Recent Developments in Workers Compensation

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Recent Developments in Workers’ Compensation

IT HAS BEEN DECIDED: PPD AWARDS UNDER THE STATUTORY CAPS DO NOT EXTEND BEYOND THE DATE OF DEATH

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 [...]

IT HAS BEEN DECIDED: PPD AWARDS UNDER THE STATUTORY CAPS DO NOT EXTEND BEYOND THE DATE OF DEATH2022-10-31T13:24:30-04:00

A PRIOR CONTINUING PAYMENT DIRECTION IS NOT SET IN STONE

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 [...]

A PRIOR CONTINUING PAYMENT DIRECTION IS NOT SET IN STONE2022-09-29T11:43:15-04:00

CHONDROMALACIA PATELLA & BLUE – WHAT DO WE DO NOW?

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 [...]

CHONDROMALACIA PATELLA & BLUE – WHAT DO WE DO NOW?2022-08-31T11:30:13-04:00

Covid Claims: Another Look

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 [...]

Covid Claims: Another Look2022-07-28T11:00:44-04:00

WHEN PRODUCING SURVEILLANCE EVIDENCE, FOLLOW THIS SIMPLE RULE: DISCLOSE IT ALL

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, [...]

WHEN PRODUCING SURVEILLANCE EVIDENCE, FOLLOW THIS SIMPLE RULE: DISCLOSE IT ALL2022-05-31T13:22:26-04:00

DON’T FORGET 1996: THE CONTINUING RELEVANCE OF THE 1996 MEDICAL GUIDELINES

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' [...]

DON’T FORGET 1996: THE CONTINUING RELEVANCE OF THE 1996 MEDICAL GUIDELINES2022-04-28T10:37:34-04:00

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 [...]

IT IS A SHORT TRIP ACROSS A TUNNEL OR BRIDGE – WHEN THE NEW YORK STATE FEE SCHEDULE APPLIES TO OUT-OF-STATE PROVIDERS2022-03-31T10:41:42-04:00

DON’T FORGET ABOUT MTG’S WHEN EVALUATING PAYMENT OF DME’S

From the Desk of Attorney David L. Niefer   PRACTICE TIP: Although the prior authorization requirements set forth at WCL § 13-a(5) do not apply to durable medical equipment (DME), any relevant Medical Treatment Guideline (MTG) provisions still must be met and a request to vary from the MTGs filed by the [...]

DON’T FORGET ABOUT MTG’S WHEN EVALUATING PAYMENT OF DME’S2022-03-31T10:43:59-04:00

IF THE CLAIMANT GETS IT WRONG, THE DOCTOR GETS IT WRONG:  DEFENDING AN OD CLAIM

From the Desk of Attorney David L. Niefer   PRACTICE TIP: Early and complete investigation is critical in successfully defending occupational disease claims.   In Urdiales v. Durite Concepts, Inc., 21 N.Y. WCLR 199 (11/18/21), the Appellate Division affirmed a decision of the Board disallowing an occupational disease claim for exposure to [...]

IF THE CLAIMANT GETS IT WRONG, THE DOCTOR GETS IT WRONG:  DEFENDING AN OD CLAIM2022-03-31T10:45:39-04:00

APPLYING GENDUSO WHEN A SINGLE CLAIM INVOLVES MULTIPLE JOINTS: THE MMI TRIGGER

From the Desk of Attorney David L. Niefer   PRACTICE TIP: Separate MMI findings leading to separate permanency decisions arising out of the same accident can trigger the application of Genduso resulting in a credit from the initial SLU award.   As a general proposition, the case of Genduso v. New York [...]

APPLYING GENDUSO WHEN A SINGLE CLAIM INVOLVES MULTIPLE JOINTS: THE MMI TRIGGER2022-03-31T10:46:42-04:00