State News : Alabama

NWCDN is a network of law firms dedicated to protecting employers in workers’ compensation claims.


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.


Alabama

FISH NELSON & HOLDEN, LLC

  205-822-6611

Common law marriage will be abolished in the state of Alabama effective January 1, 2017. Act 2016-306, provides that the only common law marriages that Alabama law will continue to recognize are those entered into prior to January 1, 2017. This will have an obvious effect on the eligibility of surviving spouse death benefits in worker’s compensation cases.

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This blog submission was prepared by Karen Cleveland, an attorney with Fish Nelson & Holden, LLC, a law firm dedicated to representing self-insured employers, insurance carriers, and third party administrators in all matters related to workers’ compensation. Fish Nelson & Holden is a member of the National Workers’ Compensation Defense Network. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Cleveland by e-mailing her at kcleveland@fishnelson.com or by calling her directly at 205-332-1599.

 

On July 22, 2016, the Alabama Court of Civil Appeals released its opinion in City of Birmingham v. Thomas, in which it addressed whether the City of Birmingham improperly reduced Thomas’ employer-provided disability benefits due to his prior workers’ compensation settlement. Thomas had filed a workers’ compensation claim while working for the City, and the parties reached a settlement in October 2013. The terms of the settlement provided that the city would pay Thomas $225,000 in exchange for a release of all claims against the City, except future medical benefits arising under The Alabama Workers’ Compensation Act. The settlement was court approved on December 12, 2013. Then on December 20, 2013, Thomas applied for "Extraordinary Disability Benefits" through the City’s Retirement and Relief Pension Board. In his application, Thomas acknowledged "I am aware that if I am granted an Extraordinary Disability Pension (job related disability), there will be a set-off with any workers’ compensation benefits that I receive". Thomas also signed a document labeled "Notice to Applicants Applying for Extraordinary Disability Pension", which provided that any Extraordinary Disability Benefits awarded by the Board would be offset, dollar for dollar, by the amount of any workers’ compensation benefit, as provided in the City of Birmingham Retirement and Relief System Pension law. The notice also informed Thomas that the City of Birmingham Retirement and Relief System was a separate entity from the City of Birmingham.

In September 2015, Thomas filed a Motion to Enforce Settlement Agreement, in which he asserted that the city had unilaterally decided to reduce his pension benefits, contrary to the workers’ compensation settlement agreement. His argument was essentially that the city improperly set off his Extraordinary Disability Benefits by the amount of his workers’ compensation settlement. The City responded to that motion, asserting that it had made all payments agreed upon in the workers’ compensation settlement; that the Board was a separate entity from the City; and that the Board had informed Thomas that his Extraordinary Disability Benefits would be offset by the workers’ compensation payments. The trial court entered an order finding that since there was no mention of the sett-off in the workers’ compensation settlement agreement and/or order, the City had waived, or was estopped from asserting, any right to a set-off. The order further directed the City to pay all Extraordinary Disability Benefits that had accrued, and to make monthly payments thereafter. The City obtained a stay of the trial court’s judgment and appealed. The Court of Appeals held that the city was not estopped from asserting its right to a set-off. It also held that since the city was separate entity from the board, the city could not have waived any right the board might have to a set-off. Finally, the Court rejected the argument that the board was merely an instrumentality of the city, and that the trial court therefore did not have jurisdiction over the Board in the workers’ compensation case. The Court of Appeals remanded the case back to the trial court with instructions that it deny Thomas’ Motion to Enforce.

My Two Cents:

The outcome of this case could have been much different if it were not for the fact that the City and the Board were two separate and distinct entities. In situations where an employer offers other disability benefits through a plan outside of the Workers’ Compensation Act, it is wise to address what, if any, effects any workers’ compensation settlement may have on eligibility for such benefits.

