You Down With 13(d)? Yeah, You Know Me: Responding to Health Insurer Reimbursement Requests

Occasionally, when a workers’ compensation claim is initiated, medical bills are paid by the claimant’s private health insurance. If this happens, you may receive correspondence from the health insurer asking for reimbursement. What should you do in that situation? The short answer is that you have no obligation to respond to a direct demand for reimbursement. However, there is a process for reimbursement. This is where the Health Insurer Match
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Using Labor Market Surveys to Rebut Disability

An issue that is frequently encountered in workers’ compensation claims is whether a claimant can prove disability — i.e., whether the claimant can show that they are incapable of earning their pre-injury wages at the same or any other employment as a result of their work-related injury. One tool that employers can use to rebut evidence of disability is a labor market survey prepared by a vocational rehabilitation expert. To
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Candy Cane Catastrophe: A Brief Look at Workers’ Compensation Defenses in New Jersey

With the holidays quickly approaching, it is important to keep in mind a number of issues that may arise when co-workers gather to celebrate. Many employers host year-end holiday parties to recognize another year gone by and to celebrate the many successes of the company. In the unfortunate event that an employee is injured during the most wonderful time of the year, it is important to remember the guiding principle
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Incarceration Upon Conviction of a Felony and its Effects on Attachment to the Labor Market

Attachment to the labor market is an important issue among employers and carriers. By pushing this issue, we can attempt to reduce indemnity costs and aid in the claimant’s return to work. Generally, a claimant who is temporarily partially disabled must show that he or she is attached to the labor market to be entitled to workers’ compensation benefits. The claimant need only seek employment within his or her restrictions,
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American Patriotism Honored: 9/11 First Responders Receive the Health Benefits They Deserve

On September 11, 2019, some of New York’s greatest heroes were honored as Gov. Cuomo signed legislation to aid first responders who developed a qualifying health condition due to harmful exposure after those dreadful attacks 18 years earlier. This legislation reminds all New Yorkers that while the effects of this horrific day continue to live physically and emotionally within first responders, New York City will continue to connect them to
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Maryland’s Second Highest Court Finds Despite Full and Final Settlement, Death is Only the Beginning

In a hot-off-the-press opinion, Maryland’s Court of Special Appeals has held that language within an agreement of final compromise and settlement releasing an employer/insurer from all future claims could not bar a spouse’s claims to death benefits in a workers’ compensation claim.[i] On June 13, 2012, Bernard Collins (the decedent) filed a workers’ compensation claim against Huntingtown Volunteer Fire Department, and two of its insurers, Chesapeake Employers Insurance Company and
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Maryland Court of Appeals Holds That for Occupational Diseases, It’s About the Whole Picture

In a recently reported opinion, the Maryland Court of Appeals held that the Circuit Court for Baltimore County did not abuse its discretion in finding that the claimant, an employee of Baltimore County, had degenerative meniscal tears classifiable as an occupational disease arising out of and in the course of his employment. Baltimore County. v. Quinlan, 215 A.3d 282 (Md. 2019). In October 2015, the claimant filed a claim against
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Maryland’s High Court Reverses Course and Strengthens Modification Powers of the Workers’ Compensation Commission

The Maryland Court of Appeals recently overturned the lower court’s decision limiting the Workers’ Compensation Commission’s (WCC) revisory powers. The Court of Special Appeals previously found the WCC did not have authority to retroactively modify a claimant’s rate of compensation. However, the high court has reversed course and affirmed the commission’s broad powers in the case of Peter Gang v. Montgomery County, No. 67 Sept. Term 2018, 2019 WL 2574657
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Bunk Dicta is Bunk Dicta: New Jersey Appellate Division Rejects Residency as a Sufficient Condition for Jurisdiction

When can an employee who was injured in another state pursue a workers’ compensation claim in New Jersey? On July 22, 2019, the New Jersey Appellate Division approved for publication a decision dealing with exactly that question. In Marconi v. United Airlines, A-0110-18T4 (App. Div. July 22, 2019), the petitioner alleged he sustained work injuries in Pennsylvania. Testimony showed that United initially hired the petitioner in San Francisco. At the
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Garrett v. Goodyear Tire & Rubber Co.

In a recent case, Garrett v. Goodyear Tire & Rubber Co. (Garrett II), the North Carolina Court of Appeals affirmed the Industrial Commission’s determination that a claimant was not disabled due to her failure to engage in a reasonable job search. This case was before the North Carolina Court of Appeals a second time. In its first hearing on the matter, the Industrial Commission concluded the claimant’s neck injury was
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