NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.
The Division has announced the State AWW and maximum/minimum weekly benefits
for the period from October 1, 2022 through September 30, 2023 as follows:
State Average Weekly Wage:
$1,111.55
Maximum Temporary Income Benefits: $1,112.00
Minimum Temporary Income Benefits: $
167.00
Maximum Impairment Income Benefits: $ 778.00
Minimum Impairment Income Benefits: $
167.00
Maximum Supplemental Income Benefits: $ 778.00
Maximum Lifetime Income Benefits:
$1,112.00
Minimum Lifetime Income Benefits:
$ 167.00
Maximum Death Benefits:
$1,112.00
Copyright 2022, Stone Loughlin & Swanson, LLP
The Division is accepting public comments on amendments to Rule 102.11(b)(1).
The proposed rule was published in the September 23, 2022 issue of the Texas Register and on the TDI
website. Comments may be submitted through 5:00 p.m. on October 24, 2022.
Insofar as the amended rule simply corrects and updates the address of the
Division website providing specific data requirements, data set transactions,
data mapping, data edits and fees per record to the correct current domain, we
expect few comments will be received.
The proposed changes direct the public to www.tdi.texas.gov/wc.
A copy of the proposed rule may be accessed here:
http://www.tdi.texas.gov/wc/rules/2022rules.html
Copyright 2022, Stone Loughlin & Swanson, LLP
We reported back in April, 2021 that the Division would be relocating its
Austin headquarters to the new Capitol Complex at 1601 Congress Avenue in the
summer of 2022.
In May of this year, however, we reported that plans had changed and
operations, including hearings, would continue at the current Metro Center
Drive location through the summer of 2022. The move date to the new location
would be announced when finalized.
Although we have seen no formal announcement, we now understand that the Austin
Field Office will move to the new Barbara Jordan State Office Building at 1601
Congress Avenue on October 10. Director of Media Relations for the Division,
Kate Sidora, advises that there are still a few items to work out but nothing
that will change the move-in date. We are not yet certain where system
participants with business in the field office will be required to park but
will update readers in the near future.
Copyright 2022, Stone Loughlin & Swanson, LLP
Readers may recall our
report in the March, 2022 installment of The Compendium
that Dr. Clinton Battle of Arlington Occupational and Medical Clinic had been
sentenced to 12 years in federal prison following his conviction for conspiracy
to distribute controlled substances and distribution of controlled substances.
Dr. Battle also pled guilty to conspiracy to commit mail fraud.
The U.S. Department of Justice advised in September, however, that Dr. Battle’s
scheduled release date has been changed to September 26, 2030. He is not
eligible for parole and will be 77 years old when released from prison.
Dr. Battle is also required to pay $376,368.00 in restitution and will be under
supervised release for three years after his imprisonment.
Copyright 2022, Stone Loughlin & Swanson, LLP
Chiropractors play a vital role in the Texas workers’ compensation system.
Therefore, we like to keep our readers apprised of the latest developments in
the field of chiropractic.
We don’t know much about TikTok; however, we understand this social media platform,
which enables subscribers to create and share short videos, is “blowing-up”
over a controversial new trend: chiropractic treatments for babies….babies as
young as 6 days old.
Proponents claim that the gentle “baby adjustments” are effective treatment for
a variety of baby ailments including colic, constipation, reflux,
musculoskeletal issues, and even the trauma experienced in childbirth.
Although manual treatments to address spinal conditions in adults were
reportedly used by Hippocrates around 400 B.C. and by Buddhist monks dating
back over 2,000 years, chiropractic as a “modern” profession began in 1895 when
Daniel David Palmer adjusted the spine of a deaf janitor which, Palmer claimed,
restored the janitor’s hearing. The primary issue, we understand, is
subluxation. Subluxations, or misalignments of the spinal vertebrae, are
thought by chiropractors to compromise and influence the function and health of
the nervous system in general and the various organ systems in the body.
Proponents argue that adjustments by a trained, qualified, and knowledgeable
practitioner to correct subluxation therefore promote proper nervous and organ
system function and health in general.
But for babies?
