Tag: Workers Comp

The California Division of Workers’ Compensation on Friday announced that new rules allowing an additional 30 days to schedule a medical-legal evaluation are now in effect.

The Office of Administrative Law approved the rules, and they took effect on Thursday when they were filed with the Secretary of State.

The rules require that a qualified medical evaluator schedule an exam with an injured worker within 90 days of being selected from a panel, an increase from the 60 days that were formerly allowed. The extended time frame applies to both initial and subsequent evaluations.

The rules also define remote health evaluations and establish criteria for when med-legal evaluations can be done using video conferencing or similar technology. The rules allow remote exams when there’s a disputed medical issue involving causation, termination, indemnity benefits or work restrictions and the parties agree to the evaluation.

The division said in a statement that proposed changes related to electronic service of documents were withdrawn from the proposal. The agency said it will initiate an additional 15-day comment period to address the electronic service regulations. 

WorkCompCentral is a sister publication of Business Insurance. More stories here.

Pie Insurance Group, an insurtech that provides workers compensation insurance to small businesses, on Thursday announced that it has secured a financial strength rating of A- (excellent) and a long-term issuer credit rating of A- from A.M. Best Co. Inc.

John Swigart, co-founder and CEO of Pie, in a statement said the new ratings will help the company advance to a full insurer providing all lines of commercial insurance.

 

New York lawmakers will consider a bill that would require employers and workers compensation insurers to cover opioid overdose deaths by presumption.

S.B. 4030, which was sent to a labor committee, states that an overdose death would be compensable if an injured worker was prescribed opioids as a result of his or her workplace injury.

The bill does not include language on rebuttals.

 

 

Chronic pain patients in New York were able to cut down on their use of prescription opioids when switching to medical marijuana, according to a study released Monday by the American Medical Association and published on the JAMA Network Open.

The study, compiled by researchers with the New York Department of Health and published by the American Medical Association, looked at New York’s Prescription Monitoring Program data between 2017 and 2019 involving 8,165 chronic pain patients.

The findings showed that those patients who were using medical marijuana for a longer period of time were able to wean their dependence on prescription opioids, and that higher opioid dosages were associated with large reductions in use.

“These findings contribute evidence toward potential clinical benefits of medical cannabis in reducing prescription opioid intake, which may decrease patients’ risk of opioid overdose,” the researchers wrote.

The study says that patients being treated for chronic pain with long-term opioid therapy are at a higher risk of developing opioid use disorder and potential overdose, proving the need for “alternative companion treatments” such as medical cannabis.

The researchers spent eight months studying individuals who made up the study sample and analyzed data from November 2021 to February 2022.

They noted that very few studies in the country so far have assessed changes in opioid dosages among medical marijuana pain patients.

The study involved two exposure groups: one made up of patients receiving medical marijuana for 30 days or less and the other made up of individuals using medical marijuana for more than 30 days.

The researchers concluded that those patients receiving medical marijuana for longer durations used less amounts of opioids, with those using medical marijuana for more than 30 days showing an opioid amount reduction by nearly half.

Another study with similar findings was published on Jan. 18 in the research journal Health Economics.

That study, previously reported by Business Insurance, found that prescriptions for the opioid codeine have decreased in states that offer legal medical marijuana for chronic pain patients.

 

 

The Occupational Safety and Health Administration cited Amazon Inc. for allegedly failing to keep workers safe from ergonomic hazards.

OSHA on Wednesday proposed $46,875 in penalties against Amazon after inspectors said they found dangerous conditions at warehouses in Aurora, Colorado; Nampa, Idaho; and Castleton, New York.

Amazon was issued citations for not providing safe workplaces. Inspectors visited the three sites after receiving referrals from the U.S. Attorney’s Office for the Southern District of New York.

OSHA accused Amazon of exposing workers to a high risk of low back injuries and other musculoskeletal disorders. The risks relate to repetitive and frequent handling of packages and other items at the warehouses for long durations of time.

OSHA said it came across high rates of musculoskeletal injuries after reviewing onsite injury logs.

In January, OSHA issued similar citations over claims of improper warehouse safety after visits to Amazon locations in Deltona, Florida; Waukegan, Illinois; and New Windsor, New York.

Amazon has 15 business days to contest the citations in the most recent case.

Lawmakers in Connecticut will be considering a cancer presumption bill that would apply to firefighters suffering from several different types of cancer.

