Texas Says Report COVID-19 Vaccination Reaction Claims (Work-Related) In reading various Workers Comp publications – yes, I do that in the evenings, I came across an article in Business Insurance Work Comp News that caught my eye. The Texas Department of Insurance released a memo on March 2, 2021, that
Missouri Workers Comp Medical Treatment 304% More Expensive Than Health Insurance I forgot to finish this article on Missouri Workers Comp medical treatment that I started at the WCRI Annual Conference two weeks ago. The comparison is still worth examining for medical costs. NCCI (National Council on Compensation) Insurance headquartered
Stay at Work -How Washington State Companies Can Be Reimbursed Up to 50% of an Injured Worker’s Light DutyWages Stay at Work sounds like a great unique program for employers and injured employees. Two months ago, Mr. Kohler (see below) contacted me. He wanted to see if I would be
Recent Court Decision Causes Wisconsin Workers Comp Conundrum For Temporary Agencies A recent Wisconsin Workers Comp Appeals Court decision redefines the definition of an employer and employee. My definition of exclusive remedy is – Employers cannot be sued in tort/civil court if a valid workers comp policy that covers an
New Virginia Medical Fee Schedule Active on January 1, 2018 The new Virginia medical fee schedule for Workers Compensation commences in a few weeks. I actually thought it would not happen for another few years. The new Virginia medical fee schedule leaves just four states that do not have medical
WCRI-Wisconsin Medical Fee Schedule Lacking A Wisconsin medical fee schedule would likely help out the Badger State. WCRI ( Workers Comp Research Institute) recently updated its analysis of the Workers Comp environment in Wisconsin. One of the easiest ways to cut Workers Comp costs in a state is to
Virginia Medical Fee Schedule Finally Enacted The lack of a Virginia Medical Fee Schedule has long been a concern of mine and many of the Dominion State’s employers. Fee schedules do save a large amount of Workers Comp dollars while still ensuring that injured employees receive the best medical
Oklahoma Opt-Out Insurance Takes Major Hit The fans of Oklahoma Opt-Out Insurance were dealt a five fingered death punch. The Oklahoma Supreme Court just wiped out any semblance of Oklahoma Opt-Out Insurance by ruling it as unconstitutional. The Oklahoma Workers Comp Commission had already said NO to the opt out
Virginia Medical Fee Schedule Passed By House and Senate A new Virginia medical fee schedule is in the works. One of the last holdouts on not having a fee schedule is going to have one January 2018. I was actually shocked that a Virginia medical fee schedule was not in
Oklahoma Federal Health Insurance Exchange vs Case Shifting The Oklahoma Federal Health Insurance Exchange has basically reported that many health policies in the state will increase by up to 34%. Reading that headline reminded me of the case shifting that was forecasted by Dr. Richard Victor (WCRI Director) at the
Oklahoma Captive Program Grows The Oklahoma Captive program added 63 captives in the last two years. In 2013, Oklahoma had 11 captives. The explosive growth of captives may be another way that the larger employers looked to reduce costs without going through the opt-out process. The Oklahoma Insurance Department
The New Virginia Rule 14 – Fee Schedule Soon? The new State of Virginia Rule 14 is now closed for comments. A copy of the Proposed Rule 14 can be found here. (PDF File). According to the Virginia Workers Compensation Commission, a public hearing on Virginia Rule 14 was
New Mexico Marijuana Recent New Mexico marijuana laws have enabled injured workers in the state to consume five joints per day – at a maximum. The state of New Mexico has always been very active in their allowance of medical marijuana for workers compensation injuries. The most recent New Mexico
Indiana Workers Comp Fee Schedule Partially Enacted The Indiana Workers Comp Fee Schedule was partially enacted 7/1/2014. That was a great move except a point was missed as to the real reason for their true cost figures. Check out the chart below. Click on the chart to
South Carolina Opt Out Coming Soon (Maybe) The South Carolina Opt Out decision may be a reality soon. The South Carolina State House introduced a bill that may actually allow South Carolina companies to Opt Out of Workers Compensation. South Carolina would join Texas, Oklahoma, and possibly Tennessee
Nevada Workers Comp Gets Trashed By the unknowing of Nevada Workers Comp Gets Trashed again. Nevada Workers Comp has usually been mostly off-the-radar since converting from a state fund. One of the main rumors was the number of companies grew when they left California for a better work environment including
Florida Court Orders Advance On TTD I was reading an article recently that referred to a Florida Court case where a Florida school system was ordered to pay a claimant an advance on benefits. For an adjuster to pay benefits in advance in usually verboten in most cases.The case was HATTIE
By Joining NCCI Texas Opt Out Could Fade Did Texas opt out of Its non-subscriber system? Texas has decided to join the Experience Rating System supplied by NCCI. According to a fellow WC blogger, Texas may also look to remove the opt-out provisions in the law for the construction industry.
