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Collateral Estoppel Precludes Worker From Challenging Validity of Settlement

The Commonwealth Court of Pennsylvania ruled that an injured worker was precluded from trying to challenge the validity of his settlement agreements with his employer. Case: May v. Dana Corp., No.




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Injured Firefighter Not Entitled to Reinstatement of Benefits

The Commonwealth Court of Pennsylvania ruled that an injured firefighter was not entitled to reinstatement of his benefits. Case: Marinack v. City of Pittsburgh (WCAB), City of Pittsburgh v. Marinack (WCAB),…




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Adjuster's Miscalculation of Lien Doesn't Allow Worker to Avoid Payment

The Commonwealth Court of Pennsylvania upheld a determination that a worker was required to pay the full amount of her employer’s lien against her third-party recovery, even though the estimate…




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Bill Would Limit Employment Protections for Medical Cannabis Users

Pennsylvania employers would be allowed to make adverse employment decisions against employees and job applicants who legally use medical cannabis, under recently introduced legislation. Senate Bill 1290, introduced Wednesday by Sen. Patrick…




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Injured Worker May Not Set Aside Settlement With Employer

The Commonwealth Court of Pennsylvania ruled that a worker was not entitled to set aside the workers’ compensation settlement she reached with her employer. Case: Clarius v. Rite Aid Corp. (WCAB),…




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Department Accepting Requests for Assessment Refund Through Feb. 24

The Pennsylvania Insurance Department announced that it will accept requests for refunds of 2009 work comp security fund assessments through Feb. 24. A provision in the budget bill lawmakers passed this…




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Court Upholds Employer's Entitlement to Terminate Worker's Benefits

The Commonwealth Court of Pennsylvania upheld an employer’s entitlement to terminate its payment of benefits to an injured worker. Case: Carter-Zimmitt v. City of Philadelphia (WCAB), No. 1597 C.D. 2022, 09/10/2024,…




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Court: WCJ Needs to Revisit Contingency Fee Agreement

The Commonwealth Court of Pennsylvania ordered a workers’ compensation judge to reconsider an agreement providing for a 20% contingency fee from a worker’s medical and indemnity benefits. Case: Elder v. Crane…




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Court Upholds UR Determination That Worker's Treatments Weren't Necessary

The Commonwealth Court of Pennsylvania upheld a utilization review determination that a worker’s ongoing treatments were neither reasonable nor necessary. Michael Perry worked for the Mid Atlantic Hose Center LLC. He…




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Employer Loses Challenges to Benefits Reinstatement, Expansion of Claim, Penalties

The Commonwealth Court of Pennsylvania rejected an employer’s challenges to orders reinstating a worker’s benefits, the expansion of his claim and the imposition of penalties. Case: Pennsylvania Liquor Control Board v. Berardi (WCAB),…




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Employer That Failed to Provide Treatment for Worker Can Still Direct Future Care

A Missouri appellate court ruled that an employer was entitled to direct a worker’s future medical care even though it had refused to pay for her treatment for more than a…




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High Court Holds That Commission Did Not Err in Assessment of Worker's Credibility

Although the Idaho Industrial Commission erred in several credibility findings, the remainder of its determinations finding that an injured worker was not a reliable witness were supported by substantial and…




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Insurance Department Adopts 6.7% Rate Cut

The Idaho Department of Insurance on Wednesday announced that it accepted the National Council on Compensation Insurance's rate filing for an average 6.7% reduction in workers’ compensation rates. Dean L. Cameron The…




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Senate Passes Bill to Prolong Electronic Payment Authorization

The California Senate unanimously passed a bill that would allow carriers to continue using debit cards to pay benefits for another two years. The Senate on Monday voted 38-0 to pass…




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Commissioner Announces CIGA, WCIRB Appointments

California Insurance Commissioner Ricardo Lara on Tuesday announced two appointments to the Workers’ Compensation Insurance Rating Bureau Governing Committee and the California Insurance Guarantee Association board of governors. C. Bryan Little (www.fels.net) …




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Court Publishes Decision Requiring SIBTF to Prove Entitlement to SSDI Offset

California’s 2nd District Court of Appeals published its July decision finding that the Subsequent Injuries Benefits Trust Fund is required to prove by a preponderance of the evidence that it…




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Appropriations Committee Passes Anti-Discrimination Treatment Bill, Ag Worker Presumption

