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Workers’ Compensation

Negligence, Even Gross Negligence, Will Not Bar a Worker’s Compensation Claim

The North Carolina Supreme Court has long recognized that an employee’s injury caused by their own negligence act, cannot, in itself, bar their workers’ compensation claim. This principle is outlined in Hartley v. N.C. Prison Department, 258 N.C. 287, 128 S.E.2d 598 (1962). In that case, Mr. Hartley, a prison guard, was on his way […]

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Supreme Court Limits Compensability of Weight Loss Treatment Recommended for Injured Employees

On Friday March 22, 2024, the Supreme Court issued a favorable decision for the defense in Kluttz-Ellison v. Noah’s Playloft Preschool, No. 173PA22 (N.C. 2024).  Lindsay Wikle and Duane Jones from Hedrick Gardner represented Defendants. The Supreme Court provided a test to determine whether requested medical treatment is “directly related” to the original compensable injury, […]

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CMS to Demand Section 111 Reporting of Funds Set Aside for Future Medicals in Workers’ Compensation Settlements

The Centers for Medicare and Medicaid Services (CMS) is expanding the existing Section 111 reporting process to capture information on all workers’ compensation claims involving Medicare beneficiaries that receive a settlement (i.e., TPOC) and funding for a Workers’ Compensation Medicare Set-Aside (WCMSA), regardless of whether the workers’ compensation settlement was reported to CMS under the […]

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Centers for Medicare and Medicaid Services (CMS) Maintains $750.00 “Low Dollar” Reporting Threshold

The SMART Act requires CMS to annually review the costs associated with the collection of Medicare conditional payments and set forth a threshold amount applicable to settlements, judgements, awards, or other payments (TPOC amount) for which it will not seek recovery. The threshold amount for 2023 was $750.00. On February 14, 2024, CMS announced the […]

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Rob Wilson Appointed as Hedrick Gardner’s Raleigh Office Managing Partner

January 2024 — Hedrick Gardner Kincheloe & Garofalo LLP is proud to announce Rob Wilson has been appointed as the firm’s new managing partner of its Raleigh office, effective January 1, 2024. Wilson will succeed Patricia Shields, who has served as managing partner since 2021. In his new role, Wilson is committed to continue the […]

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The Centers for Medicare and Medicaid Services (CMS) Confirms Civil Monetary Penalty (CMP) Rules Regarding Mandatory Insurer Reporting for Non-Group Health Plans (NGHP)

CMS held a webinar on January 18, 2024, where it provided clarification of the rules regarding the issuance of CMPs for late Section 111 reporting of the ongoing responsibility for medicals (ORM) and total payment obligations to a claimant (TPOC). The PowerPoint presentation should be posted on CMS’ website in two weeks. In sum, the […]

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CMS to Demand Section 111 Reporting of Funds Set Aside for Future Medicals in Workers’ Compensation Settlements

By Shannon Metcalf The Centers for Medicare and Medicaid Services (CMS) is expanding the existing Section 111 reporting process to capture information on all workers’ compensation claims involving Medicare beneficiaries that receive a settlement (i.e., TPOC) and funding for a Workers’ Compensation Medicare Set-Aside (WCMSA), regardless of whether the workers’ compensation settlement was reported to […]

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Hedrick Gardner Recognized as a Best Law Firm by U.S. News – Best Lawyers® 2024

November 2, 2023. Hedrick Gardner Kincheloe & Garofalo LLP received several top rankings in the U.S. News – Best Lawyers® 2024 “Best Law Firms” report. The firm received Tier 1 regional rankings, the highest category awarded, in eight categories. The full firm report is as follows: Metropolitan Tier 1 Charlotte: Raleigh: Columbia (SC): Metropolitan Tier 2 Charlotte: […]

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CMS Increasing Threshold for Liability Settlements – Fixed Percentage Option

The Fixed Percentage Option Threshold will Increase to $10,000.00 for Liability Settlements on October 2, 2023 says The Centers for Medicare & Medicaid Services (CMS) By Shannon Metcalf Since November 7, 2011, the Centers for Medicare and Medicaid Services (CMS) has permitted a Medicare beneficiary to elect to resolve his/her conditional payment claim in liability […]

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