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CA - COVID-19 Claims Could Cost at Least $2.17B Over Next 3 Years, WCIRB Says

By Mark Powell (Reporter)
08/06/2020 | 99 | 0 | 6 min read

Claims related to COVID-19 could cost California’s workers’ compensation system about $2.17 billion between now and 2022, according to projections from the Workers’ Compensation Insurance Rating Bureau. The total estimated cost could increase by roughly $500 million when accounting for self-insured employers. The WCIRB is projecting COVID-19 losses and loss adjustment expenses for 2020 of $1.3 billion, according to data presented during Tuesday's Actuarial Committee meeting. The WCIRB also assumed that the insured market will see about 63% of the COVID-19 claims this ye... Read More

NATL. - Trump Orders Permanency to Telemed Rules but Leaves Out Rehab, PT

By William Rabb (Reporter)
08/06/2020 | 103 | 0 | 18 min read

Telemedicine in workers' compensation received a shot in the arm this week from Washington and New York, another sign that remote health care will be around long after the coronavirus pandemic has subsided. President Trump on Monday issued an executive order that makes permanent what was a temporary plan by Medicare to reimburse many telemedicine services at the same rate as similar, in-person medical treatments. The Centers for Medicare and Medicaid Services proposed rules to that effect the same day. Trump's order was of particular interest to Texas and other states that ... Read More

PA - Shipwright Can't Get Comp Benefits Plus Jones Act Recovery for Same Accident

08/06/2020 | 49 | 0 | 6 min read

The Commonwealth Court of Pennsylvania ruled that a worker is not entitled to benefits under both the Jones Act and the state Workers’ Compensation Act, and that the carrier who paid Jones Act benefits is not entitled to subrogation from the employer. Case: Arlet v. WCAB (Commonwealth of Pennsylvania), No. 1722 C.D. 2018, 07/29/2020, published. Facts: Richard Arlet worked as a shipwright for Flagship Niagara League maintaining the Brig Niagara. The Acadia Insurance Co. issued a commercial hull policy to Flagship. The policy provided coverage for damages incurred by and damages caused ... Read More

MO - Court Tosses PTD Award for Worker With Pre-Existing Psychological Conditions

08/06/2020 | 31 | 0 | 2 min read

The Missouri Court of Appeals overturned a finding that a correctional officer’s employer was solely liable for her permanent total disability benefits for her psychological conditions after an assault by an inmate. Case: Williams v. City of Jennings, No. ED108393, 07/28/2020, published. Facts: Sabrina Williams worked for the City of Jennings as a corrections officer. In September 2010, she was attacked by an inmate. Williams experienced temporary swelling of her eye and face, had to have a broken tooth removed, experienced temporary slurred speech and received several weeks of p... Read More

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Press - Insurance and Risk Management Association Launches New Website Amid Coronavirus Pandemic

07/30/2020 | 191 | 0

Long Beach, CA - July 30, 2020 - The Hispanic Insurance and Risk Management Association (HIRMA) announced today the launch of its new website, www.HIRMA.org, amid the coronavirus pandemic.   Over the past 12 months, HIRMA has emerged as one of the more consistently active associations serving the Risk Management, Human Resources, Health and Safety, and Workers' Compensation communities. The association is c... Read More

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CA - Peabody: WCAB Explains That SIBTF PD Should Be Added, Not Combined

By Michael Peabody
08/06/2020 | 62 | 0

The Workers’ Compensation Appeals Board issued an en banc decision in June clarifying that prior and subsequent injuries should be “added” and not “combined” to determine whether the Subsequent Injuries Benefits Trust Fund (SIBTF) should be involved. The title of the WCAB’s en banc decision is Richard Todd. Subsequent Injuries Benefits Trust Fund. The SIBTF, which is established per Labor Code Section 4751, is designed to encourage employers to hire people with disabilities. The new employer is responsible for only that portion of the disability c... Read More

NY - Incomplete Form Sinks Carrier's Reimbursement Bid

08/06/2020 | 59 | 0 | 1 min read

A New York appellate court ruled that an insurance carrier was not entitled to reimbursement from the Special Disability Fund because it failed to properly complete the form requesting recovery. Case: Matter of Mayers v. Frito Lay, No. 529905, 07/23/2020, published. Facts and procedural history: Cynthia Mayers worked for Frito Lay in its warehouse. She injured her back while at work in September 2002 and received an award of workers’ compensation benefits. In October 2003, the workers’ compensation insurance carrier for Frito Lay filed a request for reimbursement from ... Read More

NY - Court Turns Down Challenge to Discontinuation of Benefits

08/06/2020 | 68 | 0 | 1 min read

A New York appellate court ruled that a worker’s challenge to an order discontinuing her benefits was properly dismissed due to her attorney’s failure to properly complete her application for review. Case: Matter of Lebedeva v Fojp Service Corp., No. 529235, 07/23/2020, published. Facts and procedural history: Anna Lebedeva worked for the Fojp Service Corp. as a home attendant. In June 2017, she suffered injuries in a fall while working. She filed a workers’ compensation claim and began receiving benefits. In July 2018, a workers’ compensation law judge found Lebedev... Read More

