Workers' Compensation Defense

January 7, 2019 Disability Benefits / General

Recent Trends an “Inextricably Intertwined’ Universe

Oftentimes we see applicants who sustain a specific injury but continue to work thereafter and simultaneously developed a cumulative trauma injury. When evaluating an applicant, the California Labor Code specifically requires a physician to determine what percentage of disability was caused by each industrial injury. This is consistent with the new system of apportionment under SB 899 and the enactment of Labor Code section 4663 and section 4664 which is based on causation. This means that each distinct industrial injury must be separately compensated based …

January 7, 2019 Uncategorized

The Holidays are Over. Is Your Office Party Injury Compensable?

Employers throw annual parties for the employees to commemorate another successful year. Of course, once the music starts going and the drinks start flowing, the employers are left with an annual headache of a question – are employees that were injured in relation to these festivities covered under Workers’ Compensation?

While compensability for office party injuries is a highly fact-intensive determination, claimants usually emerge victorious. Generally, even if the party was held off of the office premises, a fact-finder will rule in favor of the …

December 24, 2018 Average Weekly Wages / New York

Average Weekly Wage Calculation

Average weekly wage (AWW) can be a significant factor in determining a carrier’s exposure in a workers’ compensation case in New York because it is the basis for indemnity benefits calculation for the duration of the case. The compensation rate on a case is two-thirds of the AWW, subject to a statutory cap.

There are several methods for calculating AWW in New York. New York Workers’ Compensation Law (WCL) § 14 controls, and there is extensive case law from the New York Workers’ Compensation Board …

November 20, 2018 General

PFME: What Exactly Does it Mean and Why is it Important to Understand?

As we all know when a workers’ compensation claim is brought forward, the claimant needs to prove two basic points: (1) that he or she has an injury or illness and (2) that the illness or injury was obtained while in the course and scope of his or her employment. For a claim that is accepted from its inception, the above two points are generally easy to find in the initial reporting to the client However, the aspect that is generally overlooked is that a …

October 1, 2018 North Carolina

North Carolina Industrial Commission Uncovers Workers’ Compensation Fraudulent Activity in Craven County, North Carolina

The North Carolina Industrial Commission recently charged a woman with workers’ compensation fraud in Craven County, North Carolina.

Ms. Kimberly Ann Sutton has been charged with two counts of workers’ compensation fraud and two counts of obtaining property by false pretense. Fraud investigators found evidence that Ms. Sutton was working at the same time that she was simultaneously receiving workers’ compensation benefits. There was also evidence that she failed to disclose that she was employed by a different employer. This was in direct violation of …

October 1, 2018 Connecticut / General

Is a Workplace Injury Caused by a Non-Occupational Medical Condition Compensable? Connecticut Appellate Court says “Yes” in Clements v. Aramark Corporation

It is a fundamental principle of Connecticut workers’ compensation law that in order for an injury to be compensable, it must occur in the course of and arise out of the claimant’s employment. In the recent Appellate Court decision of Clements v. Aramark Corp., the court considered whether an employee who fell and injured herself at work due to an unrelated medical condition met this burden. In a critical decision that overturned both the Trial Commissioner and Compensation Review Board (CRB), the court found in …

October 1, 2018 Connecticut / Settlement

Moratorium to all Moratoriums

Public Act No. 11-205 significantly impacts the way in which the Connecticut Worker’s Compensation Act (C.G.S. § 31-275 through 31-355b) is applied. Generally, under Connecticut’s Worker’s Compensation laws, when an employee is injured in a work related accident, he/she is entitled to worker’s compensation benefits for their injuries. The employer is required to pay both indemnity and medical benefits, in exchange for the employee’s right to sue. However, if the accident was caused by a third party, either the employer or the employee may bring …

September 17, 2018 New Jersey

Idiopathic Injuries: Dealing with Injuries that Occur at Work, But Are Not Work-Related in New Jersey

We have all come across the case where an employee is injured at work, but the injury doesn’t seem to arise from something we would consider work-related. The injury could have just as easily happened at some time or place other than while the employee was at work. For example, the worker is walking down an aisle toward his workstation, his ankle gives out, and he falls. He didn’t trip. He didn’t slip. There was nothing wrong with the condition of the floor. His ankle …

September 17, 2018 General / New York

The Gig is Up: Couriers in the Gig Economy are not Employees in New York

The gig economy is an example of the changing workforce in our society. With that change comes the challenge of determining the employment status, under the law, of couriers who perform services in the gig economy. The appellate court in New York State recently tackled that challenge in Vega v. Postmates Inc., 162 A.D.3d 1337 (3d. Dept. 2018) and held that such couriers are not employees for the purpose of unemployment insurance benefits. Even though this claim pertained to unemployment insurance benefits, the Third …

September 5, 2018 Maryland

Limitations on the Revisory Powers of the Workers Compensation Commission

While unreported, the Court of Special Appeals has interpreted some boundaries to revisory powers in the case of Montgomery County, Maryland v. Peter Gang, No. 00768 Sept. Term 2017, 2018 WL 3801772 (Md. Ct. Spec. App. Aug. 9, 2018).

The background of the case establishes that the claimant, Peter Gang was a public safety worker for Montgomery County at the time of his September 17, 2011 work injury. Due to an oversight, he received a permanent partial disability award on May 2, 2012, which …