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Find Solutions & Strategies May 16, 2011 |
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Injured Worker Becomes First Person in U.S. to Receive Full Face Transplant
The 25-year-old construction worker suffered catastrophic electrical burns to his face | |
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A Note From the Editor |  |
Dear WC Professionals:
Thank you to our eNewsletter subscribers who have been sending us news tips. We have more interesting articles on the way...
Sincerely, Robin E. Kobayashi, J.D.
LexisNexis Editorial & Content Development
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injured worker's face transplant |
According to The Perecman Firm, "A 25-year-old construction worker who suffered catastrophic electrical burns to his face became the first person in the U.S. to receive a full face transplant in March. Dallas Wiehs was operating a boom lift in 2008 when it came into contact with an overhead power line. The construction accident cost Wiehs' most of his face, including both of his eyes, nose and eyebrows. He spent three months following the accident in a coma and underwent more than 20 surgeries to try to repair some of the damage...." Read more.
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medical foods & workers comp |
New Progressive Medical White Paper Addresses Medical Foods in Workers' Compensation. Progressive Medical, Inc. released a new white paper, "Managing the Medical Foods Dilemma." The white paper addresses the increasing role medical foods play in workers' compensation and the surrounding concern due to lack of conclusive clinical evidence to validate medical foods' effectiveness. The paper also offers insight to how payors can proactively control utilization of medical foods and manage expenses. Read more.
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property & casualty insurance |

Robert P. Hartwig, President, Insurance Information Institute, in a report entitled "Out of the Abyss: Growth, Challenges and Opportunities in the Post-Crisis World," at NCCI's annual issues symposium on May 5, 2011, presented a mixed picture of present and future conditions of the property and casualty insurance industry. Noting that uncertainty, risk, and fear abound, and citing natural disasters over the past year, the political upheaval in the Middle East, the recession and its long, slow recovery, among other challenges, Hartwig began by asking whether we are, in fact, crawling out of the abyss or falling into a new one. Read more |
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Larson's spotlight: 5 recent cases you should know about |
Larson's Spotlight reports noteworthy workers' comp cases each week. This list was compiled by Thomas A. Robinson, a staff writer for Larson's Workers' Compensation Law, the nation's leading authority on workers' compensation law.
> Read the summaries & court decisions.
1. AZ: Firefighter Must Come Forward With Evidence That Carcinogen Was Reasonably Connected to Cancer in Spite of Statutory Presumption of Compensability
2. FL: Non-Physician Toxicologist's Testimony May Not Be Used to Establish (or Deny) Medical Causation
3. NC: Industrial Commission, Not the Deputy Commissioner Hearing the Case, is the Ultimate Fact-Finder
4. VA: Risk of Spider Bite Not Peculiar to the Work Environment-Claim Fails
5. US: Licensed Message Therapist's Conviction of Workers' Compensation Fraud Upheld |
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blog round up at the lexisnexis workers' compensation law community |
Workers' Comp Fraud Blotter - Recent Arrests, Charges, Convictions, and Investigations (5/12/2011). Read it.
The Original Hoey Displaced Worker: Jewell Hoey Is Still Good Law Here In the First State, by Cassandra Roberts, Esq. Read it.
The U.S. Attorney's Office for the Western District of New York Releases MSP Protocol for Liability Cases, by Mark Popolizio, Esq. Read it.
Chicken Little? Not in Delaware Where Blue Hen Case Rules MSA Commutation Enforceable, by Cassandra Roberts, Esq. Read it.
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how to achieve medicare secondary payer compliance |

The Complete Guide to Medicare Secondary Payer Compliance
Jennifer C. Jordan, Esq., Editor-in-Chief
To order, go to www.lexisnexis.com/Medicare.
Medicare Secondary Payer Compliance is an elusive area of law - tucked away in various public laws, statutes, regulations and CMS guidance materials.
Worse, many people don't realize that the CMS approval process for MSAs is voluntary-and carries an inherent cost.
That's why you need this all-in-one handbook ...
Authored by the leading expert in the field of the MSP, "The Complete Guide to Medicare Secondary Payer Compliance" is the only available resource written by an industry insider with a deep understanding and practical knowledge about this highly complex and evolving area of the law.
For the first time, you'll find all relevant pieces of the law in one accessible place. And by understanding what CMS wants-and why it wants it-you'll be better able to:
● Take control of your insurance settlements
● Avoid pitfalls, delays and penalties
● Comply with reporting requirements
You'll also learn that CMS' preference may not be the only way to achieve MSP compliance.
Attorneys agree! This is the first comprehensive resource for achieving Medicare Secondary Payer Compliance.
"Ms. Jordan and her contributors provide concise, practical analysis of the multiple layers and nuances of Medical Secondary Payer compliance. The Guide is a valuable resource for plaintiff and defense counsel, as well as insurance carriers, employers, and third party administrators."
- Ronald E. Weiss, Esq., Hamberger & Weiss, Rochester, New York.
"The range of topics included in the book and updates is a beacon of wisdom in the confusing MSP compliance field."
