Category Archives: Workers’ Compensation

$100 Million Fraud in New Hampshire

New Hampshire Local Government CenterOur good friend and colleague Jon Gelman posted this recent piece of news on his blog the other week:

A New Hampshire insurance group has been charged by the State with improperly appropriating millions of dollars of taxpayers’ funds to a workers’ compensation insurance plan. The improper allocation is described in a petition filed by the State.

To provide a bit more detail, the amount of misappropriated funds is actually estimated at upward of $100 million. The, or LGC, is a non-government, non-profit organization that provides a range of services to municipal governments. LGC is an umbrella organization with subsidiaries that offer services in areas such as finance, personnel, and legal. They also provide a range of insurance programs that municipalities and their employees may buy into.

In this case, the municipal employees thought that they were paying for LGC’s HealthTrust and Property-Liability insurance programs. Instead LGC used the funds to pay for a completely separate workers’ compensation insurance program.

LGC asserts that they did nothing inappropriate, even though what they did is clearly illegal and they used some very tricky tactics to circumvent the law. Continue reading

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Intoxication, Work, And Workers’ Compensation Don’t Mix

Today we have a guest post our colleague Paul McAndrew of Iowa.

Most of us know that, for both professional reasons and in the interest of safety, remaining sober while on the job is essential. However, it is important to also recognize that workers who are intoxicated at the time that they sustain a work injury stand a far lower chance of ever collecting workers’ compensation.

If the blood test shows the presence of alcohol or drugs, odds that the employee will be able to collect workers’ compensation are much lower.

This is because of the intoxication defense: if an employer can prove that intoxication was the cause of the workers’ injury, then they employer is not required to provide workers’ comp for that injury.

Now, there are some notable Continue reading

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Nannies, Baby-sitters, And Comp Coverage: Yes, We Still Have “Domestic Servants”

Today we have a guest blog from our colleagues Nathan Hammons and Charlie
Domer of Wisconsin.

Most families in Wisconsin have hired a baby-sitter or nanny to watch their children. The pay generally is in cash for a defined period of time. Does the situation create an employer-employee relationship, entitling an injured baby-sitter to worker’s compensation benefits?

Under the Worker’s Compensation Act, most employers in the state are required to provide worker’s compensation coverage for their employees. Employers of ‘domestic servants’, however, are completely exempt from the requirement. (Wis. Stat. §102.07(4)(a)1.) Unfortunately, neither the Act or Wisconsin courts provide a definition. So, what exactly is a domestic servant?

Significantly, the Department appears to treat the prevalent positions of in-home baby-sitter or nanny as exempt from the Act, which could expose the in-home “employers” to general negligence claims.

The name ‘domestic servant’ is antiquated. It brings up old images of butlers, maids, and other people toiling away in the mansions of royalty and the wealthy. Indeed, search Wikipedia for ‘domestic servant’ and you’ll be directed to ‘domestic worker’, the modern term and one that doesn’t imply inequality in the workplace. Without citation or authority, a Department publication indicated that it has “consistently ruled that persons hired in a private home to perform general household services such as nanny, baby-sitting, cooking, cleaning, laundering, gardening, yard and maintenance work and other duties commonly associated with the meaning of domestic servant, meet the definition of domestic servant intended by the Act.” Significantly, the Department appears to treat the prevalent positions of in-home baby-sitter or nanny as exempt from the Act, which could expose the in-home “employers” to general negligence claims.

Consequently, nannies Continue reading

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Workplace Stress Can Make You Physically Ill

workplace stress

New studies reveal that workplace stress can make you sick.

Today’s post comes to us from Jon Rehm from Nebraska. While Jon’s post mentions Nebraska law, you should contact our office if you have any questions regarding a claim you might have under New York law.

Serious disabling medical conditions can arise from workplace stress. A recent study showed that people working long hours (11+) are more than twice as likely to experience major depression than those who work only 7-8 hours a day. Another study discovered that stressed workers have a 67% greater risk of heart disease. And other studies mention that “long working hours” lead to more risks of anxiety and a reduced ability to both think and sleep well.

Marianna Virtanen, one of the newest study’s authors, recently gave some tips to workers on ABCNews.com. One of her tips is to: “Make a distinction between work and leisure; don’t skip your holidays; take care of your health and well-being, especially sleep and exercise.” With Americans now working more hours than many of their counterparts in other countries, workers need to be proactive in taking caring of themselves.

But it isn’t just up to the workers. Psychological illnesses and depression cost companies money and result in less worker productivity, according to the CDC’s National Institute for Occupational Safety and Health. Without buy-in from employers and workers, the personal and corporate costs from psychological illness will never be reduced.

Unfortunately, Nebraska law Continue reading

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More surgeries = More benefits

Today’s post is from our colleague Charlie Domer of Wisconsin.

