National Edition Banner March 2010
Vol 2, Issue 1

Find Solutions & Strategies                            January 3, 2011

Elephant SadDepression and Delayed Recovery  

 

Depression is the "elephant in the room" for many workers' compensation injuries

In This Issue
-DEPRESSION & DELAYED RECOVERY
-HOW TO USE THIS eNEWSLETTER
-LARSON'S SPOTLIGHT: Horseplay, Illegal Alien, Sexual Assault, Independent Contractor, Chronic Pain and Depression
-BLOGOSPHERE TOP 10 READS
-WC NOTABLE PEOPLE NOMINATIONS
-BLOG ROUND UP AT THE WCLC: Fraud, DE case, PA case, TX issues
-MSP COMPLIANCE BOOK
-NATIONAL NEWS
-STATE NEWS
-WHAT'S NEW IN LARSON'S: Clear and Convincing Evidence Standard
-eNEWSLETTER ARCHIVES
A Note From the Editor
Robin Kobayashi 2010
Dear WC Professionals:
 
2011 is a pivotal year for the workers' comp industry with nine states celebrating their workers' compensation centennial. In addition, March 25, 2011 marks the 100th anniversary of the Triangle Shirtwaist Factory Fire, the deadliest industrial disaster in the history of New York City. We'll be covering all of these events throughout the year.

Sincerely,
Robin E. Kobayashi, J.D.
LexisNexis Editorial & Content Development

Happy New Year!

2011 sparklers

Workers' Comp Profile

Top 25 Blog Cut OutWork Comp Complex Care Blog, published by Total Medical Solutions. This Blog leads the way in providing thought provoking insight into the complex problems that confront employers and workers' compensation claimants who must deal with ongoing, long-term medical care. Yvonne Guibert provides well written analysis and recommendations on issues such as obesity, cancer-causing chemicals, smoking, musculoskeletal and connective tissue disorders, chronic pain, and physical therapy, and the impact of such medical issues on the participants and the workers' compensation system. The Blog is a 2010 honoree of the LexisNexis Top 25 Blogs for Workers' Compensation.

Workers'  Comp Videos

Online Video
listen to videos or read transcripts on:

NY Treatment Guidelines
 
Medicare Secondary Payer
 
Work Comp Analysis Group
 
Executive Roundtable Session
featured article

Depression BrainDepression and Delayed Recovery for Workers' Compensation Injuries, by Stephen Levit, M.D. Depression is the "elephant in the room" for many Workers Compensation injuries.  It is a major psychosocial diagnosis, yet frequently overlooked, often ignored as if it did not exist.

 

Depression can be the cause of severe personal and social consequences. And when unrecognized and untreated it is associated with delayed recovery after injury, resulting in significant economic loss to all involved parties, the patient, the employer and the insurer.

 

The prevalence of depression in the United States has been estimated at nearly 6% in any given year. As a lifetime relevance issue (the proportion of individuals in the population that at some point in their life have experienced the disorder or condition up to the time of assessment), the prevalence rises to nearly 14%. Thus, at any given time, between 6 and 14 out of 100 individuals in a work force might have a diagnosis of depression. > Read more.

 

Important Notice: This article is provided free of charge to eNewsletter subscribers through January 31, 2011, after which is available for a fee only on the LexisNexis services.

how to use this enewsletter

Email logoRely on this eNewsletter for a quick, week-at-a-glance of the top stories nationwide in workers' compensation as well as to find news and blogs for your state.

 

Use Social Media - Facebook, LinkedIn, Twitter, etc. - to push your favorite news items & articles to your colleagues.

 

Forward this eNewsletter to your clients and colleagues. 

Larson's spotlight: 5 recent cases you should know about

Larson's Spotlight reports noteworthy workers' comp cases each week. This list was c5 spotlightompiled by Thomas A. Robinson, a staff writer for Larson's Workers' Compensation Law, the nation's leading authority on workers' compensation law. 


1. OK: Injured Worker Was Not "Innocent Victim" of Horseplay; Claim Isn't Compensable

 

2. DC: Illegal Alien is Covered Employee for Workers' Compensation Purposes and Inability Legally to Return to Work Does Not Defeat Disability Benefits

 

3. NM: Employee's Delay in Reporting Work-Related Sexual Assault Does Not Defeat Claim For Benefits

 

4. WA: Federal "Economic Realities Test" Should Be Used to Determine Independent Contractor Status

 

5. AL: Worker Entitled to Nonscheduled Award Where in Addition to Ankle Injury, He Suffered From Chronic Pain and Depression

top 10 must-reads in the blogosphere & Beyond

BlogosphereNEW FEATURE: We recommend the following workers' comp-related articles recently posted in the Blogosphere and Beyond: 

 

 

1. Can an MSA Be Used for Medical Expenses Incurred Outside the USA?, by MEDVAL, LLC, The Official Medicare Set Aside Blog.