As you might expect, many physicians have expressed concern that spinal
manipulation of babies places them at greater risk for injury to their soft
developing bones and over-stretching of their looser joints. According to an
article in the Washington Post, one orthopedic surgeon at Children’s National
Hospital in Washington D.C., Dr. Sean Tabaie, commented that there is no way
one would achieve improvement in a newborn from manipulation. “The only thing
you might possibly cause is harm.”
On the other hand, a recent study of 58 colicky babies in Spain found that light
touch therapy resulted in a significant reduction of crying in those babies
receiving the treatment. The parents of the babies were aware of the treatment,
however, which can cause biased reporting of results.
And following a 2021 study in Denmark of 185 colicky babies, researchers
indicated data suggested that babies receiving chiropractic treatment “seemed”
to cry less; however, the findings were deemed not to be statistically
significant.
Call us old-fashioned, but we think we would opt for the extended 3:00 a.m. car
ride to soothe a colicky baby.
Copyright 2022, Stone Loughlin & Swanson, LLP
As we remind readers
on a regular basis, Stone, Loughlin & Swanson is a Founding Sponsor and
long-time supporter of Kids’ Chance of Texas, an organization whose mission is
to create and support scholarship programs to provide educational opportunities
for children in Texas who have had a parent catastrophically or fatally injured
while in the course and scope of his or her employment. As participants in the
Texas Workers’ Compensation system, we are particularly aware of the
devastating toll such an injury takes on a family and, especially, the
children.
Please help us continue to help the kids by becoming a participant or sponsor
and joining us for fun and camaraderie at The Cowboys Golf Club on October 28
for the Third Annual Kids’ Chance Texas Golf Tournament.
All proceeds will fund Kids’ Chance of Texas scholarships which has awarded
over $75,000 for the fall semester alone. Come help us reach our goal of
raising $150,000 while enjoying the delightfully maddening frustration that
only golfers can appreciate.
There is still time to help the kids this month! For more information and to
register as a player and/or sponsor, click here:
https://www.kidschanceoftexas.org/events/golf2022/
Copyright 2022, Stone Loughlin & Swanson, LLP
We are saddened to
announce that Gary Lynn Kilgore, long time Administrative Law Judge and Appeals
Panel Judge, with the Texas Workers’ Compensation Commission and the Texas
Department of Insurance-Division of Workers’ Compensation, passed away on September
23, 2022 at the age of 69.
Mr. Kilgore attended college at the University of Virginia and earned his Juris
Doctor in 1978 at the University of Texas School of Law. He served as managing
partner of Garcia & Kilgore, attorneys, for over 16 years before joining
the Texas Workers’ Compensation Commission where he served as an Appeals Panel
Judge for 12 years.
Thereafter, Gary heard cases as a Hearing Officer with the Division of Workers’
Compensation for 4 years before serving as Associate Director of Legal Services
with the Office of Injured Employee Counsel, in which capacity he served for
over 13 years.
Mr. Kilgore returned to the Appeals Panel in 2019 prior to his retirement this
year.
Those of us that knew Gary found him to be a wealth of knowledge regarding the
workers’ compensation law and institutional system in Texas. He was an
outstandingly gifted writer, a delightful conversationalist, and a student of
the law and American and world history. We will miss you, Gary….
Copyright 2022, Stone Loughlin & Swanson, LLP
Although not exactly a broad sweeping reform of the Alabama Workers’ Compensation Act, the Alabama legislature recently amended the statutory definitions of “employer” and “employee”.
Effective July 1, 2022, a marketplace platform is no longer considered an “employer”, and a contractor that works for a marketplace platform is no longer considered an “employee” for purposes of workers’ compensation. Under Alabama law, a marketplace platform is an entity that offers a digital network or mobile application that connects potential customers to service providers, and accepts service requests exclusively through the digital network. Examples of marketplace networks Uber, DoorDash, and Buzd. In order to be excluded from coverage, the marketplace platform and contractor must agree in writing that the contractor is an independent contractor, the platform cannot unilaterally prescribe specific hours during which the contractor must be available to accept service requests, the platform cannot contractually prohibit the contractor from accepting service requests for other platforms or engaging in another occupation or business, the platform cannot mandate furnished equipment or tools essential for the performance of the work (except as required by law or for safety reasons), and the contractor must bear substantially all of the expenses they incur in performing services.
