Luck Favors the Prepared: Reducing Exposure and Expense with a Thorough Initial Claims Investigation

The importance of thoroughly investigating a claim at its inception cannot be overly stressed. Whether a case is accepted or controverted, a thorough investigation is necessary to be prepared to raise all defenses at the first hearing to set the case on a course to the least exposure and the most cost-effective management of liability. In the event a case is accepted, a thorough investigation entails getting a detailed reporting
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The How-To’s of Virtual Hearings

New York State has recently revealed that it will be implementing a virtual hearing procedure for all workers’ compensation hearings. The roll-out of the virtual hearing process began in November and is already in place in select downstate hearing points and is making its way to Binghamton and other upstate hearing locations in the very near future. The virtual hearing process allows (read: strongly encourages) claimants, attorneys, licensed representatives, and
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Admissibility and Disclosure of Social Media Information

Facebook. Twitter. Instagram. Social media platforms have become useful sources for carrier investigation and surveillance of injured workers. Claimants utilize these social media platforms on a daily basis, posting a variety of photographs and videos. Often these photographs and videos contradict claimants’ allegations that they are “totally disabled” from performing any type of activity, allowing carriers and employers to raise fraud under Workers’ Compensation Law Section 114(a). Generally, in order
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Is Your Valid FCE Really Valid?

It may not be. There is a tendency to accept a Functional Capacity Evaluation (FCE) as an objective measurement of everything a claimant can and cannot do. However, it may pay to delve deeper as not all FCEs are created equal. Understanding what to look for and when to challenge a valid FCE can be the difference between a simple loss of use becoming a job change or even a
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Chemical Exposure Case!? Fear Not! You Are Not at the Mercy of the Claimant’s Physician

Imagine receiving a medical report from an oncologist that notes “myelodysplastic changes to chromosome 3 and chromosome 7.” Imagine further that you see such language as “cytogenetics” that reports “abnormal results,” or that both “monosomy 7 and fusion RPM 1/MECOM typically correlate with myelodysplastic syndrome and acute myeloid leukemia.” Imagine further that this medical report is attached to a C-3 opening a claim for a causally-related occupationally acquired cancerous condition.
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North Carolina Court of Appeals Affirms Full Commission Decision: Injury does not Fall under Pre-Amendment N.C. Gen. Stat. § 97-29

The North Carolina Court of Appeals has recently decided a case where the 2011 amendment of N.C. Gen. Stat. § 97-29 was in dispute. In Brown v. N.C. Dept. of Public Instruction, the plaintiff suffered three injuries in 2002, 2011, and 2012, respectively all to her right shoulder. Here, the plaintiff alleged that her 2012 injury was related to her 2011 injury, which occurred days before § 97-29 was amended
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Hey! What about Workers’ Compensation? Evidence Preservation and Investigation for Trucking Workers’ Compensation Claims

Evidence preservation seems to be the number one discussed topic in terms of defending trucking companies for liability claims. For serious accidents, it is common to dispatch defense attorneys and experts to the scene of the accident to preserve evidence necessary to contest liability when appropriate. What is less discussed is that the same data can be invaluable for investigating and defending workers’ compensation claims. A rapidly increasing number of
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The Department of Labor Announces Increased National Average Weekly Wage Now in Effect

The time has come for the annual adjustment in Longshore and Harbor Workers’ Compensation Act (LHWCA) rates. The Department of Labor, which administers the Longshore Act, has announced the new National Average Weekly Wage (NAWW) of $735.89; an increase of 2.46 percent over the previous NAWW. This NAWW will be in effect from October 1, 2017 through September 30, 2018, and will affect ongoing permanent total disability benefits and death
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The Aftermath of Zakwieia and Reger — The Court of Special Appeals Finds LE §9-610 Offset Does Not Apply to Ordinary Disability Benefits for a Different Injury

In the past year there has been a flurry of litigation in Maryland regarding what exactly a “similar benefit” is, and when an offset is warranted under Labor and Employment § 9-610. We first had Zakwieia in early 2017, holding that a similar benefit is “whether the benefits provide a similar wage loss benefit to a workers’ compensation award, not whether the benefits accrue from a similar injury.” Zakwieia v. Baltimore
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It’s Possible to Avoid Total Industrial Findings When Claimants Have a High Impairment Rating

Recent Board Panel decisions are providing guidance for employers to successfully avoid a total industrial finding when addressing Loss of Wage Earning Capacity. Indeed, there does not appear to be any basis under the law for an administrative law judge to find a total industrial disability. In Town of Fenton, Case Nos. G0501597, 90502069, G0087246, 2015 WL 7067972, at *6 (N.Y. Work. Comp. Bd. Nov. 5, 2015), the Board Panel
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