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Workers' Compensation News


 
Measuring Quality of Medical Care: More Urgent, Easier to Do 10/13/2014
State: NA | Segment: Top | 515 | 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: | 444 | 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: | 1173 | 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: | 616 | 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: | 389 | 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: | 427 | 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: | 369 | 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: | 403 | 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
 
 
Must the Adjuster Ask for Settlement Authority from the Insured? 09/04/2013
By: James J. Moore
State: NA | Segment: | 470 | 0
One of the most repeated comments we hear when reviewing claims-loss runs is an adjuster settled or agreed to accept a file without the insured agreeing to the settlement. We often hear that an adjuster increased the reserves to a very high level without consulting the employer.Almost al...Read More
 
 
Medicare-Based Fee Schedules and Work Comp 07/30/2013
State: NA | Segment: | 339 | 0
Medicare bases the physician fee schedule, known as the Resource-Based Relative Value Scale, on estimates of how much time it takes docs to do specific things, plus their operating expenses adjusted for regional cost factors. That’s a gross oversimplification but close enough (more on the deta...Read More
 
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