Claims News Archive


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Rousmaniere: Speaking for the Injured Worker

02.15.2018

By Peter Rousmaniere

The workers’ comp industry is discovering anew the injured worker.  Using the term “claims advocacy,” claims professionals say they want to anticipate and support the injured worker as she tries to navigate the medical system, keep her home life in order, and return to work. This is a welcome shift from a reactive to a proactive approach in managing claims.

Let’s take the claims advocacy concept from daily...
02.15.2018

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4-1-1 on Comp: Coverage For PTSD in Workplace Shootings

02.08.2018

By Bruce Burk

Just recently, we received news of another school shooting, this time in Kentucky, where two people died and many were injured. It seems every month now we hear of another senseless act of violence. In the workers’ comp community, we understand that these shootings can happen to people at work and can also affect first responders who have to respond to the shootings. This article will serve as an overview of stories involving workers’...
02.08.2018

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Tight Labor Market Forces Employers to Focus on Overlooked Workers: Will it Hurt Their Comp Rates?

01.31.2018

By Liz Carey

Boston, MA (WorkersCompensation.com) — With the unemployment rate hovering at around 4 percent, employers are scrambling to find people to fill job openings, sometimes focusing on often overlooked workers — the elderly, the disabled, immigrants and those with criminal records. 

But experts say those workers may help workers’ compensation costs instead of harming them.

According to the US Bureau of Labor Statistics (BLS), there are 154 million people employed in the...
01.31.2018

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FL: Judge Rules Against Pulse Nightclub First Responder

01.24.2018

By Liz Carey

Orlando, FL (WorkersCompensation.com) – A Florida workers’ compensation judge has rejected a claim from an Orlando police officer that he suffered from Post-Traumatic Stress Disorder after responding to the Pulse nightclub shooting that left 49 people dead.

Judge Neal Pitts ruled against former Orlando police officer Gerry Realin’s suit asking for $25,000 in lost wages.

Florida law covers medical benefits for first responders’ mental injuries, and prohibits payment of...
01.24.2018

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NCCI Report: MT Workers Use More Opioids for Longer

01.17.2018

By Liz Carey

Billings, MT (WorkersCompensation.com) – A recent report to the Montana Department of Labor and Industry showed that injured workers in Montana are not only more likely to be on opioids for pain, but also to be still on those drugs years after their injury.

According to a report by the National Council on Compensation Insurance, in Montana in 2016, nearly 61 percent of the prescriptions written for injured workers were for opioids, and that 40 percent...
01.17.2018

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SC Gov. Signs Executive Order Limiting Initial Prescription of Opioids to Five Days

01.10.2018

By Liz Carey

Columbia, SC (WorkersCompensation.com) – Prior to the holidays, South Carolina Gov. Henry McMaster, citing an opioid epidemic in his state, signed an executive order limiting the initial prescription of opioids to five days. 

In a press conference in Columbia, McMaster announced he would be implementing a comprehensive, statewide response to the “opioid epidemic” and declare a statewide public health emergency as a result. The emergency declaration allows state officials, private...
01.10.2018

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BLS: Workplace Deaths Continue to Rise

01.03.2018

By Liz Carey

Washington, DC (WorkersCompensation.com) – For the third year in a row, workplace fatalities have increased, to the highest level since 2010.

According to the US Bureau of Labor Statistics, there were 5,190 fatal workplace injuries in 2016, a 7 percent increase over 2015. The increase brings the fatal injury rate to 3.6 per 100,000 full-time equivalent employees (FTE), up from a rate of 3.4 in 2015.

Fatalities as a result of transportation incidents accounted for 40 percent of the workplace fatalities,...
01.03.2018

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PA Nuclear Plant Denies Retaliation for Comp Claims

12.28.2017

By Liz Carey

Susquehanna, PA (WorkersCompensation.com) – A Pennsylvania nuclear energy company admits it docked workers’ bonuses, but denied it was in retaliation for filing an on-the-job injury claims, according to a lawsuit against the company by the US Department of Labor.

The Department of Labor filed the lawsuit in US District Court for the Middle District of Pennsylvania in September accusing Susquehanna Nuclear, a subsidiary of Talen Energy, of docking two employees’ bonuses...
12.28.2017

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Rousmaniere: Ohio’s Disturbing Plan for Undocumented Workers

12.20.2017

By Peter Rousmaniere

The workers’ comp system is supposed to be predictable, accountable and biased towards inclusiveness. It’s news when state politicians vote to make their system unpredictable, unaccountable and exclusionary.

That will be the case if the state of Ohio ultimately enacts a bill that the Ohio House of Representatives approved 62-30 on December 5, which prohibits undocumented workers from receiving workers’ compensation benefits.

As reported by Workerscompensation.com’s...
12.20.2017

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Two TX Pharmacy Owners Sentenced in Healthcare Kickback Scheme

12.13.2017

By Liz Carey

Austin, TX (WorkersCompensation.com) – Two Texas pharmacy owners were sentenced Friday for their part in a multi-million-dollar kickback scheme the government said bilked the federal government of millions in federal workers’ compensation reimbursements.

