In a lengthy decision handed down by a divided court on July 18, 2013, the Third Department held that medical treatment which is not specifically included in the MTG is presumptively unnecessary and it is Claimant’s burden to overcome this presumption by proving medical necessity when a variance is sought.
The decision and an article from the New York Law Journal can be accessed below.
Treatment Outside MTG is Pre-Determined as Not Medically Necessary
New York Law Journal_ Workers Comp Reform Named Approved Procedures Judges Say
DID YOU KNOW? THE THIRD DEPARTMENT HOLDS THAT MEDICAL TREATMENT WHICH IS NOT SPECIFICALLY INCLUDED IN THE MTG IS PRESUMPTIVELY NOT MEDICALLY NECESSARY.
May 2021
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Labor Market Attachment and Retirement
May 24, 2021 -
Claim Disallowance With Unanimous Medical Opinion Giving Causal Relationship
May 17, 2021 -
Employers Do Not Have to Prove Prejudice by Late Notice, but it Certainly Doesn’t Hurt To Do So!
May 10, 2021 -
The Claimant’s Burden: Proving the Causal Relationship of an Injury
May 3, 2021
April 2021
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Social Media and Fraud – You’d Be Surprised What People Post!
April 26, 2021 -
Never Give In! Disallowance Win!
April 19, 2021 -
An “Interesting” IME Development
April 12, 2021 -
Section 44: Not Even a Portion of Liability For The Occupational Disease
April 5, 2021
March 2021
February 2021
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Occupational Disease Claims after Matter of Pinnacle Industries II, LLC (2019 NY Wrk Comp G2020587)
February 22, 2021 -
No Further Causally Related Disability Due to Intervening Unrelated Accident
February 15, 2021 -
Independent Contractor or Employee
February 8, 2021 -
No Error of Law or Fact In An Application For Full Board Review
February 1, 2021
January 2021
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Fraud in the Family – Claimant Doing Other Work while Receiving Comp Benefits
January 25, 2021 -
How Change in Conditions for Classified Claimants Changed Drastically
January 19, 2021 -
Success with WCL Section 18
January 11, 2021 -
Doubling Down – 2 Hearing Loss Claims for the Same Claimant Denied on the Same Day
January 4, 2021
2020
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Successful Disallowance!
July 26, 2020 -
Another Win for The Law Offices of Melissa A. Day!
July 22, 2020 -
A Win for The Law Offices of Melissa A. Day
July 21, 2020
2019
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Melissa A. Day, Esq. invited to join Buffalo Business First Leadership Trust
July 30, 2019 -
Claimant’s conviction of unlawful manufacture of methamphetamine does not amount to a violation under WCL 114-a.
May 31, 2019 -
Amendments to 2017 not retroactive if PPD claimant was not attached to labor market
May 31, 2019 -
LWEC & Incontinence
May 28, 2019 -
A New Quest Begins
May 21, 2019
2018
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Appeals Inventory and Forms
December 17, 2018 -
Review of Workers Compensation Board Schedule Loss of Use Frequently Asked Questions and New Permanency Forms
December 17, 2018 -
Proposed Changes Submitted Seeking to Expand the Board’s Legal Internship Program
May 25, 2018 -
You’re claiming what?!?
May 25, 2018 -
New SLU Guidelines Presentation by the Board
May 23, 2018 -
United States Supreme Court is Considering a Petition for a Writ of Certiorari Of the American Economy Decision
May 23, 2018 -
Ricky Costner Jr., 18 Year Old Slain by a Deranged Co-Worker, Honored by Family and Friends
March 31, 2018 -
Schedule Loss of Use Awards – Grrrrrrrrr
March 31, 2018
2017
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Court of Appeals Upholds 2013 Amendment to Section 25-a – Marking the End for The Fund for Reopened Cases
October 26, 2017 -
How to Avoid Bad Luck in Your Comp Claims This Friday the 13th – Some Basic Time Constraints for New York State Workers’ Compensation Claims to Keep in Mind
October 12, 2017 -
Board Finds that Medical Treatment Guidelines Apply to Out of State Claimants
June 7, 2017 -
Permanent Partial Disability “Safety Net”…What to Expect from WCL §35
February 5, 2017 -
Back to the Future: The Return of WCL 25(2-b): Fact-Finding without Judges and Legal Reasoning without Lawyers
January 18, 2017
2016
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It’s the Holiday Season!
December 8, 2016 -
HAPPY HALLO-WEAN!
October 31, 2016 -
TO WEAN, OR NOT TO WEAN, THAT IS THE QUESTION.
October 25, 2016 -
Reopened Cases
April 15, 2016
2015
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NY Allows Employer to…
November 28, 2015 -
An Employee Cannot be…
November 23, 2015 -
Vocational and Functional…
October 27, 2015 -
Challenge Yourself
September 19, 2015 -
Labor Market Attachment Refresher
September 16, 2015 -
Summer is Almost Over!
