July 21, 2016

Increased Impairment Rating for Sexual Dysfunction: Cal. Comp. Cases July Advanced Postings (7/20/2016)

Here’s the latest batch of advanced postings for the July 2016 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2016 LexisNexis. All rights reserved. City of Los Angeles, PSI, Petitioner v. Workers' Compensation Appeals Board, Arnold Montenegro, Respondents, lexis.com , Lexis Advance Permanent Disability—Rating...

July 19, 2016

National and State-by-State Workers' Comp News Powered by Larson's (7/18/2016)

DOL Announces Adjustment of Civil Penalty Fines . CA: DWC Accepting Applications for QME Examination on Oct. 29 . CA: WCIRB President’s Message About 2016 Achievements, Plans Ahead . CA: Class Action Says WC System Has Bias Against Women . HI: State Sees Significant Increases in WC Penalties . IL: Chamber of Commerce Pres Says WC No. 1 Issue . MA: Assessment Rate Paid by Employers Drops . MN: Number...

July 18, 2016

California: Two Different Paths to Establishing Permanent and Total Disability

In Anaya v. Bay Area Carbide , 2016 Cal. Wrk. Comp. P.D. LEXIS --, a split WCAB panel affirmed the WCJ’s finding that the applicant, who suffered an industrial injury to his lungs, respiratory system, psyche, and in form of diabetes while employed as a tool handler from 7/8/2009 through 7/8/2010, was entitled to an unapportioned award of 100 percent permanent disability “in accordance with the fact”...

July 14, 2016

Maine: Wrongful Death Action Barred by Exclusive Remedy Provisions of State Comp Act

The Supreme Judicial Court of Maine held that an estate’s wrongful death action against the deceased employee’s employer was barred by the exclusive remedy provisions of the Maine Workers’ Compensation Act where the undisputed evidence indicated the deceased employee had sustained fatal injuries in a vehicular accident while the deceased was engaged in employment-related activities for his employer. Representatives of...

July 14, 2016

Maryland: PTD Benefits Survive Death Due to Unrelated Causes Only to Extent of Statutory Cap

The Court of Appeals of Maryland held that when the state’s Commission finds a claimant permanently totally disabled, Md. Code Ann. Lab. & Empl. § 9–640 governs the survival of benefits whether the claimant’s PTD is due solely to accidental injury or to a combination of accidental injury and preexisting conditions. Accordingly, where the claimant died of causes unrelated to his accidental work injury, any award of...

July 14, 2016

Vermont: Employer Allowed Credit for Post-Injury “Wages” Paid under Collective Bargaining Agreement

In a divided decision, the Supreme Court of Vermont held that an employer should have been allowed a credit against future workers’ compensation benefits owed to an injured worker where the worker’s claim was initially denied and the employer accordingly paid claimant for a nonoccupational disability under the terms of a collective bargaining agreement, and where the claim was subsequently established and...

July 14, 2016

Illinois: Claimant Need Not Submit AMA Rating Report in Order to Qualify for PD

The Appellate Court of Illinois, Workers’ Compensation Commission Division, held that section 8.1b of the Illinois Workers’ Compensation Act [820 Ill. Comp. Stat. 305/8.1b (2012)], does not require an injured worker to submit an “AMA rating report” for the purpose of determining permanent disability. The court observed that section 8.1b is addressed only to a physician preparing a PPD impairment...

July 14, 2016

Does the Affordable Care Act Push Medical Expenses Toward Workers' Comp Insurers?

Recent JAMA Study Indirectly Supports Earlier WCRI Findings Since President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010, there has been a debate within the workers’ compensation (WC) world as to whether one of the ACA’s unintended consequences is to promote cost shifting from health insurance plans to WC insurers and self-insuring employers. Last September, for example, the Workers’...

