A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL

Size: px
Start display at page:

Download "A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL"

Transcription

1 CASE NO. 18 Z A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS In the Matter of the Arbitration between (Claimant) AAA CASE NO.: 18 Z v. INS. CO. CLAIMS NO.: 30V State Farm Insurance Company DRP NAME: James H. Garrabrandt (Respondent) NATURE OF DISPUTE: Causal Relationship AWARD OF DISPUTE RESOLUTION PROFESSIONAL I, THE UNDERSIGNED DISPUTE RESOLUTION PROFESSIONAL (DRP), designated by the American Arbitration Association under the Rules for the Arbitration of No-Fault Disputes in the State of New Jersey, adopted pursuant to the 1998 New Jersey Automobile Insurance Cost Reduction Act as governed by N.J.S.A. 39:6A-5, et. seq., and, I have been duly sworn and have considered such proofs and allegations as were submitted by the Parties. The Award is DETERMINED as follows: Injured Person(s) hereinafter referred to as: Claimant. 1. ORAL HEARING held on November 10, ALL PARTIES APPEARED at the oral hearing(s). NO ONE appeared telephonically. 3. Claims in the Demand for Arbitration were NOT AMENDED at the oral hearing (Amendments, if any, set forth below). STIPULATIONS were not made by the parties regarding the issues to be determined (Stipulations, if any, set forth below). 4. FINDINGS OF FACTS AND CONCLUSIONS OF LAW: This matter arose out of a motor vehicle accident that occurred on May 6, 2000 and is, therefore, subject to AICRA. Claimant seeks medical expense benefits to defray the cost of treatment, including, but not limited to back surgery, he received from Northern New Jersey Orthopedic Specialists, P.A. from May 26, 2000 through April 16, Claimant seeks medical expense benefits in the amount of $36,

2 CASE NO. 18 Z Respondent denied payment contending that the services for which Northern New Jersey Orthopedic Specialists, P.A. billed were not provided to Claimant for a condition sustained in, and causally related to the May 6, 2000 accident. In a Peer Review report dated March 13, 2001, Dr. Merrick J. Wetzler of South Jersey Orthopedic Associates, indicates that Claimant's medical history is significant for several surgeries which were related to a workman's compensation injury back in His symptomatology improved after the surgery but he was again seen by Dr. Cohen on November 13, At that point, he had recurrence of his left leg pain with numbness and tingling. This had been going on for a couple of months. An EMG showed radiculopathy at L4-5 and L5-S1. Dr. Wetzler notes that after looking at the CT myelogram which showed lateral recess stenosis with well healed fusion L4-5, the treating physician, Dr. Cohen, recommended revision spinal surgery, decompressing the lateral recess, explore the spinal fusion and if the fusion was solid, remove the spinal fixation device and then continue the fusion down to the L5-S1 area. Dr. Wetzler then notes that there are no further notes from Dr. Cohen until after the accident of 5/6/00. At that time, Dr. Cohen felt that Claimant might have a new herniated disc, but a CT scan showed solid fusion and no disc herniation. An EMG showed a positive radiculopathy. Dr. Wetzler also notes that on May 22, 2000, Dr. Cohen says that the motor vehicle accident probably caused movement and loosening of the screws and it would be his opinion to remove it. He tried conservative care, did physical therapy and on 9/29/00 recommended surgery, which was performed on 12/18/00. Dr. Wetzler states that the surgery was the exact procedure that Dr. Cohen wanted to do on Claimant prior to the motor vehicle accident of 5/6/00. Dr. Wetzler concludes that since Dr. Cohen wanted to do this procedure prior to the motor vehicle accident, it is within a reasonable degree of medical certainty that the motor vehicle accident although might have exacerbated Claimant's condition, did not cause the need for the surgery since it was contemplated prior to the motor vehicle accident. Dr. Wetzler does not feel that there is a causal relationship between the surgery and the motor vehicle accident. He does feel that the treatment provided by Dr. Cohen in this case is medically necessary but not causally related to the accident. In a report dated April 15, 2001, the treating physician, Dr. Marc A. Cohen, and commenting on the utilization review that was performed by Dr. Wetzler, states that the physician that has rendered the opinion does correlate without question that this patient did have a surgical procedure prior to this, dated back in The patient was last seen in my office on November 13, At that time, notes Dr. Cohen, the patient did have symptoms, but he was able to manage the problem for almost two years, until after the motor vehicle accident on May 6, It was only after the accident on May 6, 2000, explains Dr. Cohen, that the patient's symptoms became such that he could no longer manage and deal with the problem. Dr. Cohen continues the April 15, 2001 report by stating that there is no question that the patient did have a problem. The patient was able to deal with it and was functioning and

3 CASE NO. 18 Z it was only after the motor vehicle accident on May 6, 2000 that his symptoms became such that surgery was contemplated and performed. It is clear to Dr. Cohen that the patient did have a causal relationship from the motor vehicle accident and that the surgery performed was medically necessary. Dr. Wetzler responds in a report dated May 31, 2001, that to say that the patient was able to deal with the functioning is not true since even in Dr. Cohen's notes he did comtemplate surgery before the 5/6/00. What is true, and as gleaned from the reports of record in this case, is that even though surgery may have been contemplated for Claimant prior to the May 6, 2000 accident, he was able to tolerate his condition for nearly two years before his involvement in that accident. In a report dated May 26, 2000, Dr. Cohen notes that Claimant was involved in an accident on May 6, He has pain in the lower part of his back radiating down the right leg into the right foot, sometimes pain in his left leg. It should be noted, and as commented on by Dr. Wetzler in his report, that on November 13, 1998 Claimant had recurrence of his left leg pain with numbness and tingling. On May 26, 2000, he was complaining of pain in the lower part of his back radiating down the right leg into the right foot, sometimes pain in his left leg. Not only had Claimant sustained an exacerbation of his prior condition in, but also he began experiencing additional symptoms after the May 6, 2000 accident. In a report dated June 22, 2000, Dr. Cohen indicates that Claimant is symptomatic with his sciatica pain. Dr. Cohen explains that he told the patient that there is a probability the car accident has caused movement and loosening of the screws and it was his opinion to remove it. But, the patient at that time preferred to try conservative treatment. He was referred to physical therapy; but, if there was no improvement, then surgery would be recommended. In a report dated August 8, 2001, Dr. Cohen indicates that Claimant was treated conservatively. After failure of conservative care without significant improvement, the patient underwent a neurological evaluation by Dr. Daniel Feuer where he was noted to have a right L5-S1 radiculopathy. He also underwent diagnostic testing, which also concurred that he likely had a change in the old area of surgery, particularly at the L4-5 level. Dr. Cohen then explains that because of no significant improvement in Claimant's symptoms and with the patient having a tremendous amount of back and leg pain, and a dysfunctional quality of life, he underwent a surgical procedure at Morristown Memorial Hospital on December 18, The operation consisted of an evaluation of his old area of surgery at the L4-5 level where it was noted the instrumentation was grossly loose.

