WHICH WORKERS’ COMPENSATION “BENEFITS” CAN BE SUBROGATED? Recovery of Case Management Costs, Medical Bill Audit fees, Rehabilitation Benefits, Utilization Review Costs, IME’s, Nurse Case Worker Fees, Attorneys’ Fees, and Other “Allocated” Loss Adjustment Expenses

It’s the question every claims professional and trial attorney claims to know but few fully understand. In addition to paying for medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, independent…

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Texas

TEXAS COURT MAKES IT EASIER FOR WORKERS’ COMPENSATION CARRIER TO SETTLE DIRECTLY WITH THE TORTFEASOR AND AVOID PAYING ATTORNEYS’ FEES TO THE EMPLOYEE Sentry Casualty Company v. Bravin, 2024 WL 3083299 (Tex. App. 2024).

A new Texas Court of Appeals decision has clarified the process by which a workers’ compensation carrier can settle directly with a third-party tortfeasor and thereby avoid having to reduce its lien by a pro rata share of the employee’s attorneys’ fees. Meanwhile, the process of “selling your lien” has never been less complicated and…

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HOW TO SUE YOURSELF AND WIN: Nuances of Subrogating Workers’ Compensation Death Claims

The American horror film “Split”, directed by M. Night Shyamalan, is a psychological thriller which centers on a bizarre antagonist with 23 separate personalities. Without spoiling the plot, suffice it to say that it focuses on the fact that there is something to the adage “mind over matter.” They say that life imitates art. If…

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Workers' Comp

SOMETHING OLD, SOMETHING NEW; SOMEONE BORROWED, SOMEONE TO SUE

Workers’ Compensation Subrogation and Employee Leasing Companies At its core, workers’ compensation subrogation is quite simple. Employee injured while at work receives workers compensation benefits. Carrier paying benefits recovers those benefits from anyone responsible for causing the injury other than the employer. As the saying goes, however, “Progress is man’s ability to complicate the simple.”…

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workers' compensation

Workers’ Compensation and the Intentional Act Exception to the Exclusive Remedy Rule

The quid pro quo premise underlying the social compromise known as workers’ compensation is simple: an employee injured at work receives no-fault medical expenses and wage replacement indemnity benefits and, in exchange, the employer is given protection from employee lawsuits and a statutory right to be reimbursed from the tortfeasor who actually caused the work-related injury –…

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Delaware

DELAWARE SUPREME COURT REVERSES ITSELF: Allows Workers’ Compensation Subrogation of UIM Benefits

The ability of a workers’ compensation carrier to subrogate against and/or seek reimbursement from a recovery made from a third-party tortfeasor responsible for causing the employee’s work-related injuries is universally recognized across the country as a major tool for holding down workers’ compensation premiums for large and small businesses and employers. Whether or not this…

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Employer Immunity

STATUTORY EMPLOYER IMMUNITY AND THE TWO-CONTRACT THEORY IN LOUISIANA: Stonetrust Com. Ins. Co. v. TBT Contracting, Inc., 2023 WL 4067496 (La. App. 2023)

In Louisiana, when a company undertakes to execute any work which is a part of its trade, business or occupation, and contracts with any subcontractor for the execution of such work, the company is entitled to the exclusive remedy protection of § 23:1032. The company will be liable to pay workers’ compensation benefits to any such…

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Work Injury Claim Form

The Ten Best and Ten Worst States for Subrogating Workers’ Compensation in 2023

It has been seven years since we first published our rankings of the ten best and ten worst states for workers’ compensation subrogation. Since then, case decisions and legislatures have been busy trying to help trial lawyers destroy workers’ compensation subrogation liens in third-party personal injury cases. Therefore, it is time to revisit our rankings…

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