2. Top 10 California Workers' Comp Events in 2010, by Julius Young, Workers Comp Zone.

3. Fourteen Steps Employers Can Take to Manage Workers Compensation Claims, by Rebecca Shafer, Workers Comp Kit Blog.

4. The Benefits Package is Here, by Evan Falchuck, See First Blog.

5. The Benefits Package No. 2, by Evan Falchuk, See First Blog.

6. The top work comp stories of 2010, by Joe Paduda, Managed Care Matters (see Dec. 27, 2010 post)

7. Making Sense of Fatigue, by Julia L. Newton & David E.J. Jones, Occupational Medicine.

8. OSHA Investigates Dangerous Broadway Show That Injured Several Workers, by Philip J. Fulton, Columbus Workers' Compensation Law Blog.

9. Chronic Lyme Disease: A Dubious Diagnosis, by Patricia Callahan & Trine Tsouderos, Chicago Tribune.

10. Med Schools Flunk at Keeping Faculty Off Pharma Speaking Circuit, by Tracy Weber & Charles Ornstein, ProPublica.

 

lexisnexis workers' comp notable people - nominations

Seeking Nominations for 2010 LexisNexis Workers' Compensation Notable People awards. Nominations are being accepted for the categories of Risk Managers, Insurance Professionals, and Industry Vendors.

 

For details and to post a nomination on the Work Comp Analysis Group on LinkedIn, click HERE. Deadline: January 12, 2011.

 

Note: You must be a member of the Work Comp Analysis Group on LinkedIn to participate in this nomination process for the three categories listed above. To join the Work Comp Analysis Group on LinkedIn, click here.

 

LexisNexis will review all nominees and determine the finalists in the above three categories. Automated voting by members of the Work Comp Analysis Group on LinkedIn will occur during the second half of January 2011.

blog round up at the lexisnexis workers' compensation law community
Fraud Sign Workers' Comp Fraud Blotter - Recent Arrests, Charges, Convictions, Investigations - 12/16/2010. Read it. 

 

 

 

Fraud SignWorkers' Comp  Fraud Blotter - Recent Arrests, Charges, Convictions, Investigations - 12/22/2010. Read it.

 

 


Fraud SignWorkers' Comp  Fraud Blotter - Recent Arrests, Charges, Convictions, Investigations - 12/30/2010. Read it.
 


 

Cassandra RobertsThe Continuing Saga of Provider Certification in Delaware: Baby New Year is Distinguished from Bertha Polk! by Cassandra Roberts. Read it.


 


Cassandra RobertsHave Yourself a Merry Little Lifrak! (Delaware doctor fined under new statute), by Cassandra Roberts. Read it.

 

 

 

Kevin ConnorsPennsylvania : The Real Diehl, by Kevin L. Connors, DuffyConnors LLP. Read it


 

  

 Stuart ColburnTexas: Recent Appeals Panel Decision Provides Clarification With Regard to the SIBs Application Process, by Stuart Colburn. Read it.

  

 

  

Stuart ColburnTexas: PBM Discounts After January 1, 2011, by Stuart Colburn, Downs Stanford PC. Read it.



how to achieve medicare secondary payer compliance

Take Control of Your Insurance Settlements With A Brand New Resource From LexisNexis!

 

Thumbs Up  "Finally, someone delivers a clear, concise reading in this area, with some definitive answers for both lawyers and claims specialists and accurate reporting dealing with MSP compliance and MSA allocations with all of the necessary resources found in one place."

 

- Brad Bleakney, Esq., Bleakney & Troiani. Read his complete review at Illinois Workers Compensation blog.

 

Thumbs Up  "An excellent new book ... a one-of-a-kind resource ... [Jennifer C. Jordan's] straight-talk is much appreciated when it comes to this illusive area of the law."

 

- Rebecca Shafer, JD, President, Amaxx Risk Solutions, Inc. Read her complete review at Workers Comp Kit Blog.

