OH - Supreme Court Denies Loss-of-Use Award to Worker With Incomplete Paraplegia
05/06/2024 |
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The Ohio Supreme Court upheld a determination that a worker with incomplete paraplegia was not entitled to a loss-of-use award for his legs because he retained at least some ability to walk.
Billy Ottinger worked for B&B Wrecking & Excavation Inc. He injured his spinal cord in a fall from a roof in June 2018.
The Bureau of Workers’ Compensation allowed Ottinger’s claim for multiple injuries, including incomplete paraplegia.
Ottinger had some sensation in his lower extremities when he arrived at the emergency room, but he was unable to move his legs. He regained some...
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DC - Court Partially Overturns Award as Lacking Adequate Explanation for Rejecting Opinion
05/06/2024 |
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The District of Columbia Court of Appeals partially overturned an award of benefits that was based on the opinion of an independent medical examiner, ruling that there was no adequate explanation for why the treating physician’s ratings were rejected.
Case: Alston v. DOES, Nos. 22-AA-0957 and 23-AA-0001, 05/02/2024, published.
Facts: Connie Alston worked as a train operator for the Washington Metropolitan Area Transportation Authority. Alston injured her right arm and shoulder at work in March 2018.
After nearly three years of treatment, Dr. Joel Fechter reported in June 2021 that Als...
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NY - Worker Gets Summary Judgment on Labor Law Claim for Wood-Cutting Accident
05/06/2024 |
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A New York appellate court upheld a grant of summary judgment for a worker on his Labor Law claim arising from a wood-cutting accident.
Case: Cevallos v. WBB Construction Inc., No. 2022-01655, 05/01/2024, published.
Facts: Hernan Cevallos allegedly suffered injuries while working on a construction site trying to cut a piece of wood.
WBB Construction Inc. was the general contractor for the project, and Madison 33 Owner LLC owned the property.
According to Cevallos, he had been instructed to cut the wood, but he was unable to reach it from the ground. He found an A-frame ladder in his w...
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NY - Worker, Property Owner Get Partial Summary Judgment in Labor Law Action
05/06/2024 |
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A New York appellate court ruled that a worker was entitled to partial summary judgment on his Labor Law claims and that the individual owners of the property were entitled to summary judgment dismissing the indemnification claims against them.
Case: Guaman-Sanango v. 57 East 72nd Corp., Nos. 2021-04831 and 2022-03624, 05/01/2024, published.
Facts: Segundo Guaman-Sanango worked for GSK Contracting Corp. He allegedly was injured when he fell from a ladder while doing renovation work in an apartment.
The building was owned by 57 East 72nd Corp., and Rialto Management Corp. managed the bu...
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Press - Sullivan on Comp Launches ChatSOC, an Innovative Chatbot for California Workers' Compensation Professionals, Integrated with Authoritative Legal Treatise
04/22/2024 |
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LOS ANGELES, April 22, 2024 - Sullivan on Comp, the leading comprehensive digital resource on California workers' compensation law, proudly announces the launch of ChatSOC, an advanced chatbot designed to streamline workers' compensation inquiries for professionals in the field. Officially launching today, ChatSOC integrates directly with the Sullivan on Comp digital treatise, provid...
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Industry Insights
NATL. - Moore: Experience Mod Catastrophe
By James Moore
05/06/2024 |
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Every week, J&L Risk Management Consultants receives an employer inquiry on what is becoming a workers' comp experience mod catastrophe. Let us look at how it happened to many employers.
The employers’ situations are striking similar. A similar article I published in 2017 on this subject is worth a look.
Contacts from insurance agents, hoping to assist their insured clients with avoiding this catastrophe, increased by at least 60% since 2015.
Let us look first at the three experience mod levels. They are:
Below 1.0 — credit mod, not a pro...
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CA - Assembly Passes E-Signature Bill
05/06/2024 |
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The California Assembly unanimously passed a bill that would treat electronic signatures the same as traditional wet signatures for Workers’ Compensation Appeals Board proceedings.
The Assembly on Thursday voted 73-0 to pass AB 2337, by Assemblymember Diane Dixon, R-Newport Beach. The bill would amend the definition of signature to include electronic records and electronic signatures for WCAB hearings. The bill would also allow signature requirements in the Labor Code to be satisfied by an electronic signature.
“Electronic signatures were used effectively in workers’ compen...
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FL - Governor Signs Bill to Set Reimbursement for Emergency Services at 250% of Medicare
05/06/2024 |
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Florida Gov. Ron DeSantis signed a bill that requires workers’ compensation payments for emergency services that aren’t subject to a maximum reimbursement allowance be set at 250% of what Medicare pays for the same service.
DeSantis on Thursday enacted House Bill 989, a multifaceted measure that also gives the state some oversight of the association that serves as a backstop and pays claims when self-insured employers become insolvent, and it modifies requirements relating to a non-comp program that provides benefits to firefighters with cancer.
HB 989 would direct the Department...
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NATL. - MedRisk Acquires Conduent's Claims Business
05/06/2024 |
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King of Prussia, Pennsylvania-based MedRisk, which manages physical rehabilitation in workers' compensation, plans to acquire Conduent Inc.’s Casualty Claims Solutions business.