July 11, 2016

California: Due Diligence Is the Key

I. How NOT to Request That the Record Be Developed In the Noteworthy Panel Decision (NPD) of Quintero v. PBC Holding Corporation dba Commercial Cleaning Systems , 2015 Cal. Wrk. Comp. P.D. LEXIS 610 [ 2015 Cal. Wrk. Comp. P.D. LEXIS 610 ], applicant, Ms. Quintero, was extremely disappointed after her AOE/COE trial (i.e., a trial as to whether her injury arose out of or occurred in the course of employment). On 7/20...

July 11, 2016

National and State-by-State Workers' Comp News Powered by Larson's (7/11/2016)

Comp Insurance Profitable, At Least For the Moment . CA: DWC Posts Interim Report on Evidence-Based Comp Drug Formulary . CA: WCIRB Submits 1/1/2017 Regulatory Filing . CA: WCIRB Releases Report on 2015 Losses and Expenses . CA: Settlement May Net Lyft Drivers $27 Million . FL: NCCI Recommends Rate Hike After High Court Rulings . HI: DILR Must Get Audited Study of Closed Claims . HI: New Law Allows Electronic...

July 11, 2016

Vermont Workers’ Compensation Update: April to June 2016

This list of recent noteworthy cases was compiled by Keith J. Kasper of McCormick, Fitzpatrick, Kasper & Buchard, PC. Argentina Kearney has joined the Department of Labor staff as a Workers’ Compensation Specialist II starting May 16, 2016. Ms. Kearney has most recently been employed with the Montana State Fund, where she served as a Workers’ Compensation Claims Examiner. Form 28 COLAs due July...

July 08, 2016

Oregon: Employer’s Knowledge of Worker’s Concurrent Employment Not Imputed to Insurer for Purposes of “Extra” Benefits Award

In Oregon, if an injured worker has more than one employer, he or she may be entitled to supplemental temporary disability benefits from the Workers’ Benefit Fund, in addition to the disability benefits the worker receives from the employer’s insurer. Or. Rev. Stat. § 656.210(2)(b)(A) provides that in order to qualify for the extra benefits, however, the injured worker must show that the insurer received, within 30 days...

July 08, 2016

Oklahoma: Intentional Tort Case May Continue Under “Substantially Certain” Rule

The Supreme Court of Oklahoma held that there were material issues of fact as to whether the decedent’s employer knew that injury or death was substantially certain to result from the task decedent and his coworkers were directed to complete and the conditions in which they were required to work, where decedent, who was a mere journeyman apprentice, with nine months experience, was electrocuted when he positioned...

July 08, 2016

Oklahoma: Parking Lot Injury Covered in Spite of Special Statute’s Language

A divided Supreme Court of Oklahoma held that a university employee sustained injuries arising out of and in the course of her employment when she slipped and fell on ice in a campus parking lot where she had been instructed to park. The majority found that the employee’s actions at the time of her injury were related to and in furtherance of the business of her employer and that at the time of her injury, the employee...

July 08, 2016

New Hampshire: Appeals Board Must Consider Future Medical Benefits in Conjunction With Employee’s Attorney Fee Request

Acknowledging that contingent fee arrangements in workers’ compensation cases were not per se unreasonable, the Supreme Court of New Hampshire held it was error for the state’s Compensation Appeals Board (CAB) to follow what amounted to a blanket rule that an injured employee’s future medical expenses were always speculative and that the estimated amount of future benefits could not, therefore, be demonstrated...

July 08, 2016

North Dakota: Widow’s Tort Action Fails Under State’s “Almost Impossibly Strict Standard” for Intentional Tort Allegations

The Supreme Court of North Dakota held the trial court properly granted a former employer’s summary judgment dismissing a widow’s wrongful death action against it because the facts alleged did not provide a genuine issue of material fact to avoid the exclusive remedy provisions of the Workforce Safety and Insurance Act. The deceased worker died approximately one month after he fell from the top of a railcar...

July 08, 2016

Seizure Was Compensable Consequence of Industrial Head Injury: Cal. Comp. Cases July Advanced Postings (7/7/2016)

Here’s the latest batch of advanced postings for the July 2016 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2016 LexisNexis. All rights reserved. CR England, XL Specialty Insurance Company, Petitioners v. Workers' Compensation Appeals Board, Jack Dupont (Dec'd), Anyawan Dupont (Widow), Respondents...

