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OH - Supreme Court: Change in Precedent on TTD Awards Applies Prospectively

12/06/2022 | 0

The Ohio Supreme Court ruled that its precedent which changed the way temporary total disability is awarded to workers who voluntarily leave the workplace applies prospectively only. Dianna L. Hixson worked for Walmart Inc. She suffered injuries at work in August 2017. The Bureau of Workers’ Compensation determined that she was entitled to benefits for a left shoulder sprain/strain, a left wrist sprain/strain and a left wrist contusion. Hixson applied for temporary total disability benefits in November 2017. A district hearing officer denied the request, and Hixson appealed. A staff ... Read More

MN - Supreme Court Overturns Denial of Fee Award to Injured Worker

12/06/2022 | 0

The Minnesota Supreme Court overturned a denial of attorney fees to counsel for an injured man, finding the worker had a “genuinely disputed” claim. Case: Lagasse v. Horton, No. A21-1745, 11/30/2022, published. Facts and procedural history: Larry Horton worked for Aspen Waste Systems Inc. He suffered severe injuries in June 2017 when he was run over by a garbage truck. Horton hired attorney C. Jeremy Lagasse to pursue a workers’ compensation claim on his behalf. Horton agreed that Lagasse would receive up to 20% of the benefits recovered as a fee for his services. Followi... Read More

WY - Truck Driver Has Immunity From Civil Liability to Injured Co-Employee

12/06/2022 | 0

The Wyoming Supreme Court ruled that a truck driver was immune from civil liability to a co-employee he accidentally ran over at a job site. Case: Lovato v. Case, No. S-22-0053, 12/01/2022, published. Facts: Augustine Lovato, Tim Case and Ricky Bustos all worked for Knife River on a construction project at F.E. Warren Air Force Base near Cheyenne. Bustos was Knife River's foreman on the job and acted in a supervisory role. Case operated a truck that transported wet concrete to the job site, and Lovato worked with a crew forming and finishing the wet concrete. On June 19, 2017, Bustos d... Read More

PA - Misclassification Task Force Issues Final Report, Recommendations for Lawmakers

12/06/2022 | 0

Pennsylvania Department of Labor & Industry Secretary Jennifer Berrier announced that the Joint Task Force on Misclassification of Employees submitted its final report to the General Assembly, including 15 unanimous recommendations. The task force is recommending that lawmakers consider actions that would include expanding a workplace misclassification act beyond the construction trades to cover other industries in the state and adopting a single test to differentiate employees and independent contractors. The group is recommending lawmakers mandate that state agencies be directed to... Read More

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Press - 2022 Comp Laude® Award Winners Revealed in Huntington Beach

10/05/2022 | 0

Huntington Beach, CA - October 5, 2022: The 2022 Comp Laude® Award recipients were revealed CompLaude Award WinnersTuesday 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... Read More

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NATL. - Paduda: Pandemic's Impact on Workers' Comp Financials

By Joe Paduda
12/06/2022 | 0

A new report ($25 to download) from the National Foundation for Unemployment Compensation and Workers’ Compensation sheds light on the pandemic’s impact on work comp financials. Managed Care Matters readers will not be surprised that the impact has been pretty positive; Mark Priven and I predicted this back in September 2020. Several key takeaways: Medical costs plummeted — by more than $3.5 billion — almost 12%, likely due to lower employment resulting in fewer claims, coupled with the relatively lower cost of COVID... Read More

MO - Proposal to Privatize MEM Resurfaces

12/06/2022 | 0

Missouri lawmakers appear slated to once again deliberate mandating the transformation of a state-chartered workers’ compensation carrier into a private mutual insurance company when they convene in 2023. State Rep. Alex Riley, R-Springfield, on Dec. 1 pre-filed House Bill 277, which would order Missouri Employers Mutual Insurance Co. to convert from an independent public corporation to a private mutual insurance corporation before Jan. 1, 2025. While proposals to privatize Missouri’s state-chartered carrier surfaced in 2020 and again in 2021, Riley’s measure differs fr... Read More

CA - Actuarial Committee Meets Thursday

12/06/2022 | 0

The Workers’ Compensation Insurance Rating Bureau of California’s Actuarial Committee will meet virtually at 9 a.m. on Thursday. Committee members will discuss a review of paid and incurred loss development methods and retrospective rating plan updates. Members will also discuss a telehealth study and an updated study of characteristics associated with COVID-19 claims. The committee is also meeting today to discuss the experience of large-deductible policies, the pandemic’s impact on classification relativities, and insurer experience valued as of Sept. 30. The full agenda... Read More

NV - Emergency Rule Allows Lump Sum Settlement When Doesn't Exceed 30%

12/06/2022 | 0

The Nevada Division of Industrial Relations on Monday announced the adoption of an emergency rule that will allow injured workers with a permanent partial disability of up to 30% to accept a lump sum settlement. The emergency rules that will be in effect for 120 days will apply to anyone injured on or after July 1, 2017. The division said one of its statutory obligations is to regulate the manner in which carriers approve and reject claims, as well as how they pay benefits. “To that end, the proposed emergency regulation seeks to protect the rights of injured workers so that they have... Read More

