Workers’ Compensation & Employers’ Liability Article Archives

Client Alert: The Importance of Promptly Denying Medical Bills Upon Receipt of the Form CMS-1500

February, 2017 | By Michael S. Fox

Recently, I had an opportunity to assist with the handling of a case wherein a medical provider was seeking payment of medical bills which we contend were properly denied; however, the provider was relying upon a narrow interpretation of the COMAR regulations to argue that we waived the right to contest the bills. Specifically, in…

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Decision in Simms Calls Virginia “Horseplay Doctrine” Into Question

September, 2009 | By Kathryn Lea Harman

On July 28, 2009, the Virginia office of Semmes won an appellate decision in Simms v. Ruby Tuesday, Inc., that could spell the end of the “horseplay doctrine” in Virginia Workers’ Compensation cases. Prior to Simms, the question in claims brought by employees injured by other employees was whether the injured employee was a participant in or an innocent victim of horseplay. A claimant able to prove that he was not a participant thereby established that his injury “arose out of” his employment, and that he was entitled to compensation.

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Medical Fee Guide Revised

October, 2006

One of the most effective methods in Maryland for controlling workers’ compensation costs is use of the Medical Fee Guide to limit payments for non-hospital medical treatment. The Maryland Workers’ Compensation has worked to find the proper balance between providing injured workers with quality medical care, controlling medical costs for employers and insurers, and providing medical care practitioners with a reasonable financial incentive in order to insure their participation in the system.

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Changes at the Maryland Commission

September, 2006

In October, Governor Robert L. Ehrlich, Jr. named R. Karl Aumann to serve as Chairman of the Maryland Workers’ Compensation Commission. Chairman Aumann had originally been appointed to the Commission in August of 2005 and, prior to coming to the Commission, had served as Maryland’s Secretary of State.

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