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Find Solutions & Strategies June 6, 2011 |
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Transgenders & Workplace Issues
It's Complicated | |
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A Note From the Editor | |
Dear WC Professionals:
In this issue we're focusing on recent developments in the transgender movement here in the U.S. and the impact on workplace issues. Thanks to Karen Yotis, Esq. for contributing an article on the N.Y. disability case.
Sincerely, Robin E. Kobayashi, J.D.
LexisNexis Editorial & Content Development
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death benefits |
Death Benefits: Transgendered Woman Loses First Round in Texas, by Robin E. Kobayashi, JD.
The controversy and debate over the meaning of marriage and who can marry recently played out in a Texas case where a firefighter, who was married to a transgendered woman, died while fighting a fire at an egg farm. At stake were $600,000 in death benefits and estate assets. The mother of the firefighter, Thomas Araguz III, brought a lawsuit against Nikki Araguz, arguing that the marriage of her son to Nikki Araguz, who was born a man, was illegal since Texas bans same-sex marriages, and that her son's death benefits and estate assets should be given to his two children from a previous marriage.
The facts were disputed over when Thomas found out about Nikki's gender identity. Nikki claims she told Thomas a week into their marriage, and he supported her during her gender reassignment surgery. Thomas' mother, on the other hand, says her son found out about Nikki's gender identity shortly before his death and was planning to get a divorce.
On May 26, 2011, the Wharton County judge in the case nullified the marriage on the grounds that it was an illegal same-sex marriage. Read more. |
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short-term disability benefits |
Short Term Disability Benefits: Transgendered Woman Finally Prevails in New York, by Karen Yotis, Esq.
The conflict and opposition that surrounds the transgender community was nowhere more apparent than in a New York case where a woman sought New York State Short Term Disability Benefits during her six-week recovery from gender reassignment surgery (GRS) performed on May 30, 2005. It's a story that resonates across the nation, from Hollywood's coverage of Chaz Bono's very public transformation to Chicago's en masse outdoor celebration of same sex unions. Claimant's attorney Catherine J. Palermo didn't mince words when she stated, "I think at every step we were met with personal judgment and disdain. Denise Rhone should have been granted disability benefits immediately and this case should never have arisen."
Hartford, the carrier in this case, characterized Rhone's GRS as elective surgery. The carrier further explained the rejection by stating "elective surgery is not covered by NYS Disability.
To support her claim Rhone had produced a series of letters from medical providers stating that she had Gender identity Disorder (GID), was working and living full time as a female, was responding well to hormone replacement therapy and was an excellent candidate for GRS. Read more. |
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medical benefits |
Medical Benefits: Transgender Prevails in Wisconsin -- Psychological Treatment Significantly Related to Job Injury, Not to Preexisting Depression or Gender Identity Disorder, by Robin E. Kobayashi, JD.
Here's an interesting decision from the LexisNexis archives. In a 2005 decision, the Wisconsin Labor and Industry Review Commission affirmed the findings of the ALJ, who found that the applicant, an individual undergoing the process of changing her gender, was permanently totally disabled as a result of back injuries sustained in the course of her employment and not a viable candidate for employment under the "odd lot" doctrine, and that defendant was responsible for payment of psychological treatment related to applicant's chronic pain condition. Read more |
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. AR: Second Injury Fund Allowed No Credit for VA Disability Benefits Received by Injured Worker
2. IA: Marina Employee Not an "Employee" Under Longshore Act-State Law Governs
3. IA: Trial Court, Not Workers' Compensation Commissioner, Has Jurisdiction to Hear Carrier's Claim to Recoup Benefits Procured Through Alleged Fraud
4. MO: Claimant May Subpoena Surveillance Videotape In Spite of 2005 Amendment to Statute
5. UT: Worker's Termination for Distributing Pornography to Co-Workers Does Not Disqualify Him From Continued Disability Benefits |
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blogS at the lexisnexis workers' comp law community |
Workers' Comp Fraud Blotter - Recent Arrests, Charges, Convictions, and Investigations (6/2/2011). Painter double dips by collecting benefits while painting. 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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medical benefits, continued... |
The applicant suffered a work injury on 8/26/1997 while she tried to prevent a resident in the employer's group home from falling down some stairs. Following an MRI, a disc herniation was discovered, and a hemilaminectomy with disc excision was performed in the spring of 1998. The applicant recovered, and returned to work, but she was reinjured on 11/23/98 while trying to restrain a patient. An MRI showed degenerative changes, but not recurrent disc herniation. Nonetheless, the applicant remained symptomatic even after epidural steroid injections. Her doctors agreed she was not a candidate for further surgery.
With respect to applicant's treatment by mental health counselors, defendant contested its liability for some psychological treatment expense, arguing that applicant had pre-existing depression that was not caused or substantially exacerbated by the work injury.
The ALJ found that while applicant had a history of psychological treatment that preceded the work injury, i.e., she suffered from depression, underwent a 30-day hospitalization for treatment after her son was killed by a drunk driver and after her divorce, and she was in the process of changing her gender, which the medical reports suggested may be a psychological stressor, applicant's mental state is an "as is" condition, and she had suffered a significantly disabling work injury. More importantly, stated the ALJ, the evidence indicated that a significant portion of the expense applicant sought for counseling related to her work injury.
[Editor's Note: Administrative decisions, while not binding authority, help illustrate new trends in the law. Many of the cutting edge cases occur at the administrative level. Lexis.com subscribers can link to the Wisconsin decision here: Potter v. Productive Living Systems Inc., 2005 WI Wrk. Comp. LEXIS 126.] |
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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 [email protected]. May 31, 2011: Cell Phone Distractions
http://archive.constantcontact.com/fs077/1102828640660/archive/1105697648150.html
May 23, 2011: FECA Reform Proposals; Benefits Review Board Update
http://archive.constantcontact.com/fs077/1102828640660/archive/1105575780840.html
May 16, 2011: Full Face Transplant; Medical Foods; P&C Industry Trends
http://archive.constantcontact.com/fs077/1102828640660/archive/1105506640276.html
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
ACCESS 2010 ARCHIVES AND ARTICLES LIST HERE. |
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