- Tim Nay, Esq., Law Offices of Nay & Friedenberg, Portland, Oregon. Mr. Nay is a co-founder of the National Alliance of Medicare Set-Aside Professionals (NAMSAP).
"I have a copy of Jennifer Jordan's book The Complete Guide to Medicare Secondary Payer Compliance and I am most impressed by same! I have recommended it to a number of attorneys here in Georgia."
- Richard C. Kissiah, Esq., Kissiah & Lay, Alpharetta, Georgia.
"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."
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."
 Implementation of the MMSEA reporting program is underway. Don't wait to order! > Read more about the contents (1,350 pages). List Price: $179
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 | 2010 Edition - Call 800-833-9844 |
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what's new in larson's workers' compensation law |
Find out more about how to become a Larson's online subscriber by contacting: Robin.E.Kobayashi@lexisnexis.com.
Employee Tort Claim Against Employer and Coworker for Improper Dissemination of Medical Information Not Barred by Exclusivity. Finding that an employee's "injuries" resulting from improper dissemination of employee's HIV status did not arise out of her employment, a Tennessee court recently held the employee's tort action against her employer, a manager, and a coworker were outside the workers' compensation law and not barred by exclusivity [Doe v. Walgreens Co., 2010 Tenn. App. LEXIS 734 (Nov. 24, 2010)]. [See Ch. 100, § 100.04 n16.1] |
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P&C insurance, continued... |
Terrorism Risk Insurance
Specifically, in light of the killing of Osama bin Laden, Hartwig addressed the question of whether we still need the terrorism risk insurance program. His view is that it would be a serious mistake to allow the program to lapse, as currently scheduled, at the end of 2014. Listing the numerous thwarted terrorism attempts against the U.S. in 2009 and 2010, he suggested that the "domestic/home grown terror risk looms larger today than in 2001." He also noted that the 9/11 attacks constituted the largest workers' compensation loss-$2.2 billion-in U.S. history, and he pointed out that, in the event of a chemical, nuclear, biological, or radiation terrorist attack, or a truck bomb terrorist attack, on a major U.S. city, workers' compensation will likely amount to the largest single category of claims.
Natural Disasters
Turning to natural disasters, Hartwig stated that the recent earthquake/tsunami in Japan will probably turn out to be "among the most expensive in world history in terms of insured losses," amounting to around $30 billion. While unlikely to have any direct impact on the U.S. workers' compensation markets, the Japanese disaster is simply one among many recent natural disasters, including record floods in Australia, earthquakes in Haiti, Chile, and New Zealand, unprecedented tornadoes in the U.S., and (although too recent for Hartwig to have discussed) the present flooding of the Mississippi River, that have resulted, or will result, in major catastrophe losses. These losses, no matter where they occur, will have significant impacts on global reinsurers.
Recession
Hartwig reviewed the impact of the recession on the property and casualty lines, pointing out that "massive job losses sapped the economy and p/c exposure," but that the "trend is improving." The workers' compensation premium volume began dropping, two years before the recession began, and the recession augmented that trend, with the result that net premium written fell by 29.3 percent between 2005 and 2010, from $47.8 billion to $33.8 billion. Despite recent employment gains, stubbornly high unemployment and underemployment continue to constrain growth in workers' compensation premium.
With regard to the economy as a whole, Hartwig pointed out that far too few new small businesses are being created and that far too many small businesses are filing for bankruptcy, another trend that impedes growth in workers' compensation premium. Similarly, as long as the construction industry, formerly a major source of workers' compensation premium, remains in the doldrums, premium will stagnate. In general, of course, the insurance markets are tied to the larger economy, and, until that economy achieves sustained growth, relevant insurance premium growth will be limited. Hartwig identified several industries "poised for growth" in which many insurers do not write. Among these are health care, energy (both traditional and alternative), agriculture, natural resources, environmental, technology (including biotechnology), light manufacturing, export-oriented industries, and shipping.
Conclusion
In summary, Hartwig foresees marginally better performance for property and casualty insurers, including workers' compensation insurers, with the performance of insurers' investments being a key driver of profitability.
Read the complete report: https://www.ncci.com/Documents/AIS-2011-Robert-Hartwig.pdf |
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ENEWSLETTER ARCHIVES |
Take a deep dive into our past eNewsletters for 2011 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com. May 9, 2011: State of the Line; Workers Comp Trends
http://archive.constantcontact.com/fs077/1102828640660/archive/1105406865560.html
May 2, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1105306219674.html
April 25, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1105243933380.html
April 18, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1105151454598.html
April 11, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1105054845597.html
April 4, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104945262995.html
March 28, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104894130984.html
March 21, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104811663296.html
March 14, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104742747659.html
March 7, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104678900034.html
February 28, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104610168211.html
February 21, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104523576536.html
February 14, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104442568785.html
February 7, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104372668124.html
January 31, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104299196240.html
January 24, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104266393145.html
January 17, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104223885217.html January 10, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104176109384.html
January 3, 2011
http://archive.constantcontact.com/fs077/1102828640660/archive/1104102646819.html
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