Texas Officially Joins The NCCI System Texas officially joined the NCCI system today as the Department of Insurance files a petition to adopt NCCI’s Experience Rating Plan Manual. Earlier in the year, The Texas Department of Insurance signed order 3455 adopting NCCI’s Statistical Plan for Workers Compensation and Employers Liability Insurance
Workers’ Compensation Ended Tomorrow – Then What? If Workers’ Compensation ended tomorrow, what would be the result? One of the more prolific bloggers such as myself recently published an article that was titled “Without Comp.” I started thinking what would happen if Workers Comp was completely abolished for injured
Massachusetts And Independent Contractor The Massachusetts has an interesting take on independent contractors. One of the hottest topics that still generates interests over the years is the subcontractor vs. employee debate. Many states have publicized cracking down on “1099 employees.”Massachusetts has a landmark case that has been used for determining
Nebraska Supreme Court Cases Two days ago, I analyzed a recent court case where the Nebraska Supreme Court Cases made a ruling that can devastate a state’s Workers Comp system. The conundrum is two-fold for carriers and self-insureds and their Third Party Administrators (TPA’s): How do the insurance carriers make
Nebraska Supreme Court Makes Surprising Decision The Nebraska Supreme Court as State Supreme Courts seem to do more often lately- affirmed the Workers Comp court’s decision in one of those cases that send a chill throughout the Workers Compensation community. The full decision can be found here. This is a .PDF
Ohio’s BWC Provides 83.5 Moon Roundtrips Unsurprisingly, Ohio’s BWC (Bureau of Workers Compensation), a monopolistic state fund, had a very scorching court decision rendered against it a few months ago. Rather than keep appealing the Appeals Court decision, the BWC decided to settle with certain policyholders. If you have not
New Mexico Supreme Court Turns TTD into PTD The New Mexico Supreme Court recently ruled that Temporary Total (TTD) can be a permanent disability. These types of decisions are often not underwritten by the Workers Compensation carrier. As discussed earlier in this blog, the WC insurance process is a delayed system. The
WC And Hospitality Industries Are Similar – Service and Employees The WC and Hospitality Industries are very similar in quite a few respects. The idea for this article resulted from seeing the best in the hospitality industry and the worst. We, as consultants, usually are contacted when there is a
Rocky Mountain High – In New Mexico A New Mexico Court of Appeals has recently ruled that an injured employee’s Workers Compensation carrier must pay for his marijuana prescription. The ruling even noted the federal laws for medical marijuana would prohibit the use. According to the Santa-Fe New Mexican, The New Mexico
Ohio Appeals Court Decision Could Change BWC A recent Ohio Appeals Court Decision against the Bureau of Workers Compensation (BWC) may possibly start the progression of the state’s monopolistic Workers Compensation system to a free market system. The court decision is well worth a quick review. (Pages 5 -7 and
WCRI Study Oklahoma recently enacted new rules for opioid use as 8% of the general population were long term users of painkillers. WCRI recently performed a startling study on Workers Compensation opioid use which indicated that Louisiana and New York injured workers were ingesting massive amounts of opioids.