CA - Gemini Purchases Sayler Legal Service

12/06/2022 | 0

California-based Gemini Legal Support announced that it purchased process-serving and records-retrieval firm Sayler Legal Service. Sayler Legal Service is headquartered in Monterey and was founded in 1991. The company provides process serving, e-filing, records retrieval and other services. "We recognized some time ago that expanding into areas of civil law is a natural and desirable progression for Gemini, and we have grown the business to align with this vision," Tony Daugherty, president at Gemini Legal, said in a statement. "Acquiring Sayler helps us meet civil law att... Read More

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Press - Workers Compensation Benchmarking Study Launches 2022 Claims Performance Survey and Prepares to Deliver 10-Year Industry Report Card

10/17/2022 | 0

October 17, 2022 Chicago, IL The Workers Compensation Benchmarking Study, the largest national research program investigating top issues impacting claims organizations today, has released its annual survey, inviting claims leaders to once again participate in important industry research that will be published in its 2022 Report. Prior to launching the study over a decade ago, there was no survey-based assessment tool focused on claims organizational performance and strategy, said Rachel Fikes, said Rachel Fikes, chief experience officer and study program director at Rising Me... Read More

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NATL. - United Heartland, Third Coast Underwriters Align Services

12/06/2022 | 0

United Heartland and Third Coast Underwriters announced a strategic alignment that the companies said leverages the expertise of both divisions to create efficiencies for middle-market businesses. United Heartland and Third Coast Underwriters will align underwriting and marketing efforts into two state-focused divisions: Midwest and East. Tracy Bain, who joined United Heartland in 2012, will serve as divisional director of the Midwest division, overseeing the Chicago, Milwaukee, Wisconsin, and Kansas City, Missouri, regions. Dana Pierce, who joined United Heartland in 2007, will serve as... Read More

FL - Cop Entitled to Benefits for PTSD Under Law Effective After Injury-Causing Event

12/05/2022 | 0

A Florida appellate court said a police officer who filed a claim for post-traumatic stress disorder after responding to a school shooting that left 17 people dead was eligible for indemnity benefits because while the incident happened before a change in state law, his disability didn’t begin until he was placed on administrative leave. Matthew Casey was a police officer for the City of Hallandale Beach. He was among the officers who responded to the school shooting at Marjory Stoneman Douglas High School in February 2018. While helping to clear students and secure the building, Casey ... Read More

FL - Court Says Physicians With Different Certifications Can Be in Same 'Specialty'

12/05/2022 | 0

A Florida appellate court ruled that a judge of compensation claims found that an employer did not authorize an appropriate one-time change physician for a worker’s finger injury based solely on the fact that the doctors had different board certifications. Case: B&A Gourmet Foods LLC v. Mora-Abreu, No. 1D20-2943, 11/30/2022, published. Facts: Yeimy Mora-Abreu worked for B&A Gourmet Foods. She suffered an injury to her left index finger while working with a food press. After receiving emergency care at a local hospital, she was evaluated by Dr. Raul Cortes. He is board certifie... Read More

MD - High Court Clarifies 'Definite Proof' Standard for Hernia Claims

12/05/2022 | 0

In a case of first impression, Maryland’s highest court ruled that the "definite proof” that a worker must show in a hernia claim applies to the quality of evidence that he must submit as part of his burden of production. Case: United Parcel Service v. Strothers, No. 9, 12/01/2022, published. Facts: David Strothers worked for United Parcel Service. He injured himself at work in 2016 while attempting to dislodge a jam on a sorter. Dr. Joshua B. Macht determined Strothers had suffered a left inguinal hernia and umbilical hernia, and he attributed them to Strothers’ ... Read More

OR - Mattress Retailer Cited for Willfully Exposing Workers to Vehicle Safety Hazards

12/05/2022 | 0

Oregon’s Occupational Safety and Health Division fined a mattress retailer more than $66,000 for exposing its workers to serious injury or death from potential traffic accidents by allegedly forcing them to use a truck without windshield wipers or a working seat belt. The agency commonly known as Oregon OSHA said it cited Mattress Megastore in Hillsboro following an inspection prompted by a confidential complaint. The inspection found the employer reportedly exposed workers to potential traffic accidents by requiring them to operate a 1-ton delivery truck the agency said was clearly uns... Read More

TX - Janitorial Business to Pay $180,000 in Restitution for Fraud

12/05/2022 | 0

HSC International Ltd. was ordered to pay $180,000 in restitution after pleading guilty to premium fraud allegations, the Texas Department of Insurance announced. HSC International, a janitorial company based in Frisco, was accused of providing false payroll information to Texas Mutual Insurance Co. to fraudulently reduce its workers’ compensation premiums from Sept. 2, 2014, through Dec. 5, 2016. The corporation pleaded guilty to the felony fraud charge and was convicted last week. “The workers’ compensation system is participant-funded, and when a bad actor defrauds the ... Read More

MO - Lawmakers Again Introduce PTSD Legislation

12/05/2022 | 0

Following four years of efforts to provide first responders with coverage for post-traumatic stress disorder, Missouri lawmakers are set to consider another bill that would classify the condition as an occupational illness. HB 164, filed Thursday, would recognize PTSD as an occupational disease for first responders. State lawmakers considered similar bills in 2019, 2020, 2021 and earlier this year. Each failed to gain traction, although at least one effort was successful in highlighting mental health struggles among first responders. In 2021, Missouri Gov. Mike Parson signed SB 57 and HB 8,... Read More