Tag: Workers Comp

The Arkansas Court of Appeals has reversed a determination by the state’s Workers’ Compensation Commission that an injured construction worker was an employee of a contractor he sued after he was struck by a truck driven by one of the company’s workers.

The appeals court ruled Wednesday that the commission was wrong to find that an employment relationship existed between Jacen Gann and Bobby Kennedy Construction Co.

Mr. Gann was injured in September 2019 after being struck by a truck driven by an employee of BKC at a job site.

Mr. Gann, who worked for CK Asphalt LLC, filed a workers comp claim with his employer but also initiated a separate personal injury suit against BKC and the truck driver.

BKC argued that an employment relationship existed between itself and Mr. Gann and that the matter should be the subject of exclusive remedy protections under comp, not tort law.

An administrative law judge determined that Mr. Gann was BKC’s dual employee on the date of the injury and that exclusive remedy did, in fact, apply.

Mr. Gann appealed the determination, but the commission agreed with the judge, finding that a contract for hire existed solely because BKC employees supervised CK Asphalt workers at the job site on the date of the injury.  

In reversing the commission’s decision, the appeals court ruled that there was no express or implied employment contract between Mr. Gann and BKC for the purposes of comp exclusive remedy provisions.

The court remanded the case back to the workers comp commission for an order consistent with its opinion.      

 

 

Reducing the rung spacing of firetruck aerial ladders could help cut down on firefighter injuries, the U.S. Centers for Disease Control and Prevention’s National Institute for Occupational Safety & Health said in a report.

Reducing the rung spacing from 14 inches to 12 inches could lower muscle and joint stress, improve climbing efficiency and improve safety for firefighters, particularly those with smaller body frames as the sector’s workforce becomes more diverse, according to the report released Monday.

Researchers found that the tighter spacing correlated with increased climbing speed, increased toe and foot clearance, reduced ankle twisting, and reduced hand and foot forces.

 

Ohio lawmakers are considering a bill that would provide workers compensation coverage for testing when medical professionals are exposed to chemical substances or bodily fluids in the course of employment.

S.B. 106, introduced Tuesday, adds physicians and registered nurses as qualifying professions under the state’s existing law providing testing for first responders exposed to chemicals or bodily fluids who are provided “post-exposure medical diagnostic services, consistent with the standards of medical care existing at the time of the exposure, to investigate whether an injury or 16 occupational disease was sustained.”

 

 

The family of a woman who was among seven workers killed when a natural gas line exploded at a chocolate factory in West Reading, Pennsylvania, in March is suing the employer and 10 other defendants for wrongful death.

According to the suit, filed Tuesday in the Court of Common Pleas of Philadelphia County, the owners of the R.M. Palmer Co. failed to evacuate workers on March 24 when several complained of smelling gas at the factory, which was leveled when it exploded at about 5 p.m. that day. Those operating the gas line, individuals charged with maintaining the line, and parent companies are also named as defendants in Edith Ruiz v. UGI Corp. et al.

The complaint, filed by the family of Judith Lopez-Moran, states that the owners of the factory “were responsible for ensuring that the Factory was in safe condition and that the workers at the Factory were provided a safe place in which to work” and that they “received numerous instances of actual notice, warnings, and complaints concerning a suspected, potential, and/or actual gas leak at the Factory, including on the date of the explosion.”

“Despite this aforementioned knowledge… (the company) knowingly failed to evacuate the workers from the Factory and failed to immediately contact the appropriate authorities to determine the source of the gas leak and thus knowingly exposed the workers, including Judith Lopez-Moran, to an unreasonable and unacceptable risk of severe injury and/or death,” the complaint states.

The suit, which seeks “sums in excess of the jurisdictional threshold in damages, exclusive of interest, costs, punitive damages and delay damages” accuses the defendants of “carelessness, negligence, gross negligence, recklessness, and other liability-producing conduct.” 

The company could not be reached for comment Wednesday. 

 

Rising Medical Solutions LLC, a Chicago-based workers compensation managed care firm, announced Wednesday that it has acquired Carmel, Indiana-based regional case management company Preferred Disability Management LLC.

Financial terms of the deal were not disclosed.

Preferred Disability’s nurse case managers have expertise in community hospitals, physicians, therapists and other service providers that work in the comp space, Rising Medical said in a statement.

About 20 employees from Preferred Disability will be joining Rising Medical, which said it plans to add more staff as it expands its field case management territory.

 

The Appellate Court of Connecticut ruled the state’s workers compensation commissioner wrongly denied comp benefits to a police chief on the erroneous belief that his retirement as a patrol officer before his elevation to chief constituted a break in his employment status and barred him from benefits.  

The appeals court on Tuesday overturned a decision by the comp commissioner, which had been upheld by a review board, that determined Joseph L. Gaudett Jr. was ineligible to collect certain disability benefits in 2016 on the grounds that, although he began working as an officer in 1983, his hiring as chief in 2010 constituted a new hire date and voided his claim for benefits.

Mr. Gaudett asserted that his benefits claim should have been accepted because he was a regular member of the Bridgeport Police Department for decades, and that it should never have been concluded that there was a break in employment service that would have affected comp eligibility.

Both the comp commissioner and review board determined that Mr. Gaudett’s retirement from patrol and promotion to chief effectively created a new hire date, changing the eligibility for benefits entitlement.

The appeals court found that the comp commissioner erroneously concluded that Mr. Gaudett’s receiving pension benefits when he became police chief disqualified him from collecting other benefits.

There is nothing in state statute that supported the position that claimants are barred from collecting benefits due to pension status, the court ruled.

The appeals court remanded the case to the comp commissioner for further proceedings consistent with its opinion. 

