Make the Other Guy Pay: Using Loss Transfer to Recover First-Party Benefits When Subrogation Just Won’t Do

The New York “No-Fault” insurance scheme gives persons injured in a motor vehicle accident the right to recovery for basic economic losses. In a situation where a person is injured at work in a motor vehicle accident, a Workers’ Compensation insurer becomes the first-party benefits provider. As the Workers’ Compensation insurer/self-insurer is now burdened with the payment of benefits that may have been caused by a negligent motorist insured by
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Taher and Effect on Permanency Awards for Claimants with Both Schedulable and Classifiable Conditions

The New York State Supreme Court Appellate Division recently decided the case of Taher v. Yiota Taxi, Inc., in which it addressed the specific situation where a claimant is classified with a permanent partial disability and designated with a loss of wage earnings capacity (LWEC), but has both classifiable and schedulable conditions. The court has determined that a claimant may ultimately receive a schedule loss of use award (SLU) even
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The Going and Coming Rule Does Not Always Apply

In an unreported opinion, the Maryland Court of Special Appeals held that the Circuit Court for Prince George’s County did not err in finding that a public safety officer, who was injured in an accident while driving his personal motor cycle to retrieve his cruiser before beginning his shift, was a compensable accidental injury under the Maryland Workers’ Compensation Act. Prince George’s County v. Zonn, 1514,SEPT.TERM,2017, 2018 WL 6721767, (Md. Ct.
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New Year, New Compensation Rates!

Every year, the Maryland legislature mandates the Workers’ Compensation Commission to determine the maximum compensation rates for the state Average Weekly Wage. The Department of Labor and Licensing Regulation computes the state Average Weekly Wage and provides that figure to the Commission for consideration of compensation rates for the fiscal year. This year, the Average Weekly Wage of workers covered by Maryland Unemployment is $1,116.00, an increase of 2% from
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Is the Labor Market Attachment Forever Over?

As of 2017, a claimant with a permanent partial disability (PPD) who is entitled to awards when they are classified does not have to demonstrate ongoing labor market attachment (LMA). The mentality since the change in 2017 has been that if a claimant is entitled at classification then there is no way to bring up LMA in the future. Prior to the 2017 reform, from December 23, 2010 through February
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New York Court of Appeals Caps the “Additional Compensation” Awarded to Claimants Who Exhaust a Schedule Loss of Use Award

On December 11, 2018, the New York State Court of Appeals decided Matter of Mancini v. Office of Children and Family Services, 2018 N.Y. Slip. Op. 08425, 2018 WL 6492707. At issue was the “additional compensation” entitled to injured workers who exhausted their Schedule of Loss award (SLU) when such award was 50 percent or greater. The claimant argued that the reference to WCL Section 15(3)(w) in Section 15(3)(v) only
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The Importance of Due Diligence on Workers’ Compensation Matters

When you assign the handling of a workers’ compensation matter, it is imperative that the law firm handling the matter properly investigates the claim before proceeding to a causal relationship and/or permanency evaluation examination and definitely before engaging in settlement negotiation. The handling law firm, when applicable, should be obtaining the following: all authorized medical records, all unauthorized medical records, an ISO search claims report (lists all reported claims), run
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2019 Mileage Rates Reach Second Highest in Twenty Years

Every year the Internal Revenue Service (IRS) issues the annual mileage rates, and like clockwork, the IRS has released the updated rates for 2019. This year the mileage rate has increased from 54.5 cents per mile to 58 cents per mile, which reflects a 6.42 percent increase from 2018. A review of the mileage rates from 1997 to present show rates as low as 31 cents (1999) and as high
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I Love You, You’re Perfect, Now Change: Latest Updates on Amending The Compassionate Care Act

At the end of 2018, the original sponsors of the Compassionate Care Act, New York State Senator Savino (D) and Assemblymember Gottfried (D), introduced legislation that will require the following public health insurance plans in New York State to cover medical marijuana: Medicaid Child Health Insurance Plan (CHIP) Workers’ Compensation Elderly Pharmaceutical Insurance Coverage (EPIC) Program, and Family Health Plus Plan. The bill remained inactive in the fall and has yet to be re-introduced
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Don’t Strike Out! Coverage Needed for Traveling Professional Athletes

Consider the following scenario: an applicant filed a claim against the Arizona Diamondbacks for a date of injury of April 1, 2000 through June 1, 2010. The claim was filed August of 2018. He traveled to the state of California to play the Dodgers on six occasions throughout his entire professional baseball career. We first consider how we can combat these types of claims in the state of California. As
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