Podcast: Chevron Falls: Workers' Compensation Survives

This podcast reviews the workers' compensation landscape one year after the US Supreme Court's Loper Bright decision, which struck down the Chevron defense.

Chevron Falls: Workers' Compensation Survives

A year ago, we examined how the Supreme Court's landmark decision in Loper Bright Enterprises v. Raimondo might reshape the workers' compensation landscape, particularly regarding Medicare Set-Aside (MSA) agreements and the Centers for Medicare & Medicaid Services' (CMS) administration of the Medicare Secondary Payer (MSP) Act. Now, with twelve months of hindsight, we can assess what has actually transpired—and what remains uncertain.

Shutdown Threatens Workers' Compensation Settlements

As the September 30 deadline looms, workers' compensation professionals nationwide face an unprecedented crisis that could freeze thousands of settlements, leaving injured workers in a state of financial limbo.

WCMSAs: What You Need to Know

The Centers for Medicare & Medicaid Services (CMS) recently hosted an informative webinar on Workers' Compensation Medicare Set-Asides (WCMSAs), shedding light on these crucial financial agreements and their impact on workers' compensation claims. 

Medicare Set-Aside Shake Up Ahead?

Awaiting a decision from the U.S. Supreme Court, Federal Communications Commission v. Consumers' Research is poised to potentially redefine federal administrative agencies' authority scope. This shift could flow into various regulatory processes, including the Workers' Compensation Medicare Set Aside Agreements (WCMSAs) adjudication. 

NIOSH Gutted: Worker Safety at Risk?

The news sent shockwaves through the occupational safety and health community: the National Institute for Occupational Safety and Health (NIOSH) is facing near elimination due to significant restructuring within the Department of Health and Human Services (HHS). But what does this mean for the everyday worker and the future of workplace safety?

DOGE and Medicare Set Aside Agreements

This is the first in a series of posts concerning the potential impact of the US Department of Government Efficiency (DOGE) on the nation's patchwork of workers' compensation systems.

Podcast: Medicare Set-Aside Agreements after the Loper Bright Decision

My recent post about the US Supreme Court's decision in the Loper Bright case and its impact on Medicare Set-Aside Agreements has received considerable interest. To expand the discussion further among all workers' compensation community stakeholders, we have generated a free podcast on this topic.

Chevron's Fall: Medicare Set-Asides Face Legal Shake-Up

The recent U.S. Supreme Court decision in Loper Bright Enterprises v. Raimondo (2024), which overturned the Chevron doctrine established in Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., is likely to have significant impacts on how the Centers for Medicare & Medicaid Services (CMS) operates regarding the Medicare Secondary Payer (MSP) Act, including conditional payments and Medicare Set-Aside (MSA) agreements. 

Impacts of a Governmental Shutdown

The effects of a government shutdown on state workers' compensation systems and their integration with Social Security will vary depending on the specific circumstances of each state. However, some general trends can be expected.

Misclassification: 16 Workers Held to be Employees

 An employer need not control every facet of a person's responsibilities for that person to be deemed an employee.

“Forever Chemical” Delaware Settlement $50 Million

It has been reported that DuPont and two other spinoff companies will pay the state of Delaware $50 Million to clean up the residuals of polyfluoroalkyl substances [PFAS] pollution. 

Just Published: 2018 Update - Gelman on Workers' Compensation Law

Jon Gelman’s newly revised and updated 2018 treatise on Workers’ Compensation Law is now available from by West Group of Egan, MN within the next few weeks. The treatise is the most complete work available on NJ Workers’ Compensation law and integrated with WESTLAW™, the "most preferred online legal research service.'"

Judge Accepts Medicare’s Plan To Remedy Misunderstanding On Therapy Coverage

Today's post is shared from Kaiser Health News khn.org

"A federal judge has accepted Medicare’s plans to try once more to correct a commonly held misconception that beneficiaries’ are eligible for coverage for physical and occupational therapy and other skilled care only if their health is improving.

"'Confusion over the Improvement Standard persists,' wrote U.S. District Court Chief Judge Christina Reiss in Vermont in a decision released by the court Thursday. Advocates for seniors say coverage is often mistakenly denied simply because the beneficiary reaches “a plateau” and is no longer making progress.

Insurance Rating Company Increases Estimate for Net Ultimate U.S. Asbestos Losses to $100 Billion

A.M. Best has increased its estimate for losses that U.S. property/casualty insurers can ultimately expect from third-party liability asbestos claims by approximately 18% to $100 billion. The $15 billion increase to the net ultimate asbestos loss estimate comes as insurers are incurring approximately $2.1 billion in new losses each year while paying out nearly $2.5 billion on existing claims. The updated figures are contained in a new Best’s Special Report, titled “A.M. Best Increases Estimate for Net Ultimate Asbestos Losses to $100 Billion.” The report also states that A.M. Best is not making any change to its $42 billion estimate on net ultimate environmental losses; therefore, A.M. Best’s view of ultimate industry losses for asbestos and environmental (A&E) is now $142 billion.

CMS 2016 Recovery Thresholds for Workers’ Compensation Settlements, Judgments, Awards or Other Payments

2016 Recovery Thresholds for Certain Liability Insurance, No-Fault Insurance, and Workers’ Compensation Settlements, Judgments, Awards or Other Payments 

As required by section 1862(b) of the Social Security Act, the Centers for Medicare and Medicaid Services (CMS) has reviewed the costs related to collecting Medicare’s conditional payments and compared this to recovery amounts.

CMS Publishes Final Rule for MSP Conditional Payments Via Web Portal

This final rule, effective June 16, 2016,  specifies the process and timeline for expanding CMS' existing Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act).

Announcing the WorkersCompensation.com Best Blog Designees for 2016

WorkersCompensation.com, "the original and largest regulatory and compliance information center available for the workers' compensation industry," has announced the best blog designations for 2016:

"The blogs below were all nominated by citizens of the workers' compensation community. They were judged on several criteria. In addition to objective categories such as age of blog, frequency of posting and website traffic**, they were also assessed by an independent judging panel for content quality, value and timeliness. Designated blog category was determined by people nominating the blog. In the event of multiple nominations, the category selected by the majority of nominators was used.

Florida Appeallate Court Rules Attorney Fee Statute Unconstitutional

The Florida First District Court of Appeals has held counsel fee provisions in the Workers' Compensation Act to be unconstitutional, ,"We hold that the challenged provisions violate Claimant’s First Amendment guarantees of free speech, freedom of association, and right to petition for redress." Miles v City of Edgewater, Decided April 20, 2016, setting the stage for review by the Florida Supreme Court.

Today's guest post is authored by the Hon. David Langham, Deputy Chief Judge of Compensation Claims for the Florida Office of Judges of Compensation Claims and Division of Administrative Hearings and is shared from http://flojcc.blogspot.com. 

NJ Supreme Court to Review An Increase of Partial Disability Award in Total Disability Claim

One of the basic tenants of workers' compensation is that awards maybe reviewed and modified where the medical status has changed.1 The NJ Supreme Court on March 14, 2016 granted Certification to review a favorable Appellate Court ruling that permitted a totally and permanently disabled injured worker to receive an increase of a prior (2006 injury) partial disability award, even though the worker had been declared to be totally and permanently disability from a subsequent (2008 injury) injury.