July 08, 2016

California Workers’ Comp Case Roundup (7/7/2016)

CALIFORNIA COMPENSATION CASES Vol. 81 No. 6 June 2016 A Report of En Banc and Significant Panel Decisions of the WCAB and Selected Court Opinions of Related Interest, With a Digest of WCAB Decisions Denied Judicial Review CONTENTS OF THIS ISSUE © Copyright 2016 LexisNexis. All rights reserved. LexisNexis Online Subscribers: You can link to your account on Lexis.com or Lexis Advance to read the complete...

July 07, 2016

Missouri: Split Supreme Court Awards Bills on Hypertensive Event

The Missouri Supreme Court reversed a denial of benefits in a divided 4-3 opinion and found there was sufficient evidence in an expert’s written report to find medical causation, despite the fact the ALJ, the Commission, and the Court of Appeals found the specific opinion about causation to be too ambiguous. Malam v Department of Corrections , 2016 Mo. Lexis 210 (Mo 2016) (June 28, 2016) (Lexis Advance), 2016 Mo...

June 30, 2016

Applicant Precluded From Reopening Psychiatric Claim: Cal. Comp. Cases July Advanced Postings (6/29/2016)

Here’s the latest batch of advanced postings for the July 2016 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2016 LexisNexis. All rights reserved. Coline Antouri, Petitioner v. Workers' Compensation Appeals Board, Warner Brothers Studio Facilities, Inc., PSI, Respondents, lexis.com , Lexis Advance...

June 29, 2016

California: Top 25 Noteworthy Panel Decisions (January-June 2016)

LexisNexis has picked the top “noteworthy” panel decisions issued by the California Workers’ Compensation Appeals Board during the period January through June 2016. The list features a number of decisions addressing utilization review time deadlines and reporting requirements, several cases discussing the access standards applicable to medical provider networks, and two cases addressing Subsequent Injuries...

June 28, 2016

Missouri: Prankster Denied Workers’ Comp Benefits After Starting Fire at Work

The Missouri Labor and Industrial Relations Commission denied benefits to a claimant who burned himself after he intentionally lit a can of industrial adhesive on fire to startle to a co-worker. The claimant lapsed into a coma as a result of his injuries and woke up in the hospital with no memory of the event. The parties stipulated that the prank involved substantial injuries to the claimant, representing 45% disability...

June 27, 2016

National and State-by-State Workers' Comp News Powered by Larson's (6/27/2016)

Wearable Devices May Reduce Injuries in Extreme Environments . Nat’l Safety Council: 4,000 Die Every Year at Work . Alternative Pain Treatment Easier Said than Done . SHRM Posts 2016 Benefits Study . Employers Curtailing Wellness Benefits . Businesses Eyeing Effects of 4th Circuit’s Exotic Dancer Decision . 4 out of 10 Won’t/Can’t Retire at 65 . Physical Therapy Often Key to Better...

June 23, 2016

Claim for Psychiatric Injury as Compensable Consequence of Chronic Hepatitis Not Precluded by Compromise and Release: Cal. Comp. Cases July Advanced Postings (6/22/2016)

Here’s the latest batch of advanced postings for the July 2016 issue of Cal. Comp. Cases. Lexis.com and Lexis Advance subscribers can link to the case to read the complete headnotes and summaries. © Copyright 2016 LexisNexis. All rights reserved. City of Los Angeles (Los Angeles Police Department), PSI, Petitioner v. Workers' Compensation Appeals Board, Lawrence Reichelt, Respondents, lexis.com...

June 23, 2016

Maryland: Sole Proprietor’s AWW Computed on Net Profit, Not Gross Receipts

In a matter of first impression, the Court of Appeals of Maryland held that average weekly wage of a sole proprietor who elects coverage under the Maryland Workers’ Compensation Act should be calculated based upon the sole proprietorship’s net profit—not his or her gross income or gross receipts. Sole proprietorship’s net profit is best approximation of earnings that sole proprietor actually takes home because net profit...