Industry Insights
Malpractice by Utilization Review? | 12/19/2014 | ||
By: Dr. Robert Weinmann | |||
State: NA | Segment: Top | 0 | |||
Here's the story we're working on right now: a utilization-review physician with a California license is being challenged for a decision that is reported to have resulted in harm to a patient. As we go to press, here's what we know: 1) Patient X sustained a brain and spinal co...Read More | |||
Morales, Where Art Thou, Morales? | 11/14/2014 | ||
By: David Langham | |||
State: NA | Segment: Top | 0 | |||
What is Morales v. Zenith, and why is the Florida workers' compensation community watching for the Supreme Court's decision in that case? Perhaps the community is interested because they think that this case will be instructive. It is an interesting case in at least one regard: it...Read More | |||
Measuring Quality of Medical Care: More Urgent, Easier to Do | 10/13/2014 | ||
By: Peter Rousmaniere (Featured Columnist) | |||
State: NA | Segment: Top | 0 | |||
Why do occupational medicine clinics in Aurora, Colorado, vary so much in their quality of services to injured workers? The leading workers’ compensation insurer in the state, Pinnacol Assurance, names and rates the clinics in that city. You can find the scores at Pinnacol’s C...Read More | |||
Medicare Set-Aside Agreements Must be Crystal Clear to all Sides | 05/13/2014 | ||
By: Eugene Keefe | |||
State: IL | Segment: | 0 | |||
We consider this article required reading for all claims adjusters, risk managers, defense lawyers, and workers' compensation hearing officers across the country. In Paluch v. United Parce...Read More | |||
May 2014 Case Law Update | 05/07/2014 | ||
State: CA | Segment: | 0 | |||
JURISDICTION AND SUBROGATIONIn Smith v. New York Giants, 2014 Cal. Wrk. Comp. P.D. LEXIS 109, the WCAB declined to exercise jurisdiction over a professional football player's claim because his last two employment contracts provided that exclusive jurisdiction for resolving workers...Read More | |||
March Case Law Updates | 03/10/2014 | ||
State: CA | Segment: | 0 | |||
JURISDICTION AND SUBROGATIONIn Randle v. Seattle Seahawks, 2013 Cal. Wrk. Comp. P.D. LEXIS 621, the WCAB held that it had jurisdiction over a professional football player's workers' compensation claim even though the employment contract selected the state of Washington for all su...Read More | |||
Move to the Center? | 02/26/2014 | ||
By: Eugene Keefe | |||
State: IL | Segment: | 0 | |||
It is no secret to veteran readers of this KCB&A newsletter that we have been known to wield a sharp pen over the years when it comes to our critique of the hearing officers of our Illinois Workers’ Compensation Commission. While perhaps harsh at times, much of our criticism was meant to p...Read More | |||
More on Nurse Case Manager Selection | 01/03/2014 | ||
State: CA | Segment: | 0 | |||
Nothing ruins a Friday for a cold-hearted workers’ compensation defense attorney more than having to side with the arguments of an applicant. Well, probably a few things could make a Friday worse (like realizing that it’s only Thursday), but that’s one of the bad ones. So it is, as...Read More | |||
Myths about Obamacare and Workers' Comp | 11/25/2013 | ||
State: NA | Segment: | 0 | |||
The Obama administration has said that the Patient Protection and Affordable Care Act, enacted into law in 2010 and scheduled to take effect on Jan. 1, will reduce workers’ comp claims because so many additional people will be covered under personal insurance policies. But there is reason to t...Read More | |||
Medicare May Seek Upfront Reimbursement of Conditional Payments | 09/20/2013 | ||
By: Heather Schwartz | |||
State: NA | Segment: | 0 | |||
Some of us in the industry may remember an interesting case back from May of 2011 where a class of Medicare beneficiaries successfully obtained an injunction against the Centers for Medicare and Medicaid Services (CMS) for certain conditional payment reimbursement practices. The two conditional paym...Read More | |||