4 CASE NO. 18 Z Dr. Cohen is of the opinion that this itself was likely a direct result of motor vehicle accident. Dr. Cohen concludes his August 8, 2001 report by summarizing that Claimant incurred an accident on May 6, This accident caused a change in his old area of surgery at L4-5 where the instrumentation was made loose. At the same time, the accident caused an exacerbation and injury to the area below his old surgery at L5-S1. At the time of surgery, there was clear evidence of looseness of hardware as well as compression of the right S1 nerve root. The patient incurred this surgical procedure as a direct result from this accident. The reports rendered, and opinions expressed by the treating physician, Dr. Marc A. Cohen, are persuasive and have been given greater weight than those of the utilization review physician, Dr. Merrick J. Wetzler. It has been established by a preponderance of the credible and reliable evidence that the loosening of the instrumentation that was placed in Claimant's lower back in 1995, as well as an exacerbation of his prior condition occurred during, and a new problem below the area of the old surgery was caused by Claimant's involvement in the May 6, 2000 accident. The conditions for which Claimant underwent conservative treatment, as well as surgery from May 26, 2000 through April 16, 2002, then, were causally related to the accident. The treatment, as well as the surgery was medically necessary, reasonable and causally related to the accident and, therefore, Claimant is entitled to reimbursement for the subject dates of service. Medical expense benefits are awarded in the amount of $36,331.82, subject to the medical provider's UCR, or for those CPT codes listed in it, the prevailing medical fee schedule, and any applicable deductible and co-payment. Claimant's counsel made an application for attorney's fees in the amount of $1, in this matter. N.J.A.C. 11:3-5.6(d)3 provides that the decision of the dispute resolution professional "may include attorney's fees for a successful claimant in an amount consonant with the award and with Rule 1.5 of the Supreme Court's Rules of Professional Conduct." Claimant has been successful herein and, therefore, Claimant's counsel is entitled to an attorney's fee. With respect to attorney's fees, the Certification of Services has been reviewed and Respondent's argument that the fees sought by Claimant's counsel are excessive has been taken into consideration, as well.

5 CASE NO. 18 Z As set forth in RPC 1.5, consideration has been given, but not limited to, the novelty and difficulty of the questions involved, the skill requisite to perform the legal services properly, the fees customarily charged in the locality for similar legal services, the amount involved and the results obtained, as well as the experience, reputation and ability of the lawyer performing the service. An attorney's fee of $1, is consonant with the amount of the Award and in keeping with the guidelines of RPC 1.5. Claimant seeks reimbursement of costs in the amount of $344.54, which includes reimbursement of a $ filing fee. It is the understanding of the DRP that because the Demand for Arbitration was filed on May 8, 2003 (and the filing fee was reduced to $ effective May 1, 2003), the AAA refunded $40.00 to Claimant. The costs for which Claimant seeks reimbursement, then, have been adjusted to $ N.J.A.C. 11:3-5.6(d)2 provides that "the award shall apportion the costs of the proceedings, regardless of who initiated the proceedings, in a reasonable and equitable manner consistent with the resolution of the issues in dispute." In keeping with N.J.A.C. 11:3-5.6(d)2, Claimant's arbitration filing fee of $285.00, photocopying postage costs of $12.75 and postage costs of $6.79 shall be apportioned against Respondent. Costs are awarded in the amount of $ and are to be paid to counsel of record for Claimant. 5. MEDICAL EXPENSE BENEFITS: Awarded Provider Amount Claimed Amount Awarded Payable to Northern New Jersey Orthopedic Specialists, P.A. $36, $36,331.82* Northern New Jersey Orthopedic Specialists, P.A. Explanations of the application of the medical fee schedule, deductibles, co-payments, or other particular calculations of Amounts Awarded, are set forth below. *Subject to the medical provider's UCR, and for those CPT codes listed in it, the prevailing medical fee schedule, and any applicable deductible and co-payment.

6 CASE NO. 18 Z INCOME CONTINUATION BENEFITS: Not In Issue 7. ESSENTIAL SERVICES BENEFITS: Not In Issue 8. DEATH BENEFITS: Not In Issue 9. FUNERAL EXPENSE BENEFITS: Not In Issue 10. I find that the CLAIMANT did prevail, and I award the following COSTS/ATTORNEYS FEES under N.J.S.A. 39:6A-5.2 and INTEREST under N.J.S.A. 39:6A-5h. (A) Other COSTS as follows: (payable to counsel of record for CLAIMANT unless otherwise indicated): $ (B) ATTORNEYS FEES as follows: (payable to counsel of record for CLAIMANT unless otherwise indicated): $1, (C) INTEREST is as follows: waived per the Claimant.. This Award is in FULL SATISFACTION of all Claims submitted to this arbitration. December 31, 2003 Date James H. Garrabrandt, Esq.

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between JERSEY REHAB A/S/O C.R. CLAIMANT(s), Forthright File No: NJ1203001435098 Insurance Claim File No: ALE84350 Claimant Counsel: Melvin D. Marx, P.A. v. Claimant Attorney

More information

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL CASE NO. 18 Z 600 19775 03 2 A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS In the Matter of the Arbitration between (Claimant) AAA CASE NO.: 18 Z 600 19775 03 v.

More information

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL CASE NO. 18 Z 600 10126 02 2 A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS In the Matter of the Arbitration between (Claimant) AAA CASE NO.: 18 Z 600 10126 02 v.

