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Top Stories

NATL. - Doctor Shortages, Behavioral Treatment ID'd as Hot Topics for Work Comp

By Elaine Goodman (medical/business Reporter)
11/18/2019 | 489 | 0 | 27 min read

Marijuana, opioids and telemedicine have been hot issues this year in workers’ comp medical treatment, and they’re expected to remain so in 2020. But topics such as doctor shortages and different types of behavioral therapy may also be drawing more attention in the new year. A looming shortage of doctors, fueled in part by physician retirements, is expected to hit workers’ comp especially hard, Healthesystems said in an article in its RxInformer publication last week. Doctors who treat injured workers face a highly regulated environment and stringent requirements, ... Read More

NATL. - Cut to Discount Rate Means Largest Hike in Comp Expenses for Postal Service

By William Rabb (Reporter)
11/18/2019 | 154 | 0 | 25 min read

Almost since the day he took office, President Donald Trump has urged the Federal Reserve to cut interest rates. This year, the Fed has complied, trimming rates three times and reversing all of its rate increases for 2018. The move may be good for borrowers and the economy as a whole, but it has had a paradoxical effect on some federal agencies: Lower interest rates have triggered one of the largest increases in workers' compensation expenses for the U.S. Postal Service in more than a decade. The Postal Service released its fiscal 2019 10-K annual financial report last week and it shows ... Read More

CA - Court Revives Civil Suit Against Homeowner Over Tree Trimmer's Injuries

11/18/2019 | 627 | 0 | 29 min read

A California appellate court revived an injured worker’s civil suit against a homeowner, finding there was a triable question as to whether he qualified as the homeowner’s employee for purposes of the Labor Code’s exclusive remedy provision. Case: Contreras-Perales v. Bruno, No. D073742, 11/14/2019, unpublished. Facts: David Contreras-Perales operated a yard maintenance business. He provided routine services to several clients, including Lois Ann Bruno. In December 2014, Bruno asked Contreras-Perales to trim five trees on her property. The trees measured more than 15 ... Read More

AR - Deputy Sheriff Asserts Timely Claim for Additional Benefits

11/18/2019 | 106 | 0 | 29 min read

A divided Arkansas Court of Appeals ruled that a “linguistic technicality” did not bar the Workers’ Compensation Commission from finding that an injured deputy sheriff had timely asserted a claim for additional benefits. Case: White County Judge v. Menser, No. CV-19-148, 11/06/2019, published. Facts and procedural history: Bruce Menser worked as a patrol deputy for the White County Sheriff's Office. In December 2013, he suffered injuries from exposure to fumes when his patrol car's battery exploded. Menser did not formally file a workers’ compensation cl... Read More

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NJ - Geaney: Requirements of New Supplemental Benefits Law for Dependents of Public Safety Workers

By John H. Geaney
11/18/2019 | 95 | 0

Effective June 17, 2019, N.J.S.A 34:15-95.6 became law in New Jersey. This law applies to dependents of public safety workers, who are defined as officers of a paid, partially paid or volunteer fire or police department, force, company or district, including the State Police or a first aid or rescue squad.  The purpose of this law is to increase dependency benefits for those who received awards after Dec. 31, 1979.  The statute calls these benefits “supplemental benefits,” not cost-of-living adjustment benefits. The statute does not require the s... Read More

FL - JCC Has No Basis to Reject Expert Medical Adviser's Opinion

11/18/2019 | 135 | 0 | 37 min read

A Florida appellate court overturned the denial of a worker’s petition for additional benefits, finding the judge erred in rejecting an expert medical adviser’s opinion that the man was not yet at maximum medical improvement. Case: Olvera v. Hernandez Construction of SW Florida Inc., No. 1D19-0500, 11/15/2019, published. Facts and procedural history: Angel Olvera worked for Hernandez Construction of SW Florida Inc. He suffered an injury to his arm when he fell from a roof in 2015. Hernandez accepted liability for the injury and authorized treatment with Dr. Patrick Leach, who pe... Read More

NJ - Report: State Seeks $650M in Unpaid Taxes From Uber

11/18/2019 | 145 | 0 | 10 min read

The New Jersey Department of Labor said Uber Technologies Inc. owes the state about $650 million in unemployment and disability insurance taxes due to the misclassification of drivers as independent contractors. The $650 million includes $523 million in past-due taxes from the last four years for Uber and subsidiary Rasier LLC, plus as much as $119 million in interest and penalties on the unpaid amounts, Bloomberg Law reported. An Uber spokeswoman told Bloomberg Law that the company is challenging the “preliminary but incorrect determination.” The spokeswoman said drivers in New ... Read More

KY - Discount Rate on Settlements Drops Sharply for 2020

11/18/2019 | 106 | 0 | 26 min read

The discount rate used to calculate lump-sum settlements will drop sharply beginning in January, the Kentucky Department of Workers' Claims announced Thursday. Under Kentucky's two-tiered rate structure, settlements of $40 or less per week are set at the rate paid on 10-year U.S. Treasury Notes, as of Aug. 1. For settlements that pay more than $40 per week, the rate is a half-point lower. That means that for 2020, the discount rate will drop from 2.875% to 1.625% for settlements of $40 or less per week. For larger payments, the rate will drop from 2.375% to 1.125%. The dep... Read More

