Claims News Archive


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New Bill Would Strip Former Rep. Jesse Jackson of Workers’ Comp Benefits

05.24.2017

By Liz Carey

Washington, D.C. (WorkersCompensation.com) - A bill introduced today in Congress by Rep. Rodney Davis (R-IL) would strip federal workers’ compensation from former Rep. Jesse Jackson, Jr., as well as any other elected official convicted of the 29 crimes listed.

The bill, entitled the Protecting Taxpayers from Corruption Act, would not only prevent former congressmen from collecting workers’ compensation, but also provide Congress with an annual list of Congressmen who have applied...
05.24.2017

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Automation Has Mixed Impact on Workers’ Comp Claims

05.17.2017

By Liz Carey

National (WorkersCompensation.com) - As technology provides improvements to accuracy, productivity and costs, it doesn’t necessarily reduce workers’ compensation costs. 

According to a study by Carl Frey and Michael Osborne with the Oxford University Engineering Sciences Department, a rise in automation and robotics in American workplaces could lead to up to 47 percent of U.S. employees losing their jobs. 

And as the use of robots and automation...
05.17.2017

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Rousmaniere: Does it Matter Who Picks the Doctor?

05.10.2017

By Peter Rousmaniere

Does it matter who picks the doctor? The Workers' Compensation Research Institute concluded in a report released last week that for the most part an insurer or employer will incur roughly the same claims costs for work injuries regardless if they occur in “employer choice” or “employee choice” states. It also opened the door to fruitful discussion of what does make a difference in claims outcomes.

To get to its...
05.10.2017

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VT and CO Legislative Watch: PTSD Coverage Action

05.03.2017

By Angela Underwood

Vermont and Colorado (WorkersCompensation.com) – Nationwide attention for Post-Traumatic Stress Disorder (PTSD) coverage has turned to Colorado and Vermont recently.

The evidence is present in both states, where legislation for the mental health injury respectively passed last week in the Northwest and is considered almost two-thousand miles away in the Northeast.

Vermont Representatives Sarah Copeland-Hanzas (D-Bradford) said the reason why she introduced H 197 is because she was offered the opportunity to...
05.03.2017

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Rousmaniere: The Future of Two Cities

04.26.2017

By Peter Rousmaniere

The City of Work Injuries is shrinking in population while the City of Non-Occ Absences expands. During the Trump Administration, these trends are sure to persist. At some time they will change the workers’ comp industry as we know it.

When and how? I predicted in 2015 a scenario for the 2020s by which the current workers’ compensation would incrementally convert to a more privatized worker benefit placed on a platform shared with...
04.26.2017

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MT Bill Heads to Governor’s Desk, Would Disallow WC Claims if Employee Isn’t Truthful at Screening

04.19.2017

By Liz Carey

A bill in the Montana Legislature would allow employers to deny workers’ compensation claims for employees who fail to disclose relevant prior workplace injuries.

The bill, SB 116, was proposed by Sen. Mark Blasdell (R-Kalispell) and would require employees to be open and honest in pre-employment questionnaires with regard to any injuries that may impact their ability to perform their jobs.

If employees don’t disclose those prior injuries, and are...
04.19.2017

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Given the Green Light: FL Firefighters Will Now Have Cancer Coverage

04.19.2017

By Angela Underwood

Tallahassee, FL (WorkersCompensation.com) – There is a sigh of relief for first responders now that the Senate’s workers’ compensation bill has been amended to cover multiple myeloma and non-Hodgkin’s cancers.

In February, WorkersCompensation.com covered GA Bill 152 Could Cover Cancer Costs for Firefighters when the bill was pending after being vetoed last year by Gov. Nathan Deal, who said the measure would be too costly to consider.

...
04.19.2017

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Antibiotics as Treatment for Psyche Claim?

04.12.2017

By WorkCompAcademy

Sacramento, CA - A common antibiotic called doxycycline can disrupt the formation of negative thoughts and fears in the brain and may prove useful in treating or preventing post traumatic stress disorder (PTSD), according to research by British and Swiss scientists. In a specially designed trial involving 76 healthy volunteers who were given either the drug or a placebo dummy pill, those who were on doxycycline had a 60 percent lower fear response than those who were not. The...
04.12.2017

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WorkersCompensation.com Enters News Publication Partnership with WCI

04.05.2017

Sarasota, FL (WorkersCompensation.com) – Starting this week, WorkersCompensation.com Premium Media Services will be providing current news and blog content for the Workers' Compensation Institute. It will be available on the WCI website, located at www.wci360.com, as well as through the WCI Weekly Newsletter.

The Workers' Compensation Institute (WCI) is a nonprofit educational organization that serves as a comprehensive resource to all workers' compensation stakeholders. The WCI is an outgrowth of the long-established Florida...
04.05.2017

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Recently Released and Soon to be Released Generics Expected to Reduce Claims Costs

03.29.2017

Over the past several years, prescription drug costs related to workers’ compensation claims have risen dramatically, making it increasingly important for claims professionals to carefully evaluate this exposure and mitigate costs when possible. Optum Settlement Solutions understands that keeping up to date on new generic formulations is part of an overall strategic approach to reduce the cost of claims and ultimately the prescription allocation of a Medicare Set-Aside (MSA).

