Get Ready: New Maryland Workers’ Compensation Laws Set to Take Effect on October 1, 2017

The date for your new workers’ compensation laws to take effect is now upon us. The Maryland legislature passed several workers’ compensation bills in early 2017 that will be taking effect on October 1, 2017. The law that will likely have the greatest effect on claims handling in Maryland is the requirement that medical providers submit their bills for payment within one year from the later date of: (1) the date of service; (2) the date the claim was accepted
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Stressing the Reasonable Objective — Missouri Supreme Court Provides Clarity on When Mental Injuries Will be Compensable

The Missouri Supreme Court recently acted to provide clear parameters for when an employee will be entitled to recover for stress-related psychiatric disorders. Linda Mantia worked for the Missouri Department of Transportation for over 20 years providing traffic control and assistance at motor vehicle accident scenes on Missouri highways. Mantia responded to accident scenes as often as four times per week, including serious accidents involving fatalities. Mantia was diagnosed with depression in February 2008 and filed a workers’ compensation claim
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Holocker Widens the Interstate: A New Workers’ Compensation Decision Sets Forth Employer Defenses to Terminate Temporary Total Disability Benefits

A recent Workers’ Compensation decision has outlined employer defenses to terminate temporary total disability (TTD) benefits prior to a maximum medical improvement (MMI) finding. In Holocker v. Ill. Workers’ Comp. Comm’n, 2017 IL App (3d) 160363WC (June 16, 2017), the Appellate Court affirmed that termination of temporary total disability benefits was proper despite the petitioner’s ongoing causally related treatment. The court also affirmed that termination of benefits due to the petitioner’s discharge for cause was proper because the petitioner’s restrictions
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The Essentials: Proposed New York 2018 Schedule Loss Guidelines

On September 1, 2017, the New York Workers’ Compensation Board issued draft guidelines and regulatory changes for 2018. The guidelines are intended to revamp the schedule process to align with modern medical practices. The drafts of both the guidelines and regulations appear to include possible errors, omissions, and ambiguities. Click here for a brief overview of the new proposed SLU process and for an idea of what to expect if the new guidelines are adopted.
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Denied Again! Bronx Civil Court Rejects Request of Out-of-State Providers to Re-Litigate Denied Medical Billing

One of the most basic and well-settled tenets of New York law is that the Workers’ Compensation Board maintains exclusive subject matter jurisdiction over all work-related claims and collection disputes. However, in 2015, a small law firm based out of Westbury, New York sought to disrupt the system by commencing several hundred lawsuits in Civil Court, Bronx County on behalf of out-of-state pharmaceutical and durable medical equipment providers arising out of payment disputes involving numerous insurance carriers. The firm touted
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North Carolina Governor Signs Bill Aimed at Protecting Employees from Misclassification

On August 11, 2017, North Carolina Governor Roy Cooper signed into law Senate Bill 407, which creates Article 82, Chapter 183 of the state’s general statutes — more commonly known as the Employee Fair Classification Act (the Act). Quite simply, the Act creates an Employee Classification Division (ECD) within the North Carolina Industrial Commission, led by Director Bradley L. Hicks. The legislation creating the ECD was introduced in 2015 but failed to become law. In response, former Governor Pat McCrory
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North Carolina Court of Appeals Holds Calculations of Average Weekly Wage Must Be “Fair and Just” to Both Employer and Employee

The North Carolina Court of Appeals ruled that when calculating the average weekly wage of an employee, the calculation must be “fair and just” to both the employer and the employee. In Ball v. Bayada Home Health Care, the plaintiff alleged to have suffered injuries to her left hand, bilateral knees, and right hip while employed as a certified nursing assistant (CNA) in February 2011. Her accident took place on the first day of work with a new patient — right
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Waging the War of Wages: Board Revises Employer’s Statement of Wage Earnings (Form C-240)

On June 19, 2017, the Office of the Chair of the Workers’ Compensation Board in New York issued an official Revision of Employer’s Statement of Wage Earnings — at parties, it simply goes by the Form C-240. For the most part, the Form C-240 has stayed true to its roots: it is still required where an injured worker may be entitled to compensation or death benefits, it still demonstrates the claimant’s wage earnings for the 52 weeks prior to the date
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Maryland on High Alert after Declaring State of Emergency

With communities nationwide struggling to address the booming opioid epidemic, Maryland is the first to declare a state of emergency in an attempt to rein in overdoses within its borders. In 2016, the Maryland residents suffered more than 2,700 fatal opioid overdoses; this figure is climbing at an alarming rate. The state of emergency declaration allowed Governor Larry Hogan discretion to allocate $50 million in funding to fight the epidemic without waiting for legislative approval. This funding is in addition
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The Center for Medicare & Medicaid Services Learns about Due Process: Amended Review of Approved Medicare Set-Asides and What it Means for Defense Bar

Recently, the Center for Medicare & Medicaid Services (CMS) promulgated a revised Medicare Set-Aside (MSA) Re-Review process. This “Amended Review” process is significant, as it actually provides those submitting MSAs for approval with an opportunity to revise and amend submitted MSA proposals upon an unfavorable determination from CMS. Previously, CMS has either been unwilling to re-review a submitted MSA or has limited its review following its determination. This has been true even in the face of a significant change in
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