National Edition Banner March 2010
Vol 2, Issue 51

Find Solutions & Strategies                      December 19, 2011

Marijuana CigaretteUp in Smoke

 

How disclosures in medical marijuana cards could help defeat workers' comp claims

In This Issue
-UP IN SMOKE
-ELEPHANT IN THE ROOM
-LARSON'S SPOTLIGHT: Uninsured Motorist, Dual Persona, Compulsory Coverage, Misrepresentation Defense
-CMS & LIABILITY CLAIMS
-BLOGS @ LEXISNEXIS WORKERS' COMP COMMUNITY: Fraud, DE cases, MO case, NV case
-NATIONAL NEWS
-STATE NEWS
-eNEWSLETTER ARCHIVES
A Note From The Editor
Clock to 2012

Dear WC Professionals: 

 

We're taking a week off next week to enjoy the holidays. We'll return January 2 with all the news you could use.   See you next year! 

 

Sincerely,
Robin E. Kobayashi, JD
LexisNexis Legal & Professional Operations
The Bible of MSP Law
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"The go-to source for the MSP."

 

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up in smoke

Medical Marijuana SignUp in Smoke: How Employers Are Using Disclosures in Medical Marijuana Cards to Defeat Claims for Workers' Compensation, by Robin E. Kobayashi. Employers are scoring victories by using injured workers' disclosures in their medical marijuana cards to help defeat claims for workers' compensation benefits. For example, in a recent decision issued by the Colorado Industrial Claim Appeals Office, the Appeals Panel found the claimant failed to carry his burden of proof that his back condition arose out of and in the course of employment. > Read more

elephant in the room

Elephant Peanuts 2Dr. Richard Victor on the Workers' Compensation System's Elephant in the Room. In this LexisNexis podcast, Dr. Victor talks about the unprecedented disruption of the U.S. labor market and where workers' compensation systems may be headed. "As of this summer, we are down 6 million jobs. And since the beginning of The Great Recession, we needed to create another 7 million jobs in order to absorb new entrance into the labor market. So we are down 13 million jobs....More and more workers will be unable to go back to their preinjury employment, and they will have more limited opportunities than in the past to find new employment," Victor states.

 

      > Listen to the Podcast     > Read the Transcript

Larson's spotlight on recent cases

Tom Robinson thumbnailSelf-Insured Gets Hit in Blind Spot With Liability for Uninsured Motorist Benefits, by Thomas A. Robinson. The Court of Appeals of New York recently held that a self-insured employer, whose employee was involved in a work-related automobile accident, may be liable to that employee for uninsured motorist benefits, notwithstanding the exclusivity provision of the Workers' Compensation Law.... 

 

Other Case Highlights:   

  • PA: Worker is Unsuccessful in Suing Employer Under "Dual Persona" Theory
  • VA: Day and one-half of Labor by Worker Is Insufficient to Put Employer "Over" the Minimum Number of Employees to Require Compulsory Coverage
  • NE: Employee/Applicant Misrepresentation Defense Disallowed

> Read the summaries and court decisions

cms & liability claims

Mark Popolizio 2012CMS Announces New "Self-Calculated Final Conditional Payment Amount" Option for Certain Liability Claims, by Mark Popolizio, Esq. The Centers for Medicare and Medicaid Services (CMS) will implement a new Self-Calculated Final Conditional Payment Amount option beginning in February 2012 through which Medicare's "final" conditional payment amount may be obtained prior to certain liability settlements, judgments, awards, or other payments. This option will be limited to liability cases involving physical trauma injuries where treatment has been completed and which otherwise meet CMS' qualifying criteria as listed below. > Read more

blogS at the lexisnexis workers' comp law community
Fraud SignWorkers' Comp Fraud Blotter - Roller Coaster Mom Goes From Disneyland to Fraud Conviction, by LexisNexis Workers' Compensation Law Community Staff. Read it.   

 

 

 

CassandraElementary, My Dear Watson: First IAB Decisions to Rule on Application of DE Supreme Court's Watson v. Wal-Mart, by Cassandra Roberts, Esq. Read it

 

  

 

CassandraOh, the Pain of Inadequacy: Chiropractor Trumps Doctor in this Delaware Utilization Review Appeal, by Cassandra Roberts, Esq. Read it

 

 

 

Martin KlugMissouri: Court Keeps Civil Case Alive for Work-place Injury, by Martin Klug. Read it.