Every brand medication has a patent life...
03.29.2017

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Appraising the Grand Bargain

03.20.2017

At the 2017 WCRI Annual Issues and Research Conference, a panel debated the state of the workers’ compensation “grand bargain” in 2017. The panel was:

David Dietz, MD – David Dietz & Associates Dr. David Michaels – Milken Institute School of Public Health of George Washington University Dr. Emily Spieler – Northeastern University School of Law Bruce Wood – American Insurance Association

This session was conducted question and answer style:

Question: Why now are...
03.20.2017

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Advocating for our Industry

03.09.2017

By: Kimberly Brown, SVP Government Relations, Sedgwick

Sedgwick is proud to support the Association of Claims Professionals (ACP) to advance our industry and sustain future growth and positive outcomes. The companies that make up the ACP are leaders in the claims management industry and include independent claims adjusting companies and third party administrators. ACP companies respond every day to individuals and businesses who suffer a loss such as a workplace injury, property or casualty damage, or...
03.09.2017

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FUN WITH TEMPORARY DISABILITY

02.20.2017

By: Cynthia K. Karlen

Despite much confusion, calculating temporary disability (TD) can be easy—and fun—if we keep a few simple rules in mind.

All employees receive the maximum Temporary Disability rate UNLESS there is documentation proving the employee is not a max earner. First, get a wage statement from the employer and determine if the applicant is a full time or part time employee. When was he/she hired? Are there...
02.20.2017

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Workers’ Compensation’s Costly Psychosocial Issues (2)

02.02.2017

BY: Tom Lynch

First, a review.

Yesterday, we described the challenges confronting claims adjusters and injured workers when psychosocial issues are present in a workers’ compensation claim. These issues impede recovery and exacerbate costs. We confidently picked up our saw and walked out on the proverbial limb to suggest this thesis:

Our nation’s current system for treating injured workers with mental health issues is uncoordinated, overly fragmented, highly wasteful...
02.02.2017

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CMS Recovery Practice Ruled Improper Under the MSP

01.23.2017

By: Mark Popolizio

In an important new case—CIGA v. Burwell, 2017 WL 58821 (C.D. California, January 5, 2017)—the court ruled that the CMS practice of seeking full reimbursement of a medical provider’s single charge—even where some unsegregated portion of that charge relates to services not covered by a workers compensation plan—was improper under the Medicare Secondary Payer Statute (MSP) and its supporting regulations.

This new decision...
01.23.2017

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OSHA Issues Final Beryllium Exposure Rules

01.10.2017

A new rule issued today by the U.S. Department of Labor's Occupational Safety and Health Administration dramatically lowers workplace exposure to beryllium, a strategically important material that can cause devastating lung diseases. The new beryllium standards for general industry, construction and shipyards will require employers to take additional, practical measures to protect an estimated 62,000 workers from these serious risks.

Beryllium is a strong, lightweight metal used in the aerospace, electronics, energy, telecommunication,...
01.10.2017

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Reading the tea leaves: The Trump Administration and OSHA

12.14.2016

By: Julie Ferguson

Employers are in a state of limbo between one presidential administration and another, trying to intuit the potential impact as potential names of candidates for the  cabinet and key administrative posts are floated, debated and named. Much is still in the realm of speculation.

One thing is becoming clear: Despite the ambiguity that Trump’s recent comments about possibly preserving some parts of Obamacare, it’s clearly on the chopping block....
12.14.2016

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Florida Judge Strikes Rate Hike

12.05.2016

A Florida judge recently shot down NCCI and the Florida Office of Insurance Regulation’s (OIR) 14.5 percent rate hike for workers’ comp in that state, saying that NCCI held “secret” meetings without public notice, and because it is statutorily recognized, acted improperly in doing so. The ruling stems from a lawsuit filed by Miami-based attorney James Fee, who sued the organization in August in order to “introduce some required clarity and transparency...
12.05.2016

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More Bad News About Opioids

11.22.2016

By: Teresa Bartlett, MD SVP, Medical Quality, Sedgwick

At Sedgwick, we are committed to steering people away from opioid addiction and finding solutions to returning them back to healthy, productive lives. However, the lure of such drugs can begin even before entering the workforce and experiencing an unfortunate injury leading to the prescription of an opioid. This was exhibited last week in the following critical update from the Drug Enforcement Agency (DEA). Please read this important...
11.22.2016

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New Report Reveals Medicare’s “Low-Dollar” Threshold Calculations

11.15.2016

By: Mark Popolizio

U.S. Secretary of Health and Human Services (HHS) Sylvia Mathews Burwell released a new report to Congress that provides insight into the data the Centers for Medicare and Medicaid Services (CMS) used to calculate and substantiate its threshold figures. The report explains how Medicare calculated its recently revised “low-dollar” recovery and reporting thresholds for liability, workers compensation and no-fault settlements. 

Background Section 202 of the SMART Act requires the Secretary of...
11.15.2016

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