Category Archives: Workers Compensation

Appellate Division Issues Decision Clarifying How To Calculate Schedule Loss of Use For Shoulder Injuries

Case: Matter of Maloney v Wende Correctional Facility

Issue
In determining the Schedule Loss of Use (SLU) percentage applicable to a shoulder injury, whether it is appropriate to assign separate loss of use values for deficits in anterior flexion and abduction or if this is duplicative and results in an inflated SLU percentage.

Facts of Case
Claimant was a Correctional Officer who injured himself while working in July 2013. The claim was established for a right shoulder injury. At permanency, the claimant’s treating physician opined claimant had 90% SLU of the right arm while an IME opined the claimant had 50% SLU of the right arm. Following litigation of the issue, the law judge credited the IME opinion over that of the treating physician and found claimant to have 50% SLU of the right arm. The Workers’ Compensation Board affirmed the Law Judge’s finding and the claimant appealed to the Third Department.

Decision
Board decision is affirmed, finding claimant to have 50% SLU of the right arm. The Court noted “the Board is vested with the authority to resolve conflicting medical opinions concerning the SLU percentage to be assigned to aspecific injury.” Additionally, the Court noted “judicial review is limited, and the Board’s determination will not be disturbed as long as it is supported by substantial evidence.” Continue reading Appellate Division Issues Decision Clarifying How To Calculate Schedule Loss of Use For Shoulder Injuries

New Jersey: No Modification to Award 18 Years After Loss

Joe Jones, Esq.
Joe Jones, Esq.
The New Jersey Appellate Division just handed down a decision in Larry D. Batts v. Flag House, a case that although not precedent for other courts to follow (the decision was an unpublished decision under Docket No. A-5616-15T4, January 16, 2018), discusses two important things:

  • A decision by a workers’ compensation Judge supported by substantial credible evidence will be generally upheld as substantial deference is given to their decisions as the trier of fact. This is a common theme in many Appellate decisions but an important one to note when you are making a record in a trial.
  • When an original case settles under an Order Approving Settlement involving more than one body part (arm and back, neck and psych, etc.) and the first re-opener is filed and settled with an increase to one of the original body parts but remains silent as to the other body parts, the second re-opener may include an increase in disability to the other body part that was not increased in the prior re-opener OAS (of course the petitioner still has to prove an increase in permanency!).

In Larry D. Batts v. Flag Ship, petitioner claimed injury to his right foot as well as psychiatric disability for chronic depression and anxiety disorder as a result of an accident that occurred on April 2, 1998 while at work when a forklift ran over his right ankle. The original case settled under an Order Approving Settlement awarding the petitioner 50% of the right foot for orthopedic disability and 10% of partial total for psychiatric disability. Continue reading New Jersey: No Modification to Award 18 Years After Loss

Video: Section 20 Lump Sum Dismissals and Medicare Secondary Payer in New Jersey

Attorney Greg Lois discusses the availability of a lump-sum dismissal settlement in New Jersey Workers’ Compensation cases. The presentation looks at the limitations on this type of compromise in the statute (N.J.S.A. 34:15-20), the rules (N.J.A.C. 12:235-13.1) and the case law. Attorney Lois reviews the barriers to Section 20 settlements and presents practical advice and opinion on obtaining the dismissal in court. The discussion also include an overview of the Medicare Secondary Payer Act as a barrier to full compromise settlements in New Jersey, with practical tips for resolving cases quickly.

Subject: New Jersey, Workers’ Compensation Law, Exposure, Permanency, MMI
Date Presented: January 22, 2018
Presenter: Greg Lois
Run time: 34:34

Continue reading Video: Section 20 Lump Sum Dismissals and Medicare Secondary Payer in New Jersey

Medicare Secondary Payer Set-Asides and Conditional Payments in New York Workers’ Compensation Cases

Attorney Declan Gourley leads a presentation designed to help the attendee answer the following questions: “Can I settle this case?” and “Does Medicare have a current interest I need to consider?” and “Do I need to consider Medicare’s future interest?” Presenter Declan Gourley has years of experience representing claimants before the Social Security law judges and employers and carriers before the Workers’ Compensation Board. At the end of the presentation, the attendees will have a basic understanding of Medicare Secondary Payer exposure and when they need to consider Medicare’s interest in a lump-sum settlement.

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Video: New Schedule Loss of Use Guidelines in New York

LOIS Partner Christian Sison leads a presentation on the new-for-2018 New York Guidelines for Determining Impairment. The new Guidelines replace the prior methods of determining Scheduled Loss of Use for all claims where an impairment report was not submitted before January 1, 2018 and will have an impact on exposure join all future claims. Attorney Sison provides examples including side-by-side exposure analysis of the same impairment under the old and new Guidelines and answers questions live from the webinar audience.

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Training on 2018 New York Impairment Guidelines

2018 Impairment GuidelinesThe Board has adopted New Guidelines for Determining Impairment. These are the same Guidelines which were proposed in November 2017. The new Guidelines replace the prior methods of determining Scheduled Loss of Use for all claims where an impairment report was not submitted before January 1, 2018. For cases where an impairment rating report was submitted before January 1, 2018, the 2012 Guidelines will apply. The new Guidelines are here.

Training on the New Guidelines.

We will be running training on the new Guidelines, led by LOIS partner Christian Sison, on January 8, 2017 in multiple sessions. Register here:
Register for 12PM EST January 8 – New Guidelines Training
Register for 3PM EST January 8 – New Guidelines Training

Both webinars are LIVE and Questions-and-Answer sessions will be held.