About the Author

This article was written by Charley M. Drummond, Esq. of Fish Nelson & Holden, LLC. Fish Nelson & Holden is a law firm located in Birmingham, Alabama dedicated to representing employers, self-insured employers, and insurance carriers in workers’ compensation cases and related liability matters. Drummond and his firm are members of The National Workers’ Compensation Defense Network (NWCDN). The NWCDN is a national and Canadian network of reputable law firms organized to provide employers and insurers access to the highest quality representation in workers’ compensation and related employer liability fields. If you have questions about this article or Alabama workers’ compensation issues in general, please feel free to contact the author at cdrummond@fishnelson.com or (205) 332-3414.

 

On July 22, 2016, the Alabama Court of Civil Appeals released its opinion in Smith v Brett/Robinson Construction Company, Inc. and again found that evidence which only establishes a mere possibility that the injuries are related to the work accident is not sufficient to prove medical causation.

In May of 2013 the employee tripped and fell on the job causing her to suffer an injury to her left knee. The employer sent her to Dr. Greg Terral who ordered an MRI and stated the employee possibly suffered from an meniscus tear. Surgery was ultimately scheduled and took place 6 months after the accident. The pre-operative diagnosis was osteoarthritis and suspected meniscal pathology. The post-operative diagnosis was grade 3 chondromalacia of the medial and patellofemoral compartment with unstable chondral tissue. Dr. Terral went on to note in the operative report that the plaintiff had intact meniscal tissue. After surgery the employee stated the pain was worse and ultimately selected Dr. Joseph McGowin from a panel of 4. Dr. McGowin opined that the employee’s symptoms were from arthritis which was pre-existing and that the employee had no evident tears in her knee. In November of 2013, Dr. McGowin stated that he did not think the accident caused the employee’s arthritis. He went on to state that the current symptoms may have been the result of the injury and an aggravation of the arthritis. The employee returned in January of 2014 when Dr. McGowin placed her at MMI with a 5% impairment rating to the left leg. The employee returned in November of 2014 and reported that she felt there was some shifting. Dr. McGowin stated again that he felt that her problems were arthritic in nature. However, an MRI was performed and the doctor noted that the MRI revealed a little intrasubstance degeneration of the medial meniscus, chondrol changes and a little edema of the cruciate ligaments. The employee returned in February of 2015 and the doctor noted that the employee said that she had turned and felt her knee pop about a week prior and had felt pain since. Dr. McGowin opined that she suffered a flare up of her arthritis (of note, at trial the plaintiff denied saying that she had a new accident). In March of 2015, another MRI was performed at which time the MRI referenced a meniscal tear. However, Dr. McGowin read the MRI and again stated that she suffered from intrasubstance degeneration of the medial meniscus and that he did not think there was tear. He also noted that she was suffering from IT band tendonitis. Dr. McGowin then stated that he did not believe she would benefit from surgery. The employee returned to Dr. McGowin in April 2015. Dr. McGowin indicated that there was an option of considering an arthritic arthroscopic exam to assure that there was no tear but there was only a limited likelihood that this would result in some symptom improvement. He recommended that she be evaluated by Dr. James Cockrell for an evaluation and consideration of surgery. During this period Dr. McGowin responded to a letter from the workers’ compensation carrier and stated that it was possible that the meniscal tear was, if there, a new injury given the change in the MRI. He then stated he thought that if there was a mensical tear, it would be unrelated to the original injury. The plaintiff was treated by Dr. Cockrell in November of 2015 and reported that she wanted surgery. The doctor stated that he only thought there was a possible tear and this could all be related to arthritis and the surgery would not be beneficial. As a result, the workers’ compensation carrier refused to pay for the surgery.