CA - Labor Commissioner Sues Uber, Lyft for Misclassification

08/06/2020 | 79 | 0 | 5 min read

The California Labor Commissioner’s Office on Wednesday announced that it filed separate lawsuits against Uber and Lyft accusing the transportation companies of committing wage theft by misclassifying drivers as independent contractors. “The lawsuits allege that by misclassifying workers, Uber and Lyft failed to meet their obligations as employers as required by California labor law — including to pay drivers at least minimum wage for all hours worked, to pay overtime compensation, to provide paid rest periods, to reimburse drivers for the cost of all equipment and supplies ... Read More

CA - Feds Charge 10 With Selling Opioids From 'Sham' Clinics

08/06/2020 | 115 | 0 | 4 min read

The U.S. Attorney’s Office for Central California on Wednesday announced charges against 10 people accused of participating in a narcotics trafficking ring that sold opioid prescriptions for cash through a series of “sham medical clinics.” “The charges in this matter are the result of an investigation by agents with the DEA and IRS Criminal Investigation into ChiroMed, which operated a group of chiropractic, medical and wellness clinics in Los Angeles, Orange and San Bernardino counties,” the U.S. Attorney’s Office said in a statement. “(Dr. John M.) ... Read More

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Press - Mitchell | Genex Finalizes Coventry Workers' Comp Services Acquisition

08/03/2020 | 57 | 0

Deal expands industry-leading solutions to boost better claims outcomes and improve lives for injured individuals SAN DIEGO & WAYNE, Pa. -- (BUSINESS WIRE) -- Mitchell | Genex, a leading provider of cost containment technology, clinical services, and disability management, announced it has finalized its acquisition of Coventry Workers' Comp Services from CVS Health (NYSE: CVS). Coventry Workers' Comp Services is a prominent provider of care and cost management programs for workers' compensation and auto insurance carriers, third-party administrators,... Read More

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OH - BWC Proposes Rule Changes to Outpatient Formulary, Provider Credentialing

08/06/2020 | 53 | 0 | 75 min read

The Ohio Bureau of Workers' Compensation has proposed several rule changes, from extension of a pilot program on provisional treatment reimbursement to outpatient formulary amendments. The bureau has extended a Health Partnership pilot program through the end of 2021. The program allows managed care organizations to authorize reimbursement, without disclaimer, for medical treatments for the same body parts or conditions initially allowed in the claim or related to the same injury. The comment period for the rule closed last month. The BWC also re-adopted the 2015 vocational re... Read More

TX - DWC Offering OSHA Construction Safety Classes on Web Video Platform

08/06/2020 | 65 | 0 | 8 min read

The Texas Division of Workers' Compensation has posted dates for construction safety classes in August and September. The 10-hour classes will be offered in English and Spanish, via Zoom video conference, by instructors authorized by the U.S. Occupational Safety and Health Administration, the DWC said in a bulletin. Participants in the three-day courses will receive an OSHA 10-hour construction card. The agenda includes courses on avoiding caught-in-between hazards; electrical hazards; fall hazards; and on the use of personal protective equipment and on health hazards and materials handl... Read More

OR - WCB to Review Comments on Attorney Fees

08/06/2020 | 48 | 0 | 1 min read

The Oregon Workers’ Compensation Board will discuss public testimony on proposed changes to attorney fee rules during an Aug. 18 meeting. The board held a public hearing Friday on proposed rules that would require considering a claimants’ attorney’s contingent hourly rate when determining a reasonable fee. The rules would also allow a claimants' attorney to request bifurcation of the attorney fee determination from the merits of certain cases. Board members will discuss written and oral comments that were provided as part of the rulemaking hearing. Members will als... Read More

NATL. - IAIABC: Proof of Coverage XML Standard Released

08/06/2020 | 34 | 0 | 6 min read

The International Association of Industrial Accident Boards and Commissions announced the publication of new standards used by insurers to report workers’ compensation insurance policy data. IAIABC said the “Proof of Coverage Release 3.0 XML Standard” increases flexibility for jurisdictions and makes it easier to define required data elements and receive real-time reports. Jurisdictions can begin implementing the new standard in May 2021 to provide all stakeholders sufficient time to complete the necessary programming changes, IAIABC said. Development of the Proof of Cover... Read More

CA - WCIRB to Rely More on 'Historical Data,' Less on 2020 Stats to Craft New Premium Rate

By Mark Powell (Reporter)
08/05/2020 | 309 | 0 | 35 min read

While some people are wishing 2020 would finally end, the Workers’ Compensation Insurance Rating Bureau of California is already looking to forget it. WCIRB officials and Actuarial Committee members met via webinar Tuesday to discuss, among other topics, the impacts of the COVID-19 pandemic and multiple other statistical factors expected to be included in the bureau’s Jan. 1 advisory pure premium rate filing. WCIRB officials’ outlook on the new rate filing mirrored at least one element from the bureau’s State of the System report last month: Everything was fi... Read More