Hear what our attorneys are saying

14
Aug 2018

The Effects of Recent Supreme Court Decisions on Employers

By Anne-Marie Foster     

  Epic Systems v. Lewis & Janus v. AFSCME So far, 2018 has marked a major year of U.S. Supreme Court decisions that affect the employer-employee relationship. Two recent decisions of the Court both have an impact on how an employer manages its business and engages with its employees. First, in Epic Systems v. Lewis,
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13
Aug 2018

The Best Way to Find a Job is to Actually Look for One

By Lisa Azoory-Keller     

In an effort to substantiate a claim for permanent total disability or wage differential, a claimant may embark on a self-directed job search, which can result in significant damage to Petitioner’s case.  Self-directed job logs, ledgers and spreadsheets created by a Petitioner should be heavily scrutinized, and can be critical in pointing to a claimant’s
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31
Jul 2018

Crossing the Threshold: What’s included in the Total Settlement Amount?

By Julie A. Garrison     

    CMS will consider a proposed Medicare Set-Aside (MSA) when the Total Settlement Amount (TSA) exceeds the one of two review thresholds. The CMS review thresholds are well-known and, for Medicare beneficiaries, is only $25,000. For claimants who have a reasonable expectation of Medicare enrollment within 30 months of the settlement date, the threshold
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31
Jul 2018

The Private Cause of Action under the Medicare Secondary Payer Act

By Vinal Patel     

    The Medicare Secondary Payer (MSP) Act provides that Medicare will make conditional payments for medical services when a primary plan has not made, or cannot reasonably be expected to make, payments for those services. 42 USC §1395(y)(b)(2)(B)(i). If it turns out that the “primary payer” had a responsibility to make those payments, Medicare
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31
Jul 2018

The Lumbar MRI Dilemma

By Lisa Azoory-Keller     

    If you’ve got low back pain, you’re in good company.  Low back pain is the most common musculoskeletal condition in the adult population, with prevalence up to 84%.[1]  The use of advanced imaging (such as MRI) is dramatically on the rise, despite lack of evidence to support its benefit.[2] The fact pattern may
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24
Jul 2018

Dispelling MSP Compliance Myths

By Rasa Fumagalli     

  By now, most claims adjusters and attorneys involved in workers’ compensation and liability settlements are aware of the Medicare Secondary Payer Act (MSP Act) and the potential impact that it may have in certain settlements. An incomplete understanding of the actual obligations however may result in a less than ideal approach for claims handling
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