REGULATORY ACTIVITY:

• Issued memorandum number 2019-02 regarding Limited Liability Companies - Revised Forms 6B and 75.  In light of the recent Supreme Court decision in Gould vs. Stamford, 331 Conn. 289 (2019), holding that single-member limited liability companies (LLCs) are not required to elect to accept the provisions of the Workers’ Compensation Act, Chairman’s Memorandum 2003-02 is hereby withdrawn. The Commission has amended Forms 6B and 75 accordingly.  To view a copy of the memorandum, go to https://wcc.state.ct.us/memos/2019/2019-02.htm.   To view the revised forms, go to https://wcc.state.ct.us/download/forms.htm.
• The Workers’ Compensation Commission has just received shipment of its new Bulletin No. 53, amended to January 1, 2019, which is available to the public free of charge. Bulletin No. 53 contains the entire Workers’ Compensation Act, additional related statutes, workers’ compensation administrative regulations, and illustrations of the most up-to-date Connecticut’s workers’ compensation forms.  Please contact your nearest Workers’ Compensation Commission District Office for your free copy of the new Bulletin No. 53. You may also call the Commission’s Education Services at (860) 493-1500. To view this notice, go to https://wcc.state.ct.us/memos/2019/2019-03.htm.
• In light of Public Act 19-17 which allows for police officers, parole officers, and firefighters to receive certain workers’ compensation benefits for post-traumatic stress disorder (PTSD) caused by their participation in specific events, the Commission’s Form 30C “Notice of Claim for Compensation” has been revised, with a revision date of July 1, 2019. Please use this newest revision of the Form 30C, which can be obtained below or from our Online Forms page. To view this notice, go to https://wcc.state.ct.us/memos/2019/2019-04.htm.

REGULATORY ACTIVITY:

• Published the CRB calendar for May 2019.  To view the calendar, go to: https://www.wcc.state.ct.us/crb/calendars/may2019crb.pdf

FEE SCHEDULE NEWS:

• The Division of Workers’ Compensation has adopted the 2019 Official Connecticut Fee Schedule for Hospitals and Ambulatory Surgical Centers with an effective date of April 1, 2019. The next expected update for this schedule is April 1, 2020.

REGULATORY ACTIVITY:

• Published an updated March CRB Hearing Calendar.  To view the calendar, go to https://wcc.state.ct.us/crb/calendars/calendars.htm.
• Posted Compensation Review Board Opinions to the web site.  The opinions were posted on March 14, 2019.  To view the opinions, go to https://wcc.state.ct.us/news/new-783.htm.

REGULATORY ACTIVITY:

• The Commission’s newest Commissioner is Toni M. Fatone, who has been active in health care policy and administrative law for over 30 years, including working in both the public and private sectors. After earning her bachelor’s degree cum laude from the University of Connecticut in 1983 (with a major in political science and a minor in history), Fatone went on to earn her Juris Doctor from the Stetson University College of Law in Saint Petersburg, Florida in 1987. She was admitted to the Florida Bar in 1987 and the Connecticut Bar in 1988.

FEE SCHEDULE NEWS:

• Ambulance rates have been updated as of January 1, 2019. The next expected update to these rates is scheduled for January 2020.

REGULATORY ACTIVITY:

• Published memorandum number 2018-11 regarding the 2019 WCC Hospital and Ambulatory Surgical Center Fee Schedule. Pursuant to C. G. S. § 31-294d(d) (as amended June 11, 2014) the following will be in effect for the pecuniary liability of the employer for services rendered by a hospital and ambulatory surgical center:
  • The hospital inpatient rate shall be 174% of the Medicare rate payable to that facility.
  • The hospital outpatient and hospital-based ambulatory surgical center rate shall be 210% of the Medicare rate payable to that facility.
  • The non-hospital based ambulatory surgical center rate shall be 195% of the hospital-based outpatient Medicare rate payable in the same CBSA (Core Based Statistical Area).
  • Where there is no Medicare rate for the services in an outpatient hospital setting, the parties shall negotiate the reimbursement rate. If negotiation is not successful, the parties may request a hearing with the Commission; however, treatment shall proceed pending same.

The Workers’ Compensation Commission is working with a vendor to publish the 2019 applicable rates, rules and guidelines for this Fee Schedule. It will be available in advance of the April 1, 2019 effective date. Notice of availability will be published at https://wcc.state.ct.us/.   To view the memorandum, go to https://wcc.state.ct.us/memos/2018/2018-11.htm.

