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 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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Jurisdictional Speed Bumps in the Trucking Industry

When are Claims Compensable in New York Workers’ Compensation Law? Workers’ Compensation claims are usually straight-forward – a claimant is injured on the job and brings a claim for benefits. Sometimes, though, claims are not always that simple at the outset. A claimant may live in one state, and be injured in a different state, while working for an employer whose base is in a third state. These situations can
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Recent Trends an “Inextricably Intertwined’ Universe

Oftentimes we see applicants who sustain a specific injury but continue to work thereafter and simultaneously developed a cumulative trauma injury. When evaluating an applicant, the California Labor Code specifically requires a physician to determine what percentage of disability was caused by each industrial injury. This is consistent with the new system of apportionment under SB 899 and the enactment of Labor Code section 4663 and section 4664 which is based
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PFME: What Exactly Does it Mean and Why is it Important to Understand?

As we all know when a workers’ compensation claim is brought forward, the claimant needs to prove two basic points: (1) that he or she has an injury or illness and (2) that the illness or injury was obtained while in the course and scope of his or her employment. For a claim that is accepted from its inception, the above two points are generally easy to find in the
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Is a Workplace Injury Caused by a Non-Occupational Medical Condition Compensable? Connecticut Appellate Court says “Yes” in Clements v. Aramark Corporation

It is a fundamental principle of Connecticut workers’ compensation law that in order for an injury to be compensable, it must occur in the course of and arise out of the claimant’s employment. In the recent Appellate Court decision of Clements v. Aramark Corp., the court considered whether an employee who fell and injured herself at work due to an unrelated medical condition met this burden. In a critical decision
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The Gig is Up: Couriers in the Gig Economy are not Employees in New York

The gig economy is an example of the changing workforce in our society. With that change comes the challenge of determining the employment status, under the law, of couriers who perform services in the gig economy. The appellate court in New York State recently tackled that challenge in Vega v. Postmates Inc., 162 A.D.3d 1337 (3d. Dept. 2018) and held that such couriers are not employees for the purpose of
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