Practice Tip: Medicare Set Asides are a crucial step in settling a New York Workers’ Compensation Claim. Obtaining formal approval from the Centers for Medicare and Medicaid Services (CMS) of a set aside is never required. However, obtaining approval is obviously the best case since it allows for confirmation directly from [...]
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So far Kathryn Gitto has created 10 blog entries.
Many carriers automatically reimburse private health insurance providers in full for medical treatment and prescriptions that were initially billed to the private health insurance provider rather than a workers' compensation carrier. In many cases, full reimbursement is not appropriate. There are many valid defenses to paying some or all of these [...]
CONVERTING NEW YORK STATE WCL § 15-8 REIMBURSEMENT CLAIMS INTO A LUMP SUM ON BEHALF OF THE EMPLOYER: THE WHOLESALE WAIVER AGREEMENT PRACTICE TIP: Converting future Section 15-8 reimbursement claims into a lump sum may be a viable option resulting in immediate financial resources and elimination of the need to routinely [...]
Practice Tip: be aware that claims can be made by employees outside of the healthcare setting for infections if there is proof that the infection was contracted on the job In 1975 the Court of Appeals rendered a decision in the case of Middleton v Coxsackie Correctional Facility, 38 N.Y.2d 130 [...]
Beware of Tentative Rates and Evidence of Total Disability on Approach to Permanent Partial Disability Finding From the desk of Attorney David L. Niefer PRACTICE TIP: When addressing labor market attachment at the time of permanency, avoid “tentative rates” in the presence of medical evidence of total disability. Otherwise, the claimant [...]
From the desk of Patrick B. Guy, Attorney January 2020 PRACTICE TIP: The Workers' Compensation Board expanded the type of providers and the scope of the treatment and services they can independently provide to injured workers effective 1/1/2020. The purpose of this newsletter is to provide you with easy access to [...]
December 2019 From the Desk of Patrick B. Guy PRACTICE TIP: When evaluating a medical opinion on schedule loss of use, make certain the physician is appropriately interpreting and applying any Special Considerations set forth in the 2018 Impairment Guidelines. If a Special Consideration applies, the doctor’s opinion can be limited [...]
From the Desk of John H. Snyder November 2019 VOLUNTARY RETIREMENT: QUITTERS NEVER WIN. WINNERS NEVER QUIT. PRACTICE TIP: When you are faced with a claimant's retirement, and claim for awards, be certain to investigate the circumstances and reasons for the retirement as securing a voluntary retirement finding provides a defense [...]
From the Desk of David L. Niefer September Newsletter Old Slu Followed by New TKR: Don’t fall into the “Which Guideline” trap PRACTICE TIP: When evaluating a claim involving a previous schedule loss of use utilizing the pre-2018 Impairment Guidelines, do not assume that the old Guidelines will apply to any [...]
From the Desk of Jason M. Carlton October 2019 Temporary Awards After 130 Weeks May Now Be Permanent – Keep An Eye Out For Post-4/10/17 Claims Practice Tip: Any claim having a date of injury on or after April 10, 2017 should be flagged as a case where an [...]