CA - DWC Seeks Physician to Serve on P&T Committee

11/18/2019 | 194 | 0 | 8 min read

The California Division of Workers’ Compensation is inviting physicians to apply for a vacant spot on its Pharmacy and Therapeutics Committee. California licensed physicians — medical doctors or doctors of osteopathy — are eligible for the volunteer position, which has an initial term of two years. The application deadline is Jan. 3. The Pharmacy and Therapeutics Committee advises DWC’s administrative director on updates and improvements to the Medical Treatment Utilization Schedule’s drug formulary. The committee meets at least quarterly. DWC Executi... Read More

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Press - The California Self-Insurers Association is Soliciting Speaker Proposals

11/15/2019 | 83 | 0

The California Self-Insurers Association is soliciting speaker proposals for their 2020 Annual Meeting which will be held on April 20th and 21st at the Disneyland Resort in Anaheim, CA. The theme for the 2020 Annual Meeting is: Exceeding the Vision: Are You On The Right Path To A Successful Self-Insurance Program? Selection criteria for speakers to consider are:   Selection Criteria: All presentations must focus on ways for self-insured employers to improve the governance of their workers' compensation programs. We are specifically looking for topics that have the "how ... Read More

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CA - DWC Posts Reminder for 2019 Annual Report of Inventory

11/18/2019 | 174 | 0 | 62 min read

The California Division of Workers’ Compensation reminds claims administrators that report of claim counts for calendar year 2019 is due April 1. Claims administrators are required to file an annual report of inventory indicating the number of claims at each adjusting location for the preceding calendar year. Even if no claims were reported in the prior year, the report must be completed and submitted to the division’s DWC Audit Unit. Each adjusting location is required to submit an ARI unless the division has waived the reporting requirement. When ARI requirements are waiv... Read More

CA - WCAB: Med-Legal Claimant Must Prove Necessity, Even if Payer Doesn't Issue EOR

11/15/2019 | 1664 | 0 | 72 min read

Medical-legal lien claimants are required to prove that expenses were reasonably and necessarily incurred to collect on a lien in California, and a payer that fails to cite reasonableness or necessity as an objection to a bill doesn’t forfeit the right to raise those defenses at a lien conference, the Workers’ Compensation Appeals Board said in an en banc decision published Thursday. The unanimous decision in Colamonico v. Secure Transportation et al. ordered additional proceedings to develop the record and determine whether the $1,151.07 claimed by Med-Legal Photocopy was for ser... Read More

VA - State Sees 14% Drop in Professional Services Costs After Fee Schedule

By William Rabb (Reporter)
11/15/2019 | 255 | 0 | 26 min read

States that are struggling to keep a lid on medical costs may want to take a look at Virginia's fee schedule, which has cut costs for professional services significantly in just one year. In a webinar held this week, the Workers Compensation Research Institute reported that since Virginia's much-debated fee schedule took effect in January 2018, reimbursement for physicians and other providers dropped 14% from 2017 prices. For some services, such as minor radiology, pain management injections and emergency treatment, the prices dropped by more than 20%, the institute's r... Read More

NATL. - Cloud Security a Growing Concern for Insurers

By Elaine Goodman (medical/business Reporter)
11/15/2019 | 236 | 0 | 12 min read

As more insurance carriers make the move to cloud-based systems, information technology experts are predicting that cloud security will become a greater focus in the coming year. “What we’re seeing is an increase in spending on cybersecurity across the board,” said Jonathan Victor, chief information officer at Insurity. “I think that’s just going to accelerate.” Data security and privacy are no longer afterthoughts, Victor said. Instead, systems are being designed with security in mind from the start. “These concepts are included from day one, from ... Read More

CA - Court Rejects Worker's Malpractice Suit Against Former Attorney

11/15/2019 | 1021 | 0 | 36 min read

A California appellate court ruled that an injured bookkeeper waited too long to file a malpractice suit against her former workers’ compensation attorney for failing to timely pursue a claim. Case: Marenstein v. Sieder, No. B289426, 11/13/2019, unpublished. Facts and procedural history: Deanna Pimes Marenstein worked as a bookkeeper and legal assistant at her husband's law firm, Lewis, Marenstein Wicke & Sherwin. The firm represented Marenstein in a workers’ compensation claim for injuries she sustained in 1999 and 2000. In 2001, the firm settled the claim with its... Read More

NC - Guaranty Association Can Get Reimbursement for Deductible

11/15/2019 | 135 | 0 | 85 min read

The North Carolina Court of Appeals ruled that the state Insurance Guaranty Association was entitled to reimbursement from an employer for amounts advanced toward the deductible in a now-defunct carrier’s policy. Case: North Carolina Insurance Guaranty Association v. Weathersfield Management LLC, No. COA19-300, 11/05/2019, published. Facts: Weathersfield Management LLC is a regional staffing company that filed for protection under Chapter 13 of the U.S. Bankruptcy Code.  The bankruptcy filing made it difficult for Weathersfield to obtain workers’ compensation insurance... Read More

MD - Court Clarifies Compensability Requirements for Hearing Loss, Tinnitus

11/15/2019 | 184 | 0 | 59 min read

The Maryland Court of Special Appeals upheld an award of benefits to two firefighters for their industrial hearing loss but overturned the award for one’s tinnitus. Case: Montgomery County v. Cochran, Nos. 662 and 2930, 11/01/2019, published. Facts: Anthony Cochran and Andrew Bowen were firefighters for Montgomery County for more than 30 years. Both retired in 2013 and filed workers’ compensation claims asserting they had suffered hearing loss in the course of their employment. Bowen also asserted a claim for tinnitus, a condition commonly described as a ringing in the ears.... Read More