The California Assembly Appropriations Committee passed bills that would create a presumption that heat injuries are compensable for agricultural workers and would expose employers to penalties for denying injured workers’…




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Amended Bill Would Allow Employers to Deny Time Off for 'Business Necessity'

California employers could deny an injured worker’s request for time off to get medical treatment for business necessity, under a recently amended bill. Sen. John Laird, D-Santa Cruz, on Monday amended…




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Amendment Expands E-Signature Bill

Electronic signatures would be allowed for all California workers’ compensation documents, under a recently amended bill. Assemblymember Diane Dixon, R-Newport Beach, last week amended AB 2337 to strike a provision that…




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CWCI Publishes Report on Average Benefit Payments

The California Workers’ Compensation Institute published a report on trends in average benefit payments valued 24 months from the date of injury. CWCI reports average medical payments started declining two years…




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Assembly Passes State Licensing Requirement for UR Docs

The California Assembly passed a bill that would require some doctors who perform utilization reviews to be licensed in the state. The Assembly on Thursday voted 54-13 to pass SB 636,…




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Subcontractor Can't Demand Payment for Work Done Without Comp Coverage

A California appellate court ruled that a subcontractor on a construction project was not entitled to pursue payment for its work because it failed to maintain workers’ compensation coverage. Case: American Building Innovation LP…




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DWC Posts Quarterly Adjustment to Hospital, ASC Fees

The California Division of Workers’ Compensation posted an order adopting the latest quarterly update to the outpatient hospital and ambulatory surgery center section of the Official Medical Fee Schedule. The division…




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DWC Opens Second 15-Day Comment Period for Pharmacy Rules

The California Division of Workers’ Compensation opened a second 15-day comment period on a proposal to incorporate Medi-Cal’s reimbursement rules into its pharmacy fee schedule. In addition to technical corrections, the…




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WCRI Finds Medical Payments 10% Below Median in Golden State

The Workers Compensation Research Institute reports that average medical payments per claim in California were 10% below the median of a 17-state study. California saw little change in payments per claim…




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Court Upholds Finding of Partial Disability, Remands Dispute of Claimed Overpayment

The Michigan Court of Appeals ruled that a worker was partially disabled by carpal tunnel syndrome and the Workers’ Disability Compensation Appeals Commission should address whether she received an overpayment…




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Comp Settlement Doesn't Preclude Civil Suit Against Third Parties

The Georgia Court of Appeals ruled that a worker’s settlement of his compensation claim against his employer did not preclude him from pursuing a civil suit against alleged third-party tortfeasors…




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Governor Approves Legacy Court, Mental Health Bills

Oklahoma Gov. Kevin Stitt signed bills creating a new venue for legacy claims and covering public safety workers with mental health claims that aren’t accompanied by a physical injury. Stitt on…




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Court Upholds Worker's Entitlement to Additional Treatment, AWW Calculation

The Arkansas Court of Appeals upheld a determination that a worker was entitled to additional treatment for a foot injury, as well as the Workers’ Compensation Commission’s calculation of her…




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Court Says Worker's Lies Don't Forfeit Entitlement to Benefits

The Arkansas Court of Appeals upheld an award of benefits for a man with a rapid-repetitive-motion injury and that he did not forfeit his entitlement to benefits by lying about his medical…




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Court Upholds Causal Connection Between Coal Worker's Employment, Pneumoconiosis

A federal appellate court upheld a finding that a worker’s coal mine employment caused his pneumoconiosis. Case: Lance Coal Corp. v. OWCP, No. 23-3779, 05/09/2024, unpublished. Facts: Virgil Combs worked for Lance…




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OccMD Names Cheryl Killion Director of Nurse Case Management

Medical management firm OccMD on Tuesday announced the appointment of Cheryl Killion as the new director of nurse case management effective June 1. Killion has served as a senior nurse case…




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Court Upholds Worker's Convictions for Embezzlement, Workers' Compensation Fraud

A federal appellate court upheld a worker’s convictions and sentence to embezzlement and workers’ compensation fraud. Case: U.S. v. Holmes, No. 23-4700, 06/21/2024, unpublished. Facts and procedural history: Federal prosecutors in South…




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Bill Would Allow Treatment by Physician Assistants, Nurse Practitioners

Physician assistants and nurse practitioners would be authorized to treat injured federal workers under a bill being debated in the U.S. House of Representatives. HR 618, by Rep. Tim Walberg, R-Mich., would add…