 

 

 

Officials tasked with overseeing the workers compensation program for federal workers say they have created an effective pharmacy benefits management program that addresses concerns raised in a scathing report that found millions in overspending and prescriptions written for notoriously deadly fentanyl.

A U.S. Department of Labor’s Office of Inspector General audit of the Office of Workers’ Compensation Programs, released April 4, found that the Federal Employees’ Compensation Act program, which covers injured federal workers, failed to secure adequate pricing and clinical oversight of prescriptions, resulting in $321.3 million in excess spending.

The audit also found numerous other problems with the FECA program, including that it “lacked a pharmacy benefit manager to help contain costs and had not determined if alternative prescription drug pricing methodologies would be more competitive.”

Outside auditors analyzed six years of pharmaceutical data and studied policies, procedures and other documentation. They also compared the FECA program with industry best practices and other workers comp programs.

Assisting with the audit was Maggie Valley, North Carolina-based consultancy CompPharma LLC, headed by Joe Paduda, its Skaneateles, New York-based president.

Mr. Paduda said the worst findings included 1,330 prescriptions for fentanyl, a fast-acting opioid that had been restricted but was prescribed nonetheless. “A number of things that should not have happened did, in fact, happen,” he said.

Overall, the audit found that the FECA program paid for 12 separate controlled substances that “are considered dangerous and carry a high risk for psychological or physical dependence, abuse and addiction,” including fentanyl – named among the most dangerous.

“The concern here is really a patient safety issue. Given all of the notoriety fentanyl has achieved it’s not news to anybody that this is a really dangerous medication,” Mr. Paduda said.

“A policy or procedure where the payer ensured that prior authorizations were done would have prevented these fentanyl scripts from going to patients, of whom there’s no evidence that they met the requirements for.”

Auditors examined data from 2015 to 2020 and the Office of Workers’ Compensation Programs has since hired experts to help with its program, the office’s director Chris Godfrey said in a statement.

“The Federal Employee Compensation Act program implemented a Pharmaceutical Benefit Management function in late 2021, which addressed many of the issues raised by OIG and significantly improved patient safety, quality of care for FECA claimants, and reduced drug spending by $87.9 million in the first year alone. These improvements were not reflected in the OIG report, which covered a period prior to the implementation of the PBM,” the statement read.

 

 

The Iowa Supreme Court ruled the widower of a woman who died following a permanent work injury was entitled to collect workers compensation death benefits even though the couple was separated at the time of the death.

In a Friday decision, the court determined Roger Blasdell was entitled to receive death benefits after Heather Blasdell died from overdosing on medication she was using following the injury.  

The couple decided to live separately more than two years into their marriage for employment reasons, although they never divorced and remained financially supportive of each other.

After the couple decided to live separately, Mr. Blasdell started seeing another woman, but he also paid Ms. Blasdell’s funeral expenses following her September 2016 death.

Ms. Blasdell’s employer, Linhaven Inc., and its insurer, Accident Fund National Insurance Co./United Heartland, claimed Mr. Blasdell was barred from receiving death benefits under a section of Iowa law that prevents a spouse from receiving comp benefits in cases where a surviving spouse “willfully deserted” the deceased.  

A comp commissioner agreed Mr. Blasdell was not entitled to benefits. A district court reversed the determination, and an appeals court agreed.

The Supreme Court said both lower courts correctly determined Mr. Blasdell didn’t desert his wife, and that the decision to live separately was made jointly, and for financial reasons.

The separation should not have barred Mr. Blasdell from collecting death benefits, the court said.  

 

Pennsylvania lawmakers have proposed amending the utilization review process in the state’s workers compensation system. 

House Bill 881, introduced Tuesday, would amend the state’s Workers’ Compensation Act by mandating that requests for utilization review in injured worker claims be assigned only to organizations that are nationally accredited to handle utilization review issues for workers comp programs.

If the bill becomes law, the specific nationally recognized accreditation or certification programs that will be required of organizations seeking to be approved to handle utilization reviews will need to be published via public notice within 30 days of the bill’s passage.

Those organizations without the proper certification or accreditation will be permitted to continue engaging in utilization review for up to 18 months after the publication of the new notice so long as they are “actively attempting to achieve the selected certification or accreditation” during that timeframe, the measure states.

Utilization review is a process in workers compensation claims in which an impartial medical party can review the reasonableness or necessity of treatment being offered to injured and sick workers who are collecting comp benefits.

The bill was sent to the House Labor and Industry Committee for consideration.       

 

 

The Occupational Safety & Health Review Commission has vacated a citation and $19,114 in fines against a California contractor after the death of a painter who was crushed by a heavy gate at a casino loading dock.

In a decision filed March 6 and publicized Thursday, the commission determined OSHA failed to prove that San Diego–based Raymond-San Diego Inc. did not carry out required inspections of the heavy gate before the death of the painter on Dec. 7, 2020.

The deceased worker was part of a four-person team tasked with painting the large gate used to control access to the loading dock area of the Agua Caliente Casino, located in Cathedral City, California, and owned and operated by the Agua Caliente Band of Cahuilla Indians, a Native American tribe.

Raymond subcontracted with the general contractor, Las Vegas-based PENTA Building Group LLC, to provide painting and other services at the casino work site.

Following the fatality, OSHA inspectors concluded the company failed to adequately inspect the gate and failed to instruct its crew on how to safely open the gate, and it issued a corresponding citation for serious violations.

In vacating the citation, the review commission, in addition to determining the company properly carried out inspections of the gate, ruled the deceased worker’s supervisors “acted with reasonable diligence such that they did not have constructive knowledge of the hazardous condition of the gate.”

OSHA had claimed that the supervisors knew the gate posed a hazard to the painters because it was not in complete working order at the time the workers were tasked with painting it.