At the Trial Court level in Baldwin County, AL, testimony was presented by the plaintiff and her co-workers establishing that prior to the fall she was working full duty without knee problems and that after the accident, she had been unable to do the same. Upon hearing testimony and reviewing medical evidence, the Trial Court found that the employer was not responsible for the surgery. The Trial Court based its opinion on Dr. Terral performing surgery to repair the left knee, which noted no meniscus tear and then Dr. McGowin stating there was no meniscus tear and the employee’s problems were arthritic in nature and not work related. It further noted Dr. Cockrell’s opinion that there was a possibility of a tear but her problems could all be arthritic in nature and the Trial Court stated that Dr. Cockrell gave no opinion on medical causation in making this statement. The Trial Court’s ultimate findings were that the left knee pain, pursuant the medical evidence, was arthritic in nature, not accident related, and that there was no medical evidence supporting that she needed surgery. Therefore, they felt that the surgery was not reasonable and necessary as a result of the original injury.

On appeal the employee argued that her current problems are due to work related meniscus tear and/or the arthritis and that arthritis was caused or accelerated by the on the job accident. The employee support this by the fact that prior to the accident she did not have knee problems and that she had pain ever since. The employee cited Equity Group-Ala. Div. v Harris, 55 So. 3d 299, 311 (Ala. Civ. App. 2010). The Appellate Court pointed out that the employee’s position was correct that the Trail Court can infer medical causation based on someone’s ability to work prior to an accident and then their inability to work after the accident. However, the Court of Appeals state that this did not mean the Trial Court was required to ignore medical evidence indicating that the alleged symptoms were not work related. In the current case, the Alabama Court of Civil Appeals stated that the medical evidence only suggested a possibility of a torn meniscus, therefore, the Trial Court was within its discretion to conclude that there was not substantial evidence to support that the on the job accident resulted in a torn meniscus.

As it relates to the plaintiff’s assertion that the current problems are arthritic in nature and that the on the job accident caused or accelerated her arthritic condition, the Alabama Court of Civil Appeals stated that while it is true that no pre-existing condition is deemed to have existed for the purpose of awarding of workers’ compensation benefits if the employee could work before the accident and then is unable to work afterwards. However, again the Alabama Court of Civil Appeals stated that did not mean that the employee was not required to prove that the work accident actually caused the arthritis to manifest or to become aggravated. The Court of Civil Appeals pointed out that the employee relied on the fact that she was in no pain before and that there was one note from Dr. McGowin that the symptoms may have been the result of the injury and aggravation of the arthritis. The Court of Civil Appeals again stated that the mere possibility was not enough to establish medical causation, especially, when other evidence stated that the current problems were not work related.

ABOUT THE AUTHOR

This article was written by Joshua G. Holden, Esq., a member of Fish, Nelson & Holden, LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in worker’s compensation and related liability matters. Mr. Holden is AV rated by Martindale-Hubbell, which is the highest rating an attorney can receive. Holden and his firm are members of the National Worker’s Compensation Defense Network (NWCDN). The NWCDN is a national network of reputable law firms organized to provide employers and insurers access to the highest quality of representation in workers’ compensation and related employer liability fields. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Mr. Holden by emailing him at jholden@fishnelson.com or calling him directly at 205-332-1428.

 

Beginning July 1, 2016, the maximum worker’s compensation payable was raised to $832 per week and the minimum was raised to $229 per week. This change was based on the Commissioner of Labor’s determination that the State’s average weekly wage was $831.88 in the calendar year 2015, and the change is effective for any injury occurring on or after July 1, 2016.

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About the Author

This blog submission was prepared by Mike Fish, an attorney with Fish Nelson & Holden, LLC, a law firm dedicated to representing self-insured employers, insurance carriers, and third party administrators in all matters related to workers’ compensation. Fish Nelson & Holden is a member of the National Workers’ Compensation Defense Network. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Fish by e-mailing him at mfish@fishnelson.com or by calling him directly at 205-332-1448.

