Using the Labor Market Attachment Defense to Your Advantage During a LWEC Trial

Under Workers’ Compensation Law Section 15(3), if a claimant has a permanent impairment to a non-schedule site, then the claimant is compensated for his or her actual loss of wage earning capacity (LWEC) caused by the disability. This stage in workers’ compensation litigation is known as classification. During the LWEC trial, the law judge not only considers a claimant’s permanent medical impairment but also vocational factors such as age, education, language ability, work history, and transferrable skills that may mitigate or aggravate the percentage of …

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Obtaining and Maintaining Proper Working Papers – It’s No Minor Task

Prior to hiring a minor (an employee who is under the age of 18), an employer has an obligation to obtain the minor’s employment certificate or permit issued in accordance with the education law (commonly referred to as “working papers”). Prior to the minor starting work, the employer must file this certificate at the place of the minor’s employment so that it may be readily accessible to any person authorized by law to examine such a document.

If a minor is injured while on the …

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Medication and Transportation (M&T) Reimbursement in New York: A Primer

New York Workers’ Compensation Law (WCL) dictates that an injured worker is entitled to reimbursement for certain expenses relating to an established compensable claim. WCL Section 13(a) provides that an employer is obligated to provide an injured employee with such medical, surgical, or other attendance or treatment as the nature of the injury or the process for recovery may require. In kind, courts have ruled that transportation costs incurred in connection with medical treatment are compensable if reasonable, and that the statute should be interpreted …

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North Carolina Court of Appeals Retains Pre-Reform Definition of Suitable Employment

Suitable employment is an issue frequently litigated in workers’ compensation claims in North Carolina. Typically, a job is offered and the claimant refuses the job on the basis that it is allegedly unsuitable. For decades, this issue has troubled employers because claimants could, with seeming impunity, refuse legitimate work and continue to collect temporary total disability.

Prior to 2011, North Carolina case law dictated that post-maximum medical improvement (MMI) employment must be (1) available in the local labor market, (2) reasonably attainable and offers opportunity …

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Treatment Authorization Requests: Ensuring Proper Compliance with 12 NYCRR 325-1.4

Workers’ Compensation Law Section 13 establishes the obligation of the employer to “promptly provide for an injured employee such medical surgical, optometric or other attendance or treatment… for such period as the nature of the injury or the process of recovery may require.”

When requesting authorization for treatment, the provider submits a Board form titled, “Attending Doctor’s Request for Authorization and Insurer’s Response.”  The Board code for the form is shortened to C-4AUTH. Unlike a variance request, a request for authorization in a C-4AUTH is …

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How To Ensure Your IME is Compliant with Section 137

In order for an Independent Medical Examination (IME) report to be compliant with Section 137 of the Workers’ Compensation Law, a copy of each report must be submitted by the practitioner on the same day and to the Board, the insurance carrier, the claimant’s attending physician or practitioner, the claimant’s representatives, and the claimant themselves in the same manner (WCL Section 137(1)(a)). “If a practitioner who has performed or will be performing an independent medical examination of a claimant receives a request for …

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Concurrent Employment – Limiting and Litigating Average Weekly Wage

Claimants may have more than one job at the time of their work incident. Pursuant to New York Workers’ Compensation Law Section 14(6), the average weekly wage can be increased if the claimant has two or more jobs at the time of the work injury. Therefore, this issue of concurrent employment is raised by a claimant, and not a carrier, because it can mean more indemnity benefits to the claimant. When concurrent employment is raised, the claimant should provide written documentary proof of concurrent employment, …

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New Attachment for Schedule Loss of Use Stipulations

There are two types of permanency evaluations:

  1. Schedule awards for the impairment of extremities, vision loss, hearing loss, or facial disfigurement
  2. Non-schedule classification as a permanent partial or total disability.

On October 4, 2019, in subject number 046-1211, the Board issued specific circumstances where a new attachment must be used when stipulating to schedule loss of use and non-schedule sites are also involved.

The new stipulation must be used in three situations:

  1. When there is no medical report from either party regarding the established non-schedule
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A Quick Guide on How to Navigate Claims That Occur Outside of North Carolina

Whether the North Carolina Industrial Commission has jurisdiction to adjudicate a workers’ compensation claim can be critical to a claim’s defense. A scenario where this issue commonly arises is when an employee is injured outside of the state of North Carolina, yet chooses to file a North Carolina claim.

N.C. Gen. Stat. Section 97-36 is the statute governing the North Carolina Industrial Commission’s jurisdiction over claims arising from accidents occurring outside of the state. Of particular importance, the North Carolina Court of Appeals has held …

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When Does an Injury at Work Actually Arise Out of Employment in New Jersey?

For a work-related injury to arise out of employment, there must be a causal relationship between the employee’s injury and their employment. Simple concept, right? Well, maybe not. Consider the following hypothetical scenarios:

  • A worker faints while sitting at their desk
  • A worker is walking and, for no explicit reason, their lower back locks
  • A worker suffers a stroke while making coffee in the office kitchen

The above scenarios are all unlikely to have risen out of employment within purview of the court. Why? It …

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