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 [email protected].

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: [email protected]

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: [email protected].

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.

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