The law provides mandatory minimum ratings of disability benefits for injuries and surgical procedures

Surgeries are commonplace after a work injury.  When an injured worker in Wisconsin has a post-injury surgery, that worker is ordinarily entitled to a minimum percentage of permanent disability.

Permanent partial disability (PPD) generally represents a physician’s assessment of a worker’s functional loss. PPD is payable at a weekly rate equal to two-thirds of the employee’s average gross weekly earnings at the time of the injury, subject to a maximum rate (the rate in 2011 and 2012 is $302/week).

Administrative rules relevant to the Worker’s Compensation Act (Section DWD 80.32) provide mandatory minimum ratings of PPD for injuries to various body parts and surgical procedures. For example:

  • A laminectomy (removal of disc material) at one level of the lumbar spine (e.g., L4-5) carries a minimum 5% disability;
  • A spinal fusion at the same level (e.g. L4-5), results in a minimum 10% disability;
  • Total hip replacements carry a minimum 40% PPD (while a partial hip replacement results in 35% PPD);
  • A total knee replacement has a minimum PPD of 50% (partial knee replacement is 45%);
  • An anterior cruciate ligament (ACL) repair is 10% PPD minimum; and
  • A knee meniscectomy results in 5% PPD minimum.

If a worker has one of the listed procedures, they receive the minimum PPD percentage.  To calculate the value, we look to the applicable percentage, based on the number of weeks the body part is “worth” under the statutes.  For example, a knee is worth 425 weeks under the statutes, so the 20% PPD to the knee is 85 weeks (20% of 425) at the $302/week rate for a 2011 injury, which amounts to $25,670.


Image: taoty / FreeDigitalPhotos.net

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How do we earn your trust?

Earning your client's trust is a crucial part of being an attorney.

Today’s post comes to us from our colleague Roger Moore of Rehm, Bennett & Moore in Nebraska.

In its most basic form, trust is defined as “reliance on the integrity, strength, and ability of a person”.

Trust can also be defined as “a person on whom one relies”.

I was reminded of this earlier this week when a client for whom I had settled a case dropped by our office. This client had been a truck driver and lived out of state. While we were working on his case we never had the opportunity to meet in person, yet he came to trust me to look out for his best interests and advise him along the course of his workers’ compensation injury. He came by to thank me for the work I had done for him which had been completed over a year and a half ago.

As I spoke with him I began to understand how stressful it must be to trust someone who lives halfway across the country and with whom you may never meet in person. This is a unique aspect of trucking cases we handle which isn’t found in other types of work-related injuries.

Due to his injury he was unable to return to trucking. However, were been able to negotiate a settlement which allowed him to live his life Continue reading

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Surprising Findings On Baby Boomers and Worker’s Compensation (part 2)

The other week we shared a great post on baby boomers from our colleague Tom Domer of Wisconsin. Today we have Part 2 of this series. 

Recent NCCI stats shows that all groups of workers aged 35-64 have similar costs for work-related injury compensation.

The frequency of injury has steadily declined since the mid-1990s, with age group differences in frequency largely eliminated.  The decline in frequency has occurred for all age groups.  The differences among age groups in the early 1990s had almost completely disappeared by 2010.

A longstanding worker’s compensation maxim that “younger workers have much higher injury rates” is no longer true.  For example: the injury rate for workers age 55-64 was 16% lower than the frequency for all workers in the mid-1990s but actually 1% higher in 2010, indicating that the differences have clearly narrowed.

Lastly, in terms of severity of claims, older workers certainly cost more, primarily due to higher wages and increased medical costs for older workers.  The severity of medical costs Continue reading

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The Reality Of Post Traumatic Stress Disorder

PTSD can be caused by traumatic events that happen anywhere - at war or in the workplace.

Today’s post comes to us from our colleague Len Jernigan of North Carolina.

The other week, Margaret Anderson, a Park Ranger at Mount Ranier National Park, was killed by an Iraq war veteran who may have been suffering from Post Traumatic Stress Disorder (PTSD). Her tragic death reminded me of several workers I have represented who had this condition after experiencing and/or witnessing horrific trauma in the workplace.

One was a 20 year employee of a public gas company who was heroically trying to fix a gas leak in a neighborhood when the gas line exploded and burned off most of his face. He healed but has flashbacks of the explosion, nightmares, depression and is constantly irritable. Before this event he was a great worker, a good family man and had a good sense of humor. He hasn’t been the same since.

Adjusters, employers, co-workers, attorneys and family members should understand that PTSD is a serious condition that needs immediate medical attention and that the failue to recognize and treat the condition can lead to tragic consequences.

Another client was on an assembly line in Raleigh, N.C. when an explosion sent a ball of fire racing through the plant. The ceiling caved in and a worker right next to her was crushed to death. Fortunately, because of workers’ compensation, these injured workers got timely medical and psychiatric care, but what about those workers who don’t get adequate and quick treatment? Continue reading

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