LA - Worker Gets Benefits, Fees, Penalties for Offer of Inappropriate Job
03/27/2024 |
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A Louisiana appellate court upheld a finding that a worker was entitled to benefits, fees and penalties because her employer failed to offer her a suitable position after she twice injured her shoulder at work.
Gaynell Finister worked as an environmental services supervisor at the Golden Nugget in Lake Charles. In November 2018, Finister sustained a shoulder injury at work while attempting to break up an altercation between two employees. GNLC paid her benefits for the injury.
Just eight days after returning to work, Finister sustained a second shoulder injury when reaching to grab her ...
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WV - Supreme Court Finds Miner's Pneumoconiosis Didn't Contribute to His Death
03/27/2024 |
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The West Virginia Supreme Court upheld a determination that a worker’s occupational pneumoconiosis did not materially contribute to his death.
Case: Delung v. Speed Mining LLC, No. 22-0145, 03/20/2024, published.
Facts: Russell Delung worked for Speed Mining LLC. He died in July 2015 at the age of 60.
His death certificate stated that the immediate cause of death was metastatic squamous cell carcinoma due to stage 4 esophageal carcinoma. The other significant conditions listed as contributing to Delung's death were anemia, leukocytosis and hypertension.
Procedural histo...
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NY - Worker, Defendants Each Get Partial Summary Judgment on Labor Law Claims
03/27/2024 |
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A New York appellate court ruled that a worker was entitled to partial summary judgment on his Labor Law claim but that the defendants were also entitled to dismissal of some of his claims.
Case: Linares v. Massachusetts Mutual Life Insurance Co., No. 150159/18, 03/21/2024, published.
Facts: Capital Builders Group Inc. was the general contractor on a project to renovate residential apartments. Capital hired Tolmac Contracting Inc. as a subcontractor to do drywall, taping and compound work.
Jose Linares worked for Tolmac. He was injured in a fall while performing taping and compoun...
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NY - Court Tosses Employer's Challenge to Board's Interpretation of Subpoena Rules
03/27/2024 |
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A New York appellate court tossed an employer’s appeal challenging a decision by the Workers’ Compensation Board regarding its interpretation of the statutory and regulatory scheme of issuing subpoenas for the deposition of medical providers.
Case: Matter of Talarico v. Niagara County Department of Social Services, No. 535782, 03/21/2024, published.
Facts: Deborah Talarico was a caseworker for the Niagara County Department of Social Services. She slipped and fell while leaving a home visit with a client and allegedly sustained injuries to her lower back, left hip and left elbow.
...
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Press - Centre for Neuro Skills Study Finds Differences in Sleep Patterns Between Men and Women with Post-Traumatic Brain Injury
03/05/2024 |
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Centre for Neuro Skills Study Finds Differences in Sleep Patterns
Between Men and Women with Post-Traumatic Brain Injury
Incidental finding indicates Melatonin helps post-acute TBI patients achieve longer REM sleep
Bakersfield, Calif. (Mar. 5) Centre for Neuro Skills?(CNS), a premier provider of traumatic and acquired brain injury rehabilitation services, has shared findings from a study researching sleep-wake disturbances, published in Neurotrauma Reports on January 3, 2024. They found that sleep deficits are correlated with poorer brain injury patient outcomes (verbal ...
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NATL. - Langham: Shootings and Compensability
By David Langham
03/27/2024 |
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Three shootings. Three examples. An opportunity to discuss the interaction of "arising out of "and the parallel requirement of "course and scope."
Too often, there is confusion between these two distinct tests. The confusion is due in large part to poor appellate analysis and intermingling. The three examples for this conversation today include the instance in New Mexico in which actor and producer Alec Baldwin stands accused. Today, I address recent instances in the case law and news.
We begin here in Florida with last August's Normandy Ins. Co. v. Boua...
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ME - Insurance Bureau Cuts Loss Costs by 19%
03/27/2024 |
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The Maine Bureau of Insurance approved a 19% average loss cost decrease for policies incepting on or after April 1.
“If all insurers fully adopt the decrease, Maine businesses could save an estimated $55 million in the year following implementation,” the bureau said in a statement.
The 19% decrease is the average loss cost change. The bureau said decreases range from 17.1% to 20.1% depending on the industry group.
Loss costs are based on previous and projected losses and benefit payments, the bureau said.
Carriers can use the adopted loss costs or set their own rate levels, sub...
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NATL. - NCCI: Influence of Wage on TD Duration Depends on Claimant Age
03/27/2024 |
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The National Council on Compensation Insurance said that though high-wage earners typically have longer temporary disability duration than low-wage earners, the influence of pay on TD duration depends on the injured worker's age.
Across all age groups, average TD duration was longest for high earners — those making more than 150% of their state’s average weekly wage at the time of injury — and shortest for those earning less than 50% of their state’s average weekly wage when they were hurt.
“Looking solely at the average duration for each age ...
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LA - Bills Propose Penalty for Unreasonable Denial, Presumption of Compensability After 90 Days
03/27/2024 |
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Louisiana lawmakers have introduced bills that would presume that claims are compensable if they haven’t been denied within three months, and to allow employers to seek penalties and attorney fees when they have to recover health care payments after a work comp claim is unreasonably denied.
House Bill 769, by Rep. Neil Riser, R-Columbia, would create a civil liability for unreasonable denials of medical treatment.
Louisiana law already requires any health insurer that contracts to provide health care benefits for employees to pay for medical care if the workers’ compensation paye...