Certificates of Insurance – Delaware Toughens On Improper Use A big change in Certificates of Insurance (Certs) – Delaware recently decided to increase the enforcement of their laws by amending their old laws on improper certificate use. Certs have long been a bane of premium auditors nationwide which has resulted
WC Networks Cost Texas Employers According to WCRI WC Networks Cost employers in Texas. Did Texas make a large inadvertent mistake? WCRI recently completed a study CompScope™ Medical Benchmarks for Texas 14th Edition,. One of the conclusions of the study was the growth in medical payments per workers’ compensation claim in Texas was
Ancient Sumeria Invented Workers Compensation Insurance The origins of Workers Compensation Insurance is much more ancient than in the early 1900’s. I had always thought the beginnings of the WC system involved merchant ships or started in Wisconsin. This article from the State of Wisconsin Department of Workforce Development (DWD)
Illinois Fee Schedule Reduction Causes Changes The Illinois fee schedule reduction of 30% – blogging – WCRI live. 30% across the board reduction by Illinois and its effects As with most across the board cuts in WC in other states over time, the costs per claim were not reduced in
Texas Reforms – WCRI Conference – Live blogging The new Texas reforms were presented along with the preliminary results. This is a very informative conference-session. The current session is pre- and-post reforms in the state of TX. This example could be applied to other states with upcoming or in-place reforms
Oklahoma’s New Anti Drug Abuse Bill vs. Work Comp Oklahoma’s new anti drug abuse bill should affect WC. Oklahoma Governor Mary Fallin has given her blessing to a new bill that would limit the use of painkillers by requiring physicians to access a database to check on the prior prescriptions
Mississippi Court Uses Walsh Jurisdictional Test (Sort Of) Alabama and Mississippi were the two choices for the 5th Circuit Court of Appeals. (See yesterday’s article on a bad faith case). The Court very likely did not use the WALSH jurisdictional test. However, the results were the same. I
Alabama and Mississippi Bad Faith Springs From WC Claim Alabama and Mississippi had a bad faith case filed from a Workers Comp claim. Adjusters are usually protected from any type of Workers Comp mistake or oversight. The Exclusive Remedy doctrine has always protected other parties including employers, adjusters, and other
On The Job Alcohol v. Marijuana Debate The Job Alcohol v. Marijuana debate usually ends up with an interesting discussion. The job alcohol v. marijuana debate pits the right to privacy against the right to a safe workplace. A very interesting question popped up on the LinkedIn Work Comp Analysis
Florida Reverses Bad TTD Decision The State of Florida reverses bad TTD decision saving employers $65,000,000 in Workers Comp payouts. Florida had previously declared the 104 week cap on Temporary Total Disability (TTD) benefits as unconstitutional. I had even held it up as an example of how a Workers Comp
AOE COE – Tampa Bay Bucs The AOE COE is the Workers Comp acronym for Arising Out of Employment or in the Course of Employment. Lawrence Tynes was brought in by the Tampa Bay Bucs as a replacement for Connor Barth this NFL season. Mr. Tynes is not happy as
Physician Dispensaries Opt Out Of Opioids – A Good Sign Physician dispensaries Opt Out due to a strict ban in Florida Florida has endured an epidemic of the improper use of opioids. They have been discussed to the nth degree in Workers Compensation. One of the most prevalent
Delaware Requires Employers Job Lists To Treating Physician The State of Delaware requires employers to initiate a great risk management technique. Return to work is one of the Five Keys To Saving On Workers Comp $. I have been writing, presenting, and blogging on these Five Keys for over 25
NY Says Captives Are Shadow Insurance Captives for Workers Compensation and other types of Shadow Insurance have long drawn scrutiny – sometimes undeservedly. This week, the Superintendent of the New York State Department of Financial Services.said that captives were nothing more than shell games and all state insurance departments should
Oklahoma – Is Opting Out Going To Be Worth The Trouble? Oklahoma made a very bold move this week to allow opt out programs for Workers Compensation coverage. “Coverage” may not be the right term as no insurance carriers will be involved with the opted-out companies. One of the concerns
Oklahoma’s Workers Comp Opt Out Program vs Obamacare Oklahoma’s new opt out program legislation is working its way through the very long path to becoming law sometime in 2013. The likely passage of the bill has created quite a buzz on the Workers Comp airwaves. One of the more interesting
