Workers' Compensation Defense

October 14, 2019 Connecticut / Legislation

Connecticut Workers’ Compensation Commission Issues Important Update to Professional Guidelines Regarding One-Time Evaluations and Second Opinions

On August 29, 2019, Connecticut Workers’ Compensation Commission (WCC) Chairman Stephen M. Morelli issued Memorandum No. 2019-07 regarding updates to the Professional Guide for Attorneys, Physicians, and Other Health Care Practitioners Guidelines for Cooperation. Specifically, the memorandum highlights changes to the Professional Guide with respect to one-time medical evaluations and second opinions.

By way of background, the Professional Guide is a guidance document produced by the Workers’ Compensation Commission intended to improve the interaction between attorneys, physicians, and other health care professionals in the …

Leveraging Compromises in the New York Workers’ Compensation System

Compromises are a vital and frequent part of the workers’ compensation litigation process. However, one should take care to avoid negotiating them out of habit. With two doctors giving irreconcilable opinions, parties will often agree to split benefits straight down the middle in lieu of litigation.

Sometimes, such as when both parties concede partial disability and are within a close margin, this is a helpful way to allay costs of depositions and further court appearances. Often, upon hearing the word “compromise,” a judge will automatically …

October 7, 2019 Disability Benefits / General

Missing Check: The Status of the Law

Oftentimes, when parties in a workers’ compensation matter agree to settle or when the claimant is entitled to certain indemnity benefits, the carrier sends payment to the claimant by mailing a check to an address provided by the claimant. There are situations, though, when the check goes missing or is stolen, perhaps in transit or at the address provided by the claimant. This begs the question – what are the rights and obligations of the carrier under the law?

In prior stolen check cases, the …

September 30, 2019 District of Columbia

Paying for Claimants’ Attorney Fees is the Exception to the Rule in D.C.

The D.C. Court of Appeals was recently presented with the opportunity to weigh in on the prerequisites for ordering employers and insurers to pay for claimants’ litigation fees and costs in workers’ compensation claims. In the case of Kelly v. D.C. Dep’t of Employment Servs., No. 18-AA-13, 2019 WL 4073672 (D.C. Aug. 29, 2019), the court refused to require the employer and insurer to bear the cost of the claimant’s attorney fees.

In Washington, D.C., there are only two limited circumstances where the employer …

September 30, 2019 Legislation / New York

Special Funds Liability Under the Board’s Special Funds Group

It has become apparent over the recent years that the New York Workers’ Compensation Board, along with the Special Funds Group, will go to great lengths to resolve themselves of liability for outstanding claims under NY WCL Section 25(a), as well as 15(8), particularly in consequential death claims.

Under the 2007 reforms, the then-Second Injury Fund was closed to new claims with dates of injury on or after July 1, 2007. Then, on March 29, 2013, Section 25(a) was amended to close the Fund for …

September 23, 2019 Legislation / Medical Expenses / New York

Expanded Provider Legislation; Implications for Insurance Carriers

As part of Gov. Cuomo’s 2019-20 executive budget, a new law was passed expanding the types of medical providers that can apply to be authorized to treat injured workers under the New York State Workers’ Compensation System. The law will be effective January 1, 2020.

Prior to the legislation taking effect, only physicians, chiropractors, podiatrists, and psychologists could apply to be board-authorized to treat injured workers while nurse practitioners (NPs), physician assistants (PAs), occupational therapists, physical therapists and licensed clinical social workers (LCSWs) could only …

September 23, 2019 General / New Jersey

Due Process in the New Jersey Workers’ Compensation System

In an ideal workers’ compensation system, all parties would keep to the letter of the law. However, courts’ rules are oftentimes relaxed within our system and often not followed. In handling any New Jersey workers’ compensation claim petition, employers, employers’ attorneys and claims professionals must be diligent in making sure that employers’ fundamental rights are not violated by this relaxed approach. All parties, petitioners, and respondents have the right to due process. This right includes procedural due process and substantive due process. For instance, one …

September 16, 2019 Medical Expenses / North Carolina

North Carolina Court of Appeals Affirms Industrial Commission’s Denial of Bellwether Cases

The North Carolina Court of Appeals recently affirmed the Industrial Commission’s denial of claims, collectively known as the bellwether cases, that constituted a small portion of 144 consolidated workers’ compensation claims.

Specifically, Walter Hinson, decedent-employee, worked for Continental Tire the Americas at its factory in Charlotte, North Carolina. The decedent’s estate alleged that his employment exposed him to levels of harmful airborne asbestos sufficient to cause asbestos-related disease. In addition to the decedent’s estate, approximately 143 other employees and/or estates similarly alleged occupational exposure to …

September 16, 2019 California / Legislation

The Perils of Paragraph Three – Mind Your Step

When a case is resolved by way of a Compromise & Release (C&R), parties often believe that all pertinent issues (including claims of injury and body parts) have been disposed of in the settlement. This is because settlements will carefully delineate all of the body parts and claims that are being resolved in the written agreement. What do we make of the applicant who decides to file a subsequent claim alleging an injury that was presumably resolved in the prior settlement? An important lesson can …

September 9, 2019 New York / Schedule Loss of Use

Schedule Loss of Use Award or Classification? Litigation Trends Following Taher

On June 14, 2018, the Third Department of the New York State Appellate Division issued the decision Matter of Taher v. Yiota Taxi. In Taher, the Third Department addressed the question of whether a claimant may receive both a schedule loss of use (SLU) award and classification arising out of the same work-related injury at the time of permanency. Ultimately, the Third Department held that a claimant cannot receive both a SLU award and be classified with a loss of wage earning capacity at …