 

 

 

VirginiaHuntBad News for Nevada Injured Workers Who Fall at Work? by Virginia Hunt, Esq. Read it

 

national news
state news

AL: GOP Lawmaker Seeks Workers Comp Changes, Courts Could Reject Trial Judge's Rulings.

AK: WCD Posts Maximum Benefit Rate.

CA: Insurance Commissioner Commends SCIF Decision to Return Dividend.

CA: WCIRB Governing Committee Appoints Industry Veteran Bill Mudge President.

CA: WCIRB Says Average Cost of Workers Comp Claim Is $65,000.

CA: DWC Posts 2012 Annual Report of Inventory Advice, Form for Claims Reported CY 2011.

CA: DWC Issues Delay in Updated Prices of Pharmaceutical Fee Schedule Data File.

CA: DWC Announces 2012 Profile Audit Review, Full Compliance Audit Performance Standards.

CA: DWC Posts No Change in Mileage Rate for Medical, Medical-Legal Travel Expenses 2012.

CA: Office of Self-Insurance Plans to Improve Audit Procedures in 2012.

CA: Coalition of Business, Labor Convene to Fight Against Underground Economy.

CA: $51M Judgment Entered Against Select Staffing for Underpayment of WC Premiums.

CA: Class Action Suit Claims Apple Misclassified Employees.

CA: Cal Chamber Publishes List of 2012 Laws That Impact Employers.

CO: Task Force Questions Pinnacol's Proposal for Privatization.

FL: Employers Announces Immediate 5 Percent Workers Comp Discount for Small Businesses.

FL: Business Groups Lobby to Close Loophole for Repackaged Drugs Dispensing.

ID: NCCI's 2.9 Percent Loss Cost Increase Approved.

IL: Menard Prison Warden Demoted, State Probe Questioned His Disability.

IL: IWCC Reports Bankruptcy Order Lifts Stay on Workers Comp Proceedings for AMR.

IL: Arbitrator Jutila's Dec. 29 Call Cancelled.

IN: WCB Posts Notice of Required Forms With PPI Agreements.

IN: WCB Clarifies Report of Attending Physician Form.

MI: Governor Expected to Sign Workers Comp Reform Bill.

MS: WCC Posts Maximum Benefit Increase.

MO: Commission Must Rule on Pending WC Claim Before Exclusive Remedy May Apply.

MO: Chamber of Commerce to Lobby for Workers Comp Changes, Second Injury Fund Issues.

NH: State Authorizes On-Site Examination of LGC's Books.

NJ: Back to Work Bill Includes Provision for Workers Comp Insurance.

NM: Judge Rules Farm Hands Entitled to Workers Comp.

NY: NY Self-Insured Trusts Seek U.S. Supreme Court Intervention.

NY: SWCB Announces Domain Change for Website, Email.

OH: Medical Board Revokes License of Pain Doctor for Overprescribing Narcotic.

OH: BWC Changes Up Financial Incentives for Return to Work, Safety.

OR: WCD Posts List of Registered Vocational Rehabilitation Providers.

OR: WCD Posts Revised Workers Comp Medical Reporting Forms.

OR: WCD Report Says Insurers Paid $25,000 Per Settlement in 2010.

OR: WCD Posts Revised Claims Processing Administrative Cost Factor.

PA: Pond Lehocky Law Firm Settles $3 Million Workers Comp Cases.

PA: Governor Reappoints Alfonso Frioni, Jr. to Workers' Compensation Appeals Board.

TN: Lt. Governor Ramsey Supports Workers Comp Changes.

TN: Lt. Governor Ramsey Supports Drug Testing of Injured Workers.

TX: DWC Seeks Input for Development of UR Agent Plan Based Audit.

TX: DWC Seeks Input for Development of Medical Quality Review CY 2012 Annual Audit Plan.

TX: DWC Requests Updated Insurance Carrier Representative Authorization Information.

