Workers Comp Tidbits of News You Can Use

 
Workers Comp this week provided a lot of fodder for discussion. Here’s a review:
 
Bison Jam Delays Dr. Glimp at Medcor
Remote medical support may hold down WC costs, but it does invite some interesting circumstances. In early May, Thomas Glimp, MD, Chief Medical Officer, at Medcor, was late to an important meeting due to a "bison jam" in Yellowstone National Park. Executive Vice President Curtis Smith said, "We were waiting for our Medcor doctor, Thomas Glimp, to join us on a conference call last week while he was doing some training at the three Medcor-run clinics in Yellowstone National Park… and he was a bit late…. BUT there was good reason… there was a "bison jam" and it's difficult to make a bison move faster.”
 
 
Glimp said, “I was trapped on the road in a ‘bison jam’ for 15 minutes. They’re often difficult to influence (not unlike physicians)!  There is little to no cell coverage in the park, so I needed a land line to call.”[WCx]
 
 
 
LexisNexis Examines Oklahoma Workers Comp Opt-Out, Benefits Review and More in WC World
The Workers Compensation Law Community Powered by Larsons on LexisNexis compiled a great newsletter evaluating the details of many current  WC cases this week. Sign up for their newsletter here and get all this and more in your inbox.
 
 
1. Robinson offers Post Mortem on OK Opt Out Legislation
Thomas A. Robinson writes here, the controversial bill that would have allowed some Oklahoma employers to “opt out” of the state’s traditional workers’ compensation system fell short of having sufficient votes to move legislation through. In his analysis, he says, “A number of the bill’s proponents were crowing about how its passage was a “done deal” and, buoyed on by the Oklahoma success, we’d see a wave of similar legislation in other states. So, we see the importance of counting our chicks only after they’ve hatched. Second, and more importantly, the bill provides us with a provocative example of how states are pulling out all the stops when it comes to attracting and keeping businesses within their borders.”
 
 
2. Koenig Offers Update From Benefits Review Board
Karen Koenig, associate general counsel of the Longshore Benefits Review Board at the U.S. Department of Labor writes here the Board received 201 appeals in cases under the Longshore Act, one more than the year before. In addition to summarizing these appeals, Koenig also includes developments from the DBA.
 
 
3. Larsons Spotlight Examines 4 Recent Cases:
Larson’s Spotlight looks at several important events this week, here.
1.In Maryland, Injuries Sustained While Returning From Physical Therapy Session to Treat the Effects of Earlier Work-Related Injury Are Not Necessarily Compensable.
2. From Iowa, Forty Years of Cigarette Smoking, Not Cold Conditions of the Employer's Meat Packing Facility Caused Claimant's COPD.
3. In Hawaii, Former Employee's Suit Against Co-Employees Related to Allegedly False Claims and Harassment Were Barred By Exclusivity-Claim for Wrongful Termination Not Barred.
4. From Colorado, Offset of Permanent Total Benefits With Old-Age Social Security Payments Was Appropriate.
 
 
5. WC Fraud Blotter Looks at Wrist Pain/Facebook Case, More
The blotter takes a look at a case where an employee claimed wrist pain stopped her from processing inmates’ mail and from typing at work, yet records showed frequent texts and Facebook updates. Read more about this case and five others here.

1. Letter Carrier Fraud, Delivering the Mail Goes To the Dogs.

2. Pasta Alert: The "Noodle" Pleads Not Guilty To Workers' Compensation Fraud .

3. Doctor Indicted For Overbilling Workers' Compensation Insurer Amusement Park Owner Admits to Workers' Compensation Fraud and Tax Evasion .

4. Disability Claimant Caught On Video Working While Collecting Benefits

5. Construction Business Owner Charged With Underreporting Payroll to Workers' Compensation Insurance Carrier.

 
 
6. Read about Delaware Decision on Course and Scope
Cassandra Roberts writes here in Have Crockpot Will Travel, “I had a fall of sorts at work a month ago and a recent MRI now shows fractures of the cuboid and the calcaneous. So, no stilettos for me.  And I have a work comp prescription card. Vicodin on someone else's dime. Pretty darn sweet. Accordingly, I now relate to the plight of the injured worker. And the case recently offered up by Henry Davis strikes close to home.  Which you will understand even more so when  you hear the facts of the case.”
 