Nebraska Supreme Court The following Nebraska Supreme Court case could be considered more social legislation such as the infamous Florida decision that can actually wreck a Workers Comp system. For readability, I decided to include all of the decision. You can also find the case here. This will have
Monopolistic Ohio Overcharges Mega Amount Monopolistic Ohio and its Workers Compensation bureau had been the center of controversy a few years ago with a few questionable investments. A judge recently ruled that The Ohio Bureau of Workers Compensation (BWC) overcharged insureds $845,000,000. The average refund payable per each employer is
Florida Decision Could Cause Crisis The recent Florida decision makes all reserves possibly inadequate. The Florida Workers Comp Claim that was mentioned earlier this week shows how little the upper courts understand the intricacies of certain Workers Comp claim systems. There had been published cases by Supreme Court Justices that said they
Florida E-Mod System v. Court of Appeals The Florida E-Mod system took a massive hit last week when a Court of Appeals decided that the state’s limit on Temporary Total benefits were unconstitutional. I find these types of decisions repugnant as try to “socially legislate” Workers Compensation benefits ends us creating
Medical Fee Schedules – Virginia Legislature Moves On To Other Things Virginia’s decision on medical fee schedules will cost the state’s employers dearly. The Virginia State Legislature decided to not act on fixing their Worker Comp medical fees. As I pointed out in previous posts, Virginia is one of the
Assigned Risk Plans and Premium Bill Dispute Some assigned risk plans may become quite complicated as in the case of a reader that found themselves in a quandary. A Tennessee reader of our blog that found us in a Google search asked this question. We are about to renew
Opt-Out or Non-Subscriber Report Just Published A new report was recently released on opt-out or non-subscriber services for Workers Compensation. The report can be found here. The report should be given a thumbs up by all that read it. Please note the report is a very large PDF that will
Texas Workers Comp Report Looks Very Positive A state of Texas Workers Comp report shows progress and savings. Texas and California always seem to be microcosms of what is occurring in Workers Compensation nationwide. Last week, I came across the “Biennial Report of the Texas Department of Insurance To the 83rd Legislature.” You may want to
Iowa Approves 7.9% Increase in Rates (Ouch) The state of Iowa Approves a 7.9 percent rate increase. NCCI recommended that Iowa increase its Workers Compensation rates by 7.9% (3% effective 01/01/13 + additional 4% on 07/01/13). Iowa subsequently approved the rate increases. This was rather surprising in such a
Texas Workers Comp Payments Are Lowering The state of Texas workers comp payouts decreased for the first time in years. According to WCRI, the payments decreased overall by 4%. This is a very large one year decrease in the current Workers Comp environment. Texas enacted a large group of
5% Rate Increase Approved – Indiana – Needs Medical Fee Schedule Indiana just approved a 5% rate increase for Workers Comp advisory rates. I thought enough time had passed that most of the remaining states without fee schedules would have followed suit to help their employers receive the benefit of an easy
TPA Fees May Not Be Correct in New Jersey The TPA Fees are not correct in New Jersey. New Jersey’s Comptroller issued a statement last week that Third Party Administrators (TPA’s) for Workers Comp claims may be receiving side payments between the TPA’s and the managed care or bill
Expensive State For Workers Comp-Illinois The State of Illinois ranks as one of the most expensive. I was reading over the Illinois Abstract on Workers Comp from WCRI. Even though there was a supposed reform in Illinois over the last few years, the Workers Comp costs have remained high. A
Wisconsin – Workers Comp Medical Cost I was finishing up my last post on Workers Comp medical costs. I had a research that proved Virginia was the highest in the nation. I then read this article and now I am confused. I think the Augusta Journal article that I referenced
Workers Comp Medical Costs In Virginia The Virginia WC medical costs are the most expensive in The Old Dominion State. I have posted often on fee schedules and their effect on Workers Compensation claims. In my original post (see link) on fee schedules, I did not include Virginia. The Dominion State
Illinois House Debates Scrapping Workers Comp Program – What? If the Illinois House scraps the state’s Workers Compensation System, what will happen to the businesses and their employees? The system has been much criticized, but should these businesses and employees have to battle in court for payment for workplace injuries?
