CA - Court Overturns Finding Doctor Did Not Commit Fraud in Hiding Conviction
12/09/2022 | 1
A California appellate court on Tuesday overturned a judgment in favor a doctor that found he had not violated the Insurance Frauds Prevention Act by failing to disclose a decades-old criminal conviction when applying to become a qualified medical examiner for workers’ compensation cases.
In 1983, while he was a medical resident, Bruce Fishman was named in a Michigan federal indictment. He was accused of developing a plan with two other defendants to write and fill prescriptions for drugs that they would then sell on the black market.
Fishman pleaded guilty to a single count of co...
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A federal district court in the nation’s capital said a law school professor who claimed in an application for benefits that she was injured in the course of employment can’t now claim that she wasn’t injured in the course of employment to avoid the exclusive remedy of workers’ compensation.
Hdeel Abdelhady received workers’ compensation benefits after she fell down the stairs at an on-campus event, so her negligence claim against George Washington University and its third-party administrator is precluded by exclusive remedy, the U.S. District Court for the Distr...
The Missouri Court of Appeals upheld a denial of medical expenses and permanent disability compensation for a mechanic after a compensable injury from his exposure to truck exhaust.
Case: Mueller v. Peoplease Corp., No. SD37397, 11/18/2022, published.
Facts: Anil Mueller worked for Peoplease Corp., a staffing agency. In 2015, Peoplease sent him to work for Taylor Made Truck Repair as a mechanic.
In January 2015, Mueller was ordered to get a loaded trailer from outside. When he hooked up the trailer, exhaust fumes coming off the tractor blew right at him. He got sick and ...
The Indiana Court of Appeals ruled that an additional insured on an elevator company’s insurance policies was not entitled to coverage for an employee’s accident, but it could receive an award for its defense costs.
Case: Scottsdale Insurance Co. v. Harsco Corp., No. 21A-PL-2483, 11/21/2022, published.
Facts: In 2007, Harsco Corp. and PPL Montour Co. LLC entered into a contract to construct and maintain an elevator at a PPL work site. Harsco then subcontracted with Metro Elevator Co. to lease and install the elevator.
The contract between Harsco and PPL listed Metro as a third-p...
The California Supreme Court is on track to have a rather significant ruling in 2023 on a question of whether a civil suit stemming from a “take-home COVID” claim is barred by the derivative injury doctrine.
The state’s high court appears to be on track to have a ruling at some point in 2023 in the case of Kuciemba v. Victory Woodworks. The case is one of many that are being informally described in the media as a “take-home COVID" claims.
By “take-home COVID claim,” we mean a case where an employee allegedly gets COVID-19 at work, t...
The San Francisco Department of Human Resources announced that Julian E. Robinson will succeed Peggy Sugarman as director of workers’ compensation.
Sugarman, a former chief deputy administrator of the California Division of Workers’ Compensation, is retiring today after more than 10 years with the city and county.
Robinson has served in the workers’ compensation industry for 20 years, starting at State Compensation Insurance Fund, where he worked as an adjuster, claims auditor and eventually worked in the utilization review program. His career continued at Kaiser&r...
The Industrial Commission of Arizona is holding a virtual question-and-answer session Tuesday for self-insured employers and third-party administrators to answer questions about premium rates, tax plan eligibility and annual tax reporting requirements.
The Q&A session relates to a hearing the ICA is holding Thursday as part of its regularly scheduled meeting to discuss self-insurer premium rates for 2023.
The ICA established a 2% administrative fund tax for 2023 with no special fund assessment.
As a result, the total tax and assessment rate for calendar year 2023 is 2%, a 0.25% increase...
While cuts, falls and strains make up a large portion of workers’ compensation claims for restaurants, injuries from a worker’s extremities being crushed, and injuries related to mental stress and fainting are on the rise post-2020, according to an analysis published Wednesday by AmTrust Financial Services Inc.
In studying injuries post-pandemic, comparing 2021 with 2019 as a baseline, AmTrust found that crushing injuries are up 89%; mental stress claims are up 71%, the largest jump historically; and fainting claims are up 61%. The report did not state costs related...
A divided Alabama Supreme Court ruled that a maintenance supervisor was entitled to summary judgment dismissing a worker’s claim that his hand injury was the result of the deliberate removal of a safety guard.