 
7. No Benefits for Alleged Fume Exposure in Missouri
Martin Klug writes here about a case in which the claimant lost his claim against the second injury fund when he failed to prove an accident that his alleged exposure to muriatic acid fumes caused a heart attack. “The court rejected an argument that the commission must award benefits because the fund did not produce any evidence,” he writes.
 
 
8. Court Rules That State Bar’s Professional Liability Fund Is NOT Subject to MMSEA Reporting
Mark Popolizio, of the Crowe Paradis Services Corp. explains the case of Oregon State Bar Professional Liability Fund v. United States Department of Health and Human Services & Kathleen Sebelius, here. In the case, he writes, “The court … ruled that a legal malpractice policy, which did not provide coverage for bodily or emotional injuries, was not an ‘applicable plan’ subject to Medicare’s mandatory reporting requirements under the Medicare, Medicaid and SCHIP Extension Act of 2007.”
 
 
9. Law360 Looks at CA Facebook Privacy Laws
Erin Coe writes about a piece of legislation trying to “block California companies from making employees and future workers disclose their usernames and passwords for Facebook, Twitter and other personal social media accounts that gained unanimous approval Wednesday from a state Assembly panel,” here.
 
10. CA Department of Industrial Relations Small Business Portal Up and Running
Check out California’s new site for small businesses here. They explain “Small businesses are critical to California’s economic recovery and strength, to building America’s future, and to helping the United States compete in today’s global marketplace. Small businesses also represent 99.7 percent of all employer firms and they employ just over half of U.S. workers and pay 44 percent of total U.S. private payroll.”
 
 
11. TDI-DWC Gives Authorization to Certify Maximum Medical Improvement (MMI) and Assign an Impairment Rating
The Texas Department of Insurance Division of Workers’ Compensation reminds all workers’ compensation system participants that the Texas Labor Code and TDI-DWC rules impose certain requirements for a doctor to become authorized to certify maximum medical improvement (MMI) and assign impairment ratings for claims in the Texas workers’ compensation system. For more information, look here.
 
 
12. Oklahoma WCC Posts Proposed Change for Rule 23, Eye Impairment
Oklahoma has offered a proposed change for consideration by its supreme court following adoption by the WC court regarding definitions for what constitutes eye impairment.
 
 
WorkersCompensation.com Hosts Video Roundup
WorkersCompensation.com has started a weekly video roundup. Check it out here.
 
 
Gould and Lamb Hosting Two Training Sessions
At two casinos in Atlantic City and St. Louis, Gould & Lamb will offer what they call the most comprehensive WC, liability and risk management conferences to date. The sessions will have special focus on Medicare & Medicaid compliance. The Atlantic City conference will be at Bally’s June 18-9 and the St. Louis session will be at Harrah’s Aug. 6-7. For more information, look here.[WCx]
 
 
The “Jackpot” sessions are being billed, “Don't Gamble on Workers' Compensation, Liability & Medicare/Medicaid Compliance!  We have gathered together some of the industry's most respected leaders and experts to provide attendees with two full days of compliance education and training, as well as an exciting look into the future of Medicare/Medicaid Compliance.”   
 
 
Note: If your company has any developments you'd like to share, please send them to us at: RShafer@ReduceYourWorkersComp.com

 

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

 

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their Workers Compensation costs by 20% – 50%.  He is a writer, speaker, and website publisher.  ContactMstack@ReduceYourWorkersComp.com

 

WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Workers Comp Tidbits from Around the Globe

You’re busy, we know. So Roundtable has gathered the best and most compelling stories from the workers compensation world for you. Sit back, relax, and read about just those things that interest you, confident you won’t be missing important developments in compensation.
 
LexisNexis Communities Analyzes Motel Sex Case, Odd-Lot and More
 
The Workers Compensation Law Community Powered by Larsons on LexisNexis compiled a great newsletter evaluating the details of many current  WC cases this week. Sign up for their newsletter here and get all this and more in your inbox.
 