TX: TDI-DWC Reports 4th Year Decrease in Work-Related Injuries, Illnesses in 2010.

TX: NFIB, Texas Mutual Partnership Pays $819K Dividend.

TX: Texas Mutual Board of Directors Elects New Officers.

UT: NCCI's 1.5 Percent Loss Cost Increase Approved.

VT: 4.1 Percent Loss Cost Increase Filed by NCCI.

WA: New State Law Curbing Painkillers Hits Patients Hard.

WV: Jane Cline, Mary Jane Pickens Join Spilman Thomas & Battle Law Firm.

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Top 25 Blogs 2011

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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.

December 12, 2011: Top 10 Workers Comp Cases for 2011; Top 10 Fraud Stories.

December 5, 2011: MMSEA Sect. 111 - Identifying Reporting Triggers.

November 28, 2011: Prescription Drug Abuse in America (Part Three): Strategies.

November 21, 2011: Prescription Drug Abuse in America (Part Two): The "P" Stakeholders.

November 14, 2011: Prescription Drug Abuse in America (Part One): The Problem.

November 7, 2011: Medical Costs Trends: Claim Size Matters.

October 31, 2011: Supremes Consider Outer Continental Shelf Lands Act.

October 24, 2011: Excess Loss Development.

October 17, 2011: Diligent Job Search or Diddling Around.

October 10, 2011: Workers Compensation Claim Frequency.

September 26, 2011: Student-Athlete Controversy.

September 19, 2011: Prescription Drug Costs.

September 12, 2011: MSP Reporting: AIA Seeks Another Delay.

September 6, 2011: Tenth Anniversary of 9/11: Workers' Comp Perspective.

August 29, 2011: Battle of the AMA Guides: 5th Edition vs. 6th Edition.

August 22, 2011: Average Weekly Wage & Concurrent Employment.

August 15, 2011: War Hazards Compensation Act: Reimbursement Claims.

August 8, 2011: The Stroke Belt and Implications for Workers' Compensation.

August 1, 2011: FECA Senate Hearing.

July 25, 2011: Spinal Cord and Nerve Root Injuries.

July 18, 2011: Hearing Loss Burden of Proof.

July 11, 2011: State Workers' Comp Ball of Confusion: AIA's Position on WC Issues.

July 5, 2011: Pulmonary Embolism and the Homebased Worker.

June 20, 2011: Out of Network Pharmacies; Home Office Injuries.

June 13, 2011: Off-Label Drugs.

June 6, 2011: Transgender Issues.

May 31, 2011: Cell Phone Distractions.

May 23, 2011: FECA Reform Proposals; Benefits Review Board Update.

May 16, 2011: Full Face Transplant; Medical Foods; P&C Industry Trends.

May 9, 2011: State of the Line; Workers Comp Trends.

May 2, 2011: Prescription Drug Abuse.

April 25, 2011: Radiation Exposure; Medical Fee Schedules.

April 18, 2011: FECA Reform.

April 11, 2011: NCCI's 2011 Workers' Comp Issues Report.

April 4, 2011: Workers' Comp Centennial.

March 28, 2011: Medicare Secondary Payer Reform Legislation; LHWCA Comp Rates.

March 21, 2011: Triangle Shirtwaist Factory Fire.

March 14, 2011: Medicare Set-Aside & Special Needs Trust; Union Battle.

March 7, 2011: 50 State Labor Law Ranking; Illegal Aliens & Workers Comp.

February 28, 2011: Union Battle.

February 21, 2011: Erectile Dysfunction in Workers Comp Claims.

February 14, 2011: Workers Comp Notable People 2010.

February 7, 2011: Workers Comp Centennial; NCCI's Gauging the Economy.

January 31, 2011: Medicare Set-Aside Allocations; Workers Comp Soft Market.

January 24, 2011: Sex, Lies & Videotape - Injured Worker.

January 17, 2011: FECA & Workers Comp Waste; Medical Residents; AMA Guides.

January 10, 2011: Top 10 Bizarre Cases for 2010.

January 3, 2011: Depression and Delayed Recovery.

 

ACCESS 2010 ARCHIVES AND ARTICLES LIST HERE.

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