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MEDICARE SET-ASIDE FACTS AND FICTION-PART II

Here is the second part of my article for the Cleveland Metropolitan Bar Journal.  There are some resources at the end of the article that might be helpful if you need to contact CMS regarding any MSA issues or, as discussed in this part of the article, if you are dealing with any Medicaid lien … Continue reading MEDICARE SET-ASIDE FACTS AND FICTION-PART II

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The Ohio Workers First Act-PowerPoint Presentation

This post is the long version of the PowerPoint presentation regarding the Ohio Workers First Act I gave at the CMBA Workers' Compensation Section meeting in January.  I'm posting it in particular for those who are going to see the shortened version of the presentation at the SIGO Education Day on March 16th, and are looking for some more information regarding the … Continue reading The Ohio Workers First Act-PowerPoint Presentation

MEDICARE SET-ASIDE FACTS AND FICTION

With speaking at SIGO's education day, writing an article for the Cleveland Metropolitan Bar Association and getting ready for another CLE, I've been a little delinquent with the blog, so my apologies.   I've decided to use some of the material I put together for those events in the blog.  This is Part One of an article I'm … Continue reading MEDICARE SET-ASIDE FACTS AND FICTION

Dependency Issues? Not in this courtroom, says recent case

Last week, the 11th Appellate District ruled that a common pleas court does not have jurisdiction over an appeal from an Industrial Commission decision as to dependency status in a death claim. In the case, Centric v. Buehrer, 2018-Ohio-698, the Commission allowed death benefits to the decedent’s children, but denied benefits to his alleged common … Continue reading Dependency Issues? Not in this courtroom, says recent case

2 ways to make sure your light-duty job offer passes muster at the Industrial Commission

One of the bases for terminating ongoing temporary total disability compensation set out in R.C. §4123.56 is: “when work within the physical capabilities of the employee is made available by the employer or another employer.” However, the Ohio Supreme Court, 10th Appellate District and the Industrial Commission are very strict about how this job offer … Continue reading 2 ways to make sure your light-duty job offer passes muster at the Industrial Commission

How to Make Your Voluntary Abandonment Argument Stick

The Ohio Supreme Court has made it increasingly difficult to terminate temporary total disability compensation based upon voluntary abandonment of employment. Case in point, the recent decision in State ex rel. Cordell v. Pallet Cos., Inc.  In this post, I’m going to discuss how employers can still take advantage of the voluntary abandonment defense, and … Continue reading How to Make Your Voluntary Abandonment Argument Stick

When is a partial loss not a partial loss?

I was just involved in a loss of use case that required me to brush up on my knowledge of the subject.  In the interest of not re-inventing the wheel I’m sharing what I learned as this week’s blog post. Short version- In order to qualify for a loss of use, the amputation must be “near … Continue reading When is a partial loss not a partial loss?

How the Ohio BWC is Getting Tough on Opioid Pain Medications and Lumbar Fusion Surgery

Pursuant to Ohio Administrative Code Section 4123-6-32, which became effective January 1, 2018, the BWC will not reimburse providers for lumbar fusion surgery unless the treating physician follows the BWC’s “best practices” for the procedure. In addition to the requirement that Injured Workers undergo at least 60 days of conservative care before having a lumbar … Continue reading How the Ohio BWC is Getting Tough on Opioid Pain Medications and Lumbar Fusion Surgery

New Rules for Self-Insured Employers to Unilaterally Terminate Payment for Medications

A recent change to the Ohio Administrative Code (O.A.C.) clarifies the procedure by which employers may unilaterally terminate payment for ongoing prescriptions in claims. Specifically, O.A.C. Section 4123-6-21.1 provides that self-insured employers may terminate payment for prescription medications by: Notifying the worker, their representative, and the prescribing physician in writing that the employer will be obtaining a … Continue reading New Rules for Self-Insured Employers to Unilaterally Terminate Payment for Medications

State-funded Ohio employers can get a workers’ compensation premium credit in motor vehicle accident cases

As part of Ohio House Bill 207 , the Ohio Bureau of Workers' compensation will now credit the risk experience of state funded employers for claims arising out of motor vehicle accidents in which their employee was not found to be at fault.  The provisions of HB 207 became effective for accidents occurring on or … Continue reading State-funded Ohio employers can get a workers’ compensation premium credit in motor vehicle accident cases