 
Wacky World of Comp Sex Case Examined by Roberts
Cassandra Roberts, Esq., writes in her blog, about the Australian woman who received WC benefits for facial injuries sustained while having sex on a business trip. The Federal Court of Australia found that this injury was no different than any other that may happen on work time. Roberts’ three-part analysis looks at how Delaware might handle the case by examining state precedent in similar business trip injuries.
 
 
Spotlight Shines on Odd-Lot Doctrine, Exclusive Remedy, Retaliatory Discharge, and Disfigurement Award
Larson’s Spotlight takes a look at the odd-lot doctrine, which means total disability may be found in the case of workers who, while not altogether incapacitated for work, are so handicapped that they will not be employed regularly in any well-known branch of the labor market.
 
The spotlight also examines these three cases:
1. From New York: Employer's Corporate Subsidiary Was Shielded by Exclusive Remedy Defense Where Injured Worker Worked Under Supervision of Both the Subsidiary and the Employer
2. In Texas: Evidence That Worker Was Terminated As Part of General Reduction in Work Force Held Sufficient to Defeat Worker's Retaliatory Discharge Action
3. In Delaware: Board's Facial Disfigurement Award Reversed Where Board Did Not Compare Severity of Scar with Other Similar Scars that Board Had Observed In Its Accumulated Experience
 
Juge Looks at Louisiana 2011 In Review
Denis Paul Juge, Esq. notes that while there were no major legislative changes in 2011, significant changes are expected in 2012. He urges those interested in Louisiana WC law monitor the legislative activity at here. Further, the OWC has promulgated the new hearing rules that include limitations on the trial continuance by consent and provides for the stay of a suit if good cause is shown, he says. Read more of his noteworthy case developments here.
 
 
Max Comp Rate Determine By Date of Disability, Not Injury
Monica F. Markovich and Jonathan A. Tweedy discovered in Practical Application of Roberts vs. Sea-Land Services, Inc., that the date in which an injured worker is "newly awarded compensation" and its effect on the maximum compensation rate is defined differently than originally thought.
 
They write, “The following chart explains the practical application of the decision:
  1. Injury causing immediate disability: Maximum compensation rate is based on date of injury.
  2. Injury without immediate disability: Maximum compensation rate is based on first date of disability.
  3. Injury where disability lasts more than 3 but less than 15 days: Maximum compensation rate is based on fourth day of disability, where the disability actually begins under Section 6(a).
  4. Injury where initial disability lasts more than 3 but less than 15 days but a later period of disability occurs: Maximum compensation rate is initially based on fourth day of disability. If there is a later period of disability such that the total disability exceeds 14 days, then the maximum compensation rate would revert back to the first day of disability.”
 
Read more of the analysis here.
 
Community Blogs Shredding up The Net
Take a look at the work of these top WC blogs:
  1. LexisNexis Workers' Comp Fraud Team, here.
  2. Cassandra Roberts.
  3. Paintballing, Wrestling and a Head-Banging Good Time: Another Commentary on Horseplay in Delaware, here.
 

Longshore Seminar Coming up In New Orleans
Robert Wilson recently noted on WorkersCompensation.com there is an upcoming seminar for the National Workers' Compensation Defense Network (NWCDN). It will be June 6 and 7 in New Orleans.
 
Wilson writes that longshore topics and the related Jones act “are not as ‘well traveled’ as others in the conference arena. In fact, I am hard pressed to remember any conference where an emphasis was put on these areas. If these jurisdictions are within your realm of interest, I would suggest you look into attending.”
 
For more information about the seminar, look here.
 
 
Note: If your company has any developments you'd like to share, please send them to us at: RShafer@ReduceYourWorkersComp.com

 

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Workers Compensation This Week In Review

LexisNexis Communities Highlights Hot Topics WC In Reviewpic3

The Workers Compensation Law Community Powered by Larsons on LexisNexis offers an interesting look at WC this week:

 

 

Ronald E. Weiss and Ronald Balter analyze in “New York Workers’ Comp Stakeholders Continue to Absorb 2007 Reform Changes,” found here, “During the past year, stakeholders in the workers’ compensation system in New York have continued to absorb legislative and administrative changes initiated by the 2007 reform. Maximum indemnity rates are now indexed to two-thirds of the State Average Weekly Wage.”