 

There are many people who don't understand that the Centers for Medicare and Medicaid Services' approval process of a Medicare set-aside arrangement is voluntary and carries P1130 R12 coveran inherent cost. In fact, many of the decisions that need to be made in a settlement negotiation are risk management decisions rather than being truly Medicare Secondary Payer-oriented. Once you understand why CMS wants what it wants, you will realize that its preference may not be the only way to achieve MSP compliance. The Complete Guide to Medicare Secondary Payer Compliance, Jennifer C. Jordan, Editor-in-Chief, will help you take control of your insurance settlements. > Read more about the contents (1,350 pages). List Price: $179



national news
> ASSE President Participates In International Meeting On Work Safety
>
Solis Appoints 5 New Members To NACOSH
> MSHA Increases Focus On Implementation Of Exposure Monitoring
> A.M. Best Affirms Ratings of Safety National Group and Its Members
>
A.M. Best Affirms Ratings of Cincinnati Financial Corp. and Its Subsidiaries
> AMA Guides: A Convoluted Story With Private Interests at Issue
>
Coventry Health Care Subsidiary Enters Into Settlement in PPO Class Action Suit
>
Suspicious P&C Claims Rose 12 Percent in 3Q According to Report
> OpEd Piece on Spike in Social Security Disability Applications
>
US Congress Passes 9/11 Responder Aid, Bill Now Moves to Obama for Signature
> President Obama Signs 9/11 Health Bill
> The Hartford To Sell Specialty Risk Services To Sedgwick CMS
> Top 10 List of Insurance Stories in the West Posted by Insurance Journal
> AIG to Pay $146M in Workers' Comp Settlement for Alleged Underreporting of Premiums
> Liberty Mutual Empowers LinkedIn Professionals to Share Perspectives About Insurance Products and Services
> Reports Says Pharmaceutical Industry Biggest Defrauder of Federal Government
> NCCI Releases Reinsurance Pool Reports
> Shift Workers At Higher Risk For Injury
> Physicians Cashing in With Spinal Fusion Surgery, Studies Show Surgery Unnecessary
> Disabled Federal Workers Find Federal Employees' Compensation Act Better Than Retirement Plan
state news
> AZ: SCF Arizona Announces Arrangement With Blue Cross Blue Shield
> CA: State Fund Targets $200M In Operating Cost Savings
> CA: CHSWC Releases Draft "Liens Report" For Public Comment
CA: WCIRB Experience Rating Sheets Available to Policyholders
> CA: DWC Launches New Public Information Case Search Tool
CA: ACM Handling Zurich Workers' Comp Claims Effective 12/1/2010
CA: Corporations, Insurers, Labor Groups Back Bill to Restrict Compounded Drugs
CA: DIR Highlights New Labor Laws In The New Year
CA: Insurance Commissioner-elect Dave Jones Names His Executive Team
CA: Insurance Commissioner Urges Governor-elect Brown to Protect Workers' Comp Reforms
> CO: Pinnacol CFO Named To National Wellness Board
CO: DOI Approves Lost Cost Increase of 3.4 Percent
CT: Rate Hikes Reignite Call for Workers' Comp Reform
> DC: Court Says Illegal Immigrant Can Receive Workers' Comp
DC:
Metro Workers Filing High Rate of Claims
> ID: SIF Announces 3.7 Percent Increase in Workers' Comp Rates
> FL: Friends of 440 Celebrates Holidays, Raises Funds
FL: DWC Posts Maximum Workers' Comp Rate Effective 1/1/2011
FL: Governor Crist Appoints Two Judges of Compensation Claims
FL: FDFS Posts Report on Workers' Comp Fraud
> IL: Insurance Company Opposes "Rewrite" of PPO Settlement Agreement
> IL: Workers' Comp Panel Hears More Testimony 12/15/2010
> IL: State Rep Jim Sacia Blasts Testimony at Workers' Comp Reform Hearing 12/3/2010
> IL: Seven Arbitrators at WCC Filed Injury Claims
> IL: WCC Finds CNA Committed Deceptive Claims Practice
> IL: Prison Guards Claim Repetitive Stress Injuries From Locking, Unlocking Cells
> IL: Lame Duck Session Begins Jan. 3 for Medicaid and Workers' Comp Reform
> IL: House Drafts Bill for Workers' Comp Reform
IL: Organized Labor Seeks to Mitigate Damage From Proposed Workers' Comp Reform
IL: IWCC Chairman Calls for Probe of Workers' Comp Payments to Prison Guards
IN: WCB Says It Takes No Pre Hoc Position on Use of Utilization Review
IN: WCB Posts 2011 Second Injury Fund Assessment Report and Certification
> KY: Contractor's Fund to Return $11.3M in Dividends to Qualified Policyholders
KY: Five Top Spine Surgeons Reap Royalties, Medicare Payments for Spinal Fusions
> LA: LWCC Board Declares Policyholder Dividend Of $22.5M
> ME: FedEx Drivers File Class Action Over Alleged Misclassification
> ME: Insurance Superintendent Announces Two New Insurance Companies
> MD: Recent IWIF Success At The WCC
MI: Antitrust Suit Against Blue Cross Tests Federal Health Care Law
> MN: Peterson Named Department Of Labor And Industry Commissioner
MN: Attorney's Fees Ordered in Wells Fargo Investment Lawsuit, Minnesota Workers' Compensation Reinsurance Association Co-Plaintiff
> MO: Smoker Awarded PTD for Lung Disease
> MO: 15 Year Battle for Psych Benefits Results in $366.70 Award
> MO: DOL Finds Injuries Cause Lost Time At Work
> MO: DOI Calls For Double-Digit Drop In 2011 WC Rates
> MO: Open Medical Still Awarded When Claimant Refused to Treat
> MT: State Panel Finds Workers' Comp Bill Dead on Arrival
MT:
GOP Lawmaker Works on New Version of Workers' Comp Reform
MT: GOP Lawmaker to Push Bill to Deny Workers' Comp to Illegal Aliens
NE: WCC Posts Revised Rules of Procedure
NJ: Labor Advocate Urges Workers' Comp Provision in Unemployment Bill
> NY: Federal Tax Case Leads to Workers Comp Fraud Arrest
> NY: WCB Provides Disability Benefits Insurance Contract Bulletin
> NY: WCB Posts Latest Reimbursement Rates For Inpatient Hospital Care
> NY: WCB Makes New Transaction Code Available
> NY: Insurance Groups to Pay $120M in Workers' Comp Premium Overcharges
> NC: Court of Appeals Rules Against Workers in Sick Building Case
NC: School Principal Shot in Face Gets Workers' Comp
> OH: BWC Reviews Performance Of Cost Saving Programs
OH: BWC Employee Allegedly Abused State Computers
> OH: Administrator Ryan Reacts To Senate Denial Of BWC Board Appointees
OH: Senate GOP Rejects Appointments to BWC
OK: Lt. Governor-elect Weighs Opt Out Provision for Workers' Compensation
OK: GOP Lawmakers Prepare to Unveil Plans for Workers' Comp Reform
OK: Workers' Comp Reform to Include Task Force Recommendations on Vocational Rehabilitation
> OR: WCD Posts Claims Processing Administrative Cost Factor
> OR: WCD Spanish Translations Available For Correspondence With Injured Workers
OR: Workers' Comp Claim Rates at Record Low in 2009
> RI: Governor-elect Appoints Former Lt. Governor as Labor Commissioner
> SC: WCC Announces Two New Features To eCase
> TX: DWC Announces Performance Based Oversight Results For Insurance Carriers
> TX: DWC Adopts New Statute Regarding Case Management
TX: AG Issues Opinion on Prescription Drugs and Fee Schedule
TX:
Texas Mutual Honored by DWC as High Performer
> TX: TDI-DWC Reports A Third Year Decrease In Job Related Injuries
> VT: Decline in Claim Frequency, Increase in Medical, Indemnity Costs
>
WA:
L&I to Hold Public Hearing Jan. 4 on Proposed 12 Percent Increase in Workers' Comp Rates
WV: WV Counties Risk Pool to Provide Workers' Compensation Coverage
> WI: DWC Announces 2011 Maximum Workers' Comp Rates