Vermont Workers Comp Ending? Will Vermont Workers Comp fade away? Vermont recently appeared on the radar for Workers Comp. The state had been relatively quiet for many years. If there was a state that could possibly make 24 hour coverage work, Vermont would be one of my top picks. Having
Oklahoma Workers Comp Overhaul Continues Old System The Oklahoma Workers Comp overhaul will have little effect to the current system. Oklahoma’s Workers Comp system is where I was trained many years ago. Being from Oklahoma, I always try to monitor the Workers Comp situation there. Why I write about different
SEB Supplemental Earnings Benefit One to the blog, and we do like to see comments, asked about the SEB or Supplemental Earnings Benefit, which seems to be a Louisiana term for Temporary Partial Disability (TPD) benefits. The definition for SEB is If you can return to work, but your medical
Missouri Fines TPA Over $100,000 According to a recent press release from the Missouri Attorney General’s, Broadspire and Specialty Risk Services, settled with their office for over $100,000 total in fines. Missouri has taken a new tact on late reporting of injuries by referring the cases to the Attorney General’s
New York Policyholders Workers Comp Premiums Should the excess surcharges be returned to New York policyholders? I was reading this article in a few of the online insurance publications. Some of the posted replies asked if New York should have returned the premiums to the policyholders and not the state.
South Carolina Independent Contractors The following is a great assessment of how a specific Workers Compensation Commission views independent contractors. Even if your company has no Workers Comp concerns in SC, the control issue is spelled out here very well. The issue of employee vs. subcontractor is very important at the
Montana Has Highest Workers Comp Rates Now Montana has the highest workers comp rates. According to an Oregon-based report as covered by the Watchdog, Montana is the nation’s highest for Workers Comp Costs. The Treasure State recently produced an RFP for a review of their Workers Comp system. According to
Alaska Body Slams Non-Generic Drugs The State of Alaska body puts an end to the very expensive brand name drugs . My hat is off to Alaska’s Workers Compensation system. A bill was recently pass that REQUIRES generic drugs in all Workers Compensation cases. This very smart political move will
Monopolistic Washington Free Market Soon Monopolistic Washington will be a free market soon. Monopolistic states for Workers Compensation such as Washington and South Dakota may be a free market system someday. Actually, Washington may take the plunge into the free market system such as Nevada and West Virginia have recently.
