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.
Thanks to our wonderful clients who continue to refer more and more of their interesting cases to us, we are growing. This month we welcome attorney Amanda Schwertner to our firm.
Amanda is a native of Big Lake, Texas and attended Texas Tech University where she was a student trainer for the football team. She has two dogs named Willie Nelson and Dolly Parton.
Please go to our website to check out herbiography and, when you have a free minute, give her a call to say hello.
One of our favorite adjusters, who works at a large workers’ compensation carrier, related this conversation she had this month with a claimant:
Adjuster: Why didn’t you return to work?
Claimant: I had a problem inside myself at the Courthouse.
Adjuster: A problem inside yourself at the Courthouse?
Were you in jail?
Claimant: Yes, ma’am. I was in jail . . . but it wasn’t my fault.
The adjuster adds that, while taking the claimant’s statement, she heard a loud noise and asked the claimant what it was. He said “it was the toilet . . . I had to pee.”
Do you have a funny industry story to tell? Send it to us for our July newsletter. If we publish it we’ll reward you with a gift card to KFC or another healthy-lifestyle restaurant of your choice.
The TDI-DWC has announced that the 2017 Texas Workers’ Compensation Educational Conference will be held in Georgetown on September 11 – 12 and in Dallas on October 12 – 13. The agenda and registration link are on the TDI-DWCwebsite.
We’ll be at the Georgetown conference and hope to see you there.
When a workers’ compensation carrier issues a policy that waives its right to subrogation the carrier also waives its right to reimbursement from any recovery by a claimant. That is the conclusion of the El Paso court of appeals in its recent decision inWausau Underwriters Insurance Co. v. Wedel.
In that case, James Wedel drove a truck for Cactus Transport, Inc. which regularly picked up asphalt from a terminal owned by Western Refining Company. Western required Cactus to subscribe to a policy of workers’ compensation insurance with a waiver of subrogation rights favorable to Western. Wausau issued the policy to Cactus with a waiver of subrogation endorsement.
Wedel fell and suffered brain and spinal cord injuries while attempting to load asphalt at Western’s facility in El Paso. Wausau paid approximately $1,548,822 in compensation benefits to Wedel, and Wedel then sued Western alleging third-party negligence. Wausau intervened and asserted its comp lien against any recovery by Wedel.
Wausau argued that its waiver of subrogation endorsement waived subrogation only as to the tort-feasor (Western) and did not waive the right to reimbursement from Wedel. In other words, Wausau asserted that its statutory rights of subrogation and reimbursement are distinct and independent rights and it could waive one without waiving the other.
The court of appeals disagreed. It held that by waiving its right of subrogation Wausau waived its right of reimbursement as well.--David L. Swanson, Stone Loughlin & Swanson, LLP
The Texas Legislature last month provided a new source of funding for a prosecutorial unit dedicated to rooting out workers’ compensation insurance fraud, and that new funding will radically change the unit’s operation. The prosecutorial unit is part of the Travis County district attorney’s office in Austin.
In the past, the prosecutorial unit had been funded through a controversial arrangement between the DA and Texas Mutual Insurance Company. Under that agreement, Texas Mutual made the fraud referrals, provided the investigators, and paid bills incurred by the DA for the prosecution of Texas Mutual’s cases. That arrangement came under sharp criticism last year and, in response, the Legislature appropriated money to fund the unit.
The money will come from a maintenance tax collected from workers’ compensation insurers. As a result of the new funding source, the DA will prosecute cases from any insurer. And Texas Mutual will no longer make fraud referrals or furnish investigators. Instead, the TDI-DWC will conduct the initial investigation and, if it believes a case warrants prosecution, it will refer the case to the DA.--David L. Swanson, Stone Loughlin & Swanson, LLP
Hot on the heels of the disturbing findings of the Workers’ Compensation Research and Evaluation Group, the TDI-DWC may be doing something about them. The DWC announced this month that it is accepting comments on an informal draft of amendments to Rule 134.500 (concerning definitions) and Rules 134.530 and 134.540 (concerning requirements for use of the pharmacy closed formulary).
The proposed amendments would change the definition of "closed formulary" to exclude any prescription drug created through compounding and require preauthorization for all prescription drugs created through compounding for claims subject to, and not subject to, certified networks.
The comment period closes July 7.--David L. Swanson, Stone Loughlin & Swanson, LLP
In 2016, the average cost of a compounded drug prescription in workers’ compensation claims in Texas rose to a whopping $829. That’s the conclusion of the Texas Department of Insurance, Workers’ Compensation Research and Evaluation Group. The group announced this finding and others last month in its publication Baseline Evaluation of the Utilization and Cost Patterns of Compounded Drugs.
Among the group’s many other findings are the following:
The group’s publication is available on the TDI-DWC website.--David L. Swanson, Stone Loughlin & Swanson, LLP
Do you have a ping-pong table at your office? If not, maybe you should lobby for one. That’s the implication from an article in the June 24th edition ofThe Wall Street Journal which describes the extraordinary steps that insurance companies are taking to recruit, and retain, employees these days.
For example, according to theJournal, Acuity Insurance has furnished its offices with ping-pong tables, a 45-foot climbing wall, and a 27,000 square-foot fitness center, and it organizes twice-monthly happy hours to boot. And at school-recruiting events last autumn, Acuity reportedly served mounds of freshly cooked bacon, whose aroma drifted around the grounds. Also according to theJournal, some insurers are taking a page from Silicon Valley’s hip offices. For example, Allstate Corp. has a “happiness guru” in a building where it locates many data scientists.
The reason for these over-the-top enticements? It turns out that Americans under 30 (millennials) generally aren’t excited about the idea of working for an insurance company (gasp!). And that’s a problem because insurers reportedly must hire 500,000 newcomers over the next several years as a wave of retirement hits.--David L. Swanson, Stone Loughlin & Swanson, LLP
Jessica Barta was reappointed by Governor Greg Abbott as Public Counsel for The Office of Injured Employee Counsel (OIEC) for a term to expire in February 2019. In that role, Barta has also accepted a position on the Board of Kids’ Chance of Texas, along with Jane Stone from the Firm, who has been on the Board since its inception.
Kids’ Chance is a non-profit organization that creates and supports scholarship programs for children who have had a parent involved in a workplace accident that was fatal or left them severely injured. Look for new upcoming Kids’ Chance events in Texas in the near future. In the meantime, don’t forget that Kids’ Chance is also looking for eligible scholarship recipients. Please visit Kids’ Chance of Texas’s website (www.kidschanceoftexas.org) for more details. --Erin Shanley, Stone Loughlin & Swanson, LLP
Senate Bill 1895 (Sen. Larry Taylor) was passed by the Texas Legislature and signed into law by Governor Abbot on May 26, 2017. The bill amends the Texas Labor Code to require the commissioner of workers’ compensation in assessing an administrative penalty under the Texas Workers’ Compensation Act, to consider, in addition to other existing factors: (1) whether the administrative violation has a negative impact on the delivery of benefits to an injured employee, and (2) the history of compliance with electronic data interchange requirements. The bill also requires the commissioner to adopt rules that require the Division, in the assessment of an administrative penalty against a person, to communicate to the person information about the penalty, including the relevant statute or rule violated, the conduct that gave rise to the violation, and the factors considered in determining the penalty.
The amended statute is effective on September 1, 2017. --Erin Shanley, Stone Loughlin & Swanson, LLP