Caring for Construction Worker Employees Could Lead to a Reduction in Workplace Accidents

At a recent OSHA training course, multiple construction workers expressed that their biggest concern regarding safety was associated with how their employer respected their own safety at a job site. If their employer respected safety over rushing a project and cutting corners, the construction workers expressed that they noticed fewer worker-related injuries. While the construction employer may believe they are saving costs by completing a project quickly, this could cost more
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Causal Relationship for Preauthorized Surgeries: Questioning Causality

It is easy to accept preauthorized surgeries as a foregone conclusion where the site of surgery is established and the procedure is approved by the Medical Treatment Guidelines. However, it shouldn’t be. Earlier in 2019, Goldberg Segalla’s workers’ compensation team won an appeal on this very issue. The claimant underwent preauthorized left shoulder surgery on a file established to the left shoulder for an injury that occurred in 2016. However,
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Get It Right the First Time: Why You Should Not Skimp on an IME Cover Letter

We have all been there. The workers’ compensation law judge has directed the carrier to produce an Independent Medical Examination (IME) within a specified number of days. Somehow, we managed to get the report completed timely, even after many scheduling attempts, cancellations, or claimant no-shows. Then, your IME consultant failed to address the key questions. We can try our best to have the law judge grant the carrier an opportunity
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Maryland Statutes of Limitation are Not Liberally Construed in Favor of the Claimant

Bonnie Miller v. Jacobs Technology, Inc.[1] , an unreported case handed down from the Court of Special Appeals earlier this year is unequivocal in its holding that the all statutes of limitation in the Workers’ Compensation Act will not be liberally construed in favor of the claimant. In Bonnie Miller v. Jacobs Technology, Inc., the claimant sustained an accidental injury on September 29, 2011 and filed a claim with the commission
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One Missing IME, Too Many

I recently attended a hearing that was scheduled pursuant to claimant’s RFA-1, requesting reinstatement of awards. You’re probably wondering, why were awards suspended in the first place? Because claimant had missed three scheduled independent medical examinations (IMEs)! She also did not have current medical evidence of a further causally related disability at the last hearing. The prior notice of decision read wonderfully, “suspension is effective until such time that the
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Combating Injured Workers’ IME Reports

Employers, carriers, and third-party administrators are all too familiar with Section 137 of the New York Workers’ Compensation Law and 12 NYCRR Section 300.2, as they govern Independent Medical Examinations (IMEs). Failure to meet or substantially comply with the necessary requirements of Section 137 puts you at risk of having your IME report precluded by a workers compensation law judge. The same holds true for injured workers when they are
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How Does it Work? Incarceration and Workers’ Compensation Benefits

The incarceration of a claimant receiving workers’ compensation benefits can be used as a defense to payment of indemnity benefits based on two similar, but distinct, arguments. In general, where the carrier has been directed to pay workers compensation indemnity benefits by the New York Workers’ Compensation Board, the carrier may only suspend indemnity benefits unilaterally (without a new direction from the board) in certain circumstances. Per 12 NYCRR Section
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Forum Section Critical in Carolina UIM Benefits Case

A recently published North Carolina Court of Appeals workers’ compensation case highlights an issue for consideration when there is an opportunity to select a forum for workers’ compensation benefits involving a claim where UIM benefits are a potential recovery source for subrogation. In Walker v. K&W Cafeterias, Robert Walker (decedent) was killed in a motor vehicle accident while driving a truck for his employer, K&W Cafeterias, Inc. K&W is a North Carolina
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The Current State of the North Carolina Industrial Commission

Before Governor Cooper was set to take office in 2017, the North Carolina legislature allowed outgoing Governor, Pat McCrory, to appoint Charlton Allen as the chair of the North Carolina Industrial Commission. McCrory also appointed Yolanda Stith as vice-chair of the commission and provided her with a nearly nine-year term. Following McCrory’s appointments, incoming Governor Cooper brought suit against Senate Leader Philip Berger and House Speaker Tim Moore, as well
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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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