More information

Award of Dispute Resolution Professional. Hearing Information

Award of Dispute Resolution Professional. Hearing Information In the Matter of the Arbitration between Allied PT & Acupuncture a/s/o V.B. CLAIMANT(s), Forthright File No: NJ1012001364788 Insurance Claim File No: NJP66574 Claimant Counsel: Pacifico & Lawrence v. Claimant

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between Hudson Pain Management, Osteopathic Medicine a/s/o C. B. CLAIMANT(s), Forum File No: NJ0904001256220 Insurance Claim File No: 254801049148 v. Claimant Attorney

More information

In the Matter of the Arbitration between

In the Matter of the Arbitration between In the Matter of the Arbitration between Advanced Spine Surgery Center a/s/o Magdalena Villacis CLAIMANT(s), Forthright File No: NJ1409001581707 Proceeding Type: In Person Insurance Claim File No: 20951803

More information

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL

A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS AWARD OF DISPUTE RESOLUTION PROFESSIONAL CASE NO. 18 Z 600 01641 03 2 A M E R I C A N A R B I T R A T I O N A S S O C I A T I O N NO-FAULT/ACCIDENT CLAIMS In the Matter of the Arbitration between (Claimant) AAA CASE NO.: 18 Z 600 01641 03 v.

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between Atlantic Orthopaedic Associates a/s/o M.C. CLAIMANT(s), Forthright File No: NJ1010001354284 Insurance Claim File No: 0267652480101027 Claimant Counsel: Law Offices

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between Objective Diagnostic & Rehab Services a/s/o V.K. CLAIMANT(s), Forthright File No: NJ1003001314411 Insurance Claim File No: 58993 Claimant Counsel: Law Offices of

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between Dr. Arthur C. Rothman MD a/s/o JMI CLAIMANT(s), Forthright File No: NJ0909001283720 Insurance Claim File No: 0285625840101018 Claimant Counsel: Law Offices of Thomas

More information

Award of Dispute Resolution Professional. In Person Proceeding Information

Award of Dispute Resolution Professional. In Person Proceeding Information In the Matter of the Arbitration between BACK PAIN, P.C. A/S/O JC CLAIMANT(s), Forthright File No: NJ1104001382836 Proceeding Type: In Person Insurance Claim File No: 1013647 Claimant Counsel: The Law

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between North Jersey Rehabilitation Center a/s/o Y.L. CLAIMANT(s), Forthright File No: NJ0903001250685 Insurance Claim File No: 040900064409-003 Claimant Counsel: Joseph

More information

Award of Dispute Resolution Professional. Hearing Information

Award of Dispute Resolution Professional. Hearing Information In the Matter of the Arbitration between Xcalibur Chiropractic a/s/o M.P. CLAIMANT(s), Forthright File No: NJ1111001414166 Insurance Claim File No: NJP87566 Claimant Counsel: Console & Hollawell v. Claimant

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between Neurosurgical Spine Specialists of NJ A/S/O D.O. CLAIMANT(s), Forthright File No: NJ1102001370534 Insurance Claim File No: 0336333740101035 Claimant Counsel: Law

More information

Award of Dispute Resolution Professional

Award of Dispute Resolution Professional In the Matter of the Arbitration between Neurology & Pain Treatment Center a/s/o J.A. CLAIMANT(s), Forthright File No: NJ1108001403811 Insurance Claim File No: NJP86737 Claimant Counsel: Law Office of

More information

John Coronis v. Granger Northern Inc. (April 27, 2010) STATE OF VERMONT DEPARTMENT OF LABOR

John Coronis v. Granger Northern Inc. (April 27, 2010) STATE OF VERMONT DEPARTMENT OF LABOR John Coronis v. Granger Northern Inc. (April 27, 2010) STATE OF VERMONT DEPARTMENT OF LABOR John Coronis Opinion No. 16-10WC v. By: Sal Spinosa, Esq. Hearing Officer Granger Northern, Inc. ATTORNEYS: For:

More information

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT CONTINENTAL CASUALTY CO., INSURANCE CARRIER RESPONDENT

More information

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F608015. AMANDA VOLKMANN, Employee. SONIC DRIVE-IN, Employer

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F608015. AMANDA VOLKMANN, Employee. SONIC DRIVE-IN, Employer BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F608015 AMANDA VOLKMANN, Employee SONIC DRIVE-IN, Employer FARMERS INSURANCE EXCHANGE, Carrier CLAIMANT RESPONDENT RESPONDENT OPINION FILED

More information

BEFORE THE KANSAS WORKERS COMPENSATION APPEALS BOARD

BEFORE THE KANSAS WORKERS COMPENSATION APPEALS BOARD BEFORE THE KANSAS WORKERS COMPENSATION APPEALS BOARD DONALD B. KNARD ) Claimant ) v. ) ) Docket No. 1,072,705 APPLEBEES SERVICES, INC. ) Respondent ) and ) ) LIBERTY MUTUAL INSURANCE CORP. ) Insurance

More information

STATE OF NEW JERSEY DEPARTMENT OF LABOR DIVISION OF WORKERS COMPENSATION ATLANTIC CITY DISTRICT

STATE OF NEW JERSEY DEPARTMENT OF LABOR DIVISION OF WORKERS COMPENSATION ATLANTIC CITY DISTRICT STATE OF NEW JERSEY DEPARTMENT OF LABOR DIVISION OF WORKERS COMPENSATION ATLANTIC CITY DISTRICT CAPE REGIONAL MEDICAL CENTER : (Jeffrey Davis) Petitioner, : CLAIM PETITION NO. 2012-28812 v. : RESERVED

More information

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

IN THE COMMONWEALTH COURT OF PENNSYLVANIA IN THE COMMONWEALTH COURT OF PENNSYLVANIA Carmelo Olivares Hernandez, No. 2305 C.D. 2014 Petitioner Submitted May 15, 2015 v. Workers Compensation Appeal Board (Giorgio Foods, Inc.), Respondent BEFORE

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION GEORGIA R. KATZ ) Claimant ) VS. ) ) Docket No. 1,068,293 USD 229 ) Self-Insured Respondent ) ORDER STATEMENT OF THE CASE Claimant

More information

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT GREG STURTZ, HF No. 277, 2000/01 Claimant, v. DECISION YOUNKERS, INC., Employer, and LIBERTY MUTUAL INSURANCE CO., Insurer. This is a workers

More information

CARE PATHS/DECISION POINT REVIEW

CARE PATHS/DECISION POINT REVIEW Personal Service Insurance Company PO Box 3001 Plymouth Meeting, PA 19462 Ph: 610.832.4940 Fax: 610.832.2138 Toll Free: 800.954.2442 Date (##/##/####) Physician Name Street Address City, State, Zip Claimant:

More information

PERSONAL INJURY PROTECTION DISPUTE RESOLUTION. The purpose of this subchapter is to establish procedures for the resolution of disputes