• The mileage reimbursement rate for all travel expenses incurred on or after January 1, 2019 has risen to $0.58 per mile. This rate change applies to all claimants, regardless of injury date, and coincides with the federal mileage reimbursement rate pursuant to Section 31-312(a) of the Workers’ Compensation Act.

REGULATORY ACTIVITY:

• Pursuant to Section 31-280b, Chairman Stephen M. Morelli has appointed Commissioners Peter C. Mlynarczyk and David W. Schoolcraft to sit as panel members on appeals before the Compensation Review Board for the calendar year beginning January 1, 2019.

REGULATORY ACTIVITY:

• In consultation with practitioners, insurers and the Medical Advisory Panel, medical protocols for Foot and Ankle injuries are being implemented. These protocols are not meant to be absolute and there must be room for medical judgment.  Medical providers are urged to contact the insurer if they feel that a treatment pattern other than the published protocol is required. It is expected that the payer will work with the provider to ensure that the injured worker receives the most appropriate treatment. These protocols will be used by the Commission to evaluate whether a treatment is reasonable and appropriate based on the diagnosis of injury. The effective date of these protocols was November 1, 2018. We are grateful to the medical professionals who have spent and continue to spend many hours working with us to bring the most appropriate and the highest standard of care to injured workers in Connecticut. The protocols can be found at http://wcc.state.ct.us/download/acrobat/protocols.pdf.
• Published memorandum number 2018-09 regarding guidelines for mediation effective November 1, 2018.  This memo supersedes Memo number 2017-03.  To view the memo, go to https://wcc.state.ct.us/memos/2018/2018-09.htm.
• The Commission’s newest Commissioner is Pedro E. Segarra, who has been active in the practice of law for over 30 years, in addition to his extensive experience in community activism, social work, and public service. After earning his Bachelor of Arts degree in Political Science from the University of Hartford and his Master’s degree in Social Work from the University of Connecticut, Segarra went on to earn his Juris Doctor from the University of Connecticut School of Law. From 1982-1986 Commissioner Segarra worked at Hartford Hospital as a Psychiatric/Medical Social Worker/Psychotherapist.  During the years 1986-2010, Segarra owned and operated a general practice of law in the areas of civil, criminal, real estate, probate, bankruptcy, disability, employment, and workers’ compensation law. Working in public service, Segarra worked in the State of Connecticut State’s Attorney’s Office as a Deputy Assistant State Attorney from 1989-1990, and served as Corporation Counsel for the City of Hartford from 1991-1995. From 2006-2010 he was Council President and Council Member of the City of Hartford, later serving as Mayor of the City of Hartford from 2010-2016. Since 2016, Segarra has served Office Counsel to the firm of Shimkus, Murphy & Rosenberger, specializing in the areas of real estate, zoning, probate and estate administration, landlord/tenant administration, organizational law, personal injury, criminal, and civil litigation. In addition to his work in the law, Segarra has been a co-founder of several organizations including Hogar Crea Drug/Alcohol Treatment Center, Connecticut Latinas/os Achieving Rights and Opportunities, and the Hispanic Health Council, and in 2012 he was recognized with a Service Award by the University of Connecticut Law School Alumni Association.

REGULATORY ACTIVITY:

• Average Weekly Wage, Maximum Compensation Rate and Cost of Living Adjustments: Section 31-309 of the Connecticut General Statutes as amended by Public Act 93-228 sets the maximum weekly compensation rate to be the same as the average weekly earnings of all employees in Connecticut. This maximum rate applies to total disability benefits provided in § 31-307 and decedents’ dependents benefits provided in § 31-306.The State Labor Commissioner has determined that the estimated average weekly earnings of all employees in Connecticut effective October 1, 2018 will be $1,298.00. Therefore, the maximum compensation rate for total disability and decedents’ dependents will also be $1,298.00 for injuries occurring on or after October 1, 2018.The maximum compensation rate for partial disability (incapacity), i.e., benefits pursuant to § 31-308, is equivalent to the average weekly earnings of production and related workers in manufacturing in Connecticut. The State Labor Commissioner has determined that the average weekly earnings of production and related workers in manufacturing in Connecticut effective October 1, 2018 will be $1,046. To view this notice, go to https://wcc.state.ct.us/.
• Calculating Weekly Benefit Amounts without FICA and/or Medicare Deductions: In the event that a Commissioner decides that an employee is not subject to FICA and/or Medicare taxes, he or she may exclude the equivalent amount of deduction from gross pay to determine the compensation rate. Currently, such rates are not calculated by the system, nor are the formulae for determining them manually written anywhere - on the VA or elsewhere. One method for calculating these amounts is by manually following the steps from the exhibits in the front of the rate table book but omitting the FICA and/or Medicare deductions. Since this is rather involved, the Commission has come up with some "short cut" equations.  To view this notice, go to https://wcc.state.ct.us/.
• Workers' Compensation Benefit Rate Tables October 1, 2018-September 30, 2019:  Tables for determining the workers' compensation benefits for Connecticut workers injured between October 1, 2018 through September 30, 2019 are now available.  To view this notice, go to https://wcc.state.ct.us/.

