I am sure that everyone has heard some version of the quote, “Rules are made to be broken.” As an attorney, this makes me cringe. Often times when I am reviewing a file or talking to an employer I note that there is a handbook, manual, policy or other form of rules reduced to writing.
Workers' Compensation
Evidence-Based Medicine in South Dakota Workers’ Compensation
By Mike McKnight on
Posted in Litigation, Workers' Compensation
Doctors, lawyers and judges often ignore South Dakota’s adoption of an evidence-based medicine standard in workers’ compensation claims. SDCL 62-1-15 was enacted in 1995 and simply provides:
“In any proceeding or hearing pursuant to this title, evidence concerning any injury shall be given greater weight if supported by objective medical findings.”
Despite its clear and…
Facts Surrounding the Nature of the Injury Are Critical
By Laura Hensley on
At the end of 2016, the Department of Labor issued a decision denying summary judgment for Claimant in Eixenberger v. Rapid City Winair Company and Travelers Ins. Co., HF No. 128, 2014/15, citing that several factual issues still needed to be hashed out and summary judgment was not proper.
Eixenberger worked for Rapid City…
Four Common Mistakes From Those in Charge
By Laura Hensley & Mike McKnight on
Thirty plus years of employment and worker’s compensation practice has exposed me to thousands of personnel files and interviews, not to mention my experience with what could easily be twice that many management-level employees. Those that manage employees or those charged with the responsibility of managing the business’ worker’s compensation claims routinely make four common…
Seeking a Zero Medicare Set Aside in South Dakota
By Charlie Larson on
In recent weeks, zero dollar allocation Medicare Set Aside’s (MSA) came into question. Initially it was thought that on any claim, even fully denied claims, where approval of a zero dollar MSA was sought, documentation would have to be provided to the Centers for Medicare and Medicaid Services (CMS) to support the zero dollar MSA.
South Dakota Department of Labor Holds that Change of Condition Does Not Resurrect Claim from Two Year Statute of Limitations
By TJ Von Wald on
The South Dakota Department of Labor recently held that when a Petition for Hearing is not filed within two (2) years from the date of the denial letter, the claim cannot be reopened for a change in condition pursuant to SDCL 62-7-33. In Palmquist v. Luverne Truck Equipment, Inc. and Travelers Insurance, the Claimant’s…
Common Myths Surrounding Compulsory Medical Examinations in South Dakota
By Laura Hensley on
Posted in Litigation, Workers' Compensation
There are some common myths that prevail in the field of workers’ compensation surrounding compulsory medical examinations set up by the Employer and Insurer. Below, some of those myths are dispelled and the law on this issue clarified.
Myth #1: The Compulsory Medical Exam Must Be Set up Where the Employee Resides
At the…
Potential Impact of Medical Coding on South Dakota Workers’ Compensation
By Laura Hensley on
Posted in Workers' Compensation
As you may know, in order to receive reimbursement from Medicare, Medicaid, or private insurance companies, E&M coding, or evaluation and management coding, to support medical billing is required. Importantly, the current system was designed for use by primary care and group health plans, which often times fail to align with the needs of workers’…
South Dakota Supreme Court Reverses Motion to Dismiss Bad Faith Suit
By Laura Hensley on
Posted in Employment Law, Workers' Compensation
In James “Jake” Mordhorst v. Dakota Truck Underwriters and Risk Administration Services, 2016 S.D. 70, the South Dakota Supreme Court heard an appeal arising out of the Circuit Court’s granting of Risk Administration Services’ (“Insurer”) motion to dismiss Jake Mordhorst’s allegations of bad faith denial of workers’ compensation benefits. In the underlying workers’ compensation…