 

 

Hospice Family Care v. Joseph Allen, dependant spouse of Suzanne Sharp Allen, deceased
Released June 10, 2016

This case was on appeal from the Madison County, Alabama Circuit Court who ruled the employee’s dependant spouse was owed burial and death benefits in accordance with the Alabama Workers’ Compensation Act. The issues brought up on appeal by the employer were 1) Was the claim barred by the coming and going rule, 2) Was the claim barred due to the employee deviating from her employment, 3) Was the employer entitled to set-off for certain insurance benefits provided by the employer and 5) Was the trial court correct in awarding $6,500.00 in burial expenses.

The employee was a nurse on the day shift from 8:00 a.m. to 4:30 p.m. Her responsibilities included driving to patient’s homes, recording a voice message for the benefit of the night nurse who would take over for the patient, and then entering billing codes and charting on each patient within 24 hours of the visit. The billing codes, voice message and charting could be done anywhere, and employees were encouraged not to come back to the office to chart, with a laptop provided by the employer. As a part of the employment the employee received life and accidental death & dismemberment insurance paid for by the employer. The employee was also reimbursed milage for travel but not the mileage from the last patient’s home to the employee’s home. The employer required that all day shift nurses be available, should a patient call, until 4:30, unless they submitted a leave of absence form.

On February 3, 2014, the employee in this case had called her spouse and informed him she was leaving her last patient’s home and on her way to their home. The employee informed her spouse that she was stopping at the pharmacy to pick up a personal prescription and then would be home. After stopping at the pharmacy the employee was on her way home and involved in a motor vehicle accident that resulted in her death. The accident occurred before 4:30 p.m. At the time of the accident she had not recorded the voice message for the night nurse nor had she completed her billing entries, voice message or charting.

Testimony by the employee’s spouse at trial established that it was common for the employee to come home and work several more hours, which included phone calls to patients, a phone call to the employer and charting. The employer acknowledged that this was actually encouraged that they do this from home or some other location other than the office. The employer also acknowledged that if a nurse, a salaried employee, got home before the end of their shift they were still paid the same. The employer further acknowledged that employees were allowed to complete personal errands during their shift, such as picking up a prescription without requesting permission or leave, they just had to be available to meet a patient’s needs until the end of their shift.

The Alabama Court of Civil Appeals ruled that the while the coming and going rule may be applicable, the subject case fell within an exception to the rule, “when and employee, during his travel to and from work, is engaged in some duty for his employer that is in furtherance of the employer’s business.” See Tucker v/ Die-Matic Tool, Co., 652 So. 2d 263, 265 (Ala. Civ. App. 1994). The Court of Appeals ruled that at the time of the accident the employee was still acting in furtherance of the employers business affairs and the deviation to pick of the prescription was not substantial and had ended at the time of the accident, therefore, the accident arose out of and occurred in the course of her employment. The factors they pointed to are as follows: 1) The employee was required to be available until 4:40 p.m. and the accident happened before that; 2) The employer furnished the employee with a cell phone and laptop; 3) The employer encourage the employee to do charting from her home or another location and actual discourage returning to the office to do it; and 4) The employee had not requested to leave before 4:30 p.m. as required if she wanted to do so. Therefore, they found the employee’s journey home was in furtherance of the employer’s business and she was still fulfilling her duties.

In addressing the set-off issue the Alabama Court of Civil Appeals pointed out that the employer was arguing that workers’ compensation was not designed for double recovery and for the employee’s dependants to receive the employer provided death benefits, as well as workers’ compensation death benefits, would amount to double recovery. The Court said that was true as to third party liability cases. The employer’s argument on this issue focused on §25-5-57(c)(1), which says if the employer paid for the benefits or plan, the employer may reduce the amount of benefits paid under worker’s compensation pursuant to the amount of benefits paid under the disability, retirement or another plan providing for sick pay, and/or §25-5-57(c)(3), which says if an employer continues salary or similar benefit of an injured employee during the benefits period, the employer can set of both of which reference an employer being entitled to a set off in weeks against the compensation owed. As for §25-5-57(c)(1), the Court of Appeals stated it did not apply because the life insurance and accidental death benefits were not a disability plan, retirement plan or another plan providing for sick pay. As for §25-5-57(c)(3), the Court of Appeals stated the plain language of the statute applied to an “injured employee” during weeks salary or similar benefits were continued while the employee could not work, not a deceased employee.