REGULATORY ACTIVITY:

• Announces the publication of the 2018 Official Connecticut Practitioner Fee Schedule. Published by Optum, the 2018 Official Connecticut Practitioner Fee Schedule will reflect all changes to the 2017 schedule. This new schedule will include revisions and clarification of some rules, and the new 2018 CPT codes. This new publication will be effective for medical services rendered on or after July 15, 2018, regardless of the date of injury, that are payable to health care providers authorized or permitted to render care under the Connecticut Workers’ Compensation Act. To order, please contact OPTUM360 at 1-800-464-3649, option 1, or visit optum360coding.com keyword “Connecticut”.  To view the official notice, go to https://wcc.state.ct.us/.
• Published the August Compensation Review Board calendar. To view the calendar, go to           https://wcc.state.ct.us/crb/calendars/calendars.htm

FEE SCHEDULE NEWS:

• The state has adopted the 2018 Official Connecticut Practitioner Fee Schedule effective on and after July 15, 2018.  The next update is expected in July 2019.

REGULATORY ACTIVITY:

• Issued Memorandum No. 2018-03 regarding peer reviews performed by Excel O.  The Connecticut Workers’ Compensation Commission has recently learned that a former New York based orthopedic surgeon, Spyros Panos, whose license to practice medicine was previously suspended, is accused of misappropriating another physician’s identity and fraudulently performing peer/utilization review services.  Currently, the matter is under investigation by federal and New York state authorities. We have reason to believe that a company identified as Excel O LLC may have acted as a peer/utilization review organization and utilized Panos’ assumed medical alter ego to perform peer/utilization reviews. We further believe that some Connecticut Workers’ Compensation insurance carriers may have utilized the peer/utilization review services of Panos under his assumed identity and the peer/utilization review entity known as Excel O LLC. At this juncture, we are aware that one of the insurers which utilized the allegedly fraudulently based peer/utilization review services of Panos/Excel O LLC is The Hartford. Additionally, there may be a number of other Workers’ Compensation insurance carriers who may have utilized these peer/utilization review services. The Connecticut Workers’ Compensation Commission has reached out to the Connecticut Insurance Department, the Attorney General and others advising them of this situation. In the meantime, if you are a Workers’ Compensation claimant and are concerned, you should contact the insurance carrier handling your claim. You should ascertain from the carrier if any peer/utilization review services related to your claim were performed as part of this alleged illegal scheme. We understand that the Hartford is investigating the matter and seeking to develop an action plan that will remediate this problem. We expect, and encourage, other insurance carriers and entities to self-report to this Commission any dealings they may have had with Panos, his associated organization and their fraudulent peer/utilization activities. Any parties impacted by the above that seek additional information or would like to report additional information to the Connecticut Workers’ Compensation Commission, should contact the Chairman’s office at (860) 493-1500.  To view the memorandum, go to  http://wcc.state.ct.us/memos/2018/2018-03.htm
• Issued Memorandum No. 2018-04 regarding co-signatures for physician's assistants. Effective June 1, 2018, the Workers’ Compensation Commission will no longer require the co-signature of a physician on forms (Forms 36, Voluntary Agreements, etc.) or medical reports signed by a physician’s assistant (PA). This action is being taken so as to reflect what appears to be the real-world custom and practice of medical providers. Forms will no longer be denied at the district office level solely for the lack of a co-signature. To view the memorandum, go to  http://wcc.state.ct.us/memos/2018/2018-04.htm.