NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.
Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.
Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.
Although not a
workers’ compensation case, 36-year-old Irish lass, Kamila Grabska, has had her
$820,000.00 injury claim dismissed after having a really good day with cameras
present.
It seems Ms. Grabska sued RSA Insurance for damages after the vehicle in which
she was a passenger was rear-ended while she was on her way to work. She
recently told a High Court sitting in Limerick** that the accident left her often
bedridden with constant debilitating cervical, thoracic, and lumbar pain. She
also claimed she was unable to perform household chores or even to play with
her young children.
She further swore in an affidavit that she was unable to work in any capacity
and had past and future lost wages totaling more than $500,000.
In an unfortunate twist of fate for Ms. Grabska, photos recently surfaced
showing her participating in and winning a local Christmas tree throwing
competition, apparently a very popular event in County Clare, Ireland.
Furthermore, the competition took place just two days after she had reported to
a doctor that she was unable even to lift a bag of groceries.
When asked in court why she did not inform her doctors of the Christmas tree
throwing competition, she said she “forgot.”
Some of the other riveting testimony:
Counsel for RSA:
“Did it hurt you to throw the
Christmas tree?”
Grabska: “I had a pain, yeah.”
Counsel: “You had a large smile on your face as
you threw the tree.”
Grabska: “I was smiling but that doesn’t mean I
didn’t have a pain.”
Counsel: “You were also smiling when you received
your prize.”
Grabska: “I can say I was trying to live a normal
life.”
Following review of a photo showing Ms. Grabska’s award winning Christmas tree
toss, described as a “very graphic picture,” as well as video footage of Ms.
Grabska play-wrestling with a “large and strong” Dalmatian for an hour and a
half, Judge Carmel Stewart stated:
“I am afraid I cannot but conclude the claims were entirely exaggerated. On
that basis, I propose to dismiss the claim.”
A spokesperson from RSA Insurance indicated they were “very pleased with the
outcome of the case and it sends out a clear message that we will robustly
challenge any attempt to pursue claims that are not genuine.”
**
Another Limerick:
There was a
young woman from Clare
Whose claim
of bad pain proved unfair
Her suit was
undone
By some
Christmas-time fun
When she
tossed a large tree through the air
Copyright 2024, Stone Loughlin & Swanson, LLP
We have recently learned that Benefit Review Officers Laila Johnson, assigned
to the Fort Worth Field Office, and Olivia Turner, in Tyler, are retiring. We
are sorry to see these knowledgeable and effective BROs leave the Division.
It is our understanding that Ms. Johnson will spend time living the country
life out west and we suspect Ms. Turner might be spending more time enjoying
the breeze on her Harley-Davidson.
We extend them our best wishes in whatever new adventures they choose to
pursue.
Copyright 2024, Stone Loughlin & Swanson, LLP
On February 14, 2024, the Commissioner signed a consent order concerning disciplinary action against Rhema Medical, a provider of durable medical equipment and hospital supplies. The Commissioner found that Rhema failed to timely comply with a refund request from an insurance carrier by either refunding the requested amount or submitting an appeal to the carrier within 45 days of receiving the refund request. Rhema further failed to timely comply with the Division’s order for production of documents. The Commissioner found that Rhema violated Tex. Lab. Code §§408.-271(b) and (c)415.003(5) and (6); and 28 Tex. Admin Code §133.260(c) by failing to comply with a refund request and Tex. Lab. Code §§415.0035(e); 415.003(5) and (6); 415.021(a); and 28 Tex. Admin Code §102.9 by failing to comply with a DWC order to produce documents. Rhema was assessed an administrative penalty of $5,500.00 to be paid within 30 days from the date of the order. Rhema Medical certainly appears to have lived up to its Better Business Bureau rating of F and customer reviews averaging 1.38 out of 5 stars.
On February 24, 2024,
the Commissioner signed a consent order concerning disciplinary action against
DJO LLC, a provider of medical devices and services. The Commissioner found
that DJO improperly billed an injured employee for health care services in violation
of Tex. Lab. Code §§413.042 and 415.003(6) and assessed an administrative
penalty of $500.00 to be paid within 30 days from the date of the order.
Copyright 2024, Stone Loughlin & Swanson, LLP
In an opinion filed
March 7, 2024, the 11th Court of Appeals (Eastland) reversed
the trial court’s summary judgment that Michael Belew developed pancreatic
cancer during his employment as a firefighter and emergency medical technician
with the City of Stephenville. Mr. Belew passed away in 2014.
Following a contested case hearing, the hearing officer relied upon Appeals
Panel Decision Nos. 150098-s and 151156 in determining that the statutory
presumption created by Section 607.055 (as it existed prior to its amendment
effective June 10, 2019) applied to the pancreatic cancer developed by Mr.
