CAUSATION Who Wants to Be a Millionaire?. RULES Answer A, B, C or D You can have – –1 lifeline –1 50/50 –1 audience vote Who Wants to Be a Millionaire?

Slides:



Advertisements
Similar presentations
Contract Interpretation CBA’s – Contracts Between two parties – Rules for Governing a Workplace Govern a continuing relationship between two parties “Workplace.
Advertisements

The New Standard— Developing Medical Proof Regarding Causation James Tucker, Barrett Albritton, Patrick Cruise, Jeffery Boyd, Panelists Robert Davies,
October 2013 Presentation to EJW William F. Russo Office of the General Counsel US Department of Veterans Affairs.
Changes to the Tennessee Law Statutory Construction and Medical Causation: Comparative Views David Langham, Blake Matthews & Robert Durham, Panelists Jim.
WHAT IS WORKERS COMPENSATION? Workers compensation laws provide money and medical benefits to an employee who has an injury as a result of an accident,
Loss of Wage Earning Capacity. This year New York State has had a new tool.
Occupational Disease and Experience Rating. Overview  Statistics suggest a high prevalence of occupational disease (‘OD’) in New Zealand.  Our no-fault.
 Federal Employee Compensations Act coverage ◦ People, Injury/Illness, Duty  Causal Relationship  Exclusions  Supervisor Responsibilities  Containing.
September 27, 2012 February 8, 2011  A brief history of the Patient Protection and Affordable Care Act.  How Health Reform will affect people and businesses.
Jody Blanke, Professor Computer Information Systems and Law Mercer University, Atlanta 1.
 Effective February 1, 2014  Creates the Workers Compensation Commission “OWCC”  Effective for injuries on or after February 1, 2014 for single event.
Workers’ Compensation: are we getting benefits to the workers who need them? Emily A. Spieler Northeastern University School of Law June 7, 2013.
PSYCHIATRIC AND PSYCHOLOGICAL DISABILITY. POLICY STATEMENT The Workers’ Safety and Compensation Commission (WSCC) may provide compensation benefits to.
Cost Containment Strategy: Utilizing The Misrepresentation Defense (N.C.G.S. § )
Rule 16-Requests for Prior Authorization for Medical Services Who Wants to Be a Millionaire?
South Carolina Workers’ Compensation: Nuts and Bolts Medical Version Sarah S. Alphin.
Benefits and Burdens of Public Safety Claims & Innovative Settlement Solutions Wednesday, September 11, :00 am – 12:15 pm.
Evidence and Argument Evidence – The asserted facts that the arbitrator will consider in making a decision – Information – What is presented at the hearing.
An Act of Parliament to provide for compensation to employees for work related injuries and diseases contracted in the course of their employment and for.
Safety and Health Programs
An Insider’s View Workers’ Compensation Reform in North Carolina:
Should a “carve out” be in your future? CAJPA 2012 Patti Williams, ARM, WCCP Risk Manager.
Summary of New Jersey Workers’ Compensation. NEW JERSEY’S COMPUTERIZED SYSTEM Most Comprehensive In The United States (
What employers should know about the system in California CALIFORNIA WORKERS’ COMPENSATION.
Qualified Medical Evaluations and Spinal Surgery Second Opinion Presented by Janet Coulter, WCALJ James Fisher, Industrial Relations Council III Suzanne.
EXPERT EVIDENCE UNDER THE NEW RULES OF CIVIL PROCEDURE ARTHUR ROBERT CAMPORESE Camporese Sullivan Di Gregorio.
What Makes a Good Medical Report? And What Makes a Bad One? Medical-Legal Reports and Testimony – November 6,
NYS Workers’ Compensation System
Long Term Disability Insurance Chapter 51 Employee Benefit & Retirement Planning Copyright 2009, The National Underwriter Company1 What is it? An employer-sponsored.
An Overview Kelly Blad, MA, EDPNA Traumatic Brain Injury and the Social Security Disability Process.
Establishing a Return-To-Work Program Complying with Statutes, Laws and Rules on Return to Work.
MADALENE WITTERHOLT CHRISTINA TOON OKLAHOMA WORKERS’ COMPENSATION CODE.
WCLA MCLE Evidence Update Jack Cannon Dennis M. Lynch Healy Scanlon Law Firm.
The Industrial Commission is the state regulatory agency that administers the workers’ compensation law in Idaho. The Commission has exclusive jurisdiction.
Administrative Law Judge Oklahoma Workers’ Compensation Commission
1 An Act To Improve The Workers’ Compensation System HB 194/SB 200.
NYS Workers’ Compensation System Compliance Outreach: Measuring and Monitoring Payor Performance /8/15 & 9/9/15.
Michigan Association of School Personnel Administrators December 3, 2008 Disabilities Management – Integrating FMLA, ADA and Workers’ Compensation Melvin.
Workers’ Compensation Mock Trial Presented to ASSE Joint Meeting with RIMS-Chicago November 15, 2011.
AGENCY The Agency Relationship. Creation of Agency An Agreement of two parties that on party (the agent) will act for the benefit of the other (the principal)
Bye Brown v. Bi-Lo Presented by Harold J. Willson, Jr. (864)
Mon. Nov. 26. Work Product “Privilege” A witness, X, who is friendly to the D was interviewed by P’s attorney and a statement was drawn up Is there any.
Task 1:Workplace rights and responsibilities Your Rights Your Rights By law you are entitled to a safe and health workplace. By law you are entitled to.
You Decide: A Jury Simulation Amendment Unit P.S. 3.
Yu v. Mummaneni Judge Randy Rich Gwinnett State Court You have been considering the case of Xiaohoung Yu, Plaintiff, vs. Vidasagar Mummaneni, as.
The Criminal Trial Process Section 11 (d) of the Charter of Rights and Freedoms states that each person charged with an offence is to be ‘presumed innocent.
Repetitive Trauma Injuries in South Carolina Presented by Commissioner Andrea Roche Richard V. Davis, Esq. Jeffrey S. Jones, Esq.
Utah Labor Commission Workers’ Compensation Educational Conference APPEALS AND LEGISLATIVE UPDATES.
Understanding Workers’ Compensation Coastal Carolina University Office of Risk Management.
Medical Malpractice a particular form of negligence which consists in the failure of a physician or surgeon to apply to his practice of medicine that degree.
NEGLIGENCE “Carelessness” or “Not to give proper care”
AGENCY. Definition of Agency A fiduciary relationship. –Trust and confidence Mutual agreement of two persons –that one person (agent) will act on the.
Elements of the Violation Department of Pesticide Regulation Enforcement Branch 1.
4/2000COPYRIGHT SCOTT HAINZ, D.C, DABQAURP DEFINITIONS.
Colville Confederate Tribes Workmen’s Compensation What is Workmen’s Compensation?
Claim Administration & Management © 2014 CopperPoint Mutual Insurance Company. All rights reserved.
The Hearing Process 1. 2 Notice of Claim Status Issued by Carrier Legally Binding Triggers Protest Period (usually 90 days)
A Basic Guide to Social Security Disability Benefits Presented by Matthew Lane and Nancy Goodwin of Ziegler & Lane, LLC.
Death and Disability Ombudsman WSCFF Educational Seminar April 21-23, 2015.
Workers’ Compensation Program BAM SECTION Objectives: Learn about Workers’ Compensation Understand the responsibilities of all the interested parties.
TORTS: A CIVIL WRONG Chapter 18. TORTS: A CIVIL WRONG Under criminal law, wrongs committed are called crimes. Under civil law, wrongs committed are called.
Pure Economic Loss. Outline 1.Exam format. 2.The Charter and tort law. 3.Pure economic loss. 4.Negligent misrepresentation. 5.Pulling it all together.
D ETERMINATION OF D ISABILITY. Over 7 million disability assessments are made annually in the United States. Many of which are made by physicians in the.
Is Exposure To Infectious Disease Covered By Workers Compensation? Five employees in the “Happiest Place on Earth” were recently diagnosed with measles,
INTRODUCTION TO THE COURT SYSTEM
Causation Analysis in Occupational and Environmental Medicine
Iowa Workers’ Compensation 2017 Changes and Practical Application
Determination of Disability
Presentation transcript:

CAUSATION Who Wants to Be a Millionaire?

RULES Answer A, B, C or D You can have – –1 lifeline –1 50/50 –1 audience vote Who Wants to Be a Millionaire?

The term “causation” and its derivatives (“caused by”, “proximately caused”, “cause”) in the Colorado workers’ compensation system are: c. Defined in the AMA Guides, Third Edition (revised), but are largely unknown or are disregarded b. Inconsistently defined in case law a.Not defined at all in the Workers’ Compensation Act CAUSATION d. All of the above

“Arising out of … employment” (See Section (1)(b) and (c), CRS: d. Must be proven by medical evidence b. Means “caused by work conditions or events” a. Is as close as we get to a reference to causation in the Workers’ Compensation Act CAUSATION c. Is the sole test for determining compensability of an injury

When reaching a decision about the compensability of a back injury, an ALJ (Administrative Law Judge) MUST rely on: c. Credible lay testimony plus b above b. A medical opinion based on peer-reviewed studies, objective data, or other evidence beyond the subjective impression of the physician a. A medical opinion of some sort CAUSATION d. None of the above

When choosing to rely on one doctor’s opinion over another’s when determining causality of a back injury, the ALJ MUST CHOOSE: c. The opinion of the doctor who has more expertise in back injuries b. The opinion that is more credible a. An evidence-based opinion over a subjective impression CAUSATION d. The opinion of a treating physician over an independent medical examiner

When it comes to a compensability decision early in a case, an ALJ must apply which standard of proof with respect to causation: c. Preponderance of the evidence b. Clear and convincing evidence a. Beyond a reasonable doubt CAUSATION d. Substantial evidence

To overcome an ALJ’s decision that a back injury is caused by employment, the respondents must show (see Section , CRS): d. The ALJ is biased c. Conflicting evidence in the record b. Lack of substantial evidence to support the decision CAUSATION a. No evidence to support the decision

