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Court Upholds Denial of Coverage for Worker's Opioid Medication

The Kentucky Court of Appeals upheld the denial of coverage for a worker’s opioid medication. Case: Howell v. Floyd County Board of Education, No. 2024-CA-0122-WC, 10/18/2024, unpublished. Facts and procedural history: Judy…




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Supreme Court Says Traveling Worker Suffered Compensable Fall While Souvenir Shopping

The Kentucky Supreme Court ruled that a traveling worker was entitled to benefits for her injuries from a fall while leaving her hotel to go souvenir shopping. Kimminee Costello worked for…




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Split Supreme Court Awards PTD Benefits to Worker for Electric Shock Injuries

A divided South Dakota Supreme Court ruled that a worker was entitled to permanent total disability benefits for his electric shock injuries, finding he developed both a cardiac condition and…




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Court Orders DLI to Decide Reasonableness of Worker's Refusal to Attend Appointment

The Montana Workers’ Compensation Court ruled that the Department of Labor & Industry needed to make a finding as to the reasonableness of a worker’s refusal to attend a therapy…




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Maximum Weekly Benefits Increasing 4.84%

The Montana Department of Labor & Industry announced that the maximum weekly compensation rate will increase by 4.84% for the fiscal year starting July 1. “For injuries occurring on or after July…




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DLI Rules Would Authorize Max Penalty for Misclassification

The Montana Department of Labor and Industry proposed rules that would add intentional misclassification to the list of violations that justify assessing the maximum penalty. The department will hold a hearing…




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Lack of Objective Medical Evidence Results in Summary Denial of TTD Claim

The Montana Workers’ Compensation Court granted summary judgment denying a worker’s request for additional temporary total disability benefits because he failed to offer objective medical findings of his alleged chronic headaches. Case:…




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JCC Errs in Failing to Find Worker's Claim for Additional Benefits Untimely

A Florida appellate court ruled that a judge erred in failing to find that a worker’s claim for additional benefits was time-barred. Case: American Airlines Group v. Lopez, No. 1D2023-0379, 05/22/2024,…




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Court Overturns Denial of Employer's Motion for Costs as Partially Prevailing Party

A Florida appellate court overturned a judge’s decision denying an employer’s motion for costs as a prevailing party on a worker’s claim. Frances Smith worked for the Palm Beach County School…




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Governor Approves Pay Raise for Doctors Treating First Responders

Florida Gov. Ron DeSantis signed a bill allowing police and firefighters with injuries that are presumed to be compensable to select a doctor and increasing the provider’s reimbursement to twice…




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Judge Whiffs in Calculating Pro Baseball Player's Average Weekly Wage

A Florida appellate court ruled that a judge of compensation claims erroneously calculated a minor league baseball player’s average weekly wage. Austin Sodders entered into a seven-year minor league contract with…




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Report: Clearwater Cop Arrested for Alleged Comp, Pension Fraud

A police officer in Clearwater, Florida, was arrested after investigators allegedly observed him engaging in activities that contradicted the limitations he cited when seeking workers’ compensation benefits and a disability…




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DWC Publishes Fee Schedule

The Florida Division of Workers’ Compensation published the state's 2024 medical fee schedule. The schedule of maximum reimbursement allowances for physician and nonhospital services takes effect Jan. 1. The fee schedule is…




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Employer Entitled to Recover Full Lien From Worker's Third-Party Settlement

A Florida appellate court overturned a judge’s determination that an employer was not entitled to recover the full amount of its lien against an injured worker's third-party settlement. Regina Akins suffered…




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DWC Posts Rulemaking Notice for Fee Schedule, Related Documents

The Florida Division of Workers’ Compensation posted a notice of development of rulemaking to implement the most recent edition of its health care provider fee schedule and related documents. The DWC…




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Federal Court Upholds Conviction for Pharmacy Kickback Scheme, Overturns Restitution Order

A federal appellate court upheld a defendant’s conviction for a long-running and lucrative kickback scheme but overturned the restitution order that had been imposed. Case: U.S. v. Young, Nos. 20-13091 and…




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Comp Judge Nominating Commission Meeting Aug. 19