 

 

The Law Community also takes a look at the Workers Compensation Board policy on firearms here by examining what the policy is, how it affects law enforcement and what notification rules are.

 

 

They also take an insightful look into a Florida pizza delivery man who was fired after being robbed. See complete article here. Reporter Michael Miller notes the man is suing Domino’s, his former employer, “claiming (they) cruelly denied him workers’ compensation for his injuries from that night and then unlawfully fired him.”

 

 

In the Pittsburg Post-Gazette, writer Gina Passarell comments on how the Steelers football team does not have to pay attorney fees in a workers’ comp case. The incident (see full story here) is related to a former player’s WC case in which he suffered injuries while with the team. “The team argued he was not ‘disabled’ since he went on to play for other pro teams, the Commonwealth Court has ruled,” Passarell wrote. “Pennsylvania law automatically provides attorney fees to prevailing claimants when employers contest a claim for workers’ compensation benefits, unless that protest is ‘reasonable.’ “

 

 

Working Immigrants Blog Looks at Pew Study

Working Immigrants, a weblog about the business of immigrant work: employment, compensation, legal protections, education, mobility, and public policy writes this week that net migration from Mexico fell to zero.

 

 

“According to a report by the Pew Hispanic Center, ‘The largest wave of immigration in history from a single country to the United States has come to a standstill. After four decades that brought 12 million current immigrants—more than half of whom came illegally—the net migration flow from Mexico to the United States has stopped—and may have reversed, according to a new analysis by the Pew Hispanic Center of multiple government data sets from both countries.’ “The blog takes a deeper look into this study here.

 

 

TDI-DWC Approves 7 Companies to Self-Insure for Workers’ Compensation Claims

According to Stuart Colburn, shareholder in Downs Stanford, P.C. , the Texas Department of Insurance, Division Workers’ Compensation reports here The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) approved seven renewals of the Certificates of Authority for companies to self-insure their workers’ compensation claims for a one-year period under the TDI-DWC Self-Insurance Program. These companies collectively employ approximately 27,900 employees in Texas.

 

 

The report notes, “Under Texas law, certain large, private companies can self-insure for workers’ compensation claims, while retaining the protection of the Texas Workers’ Compensation Act for the company and for its employees. To qualify, a company must have a minimum workers’ compensation insurance unmodified manual premium of $500,000 and meet other requirements subject to annual review.”

 

 

Capital Community College Offers Live Classes in Risk Management

Capital Community College of Hartford, CT is now offering these live instruction classes in ARM:

 

ARM 54: Risk Assessment (PRFD 5359-2176)

Tuesdays/Thursdays from 5 PM – 9 PM

May 8 – June 14, 2012

$699 plus textbook

 

ARM 55: Risk Control (PRFD 5360-2177)

Tuesdays/Thursdays from 5 PM – 9 PM

June 19 – August 2 (excluding July 3 & July 5)

$699 plus textbook

 

ARM 56: Risk Financing (PRFD 5395-3602)

Tuesdays/Thursdays from 5 PM – 9 PM

September 25 – Nov. 1

$699 plus textbook

 

To register by phone, call (860) 906-5130. Contact Carol Vassar-Pettit with questions, cpettit@ccc.commnet.edu.

 

 

Advisen’s Casualty Insights Conference Coming May 1

Register here for keynote speakers, Allied World’s Lou Iglesias, Navigators’ Stan Galanski, and Arch’s Mark Lyons and an all-star Risk Manager panel.

 

 

The casualty conference at the McGraw Hill Conference Center is free for risk managers and insurance buyers; Advisen Clients are $395; general registration is $495. Further, eight CE credits are available for $125.

 

 

Other speakers include: Mitchell J. Auslander of Willkie Farr & Gallagher, Alfred Bergbauer of Marsh and Carmelite Bertaut of Stone Pigman Walther Wittmann LLC

 

 

Broadspire Promotes Erica Fichter to Senior Vice President of Medical Management

Broadspire, a TPA WC claims administrator and medical management service provider, has named Erica Fichter to senior vice president of medical management services.