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Kentucky's "Clear and Convincing" Evidence Requirement Relating to Certain Pneumoconiosis Claims Held Unconstitutional.  In Gardner v. Vision Mining, Inc., 2010 Ky. App. LEXIS 69 (Apr. 9, 2010), the Kentucky Court of Appeals, in a divided opinion, held unconstitutional Ky. Rev. Stat.  § 342.316, to the extent that it requires a coal workers' pneumoconiosis ("CWP") claimant to come forward with clear and convincing evidence in order to overcome the consensus of a three-physician panel who have reviewed the claimant's chest x-rays and indicated the claimant did not have the condition.  The claimant contended in relevant part that the "clear and convincing evidence" standard for coal workers sharply contrasted with the prevailing standard applied to workers seeking compensation for other pneumoconiosis claims such as exposure to limestone, various particulates, talc, and graphite. In its majority opinion, the court agreed, indicating that it was unreasonable and improper to impose more onerous procedural and substantive burdens on coal workers than on others.  The majority indicated that the only distinction between CWP claimants and other pneumoconiosis claimants was the source of the disease. In all other respects, the disease process and the nature, extent and duration of the disease were the same. Imposing more onerous procedural and substantive burdens on coal miners was unreasonable and, therefore, unconstitutional.  [See Ch. 52, § 52.03[3][a] n22 (Digest)]

ENEWSLETTER ARCHIVES
Take a deep dive into our past eNewsletters for 2010...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

ACCESS 2010 ARCHIVES AND ARTICLES LIST HERE.

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