September 7, 2015 -
Claims Handling Performance
August 23, 2015 -
Answers to the Quiz
August 10, 2015 -
Average Wages?
August 7, 2015 -
Non-Acute Pain Treatment Guidelines
August 5, 2015 -
Test Your NY Workers’ Compensation Chops
August 3, 2015 -
Liability for Treatment by Social Workers
July 21, 2015 -
MDs, JDs AND TTDs
July 13, 2015 -
HOT DOGS OR HAMBURGERS?
July 1, 2015 -
IMEs : The Next Summer Movie Blockbuster or Just Another IME Gone Bust?
June 29, 2015 -
WCB’s Regulatory Agenda May Include…
June 14, 2015 -
An Underwriting Nightmare Come True
February 5, 2015 -
Hearing Loss becomes Hearing Win
February 5, 2015
2014
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Non Acute Pain Medical Treatment Guidelines Offer a Framework for Controlling Costs Associated with Chronic Pain Management, Especially Opioid Use
November 24, 2014 -
In Kigin v. WCB, the Court of Appeals upholds the presumption that treatment outside the MTGs is not medically necessary and the attending physician has the burden of proof of the need for a variance.
November 23, 2014 -
The Law Offices of Melissa A. Day, PLLC Won a Finding of a 0% Loss of Wage Earning Capacity
November 22, 2014 -
Navigating the Low Back Medical Treatment Guidelines for Chiropractic Care
Sseptember 12, 2014
2013
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DID YOU KNOW? THE BOARD HAS RETIRED THE CONCEPT OF THE COMPENSABLE RETIREMENT. The Death Knell of the Trifecta: Zamora and the so-called “Compensable Retirement”
December 17, 2013 -
A Blind Leap across an Inscrutable Chasm – Arbitrary and Capricious Loss of Wage Earning Capacity (LWEC) Determinations
November 30, 2013 -
LESS THAN TWELVE WEEKS REMAINING FOR WCL §25-a! Because Subject # 046-630 Contains Stricter Requirements for Reopening a Claim on the Issue of §25-a, Prudent Carriers and Employers May Want to Refer Applications to Defense Counsel
October 10, 2013 -
BOARD PROCESS RE-ENGINEERING (“BPR”) – NY WORKERS’ COMPENSATION FORUM MEMBERS SHOULD BE INCLUDED IN THE DIALOGUE
September 13, 2013 -
DID YOU KNOW? The 2nd Circuit certified a question to the NY Court of Appeals on the exclusivity provision of the WCL?
August 14, 2013 -
DID YOU KNOW? Twenty Insurance Carriers Have Filed an Action Seeking to Obtain a Declaration that the Elimination of The Fund for Reopened Cases Is Unconstitutional.
August 3, 2013 -
DID YOU KNOW? THE THIRD DEPARTMENT HOLDS THAT MEDICAL TREATMENT WHICH IS NOT SPECIFICALLY INCLUDED IN THE MTG IS PRESUMPTIVELY NOT MEDICALLY NECESSARY.
July 30 2013 -
DID YOU KNOW? AN EMPLOYER OR CARRIER MAY BE ABLE TO REOPEN A PPD CLAIM ON THE ISSUE OF LABOR MARKET ATTACHMENT.
July 13, 2013 -
DID YOU KNOW? A bill being considered by the NY State Legislature which would create a presumption of permanent total disability for claimants who are found eligible for social security?
April 30, 2013 -
DID YOU KNOW? 25-A IS GOING AWAY.
April 6, 2013 -
DID YOU KNOW? A chiropractic variance request based on alleged functional improvements and expected continued improvements may not be granted if the chiropractor continues to find that the claimant is totally disabled.
March 13, 2013 -
DID YOU KNOW? The Federal Government Is Not Subject to the Jurisdiction of the NY Workers’ Compensation Board on a Theory of General/Special Employment?
February 23, 2013 -
DID YOU KNOW? GOVERNOR CUOMO’S BUDGET PROPOSES TO ELIMINATE MANDATORY DEPOSITS INTO THE ATF AND TO CLOSE THE FUND TO NEW DEPOSITS?
February 5, 2013 -
DID YOU KNOW? IMPLEMENTATION OF THE CHANGES TO THE MTG HAS BEEN DELAYED UNTIL MARCH 1, 2013.
January 22, 2013 -
DID YOU KNOW? FACEBOOK PAGES ARE NOT CONSIDERED “SURVEILLANCE” THAT HAS TO BE DISCLOSED BEFORE A CLAIMANT TESTIFIES.
January 22, 2013 -
DID YOU KNOW? WCL §15(3)(v) BENEFITS MAY NOW BE CAPPED UNDER WCL §15(3)(w)
January 14, 2013 -
WHY? Why do judge’s even set deadlines for the submission of Memoranda of Law?
January 10, 2013 -
DID YOU KNOW?
January 5, 2013