Commissioner proposes new practice changes October 20, 2008 in Office of Workers' Claims, law | Tags: AMA Guides, brc, Department of Workers' Claims, DWC, dwight lovan, e-filing, impairment ratings, Kentucky, medical fee disputes, sixth edition | by rolandniemi | No comments Hon. Dwight T. Lovan Based upon the presentation of Workers’ Compensation Commissioner Dwight T. Lovan at the 17th Biennial Workers Compensation Institute that was held in Lexington, KY on October 16th & 17th, 2008, the following proposals are being considered as potential Practice Regulation Changes: SIXTH EDITION OF THE AMA GUIDES The approval of the 6th Edition of the AMA Guides is still very much in the air. While some improvements are recognized, such as bringing impairments for cervical and lumbar fusions more in line with their actual disabling realities, the 6th Edition of the AMA Guides is still being evaluated from a practicality standpoint. Analysis & Practice Impact: The complexity of rating impairments under the 6th Edition raises concerns about who will be qualified and willing to prepare a basic impairment rating. For example, many treating physicians may be unwilling to invest the time and effort needed to become familiar with the 6th Edition of the AMA Guides. This could create a situation where IME physicians take an even more important role in the litigation process, which is something that the Commissioner clearly wants to avoid. You may not want to invest a lot of time memorizing the 6th Edition of the AMA Guides until a definitive effective date is adopted by the Commissioner. For now, it looks as if Kentucky will continue to operate under the 5th Edition into the foreseeable future. E-FILING By 2009 the Office of Workers’ Claims hopes to truth about enzyte provide on-line access to all cases through the attorney of record’s Bar Identification Number (which would be required on all initial pleadings). Form 101’s, Form 111’s, Motions for Extension, & other basic pleadings will be able to be filed on-line. Analysis & Practice Impact: This obviously will simplify the practice of law. Law firms and insurance companies with the technological ability to take advantage of these filing and file access options will be able to eliminate administrative costs and make more efficient use of their human resources. MEDICAL FEE DISPUTES Medical Fee Disputes may be transferred outside of the normal adjudication process, with a “handful” of ALJ’s taking turns on 6 month appointments where they do nothing but handle Medical Fee Dispute dockets. Analysis & Practice Impact: The Commissioner obviously wants to do something to eliminate the additional litigation that is being generated by Medical Fee Disputes. However, until substantive changes are made to how medical benefits are awarded to injured workers’, the need for insurance companies to review and challenge ongoing medical treatment will continue. This proposed change is purely procedural in nature, and should not affect our ability to effectively challenge and eliminate proposed medical treatment that is neither “medically reasonable nor necessary for the cure and/or relief” of a work related injury. BENEFIT REVIEW CONFERENCES Formal BRC’s may be done away with in favor of a Status Conference within 45 days of the Form 101 being filed. At the Status Conference parties would be required to submit a formal proof strategy listing witnesses and issues being contested. An expanded 60/60/15 proof schedule would be the standard, and the formal ALJ assignment to a particular claim would not occur until AFTER the Status Conference where witnesses were submitted. Analysis & Practice Impact: Under this new litigation process, extensions of proof time would become much more difficult to obtain following the Status Conference. In order to avoid postponed dockets, parties would be held to the strict requirements under the Kentucky Administrative Regulations in order to obtain extensions of proof time. For example, the requesting attorney would have to submit an Affidavit indicating when the desired witness was first contacted, when that witness is first available, and why that particular witness is essential. Because the formal ALJ assignment would not occur until after witnesses and issues are chosen at the initial Status Conference (with that assignment being based upon which ALJ’s are scheduled to be in the local area at that time of the proposed Final Hearing), it will be more difficult to tailor the selection of experts toward particular ALJs who typically might find certain experts more credible than others. Additionally, because a BRC could still be scheduled at the ALJ’s