WV - TTD Award for Worker's Electric Shock Injury Overturned
02/05/2025 | 0
West Virginia’s Intermediate Court of Appeals overturned an award of temporary total disability benefits for a worker who suffered an electric shock injury.
Dainel Smith worked for the West Virginia Parkways Authority. She suffered an electric shock from an earpiece while she was at work in April 2023.
Smith went to the hospital the next day, complaining of decreased hearing in her right ear. She was diagnosed with a ruptured eardrum.
In May 2023, Smith saw Dr. David Blaine. She denied any dizziness or vertigo and said she was told that she had no infection. Blaine opin...
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The Arkansas Court of Appeals upheld an award of temporary total disability benefits for a worker’s back injury.
Case: Arkansas Department of Transportation v. Evans, No. CV-24-296, 01/29/2025, published.
Facts: Travis Evans worked for the Arkansas Department of Transportation. He injured his left leg at work in August 2021.
Evans was initially diagnosed with a left hamstring strain, but a magnetic resonance imaging scan revealed a complete tear of the biceps femoris tendon.
At an appointment with Dr. Bryan Smith in September 2021, Evans complained of knee pain. Smith performed a kne...
A New York appellate court ruled that a trial justice should have referred a dispute over a worker’s death in a car accident to the Workers’ Compensation Board to determine if her death was compensable.
Case: Lin v. Lu, No. 2023-01011, 01/22/2025, published.
Facts and procedural history: Xiu Rong Yang sustained fatal injuries when a vehicle in which she was a passenger drove off a roadway during a snowstorm.
The administrator of Yang’s estate filed a wrongful death action against Xiaoping Lu.
Lu moved for summary judgment to dismiss the complaint, arguing that Yang ...
A New York appellate court denied review of an interlocutory decision of the Workers’ Compensation Board.
Case: Matter of Sessa v. Allen Health Care Service, No. CV-23-1522, 01/23/2025, published.
Facts and procedural history: Patrice Sessa worked for Allen Health Care Service. She established a workers’ compensation claim for injuries to her neck and back sustained in 2006.
Sessa received an award of temporary partial disability benefits in December 2020. Following the submission of medical reports from two orthopedic surgeons who opined that Sessa had reached maximum medical i...
In daisyBill’s experience, the United States Department of Labor is a model workers’ comp claims administrator (aka payer or carrier), consistently paying providers accurately and rapidly for injured worker treatment.
When sending the DOL a paper bill for non-facility treatment, providers treating injured DOL workers must send the DOL a compliant OWCP-1500 form that conforms to the Office of Workers’ Compensation Programs OWCP-1500 rules.
Providers must complete the OWCP-1500 form with information d...
The Virginia House of Delegates unanimously passed a bill that doubles the duration of workers' compensation benefits available for law enforcement and firefighters with certain mental health injuries.
The House on Tuesday voted 99-0 to pass HB 2060, by Rep. Paul E. Krizek, D-Alexandria. The bill would increase the duration of benefits for post-traumatic stress disorder, anxiety and depression to 104 weeks from 52 weeks if the claimant is in law enforcement or firefighting.
Krizek amended the bill two days before the House passed it to remove a provision that would have increased the dur...
The Industrial Commission of Arizona proposed a fee schedule update that will incorporate revisions in Medicare's payment system and 2025 American Medical Association Current Procedural Terminology.
The ICA is not proposing to update conversion factors as part of the update. The proposed conversion factors for the 2025/2026 fee schedule are:
Anesthesia — $61.
Surgery — $72.
Radiology — $70.
All other services — $68.
The proposed 2025/2026 fee schedule would apply for services provided on or after May 1.
The Industrial Commission is holding a stakeholder me...
The California Division of Workers' Compensation announced updates to its fee schedules for ambulance services and outpatient surgical facilities.
The division in December announced that it was amending the ambulance services section of the Official Medical Fee Schedule to adopt changes in the Medicare payment system for services provided on or after Jan. 1.
After the division announced the fee schedule update, the U.S. Centers for Medicare and Medicaid Services revised its ambulance fee schedule. The DWC on Tuesday announced that it adopted the revised Medicare fee schedule.
