PRACTICE TIP: Under compelling circumstances, an apportionment can be implemented with regard to medical and indemnity treatment prior to a finding of MMI/permanency. In the Full Board Panel Decision of Robert Macvie Inc., WCB G2036125 (8/11/20), the NYS WCB considered whether apportionment is appropriate prior to a finding of permanency. In [...]
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So far Kathryn Gitto has created 37 blog entries.
PRACTICE TIP: In order to limit additional indemnity awards, do not let a prior PPD ruling prevent ongoing claim administration. The New York State Appellate Division has affirmed a ruling of the WCB holding that injured workers are entitled to indemnity awards post-cap when causally related surgery results in temporary disability. [...]
WHO TOOK ECONOMICS 101: THE WCB “REMEDY” TO FILLING PRESCRIPTIONS OUTSIDE OF AN APPROVED PHARMACY NETWORK
PRACTICE TIP: The WCB has now firmly established that an injured worker can freely obtain prescription medications outside of a carrier’s approved pharmacy network, therefore, C-8.1B objections will routinely be found in favor of the provider at the carrier’s approved network rate pending legislative revisions or Appellate review. In the case [...]
From the Desk of Attorney David L. Niefer PRACTICE TIP: If you are paying PPD non-schedule awards, those awards will terminate as of the date of death even if there are additional weeks owed under the statutory cap. After the enactment of the statutory caps on PPD non-schedule awards, an [...]
PRACTICE TIP: Upon receipt of medical evidence meriting an alteration in continuing indemnity awards, the WCLJ should consider the medical evidence for purposes of implementing awards since the prior hearing with a CCP direction. WCLJs routinely take the position that they do not want to create an overpayment by modifying awards [...]
From the Desk of Attorney David L. Niefer PRACTICE TIP: Consider a finding of no MMI if there is the possibility of a high SLU followed by TKR surgery. In previous editions of our newsletter, we highlighted the provisions of the Impairment Guidelines limiting a schedule award arising out of [...]
From the Desk of Attorney David L. Niefer PRACTICE TIP: Even if claimant works for a healthcare facility, careful analysis of the facts of each claim will increase the prospect for a disallowance. In the case of Ryan Health Women & Children, WCB G3002731 (7/26/22), a three member Board Panel [...]
From the Desk of Attorney David L. Niefer PRACTICE TIP: While the rules of evidence governing the admissibility of surveillance evidence in a New York State workers’ compensation proceeding are liberal, the party producing surveillance evidence must have a witness ready to confirm the completeness of the evidence produced. Previously, [...]
From the Desk of Attorney David L. Niefer PRACTICE TIP: When considering a claimant's temporary level of disability arising out of cervical and lumbar injuries, reference should be made to the criteria set forth in the 1996 Medical Guidelines defining various levels of disability. Although the New York State Workers' [...]
IT IS A SHORT TRIP ACROSS A TUNNEL OR BRIDGE – WHEN THE NEW YORK STATE FEE SCHEDULE APPLIES TO OUT-OF-STATE PROVIDERS
From the Desk of Attorney David L. Niefer PRACTICE TIP: Even though an injured worker might reside out of state, the New York State fee schedule can apply to treatment provided out of state as long as it would not be a “hardship” if the claimant were limited to treatment in [...]