US District Judge Sam Sparks sentenced Brian David Haney, the 38-year-old partial owner of Vidor Pharmacy in Austin, and Kevin Michael Gray, the 45-year-old operator of Family Pharmacy, Inc., in Houston, to 28 months in federal prison on bribery and...
12.13.2017

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CO: ISIS-Like Group Used Work Comp Claims to Fund Activities, Report Shows

12.06.2017

By Liz Carey

Buena Vista, CO (WorkersCompensation.com) – In the 1990s, an Arabic group, similar to ISIS (Islamic State in Iraq and the Levant) or Al-Qaeda, lived in a secluded camp in the Colorado mountains, and used workers’ compensation claims as a way to fund their activities, KRDO in Colorado reported recently. 

Known as “ul Fuqra,” the group lived in a 101-acre campground in Chaffey County, CO, without electricity or running water,...
12.06.2017

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IL: Another Children and Family Services Worker Assaulted on the Job over the Weekend

11.30.2017

By Liz Carey

Chicago, IL (WorkersCompensation.com) – Seven weeks after an attack on an Illinois Department of Children and Family Services (DCFS) caseworker left her in a coma, another DCFS caseworker has been attacked while on the job. 

The latest attack is one of more than a dozen in the past four years, according to a report by the Chicago Tribune. 

Neil Skene, Senior Deputy Director for DCFS, said this weekend a...
11.30.2017

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NY: Surviving Sons of Nuclear Weapons Worker Sue Feds for Compensation

11.22.2017

By Liz Carey

Buffalo, NY (WorkersCompensation.com) – The two surviving sons of Arnold Young have sued the US Department of Labor and the US Department of Health and Human Services over those agencies’ denial of their father’s compensation claim. 

Arnold Young, a New York man who worked at nuclear weapons facilities in the 1940s and 1950s, died of prostate cancer in 1985. Under the EEOICP, or the Energy Employees Occupational Illness Compensation Program...
11.22.2017

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FL Contractor Arrested in $1M Fraud Scheme

11.15.2017

By Liz Carey

Jacksonville, FL (WorkersCompensation.com) – A Florida contractor arrested in a $1 million workers’ compensation fraud scheme remains in custody after failing to post bond and filing for indigent status.

Authorities with Florida’s Department of Financial Services (DFS) arrested Carlos Contreras in October, charging him with workers’ compensation fraud after a months-long investigation. Authorities said Contreras claimed to only have $273,786 in annual payroll, but investigators discovered that Contreras had cashed more...
11.15.2017

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Confidential Records? With Workers’ Comp Policies, it Depends on the State

11.08.2017

By Liz Carey

An Indiana appeals court has rejected a request from LexisNexis Risk Solutions for workers' compensation records, saying the records sought, which could include data on premiums, are confidential.

The ruling comes after LexisNexis Risk Solutions sued the state for access to policy records that were previously compiled by the National Council on Compensation Insurance (NCCI).

According to court records, the state contracted with NCCI in 1998 to collect policy data. In 2013, that contract...
11.08.2017

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You Have a Work Comp Dental Injury…Pre-Existing Versus Related

11.01.2017

Written by Jacob Berger, DMD | EZ Dental Care, Inc.

A causality dilemma can be summed up as “which came first, the chicken or the egg?” In dental workers compensation terms, which came first, the injury or the bad teeth?

It is very common for a dentist to tell a patient that has been involved in an accident with dental trauma that he or she needs to have other dental needs taken care of as well...
11.01.2017

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Workers’ Comp May Not Be Best or the Only Remedy in Workplace Sexual Assaults

10.25.2017

By Jim Thompson

Sarasota, FL (WorkersCompensation.com) - Fallout from the massively publicized sexual assault allegations made against Hollywood producer Harvey Weinstein — perhaps most notably, the use of the #MeToo social media hashtag — indicates that sexual misconduct is a depressingly regular workplace occurrence.

However, questions of how — or even whether — injuries resulting from workplace sexual assaults are pursued through workers’ compensation claims is difficult to answer. In large part, that’s...
10.25.2017

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TX: Wife of Slain Officer Goes to Court for Workers’ Comp Death Benefits

10.18.2017

By Liz Carey

Pearland, TX (WorkersCompensation.com) – For the third time, the wife of a Pearland police officer killed by a drunk driver while on duty will go to court to prove she is entitled to his workers’ compensation benefits.

Lucy Lugo, common law wife of officer Endy Ekpanya, has already proven in court twice that she is entitled to Ekpanya’s death benefits. Now a lawsuit by the Texas Municipal League Intergovernmental Risk...
10.18.2017

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Sleeplessness, Fatigue are Safety Issues in the Workplace, Study Says

10.11.2017

By Liz Carey

Indianapolis, IN (WorkersCompensation.com) – According to a study by the National Safety Council (NSC), sleeplessness and fatigue can cost employers millions in decreased productivity, missed work and employee health issues. 

Last week, the NSC and the Bingham Health Sleep Matters Initiative released a tool that will help employers see just how much fatigue is costing them. NSC estimates that the average Fortune 500 company could see as much as $80 million a year in...
10.11.2017

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Appellate Court Renews Dancers’ Claim Against Men’s Club; Mary Kay Sellers Take Note

10.04.2017

By Liz Carey

Rahway, NJ (WorkersCompensation.com) –  The ruling in a New Jersey appellate court in a case by two dancers against a men’s club is not only going back to court, but also is generating interest from some Mary Kay Cosmetics sellers. 

In August 2015, Alissa Moon and Yasmeen Davis filed suit in District Court against Breathless Men’s Club, claiming that the club illegally misclassified them as independent contractors to...
10.04.2017

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