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CA - DWC Posts 2nd Quarter Adjustments to OMFS
03/27/2024 |
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The California Division of Workers’ Compensation posted an order updating the physician and nonphysician practitioner section of the Official Medical Fee Schedule to incorporate changes made by Medicare.
The division said the order adopts several changes the Centers for Medicare and Medicaid Services made for the second quarter of 2024, including:
CMS’ Medicare National Physician Fee Schedule Relative Value file effective April 1, quarterly update — RVU24B.
CMS’ ZIP code to carrier locality files effective April 1, quarterly update for locality mapping.
Updated pr...
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Press - Centre for Neuro Skills Promotes Nicholas Ashley to Chief Governance Officer
03/13/2024 |
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Centre for Neuro Skills Promotes Nicholas Ashley to Chief Governance Officer
Bakersfield, Calif. (March 13, 2024) - Centre for Neuro Skills (CNS), a leader in traumatic brain injury and stroke rehabilitation services, today announced the promotion of Nicholas Ashley, J.D., M.D.R., to chief governance officer.
Nick has been instrumental to the growth and expansion of CNS, says David Harrington, president and chief executive officer of Centre for Neuro Skills. Im excited to continue working closely with him to advance patient care.
During his 11-year tenure at CNS, Ashley serve...
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NC - Split Supreme Court Endorses 'Directly Related' Test for Compensability of Treatment
03/26/2024 |
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The North Carolina Supreme Court expressly adopted a long-standing Court of Appeals precedent using the "directly related" test to determine whether the causal connection required for treatment to be compensable has been satisfied.
Robin Kluttz-Ellison worked at Noah's Playloft Preschool. She filed two workers’ compensation claims for two workplace falls. The Industrial Commission consolidated the claims.
Kluttz-Ellison had undergone a knee arthroplasty before her workplace accidents and struggled with weight issues for years.
After her falls, her doctors determined that...
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NE - Supreme Court Tosses Injured Worker's Wrongful Termination Claim Against Public Employer
03/26/2024 |
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The Nebraska Supreme Court threw out an injured worker’s wrongful termination claim against her public employer, finding the decision to fire her involved an element of judgment of the type that the Legislature intended to shield from tort action.
Case: Simpson v. Lincoln Public Schools, No. S-23-490, 03/22/2024, published.
Facts: Lynne Simpson worked for Lincoln Public Schools as an at-will employee.
In August 2017, Simpson sustained an injury at work. She filed workers' compensation forms with LPS to be reimbursed for examinations and treatment. While reviewing Simpson's med...
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WV - Supreme Court Denies Additional Impairment for Coal Miner With Crush Injury
03/26/2024 |
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The West Virginia Supreme Court upheld a determination that a coal miner was not entitled to additional disability for a crush injury to his left leg and foot.
Case: Workman v. Patriot Coal Corp., No. 22-617, 03/20/2024, published.
Facts: Charles Workman worked for Patriot Coal Corp. as an underground miner. He suffered a severe crush injury to his left leg and foot in August 2014.
Workman underwent multiple surgeries to provide internal fixation of the bones, then saw Dr. Prasadarao B. Mukkamala for an independent medical evaluation in March 2018.
Mukkamala opined that Workman had a 13% w...
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NY - Court Partially Revives Labor Law Claim for Worker's Grinder Accident
03/26/2024 |
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A New York appellate court partially revived a worker’s Labor Law claim for his injuries from a malfunctioning grinder.
Case: Desprez v. United Prime Broadway LLC, No. 156088/20, 03/21/2024, published.
Facts: Richard Desprez was injured while using a grinder on a construction project. He was standing on a ladder using the grinder to cut a metal plate at chest height when the grinder began shaking and kicked back, striking his face. Although the ladder moved after the grinder malfunctioned, it did not fall or collapse, nor did Desprez fall because he held on to a wooden beam, ...
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CA - CDI Hearing on Regulatory Filing Set for April 25
03/26/2024 |
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The California Department of Insurance will hold a public hearing on the Workers’ Compensation Insurance Rating Bureau’s annual regulatory filing April 25.
The WCIRB’s regulatory filing proposes changes to wage and payroll limitations and dual wage thresholds in the Standard Classification System and would also start experience rating COVID-19 claims.
“With respect to the proposed amendments to the (Uniform Statistical Reporting Plan) and (Experience Rating Plan) to sunset the exclusion of COVID-19 claims with accident dates on or after Sept. 1, 2024, it should be not...
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CA - DA: Former City Worker Stole More Than $627,000 With Phony Comp Audits
03/26/2024 |
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A former human resources worker in San Francisco allegedly stole more than $627,000 from the city’s self-insured workers’ compensation fund by using a fake business in Illinois to charge for auditing services that were never provided, the District Attorney’s Office announced.
Stanely Ellicott, 38, was the assistant director of finance and technology for the workers’ compensation division of the city’s Human Resources department where one of his responsibilities was to oversee the financial integrity of the comp program. He allegedly enlisted a friend to create a ...
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CA - Amended Bill Would Tap Revolving Fund to Pay for Heat Injury Presumption
03/26/2024 |
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A one-time transfer of $5 million from the Workers’ Compensation Administration Revolving Fund would be used to establish an account to cover administrative costs associated with a proposed heat injury presumption for California farmworkers, under a recently amended bill.
Sen. Dave Cortese, D-Campbell, on Thursday amended SB 1299 to add language that would presume compensability for all heat-related injuries where the employer failed to comply with heat illness prevention standards.
The bill would also authorize taking $5 million from the revolving fund, an account financed through sur...
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