The update...
An Illinois appellate court said an injured worker's subjective complaint of pain was sufficient evidence to support a determination that her repetitive trauma claim was compensable.
The court said the aggravation or acceleration of a preexisting condition caused by work-related activity is compensable under the Workers' Compensation Act.
"We believe that, when a preexisting condition is asymptomatic and then becomes painful as the result of work-related activity, that symptomatic condition is compensable under the act as an aggravation of the preexisting condition even in the a...
The Kansas Court of Appeals overturned a finding that a worker’s medical malpractice settlement had to be exhausted before he could seek additional benefits from his employer for the treatment of his back injury.
Case: Rumbaugh v. DirecTV, No. 127,031, 01/17/2025, published.
Facts: Justin Rumbaugh injured his back in 2014 while working for DirecTV. American Zurich Insurance Co. paid Rumbaugh benefits and covered his medical treatments.
In October 2016, about eight months after Rumbaugh was released to return to work, he went to the hospital with symptoms of cauda equina syndrome.
Cau...
West Virginia’s Intermediate Court of Appeals upheld a determination that a worker who injured his right shoulder on the job failed to establish a compensable injury to his left shoulder.
Case: Cella v. Raleigh County Board of Education, No. 24-ICA-166, 01/29/2025, published.
Facts: Donald Cella worked for the Raleigh County Board of Education. He injured his right shoulder at work in February 2022 while lifting a stage prop.
A claims administrator for the board of education accepted liability for a right shoulder strain.
A magnetic resonance imaging scan taken in March 2022 rev...
A New York appellate court upheld a partial grant of summary judgment on a worker’s Labor Law claim arising from an alleged mishap on a plywood ramp.
Case: Medina v. 1277 Holdings LLC, No. 2023-02988, 01/22/2025, published.
Facts: Victor Medina worked for Hiline Construction Inc. He allegedly suffered injuries while working on a construction project at a property owned by 1277 Holdings LLC.
Ray Builders Inc. was the general contractor. Ray hired Hiline as a subcontractor on the project.
According to Medina, he and a co-worker were pushing a pallet jack up a plywood ramp when the co-w...
A New York appellate court upheld a determination that a defendant in a Labor Law action was not entitled to summary judgment on a third-party defendant’s claim for contribution from it.
Case: Velasquez v. Mosdos Meharam Brisk of Tashnad, No. 2022-05670, 01/22/2025, published.
Facts and procedural history: Carlos Velasquez filed suit against Mosdos Meharam Brisk of Tashnad, asserting claims for violations of the Labor Law.
Mosdos filed a third-party action against Active Fire Protection Inc. Active answered and asserted counterclaims against Mosdos for contribution an...
The Workers’ Compensation Insurance Rating Bureau of California announced that Andrea Coleman has assumed the role of president and chief executive officer.
Coleman joined WCIRB in May 2022 as executive vice president and chief operating officer. She's a member of the senior leadership team providing strategic oversight across several key operational areas, including finance, human resources, customer experience, marketing and communications.
She has more than 20 years of leadership experience in the insurance industry in underwriting, distribution and the management of complex...
The Montana State House of Representatives passed a bill that would terminate temporary disability benefits automatically when a claimant is released to return to work.
The House voted 58-42 on Thursday to pass House Bill 197, by Rep. Anthony Nicastro, R-Billings.
The bill would terminate temporary disability benefits by operation of law at the time an injured worker is released to full duty before or upon reaching maximum medical improvement.
A fiscal analysis of the measure by the Governor's Office of Budget and Program Planning projects savings of $222,000 per year for the Montana St...
The Texas Division of Workers' Compensation adopted a new rule requiring verification of certain information about injured employees who are getting lifetime income benefits.
The rule requires the Subsequent Injury Fund to confirm that the recipient is alive and that the recipient’s contact information is correct before paying lifetime income benefits.
The rule also requires the recipient to provide the required information to the fund each month through an online verification system, a telephone call or a video call.
“New Section 131.5 is necessary for DWC to verify that th...
