Hawaii’s largest workers’ compensation insurer, Hawaii Employers’ Mutual Insurance Co. (HEMIC), is canceling insurance policies for seven medical marijuana dispensaries that prepared to open this summer. The insurance company notified the affected dispensaries Wednesday that their policies will be cancelled in 30 days and that premiums will be refunded. The company said that the board of directors were concerned about marijuana remaining on the list of illegal substances by the federal government. If the dispensaries cannot find companies to provide workers’ compensation insurance, it may delay their opening. HEMIC was quick to state: “We’re not providing an opinion of moral judgment on someone’s use of marijuana or not, and we’re certainly not taking a position opposed to the value of medicinal marijuana to treat certain medical conditions or chronic pain. This was really simply a legal decision.”
In Fort Lauderdale, Sheyla Veronica White, was caught on camera hitting herself on the head with a sprinkler that fell on her desk. She then filed a workers’ compensation claim for her “on-the job” injury. Her employer’s insurance company thought the footage looked suspicious, so they directed the incident to the Florida Division of Investigative and Forensic Services. Ms. White was convicted of workers’ compensation fraud, a third degree felony, and sentenced to 18 months of probation.
The New York Compensation Insurance Rating Board has decided to decrease the statewide workers’ compensation rate by 4.5 percent, which will save employers around $400 million in 2017. The Department of Financial Services must review and approve the decision; if they do, it will take effect October 1st. As part of the state budget, the workers’ compensation reforms include providing relief for first responders who are exposed to trauma and extreme stress in emergency situations, requiring injured workers who have not received benefits to receive a hearing within 45 days, and allowing seriously injured workers to apply for lifetime benefits when their benefit caps are set to expire.
When the New York State Senate passed its $153 billion budget in April, it included reforms to the state’s workers’ compensation system. The goal of the reforms is to make it more affordable to do business in New York by providing employers with rebates and annual savings in premium costs. The reforms also ensure severely injured workers have the right to be considered for lifetime benefits. Additionally, they provide relief for first responders exposed to traumatic events at work and create a formulary for prescription drugs. Furthermore, the budget creates a two-and-a-half-year period for temporary claim benefits. If the injured worker can prove a continued need for benefits, he or she can apply for an extension through the Workers’ Compensation Board. The budget also increases eligibility for extended permanent benefits for workers determined to be 75 percent injured; currently, these benefits are only for workers determined to be 80 percent injured. Lastly, the Workers’ Compensation Board must issue new medical impairment guidelines by the end of the year to reflect advances in modern medicine that increase better outcomes and healing for patients.
When the Americans with Disabilities Act was passed initially in 1990, the Act did not provide protections for employees whose cancer went into remission. The law changed in 2009 to allow a worker to file an ADA complaint if he or she experienced discrimination based on the long-term effects of previous cancer. The Journal of Oncology Practice recently published a study that examined the number of ADA allegations filed between 2001 and 2008, before the amendments went into effect, and between 2009 and 2011, after the amendments passed. The study found that employees were more likely to file claims for reasons like forced retirement or denied promotions or workplace retaliations like intimidation or harassment after the amendments passed. But in terms of claims for reasonable accommodation, termination, and hiring, the number of claims remained the same for both periods. Therefore, researchers concluded that employees with histories of cancer filed ADA allegations at the same pace before and after the 2009 amendments. The researchers suggest involving patients’ oncologists in the process since they can provide informed explanations of the employees’ capabilities and help both employees and employers agree on reasonable expectations for workplace performance.
David Howke recently pleaded guilty to criminal theft in Montana after he fraudulently collected two years’ worth of workers’ compensation benefits. Along with a five-year suspended sentence, Mr. Howke will have to pay $27,478 back to the state of Montana. Mr. Howke filed a claim in 2012 based on his assertion that a work-related injury prevented him from working his construction job. But the state received a tip in November 2014 that he was working again and bragging about playing thirty-six holes of golf every day. As Attorney General Tim Fox stated: “Workers’ compensation fraud is a drain on Montana businesses, and anytime we can mitigate this deceitful behavior, we’re reducing upward pressure on the costs shouldered by businesses in our state.”
In 2008, LeAndra Lewis was shot by a stray bullet fired in the strip club where she performed as an exotic dancer. Because of the incident, Ms. Lewis lost a kidney and suffered internal injuries. Ms. Lewis filed for workers’ compensation benefits, but the club at which she worked argued she was an independent contractor and not an employee entitled to benefits. Nevertheless, Supreme Court justices in South Carolina, where the incident took place, ruled that she was an employee because the club controlled which music she danced to, did not allow her to leave early without risking a fine, and required her to dance for certain customers. However, the Workers’ Compensation Committee set her benefit award at $75 each week without documenting how it arrived at that amount. Now, Ms. Lewis will receive a new hearing ordered by the South Carolina Supreme Court because the commission’s order “was devoid of any specific and detailed findings of fact to substantiate the award,” the court said.
Recently, Margaret M. Davis, a former postal service worker from Massillon, Ohio was sentenced to eighteen months in prison and ordered to pay approximately $50,000 for workers’ compensation fraud. In 2015, Ms. Davis falsely stated that she had not been imprisoned for the past fifteen months on forms to continue her disability benefits under the Federal Employees’ Compensation Act. At the time she was completing her forms, Ms. Davis was in prison in Ohio. She had previously been sentenced to thirty months in prison in 2014 after pleading guilty to a felony charge for failing to comply with an order or signal of a police officer.
In 2013, Shawn Gallen, a vending machine servicer, was exposed to droplets of water contaminated with Legionnaires’ bacteria, and the incident left him severely disabled. The Commonwealth Court panel in Pennsylvania upheld Mr. Gallen’s benefit award in late March, siding with the Workers Compensation Appeal Board that stated the exposure to Legionnaires’ bacteria left Mr. Gallen with brain damage, and the exposure was work-related. Upon exposure, Mr. Gallen was in a coma within days. He is currently confined to a wheelchair, requires constant care, and cannot speak properly. Although Nestle presented an industrial hygienist who said Legionnaires’ bacteria is unlikely to grow inside a vending machine, he did not actually test any vending machines to see if the bacteria were present. On the other hand, Mr. Gallen’s doctor testified that vending machines are good incubators for the bacteria, and Mr. Gallen’s exposure could only be work-related. Close to the time Mr. Gallen was infected, the Pennsylvania Department of Health had issued a warning that there was a spike in Legionnaires’ cases around the state.
At the Freedman firm, we see a number of clients whose lives have been changed by serious injuries that have impacted their abilities to work. When these injuries happen in the workplace, Workers Compensation doesn’t always just offer up a fair and equitable financial settlement. It may become necessary for the claimant to hire an attorney with knowledge and experience in order to get the compensation he or she deserves. In the past year, our attorney who focuses on Workers Compensation has obtained the following settlements for clients: A registered nurse who suffered a severe injury to her thoracic spine received $210,000 and continuing coverage for her medical care. The injury, although it caused serious symptoms, could not be improved with surgery. An account manager who had to retire early due to serious neck and back injuries received a settlement of $200,000, plus continuing medical care. The client had undergone extensive medical care and had tried to work for almost 10 years after the injury and before retiring. A corrections officer whose hand and shoulder were injured by a slamming door received $155,000 after the New York State Insurance Fund initially denied his claim. A teaching assistant who was injured… Continue Reading Workers Compensation settlements make a difference in the lives of those who have been injured