WORKERS’ COMPENSATION INSIGHT
Workers’ Compensation News & Case Law
December 13, 2016
QUICK FACTS:

Don't forget, effective January 1, 2017 OSHA's final rule regarding electronic submission of logs goes into
effect.

Effective January 1, 2017, the California WCIRB's rule that all insured employers must report all claims
for which any medical treatment costs are incurred goes into effect.

New California employment laws will be going into effect January 1, 2017 in California ranging from
increases in minimum wage, to Cal-OSHA changes, to EEO-1 form reporting changes.

Specific to workers' compensation insurance, California Assembly Bill 2883 was passed and will be
effective January 1, 2017.

A Colorado postal worker was arrested for workers' compensation fraud in November when she
reported in to work.

The U.S. Supreme Court declined to review the Florida court case (Daniel Stahl v. Hialeah Hospital) that
challenged the constitutionality of Florida's workers' compensation system.

NFL players currently living with chronic traumatic encephalopathy (CTE) have sued the NFL and the NLF
teams in Florida to force the teams to pay the players workers' compensation benefits.

The Illinois Appellate Court, in Calumet School District #132. v. Illinois Workers' Compensation Comm'
found that a school teacher's injuries sustained in an after school student-teacher basketball game were
compensable under workers' compensation.

The New Mexico Supreme Court recently held that in a case where the estate of a worker killed in an on
the job vehicle accident sued the insurance company providing the employer's uninsured motorists
coverage, it was the employer not the estate that was entitled to any excess insurance benefits.

The New York governor vetoed a State Senate Bill that would permit a physical therapist assistant to
provide covered treatment under workers' compensation.

New Pennsylvania legislation signed in early November will make it easier for seasonal workers to be
eligible for unemployment compensation.

