claimant

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The Return of Apportionment Before Permanency

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 [...]

The Return of Apportionment Before Permanency2023-04-27T13:23:11-04:00

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 [...]

WHO TOOK ECONOMICS 101: THE WCB “REMEDY” TO FILLING PRESCRIPTIONS OUTSIDE OF AN APPROVED PHARMACY NETWORK2022-12-15T13:12:40-05:00

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

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

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

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

All or Nothing: Dealing with the WCB’s New Section 32 Guidance

Practice Tip: When seeking to have the claimant sign a Resignation Agreement or General Release, it must now be included in the Section 32 agreement. You need to consider whether its inclusion might jeopardize approval of the Section 32.   When settling workers’ compensation claims by a Section 32 agreement, some employers [...]

All or Nothing: Dealing with the WCB’s New Section 32 Guidance2022-03-31T10:47:41-04:00

A Cash Advance is Not a Litigation Expense

A Cash Advance is Not a Litigation Expense: Remember to carefully scrutinize any closing statement arising out of a third-party action PRACTICE TIP: While the workers’ compensation insurance carrier is responsible for its equitable share of the cost of litigation giving rise to a third party settlement or judgment, careful scrutiny of [...]

A Cash Advance is Not a Litigation Expense2022-03-31T10:50:03-04:00

Don’t pay for a hand when a thumb will do

PRACTICE TIP: If a work injury has resulted in a diagnosis of de Quervain’s disease, make sure that the attending and consulting physicians are properly determining whether permanency remains in the hand or thumb.    Under Chapter 3 of the 2018 Workers' Compensation Guidelines for Determining Permanency, Injuries to the Hand are [...]

Don’t pay for a hand when a thumb will do2022-03-31T10:51:15-04:00