Bentley v. Jonathan Piner Construction (NC Court of Appeals, 9/20/16) Plaintiff suffered a right eye injury on March 3, 2014, when working on a construction site. Defendants denied the claim, arguing that plaintiff was not an employee. The claim was heard by Deputy Commissioner Mary Vilas on December 5, 2014. Deputy Commissioner Vilas suggested that […]
Saunders v. ADP Totalsource (NC Court of Appeals, 9/6/16) In a compensable claim, defendants were ordered to pay for prior attendant care services that were performed by plaintiff’s partner. The deputy commissioner approved an attorney fee of 25% of the award of the retroactive attendant care services provided. The Full Commission also awarded retroactive attendant […]
When Apportionment of an Injury is Appropriate Harris v. Southern Commercial Glass and/or Southeastern Installation Inc. (8/16/16) Facts and Procedural History: Plaintiff sustained a compensable back injury on July 13, 2000 while working for Southern Commercial Glass. The employer accepted the claim and plaintiff received workers’ compensation medical and disability benefits. At some point after […]
Workers’ Compensation Liens and Standing Dion v. William Robert Batten, Sr. (8/2/16) Facts and Procedural History: Plaintiff was employed by Neuwirth as a servicing agent. In the course and scope of his employment with Neuwirth, he was involved in a car accident. William Batten failed to stop at a red light and ran into plaintiff. […]
Rainey v. City of Charlotte (5/17/16) This case the North Carolina Court of Appeals analyzed N.C. Gen. Stat. §97-58 and the statutory time limit to file an occupational disease. The Court dismissed an injured worker’s claim based on plaintiff’s failure to comply with the time requirements of the statute based on the plaintiff’s own admissions. Facts […]
Barnette v. Lowes (4/19/16) The North Carolina Court of Appeals overturned a Deputy Commissioner and the Full Commission Opinion and Award denying the plaintiff’s claim. The Court found that an “accident” occurred where plaintiff was “engaged in his normal work duty…” at the time of alleged injury, but there was an interruption in the normal work routine […]
This final segment in this “Cost Containment Strategies” Blog series addresses strategies for the end of the worker’s compensation claim. The considerations at this point in the claim are typically whether to keep the claim open and manage it accordingly or whether to settle out the claim- either on a “clincher agreement” or to pay […]
One of the most effective cost containment strategies for the middle of a workers’ compensation claim is offering the claimant a suitable return to work with the employer of injury or a prospective new employer through vocational rehabilitation. This leads us to one of the biggest advantages for employers, administrators and insurance carriers in the […]
Social Media presents an important- and free – tool for investigating and defending against workers’ compensation claims when used properly. Today’s Social Media, which includes, but is not limited to, Facebook, Instagram, Snapchat, YouTube, Twitter, Blogs- allows previously unprecedented access to the lives, actions and activities of workers’ compensation claimants. Through access to Social Media, employers/claims […]
This segment in the Cost Containment Strategies Blog Series will focus on the fourth initial investigation cost containment strategy- utilizing Rule 607(a) of the Workers’ Compensation Rules of the North Carolina Industrial Commission and Discovery. These tools help secure additional information about the following: The claimant’s relevant pre-existing medical history/condition; The alleged injury or condition […]
This segment in the Cost Containment Strategies Blog Series will focus on the third initial investigation cost containment strategy- tips for securing relevant Medical Records/Medical Information. Medical Records/Medical Information Pursuant to the June 26, 2011, North Carolina Workers’ Compensation Legislative Reform, defendants are entitled to have reasonable access to all relevant medical information. N.C.G.S. § […]
This segment in the Cost Containment Strategies Blog Series will focus on the second initial investigation cost containment strategy – considerations for the Recorded Statement of the claimant. Recorded Statement A Recorded Statement provides a great tool to learn additional information about the claimant’s educational and work background; relevant pre-existing medical conditions; whether the claimant […]
This segment in the Cost Containment Strategies Blog Series will focus on the first initial investigation cost containment strategy- background investigation for examining the alleged accident and the claimant. Background Investigation- Alleged Accident The employer/claims adjuster should investigate the background of the alleged accident/incident leading to the workers’ compensation claim. Examples of questions to ask […]
When a workers’ compensation claim is first reported, the employer/claims adjuster wants to be proactive and formulate a strategic plan for investigation to determine whether the claim is compensable, and if so, what benefits are owed. Again, timing is key. Start at the beginning- review the existing information and documentation about the alleged incident to […]
Mica Nguyen Worthy (Charlotte) recently obtained a favorable Opinion and Award from the Industrial Commission wherein a claimant alleged he sustained an injury by accident or specific traumatic incident to his back while working. Plaintiff received medical treatment without prejudice and his alleged back condition resolved allowing him to work an additional 8 months for […]