Tag: medical benefits

Jun 2, 2021

$15K “Fine” Against Florida Comp Insurer Not Supported by Evidence

In an appeal and cross-appeal from an order granting sanctions against an insurer for failure to provide orthopedic treatment to an injured worker, a Florida appellate court held that a...

$15K “Fine” Against Florida Comp Insurer Not Supported by Evidence $15K “Fine” Against Florida Comp Insurer Not Supported by Evidence
Apr 2, 2021

Virginia Pharmacy is “Health Care Provider” for Purposes of Statute of Limitations

A Virginia pharmacy is a “health care provider” that must file its claims within the one-year period prescribed in Va. Code Ann. § 65.2-605.1(F), held the Court of Appeals of...

Virginia Pharmacy is “Health Care Provider” for Purposes of Statute of Limitations Virginia Pharmacy is “Health Care Provider” for Purposes of Statute of Limitations
Nov 18, 2020

Medical Provider's Decision to Bill Medicare, Rather than Carrier, Results in NC Employee's Loss of Benefits on Statute of Limitations Grounds

The Court of Appeals of North Carolina affirmed a decision by the state’s Industrial Commission that denied additional medical benefits claimed by an injured worker on statute of limitations grounds...

Medical Provider's Decision to Bill Medicare, Rather than Carrier, Results in NC Employee's Loss of Benefits on Statute of Limitations Grounds Medical Provider's Decision to Bill Medicare, Rather than Carrier, Results in NC Employee's Loss of Benefits on Statute of Limitations Grounds
Nov 12, 2020

Sedgwick Prevails in Dispute Over Unpaid Prescription Charges for Louisiana Claimant

Reversing a decision of the state’s Office of Workers’ Compensation (OWC), a Louisiana appellate court held the State was not responsible for almost $48,000 in unpaid prescription bills related to...

Sedgwick Prevails in Dispute Over Unpaid Prescription Charges for Louisiana Claimant Sedgwick Prevails in Dispute Over Unpaid Prescription Charges for Louisiana Claimant
Apr 18, 2018

PA Court Nixes Chiropractor’s Separate Charges for “Office Visits” in Connection with Treatments

A Pennsylvania appellate court has concluded that an examination involving no new medical condition, change in medical condition, or other circumstances that require an examination and assessment above and beyond...

PA Court Nixes Chiropractor’s Separate Charges for “Office Visits” in Connection with Treatments PA Court Nixes Chiropractor’s Separate Charges for “Office Visits” in Connection with Treatments
Dec 1, 2017

Medical Benefits Must be “Reasonable and Necessary”—Not Just Beneficial

Virginia Employer Need Not Provide Specialized “Running Blade” Prosthesis While all but a few American jurisdictions require employers to provide medical benefits that are essentially unlimited in terms of duration...

Medical Benefits Must be “Reasonable and Necessary”—Not Just Beneficial Medical Benefits Must be “Reasonable and Necessary”—Not Just Beneficial
Sep 7, 2017

2017’s Top 10 Workers’ Compensation Cases

During September of each of the past five years, my colleague, Robin Kobayashi, and I have pulled together a volume entitled, Workers’ Compensation Emerging Issues Analysis. Annually published by LexisNexis®,...

2017’s Top 10 Workers’ Compensation Cases 2017’s Top 10 Workers’ Compensation Cases
Feb 16, 2017

Wyoming Worker Fails to Connect the Dots Between Original Surgery and Subsequent Procedure to Alleviate Continued Pain

The Supreme Court of Wyoming affirmed a finding by a state district court that an injured worker failed to establish a causal connection between her 2013 need for shoulder surgery...

Wyoming Worker Fails to Connect the Dots Between Original Surgery and Subsequent Procedure to Alleviate Continued Pain Wyoming Worker Fails to Connect the Dots Between Original Surgery and Subsequent Procedure to Alleviate Continued Pain
Feb 13, 2015

Workers’ Comp “Opt-Out” Bill Introduced in Tennessee Legislature

Senate Bill 721 On Wednesday, state senator Mark Green (Republican from Clarksville), introduced Senate Bill 721 to the Tennessee legislature. If enacted, many Tennessee employers would be allowed to opt-out...

Workers’ Comp “Opt-Out” Bill Introduced in Tennessee Legislature Workers’ Comp “Opt-Out” Bill Introduced in Tennessee Legislature
Dec 24, 2014

8th Circuit: Insurer’s Refusal to Pay for Injured Undocumented Worker’s Groceries and Cable TV Not Bad-Faith Denial of Insurance Benefits

In an action alleging bad-faith denial of insurance benefits filed by an undocumented worker who sustained severe injuries in a work-related accident, the Eighth Circuit Court of Appeals, construing Iowa...

8th Circuit: Insurer’s Refusal to Pay for Injured Undocumented Worker’s Groceries and Cable TV Not Bad-Faith Denial of Insurance Benefits 8th Circuit: Insurer’s Refusal to Pay for Injured Undocumented Worker’s Groceries and Cable TV Not Bad-Faith Denial of Insurance Benefits
Apr 29, 2013

Montana: Carrier’s Decision to Stop Paying For Pain Medication Did Not Justify Attorney’s Fee Award Where Decision Was Based On Prior Decision of Workers’ Compensation Court

Stressing that “reasonableness” is a question of fact and that the review the Workers’ Compensation Court’s findings of fact were to be affirmed if supported by substantial credible evidence, the...

Montana: Carrier’s Decision to Stop Paying For Pain Medication Did Not Justify Attorney’s Fee Award Where Decision Was Based On Prior Decision of Workers’ Compensation Court Montana: Carrier’s Decision to Stop Paying For Pain Medication Did Not Justify Attorney’s Fee Award Where Decision Was Based On Prior Decision of Workers’ Compensation Court