Tulsa’s Workers Comp Payment The City of Tulsa’s Workers Comp will be double Payouts in six years. When something comes across my radar screen from my original home state, I always make sure that I read it over closely. According to the Tulsa World – Oklahoma’s second-largest city – Tulsa
Term Of The Day – Maryland The State Of Maryland claims a first in Workers Comp. This post is more of a question and answer – What state was the first to enact Workers Compensation laws? Maryland enacted the first set of Workers Comp laws in 1902. All states had
The Feds Crackdown Down On Subcontractors The State of Oklahoma and Feds crackdown on dishonest subcontractors. Oklahoma organizations that misclassify employees as independent contractors are the target of new legislation approved by the Oklahoma House of Representatives. Senate Bill 1384 would allow the Oklahoma Tax Commission, the Oklahoma Workers’ Compensation
Second Most Expensive State Is M0ntana I noticed that the 2nd most expensive state is Montana. I have not posted for some time on the state funds. One article that caught my eye was on the Workers Compensation situation in the state of Montana. Montana had been off the news
Workers Comp In Oklahoma – Five Fixes I wrote five fixes for Workers Comp in Oklahoma to help small businesses. My last post covered Oklahoma’s CompSource. I am under the impression that CompSource will be sold in the future. What could Oklahoma do to help small businesses when there is
Washingtons Workers Comp System An internal audit by the State of Washingtons Workers Compensation Department of Labor and Industry (L&I) may be the start of another Workers Comp system converting from a monopolistic system to a private system. West Virginia recently converted their state-run system into a free market. Washington’s
Tennessee Legislature Workers Comp Mistake A highly controversial piece of legislation just went into effect due to the Tennessee Legislature’s severe error. The error was due to the state trying to over-regulate the Workers Compensation insurance industry. On January 1, 2010 the small business people of Tennessee will bear the
Bad Decisions By Tennessee Workers Comp Judges In Tennessee Workers Comp system the Workers Comp judges made a few questionable decisions. A recent decision by a Tennessee Circuit Court judge may cause a landslide of permanent total disability cases. This is the second horrible court ruling I have seen in
Kansas Supreme Court Issues Questionable Decision The Kansas Supreme Court issued a bad opinion for Workers Comp this week. Someone had emailed me this decision No. 99,369 CAROLYN BERGSTROM, Appellant, v. SPEARS MANUFACTURING COMPANY AND ZURICH U.S. INSURANCE COMPANY, Appellees. I thought that it was just another Supreme Court Decision
Employee vs Subcontractor IRS Rules This subcontractor vs employee determination question has made a comeback in blogs and publications that I have read over the last few weeks. It has to do with the classification of employees or non-employees for Workers Compensation while on the job. I had posted
The Way Workers Compensation Operates in Maryland – Updated It is the way Workers Compensation should work? I could hardly believe my eyes when I read that the Maryland State Senate had passed a bill that will establish a unit with the State Department of Labor allowing labor inspectors to
Ohio Workers Comp Changing With Recent Court Decision The Ohio Workers Comp lawsuit result indicated a bad result for the monopolistic carrier. I had posted on this situation November 22nd. If a judge can grasp why the state cannot artificially structure the Workers Comp premium rates for Ohio business, why
Attorney Conflict of Interest The Oklahoman Newspaper Reports An attorney conflict of interest case in Oklahoma was revealed by The Oklahoman newspaper. On a recent visit to Oklahoma, I came across an article in The Oklahoman newspaper that was of great concern to me. A group of reporters for The
Oklahoma Manufacturers Association A few days ago I had posted about the Oklahoma Manufacturers Association wanting to establish a self-insurance pool for Workers Compensation. They have done well with a health insurance pool and wanted to try to do the same with Workers Comp. Workers Comp requires a large pool
Oklahoma Insurance Bill Would Change CompSource A new Oklahoma insurance bill is dangerous to Workers Comp. Oklahoma is near and dear to my heart, as it is my home state. There are many problems with this bill that is not understood by the Oklahoma house. This could be an
Wyoming Workers Comp State Fund Banking Funds While we are on the topic of State Fund, Wyoming Workers Comp State Fund has been in quite a few online Workers Compensation publications with their huge surplus. Basically, the two basic questions that are being asked are: What do they do with
Rating Viewings South Carolina Workers Comp News Item South Carolina Workers Comp took a turn for the worse for adjusters trying to set permanency reserves on files. On Friday, the South Carolina Industrial Commission decided to not go along with Governor Mark Sanford’s previous Order that the Industrial Commissioners decide permanency
Automated Reserving Programs For Workers Comp – Better Than An Adjuster? I received this question on automated reserving in response to yesterday’s post. You had said there are no guidelines for a Workers Compensation Adjuster to set the Workers Comp reserves on a file – How about the automated reserving