discretion for the purposes of settlement prior to the Final Hearing, this proposal would create additional travel expenses and billable hours that do not necessarily help the defense obtain as efficient resolution of a claim as it did under the old system. October 12, 2008 in Office of Workers' Claims | Tags: workers' compensation, Roland Niemi Law Group, Lexington, Kentucky, Department of Workers' Claims, DWC, 3.5%, present value table, 2009, discount rate, present worth | by rolandniemi | No comments The Kentucky DWC has released the 3.5% Present Worth Table for 2009. September 30, 2008 in Uncategorized | Tags: burkitt lymphoma, chemotherapy, donation, family, fund, gallagher bassett, lymphoma, National City, need | by rolandniemi | No comments Roland Niemi’s blog will go slightly off-topic for today’s post to tell you about a family in need. Kathryn Keller, an adjuster with Gallagher Bassett in Louisville, Kentucky recently learned that her 13 year old son, Jamie, had been diagnosed with Burkitt Lymphoma. Jamie is currently in the cancer unit at UK Hospital in Lexington Kentucky. Kathryn is a single mother with a younger son, and has been driving daily between her home in Liberty, Kentucky, the hospital and her office. To help assist with the increasing costs facing Kathryn and her family, a benefit fund has been set up at National City Bank. Donations can be mailed or taken to any National City Bank in the United States and can be made payable to Kathryn Keller c/o James Kuhn. Any donation amount will be appreciated. In an e-mail Kathryn told us, “I think all parents should be aware of this disease. Although it is rare it can happen. If we had waited another 24 hrs of taking Jamie to the doctor, we would not be talking about his treatment, future treatment or his future at all. I pray that no other parent or family would have to go through what my family has gone through the past couple of weeks.” Please feel free to forward or link to this post. Above all, keep Kathryn and her family in your prayers. For those unfamiliar with Burkitt Lymphoma, the disease is named after Dr. Denis Burkitt who first described it in 1955. The symptoms of Burkitt Lymphoma, also known as B-cell lymphoma, High-grade B-cell lymphoma, and Small non-cleaved cell lymphoma, most commonly involve swelling of the lymph nodes. While the swollen lymph nodes can often be painless, they can have a rapid growth rate. Treatment involves intensive chemotherapy that in more than 50% of cases can result in a cure of the disease. For more information on Burkitt Lymphoma, visit these sites: http://www.nlm.nih.gov/medlineplus/ency/article/001308.htm September 29, 2008 in Office of Workers' Claims | Tags: compensation, December, finance cabinet, increase, Kentucky, kentucky mileage reimbursement rate, kentucky state mileage rate, ky, Lexington, mileage, niemi, October, rate, reimbursement, roland, workers', workers' compensation | by rolandniemi | No comments FROM THE KENTUCKY DEPARTMENT OF WORKERS’ CLAIMS: The Commonwealth of Kentucky’s Finance and Administrative Cabinet has announced the mileage reimbursement rate for Oct. 1 – Dec. 31, 2008 to be 49¢ per mile. The Finance Cabinet notes that the reimbursement rate is determined using the American Automobile Association (AAA) Daily Fuel Gauge Report for Kentucky for regular unleaded gasoline. September 16, 2008 in insurance | Tags: AIG, Chris Isidore, cnnmoney.com, downgrade, insurance | by rolandniemi | No comments For more coverage on AIG’s worries (as well as Wall Street’s) read this recent article by CNNmoney.com’s Chris Isidore who discusses why the AIG debacle matters to the firm’s customers and non-customers. http://money.cnn.com/2008/09/16/news/companies/aig_questions/index.htm?postversion=2008091614 September 16, 2008 in insurance | Tags: AIG, downgrade, insurance, wall street, workers' compensation insurance, workers' compensation Standard and Poor | by rolandniemi | No comments NEW YORK (CNNMoney.com) — CNNmoney.com reports that things are looking like there might be egg or, AIG rather, on the face of the US’s largest insurance company. On Monday of this week potentially deadly credit ratings hit the company. According to CNNmoney.com, the ratings indicated AIG’s ability to raise cash “is ‘extremely limited’ because of its plummeting stock price, widening yields on its debt, and its difficult capital market conditions.” In the past nine months alone, AIG has lost more than $18 billion. AIG’s motto, as indicated on its website is, “The strength to be there.” But to paraphrase Gertrude Stein, there may be no there there. To read the CNNmoney stories click the following links: |