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Truck Driver's Work Counts as Coal Mine Employment for Black Lung Benefits

A federal appellate court upheld an award of compensation under the Black Lung Benefits Act to a worker, finding that the time he spent as a truck driver was “substantially…




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WCRI Webinar to Cover Trends in Drug Payments

The Workers Compensation Research Institute is holding a 30-minute webinar Aug. 1 to discuss key findings from its study of interstate variation and trends in work comp drug payments. The WCRI…




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NCCI Study Finds Average Impairment Rating of 6.5%

The National Council on Compensation Insurance said its analysis of impairment ratings in 33 states plus the District of Columbia found that the average whole-body impairment rating for permanently disabled…




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Carrier Not Contributing Assessments to Trust Fund Can Still Get Reimbursements

The Massachusetts Appeals Court ruled that an insurance company that was not contributing any assessments to the Workers’ Compensation Trust Fund was still eligible for reimbursement for benefits paid to…




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Report: Lawmaker Failed to Report Outside Employment While Collecting Comp

The Connecticut Insider on Wednesday reported that a state lawmaker received more than $100,000 in workers’ compensation benefits despite having three outside sources of income that he never disclosed. Sen. Paul…




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Injured Flight Paramedic Fails to Prove Entitlement to Additional Awards

The Virginia Court of Appeals upheld benefit awards of closed periods for an injured paramedic, finding that she failed to prove her entitlement to additional compensation. Case: Martinka v. PHI Group Inc.,…




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Employer Can't Relitigate Reasonableness of Worker's Mileage for Treatment

The Virginia Court of Appeals ruled that an employer could not relitigate the reasonableness of a worker’s mileage expenses from traveling to see a chiropractor 78 miles from his home. John Edelblute…




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Court Upholds Award for Postinjury Mental Health Treatment

The Virginia Court of Appeals upheld an award of benefits for a worker’s mental health treatment after her on-the-job injury. Case: Virginia Commonwealth University v. Miller, No. 1859-23-2, 08/20/2024, unpublished. Facts: Sabrina…




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Supreme Court Establishes Method for Apportioning Preexisting Impairment

The West Virginia Supreme Court clarified the proper method for apportioning preexisting impairments that have been definitely ascertained and impact multiple body parts. Case: Logan-Mingo Area Mental Health Inc. v. Lester,…




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Worker Fails to Establish Causal Connection Between Injury, Need for Nerve Block Treatments

The West Virginia Intermediate Court of Appeals upheld a denial of authorization for nerve block treatments for an injured worker. Case: Cooper v. Lowe’s Home Centers Inc., No. 24-ICA-55, 07/30/2024, unpublished. Facts:…




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No Additional Treatment, Benefits for Injured Mine Worker

The West Virginia Intermediate Court of Appeals upheld the denial of additional treatment and temporary total disability benefits for an injured mine worker. Case: Polinski v. Consol Bailey Mine WV, No.




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Supreme Court Overturns PPD Award on Deficiencies in Apportionment Opinion

The West Virginia Supreme Court overturned an award of permanent partial disability benefits to an injured worker, finding that it was improperly based on the opinion of a doctor who failed…




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Supreme Court Upholds Authorization of Pain Management Consultation for Worker

The West Virginia Supreme Court upheld the authorization of a pain management consultation for an injured worker. Case: Murray American Energy Inc. v. Stapel, No. 22-923, 08/01/2024, published. Facts: Sean Stapel worked…




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Supreme Court Upholds Denial of Worker's Request to Add Mental Injuries to Claim

The West Virginia Supreme Court upheld the denial of a doctor’s request to expand a worker’s claim to add post-traumatic stress disorder and anxiety as compensable conditions. Case: Travers v. Blackhawk…




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Supreme Court Upholds Denial of Worker's Request for More Treatment, Benefits

The West Virginia Supreme Court upheld the denial of a worker’s request for additional treatment and benefits, and the expansion of his claim. Case: Hankins v. Sprouting Farms Corp., No. 22-919,…




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Court Finds Worker Has No Impairment Despite 43 Years of Coal Dust Exposure

West Virginia’s Intermediate Court of Appeals upheld a determination that a worker had a 0% impairment despite his many years of occupational exposure to coal dust. Case: Jarrell v. Blackhawk Mining…