As to the issue concerning the amount of burial expenses, the employee conceded the trial court was in error awarding $6,500.00 so the Court of Appeals did not address it and instructed the trial court to award the appropriate amount under the Act.

MY TWO CENTS

As far as the burial expenses, I would suspect that the amount was reduced to $3,000.00 because that was the applicable amount at the time of the accident, even though $6,500.00 was the applicable amount at the time of the trial.


ABOUT THE AUTHOR

This article was written by Joshua G. Holden, Esq. A member of Fish, Nelson & Holden, LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in worker’s compensation and related liability matters. Mr. Holden is AV rated by Martindale-Hubbell, which is the highest rating an attorney can receive. Holden and his firm are members oft he National Worker’s Compensation Defense Network (NWCDN). The NWCDN is a national network of reputable law firms organized to provide employers and insurers access to the highest quality of representation in workers’ compensation and related employer liability fields. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Holden by emailing him at jholden@fishnelson.com or calling him directly at 205-332-1428.

 

On December 29, 2014 we reported on an opinion handed down by the Alabama Court of Civil Appeals inFlexicrew Staffing, Inc. v Champion. In that case, the Court of Civil Appeals agreed that the employee’s injury was compensable and the case went back to the trial court level for disability determination. Following the case being sent back to trial court, the employee amended his Complaint and named his supervisor as a defendant. After the appellate decision, Flexicrew ultimately settled the worker’s compensation case with the employee and the case went to trial on the claims against the employee’s supervisor.

The employee’s action against his supervisor was brought under §25-5-11(c)(2) based a willful failure to maintain, repair and/or replace the safety handle on the grinder. The employee further alleged that the supervisor was negligent and wanton in his actions when instructing the employee to drive himself to the clinic 30 miles away, which was in violation of the policies and procedures put in place by Flexicrew, the employer, which required that injured employees be transported and/or accompanied to a medical clinic or facility whenever possible. The employee did not specifically state which section of the act the negligence and wantonness claims fell under but willful and intentional violation of specific written safety rules of an employer would fall under §25-5-11(c)(4). The cause of action against the supervisor would fall under §25-5-11(b) which allows an employee to file suit outside of the worker’s compensation act against an officer, director, agent or employee of an employer when the officer, director, agent or employee commits willful conduct that results in the employee’s injury or death.

During the trial against his supervisor, the employee asserted that his supervisor had instructed him to drive himself to a distant medical facility in spite of his injured leg. He also made a claim that the side handle of the grinder that he was using when he cut his leg was missing causing it to be unstable and unsafe. The supervisor defended and argued that the employee’s cut was superficial and it was the supervisor’s position that the employee had simply run a red light. The supervisor further disputed whether or not the missing side handle of the grinder was significant in causing the employee’s leg injury. After a four day trial in Baldwin County, the jury returned a defense verdict in favor of the supervisor and the employee’s motion for a new trial was ultimately denied.

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About the Author

The article was written by Joshua G. Holden, Esq. a Member of Fish, Nelson & Holden, LLC, a law firm dedicated to representing employers, self-insured employers and insurance carriers in workers’ compensation and related liability matters. Mr. Holden is AV rated by Martindale-Hubbell, which is the highest rating an attorney can receive. Holden and his firm are members of The National Workers’ Compensation Defense Network (NWCDN). The NWCDN is a national and Canadian network of reputable law firms organized to provide employers and insurers access to the highest quality representation in workers’ compensation and related employer liability fields.

 We are pleased to announce that our Blawg was named a Best Blog for 2016!  A complete list of the winners and the criteria used in the selection process can be found at http://www.workerscompensation.com/workers_comp_best_blogs.php.  We wish to thank the judges for their time and consideration as well as our readers who took time out of their day to submit nominations on our behalf. 

