For workers' compensation attorneys and adjusters the best claim is a closed claim. The best thing you can do for your clients is to get your claims to a place where they can settle. Obviously this starts with the administrative process, but for the purpose of this post we're going to focus on settling a … Continue reading How to Succeed at Mediation
On October 9, 2019 the Center for Medicare and Medicaid Services issued the Medicare Set-Aside Self Administration Toolkit. Although I feel like I'm condemning myself to an eternity in a very bad place for encouraging such a huge consumption of paper, EVERY injured worker who is going to self-administer a workers' compensation claim approved by … Continue reading Injured Workers Who Are Going to Self-Administer Their Medicare Set Aside Need This Guide
Whenever an employer reaches a settlement agreement with an employee who has open workers' compensation claims, the employer should not forget about their potential obligations to protect Medicare's interest in the settlement proceeds. I've written about this issue several times in the past, so for more details, see my posts here: Dealing With Medicare … Continue reading Medicare Advantage Plans-Another Thing for Employers to Pay Attention to When Settling with an Employee
The Ohio Supreme Court recently terminated the permanent total disability ("PTD") compensation of a man who was caught performing various horse-training and grooming activities at a racetrack in exchange for a waiver of housing and feeding expenses for the worker’s own horses. In the case, (The State Ex Rel. Seibert v. Richard Cyr, Inc., 2019-Ohio-3341, … Continue reading Just Because You Don’t Get Paid for Working at the Racetrack While You’re off on Workers’ Compensation Doesn’t Mean You Aren’t Committing Fraud, Says the Ohio Supreme Court
In Ohio, an employee is not entitled to temporary total disability compensation if they have "voluntarily abandoned" their employment. Voluntary abandonment is defined as violating a written work rule or policy that: (1) clearly defined the prohibited conduct, (2) was previously identified by the employer as a dischargeable offense, and (3) was known or should … Continue reading If You Deny TTD Because an Employee Was Fired for Failing a Drug Test, You Had Better Be Ready to Produce That Drug Test, According to This Recent Case
A recent Supreme Court case addressed the conditions that must be met in order for an employer to terminate ongoing temporary total disability compensation based upon an offer of light duty employment. Under O.R.C. 4123.56(A), once started, temporary total disability payments continue until: 1) the employee has returned to work; 2) the employee's treating physician … Continue reading Was Your Light Duty Job Offer “Made in Good Faith”?
According to a 2018 study in the Journals of Scientific Reports, unusual bone spurs have begun showing up in the necks people aged 18 to 30. Researchers suggest that the changes are the result of sustained altered neck posture due to extensive use of hand-held technologies, such as smartphones and tablets. The study was reported in … Continue reading Will You Be Seeing a “Tech Neck” Claim Anytime Soon?
The Center for Medicare and Medicaid Services ("CMS) recently included generic versions of Oxycodone and Lyrica in its "Red Book". The "Red Book" is the pricing source for prescription medications utilized by CMS when evaluating whether an appropriate amount has been set aside to cover future medical expenses in a settlement of a workers' compensation … Continue reading Dust off That Medicare Set-Aside Evaluation-Oxycodone and Lyrica Prices Have Dropped
As we all know, to be compensable under Ohio Workers' Compensation law an injury must have occurred "in the course and scope of employment". Both parts of the test must be met. The Ohio Supreme Court developed a two part approach to the course and scope of employment analysis. To determine whether an injury occurred … Continue reading Are You Smarter Than a Workers’ Compensation Attorney?
Under Ohio law either the Bureau of Workers' Compensation or the Industrial Commission has the right to have an injured worker examined by a physician of their choosing in connection with any issue to be heard before the Industrial Commission. If the injured worker refuses to submit to the examination, their claim for compensation “is … Continue reading How Many Workers’ Compensation Examinations Must One Person Endure? More Than One, According to the Ohio Supreme Court