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 [...]
PRACTICE TIP: In order to limit additional indemnity awards, do not let a prior PPD ruling prevent ongoing claim administration. The New York State Appellate Division has affirmed a ruling of the WCB holding that injured workers are entitled to indemnity awards post-cap when causally related surgery results in temporary disability. [...]
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 [...]
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 [...]
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 [...]
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 [...]
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 [...]
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 [...]
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 [...]
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 [...]