 

On April 29, 2016, the Alabama Court of Civil Appeals released its opinion in Leesburg Yarn Mills, Inc v. Thomas Hood.  In Hood, the trial judge found the claimed stenosing tenosynovitis (also known as “trigger finger”) to be compensable.  The employer had denied the claim presumably based on the opinion of the authorized treating physician.  The employee then proceeded to treat with his own physician, Dr. Glenn Wilson, and subsequently filed a Complaint for workers’ compensation benefits.  In finding in favor of the employee, the trial judge retained jurisdiction to later determine the extent of disability.  The employer appealed the decision. 

 

On appeal, the employer asserted that the employee failed to meet his burden of proving both legal and medical causation by clear and convincing evidence.  The employer argued that, in order for the employee to prove legal causation, it was necessary for him to establish that the repetitive nature of his job exposed him to his injury materially in excess of the risk to which people are exposed to in their everyday lives. 

 

In affirming the trial judge’s decision, the Court of Civil Appeals noted that the employee had worked for the employer for twenty-three years.  According to the employee, he was regularly exposed to repetitive pinching and grasping motions with his hands, multiple times per day.  He also testified that he regularly moved 306 lb cans, three or four times per day, on wheels that were in poor condition.

 

The Court also addressed medical causation.  At his deposition, Dr. Wilson testified that the employee’s exposure to job related overuse could be the cause of the trigger finger.  Although the employer offered the testimony of Dr. Howard Miller, who stated that the employee’s condition was age related, he was not able to rule out the possibility that the job activities were a contributing cause. 

 

Despite Dr. Wilson’s less than certain opinion as to medical causation, the Court of Civil Appeals affirmed the judgment because, considering the medical opinion along with the employee’s opinion and other evidence, the trial judge could reasonably have been clearly convinced that the employee met his burden of proof.

 

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About the Author

This blog submission was prepared by Mike Fish, an attorney with Fish Nelson & Holden, LLC, a law firm dedicated to representing self-insured employers, insurance carriers, and third party administrators in all matters related to workers’ compensation. Fish Nelson & Holden is a member of the National Workers’ Compensation Defense Network. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Fish by e-mailing him at mfish@fishnelson.com or by calling him directly at 205-332-1448.

 

 

 

The Medicaid Secondary Payer Act will take effect on October 1, 2016. The new law substantially expands state Medicaid recovery rights, and these changes will affect settlements of workers’ compensation and liability claims involving Medicaid beneficiaries.

 

The Medicaid Secondary Payer Act represents the federal government’s response to the problems facing state Medicaid programs in their recovery efforts. The Affordable Care Act expanded the scope of persons eligible for Medicaid coverage, and at the same time, a state’s recovery efforts remained inhibited by court decisions and anti-lien provisions. In other words, the number of persons covered became disproportionate to the amount of money being recovered. The Medicaid Secondary Payer Act would seemingly strike a balance.

 

Under current law, a state’s Medicaid reimbursement rights are limited to portions of a settlement designated as medical expenses. In contrast, the Medicaid Secondary Payer provision allows states to recover from the entire settlement amount. More specifically, this provision eliminates the statutory language the Supreme Court relied on in Arkansas Department of Human Services v. Ahlborn, which limited Medicaid reimbursement rights to portions of the settlement or judgment related to “health care items or services.” The new language allows recovery against “any payments.” As a result, Medicaid will be able to claim 100 percent of its lien from settlements with its beneficiaries.

 

Whether you are attempting to settle a workers compensation claim or simply protecting your subrogation lien in a third party settlement, it will soon be more important than ever to determine the existence and extent of any Medicaid liens.

