Claim Closure with Brian Groesser

08/08/2023

Claimant has a positive drug screen and is fired for violating the employer's drug-free work zone. Automatic denial, right? Maybe, but will it ultimately hold up in court? Maybe not. Intoxication is an affirmative defense in North Carolina meaning that you as the employer and carrier need to prove it. What exactly do you need to do to prove intoxication? Take a shot of this episode and find out. Download, follow and listen here:

Apple: https://podcasts.apple.com/us/podcast/intoxication/id1660597638?i=1000623802666

Spotify: https://open.spotify.com/episode/39fnCt4fOzGxDAM31fFl9V

iHeart: https://www.iheart.com/podcast/269-claim-closure-with-brian-g-106179968/episode/intoxication-120647210/

Amazon: https://music.amazon.com/podcasts/bc865c19-fc8f-48ef-8563-96f0ce867692/episodes/81f30f33-3051-4c52-bb99-15d183cc2da4/claim-closure-with-brian-groesser-intoxication

Google: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5idXp6c3Byb3V0LmNvbS8yMDc3ODE5LnJzcw==

07/06/2023

Today I discuss what it means to be injured in the course and scope of the employment. This is focused on the time, place and circumstances of an injury. It is the claimant’s burden to prove and if he or she is unable to do so, then the claim is not compensable even if it stemmed from an accident arising out of the employment. The following of this podcast is growing every week across the country. Be sure to join in by downloading, following and listening here:

Apple: https://podcasts.apple.com/us/podcast/claim-closure-with-brian-groesser/id1660597638

Spotify: https://open.spotify.com/show/4gMNehrvNetVpaXIQSemwA?si=XZad5V-BTVWfW2gJuwghJw&nd=1

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08/05/2023

A special treat of three published Court of Appeals cases in one week. Baker discusses the requirement for a Pleasant case to survive summary judgment in a civil proceeding. Brewer discusses the burden when it comes to the Parsons presumption. And Marlow allowed a civil case to survive summary judgment with a finding that the accident did not arise out of the employment - despite the employer already accepting the accident as compensable on a Form 60. Listen in to learn how these cases can impact your claim handling. Download, listen and follow here:

Apple: https://podcasts.apple.com/us/podcast/claim-closure-with-brian-groesser/id1660597638

Spotify: https://open.spotify.com/show/4gMNehrvNetVpaXIQSemwA?si=XZad5V-BTVWfW2gJuwghJw&nd=1

iHeart: https://www.iheart.com/podcast/269-claim-closure-with-brian-g-106179968/

Amazon: https://music.amazon.com/podcasts/bc865c19-fc8f-48ef-8563-96f0ce867692/claim-closure-with-brian-groesser

20/04/2023

12 hours after the last episode published, the Court of Appeals came out with its revised decision in Sturdivant. The verdict? The 500-week cap on indemnity benefits is gone. I will discuss this decision and take a deep dive into what is actually left of the alleged pro-employer amendments that were made to the Act in 2011. I will also discuss what a veto-proof General Assembly can do to immediately address the problems that have arisen since those amendments were enacted 12 years ago. The Sturdivant decision can be found here: https://appellate.nccourts.org/opinions/?c=2&pdf=42140

You can download, listen and follow the podcast here:

Apple: https://podcasts.apple.com/us/podcast/sturdivant-2-0/id1660597638?i=1000609744251

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Amazon: https://music.amazon.com/podcasts/bc865c19-fc8f-48ef-8563-96f0ce867692/claim-closure-with-brian-groesser

18/04/2023

This one has been 12 years in the making. Ever since the Act was changed in 2011 and a 500-week cap installed regarding entitlement to indemnity benefits, employers and employees have been waiting for the Court of Appeals to decide what it actually takes to have benefits extended beyond 500 weeks. And now we have our answer in Sturdivant. Or do we? The Court of Appeals actually vacated its own decision and will reassess after essentially eliminating the 500-week cap by its original decision. We will discuss this case along with a Woodson analysis of what it takes for an employer to be sued in civil court and not have the exclusive remedy protection typically afforded under the Act. Download, listen and follow here:

Apple: https://podcasts.apple.com/us/podcast/claim-closure-with-brian-groesser/id1660597638

Spotify: https://open.spotify.com/show/4gMNehrvNetVpaXIQSemwA?si=XZad5V-BTVWfW2gJuwghJw&nd=1