[WCx]

Fichter will oversee a staff of more than 500 clinical professionals and support personnel located throughout the United States. Broadspire has the fifth largest medical management company in the country, with integrated services including: medical bill review, field and telephonic case management, utilization review, physician review, the BOLD® Network preferred provider offering and chronic pain management. “With this array of services, Broadspire’s cost containment results are typically 10 to 15 percent better than those produced by other TPAs and managed care companies,” they claim.

 

 

Note: If your company has any developments you’d like to share, please send them to us at: mbstack@gmail.com

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%Contact: RShafer@ReduceYourWorkersComp.com.

 
WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

Workers Compensation News From Around the Net

Input Needed in Providers Opioid Audit
 
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) acknowledges that prescription drug abuse and misuse, including opioids, is a serious issue in all health care delivery systems, including workers’ compensation.
 
 
The TDI-DWC seeks input and suggestions regarding the development of a new Plan-Based Audit for health care providers prescribing opioids. The Plan-Based Audit sets the scope, methodology, selection criteria, and program area responsibilities as laid out in the Medical Quality Review Procedure. A copy of the proposed Health Care Providers Pain Management Services (Opioid) Plan-Based Audit can be viewed at the TDI website here. [WCx] 
 
 
Broadspire Launches BOLD® Rx Network
 
Broadspire, a Crawford Company and TPA of workers compensation claims, liability claims and medical management services, has launched its BOLD Rx Network to help control the medical costs associated with WC claims. See here for more information.[WCx]
 
 
According to Broadspire, the BOLD Rx Network uses a multi-leveled strategy to achieve superior penetration rates and savings compared to the rest of the industry. “Rather than just partnering with one pharmacy benefit management (PBM) company, as is traditionally seen in the marketplace, Broadspire leverages multiple partners based on the value they bring to clients, creating a stronger pharmacy program,” they write.
 
Federal Court Rejects NLRB Authority to Force Posting of Employee Rights Notice
 
According to a well-written newsletter from McGuireWoods, a world-wide lawfirm with 900 lawyers, in Chamber of Commerce of the U.S., et al. v. NLRB (Dist. S.C., April 13, 2012), a South Carolina federal district court held that the National Labor Relations Board (NLRB or the Board) does not have statutory authority to force employers to post notices that the NLRB claims are designed to inform employees of their rights under the National Labor Relations Act.
 
 
McGuireWoods writes, “The Court’s decision directly conflicts with a recent decision from a separate federal court in the District of Columbia. These developments place all employers covered by the Act in a very difficult position.”
 
 
The regulations are to take effect April 30, 2012. “The conflicting court cases make it unclear whether employers will be required to post the NLRB notices on the current April 30, 2012 deadline. (Click here for more),” they write.
 
 
Columbus Dispatch Notices Lawsuits Against Doctors on Decline
 
Columbus Dispatch reporter Alan Johnson writes here that Ohio’s tort-reform law has reduced closed claims by 41 between 2005 and 2010. He discovered average payments for medical malpractice cases have declined 38 percent over that period.
 
 
Johnson writes, “The legal fight over curbing lawsuits and settlements in medical malpractice cases reached a tipping point in 2003 when the General Assembly passed and Gov. Bob Taft signed Senate Bill 281. The law capped non-economic damages, commonly known as ‘pain and suffering,’ at $500,000 per occurrence.”
 
 
Johnson reports that Tim Maglione, of the Ohio State Medical Association says doctors’ medical malpractice rates have dropped more than 26 percent. “It’s not only good news and a good trend, but it is proof that tort reform accomplished what it set out to do — slow the growth of what we thought were runaway lawsuits and to stabilize the market for physicians,” Maglione said. The numbers have also gone down, he said in the article, because doctors and hospitals are working harder to improve safety and cut down on mistakes. “The best error is the one that never happens.”
 
 
Progressive Medical Releases Annual Workers’ Compensation Medication Trends Report
 
According to Progressive Medical, Inc., WC medication spending declined in 2011. Their annual analysis, found here, reveals changes to medication expense patterns in workers’ compensation claims from 2010 to 2011 for Progressive Medical clients, as well as key factors that may influence future expenditures, such as chronic pain, product mix and government activity.
 
