National Banner 2012 Chess Board
Vol. 3, Issue 28

Find Solutions & Strategies                               July 9, 2012

Caduceus DollarImpact of Affordable Care Act on Insurance Industry 

 

Who gains? Who loses? What about workers' comp? 

In This Issue
-ACA & INSURANCE
-LARSON'S SPOTLIGHT: OSHA Violation and Intentional Wrong, Offset of Wage Loss Benefits, Injury During Work Break, Slip and Fall in Company Lot
-AMA GUIDES TIP
-NATIONAL CONFERENCE
-BLOGS AT THE WCLC: Fraud, DE benefit rates, MO co-employee liability, WV special employer
-NATIONAL NEWS
-STATE NEWS
-eNEWSLETTER ARCHIVES
A Note From The Editor
Robin Kobayashi 2010

Dear Workers' Comp Community:

 

To sign up for this free weekly eNewsletter, click here. To read past issues, access the archives.

 

Sincerely,
Robin E. Kobayashi, JD
LexisNexis Legal & Professional Operations
The Industry's Leading Training Event
LRP National Workers Comp Conference 2012 combined

Register today

 

Solutions for Opioid Crisis

Regional Differences Sessions

New Interactive Think Tanks

LexisNexis Enhanced Legal Track

Cutting Edge, But Practical Solutions

 

***LexisNexis Workers' Comp Law Community members are eligible for a special discount.*** 

ACA impact on insurance industry

The Impact of the Affordable Care Act on the Insurance Industry, Including Workers' Compensation. In an interview with wrintv.com, Dr. Robert Hartwig of the Insurance Information Institute gave a rundown on the impact of the ACA on the insurance industry, now that the Act has been declared constitutional by the U.S. Supreme Court. Read more.

Larson's spotlight: intentional wrong

Tom Robinson thumbnail

Employer's OSHA Violation Falls Short as Substantial Evidence of Intentional Wrong in Tort Action, by Thomas A. Robinson. Relying upon its earlier decision in Millison v. E.I. du Pont de Nemours & Co., in which the Supreme Court of New Jersey adopted the "substantial certainty" rule, the state high court nevertheless reversed the decision of a lower appellate court which had found, on the basis of the employer's OSHA violation, that there was substantial evidence of an intentional wrong. The Supreme Court indicated that also under Millison, it had held that a probability or knowledge that injury or death could result was not sufficient to demonstrate an intentional wrong. Read more about this case and other cases involving Offset of Wage Loss Benefits, Injury During Work Break, and Slip and Fall in Company Lot.

ama guides tip

Robert Rassp grayUnderstanding the DRE Gap, by Robert G. Rassp, Esq. There is significant confusion in the workers' comp community about whether a spinal injury should fall into a DRE category I, II, or III. Carefully read the instructions in the AMA Guides Fifth Edition, Ch. 15, Sec. 15.3, p.383, where the authors distinguish the categories. Consider the DRE gap: Category I assumes that people with a sprained back recover within 6 months to 1 year, justifying a 0% WPI.  But the reality is that there are patients who intermittently have symptoms, such as muscle spasms, muscle guarding, decreased range of motion, etc., and their ADLs are significantly affected for many years. Some physicians try to avoid the DRE gap by ... Read more.  

brad bleakney to speak at national workers' comp conference

LexisNexis has partnered with the National Workers' Compensation Conference to create an enhanced legal track for attorneys and other workers' comp professionals. Larson's Brad BleakneyAdvisory Board Executive Committee member Brad Bleakney will be speaking on Legal Triage. View the program agenda. Overall, there are 15 members of the Larson's National Workers' Compensation Advisory Board speaking at this event. You don't want to miss this conference! Take advantage of the special discount for all LexisNexis Workers' Compensation Law Community members. Community membership is free at our site.

blogs at the lexisnexis workers' comp law community

Fraud SignWorkers' Comp Fraud Blotter: Washing and Detailing Cars and Pickup Trucks While on Disability Leads to Conviction, by LexisNexis Workers' Compensation Law Community Staff. Read it.

  

 

 

 

CassandraAs the Temperature Climbs, So Do the Rates: DE Dept. of Labor 2012-2013 Rates Released, by Cassandra Roberts, Esq. Read it.

 

 

 

 

Martin KlugMissouri: Court Rejects Co-employee Liability in Wrongful Death Claim, by Martin Klug, Esq. Read it.