Clifford Bufford worked for Borbet Alabama Inc. as a maintenance technician at a wheel-manufacturing facility in Auburn for about 12 years.
One of his duties was servicing the recycling system that transformed metal chips and shavings back into usable material. The system included a machine known as the VSS300.
An auger and a vacuum pulled scrap metal through the VSS300 as the m...
Tuesday evening, October 4, in an in-person ceremony at the Paséa Hotel and Spa in Huntington Beach, CA.
Yvonne Guibert and Rafael Gonzalez, Esq. co-hosted the awards ceremony that took place on Paséa's Ocean Lawn with the sun setting over the Huntington Beach Pier. Yvonne Guibert, vice pre...
The West Virginia Supreme Court ruled that an insurance carrier did not have a right to intervene in a wrongful death case against its insured to assert a workers’ compensation immunity defense on behalf of the business.
Case: Praetorian Insurance Co. v. Chau, Nos. 21-0243 and 21-0682, 11/17/2022, published.
Facts and procedural history: Anh Kim Ho worked for Air Cargo Carriers LLC. She was serving as first officer on a flight when the plane crashed on May 5, 2017. Ho was killed.
The administratrix of her estate filed a wrongful death action in the Circuit Court of Kanawha County.
Ai...
The Montana Workers’ Compensation Court dismissed an alleged employer’s appeal of a determination that a worker was an employee and not an independent contractor.
Case: GuideTime Inc. v. Clinch, No. 2022-6000, 11/14/2022, published.
Facts and procedural history: Clinch filed a wage claim against GuideTime Inc. with the Department of Labor & Industry’s Employment Relations Division.
GuideTime responded, denying that Clinch was its employee and contending that the parties had a handshake agreement that he would be paid for his time in equity after the business they were ...
The California Workers’ Compensation Institute reported that data from the state Office of Self-Insurance Plans shows that reported claim volume for public self-insured employers increased 35% in the most recent fiscal year despite a less than 1% increase in the workforce.
CWCI said the medical-only claim count was up 29.9% in the 12-month period ending June 30, while the number of indemnity claims increased 38.1%.
“CWCI’s analysis of the data shows that with both medical-only and indemnity claim volume up steeply, public self-insureds’ total paid losses increased by ...
The Workers’ Compensation Insurance Rating Bureau of California named Sean Cooper executive vice president and deputy chief actuary.
Cooper will succeed outgoing WCIRB Chief Actuary Dave Bellusci, who is retiring in the spring.
In his new role, Cooper will serve as a member of the WCIRB senior leadership team and will be charged with leading the actuarial and research functions.
The WCIRB said Cooper brings more than 30 years of experience as an actuary and leader in various property and casualty insurance roles.
Most recently, he served as practice leader and senior actuary for ...
The Texas Division of Workers’ Compensation is extending its call for data on COVID-19 claims through the end of March.
The division on Dec. 6 issued a mandatory data call through the first quarter of 2023 for information related to COVID-19 injuries reported to selected insurance carriers on or after Dec. 1, 2019.
“To ensure that DWC has sufficient information to determine the impact of COVID-19 injuries on the Texas workers’ compensation system, DWC is extending the data call through March 31, 2023,” the agency said in a bulletin.
The division said only selected in...
A bill to expand the presumption of compensability for several types of cancers in certain first responders has been introduced in the Virginia General Assembly.
HB 1408, introduced Tuesday, would expand the presumption for certain emergency responders who have completed five years of service in their position and have been diagnosed with melanoma, non-Hodgkin’s lymphoma, bladder cancer or thyroid cancer, according to a summary of the measure.
The presumption would not apply to individuals diagnosed with a qualifying cancer before July 1, 2023.
The workers covered under the bill inclu...
The New Mexico Workers' Compensation Administration is seeking applications to fill two judicial vacancies — one in Albuquerque and another newly created position in Las Cruces.
Judges would be appointed to an initial one-year term with the possibility of reappointment to a subsequent five-year term.
Applicants must be licensed by and in good standing with the New Mexico Supreme Court and have five years of experience as practicing attorneys.
Attorneys interested in applying for the position must complete a judicial application and submit to the WCA with a resume and a legal ...