About the Author
This blog submission was written by Charley Drummond, an attorney with Fish Nelson & Holden, LLC, a law firm dedicated to representing self-insured employers, insurance carriers, and third-party administrators in all matters related to workers’ compensation. Fish Nelson & Holden is a member of the National Workers’ Compensation Defense Network. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Mr. Drummond by e-mailing him at cdrummond@fishnelson.com or by calling him directly at (205) 332-3414.
According to People magazine, Q'orianka Kilcher has been charged with two felony counts of workers' compensation fraud.
Ms. Kilcher allegedingly injured her neck and right shoulder while filming Dora the Explorer and the Lost City of Gold, which was released in 2019. She saw the doctor a few times and then did not respond to the insurance company. In October 2019, she allegedly requested authorization to see a doctor and told that doctor that she had been unable to accept work due to the severe neck pain. Despite this statement, it was found that she had worked as an actress on Yellowstone from July 2019 to October 2019. She apparently started receiving disability benefits five days after last working.
There have been other instances of celebrities being accused of workers' compensation fraud. For example, Brad Culpepper, a former NFL player, was suspected of workers' compensation fraud when he appeared on Survivor after his workers' compensation claim for injuries sustained while playing football. He was sued by his insurance company.
This just goes to show that anyone can be suspected of workers' compensation fraud if the facts are there.
Read more here: https://highlights.hannabrophy.com/post/102hsre/even-actors-can-be-subject-to-workers-compensation-fraud
Independent Medical Review (IMR) is the process by which an injured worker may seek to overturn an adverse utilization review determination. Many among the Applicants’ bar in California will argue that only an employee may appeal the IMR determination. However, that is a misconception, likely driven by the rule that only an Applicant may seek IMR following a UR decision. Once an IMR determination is served, it is binding unless appealed timely on very limited grounds. LC 4610.6(h) outlines how to appeal an IMR determination and does not specify which party may file and it clearly does place any restrictions against any particular party seeking to appeal an IMR determination.
For the general practitioner, LC 4610.6(h) provides five grounds for appealing an IMR Determination within 30 days of service of an IMR determination. The determination of the administrative director shall be presumed to be correct and shall be set aside only upon proof by clear and convincing evidence of one or more of the following grounds for appeal:
(1) The administrative director acted without or in excess of the administrative director’s powers.
(2) The determination of the administrative director was procured by fraud.
(3) The independent medical reviewer was subject to a material conflict of interest that is in violation of Section 139.5.
(4) The determination was the result of bias on the basis of race, national origin, ethnic group identification, religion, age, sex, sexual orientation, color, or disability.
(5) The determination was the result of a plainly erroneous express or implied finding of fact, provided that the mistake of fact is a matter of ordinary knowledge based on the information submitted for review pursuant to Section 4610.5 and not a matter that is subject to expert opinion.
In the case of Jordan Stone v AchieveKids, Caps-Sig (2014 Cal. Wrk. Comp. P.D. LEXIS 663), the Board not only decided it was permissible for Defendant to appeal the IMR determination, the Board even granted Defendant’s appeal of an IMR determination. Factually, the Stone case involved an initial IMR determination overturning utilization review’s denial a right knee cartilage transplant. Defendant appealed the IMR determination on the grounds that it was issued in excess of the Administrative Director’s powers described in LC 4610.6(h)(1) and that it contained plainly erroneous findings that were not subject to an expert’s opinion per LC 4610.6(h)(5).
Defendant's IMR appeal was originally denied by the trial judge and reversed on appeal. The Board found that there was a "patent discrepancy" in stating that the requested surgery was not medically necessary in one section, but then stating that it was medically necessary in another section. The issue was sent to an alternative/new IMR organization to conduct a neutral review. This is the appropriate remedy when an appeal of an IMR determination is granted (LC 4610.6(i)).
So, if you receive an IMR determination that overturns a UR decision look to the 5 grounds for appeal noted above. If you have questions about how this can apply to your workers' compensation cases, email me or find your local Hanna Brophy attorney at www.hannabrophy.com.
Read more here: https://highlights.hannabrophy.com/post/102hw9p/defendants-may-appeal-adverse-imr-determination