 

 

 

 

H. Dill BattleWest Virginia Supreme Court Applies Special Employer Rule to Find Temporary Employer Immune From Common Law Suits, by H. Dill Battle, III, Esq. Read it.  

national news
state news

AZ: Governor Names Germaine Marks as Acting Director for Dept of Insurance.

CA: SCIF Alleges Two Doctors Submitted Bogus Workers Comp Claims.

CA: Insurance Dept Deposits $1.5M to General Fund From Settlement With Travelers.

CA: WCIRB Posts Annual Workers Comp Conference Recap.

CA: WCIRB Adds Experience Modification Calculator to Free Online Services.

CA: DIR's Baker Says Alternative Security Program Puts $6.17B in Capital Back Into Business.

CA: DWC Posts National Drug Codes Affected by Unavailability of Fee Schedule Updates.

CA: DWC Posts Adjustment to DMEPOS Section of OMFS.

CT: Updated WCC's Revised Medical Protocols Effective 7/1/2012.

CT: Governor Announces Resignation of Dept of Labor Commissioner.

DE: OWC Posts Updated Maximum, Minimum Benefit Rates.

FL: Limited Bandwidth WIFI Coming Soon to OJCC Offices.

FL: Remployment Services Have Transferred to DWC.

FL: DWC Sets Assessment Rate for WC Administration Trust Fund for CY 2013.

FL: DWC Sets Assessment Rate for Special Disability Trust Fund.

IL: Governor Signs SB 2885 for Employers to Pool Resources to Provide Health Insurance.

IL: WC Adjusters Lacked Standing in Legal Malpractice Claim Against WC Defense Attorneys.

IL: Lumbermens, American Manufacturers Ordered Into Rehabilitation.

MD: WCC Posts Revised Settlement Worksheet.

MD: IWIF Posts 2011 Annual Report.

MA: AG Settles w/Target, Wal-Mart Re Overcharging WC Insurers for Prescription Drugs.

MI: WCA Revises WC-701, Notice of Compensation Payments.

NE: Workers Comp Court Announces Retirement of Judge Ronald L. Brown.

NE: Judicial Nominating Commission Re Workers Comp Judge Applications.

NH: Dept of Labor Posts New Maximum, Minimum Benefit Rates.

NJ: Court Strikes Down Occupational Stress Claim of Former Bank Employee.

NY: SWCB Posts Rule on Requests for Venue Change.

NC: Governor Signs Bill to Crack Down on Employer Without WC Coverage.

NC: Governor, Lawmakers Agree to Amend HB 237 Re Public Record of WC Insurance.

OH: Attorney Kevin J. Cooper to Head Toledo Bar Assoc. Workers Comp Committee.

OK: WCC Addresses Compliance With Rule for Settlements While Petition for Review Pending.

OK: GOP Lawmakers Request Study on Workers Comp Opt Out Program.

OR: WCD Issues Temporary Rule on Attorney's Fees Effective 7/1/2012.

RI: DWC Posts Changes to WC Hospital Rates Effective 7/1/2012.

TX: Supreme Court Denies Privileged Communication Between Employer, Insurer's Attorney.

UT: Workers Compensation Fund CEO to Serve as Salt Lake Chamber Chairman of Board.

WA: L&I Names Elizabeth Smith as Head of Fraud Prevention.

New York Workers Comp 2012

Order 2012 Edition

Buy Print Book, Get eBook Version Free (limited time offer)

68805
 Order today
4322 4th  Edition

Ohio Workers' Compensation Law

Order Fourth Edition

Top 25 Blogs 2011

View the honorees.

ENEWSLETTER ARCHIVES

ArchivesTake a deep dive into our past eNewsletters for 2012 and prior...warning - some links to articles may not work...report any linking problems to Robin.E.Kobayashi@lexisnexis.com.

 

July 2, 2012: Health Care Reform Law Upheld.

June 25, 2012: Compromising "The Great Compromise".

June 18, 2012: Muddying the Water in Longshore Act Hearing Loss Cases.

June 11, 2012: Claimants' Narcotic Use Mismanaged.

June 4, 2012: Self-Insured Groups for Workers Comp.

ACCESS 2010-2012 ARCHIVES AND ARTICLES LIST HERE.

LexisNexis and the Knowledge Burst logo are registered trademarks of Reed Elsevier Properties Inc., used under license. Other products or services may be trademarks or registered trademarks of their respective companies.

Privacy & Security Copyright © 2012 LexisNexis, a division of Reed Elsevier Inc. All rights reserved.