Twenty-one individuals associated with the Forest Park Medical Center chain of Texas hospitals have
been indicted for a four-year kick-back conspiracy that allegedly generated $40 million.
1
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OSHA
Don’t forget, effective January 1, 2017 OSHA’s final rule regarding electronic submission of logs goes
into effect. OSHA‘s FAQs can be found here:
https://www.osha.gov/recordkeeping/finalrule/finalrule_faq.html.
The news release can be found here: https://www.osha.gov/Publications/OSHA3862.pdf.
CALIFORNIA
Effective January 1, 2017, the WCIRB’s rule that all insured employers must report all claims for which
any medical treatment costs are incurred goes into effect. This includes all “first aid” claims in which
the treatment is paid for by the employer and not the insurance carrier. Now, if an employer still
chooses to pay for the first aid treatment, they must now report that treatment to their insurance
carrier or TPA. A WCIRB bulletin summarizes the changes and the new rule here:
http://www.wcirb.com/sites/default/files/bulletins/201625_reporting_small_medical_only_first_aid_claims.pdf. More information to follow.
New employment laws will be going into effect January 1, 2017 in California ranging from increases in
minimum wage, to Cal-OSHA changes, to EEO-1 form reporting changes. A good overview of these laws
can be found here: http://www.lexology.com/library/detail.aspx?g=c3cb11e7-bddc-4b61-8bcf60271632c2ae
Specific to workers’ compensation insurance, Assembly Bill 2883 was passed and will be effective
January 1, 2017. This bill requires that all current and new workers’ compensation insurance policies
must cover certain officers and directors of private corporations and working members of partnerships
and limited liability companies that may have previously been excluded. The full text of the Bill and
details on the provisions can be found here:
https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160AB2883
COLORADO
A Colorado postal worker was arrested for workers’ compensation fraud in November when she
reported in to work. For over a year she had been submitting documentation that she was too injured
to work but recently investigators caught her performing very physical activities at her home such as
wood cutting, shoveling and climbing ladders.
http://www.julesburgadvocate.com/julesburg-news/ci_30574795/julesburg-postal-worker-arrestedfraud-charges
2
tel: 650.295.4600
2000 alameda de las pulgas, suite 280, san mateo, ca 944403
edgewood partners insurance center
epicbrokers.com
ca license 0B29370
FLORIDA
The U.S. Supreme Court declined to review the Florida court case (Daniel Stahl v. Hialeah Hospital) that
challenged the constitutionality of Florida’s workers’ compensation system. The Florida Supreme Court
had previously refused to hear the case as well. This was essentially the last venue for the case and is
now effectively over. Challenges to parts of the workers’ compensation system might still be successful
however similar to the cases challenging the mandatory attorney fee schedule and temporary total
disability cap.
http://www.insurancejournal.com/news/southeast/2016/11/10/431983.htm
NFL players currently living with chronic traumatic encephalopathy (CTE) have sued the NFL and the NLF
teams in Florida to force the teams to pay the players workers’ compensation benefits. The suit also
alleges that the NFL violated OSHA guidelines by failing to warn the players of the possibility of CTE and
that the NFL has ignored proof that CTE is a legitimate brain injury/disease.
http://www.insurancejournal.com/news/national/2016/11/30/433521.htm
ILLINOIS
The Illinois Appellate Court, in Calumet School District #132. v. Illinois Workers’ Compensation Comm’
found that a school teacher’s injuries sustained in an after school student-teacher basketball game were
compensable under workers’ compensation. Illinois has an exception to their workers’ compensation
statute that allows an employer to deny compensability of injuries sustained in voluntary recreational
activities. The Court found however that this exception does not apply because even though the time
spent after school was not paid; the teacher felt that his employment would be jeopardized if he did not
participate. The school had made clear that teachers were expected to participate as the games were
meant to build rapport. So, the exception did not apply as the teacher’s participation was not voluntary.
http://illinoiscourts.gov/Opinions/WorkersComp/2016/1153034WC.pdf
NEW MEXICO
The New Mexico Supreme Court recently held that in a case where the estate of a worker killed in an on
the job vehicle accident sued the insurance company providing the employer’s uninsured motorists
coverage, it was the employer not the estate that was entitled to any excess insurance benefits. The
Court had to navigate between two conflicting New Mexico statutes: one that says that workers’
compensation benefits are provided in lieu of any other liability whatsoever and the other that says that
no cause of action outside of workers’ compensation can be brought against the employer. The former
statute would indicate that the estate was not entitled to any other benefits (including the uninsured
motorist benefits) and the latter would indicate that since the estate sued the uninsured motorist
insurance company, not the workers’ compensation insurer, the estate would be entitled to those
benefits.
http://law.justia.com/cases/new-mexico/supreme-court/2016/35-681.html
3
tel: 650.295.4600
2000 alameda de las pulgas, suite 280, san mateo, ca 944403
edgewood partners insurance center
epicbrokers.com
ca license 0B29370
NEW YORK
The New York governor vetoed a State Senate Bill that would permit a physical therapist assistant to
provide covered treatment under workers’ compensation. Currently, the law only allows a licensed
physical therapist to provide treatment to a workers’ compensation patient. The governor cited the fact
that the legislation would increase costs to employers and insurers.
https://www.nysenate.gov/legislation/bills/2015/S2718
PENNSYLVANIA
New legislation signed in early November will make it easier for seasonal workers to be eligible for
unemployment compensation. Previously, workers who earned more than 50.5% of their income in a
single quarter were not eligible for unemployment benefits. Now, that cap is increased to 63%. The
legislation also increased fraud penalties for people who make false statements to obtain benefits.
http://www.post-gazette.com/news/politics-state/2016/11/03/Restrictions-on-unemploymentcompensation-loosened-for-Pennsylvanias-seasonal-workers/stories/201611030216
TEXAS
Twenty-one individuals associated with the Forest Park Medical Center chain of Texas hospitals have
been indicted for a four-year kick-back conspiracy that allegedly generated $40 million. The conspiracy
involved individuals ranging from surgeons to advertising executives who were all involved with
accepting monetary bribes for referring patients, laundering money, and committing general insurance
fraud. If convicted, the individuals will face decades in prison and millions in fines.
http://healthcare.dmagazine.com/2016/12/01/doj-indicts-21-alleges-forest-park-officials-paid-40million-in-kickbacks-for-patient-referrals/
Allison Amenta, Workers’ Compensation Claims / Legal Consultant, EPIC
For further information on this or any other topics, please contact your EPIC Workers’ Compensation consulting
team.
This Workers’ Compensation Insight is offered for general informational purposes only. It does not provide,
and is not intended to provide, tax or legal advice.
4
tel: 650.295.4600
2000 alameda de las pulgas, suite 280, san mateo, ca 944403
edgewood partners insurance center
epicbrokers.com
ca license 0B29370