The Employer’s Perspective – Third Fridays Podcast

In this episode, Christian Sison welcomes the employer’s perspective to the Third Fridays podcast. Christopher Lahey, a Senior Supervising Engineer from National Grid, starts a discussion about the issues involved when investigating alleged work accidents. Christopher talks about the types of injuries sustained by National Grid employees, and how the company puts its employees in the best position to return to full duty work. Continue reading The Employer’s Perspective – Third Fridays Podcast

Video: Impact of Law Changes on Workers’ Compensation in New York

This is our updated presentation on impact of the 2017 legislative changes to the New York Workers’ Compensation Law. The New York workers’ compensation statute was changed on April 10, 2017. Lois LLC held a webinar for clients and guests on how the statutory changes will affect employers, carriers, and self insureds in New York.

Subject: New York, Workers’ Compensation Law, Reforms
Date Presented: May 17, 2017
Presenter(s): Greg Lois, Esq.
Run time: 21:41 Continue reading Video: Impact of Law Changes on Workers’ Compensation in New York

Video: Which Defense Applies? Common Defenses in New York

Attorneys Tim Kane and Greg Lois cover the fundamentals on challenging the the basic presumptions relied upon by the claimant in establishing their case, disputing new “consequential” body parts, and raising all applicable defense. We discuss some little used (but available) defenses, such as the intoxication defense. At the end of the presentation attendees will have a basic understanding of various common defenses under the New York Workers’ Compensation Law.

Subject: New York, Workers’ Compensation Law, Intoxication, Idiopathics, Consequential, Notice, Statute of Limitations, Defenses, Employer-Employee
Date Presented: May 15, 2017
Presenter(s): Greg Lois, Esq.
Run time: 29:26 Continue reading Video: Which Defense Applies? Common Defenses in New York

Explainer: Permanency Benefits in New York

The New York Workers’ Compensation Law allows for four types of benefits to be provided to injured workers: medical treatment, lost time wage replacement, death benefits, and permanent disability benefits. This article discusses the three types of permanent disability benefit available to the injured worker:

  • Scheduled loss of use.
  • Classification/LWEC
  • Permanent Total Disability.

The employer is exposed for permanent disabilities which the claimant may prove. These three types of disability are compensated at different rates.

Scheduled Loss of Use.

Values come from tables which establish the compensation for loss of limbs, vision, and hearing in terms of ‘weeks of compensation.’ Scheduled loss is the percent of those weeks equal to the percentage loss of function of the member (for example a 10% schedule use loss of the arm equates to 31.2 weeks of compensation. The award is the number of weeks of compensation according to the schedule multiplied buy the workers’ maximum rate (2/3rd of Average Weekly Wages subject to the maximum and minimum rates in place according to the year of the accident). Prior payments of compensation and wages (all wages, not just those paid at the compensation rate) are deducted from the award. Continue reading Explainer: Permanency Benefits in New York

Settlements in New Jersey: What gets deducted?

What does the petitioner have to pay back when a settlement is reached in a New Jersey workers’ compensation case?

Has to be paid back: State Disability

Any petitioner’s award is offset by any amounts paid to the petitioner by State Disability as provided by N.J.S.A. 34:15-57.1. Temporary disability paid by the state for injuries later deemed compensable or settled via Section 20 must be reimbursed to the state. Before settling a case, counsel should be expected to investigate all outstanding liens. The New Jersey workers’ compensation law judge can provide the parties with the amount of the State temporary disability lien at the time of settlement.

Has to be paid back: Health Insurance

By the very terms of the Act, workers’ compensation insurance is primary to medical insurance. Therefore, any amounts paid on behalf of the petitioner for treatment deemed by a judge “reasonable and necessary” to cure the petitioner of the effects of the work-related accident, can be collected by the health insurer at the time of settlement, or later. Recent case law instructs that even matters disposed of pursuant to Section 20 may not extinguish a health insurer’s lien. Continue reading Settlements in New Jersey: What gets deducted?

Is there a $50,000.00 “Carve-Out” to a Workers’ Compensation Section 29 Lien When the Underlying Accident Occurs Outside the State of New York?

When an accident occurs outside the State of New York the $50,000.00 “carve-out” under New York Insurance Law §§ 5102 and 5104 does not apply to a Workers’ Compensation Law Section 29 lien.

The seminal case setting forth this bright-line rule is McHenry v. State Ins. Fund, 236 A.D.2d 89, 666 N.Y.S.2d 221 (3rd Dept. 1997). The Court in McHenry held that “absent an express statutory provision, a workers’ compensation carrier has the ‘inviolable’ right to a lien against the proceeds of ‘any recovery obtained by a compensation claimant in a third-party action.” Id. at 90-91 (citing Matter of Granger v. Urda, 44 N.Y.2d 91, 96 (1978)). The Court further stated that by the express terms of Insurance Law § 5104 itself the statute applies only to injuries stemming from the negligent operation of a motor vehicle in the State of New York. Id. at 91. Insurance Law § 5104(a) is not given “extraterritorial effect” even in situations where all parties are New York residents and the accident merely occurred in another state. Id. (citing Morgan v. Bisorni, 100 A.D.2d 956, 475 N.Y.S.2d 98 (1984)).

Subsequent decisions have likewise enforced this ruling even though the peripheral facts of the case may differ. (See discussion below of Ofori v. Green, 74 A.D.3d 474, 901 N.Y.S.2d 835 (1st Dept. 2010)). Continue reading Is there a $50,000.00 “Carve-Out” to a Workers’ Compensation Section 29 Lien When the Underlying Accident Occurs Outside the State of New York?

Defending Employers