Florida’s Statewide Nominating Commission for Judges of Compensation Claims will meet Aug. 19 in Orlando to interview judges for reappointment. The following judges are being considered for reappointment: William Anderson; Robert…




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Cashier Shot During Robbery Leads to OSHA Fines for Circle K

Federal workplace safety investigators cited Circle K Stores Inc. for failing to provide a safe place of employment after a cashier suffered a serious gunshot injury during a robbery. Two men…




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NCCI Recommends 1% Rate Cut

The National Council on Compensation Insurance recommended that the Florida Office of Insurance Regulation reduce workers’ compensation rates by an average of 1%, effective Jan. 1. NCCI said in a summary…




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CFO Asks Court to Revisit Definition of Heart Disease for Presumptive Claims

Florida's Chief Financial Officer is asking the state's 1st District Court of Appeal to revisit its definition of heart disease under a 2023 decision dealing with presumptive claims by first…




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Construction Labor Contractors Charged With Fraud

Federal prosecutors in Florida announced that five people were indicted on fraud charges for an alleged labor contracting scheme that was structured to avoid payroll taxes and comp coverage. The U.S.




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OSHA Cites Contractors for Fatal Fall

The federal Occupational Safety and Health Administration cited two contractors that it said could have prevented a fatal accident if they followed workplace safety rules. Jorge De La Torre, 27, died…




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Employer Should Have Been Granted Continuance After Doctor's Unexpected Change in Opinion

A Florida appellate court ruled that an employer should have been granted a continuance after its medical expert expressed an unforeseen change in opinion shortly before the scheduled hearing on…




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Court Upholds Worker's Entitlement to Further Medical Care

An Arizona appellate court upheld a determination that a worker was entitled to additional treatment as he had not reached a medically stationary state. Case: Tenet Health System Medical v. Industrial…




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Court Upholds Denial of Worker's Request to Reopen Car Accident Claim

The Arizona Court of Appeals upheld the denial of a worker’s request to reopen his claim arising out of a car accident. Case: Parr v. Industrial Commission, No. 1 CA-IC 23-0018,…




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ICA Sets Annual Claims Seminar for August

The Industrial Commission of Arizona is holding its 2024 Claims Seminar Aug. 15-16 in Scottsdale. The seminar will cover topics including an overview of state work comp statutes, the role of…




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ALJ Abuses Discretion in Denying Worker's Request for Relief

The Arizona Court of Appeals ruled that an administrative law judge committed an abuse of discretion in denying a worker’s request for relief from the dismissal of her hearing due…




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Missed Deadlines, Lack of Discovery Wreck Worker's Request for Hearing

The Arizona Court of Appeals ruled that a worker’s request for hearing was properly dismissed, given her failure to adhere to deadlines and failure to participate in discovery and a…




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ICA Names New Safety and Health Program Manager

The Industrial Commission of Arizona announced that Joanna Martelles was chosen to serve in the newly created position of Safety and Health Program manager. The new position will be tasked with…




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Industrial Commission Announces New Training Opportunities

The Arizona Industrial Commission announced that it's Medical Resource Office has added training opportunities for providers, payers and third-party administrators. The training course for providers is comprised of four, 30-minute webinars…




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Performer Injured During Jousting Match Not Subject to Comp Coverage

A Louisiana appellate court ruled that a worker injured while participating in a jousting demonstration was exempt from coverage under the state Workers’ Compensation Act as a “performer.” Case: McKeane v.




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Court Upholds Dismissal of Municipal Employee's Tort Suit Against Employer

A Louisiana appellate court upheld the summary dismissal of a municipal employee’s suit against her employer for her injuries from a fall allegedly caused by the city’s negligence in maintaining…




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Court Holds Guaranty Association Liable for Worker's Mesothelioma Benefits

A Louisiana appellate court ruled that the state insurance guaranty association was liable for covering the obligations of two insolvent insurance carriers for a worker’s mesothelioma. Case: Ehlers v. Ports America…




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Lawmakers Pass Bill Limiting Recovery for Misclassification

Louisiana lawmakers passed a bill that would establish notice requirements for carriers to seek additional premium payments from employers that misclassified their workers and limit how much insurers can recover. Rep.