Belew, thereby relieving Appellees of the burden to prove causation, i.e. that
Mr. Belew’s cancer arose out of the course and scope of his employment as a
firefighter. The Appeals Panel adopted the hearing officer’s decision without
issuing a written decision.
The Eastland Court, however, determined that, in the decisions listed above,
the Appeals Panel “simply misapplied the effect of the statutory presumption.”
Section 607.055 that is applicable to this case provides:
(a) A firefighter or emergency medical technician who suffers from cancer resulting in death or total or partial disability is presumed to have developed the cancer during the course and scope of employment as a firefighter or emergency medical technician if:
(1) the firefighter or emergency medical technician:
(A) regularly responded on the scene to calls
involving fires or firefighting; or
(B) regularly responded to an event involving the
documented release of radiation or a known or suspected carcinogen while the
person was employed as a firefighter or emergency medical technician; and
(2) The cancer is known to be associated with fire fighting
or exposure to heat, smoke, radiation, or a known or suspected carcinogen, as
described by Subsection (b).
(b) This section applies only to a type of cancer that
may be caused by exposure to heat, smoke, radiation, or a known or suspected
carcinogen as described by the International Agency for Research on Cancer
(IARC).
The IARC conducts critical reviews and evaluations on the carcinogenicity of a
wide range of human exposures and publishes the results of its evaluations in
monographs. The 98th Monograph evaluated the occupational cancer
hazards of painting, firefighting, and shift work. The authors of the monograph
found limited evidence of the development of cancer as it relates to exposure
as a firefighter; however, after considering a variety of studies, as well as
large meta-analyses, the authors concluded that the only cancers statistically
significant for cancer risks in firefighters were testicular, prostatic, and
non-Hodgkin’s lymphoma. Pancreatic cancer is not a type of cancer that is
connected to or may be caused by firefighting.
The Court agreed with the City that Mr. Belew’s pancreatic cancer does not meet
the requirements of section 607.055 and therefore the presumption of causation
does not apply. The court reversed the trial court’s judgment that Mr. Belew
sustained a compensable injury and rendered judgment in favor of the City.
Copyright 2024, Stone Loughlin & Swanson, LLP
The Texas Department of Insurance, Division of Workers’ Compensation is
accepting public comments on a proposed rule amending TAC Chapter 147
concerning dispute resolution through agreements and settlements.
The rulemaking will amend 28 TAC §§ 147.4, 147,5, 1247.7, 147.10 and 147.11.
Sections 147.1, 147.2, 147.3, 147.6, 147.8, and 147.9 will be repealed and a
new § 147.1 added.
The amendments are calculated to streamline the agreements and settlements
process and eliminate unnecessary work for DWC staff.
The proposed new rule will be published in the April 5, 2024 issue of the Texas Register and available
at http://www.sos.state.tx.us/texreg/index.shtml.
A copy of the proposed rule is also posted on the Division website at http://www.tdi.texas.gov/wc/rules/2024rules.html.
Comments may be submitted to RuleComments@tdi.texas.gov.
The deadline to submit comments is May 6, 2024.
Copyright 2024, Stone Loughlin & Swanson, LLP
The Division is also accepting public comments on a proposed rule amending 28
TAC § 180.2 to ensure that no health care provider or agent can use the DWC’s
complaint process to bypass the medical fee dispute resolution filing deadline
in 28 TAC § 133.307(c).
The proposed rule was published in the March 22, 2024 issue of the Texas Register and is
available at http://www.sos.state.tx.us/texreg/index.shtml.
A copy of the proposed rule is also posted on the Division website at http://www.tdi.texas.gov/wc/rules/2024rules.html.
A public hearing on the proposed rules will be held at 11:00 a.m., Central
time, on April 16, 2024.
Written comments on the proposed rule may be submitted to RuleComments@tdi.texas.gov.
The deadline to submit comments is 5 p.m., Central time, on April 22, 2024.
Copyright 2024, Stone Loughlin & Swanson, LLP
| Carrier Attorney | Approved Fees | Hours Per Day |
| Dean Pappas | $923,472.50 | 12.65 |
| Jeremy Lunn | $640,487.00 | 8.77 |
| Mark Midkiff | $523,012.20 | 7.16 |
| Claimant Attorney | Approved Fees | Hours Per Day |
| Adam Henderson | $1,029,800.00 | 14.10 |
| Bill Abbott | $923,175.00 | 12.64 |
| Fyodor Clay | $817,950.00 | 11.20 |
Copyright 2024, Stone Loughlin & Swanson, LLP