PERSONAL INJURY PROTECTION DISPUTE RESOLUTION. The purpose of this subchapter is to establish procedures for the resolution of disputes SUBCHAPTER 5. PERSONAL INJURY PROTECTION DISPUTE RESOLUTION 11:3-5.1 Purpose and scope (a) The purpose of this subchapter is to establish procedures for the resolution of disputes concerning the payment

More information

STATE OF WEST VIRGINIA SUPREME COURT OF APPEALS MEMORANDUM DECISION

STATE OF WEST VIRGINIA SUPREME COURT OF APPEALS MEMORANDUM DECISION STATE OF WEST VIRGINIA GARY E. GOSNELL, Claimant Below, Petitioner SUPREME COURT OF APPEALS FILED March 27, 2015 RORY L. PERRY II, CLERK SUPREME COURT OF APPEALS OF WEST VIRGINIA vs.) No. 14-0614 (BOR

More information

NOVA SCOTIA WORKERS COMPENSATION APPEALS TRIBUNAL

NOVA SCOTIA WORKERS COMPENSATION APPEALS TRIBUNAL NOVA SCOTIA WORKERS COMPENSATION APPEALS TRIBUNAL Appellant: [X] (Employer) Participants entitled to respond to this appeal: [X] (Worker) and The Workers Compensation Board of Nova Scotia (Board) APPEAL

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION DALE L. STILWELL ) Claimant ) VS. ) ) BOEING COMPANY and ) Docket Nos. 253,800 CESSNA AIRCRAFT COMPANY ) & 1,031,180 Respondents

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION TRACY WRIGHT ) Claimant ) ) VS. ) Docket No. 1,058,254 ) GEAR FOR SPORTS ) Respondent ) ) AND ) ) LIBERTY MUTUAL FIRE INS. CO. and

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION TRISTA RAULS ) Claimant ) VS. ) ) PREFERRED RISK INSURANCE SERVICES ) Docket Nos. 1,061,187 Respondent ) & 1,061,188 AND ) ) HANOVER

More information

2015 IL App (1st) 142747WC-U NO. 1-14-2747WC. Order filed: October 9, 2015 IN THE APPELLATE COURT OF ILLINOIS FIRST DISTRICT

2015 IL App (1st) 142747WC-U NO. 1-14-2747WC. Order filed: October 9, 2015 IN THE APPELLATE COURT OF ILLINOIS FIRST DISTRICT 2015 IL App (1st) 142747WC-U NO. 1-14-2747WC Order filed: October 9, 2015 NOTICE: This order was filed under Supreme Court Rule 23 and may not be cited as precedent by any party except in the limited circumstances

More information

Tina Ploof v. Franklin County Sheriff s Department and (August 8, 2014) Trident/Massamont STATE OF VERMONT DEPARTMENT OF LABOR

Tina Ploof v. Franklin County Sheriff s Department and (August 8, 2014) Trident/Massamont STATE OF VERMONT DEPARTMENT OF LABOR Tina Ploof v. Franklin County Sheriff s Department and (August 8, 2014) Trident/Massamont STATE OF VERMONT DEPARTMENT OF LABOR Tina Ploof Opinion No. 13-14WC v. By: Phyllis Phillips, Esq. Hearing Officer

More information

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. F102457 OPINION FILED JULY 20, 2004

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. F102457 OPINION FILED JULY 20, 2004 BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. F102457 KEN WATERS, EMPLOYEE CENTURY TUBE CORPORATION, EMPLOYER CROCKETT ADJUSTMENT, CARRIER CLAIMANT RESPONDENT RESPONDENT OPINION FILED

More information

State Farm Indemnity Company State Farm Guaranty Insurance Company Personal Injury Protection Benefits New Jersey Decision Point Review Plan

State Farm Indemnity Company State Farm Guaranty Insurance Company Personal Injury Protection Benefits New Jersey Decision Point Review Plan State Farm Indemnity Company State Farm Guaranty Insurance Company Personal Injury Protection Benefits New Jersey Decision Point Review Plan Pursuant to N.J.A.C. 11:3-4.7, State Farm submits the following

More information

United States Department of Labor Employees Compensation Appeals Board DECISION AND ORDER

United States Department of Labor Employees Compensation Appeals Board DECISION AND ORDER United States Department of Labor T.M., Appellant and DEPARTMENT OF HOMELAND SECURITY, IMMIGRATION & CUSTOMS ENFORCEMENT, New York, NY, Employer Appearances: Thomas S. Harkins, Esq., for the appellant

More information

Our Customer: Claim Number: Date of Loss: Dear

Our Customer: Claim Number: Date of Loss: Dear MetLife Auto & Home Our Customer: Claim Number: Date of Loss: Dear Personal Injury Protection (PIP) is the portion of the auto policy that provides coverage for medical expenses. These medical expenses

More information

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT. MARK DENNIS MCQUAY HF No. 137, 2004/05

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT. MARK DENNIS MCQUAY HF No. 137, 2004/05 SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT MARK DENNIS MCQUAY HF No. 137, 2004/05 Claimant, v. DECISION FISCHER FURNITURE, and ACUITY, Employer, Insurer. This is a workers compensation

More information

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

IN THE COMMONWEALTH COURT OF PENNSYLVANIA IN THE COMMONWEALTH COURT OF PENNSYLVANIA James Conace, : Petitioner : : v. : : Workers Compensation Appeal : Board (Armen Cadillac, Inc.), : Nos. 346 & 347 C.D. 2014 Respondent : Submitted: September

More information

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NO. G ABILENE L. WENDT, EMPLOYEE ARKANSAS HEALTH CENTER, EMPLOYER

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NO. G ABILENE L. WENDT, EMPLOYEE ARKANSAS HEALTH CENTER, EMPLOYER BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NO. G002506 ABILENE L. WENDT, EMPLOYEE ARKANSAS HEALTH CENTER, EMPLOYER PUBLIC EMPLOYEE CLAIMS DIVISION, INSURANCE CARRIER/TPA CLAIMANT RESPONDENT

More information

Understanding Florida s PIP Laws

Understanding Florida s PIP Laws Understanding Florida s PIP Laws Bacen & Jordan, P.A. Renee Jordan, Esq. 4801 South University Drive Suite 3100 Davie, FL 33328 (954) 961-5511 rjordan@bacenjordan.com PIP = No Fault!! No Fault are first

More information

IMPORTANT NOTICE. Decision Point Review & Pre-Certification Requirements INTRODUCTION

IMPORTANT NOTICE. Decision Point Review & Pre-Certification Requirements INTRODUCTION IMPORTANT NOTICE Decision Point Review & Pre-Certification Requirements INTRODUCTION At GEICO, we understand that when you purchase an automobile insurance policy, you are buying protection and peace of

More information

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT WORKERS COMPENSATION. CALVIN BOSWORTH, HF No. 173, 2008/09

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT WORKERS COMPENSATION. CALVIN BOSWORTH, HF No. 173, 2008/09 SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT WORKERS COMPENSATION CALVIN BOSWORTH, HF No. 173, 2008/09 Claimant, v. DECISION P.I.E INC., and CONTINENTAL WESTERN INSURANCE COMPANY v.

