CA - Trial Court Did Not Abuse Discretion in Considering New Evidence, Remanding Case
09/13/2024 | 0
A trial court did not abuse its discretion when it reviewed new medical reports finding that a man was unable to return to work and in ordering San Francisco’s retirement system to review his related retirement application, a California appeals court ruled.
Justin W. Webster was injured in the course of his employment as a San Francisco police officer.
An administrative law judge denied his request for industrial disability retirement after finding that the retirement system’s medical expert relied on objective evidence and was more persuasive than Webster’s ...
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The Ohio Supreme Court ruled that a worker was not entitled to writ relief compelling the Industrial Commission to order his employer to pay for his medical treatments and pay temporary total disability benefits.
Case: State ex rel. Tchankpa v. Industrial Commission, No. 2024-OHIO-3430, 09/11/2024, published.
Facts: Kassi Tchankpa worked for Ascena Retail Group Inc. as a database administrator. In December 2012, he allegedly suffered injuries while lifting two laptop computers.
Procedural history: Tchankpa filed a workers’ compensation claim, which Ascena contested.
In July 2014, a d...
West Virginia’s Intermediate Court of Appeals upheld a determination that a worker was not entitled to an increase in his award for occupational pneumoconiosis.
Case: Puleo v. Coronado Group LLC, No. 24-ICA-96, 09/04/2024, unpublished.
Facts: Lonnie R. Puleo worked for Coronado Group LLC. He filed a workers’ compensation claim in October 2021 asserting that he had occupational pneumoconiosis. Puleo said he was exposed to the hazards of occupational pneumoconiosis for 14 years and that his date of last exposure was July 14, 2021.
A claims administrator for Coronado’s insura...
The Kansas Court of Appeals ruled that an injured worker failed to prove that his employer’s payroll met the statutory threshold for coverage under the state Workers Compensation Act.
Case: Romero v. Hornung, No. 126,331, 08/30/2024, unpublished.
Facts: Norbert Hornung operated a farm and ranch near Offerle, a small town in southwestern Kansas. Alberto Romero worked for Hornung, operating heavy equipment and driving a truck for Hornung's manure-spreading business.
When Hornung's manure work was slow, Romero would help with other farm and ranch duties.
In August 2013, Rom...
After receiving a first report of injury, how quickly the injured worker receives contact from the claims adjuster remains a critical element.
Twenty-four business hours do not count. The deadline has to be 24 hours, even if the first report of injury arrives on at 4 p.m. on a Friday.
With our risk management claims reviews, one area of the three-point contact by claims adjusters has now become increasingly important.
The three-point contact consists of three parties (not in any specific order):
Injured worker.
Treating physician.
Employer/insured contact.
In the ...
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 DE Investments, No. 55,874-WCA, 08/28/2024, published.
Facts: Thomas Southern worked for Servpro DE Investments as a crew chief. He injured his back at work in February 2019 but continued to work in a light-duty position for more than two years.
Southern initially received treatment from Dr. Thomas Dansby, who had Southern participate in physical therapy.
When So...
The California Chamber of Commerce on Thursday issued a statement urging Gov. Gavin Newsom to veto a bill that would create a presumption of compensability for certain heat-related injuries suffered by agricultural workers.
SB 1299, by Sen. Dave Cortese, D-Campbell, would create the rebuttable presumption that a heat-related injury arose out of employment when the employer failed to comply with heat standards promulgated by the Division of Occupational Safety and Health.
The Assembly on Aug. 28 voted 60-16 to pass the bill, and the Senate voted 29-9 to pass it May 22.
CalChamber said in its...
The Oregon Department of Consumer and Business Services said employers will pay an average of 3.2% less for workers’ compensation coverage next year.
The department said the advisory pure premium rate for 2025 will be 91 cents per $100 of payroll, down from 93 cents in 2024.
“The decline in costs marks 12 years of average decreases in the pure premium rate — the base rate insurers use to determine how much employers must pay for medical costs and lost wages,” the department said in a statement Thursday.
The department also announced that it is proposing no change in ...
NATL. - AM Best: Comp Remains Most Profitable Property/Casualty Line
The workers’ compensation segment continues to outperform every other line of business in the U.S. property/casualty industry, bolstered by ongoing declines in loss frequency and favorable reserve development, according to a market segment report released Thursday by credit rating agency AM Best.
Citing a trend that dates from 2015, AM Best said medical severity also remains low, “adding to favorable loss development,” and despite recent reserve releases, the line’s “overall reserve position appears to have improved.”
Pricing has dropped slightly in each o...
An injured worker’s 2023 medical malpractice action was time-barred because more than three years had passed since she underwent the physical therapy that allegedly caused the additional injuries, a California appellate court ruled.
Wenqian Zuo has not worked since December 2018 when she suffered a work-related injury resulting in a frozen left shoulder.
She had surgery on her shoulder in May 2019. In June 2019, she had two physical therapy sessions with providers from Select CAL Physical Therapy.
Though Zuo conceded that the physical therapy was effective in releasing her frozen shou...
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 Edwards worked for InterMoor Inc. He allegedly suffered injuries on Dec. 24, 2022, while working onboard the M/V Pacific Duchess.
Procedural history: Edwards filed suit against InterMoor in a Louisiana state court, asserting claims under the Jones Act, Louisiana law and general maritime law.
InterMoor removed the case to federal court, and Edwards moved to send ...
The 11th U.S. Court of Appeals ruled that the City of Atlanta was entitled to summary judgment dismissing an injured worker’s retaliation claims against it.
Case: Fripp v. City of Atlanta, No. 23-14141, 08/29/2024, unpublished.
Facts: Sylvia Fripp worked for the City of Atlanta’s Department of Transportation under the supervision of Allen Smith.
In November 2017, Fripp complained to Smith that a co-worker had sexually harassed her. Smith claimed he conducted an investigation but was unable to substantiate Fripp’s allegations. Smith then transferred her ...
The Kansas Court of Appeals ruled that a worker failed to show good cause for his delay in prosecuting his claims and that they were therefore properly dismissed after pending for three years.
Case: Hamwi v. First Student Services LLC, No. 126,272, 08/30/2024, unpublished.
Facts: Sam Hamwi worked for First Student Services LLC as a bus driver He allegedly suffered injuries at work in October 2017 when a student threw a rock that hit him in the head.
Hamwi also claimed that he lost consciousness and hit a curb while driving a bus in December 2017.
Procedural history: Hamwi filed a work...
The West Virginia Intermediate Court of Appeals upheld a finding that a worker was entitled to an additional permanent partial disability award.
Case: Zavala v. Concrete Pipe & Precast Martinsburg, No. 24-ICA-92, 09/04/2024, unpublished.
Facts: Juan Zavala worked for Concrete Pipe & Precast Martinsburg. He was struck by a forklift at work in March 2020 and reported injuries to his knees.
After about a year, Zavala was released to return to work. He continued to complain of pain, difficulty standing for prolonged periods, and leg cramps.
Dr. Bruce Guberman examined Zavala in De...
The Oregon Workers’ Compensation Division's rulemaking advisory committee will review medical treatment regulations during a Nov. 5 meeting.
The division said a preliminary list of topics that the committee will discuss this year includes annual updates to fee schedules and billing codes.
The committee will also discuss additional questions including:
Should providers be able to employ an interpreter and bill for interpreter services?
Should medical providers be compelled to respond to return-to-work inquiries within a certain time frame?
Should an attending physician’s ...
