Maine federal judge lets class action in care suit
Headline Legal News
A federal judge in Maine says 40 residents with cerebral palsy, epilepsy and other conditions can join a lawsuit seeking to force the state to provide opportunities for them to live outside nursing homes.
On Monday, U.S. District Court Judge John Woodcock granted class-action status to a lawsuit filed by three men with cerebral palsy who want to live on their own but retain services provided by the Maine Department of Health and Human Services.
In the lawsuit filed in December 2009, the three argued the state violated the Americans with Disabilities Act and the Nursing Home Reform Act because it failed to make it possible for them to live outside nursing homes.
The Bangor Daily News says state officials couldn't be reached Wednesday because of the storm.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.