More information

STATE BOARD OF WORKERS' COMPENSATION Heritage Tower, Suite 200, 18 9th Street Columbus, Georgia 31901 (706) 649-7372 www.sbwc.georgia.

STATE BOARD OF WORKERS' COMPENSATION Heritage Tower, Suite 200, 18 9th Street Columbus, Georgia 31901 (706) 649-7372 www.sbwc.georgia. 2012003449 Trial Heritage Tower, Suite 200, 18 9th Street Columbus, Georgia 31901 (706) 649-7372 www.sbwc.georgia.gov STATEMENT OF CASE The employee requested a hearing in the above referenced claim for

More information

American Commerce Insurance Company

American Commerce Insurance Company American Commerce Insurance Company INITIAL INFORMATION LETTER TO INSURED/CLAIMANT/PROVIDERS Dear Insured and/or /Eligible Injured Person/Medical Provider: Please read this letter carefully because it

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION MICHAEL L. McDONALD Claimant VS. FIBERGLASS SYSTEMS, LP Respondent Docket No. 1,003,977 AND PACIFIC EMPLOYERS INS. CO. Insurance

More information

Marc A. Cohen, MD, FAAOS, FACS Diplomate American Board of Spinal Surgery Fellow American College of Spinal Surgery

Marc A. Cohen, MD, FAAOS, FACS Diplomate American Board of Spinal Surgery Fellow American College of Spinal Surgery Marc A. Cohen, MD, FAAOS, FACS Diplomate American Board of Spinal Surgery Fellow American College of Spinal Surgery 221 Madison Ave Morristown, New Jersey 07960 (973) 538 4444 Fax (973) 538 0420 Patient

More information

New Jersey No-Fault PIP Arbitration Rules (2013)

New Jersey No-Fault PIP Arbitration Rules (2013) New Jersey No-Fault PIP Arbitration Rules (2013) Amended March 1, 2013 ADMINISTERED BY FORTHRIGHT New Jersey No-Fault PIP Arbitration Rules 2 PART I RULES OF GENERAL APPLICATION...5 1. Scope of Rules...5

More information

STATE BOARD OF WORKERS' COMPENSATION Suite 600, 270 Peachtree Street, NW Atlanta, Georgia 30303-1299 www.sbwc.georgia.

STATE BOARD OF WORKERS' COMPENSATION Suite 600, 270 Peachtree Street, NW Atlanta, Georgia 30303-1299 www.sbwc.georgia. 1994007422 Trial STATE BOARD OF WORKERS' COMPENSATION Suite 600, 270 Peachtree Street, NW Atlanta, Georgia 30303-1299 www.sbwc.georgia.gov (404) 656-2978 STATEMENT OF THE CASE On or around September 22,

More information

The Worker sought compensation under the new Chronic Pain Regulations. This led to the following two decisions:

The Worker sought compensation under the new Chronic Pain Regulations. This led to the following two decisions: CLAIM HISTORY AND APPEAL PROCEEDINGS: On August 30, 1983, the Worker* injured his lower back while lifting an arch rail. The Board accepted his claim and provided him with 22 weeks of temporary benefits

More information

Company Name: Claim Number: Loss Date: Policy Holder: Premier Prizm Acct No.: Injured Party:

Company Name: Claim Number: Loss Date: Policy Holder: Premier Prizm Acct No.: Injured Party: PO Box 9515 Fredericksburg, VA 22403-9515 Mail Date: Date Loss Reported to GEICO:!!!### Company Name: Claim Number: Loss Date: Policy Holder: Premier Prizm Acct No.: Injured Party: Personal Injury Protection

More information

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. G405820. LINDA BECKER, Employee. GOODWILL INDUSTRIES, Employer

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. G405820. LINDA BECKER, Employee. GOODWILL INDUSTRIES, Employer BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. G405820 LINDA BECKER, Employee GOODWILL INDUSTRIES, Employer RISK MANAGEMENT RESOURCES, Carrier CLAIMANT RESPONDENT RESPONDENT OPINION FILED

More information

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or

1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or 1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual

More information

IMPORTANT INFORMATION ABOUT YOUR PERSONAL INJURY PROTECTION COVERAGE (ALSO KNOWN AS NO-FAULT MEDICAL COVERAGE)

IMPORTANT INFORMATION ABOUT YOUR PERSONAL INJURY PROTECTION COVERAGE (ALSO KNOWN AS NO-FAULT MEDICAL COVERAGE) IMPORTANT INFORMATION ABOUT YOUR PERSONAL INJURY PROTECTION COVERAGE (ALSO KNOWN AS NO-FAULT MEDICAL COVERAGE) The New Jersey Automobile Insurance Cost Reduction Act (AICRA) introduced changes to how auto

More information

Overview of the Provisions of the NJ Automobile Insurance Cost Reduction Act

Overview of the Provisions of the NJ Automobile Insurance Cost Reduction Act Overview of the Provisions of the NJ Automobile Insurance Cost Reduction Act has requested that CorVel Corporation work with you and your physician to assure that you receive all medically

More information

INITIAL INFORMATION LETTER TO INSURED/CLAIMANT/PROVIDERS Sent on Concentra Integrated Services Letter Head

INITIAL INFORMATION LETTER TO INSURED/CLAIMANT/PROVIDERS Sent on Concentra Integrated Services Letter Head INITIAL INFORMATION LETTER TO INSURED/CLAIMANT/PROVIDERS Sent on Concentra Integrated Services Letter Head Dear Insured and/or Eligible Injured Person/Medical Provider: Please read this letter carefully

More information

OFFICE OF INSURANCE REGULATION Property and Casualty Product Review

OFFICE OF INSURANCE REGULATION Property and Casualty Product Review OFFICE OF INSURANCE REGULATION Property and Casualty Product Review NOTIFICATION OF PERSONAL INJURY PROTECTION BENEFITS YOUR PERSONAL INJURY PROTECTION RIGHTS AND BENEFITS UNDER THE FLORIDA MOTOR VEHICLE

