Workers' Compensation Defense

September 9, 2019 Illinois / Medical Marijuana

Recreational Marijuana and Workers’ Compensation: What Employers Need to Know

With the impending legalization of recreational marijuana in Illinois on January 1, 2020, employers are abuzz about the potential implications on their operations, particularly how legalization impacts alleged work injuries. Under the Illinois Workers’ Compensation Act, employees found intoxicated at the time of an accident are denied compensation if the intoxication was the proximate cause of the injury or if the employee was so intoxicated it constituted a departure from the employment. 820 ILCS 305/11.

The act already considers evidence of intoxication from the use …

September 3, 2019 Disability Benefits / New York

The Effect of Immigration on New York Workers’ Compensation

New York state has one of the largest undocumented immigrant populations in the nation, coming in fourth behind Texas, California, and Florida. According to the most recent study taken by Pew Research Center in 2016, 725,000 unauthorized immigrants lived in New York state. Although it is illegal for employers to hire immigrant workers who are not documented and authorized to work in the United States, whether it is intentional or not, employers continue to hire undocumented immigrant workers every day.

When undocumented workers are injured …

August 26, 2019 Connecticut / permanent partial disability / Temporary Total Disability (TTD)

Undocumented Immigrants Lose Out on Benefits

Under the Connecticut workers’ compensation statutes (codified under Title 31), immigrants who are not U.S. citizens enjoy many, but not all, of the same rights as U.S. citizens. The workers’ compensation system affords medical and indemnity benefits to eligible claimants. Within the indemnity category, there are lost time benefits, permanency benefits, and earning impairment benefits. Particularly, this eligibility hinges on whether an individual is documented and can legally work in the United States.

Immigrants that lack citizenship or proper documentation are still eligible for medical …

August 12, 2019 Connecticut / Legislation

Connecticut Legislative Update: Workers’ Compensation Coverage Expanded for Some First Responders

In a rare legislative change to Connecticut Workers’ Compensation Law, Gov. Ned Lamont recently signed into law Senate Bill No. 164 (Public Act 19-17), which expands workers’ compensation coverage for some first responders who experience mental or emotional impairment following certain traumatic events experienced in the line of duty. Specifically, the bill allows for police officers, firefighters, and parole officers that have been diagnosed with Post-Traumatic Stress Disorder (PTSD) to be eligible for workers’ compensation benefits. In order to be eligible for benefits, the first …

August 12, 2019 Connecticut / Disability Benefits

Construction Sites, Injured Contractors & Workers’ Compensation

In Connecticut, the “traditional” rules of workers’ compensation are relatively well established. A restaurant employee cuts his finger preparing food on shift; a home health aide pulls a muscle in her back while moving a patient on shift; a delivery truck driver gets into a motor vehicle accident while delivering to a customer. But what if you are a contractor or subcontractor on a job/site and get injured? Do you know who your direct employer is? Is there workers’ compensation coverage? For the most part, …

July 29, 2019 Disability Benefits / General

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, the claimant underwent left shoulder surgery secondary to a 2004 motor vehicle accident prior to …

July 22, 2019 Average Weekly Wages / New York

What to Expect with Wage Expectancy: A Primer

When dealing with claims of injured workers under the age of 25, the wage expectancy statute of New York’s workers’ compensation law looms overhead that first time you calculate the claimant’s wage at the time of injury. While it does not apply in every instance, there are some ways to effectively avoid pitfalls. One major key to your defense is setting up a game plan as early as possible.

The wage expectancy provision of the workers’ compensation law was enacted in recognition of the fact …

July 22, 2019 Disability Benefits / New York

The Biggest Loser: How to Handle Requests for Causally Related Bariatric Bypass Surgery

Under the New York State workers’ compensation law, an employer or carrier “shall promptly provide for an injured employee such medical, surgical, optometric or other attendance of treatment . . . for such period as the nature of the injury or the process of recovery may require.” This is a pretty general requirement, but it opens the door to a new question: what happens when an injured worker requires back surgery, but is not a candidate because he or she is overweight? They have two …

July 15, 2019 General

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 to obtain an addendum, but the reality is that we run the risk of preclusion …