When an ALJ is determining whether a back injury is caused by work, which of the following is NOT TRUE: d. The ALJ can disregard all lay testimony and medical evidence in this particular case in favor of his or her knowledge of back injuries gained from other cases b. The ALJ can disregard an evidence- based opinion in favor of an opinion based on the subjective opinion of the doctor a. The ALJ can disregard the opinion of an IME doctor in favor of a treating physician CAUSATION c. The ALJ can choose a doctor’s opinion which is poorly articulated, whether in writing or in live testimony

When it comes to traumatic back injuries, compensability can be proved by showing: c. Evidence of an aggravation of a symptomatic, pre-existing condition or injury b. Evidence of an aggravation of an asymptomatic, pre-existing condition or injury a. Evidence of a new injury CAUSATION d. All of the above

When it comes to traumatic back injuries, compensability can be proved by showing: c. Evidence of the need for treatment which is new, different or increased b. Evidence of the need for restrictions, time off, assistive devices, or other negative effects on working a. Evidence of an acceleration of a pre-existing degenerative process CAUSATION d. All of the above

The carrier or self-insured employer at risk for an occupational disease claim is the one where the place of employment: c. Has conditions which have definitely caused the disabling condition b. Is the place where the employee suffers a substantial and permanent aggravation of the condition which causes his/her disability a. Is the place where the employee is last injuriously exposed to the work conditions which caused his/her disability CAUSATION d. Is the place where the employee suffers a last injurious exposure AND a substantial, permanent aggravation of his/her disabling condition

When interpreting the “last injurious exposure” requirement to prove liability for an occupational disease, Colorado courts have told us that the phrase means: c. The employee’s last exposure to the work condition, period b. The employment did cause the disabling condition a. The employment could have, if prolonged, caused the disabling condition CAUSATION d. The date that the employee first demonstrates reduced efficiency at work

When proving “substantial permanent aggravation” in an occupational disease case (see Section , CRS): c. A party must present evidence- based medical testimony or report(s) b. A party must present medical evidence a. The parties have to wait until the claimant is at MMI CAUSATION d. A party can rely on the subjective impressions of the claimant

When it comes to proving causation in mental impairment cases (see Section , CRS): c. The claim cannot be based, in whole or in part, on conditions of employment which are common to all fields of employment b. The condition cannot be self- inflicted a. The claimant must show that the disabling impairment is “primarily caused” by then conditions at work CAUSATION d. All of the above

When it comes to proving causation under the heart attack statute (Section (2)): c. The exertion causing the heart attack must be unusual for the employee experiencing the attack, rather than unusual for any worker in his/her job category b. The heart attack must be proximately caused by unusual exertion a. The condition must be a myocardial infarction CAUSATION d. All of the above

When it comes to proving the “intoxication” penalty (see Section , CRS): c. Causation must be proven by clear and convincing evidence b. Causation can be proved by competent evidence of impairment at the time of the injury a. The injury is presumed to be caused by to the intoxication CAUSATION d. If respondents prove intoxication, then the claimant cannot avoid the penalty

When it comes to proving causation of hepatitis C in a firefighter (see Section , CRS), it shall be presumed that the disease was contracted at work as long as which one of the following conditions is satisfied: c. The employee is determined to have hepatitis C with 24 months of exposure b. The employee complies with reasonable and necessary medical procedures under the Workers’ Compensation Act a. The employer performs a baseline test within 5 days of report of claim that shows the employee does not have hepatitis C CAUSATION d. All of the above

When it comes to proving cancer in a firefighter (see Section , CRS), it shall be presumed that the cancer is work related as long as which of the following conditions are met: c. The firefighter contracts a cancer of the brain, skin, digestive system, hematological system or genitourinary system b. The employer conducted a pre- employment or subsequent test which showed that claimant was cancer-free or at least not impaired at time of hire a. The firefighter has completed 5 years or more of service CAUSATION d. All of the above

When it comes to disability beginning 5 years after injury (see Section , CRS): c. The presumption of no causation can be overcome by clear and convincing evidence b. The presumption of no causation can be overcome by preponderance of the evidence a. Any disability, without exception, is conclusively presumed not to be caused by the injury CAUSATION d. The presumption does not apply to conditions resulting from exposure to radioactive materials or uranium, or to asbestos, silicosis or anthracosis

When it comes to death after 2 years post-injury (see Section , CRS): c. The presumption can be rebutted by competent evidence b. The presumption does not apply to cases involving exposure to radioactive materials or uranium, or to asbestosis, silicosis or anthracosis a. There is a prima facie presumption of no causation CAUSATION d. All of the above

When it comes to apportionment (see Section , CRS), causation determinations are important in which one of these scenarios: c. Apportionment of permanent partial disability where there is a previous non-industrial condition or injury b. Apportionment of permanent partial disability where there is a previous industrial injury a. Apportionment of medical care between carriers CAUSATION d. Apportionment of permanent total disability where there are two or more industrial conditions allegedly causing total disability