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January 03, 2007 2:56 AM
Workers' Compensation News - Jan 3, 2007, Volume 5 Issue 105

 STATE PREMIUM RANKINGS ANNOUNCED 
1. Alaska 
2. California 
6. Florida (down from 3) 
10. New York (up from 18) 
23 New Jersey (up from 29) 
51. North Dakota 
Source: State of Oregon 
Entire report: http://www.cbs.state.or.us/imd/rasums/2082/06web/06_2082.pdf 

SOME HEARING OFFICER MANUALS - IN THE PUBLIC DOMAIN 
OHIO POSTS MANUAL ON LINE 
This Hearing Officer manual is designed to serve as both a training tool and a reference that sets forth guidelines and the basis for decision making for hearing officers and for members of the Industrial Commission of Ohio. 
http://www.ohioic.com/appeals/hom.htm 

CALIFORNIA POLICY MANUAL ON LINE 
Policy & Procedural Manual Policy & Procedural Manual 
http://www.dir.ca.gov/WCAB/WCAB_Policy_ProcedureManual/Policy_andProcedure_Manual.pdf 

RHODE ISLAND SEEKS TO OUTSOURCE WORKERS' COMPENSATION DIVISION 
The Carcieri administration has been quietly — and without any public announcement — shopping since fall for a private company to run state government’s $19.9-million-a-year, self-insured workers’ compensation claim program for its own employees. 
The Providence Journal 12/29/06 (Subsrcition Free) 
http://www.projo.com/news/content/workers_compensation29_12-29-06_8F3KK78.2ce040a.html 

OHIO - VIOLATION OF SAFETY RULES BARS RECOVERY 
The Ohio Supreme Court earlier this week ruled that a 16-year-old former KFC employee who was badly burned after attempting to clean a gas pressure cooker by putting water into it – a violation of the restaurant's safety rules – is not entitled to workers' compensation benefits. 
Occupation Hazards 12.29.06 
http://www.occupationalhazards.com/News/Article/43939/Court_No_Workers_Comp_for_Negligent_Worker.aspx 
State ex rel. Gross v. Indus. Comm. 112 Ohio St.3d 65, 2006-Ohio-6500 
http://www.sconet.state.oh.us/rod/newpdf/0/2006/2006-ohio-6500.pdf 

OHIO - NO TOLERANCE LEVEL FOR KICKBACKS 
Governor-elect Ted Strickland yesterday said managed-care companies should be "terminated" from doing business with the Ohio Bureau of Workers' Compensation if investigators determine that the firms have offered kickbacks in exchange for employer referrals. 
The Toledo Blade 12.19.06 
http://toledoblade.com/apps/pbcs.dll/article?AID=/20061219/NEWS24/612190362/0/NEWS12 

EMPLOYER 100% INJURY FREE 
Frito-Lay Inc. has taken workers' compensation risk management to the next level with laser-like focus on eliminating injures for good. Every last one. 
http://www.riskandinsurance.com/061101_choice.asp 

NEW JERSEY ISSUES MEMO ON COUNSEL FEES 
Judges have discretion of awarding a reasonable counsel fee not to exceed 20% of the award. 
Memorandum 12.18.06 - Continuing Policies Section of the Judicial Information System 
http://www.state.nj.us/labor/wc/forms/121806_counselfees.pdf 

NEW JERSEY NOW REQUIRES A MORE DETAILED DESCRIPTION ON JUDGMENTS 
Judgments in New Jersey will now require more standardized language describing disabilities and injuries. 
Memorandum 12.21.06 - DWC Continuing Policy Manual for Judges 
http://www.state.nj.us/labor/wc/forms/122106_injurydata.pdf 

NEW JERSEY PROVIDES GUIDANCE IN PUBLIC EMPLOYEE PENSION CLAIMS 
Prodcedures announced for handling of claims involving Ordinary & Accidental Disability Claims. 
Memorandum 11.16.06 - DWC Continuing Policy Manual for Judges 
http://www.state.nj.us/labor/wc/forms/111606_PublicEmployeePensionIssues.pdf 

WHO KILLED THE MASS TORTS BONANZA?
The power of the plaintiffs bar is on the wane in this country, and will be for a long time to come.
The American Lawyer 12-12-2006 
http://www.law.com/jsp/article.jsp?id=1165869434510 

UNVERSAL HEALTH CARE - MERGING WORKERS' COMPENSATION INTO A SINGLE DELIVERY SYSTEM 
CAPITOL HILL WATCH 
Sen. Wyden To Propose Plan That Would Provide Universal Health
Care Coverage to All U.S. Residents Without Increasing Costs
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=41668 

OHIO JUDGE 6 YEAR TARGET FOR WORKERS' COMPENSATION VOTES 
PERSPECTIVE: Lawyers make career out of Resnick case 
State Supreme Court Justice Alice Robie Resnick was elected to her last six-year term in 2000. Lawyers, elections officials and others served her six-year term as well.
Ohio Beacon Journal 
http://www.ohio.com/mld/beaconjournal/news/state/16314447.htm 