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION RONALD L. MARTENS Claimant VS. BRULEZ FOUNDATION, INC. Respondent Docket No. 1,019,265 AND COMMERCE & INDUSTRY INS. CO. Insurance

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION QUANITA A. PEOPLES ) Claimant ) VS. ) ) Docket No. 1,045,122 LANGLEY/EMPIRE CANDLE COMPANY ) Respondent ) AND ) ) SECURA INSURANCE,

More information

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1708/15

WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1708/15 WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1708/15 BEFORE: E. Kosmidis : Vice-Chair E. Tracey : Member Representative of Employers C. Salama : Member Representative of Workers HEARING:

More information

Christa Hoisington v. Ingersoll Electric (December 28, 2009) STATE OF VERMONT DEPARTMENT OF LABOR. By: Phyllis Phillips, Esq. v.

Christa Hoisington v. Ingersoll Electric (December 28, 2009) STATE OF VERMONT DEPARTMENT OF LABOR. By: Phyllis Phillips, Esq. v. Christa Hoisington v. Ingersoll Electric (December 28, 2009) STATE OF VERMONT DEPARTMENT OF LABOR Christa Hoisington Opinion No. 52-09WC By: Phyllis Phillips, Esq. v. Hearing Officer Ingersoll Electric

More information

CURE DECISION POINT REVIEW PLAN (DPRP) DISCLOSURE NOTICE Page 1 of 5

CURE DECISION POINT REVIEW PLAN (DPRP) DISCLOSURE NOTICE Page 1 of 5 CURE DECISION POINT REVIEW PLAN (DPRP) DISCLOSURE NOTICE Page 1 of 5 How To Comply with the DPRP Requirements Of Your CURE Policy The 'Automobile Insurance Cost Reduction Act' was signed into law on May

More information

IN THE WORKERS COMPENSATION COURT OF THE STATE OF MONTANA 2005 MTWCC 42. WCC No. 2004-1039 JOHN STROM. Petitioner. vs.

IN THE WORKERS COMPENSATION COURT OF THE STATE OF MONTANA 2005 MTWCC 42. WCC No. 2004-1039 JOHN STROM. Petitioner. vs. IN THE WORKERS COMPENSATION COURT OF THE STATE OF MONTANA 2005 MTWCC 42 WCC No. 2004-1039 JOHN STROM Petitioner vs. MONTANA MUNICIPAL INSURANCE AUTHORITY Respondent/Insurer. FINDINGS OF FACT, CONCLUSIONS

More information

COMPENSATION ORDER TIMOTHY BURROUGHS, ) Claimant, ) ) AHD No. 06-094 v. ) OWC No. 597835 J & J MAINTENANCE, INC., ) and ) AIG CLAIMS SERVICES, )

COMPENSATION ORDER TIMOTHY BURROUGHS, ) Claimant, ) ) AHD No. 06-094 v. ) OWC No. 597835 J & J MAINTENANCE, INC., ) and ) AIG CLAIMS SERVICES, ) IN THE MATTER OF, TIMOTHY BURROUGHS, Claimant, AHD No. 06-094 v. OWC No. 597835 J & J MAINTENANCE, INC., and AIG CLAIMS SERVICES, Employer/Carrier. Appearances REBEKAH ARCH MILLER, ESQUIRE For the Claimant

More information

NOVA SCOTIA WORKERS COMPENSATION APPEALS TRIBUNAL

NOVA SCOTIA WORKERS COMPENSATION APPEALS TRIBUNAL NOVA SCOTIA WORKERS COMPENSATION APPEALS TRIBUNAL Appellant: [*] (Worker) Participants entitled to respond to this appeal: J. W. Lindsay Enterprises Limited (Employer) and The Workers Compensation Board

More information

Warwick v. Howard University, CRB No. 14-112, AHD No. 12-440A, 5 (February 10, 2015).

Warwick v. Howard University, CRB No. 14-112, AHD No. 12-440A, 5 (February 10, 2015). A full evidentiary hearing occurred on August 4, 2014. Claimant sought an award of temporary total disability benefits from December 13, 2011 to the present and continuing as well as causally related medical

More information

IN THE COMMONWEALTH COURT OF PENNSYLVANIA

IN THE COMMONWEALTH COURT OF PENNSYLVANIA IN THE COMMONWEALTH COURT OF PENNSYLVANIA Advanced Dermatology Associates : (Selective Insurance Company of : America), : Petitioners : : v. : No. 2186 C.D. 2014 : Submitted: May 22, 2015 Workers Compensation

More information

SUBCHAPTER 29. MEDICAL FEE SCHEDULES: AUTOMOBILE INSURANCE PERSONAL INJURY PROTECTION AND MOTOR BUS MEDICAL EXPENSE INSURANCE COVERAGE

SUBCHAPTER 29. MEDICAL FEE SCHEDULES: AUTOMOBILE INSURANCE PERSONAL INJURY PROTECTION AND MOTOR BUS MEDICAL EXPENSE INSURANCE COVERAGE SUBCHAPTER 29. MEDICAL FEE SCHEDULES: AUTOMOBILE INSURANCE PERSONAL INJURY PROTECTION AND MOTOR BUS MEDICAL EXPENSE INSURANCE COVERAGE 11:3-29.1 Purpose and scope (a) This subchapter implements the provisions

More information

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NO. F201987 ORDER AND OPINION FILED SEPTEMBER 24, 2003

BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NO. F201987 ORDER AND OPINION FILED SEPTEMBER 24, 2003 BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NO. F201987 NANCY SISCO DAS FAMILY, INC. UNION STANDARD INSURANCE CO. CLAIMANT RESPONDENT EMPLOYER RESPONDENT CARRIER ORDER AND OPINION FILED SEPTEMBER

More information

Next Level Physical Therapy PC Patient Information

Next Level Physical Therapy PC Patient Information Next Level Physical Therapy PC Patient Information First Name M.I. Last Name Date of Birth SS# (if minor, leave blank) Student? F/T P/T NO Street Address Billing Address (if different) City State Zip Home

More information

S T A T E O F M I C H I G A N WORKERS COMPENSATION APPELLATE COMMISSION

S T A T E O F M I C H I G A N WORKERS COMPENSATION APPELLATE COMMISSION 2009 ACO # 155 S T A T E O F M I C H I G A N WORKERS COMPENSATION APPELLATE COMMISSION MARK T. VALESANO, PLAINTIFF, V DOCKET #09-0001 IRON COUNTY, MICHIGAN COUNTIES WORKERS COMPENSATION, AND ACCIDENT FUND

