Claims News Archive


Page 1 of 52 pages  1 2 3 >  Last ›

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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


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

Read More


Highlights from NCCI’s Workers’ Compensation 2016 Issues Report

11.09.2016

By: Julie Ferguson

“NCCI just released its Workers Compensation 2016 Issues Report: Fall Edition. It’s a robust 68-page edition, an important barometer of industry results and trends that we think should be on everyone’s reading list. In addition to updated State of the Line results for the workers compensation for 2014 and 2015 and preliminary estimates for Calendar Year 2016, this edition includes articles and reports on a number of key issues. It’s...
11.09.2016

Read More


US Supreme Court Denies Workers’ Comp Petition in Florida

11.01.2016

The United States Supreme Court DENIED the petition in the matter of Stahl v Hialeah raising constitutional issues in the present workers' compensation system in Florida. The Florida program mirrors trending aspects of other state programs that have also been questioned on constitutional grounds. No. 16-98  Title:  Daniel Stahl, Petitioner v. Hialeah Hospital, et al. Docketed: July 21, 2016 Lower Ct: District Court of Appeal of Florida, First District Case Nos.: (1D14-3077) Decision Date: March 25, 2015 Rehearing...
11.01.2016

Read More


October is National Disability Employment Awareness Month

10.28.2016

By: Sedgwick Connection

October is National Disability Employment Awareness Month (NDEAM), a time devoted to exploring disability employment issues and celebrating the many and varied contributions of America’s workers with disabilities. Reflecting the important role disability plays in workforce diversity, the national theme of this year’s NDEAM observance is #InclusionWorks. In line with Sedgwick’s commitment to fostering a diverse and inclusive workplace and supporting the full potential of people with disabilities in our...
10.28.2016

Read More


IL Supreme Court Blocks Amputation Claim Against Union Pacific

10.27.2016

Editor's comment: The Illinois Supreme Court restored a ruling in favor of Union Pacific Railroad in a court fight with a worker, employed by a third-party contractor, whose legs were amputated removing and scrapping an abandoned railroad bridge in Chicago, as the court’s majority ruled the IL Appellate Court erroneously overturned the ruling of a Cook County judge who found the railroad owed no duty in this case to the scrap contract worker. 

10.27.2016

Read More


Illinois Workers’ Compensation Fraud Investigations

10.17.2016

At the 2016 Illinois Self Insurers’ Association 38th Annual Educational Seminar and Membership Meeting, William Blumthal Jr, Deputy Director Investigations from the Illinois Department of Insurance, provided an update on their efforts to combat workers’ compensation insurance fraud.

            First, the definition of fraud is important to understand. It is an intentional act that results in financial gain. This contrasts with abuse, which is the improper...
10.17.2016

Read More


Page 1 of 52 pages  1 2 3 >  Last ›

Advertise with WCI