 

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About the Authors

This blog submission was prepared by Mike Fish and Ashleigh Hunnicutt.  Both are attorneys with Fish, Nelson & Holden, LLC, a law firm dedicated to representing self-insured employers, insurance carriers, and third party administrators in all matters related to workers’ compensation. Fish Nelson & Holden is a member of the National Workers’ Compensation Defense Network. If you have any questions about this submission or Alabama workers’ compensation in general, please contact Fish or Hunnicutt by e-mailing then at mfish@fishnelson.com  or ahunnicutt@fishnelson.com or by calling them at 205-332-1448.

 

 

 

The following blog article is published with the permission of guest blogger, Brian Francis.

 

Dateline: NEW ORLEANS- A few blocks from the commotion of New Orleans’ Bourbon Street, just outside the French Quarter, a group of one hundred and fifty worker’s compensation professionals recently met at the Roosevelt Hotel to discuss trends and issues affecting the worker’s compensation system.

 

In contrast to the noise and distractions of the French Quarter, the tempo in the conference room was focused deliberation. The conversations were important because in the end they affect the delivery of health care to injured employees throughout the United States. Conversely, from a business perspective, the exchanges have an impact on the financial health of employers, insurers and self-insurers.

 

The American Bar Association’s (ABA) mid-winter worker’s compensation meeting is the high water mark for issues concerning claims and litigation. The event, which is sponsored by the ABA’s Labor & Employment Law Section (LEL), and the Tort & Insurance Practice Section (TIPS), is a two-day thought-provoking conference. The program brings together a multi-jurisdictional cross section of plaintiff and defense bar members, judges and magistrates, insurance regulators, workers’ compensation insurance executives, self-insurers, reinsurers and physicians and medical professionals.

                        

The majority of seasoned insurance executives in attendance were able to recall when “workman’s” compensation (comp) was a fairly predictable and profitable line of insurance coverage. Comp possessed ideally insurable attributes such as foreseeable loss expectancy and a few core statutory issues affecting compensability. Together, these made “work comp” a stable, and at times, profitable line of insurance coverage.

 

Today, there is no shortage of critical issues creating volatility and obscured predictability. The once profitable line of coverage faces a myriad of complex issues such as: evidenced-based medicine, attacks on the exclusive remedy doctrine,  an aging workforce, medical fee schedules, home-based employment, professional employment organizations, natural disasters, terrorism and the aggregation of losses, undocumented workers, nanotechnology, ADA and FMLA regulations, Medicare Set-Asides, obesity and co-morbidity issues, social media, RICO violations, the Federalization of Workers’ Compensation, Opt-in and Opt-Out ERISA plans and claims of bad faith conduct; so much for predictability and profitability.

 

While two days of meetings are insufficient to address all of these issues, the panel-format presentations were well-composed, articulate and balanced. Panels discussed topics such as: the loss mitigation of high value claims, the management of psychological injuries, compound drug use, effective claim management, social media and claimant credibility. Presentations were composed of the views of a cross-section of defense/insurer, plaintiff/employee and union/employer perspectives.

 

For those followers of the FN&H Alabama Workers’ Comp Blawg, both Counsel Mike Fish and Joshua Holden contributed to the ABA meeting. Josh Holden’s presentation addressed issues pertaining to Social Media uses and their associated pitfalls, while Mike Fish was a participant in a lightning round presentation of 60 Legal Tips in 60 minutes.

 

The ABA does not restrict its membership to attorneys. Associate memberships are available to any and all non-attorney specialist in the area of Workers’ Compensation. Membership should be attractive to those insurance professionals charged with the profitability of a workers’ compensation program. Whether your corporate role is chief underwriter, home office or regional claims manager, or self-insured program manager, I’m confident that either of the ABA committees (LEL or TIPS) would welcome your expertise and participation. To learn more about membership or associate membership visit: www.americanbar.org and click on the “join or renew tab. For question about the ABA contact Mike Fish or Joshua Holden at 205 332 3430.

 

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Guest blogger, Brian Francis, is a Principal and Manager in a Michigan based third party administrator.