 
Key highlights from the 2012 Workers' Compensation Medication Trend Report include:
  1. Although medication AWP inflation was 5.8 percent in 2011, data shows a 1.3 percent reduction in total medication spend per claim.
  2. There was an overall 3.3 percent decrease in utilization per injured worker from 4.3 percent fewer prescriptions and a 1.1 percent decrease in average days of medication supply received.
  3. Across the industry, narcotics account for 35 percent-40 percent of workers' compensation medication spend while Progressive Medical showed a 3.9 percent decrease in total spending per claim in this drug category. Progressive Medical believes this is due to an emphasis on conducting interventions earlier in the lifecycle of a claim.
 
 
Note: If your company has any developments you'd like to share, please send them to us at: RShafer@ReduceYourWorkersComp.com

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Tidbits From the Workers Compensation Community

LexisNexis Communities Highlights Hot Topics WC In Review
 
The Workers Compensation Law Community Powered by Larsons on LexisNexis offers several great pieces recently:
 
 
1. Statutory Presumptions of Intoxication and Drug Use Don’t Always Ensure an Easy Win for Employers found here by Thomas A. Robinson explains the doctrine of employee fault not being considered when determining compensability of an employee’s claim.
 
 
2. The Spotlight looks at a clash of medical opinions over surgery to correct an injured worker’s enlarged breast condition. The analysis, found here, notes, “In a recent Florida case, an appellate court found the dismissal, by a judge of compensation claims, of a police officer's petition for additional benefits and medical expenses related to his gynecomastia (the abnormal enlargement of male breasts), was premature and in error where the JCC had entered an order appointing an EMA, but because of delay in securing a physician willing to serve, the police officer went ahead and had surgery to correct the condition.” [WCx]
 
 
3. The Spotlight also takes a look at these cases:
  • Future Medical Payments Too Speculative to Support Taxing of Litigation Expenses Against Comp Carrier
  • Employer's Failure to Enforce General Safety Rules Regarding Food Slicer Did Not Mean More Specific Rules Could Be Ignored by Employee
  • Lump-Sum Settlement Agreement, Silent On Employment Status and Approved By Board, Nevertheless Bars Later Tort Action Claiming Independent Contractor Status
And these, found here:
  • Claimant's Trauma Induced Stroke In Fall From Wheelchair Is Not Compensable Aggravation of Original Injury
  • After Full Payment of Scheduled Injury, Employer Allowed Credit Against Additional Disability Benefits Owed Permanently Injured Claimant Related to Pension to Which It Contributed
  • No Compensation Awarded for Injuries Sustained in Auto Accident Following Doctor's Appointment for Treatment Related to Earlier Compensable Claim
 
4. And, in “Aggressive Surveillance of Injured Worker’s Family: Federal Court Says Spouse’s Tort Action Not Barred by Exclusive Remedy Rule” the site notes, “In a diversity action filed by the spouse of an injured worker against the third-party firm administering her husband's workers' compensation claim, a federal district court recently refused to grant the defendant's summary judgment motion, finding the tort action was not barred by the exclusive remedy provisions of the Connecticut Workers' Compensation Act.” Read more on this topic here.
 

WCRI Hosting Webinars Now through July 19  
 
Each webinar is 60 minutes long. Price per webinar is $35 for members, $50 for non-members, and no charge for public officials and members of the media. To register for any of the webinars, follow this link: http://www.wcrinet.org/conference.html.
 
 
One webinar will be about hospital outpatient costs and the impact of fee schedules. WCRI writes, “As legislators, employers and other stakeholders look for ways to control the rising costs of medical care for injured workers, the Workers Compensation Research Institute (WCRI) is offering a series of webinars on important workers’ compensation topics and research that will be both interesting and actionable. The first of the series is a webinar based on WCRI’s recent study, Hospital Outpatient Cost Index for Workers’ Compensation.”
 
 
Hanover Stone Partners names Brent Clark, Marnix Guillaume and Joseph A. Milan as Senior Risk Advisors
 
Hanover Stone Partners, a risk management services firm, recently expanded its capabilities in alternative risk transfer, international, and ERM by appointing three new risk advisors. The executives, Brent Clark, Marnix L.K. Guillaume, and Joseph A. Milan, bring specialized expertise and veteran leadership to the firm's clients in the areas of alternative risk transfer; international risk management; and enterprise risk management, respectively.
 
