had elapsed since she reached maximum medical improvement for a physical injury. Case: Jones v. State of Florida, No. 1D20-1741, 07/29/2021, published. Facts: Le’tavia Jones worked for the state Department of Corrections. An inmate attacked her, placing her in a chokehold and causing neck and throat injuries. Jones reached maximum medical improvement about two weeks later and received a 0% permanent impairment rating. Meanwhil... Read More

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Press - Mullen & Filippi welcomes Leslie Tuxhorn

07/13/2021 | 0

Since 1991, Leslie Tuxhorn has been a practicing California Workers' Compensation Defense Attorney. In the course of her years of practice, she has appeared at every single board with the exceptions of Fresno and San Jose. After attaining partnership, ascending to management and finally being elected to three consecutive terms as the manager of a large statewide defense firm,... Read More

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Industry Insights

NATL. - Moore: Workers' Comp Adjuster Turnover

By James Moore
07/30/2021 | 0

I do not like to write any articles on how the pandemic has affected anything, but a workers' comp adjuster turnover trend spiked in early 2020. When I wear my workers' comp consultant hat, I often review claims for carriers, agencies, employers and other organizations. One of the hallmarks of a good claims resolution involves having the same adjuster throughout a claim. Claims adjusters can operate from memory on a claim they have handled since day one. When I was adjusting claims (long ago), I would dread taking over claims that were started by an... Read More

CA - Teacher Ordered to Pay Nearly $9,000 After Pleading No Contest to Fraud

07/30/2021 | 0

A California teacher was ordered to pay nearly $9,000 in restitution after pleading no contest to a fraud charge for participating in a marathon a month after reporting a back injury that prevented her from working, according to PROBE, a division of VRC Investigations. Denise Jorgensen said she injured her back while working as a teacher for Kern County Superintendent of Schools in September 2017. She complained of constant, aching back pain that she rated as a six out of 10 and said was aggravated by bending and sitting. She was diagnosed with a sprain of ligaments in the lumbar spine and st... Read More

CA - WCIRB Posts Updated Loss-Elimination Ratios, Advisory Plan Tables

07/30/2021 | 0

The Workers’ Compensation Insurance Rating Bureau of California published updated loss-elimination ratios that were used to compute classification relativities in the recently approved Sept. 1 regulatory filing. “This annual update reflects the most current claim severity and benefit on-leveling factors,” the WCIRB said in a Wire Alert issued Thursday. “Additionally, the WCIRB has updated other tables included in the advisory California Retrospective Rating Plan, California Large Risk Deductible Plan and California Small Deductible Plan.” The WCIRB said it ... Read More

NATL. - Purdue Developing Opioid Antagonist of Potential Interest to Comp

07/30/2021 | 0

Purdue Pharma is developing a long-acting opioid antagonist for treating overdoses that will likely be of interest to the workers’ compensation community, pharmacy benefit manager myMatrixx reports. The drug under development, nalmefene, has a plasma half-life of almost 11 hours, myMatrixx said. The only FDA-approved treatment for opioid overdose, naloxone, has a half-life of about two hours. “As a result, nalmefene has been shown to reverse opioid intoxication for as long as eight hours, whereas naloxone requires monitoring and repeat dosing, as needed,” myMatrixx said. P... Read More

LA - LASIE Seminar to Cover Medical Trends in Comp

07/30/2021 | 0

The Louisiana Association of Self Insured Employers is hosting a one-day seminar Aug. 16 covering basic principles of medical injuries commonly seen in workers’ compensation. The seminar is designed to teach how to review and understand medical reports and covers many standard treatment options for various medical problems. Topics will include medical protocols, evidence-based medicine, cost containment and utilization review. The course that starts at 8:30 a.m. on Aug. 16 will be held at Bankers Center in Baton Rouge. Registration information is available here. ... Read More

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Press - PRESS RELEASE - Cadence Rx Welcomes New Members to Round Out Industry-Leading Board of Directors

07/20/2021 | 0

TAMPA, FLORDIA., JULY 20, 2021 -- Cadence Rx announced today the appointment of Danielle Lisenbey, Harry Spencer, and Bud Watts to the Board of Directors joining alongside Artemis Emslie and Lisa Hannusch. The joint team of industry-leading experts has a century of combined experience in both building and transforming the architecture of pharmacy benefit management and healthcare space to the next generation.  Artemis Emslie, 25-year industry veteran, founder and CEO, the majority shareholder and corporate President says, "Cadence Rx is pleased to ... Read More