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LASIE Seminar to Cover Basic Principles of Medical Injuries

The Louisiana Association of Self Insured Employers is holding a one-day seminar covering the basic principles of medical injuries commonly seen in workers’ compensation. The seminar will cover how to review…




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Court Upholds Award for Carpal Tunnel, Denies Employer's Request to Take Offset

A Louisiana appellate court upheld an award of benefits for a worker with carpal tunnel syndrome and ruled that his employer was not entitled to an offset against its liability. Case: Caldwell…




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Federal Court Finds Worker Doesn't Qualify as Jones Act Seaman

The 5th U.S. Circuit Court of Appeals upheld a determination that a worker did not qualify as a Jones Act seaman. Case: Edwards v. InterMoor Inc., No. 23-30727, 08/29/2024, unpublished. Facts: Lawrence…




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Court Overturns Approval for Change in Doctors, Denies Forfeiture Claim

A Louisiana appellate court overturned a judge’s decision approving a worker’s change of physician but upheld the denial of the employer’s request for a forfeiture of benefits. Case: Southern v. Servpro…




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Appeals Court Partially Reverses Employer's Win

A Louisiana appellate court overturned a finding that a worker’s stiff person syndrome was not related to her work accident, and a finding that she was capable of engaging in gainful employment…




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Res Judicata Does Not Bar Worker's Intentional Tort Claim Against Colleague

A Louisiana appellate court ruled that res judicata did not bar a school district employee’s intentional tort claim against a colleague even though she received a workers’ compensation settlement for her…




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High Court: No Compensation for Jouster Injured at Renaissance Festival

The Louisiana Supreme Court declined to hear the appeal of a decision finding that a man injured while jousting was excluded from the state's workers' compensation system. On Tuesday, a 6-1…




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Injured Firefighter Successfully Challenges Reduction in Benefits

A Louisiana appellate court ruled that an injured firefighter’s benefits were wrongly reduced and that he was entitled to full reinstatement, plus an award of penalties and attorney fees. Case: Prevost…




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Supreme Court Says Injured Worker Using False Identity Can't Pursue 3rd Party Tort Claim

The Louisiana Supreme Court ruled that an injured worker lost his ability to pursue a civil suit he had filed under a false name and an illegally obtained identity. Rafael Antonio…




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WCC: Amended Rules Allow Electronic Payment

The South Carolina Workers’ Compensation Commission adopted new benefit payment rules after lawmakers permitted the agency to allow electronic payments. The commission on Friday published a statement announcing that the new…




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Court Upholds Denial of Worker's Claim for PTD

The South Carolina Court of Appeals upheld the denial of a worker’s claim for permanent total disability benefits. Case: Cox v. Palmetto State Transportation, No. 2019-001936, 05/29/2024, unpublished. Facts: Jennie Cox allegedly…




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Supreme Court Reinstates PTD Award for Worker With Back Injury

The South Carolina Supreme Court reinstated an award of permanent total disability benefits for a worker who lost the use of his back, despite the low impairment ratings he had received. Case: Paulino…




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Court Upholds Summary Dismissal of Worker's Defamation Claims Against Employer

The South Carolina Court of Appeals upheld the summary dismissal of a worker’s defamation claim against his employer for alleged statements made after he appeared to suffer an on-the-job injury. Case:…




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Court Upholds Award of Benefits to Nurse, Corrects AWW Calculation

The South Carolina Court of Appeals ruled that an injured nurse was entitled to benefits for a closed period and that the Workers’ Compensation Commission erred in calculating her average weekly wage. Rachel…




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High Court Questions Viability of Defense Based on Worker's Failure to Disclose Prior Injury

The South Carolina Supreme Court upheld a finding that a worker was entitled to benefits for a back injury, but it questioned the continued viability of its case law allowing…




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Supreme Court Clarifies Statutory Review Process for Comp Cases

The South Carolina Supreme Court seized an opportunity to clarify the statutory review process for workers' compensation cases in addressing an injured correctional officer’s long-pending claim. Gena Cain Davis worked as…