 
"As Hanover Stone Partners continues to expand our capabilities, we remain committed to bringing clients the best available expertise across a range of critical disciplines to address their complex risk management needs," said John J. Kelly, founder and managing partner of Hanover Stone Partners. "These three outstanding professionals bring world class capabilities in alternative risk transfer, international risk management, and enterprise risk management, all of which are integral to effective risk management on a global scale."  
 
 
Pat Chavanu  named Senior Vice President of Sales at Network Synergy Group
 
Network Synergy Group (NSG), a national physical therapy management company, recently named Pat Chavanu as its Senior Vice President of Sales. Chavanu will be responsible for leading all sales efforts for NSG, a company regarded in the managed care industry as a true innovator.
 
 
“We are extremely excited about Pat joining our team. He’s a highly regarded executive with over 20 years of experience in our industry,” said John D. Hanselman, President of NSG. “His experience directing sales and account-retention efforts and positioning companies for profitable growth will be an asset to our company as we continue our nationwide expansion.”
 
 
New Page At The WC Resource Center
 
Check out www.LowerWC.com where we have a new page on best practices in WC claim handling. Best practices are often referenced in the handling of workers compensation claims without an explanation as to what they are or what the insurance industry standards are for handling workers compensation claims. While best practices vary slightly from insurance company to insurance company, we offer a synopsis of the basic standards of how the insurance adjuster handles workers compensation claims.

American Chiropractic Association Looks at Obesity
 
David C. Radford, DC, Robert C. Jones, DC, and James F. Winterstein, DC recently wrote an article, found here, that notes this generation of Americans is the first predicted to die at a younger than their parents. This is mostly due to the chronic health issues associated with being overweight, they write. “Since 1985, the first year the CDC started keeping body mass index (BMI) statistics on the population in all 50 states, there has been a dramatic increase in obesity rates, and this trend is not improving. In 1994, there was not a single state that had an average rate of obesity over 19 percent, and the data showed greater than 50 percent of the general population had an obesity rate of 10 percent to 14 percent or less.”
 
 
NCIB releases Sitting Study: Mortality Risk Higher
 
US National Library of Medicine through the National Institutes of Health recently released a new Australian study showing sitting is the new smoking.
 
 
The abstract, published here, shows prolonged sitting is detrimental to health, but evidence regarding the independent relationship of total sitting time with all-cause mortality is limited. The NCIB linked prospective questionnaire data from about 200,000 people 45 years or older and examined all-cause mortality in relation to sitting time.
 
 
The study indicated, “Prolonged sitting is a risk factor for all-cause mortality, independent of physical activity. Public health programs should focus on reducing sitting time in addition to increasing physical activity levels.”
 
 
WCRI Hosting Annual Issues & Research Conference
 
The Workers Compensation Research Institute is offering signups for the 29th annual Issues & Research Conference Nov. 14-15th, 2012, at the Boston Marriott in Cambridge, Mass.
 
 
WCRI suggests saving the dates now in order to learn the latest research findings from WCRI, hear renowned speakers, and participate in networking opportunities with WC experts and policymakers, and WCRI staff.
 
Conference and registration information will be posted on the WCRI website, here, in May. For more information email Sarah Solorzano at ssolorzano@wcrinet.org.
 
 
TDI-DWC Hosts Educational Sessions on Returning Injured Employees to Work
 
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) is hosting brown bag educational sessions Returning Injured Employees to Work at its field offices around the state in May 2012. Check here for more information. The educational sessions are for all Texas WC participants, including: injured employees, employers, health care providers, insurance carriers, claim adjusters, case managers and attorneys.[WCx]
 
 
The session will illustrate the importance of returning injured employees to work and provide tools to help facilitate the process. For more details on the educational sessions, visit the TDI-DWC Events and Training Calendar on the TDI website at http://www.tdi.texas.gov/wc/events/index.html.
 
 
Note: If your company has any developments you'd like to share, please send them to us at: RShafer@ReduceYourWorkersComp.com

 

 

 

 

Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

MODIFIED DUTY CALCULATOR:  
www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

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