S.B. 937, introduced Thursday, states that the presumption would apply to “any condition of cancer affecting the brain, skin, skeletal system, digestive system, endocrine system, respiratory system, lymphatic system, reproductive system, urinary system or hematological system that results in the death or temporary or permanent total or partial disability of such firefighter.” 

The presumption would be rebuttable under certain conditions, including if the firefighter is a smoker or it is proven that the firefighter failed to use respiratory protection. Also, the presumption would be rebuttable if the firefighter presents evidence of cancer in a pre-employment physical or if the firefighter fails to submit to annual physical examinations.

 

New York lawmakers are proposing changes to guidelines used for medical treatment of injured employees in workers compensation claims.

Senate Bill 3550, which was introduced Tuesday, would prohibit insurers from paying for charges that exceed the state’s medical fee schedule or that are not provided for under the current fee schedule and compensable under Medicare. 

Language in the bill says that insurers should never pay any charge for professional health services that exceeds the charges permissible under the schedule established by the chair of the Workers’ Compensation Board.

Deviations from medical treatment guidelines would only be allowed with prior written request to insurers before treatment of injured workers commences.

The bill says that treating physicians will bear the burden of proving the necessary treatment if it deviates from the guidelines, and that failure to provide the request would result in maximum reimbursement of 50% of the treatment guidelines.

The bill would also give insurers the ability to order independent medical examinations of injured workers at any time during the course of treatment.

The measure also states that services not covered under the treatment guidelines or workers comp fee schedule will be determined non-compensable.    

 

 

A Pennsylvania appellate court has struck down a $5.59 million jury award for a former roofer who suffered catastrophic spinal injuries after falling 20 feet through an unmarked hole in a roof.

The Pennsylvania Superior Court reversed the multi-million-dollar jury award for Jason Yoder because the general contractor on the roofing job qualified as the worker’s statutory employer and was therefore immune from civil suit.

Mr. Yoder was critically injured on Oct. 25, 2016, while working for Warminster, Pennsylvania-based roofing company RRR Contractors Inc., which was subcontracted by Glenolden, Pennsylvania-based McCarthy Construction Inc. on a roof repair job at the Norwood Public Library in Delaware County, Pennsylvania.

Following his injuries, Mr. Yoder sued McCarthy for negligence. A lower judge found that McCarthy failed to qualify as Mr. Yoder’s statutory employer and that Mr. Yoder was an independent contractor.

Following a June 2021 trial, a jury awarded $5 million to Mr. Yoder. After delay penalties, the award totaled $5,590,650.69. McCarthy appealed.

On Tuesday, the Pennsylvania Superior Court reversed the entire judgment and remanded the case to the lower court to enter judgment for McCarthy, saying while it expressed “displeasure with having to disturb the jury’s verdict,” the award was legally improper.

The court determined that Mr. Yoder should have been prohibited from claiming independent contractor status since he previously claimed to be an employee and was able to secure workers compensation benefits after the workplace injury.

The court said McCarthy, as statutory employer, should have been immune from tort liability.

The judges said Mr. Yoder should have been prohibited from claiming independent contractor status since he was able to secure comp benefits after the accident.   

 

New York and Maryland lawmakers will consider legislation that would provide workers compensation benefits to certain first responders who suffer from post-traumatic stress disorder.

S.B. 3367, introduced Tuesday in New York and sent to the labor committee, would apply to police officers, correction officers, firefighters, emergency medical technicians, paramedics, emergency dispatchers or those certified to provide medical care in emergencies, and would require diagnosis by a psychiatrist or psychologist.

The bill states that if diagnosed “it shall be presumed to have been incurred during service in the line of duty and shall be compensable, unless it is shown by a preponderance of the evidence that the PTSD was caused by nonservice-connected risk factors or nonservice-connected exposure.”

The bill also states that such person who is diagnosed with PTSD within three years of the last active date of employment would be eligible for benefits.

Lawmakers in Maryland introduced S.B. 406 on Wednesday, cross-filed one week after the state’s House of Representatives introduced H.B. 335. Both bills, sent to committees, would apply to a list of professionals that include police officers, firefighters, members of a “rescue squad,” correctional officers, and 911 specialists.

In addition to diagnosis requirements, the first responder would have to complete at least two years of cumulative service within the state as a first responder and the claim would have to be filed while serving or within 18 months of separation from job duties. Benefits would be capped at two years from diagnosis, according to both bills.