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NATL. - CLM Names Ronna Ruppelt as New CEO

07/30/2021 | 0

Insurance industry association CLM on Thursday named Ronna Ruppelt as its new CEO. Ruppelt brings nearly three decades of experience with legal, regulatory, compliance and claims issues. She comes to CLM from Good2Go Auto Insurance, where she was senior vice president, general counsel and corporate secretary. Before that, she held executive positions that included vice president of casualty claims at National General Insurance, vice president of claims at AIG Personal Lines, and director of claims at Direct General Insurance. Ruppelt has been a CLM fellow since 2009 and has presented at... Read More

CA - Some Things Change, Some Stay the Same Under Updated Cal/OSHA COVID-19 Rules

By Mark Powell (Reporter)
07/29/2021 | 0

California’s COVID-19 workplace safety rules no longer require physical distancing for workers in most cases, but versions of many of Cal/OSHA’s temporary emergency standards adopted last year remain in effect, state safety officials said. And as the state continues its battle with the virus’ delta variant, employers may want to maintain their own strict, site-specific safety guidelines and encourage as many workers as possible to get vaccinated, they said Wednesday during a live webinar.  “It's really important that you stay up to date on the regulations tha... Read More

TX - City Gets Summary Dismissal of Worker's Claim for Injuries

07/29/2021 | 0

A Texas appellate court upheld the dismissal of a worker’s claim for injuries from exposure to contaminants while working on a municipal water and sewer project. Case: Cornejo Garcia v. City of West Columbia, No. 01-20-00653-CV, 07/27/2021, published. Facts and procedural history: J. Marcelino E. Cornejo Garcia worked for Matula & Matula Construction Inc. M&M contracted with the City of West Columbia to work on a municipal water and sewer project. Cornejo Garcia later filed suit against the city alleging that he was injured due to exposure to contaminated water ... Read More

TX - Injured Football Player Fails to Establish Proper Venue for Appeal

07/29/2021 | 0

A Texas appellate court overturned a jury’s determination that a former professional football player was entitled to benefits for a training injury, finding he had not established the proper venue in the county where the trial had been held. Case: Great Divide Insurance Co. v. Fortenberry, No. 05-19-01541-CV, 07/26/2021, published. Facts: After graduating from Texas Tech University in May 2015, Alcus Reshod Fortenberry entered into a player contract with the Dallas Cowboys to become an offensive lineman. While the term of the contract was for three seasons, it contained various early t... Read More

CA - Worker's Family Can't Get Jury Trial

07/29/2021 | 0

A California appellate court ruled that a worker’s family was not entitled to a jury trial to determine whether his employer was uninsured at the time of his fatal accident. Case: Hollingsworth v. Heavy Transport Inc., No. B306127, 07/27/2021, published. Facts: Kirk Hollingsworth worked for Heavy Transport Inc.  On June 20, 2016, two tires failed on a tractor-trailer that was hauling a large crane. Hollingsworth was called to the location to change the tires. After the tires were changed and the tractor-trailer began traveling again, a third tire failed. The rubber treads came lo... Read More

IL - Ex-Mayor Indicted for Alleged Scheme Involving City's Comp Coverage

07/29/2021 | 0

A federal grand jury indicted the ex-mayor of a city in Southern Illinois for allegedly lying to investigators about his role in an insurance scheme involving the mayor of another city, according to a report by the Belleville News-Democrat. Former Red Bud Mayor Tim Lowry was charged with making one false statement to members of the Southern Illinois Public Corruption Task Force. Columbia Mayor Kevin Hutchinson was indicted Feb. 24 on the same charges. Hutchinson resigned March 1 and pleaded guilty March 22. He was sentenced to two years' probation and fined $500. The indictments all... Read More

IN - WCB to Require Electronic Submission of Appearances in August

07/29/2021 | 0

The Workers’ Compensation Board of Indiana launched a new module allowing attorneys to submit appearances electronically and will stop accepting paper submissions in August. The new module was launched Tuesday. Users will have the option to search for cases by dispute number, date of injury or last name. After searching, the users can select the party they represent. Once submitted, an email will be sent to all attorneys already on the case. If the injured worker is not represented, the notice will be sent to the case coordinator and the worker if the WCB has the worker’s email ... Read More