What’s Hot in Workers’ Comp - News and Results*
NEWS
Michele Punturi (Philadelphia, PA) is speaking at the 2020 CLM Annual Conference in Dallas, Texas in March. In “Changing the Employee Safety and Wellness Mindset to Reduce Workers’ Compensation Costs and Avoid Liability,” Michele will join other industry professionals to discuss how changing the claims management mindset surrounding employee safety and wellness can drive down workers’ compensation costs and avoid liability exposure. The CLM Annual Conference is the premier annual event for professionals in the claims and litigation management industries. For more information, visit https://www.theclm.org/Event/ShowEventDescription/11972.
On March 18, 2020, Kacey Wiedt (Harrisburg, PA) will be a featured speaker at the Spring Risk Management Workshop seminar hosted by the County Commissioners Association of Pennsylvania. Kacey will be joined by Dr. S. Ross Noble to present “Don’t Let Injured Workers ‘Lay You Up,’” a discussion about independent medical exams and how they can help with return to work for injured employees. For more information, visit https://www.eiseverywhere.com/ereg/index.php?eventid=519615&.
The Pennsylvania Insurance Fraud Prevention Authority, together with the Delaware Valley and Greater Pittsburgh Chapters of the International Association of Special Investigation Units, will jointly host the 2020 Pennsylvania Insurance Fraud Conference on April 2nd and 3rd. Anthony Natale III and Ashley Eldridge (Philadelphia, PA) will present the topic “Prosecuting Workers’ Compensation Fraud.” Participants will be introduced to the steps of identifying and prosecuting workers’ compensation fraud. The presentation will start with a video of a fraudulent injury and begin an interactive journey through the criminal and civil prosecution methods for workers’ compensation fraud. For more information, go to https://www.helpstopfraud.org/Fighting-Insurance-Fraud/Insurance-Fraud-Conference.
We are proud to sponsor the annual Florida Bar Workers’ Compensation Forum on April 16th and 17th presented by the Workers’ Compensation Section of The Florida Bar and the Association of Workers’ Compensation Claims Professionals. On April 16, Heather Carbone (Jacksonville, FL) will participate in the program “Average Weekly Wage and Indemnity Benefits (Other than PTD).” For more information, go to https://www.wccp.org/.
On May 20th, Michele Punturi (Philadelphia, PA) is speaking at the 2020 CLM Workers’ Compensation and Retail, Restaurant & Hospitality Conference in Chicago. In “Survivor — Workers’ Compensation Edition,” Michele joins an industry panel to discuss how employers can survive and thrive in the workers’ compensation claims management arena. For more information, visit https://www.theclm.org/Event/ShowEventDescription/12673.
RESULTS*
Gregory Bartley (Roseland, NJ) successfully handled a case inherited from staff counsel after the litigation and motion practice. Our client was under an order from the court to provide medical and temporary benefits to the petitioner, without prejudice. Staff counsel for the carrier was handling this matter at the time the order was entered. The case was then transferred to us, due to a conflict. Greg tried to settle the case under section 20 of the New Jersey Workers’ Compensation Act, finally making an offer in excess of $16 million in various benefits, annuities and a lump sum payment. This offer was rejected, and we proceeded to trial. At trial, we were able to show that there was an uninsured subcontractor hired by the general contractor who was the actual employer. Under New Jersey Law, the general contractor was deemed responsible for workers’ compensation benefits to this petitioner, and our client was dismissed.
Angela DeMary, Kiara Hartwell and Bob Fitzgerald (Mount Laurel, NJ) obtained a defense verdict for a prominent health care system. The petitioner filed a motion for additional medical and temporary disability benefits, essentially alleging she was permanently and totally disabled from prior compensable shoulder and leg injuries. After a three-day trial and extensive briefing, the judge dismissed the motion, determining that, despite the compensable injuries, the petitioner had plateaued medically and was not entitled to any further benefits.
Michele Punturi (Philadelphia, PA) successfully defended a claim petition on behalf of a renowned local hospital. The claimant, an ultrasound technician, alleged right hand tendonitis, ulnar neuropathy, and right thumb trigger finger due to the repetitive nature of her job duties and resultant cumulative trauma. Michele presented fact witnesses from the employer, who were able to demonstrate a discrepancy with the date of injury, lack of notice that any complaints were related to her job duties, text messages revealing activity and complaints occurring at places outside of work, all of which significantly challenged the claimant's credibility on any alleged date of injury, causation and notice. The defense also presented multiple dates of surveillance, which showed no observable difficulty in using the alleged injured body part. The judge ultimately found the claimant not credible with respect to sustaining any alleged work injury. The claim petition was denied and dismissed, and the defense was not liable for the significant litigation costs presented by the claimant. This case clearly demonstrates the significance of challenging the mechanism of injury with factual and medical evidence, securing any and all medical records, and establishing through surveillance activities contrary to any alleged disability and/or injury when in litigation before a judge.
Tony Natale (Philadelphia, PA) successfully defended a Philadelphia-based university in litigation surrounding the efficacy of the utilization review system in the Commonwealth of Pennsylvania. The case is one of first impression at the lower court level and may be destined to be the subject of appellate review action. The claimant treated with a well-known provider (pain specialist) and was prescribed narcotic medication, which was made the subject of a utilization review request and found to be unreasonable. The claimant appealed that determination. After very lengthy litigation, the judge found the medication unreasonable. As a result, the provider referred to claimant to his partner (another pain specialist), who prescribed the same narcotics. Since the utilization review provisions follow the provider, as opposed to the treatment, the employer was required to file a new utilization review request on the same narcotic treatment that the judge and the previous URO found unreasonable. This time the narcotics were found to be reasonable. Tony filed an appeal to this new determination (in the form of a petition to review), arguing that the new UR determination collaterally attacked the previous judge's decision pertaining to the narcotic medication at issue. The Philadelphia Judge Supervisor presided over the case and concluded as a matter of law that the new UR determination was an unlawful collateral attack on the previous judge's decision. All narcotic treatment was deemed unreasonable.
*Prior results do not guarantee a similar outcome
What's Hot in Workers' Comp is prepared by Marshall Dennehey Warner Coleman & Goggin to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We would be pleased to provide such legal assistance as you require on these and other subjects when called upon. ATTORNEY ADVERTISING pursuant to New York RPC 7.1 Copyright © 2020 Marshall Dennehey Warner Coleman & Goggin, all rights reserved. No part of this publication may be reprinted without the express written permission of our firm. For reprints or inquiries, or if you wish to be removed from this mailing list, contact tamontemuro@mdwcg.com.