More information

IMPORTANT NOTICE NOT TO BE PUBLISHED OPINION

IMPORTANT NOTICE NOT TO BE PUBLISHED OPINION IMPORTANT NOTICE NOT TO BE PUBLISHED OPINION THIS OPINION IS DESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THE RULES OF CIVIL PROCEDURE PROMULGATED BY THE SUPREME COURT, CR 76.28(4)(C), THIS OPINION IS

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION DONALD BRYAN SMITHHISLER Claimant VS. LIFE CARE CENTERS AMERICA, INC. Respondent Docket No. 1,014,349 AND OLD REPUBLIC INSURANCE

More information

DECISION POINT REVIEW PLAN REQUIREMENTS IMPORTANT INFORMATION

DECISION POINT REVIEW PLAN REQUIREMENTS IMPORTANT INFORMATION NJM Insurance 301 Sullivan Way, West Trenton, NJ 08628 Group 609-883-1300 / www.njm.com DECISION POINT REVIEW PLAN REQUIREMENTS IMPORTANT INFORMATION For Licensed Health Care Providers About No-Fault Medical

More information

Low Back Injury in the Industrial Athlete: An Anatomic Approach

Low Back Injury in the Industrial Athlete: An Anatomic Approach Low Back Injury in the Industrial Athlete: An Anatomic Approach Earl J. Craig, M.D. Assistant Professor Indiana University School of Medicine Department of Physical Medicine and Rehabilitation Epidemiology

More information

PRAETORIAN INSURANCE COMPANY PERSONAL INJURY PROTECTION IMPORTANT NOTICE TO POLICYHOLDERS MEDICAL PROTOCOLS

PRAETORIAN INSURANCE COMPANY PERSONAL INJURY PROTECTION IMPORTANT NOTICE TO POLICYHOLDERS MEDICAL PROTOCOLS PRAETORIAN INSURANCE COMPANY PERSONAL INJURY PROTECTION IMPORTANT NOTICE TO POLICYHOLDERS MEDICAL PROTOCOLS DECISION POINT REVIEW: Pursuant to N.J.A.C. 11:3-4, the New Jersey Department of Banking and

More information

SUMMARY. Carpal tunnel syndrome; Permanent impairment [NEL] (rating schedule) (AMA Guides) (functional impairment).

SUMMARY. Carpal tunnel syndrome; Permanent impairment [NEL] (rating schedule) (AMA Guides) (functional impairment). SUMMARY DECISION NO. 1033/98 Carpal tunnel syndrome; Permanent impairment [NEL] (rating schedule) (AMA Guides) (functional impairment). The worker was a stope miner for four years beginning in 1987. In

More information

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION

BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION BEFORE THE APPEALS BOARD FOR THE KANSAS DIVISION OF WORKERS COMPENSATION WILLIAM G. GUGENHAN ) Claimant ) VS. ) ) Docket No. 162,711 GEORGIA PACIFIC CORPORATION ) Respondent ) Self-Insured ) AND ) ) WORKERS

More information

Khaled s Radiology report

Khaled s Radiology report Khaled s Radiology report Patient Name: Khaled Adli Moustafa Date 06/15/2014 The patient is not present. And the following report is based upon what was in the MRI of the cervical and lumbar spine report

More information

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. G103629 SHIKITA WRIGHT, EMPLOYEE OPINION FILED JULY 10, 2013

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. G103629 SHIKITA WRIGHT, EMPLOYEE OPINION FILED JULY 10, 2013 BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. G103629 SHIKITA WRIGHT, EMPLOYEE ARKANSAS DEPARTMENT OF HUMAN SERVICES, EMPLOYER PUBLIC EMPLOYEE CLAIMS DIVISION, INSURANCE CARRIER CLAIMANT

More information

STATE OF VERMONT DEPARTMENT OF LABOR. Glenn Ashley Opinion No. 27-11WC. v. By: Jane Woodruff, Esq. Hearing Officer

STATE OF VERMONT DEPARTMENT OF LABOR. Glenn Ashley Opinion No. 27-11WC. v. By: Jane Woodruff, Esq. Hearing Officer STATE OF VERMONT DEPARTMENT OF LABOR Glenn Ashley Opinion No. 27-11WC v. By: Jane Woodruff, Esq. Hearing Officer R.E. Michel Co. For: Anne M. Noonan Commissioner APPEARANCES: State File Nos. AA-51728;

More information

DOCKET NO. 453-04-0995.M5 MDR TRACKING NUMBER: M5-03-2837-01 ' ' ' ' ' ' ' DECISION AND ORDER

DOCKET NO. 453-04-0995.M5 MDR TRACKING NUMBER: M5-03-2837-01 ' ' ' ' ' ' ' DECISION AND ORDER DOCKET NO. 453-04-0995.M5 MDR TRACKING NUMBER: M5-03-2837-01 TEXAS MUTUAL INSURANCE COMPANY, Petitioner vs. AZALEA ORTHOPEDIC & SPORTS, Respondent BEFORE THE STATE OFFICE OF ADMINISTRATIVE HEARINGS DECISION

More information

The Petrylaw Lawsuits Settlements and Injury Settlement Report

The Petrylaw Lawsuits Settlements and Injury Settlement Report The Petrylaw Lawsuits Settlements and Injury Settlement Report BACK INJURIES How Minnesota Juries Decide the Value of Pain and Suffering in Back Injury Cases The Petrylaw Lawsuits Settlements and Injury

More information

OFFICE OF INSURANCE REGULATION Property and Casualty Product Review

OFFICE OF INSURANCE REGULATION Property and Casualty Product Review OFFICE OF INSURANCE REGULATION Property and Casualty Product Review NOTIFICATION OF PERSONAL INJURY PROTECTION BENEFITS YOUR PERSONAL INJURY PROTECTION RIGHTS AND BENEFITS UNDER THE FLORIDA MOTOR VEHICLE

More information

PROMPT PAYMENT, MANAGED CARE CLAIM BILLING AND COLLECTION ISSUES ERIC D. KATZ, ESQ.