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13/03/2023

Employee injures his ankle playing volleyball at a company picnic. Not compensable. Employee injures her ankle dancing at the company Christmas party. Compensable. Say what? Injuries that occur during social activities hinge not on the injury, itself, but the voluntariness of the activity the injury occurred during. There are a set of guideposts to follow when receiving these fact patterns, and this episode will cover all of them. Be sure to download and follow here:

Apple: https://podcasts.apple.com/us/podcast/arising-out-of-the-employment-social-activities/id1660597638?i=1000603898581
iHeart: https://www.iheart.com/podcast/269-claim-closure-with-brian-g-106179968/episode/arising-out-of-the-employment-social-110436669/
Spotify: https://open.spotify.com/episode/4CJ5lhwwEakopI1cDnW7ry
Amazon: https://music.amazon.com/podcasts/bc865c19-fc8f-48ef-8563-96f0ce867692/episodes/1055af0b-bddf-4725-bcba-f297aa9ab5fc/claim-closure-with-brian-groesser-arising-out-of-the-employment-social-activities

06/03/2023

This episode is a departure from our Arising Out of the Employment series and reviews a recent published opinion from the Court of Appeals. I will discuss the implications of a death at work, the presumption that accompanies it, and how experts can shape the opinion of the court. Further, we will discuss how the court determines an average weekly wage of a temporary employee who dies prior to the end of his employment period. You can download the most recent episode here:

Apple: https://podcasts.apple.com/us/podcast/case-law-update-gilliam-v-foothills-temporary-employment/id1660597638?i=1000602940458
iHeart: https://www.iheart.com/podcast/269-claim-closure-with-brian-g-106179968/
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The must-have resource for opening, navigating and ultimately closing workers' compensation claims in North Carolina. Adjusters, risk managers, and employers alike can follow for a discussion of all things workers' compensation, from forms handling to common topics/issues and monthly case law upd...

02/03/2023

Employee gets injured goofing off with another employee. Automatic denial, right? Not necessarily. This episode will delve into the history of horseplay and how such injuries have actually generally been found to be compensable unless certain exceptions apply. People who work together tend to play together.

https://podcasts.apple.com/us/podcast/arising-out-of-the-employment-horseplay/id1660597638?i=1000601836073

20/02/2023

So a worker is assaulted on the job. Is it compensable? This episode will discuss when an assault arises out of the employment making it compensable and when it should be denied. All episodes can be downloaded here:

Apple: https://podcasts.apple.com/us/podcast/claim-closure-with-brian-groesser/id1660597638
Spotify: https://open.spotify.com/show/4gMNehrvNetVpaXIQSemwA?si=XZad5V-BTVWfW2gJuwghJw&nd=1
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13/02/2023

Today’s episode is a primer for what it means for an injury by accident to “arise out of” the employment. Future episodes will then use this foundation to discuss fact patterns often seen when this issue arises, including workplace assaults, horseplay, social activities, idiopathic conditions and pre-existing conditions, among others. The audience continues to grow weekly for this podcast so I appreciate you listening and sharing with your colleagues. All episodes can be found here:

Apple: https://podcasts.apple.com/us/podcast/claim-closure-with-brian-groesser/id1660597638
Spotify: https://open.spotify.com/show/4gMNehrvNetVpaXIQSemwA?si=XZad5V-BTVWfW2gJuwghJw&nd=1
iHeart: https://www.iheart.com/podcast/269-claim-closure-with-brian-g-106179968/
Amazon: https://music.amazon.com/podcasts/bc865c19-fc8f-48ef-8563-96f0ce867692/claim-closure-with-brian-groesser

06/02/2023

Work injuries happen. But not all work injuries are the result of an accident. And if there is no accident, then it is not a compensable claim. Too often adjusters make the mistake of accepting injuries that do not stem from accidents. This episode will go over what constitutes an injury by accident in North Carolina and how to identify it in your initial investigation of a claim.

We are over 500 downloads now of this podcast after the first month and it continues to grow every week. I continue to hear positive feedback and appreciate all of you who have taken the time to listen. You can find and download today’s episode here:

https://podcasts.apple.com/us/podcast/claim-closure-with-brian-groesser/id1660597638

30/01/2023

Who is an employee for purposes? Pay him on a 1099? Still could be an employee. An undocumented worker? Can still be covered. A minor? Age is just a number. This episode goes into what it means to be an employee. Download, Listen & Follow here:

https://podcasts.apple.com/us/podcast/who-is-an-employee/id1660597638?i=1000597280414