The $240 million sale is subject to customary adjustments and regulatory approval and consists of Conduent’s workers’ compensation and auto casualty bill review solutions and services, including medical bill processing and clinical services, and its portfolio of Strataware bill review software products, Conduent said in a statement.
In 2023, the business, with about 100 clien...
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OH - Commission's Lack of Jurisdiction Over Claim Doesn't Affect Worker's Appeal
05/03/2024 |
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The Ohio Supreme Court unanimously ruled that the Industrial Commission’s lack of statutory jurisdiction over a worker's claim did not affect his right to appeal for additional benefits.
Brian Caldwell worked for Whirlpool Corp. He suffered an on-the-job injury in March 2015 and filed a workers’ compensation claim.
The Bureau of Workers’ Compensation accepted the claim as compensable. The last medical bill was paid under the claim in May 2016, and Caldwell received his last permanent partial disability payment in January 2017.
In December 2019, Caldwell sough...
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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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PA - Court Upholds Penalties Against Employer That Failed to Pay for Worker's Medications
05/03/2024 |
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The Commonwealth Court upheld the assessment of penalties on an employer for failing to pay for medications to treat a worker’s depression.
Case: St. Luke’s Physician Group v. Kuzo, No. 955 C.D. 2022, 04/29/2024, unpublished.
Facts: Sheila Kuzo worked for St. Luke’s Physician Group as a critical care nurse. She suffered injuries at work in September 1996 while assisting a patient. SLPG accepted liability for a herniated disc as well as Kuzo’s esophageal problems, depression and sleep disorder.
Procedural history: Kuzo filed a penalty petition against SLPG, asser...
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NY - Court Upholds Summary Dismissal of Labor Law Claim for Worker Struck by Falling Object
05/03/2024 |
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A New York appellate court upheld the summary dismissal of a worker’s Labor Law claim based on his injuries from being struck by a falling fire extinguisher.
Case: Flores v. Fort Green Homes LLC, No. 2021-02902, 05/01/2024, published.
Facts: Carlos Flores allegedly suffered injuries while backfilling the foundation at a construction site when a fire extinguisher struck him on the head. According to Flores, the fire extinguisher was resting unsecured on a beam approximately 20 feet above him when it fell.
Procedural history: Flores filed suit against Fort Green Homes LLC, assertin...
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NY - Labor Law Defendant Gets Partial Summary Judgment
05/03/2024 |
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A New York appellate court ruled that a defendant in a Labor Law claim should have been granted partial summary judgment.
Case: Malecaj v. West 70th Owners Corp., No. 307346/12, 04/30/2024, published.
Facts: Besnik Malecaj was injured when he fell from a plank while excavating a pool during the renovation of a townhouse in Manhattan. The property was owned by West 70th Owners Corp. The renovation was being overseen by New Order Construction Management Inc. and Bronx Excavation Co. Inc.
Procedural history: Malecaj filed suit against New Order and West, asserting claims for negligence and vio...
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TX - DWC Proposes Revisions to Gifts, Grants and Donations Rule
05/03/2024 |
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The Texas Division of Workers’ Compensation proposes amendments that it says will update regulatory language to ensure that its gifts, grants and donations rule is clear and accurate.
The division proposes eliminating references to the Workers’ Compensation Commission, which was abolished in 2005. The division also proposes eliminating rules requiring the commission to acknowledge gifts worth more than $500 by a majority vote and in official minutes of public meetings. Additionally, the division proposes to eliminate rules that allow the executive director to accept...
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FL - WCRI Reports 13% Increase in Indemnity Benefits
05/03/2024 |
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The average indemnity benefit per claim increased 13% in 2022 and was the main driver of growth in overall costs per claim in Florida, according to the Workers Compensation Research Institute.
“An increase in indemnity benefits per claim in 2022 was a common finding across study states, including Florida,” Sebastian Negrusa, vice president of research at WCRI, said in a statement. “Faster wage growth and longer duration of temporary disability drove the indemnity growth in 2022, likely related to changing labor market and economic conditions.”
Other findings from the ...
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HI - Lawmakers Pass Bill to Establish Entitlement to MRIs
05/03/2024 |
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Hawaii lawmakers on Thursday sent the governor a bill that would entitle injured workers to receive magnetic resonance images during the first 60 days after an injury before a medical treatment plan is in place.
The House of Representatives and Senate on Wednesday both signed off on a conference committee amendment to HB 1944 that would make the bill take effect July 1.
HB 1944 would declare that injured workers are entitled to an MRI of the cervical spine or the lumbar spine if the attending physician finds objective indicia of radicular symptoms “that reasonably could be caused by in...
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WA - Employer Hit With $1.7 Million Judgment for Misclassifying Workers, Underpaying Premiums
05/02/2024 |
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The Washington Court of Appeals upheld a $1.7 million judgment against an employer for deliberately misclassifying its workers and underpaying its premiums.
O.M.A. Construction Inc. is a contractor and subcontractor for public works projects. Its employees drive dump trucks loaded with materials to, from and within construction or reclamation sites. Approximately 70%-75% of its employees’ driving is on or within construction sites, and the drivers primarily stay in the cab of the truck and do not run excavation equipment.
In June 2015, the Department of Labor and Industries audited O.M...
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