PROMPT PAYMENT, MANAGED CARE CLAIM BILLING AND COLLECTION ISSUES ERIC D. KATZ, ESQ. PROMPT PAYMENT, MANAGED CARE CLAIM BILLING AND COLLECTION ISSUES ERIC D. KATZ, ESQ. 1 1 I. PROMPT PAYMENT UNDER THE Laws equally applicable to pars and non pars (as long as there is an assignment) Physicians,

More information

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F409768. JUVENAL PEREZ, Employee. BUILT-WELL CONSTRUCTION COMPANY, Employer

BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F409768. JUVENAL PEREZ, Employee. BUILT-WELL CONSTRUCTION COMPANY, Employer BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION WCC NO. F409768 JUVENAL PEREZ, Employee BUILT-WELL CONSTRUCTION COMPANY, Employer CONTINENTAL CASUALTY COMPANY, Carrier CLAIMANT RESPONDENT RESPONDENT

More information

DECISION POINT REVIEW PLAN REQUIREMENTS

DECISION POINT REVIEW PLAN REQUIREMENTS NJM Insurance 301 Sullivan Way, West Trenton, NJ 08628 Group 609-883-1300 / www.njm.com DECISION POINT REVIEW PLAN REQUIREMENTS IMPORTANT INFORMATION ABOUT YOUR NO-FAULT MEDICAL COVERAGE For NJM Insurance

More information

CHUBB GROUP OF INSURANCE COMPANIES

CHUBB GROUP OF INSURANCE COMPANIES CHUBB GROUP OF INSURANCE COMPANIES Dear Insured, Attached please find an informational letter which is being sent to your treating provider outlining the processes and procedures for Precertification and

More information

NO. COA09-259 NORTH CAROLINA COURT OF APPEALS. Filed: 20 October 2009

NO. COA09-259 NORTH CAROLINA COURT OF APPEALS. Filed: 20 October 2009 An unpublished opinion of the North Carolina Court of Appeals does not constitute controlling legal authority. Citation is disfavored, but may be permitted in accordance with the provisions of Rule 30(e)(3)

More information

Northern Insurance Company of New York v. Resinski

Northern Insurance Company of New York v. Resinski MONTGOMERY COUNTY LAW REPORTER 140-301 2003 MBA 30 Northern Ins. Co. of New York v. Resinski [140 M.C.L.R., Part II Northern Insurance Company of New York v. Resinski APPEAL and ERROR Motion for Summary

More information

REVIEW DECISION. Review Reference #: R0103014 Board Decision under Review: March 3, 2009

REVIEW DECISION. Review Reference #: R0103014 Board Decision under Review: March 3, 2009 REVIEW DECISION Re: Review Reference #: R0103014 Board Decision under Review: March 3, 2009 Date: Review Officer: Lyall Zucko The worker requests a review of the decision of WorkSafeBC (the Board) dated

More information

Workers Compensation Law Update April 2012

Workers Compensation Law Update April 2012 Workers Compensation Law Update April 2012 Sean C. Pierce Carr Allison Court of Civil Appeals of Alabama Maxim Healthcare Servs. v. Freeman, 2012 Ala. Civ. App. LEXIS 91 (Ala. Civ. App. April 13, 2012)

More information

10 Woodbridge Center Drive * PO Box 5038* Woodbridge, NJ 07095

10 Woodbridge Center Drive * PO Box 5038* Woodbridge, NJ 07095 10 Woodbridge Center Drive * PO Box 5038* Woodbridge, NJ 07095 Date Name Address RE: CLAIMANT: CLAIM#: INSURANCE CO: CAMDEN FIRE INSURANCE ASSOCIATION CISI#: DOL: Dear : Please read this letter carefully

More information

ENCOMPASS INSURANCE COMPANY OF NEW JERSEY DECISION POINT & PRECERTIFICATION PLAN

ENCOMPASS INSURANCE COMPANY OF NEW JERSEY DECISION POINT & PRECERTIFICATION PLAN ENCOMPASS INSURANCE COMPANY OF NEW JERSEY DECISION POINT & PRECERTIFICATION PLAN DECISION POINT REVIEW: Pursuant to N.J.A.C. 11:3-4, the New Jersey Department of Banking and Insurance has published standard

More information

ROAD ACCIDENT FUND AMENDMENT BILL

ROAD ACCIDENT FUND AMENDMENT BILL REPUBLIC OF SOUTH AFRICA ROAD ACCIDENT FUND AMENDMENT BILL (As introduced in the National Assembly as a section 75 Bill; explanatory summary of Bill published in Government Gazette No. 25540 of 3 October

More information

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT

SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT SOUTH DAKOTA DEPARTMENT OF LABOR DIVISION OF LABOR AND MANAGEMENT MEGAN PETERSON, HF No. 109, 2009/10 Claimant, v. DECISION THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, Employer, and SENTRY INSURANCE,

More information

Award of Dispute Resolution Professional. In Person Proceeding Information

Award of Dispute Resolution Professional. In Person Proceeding Information In the Matter of the Arbitration between ADVANCED ORTHOPAEDICS & SPORTS MEDICINE CENTER, PC A/S/O G.B. CLAIMANT(s), Forthright File No: NJ1202001429526 Proceeding Type: In Person Insurance Claim File No:

More information

[Cite as State ex rel. Packaging Corp. of Am. v. Indus. Comm., 139 Ohio St.3d 591, 2014-Ohio- 2871.]

[Cite as State ex rel. Packaging Corp. of Am. v. Indus. Comm., 139 Ohio St.3d 591, 2014-Ohio- 2871.] [Cite as State ex rel. Packaging Corp. of Am. v. Indus. Comm., 139 Ohio St.3d 591, 2014-Ohio- 2871.] THE STATE EX REL. PACKAGING CORPORATION OF AMERICA, APPELLANT, v. INDUSTRIAL COMMISSION OF OHIO ET AL.,

More information

The effective date of the plan is the date approved by the Department of Banking and Insurance.

The effective date of the plan is the date approved by the Department of Banking and Insurance. Decision Point Review/Pre-Certification Plan for: New Jersey Skylands Management, LLC servicing: New Jersey Skylands Insurance Association (NAIC# 11454) New Jersey Skylands Insurance Company (NAIC# 11453)

More information

DECISION POINT REVIEW

DECISION POINT REVIEW ALLSTATE NEW JERSEY INSURANCE COMPANY/ALLSTATE NEW JERSEY PROPERTY AND CASUALTY INSURANCE COMPANY DECISION POINT REVIEW PLAN INCLUSIVE OF PRE-CERTIFICATION REQUIREMENT DECISION POINT REVIEW Pursuant to

More information