NY EMPLOYER CHARGED WITH FRAUD 
A New York business owner faces charges of insurance fraud following his arrest by Manhattan District Attorney Robert Morgenthau's office for allegedly defrauding the New York State Insurance Fund of more than $200,000 in premium on his workers' compensation policy. 
Insurance Journal 12.15.06 
http://www.insurancejournal.com/news/east/2006/12/15/75093.htm 

CMS CONTINUES TO ENCOURAGE STATE AGENCY DATA SHARING AGREEMENTS 
The CMS is currently in the process of identifying those states that are able to provide WC data to match with our Medicare eligible database. 
http://www.cms.hhs.gov/WorkersCompAgencyServices/10_wcdatamatch.asp#TopOfPage 

THE COURSE AHEAD WILL BE GUIDED BY HEALTH CARE ISSUES 
CALIFORNIA: Outgoing commissioner of insurance claims reforms is necessary: 
A long-time proponent of health care reform, Garamendi said the absolute need to reform the health care system remains critical, including reform of benefits packages 
http://www.insurancejournal.com/news/west/2007/01/02/75562.htm 
NCCI: 
"Medical costs continue to grow much faster than average wages and the Medical Consumer Price Index. Utilization increases are a ignificant contributor. For NCCI states, medical losses are now approaching 60% of total losses. Workers compensation is increasingly becoming a medical management business as policy makers, employers, and carriers strive to control these costs." 
http://www.ncci.com/media/pdf/SOL-2006-article.pdf 
NJ LAWMAKERS LOOK AT UNIVERSAL HEALTHCARE MEASURE
The blueprint now being crafted for introduction in the Legislature next spring would force residents to get health insurance and would require them to prove they have it when they file their state income tax returns.
http://1010wins.com/pages/151651.php?contentType=4&contentId=262943

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CASES 

CREDIBILITY 
Injured worker was found not to be credible by Judge of Compensation and case was dismissed. Testimony concerning a prior bogus claim was introduced at the time of trial. 
Spense v. Raytheon 2006 WL 3815271 (N.J.Super.A.D.) Decided 12.13.06 DOCKET NO. A-4747-05T2 
Herbert I. Ellis, attorney for appellant (Gerald A. Dienst, on the brief) 
Margolis Edelstein, attorneys for respondent (Michael S. Affanato, on the brief) 

SETTLEMENT BY THE PARTIES IS NOT A JUDICIAL FINDING OF DISABILITY 
"The settlement of plaintiff's workers' compensation claim against her employer was not a finding of the judge of compensation as to the extent of plaintiff's disability; it was no more than a voluntary resolution between disputants." 
Hamilton v. Academy Bus Tours, 2006 WL 3815579 (N.J.Super.A.D.) Decided September 27, 2006 DOCKET NO. A-6128-04T1 
Leonard D. Weiss argued the cause for appellant (Baer, Arbeiter, Ploshnick, Tanenbaum & Weiss, attorneys; Mr. Weiss, on the brief). 
Robert M. Brigantic argued the cause for respondents Academy Bus Tours, Inc. and Portia Shariff (Maloof, Lebowitz, Connahan & Oleske, attorneys; Mr. Brigantic, on the brief). 
Respondent Continental Airlines did not participate in this appeal. 

EMPLOYER SUFFERS PENALTY FOR USE OF INCORRECT ADDRESS 
Employer that sent claimant's settlement payment to wrong address was required to pay penalty for late payment. 
An employer received actual or constructive notice of a workers' compensation claimant's current address such that the employer was liable for the statutory 20% penalty payment after failing to make a payment to the claimant, within the 10-day period prescribed by the statute, when it sent payment to the claimant's former address. Even though the claimant did not file an official change of address form or other notification with the employer, the claimant's updated address appeared on nearly a dozen documents filed with the employer or the employer's attorney, including the compensation order itself. Moreover, workers' compensation law imposed no specific method by which the claimant was required to file notice of a change of address. 
Hard Rock Cafe v. District of Columbia Dept. of Employment Services, 2006 WL 3370175 (D.C.) 12.11.06 

WIDOW OF RETIRED WORKER ENTITLED TO BENEFITS 
The fact that a retired employee had no earnings at the time of his death from injury did not disqualify surviving spouse from receiving the minimum weekly benefit of $110 in survivor's benefits. A Massachusetts statute required payment to a widow if dependent on an employee's earnings at the time of death or injury. The spouse depended on the employee's earnings at the time of injury although not at time of death. The statute also stated that in no instance would the benefit be less than $110 per week. 
448 Mass. 79, 2006 WL 3742355 (Mass.) Decided December 28, 2006 

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ARTICLE 
What You Need To Know About Medical Reimbursement Issues 
By Nancy Johnson (09/06) 
http://www.njicle.com/sample_content/Dart165806s.pdf 
(Sample Article Offered by NJ-ICLE)

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