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The Court upholds TPA penalties for unfair payments



A casino and its third-party administrator were denied judicial review of penalties and fines they received for not paying workers' compensation benefits on time.

Treasure Island Hotel and Casino v. Voorhees On Wednesday, the Nevada Appeals Court unanimously approved the Nevada Division of Industrial Relations to impose penalties and fines on the employer and the insurer for failing to provide disability payments and professional rehabilitation.

Heidi Voorhees worked as a cocktail waitress for Treasure Island Hotel and Casino when she slipped and fell on a wet floor during a shift in November 2014, with injuries to her knees, ankles and elbows. She filed a workers' compensation claim, and TPA, York Risk Services Group Inc., handled it. Miss Voorhees was released for light duty, but as the casino could not accommodate her work restrictions, she was granted temporary total disability benefits.

She filed an administrative complaint alleging that York issued her payments late and revoked her occupational rehabilitation benefits. The Industrial Relations Division considered that York participated in a pattern of early payments and erroneously terminated occupational rehabilitation benefits for Miss Voorhees and imposed penalties and fines for each violation.

Treasure Island and York filed a district court for review of the division's decisions that were denied. They then petitioned the Court of Appeal for review, arguing that the Division's finding was not supported by substantial evidence.

The Appeals Court upheld the division's decision. Although York and Treasure Island claimed that the payments were delayed due to a transfer of care and an administrative error, the court found that the division had substantial evidence to base its decision.

The Court of Appeal also retained the penalties for the repeal of occupational rehabilitation benefits. Although York claimed it believed Voorhees was not a US citizen because she was born in Libya and was not eligible for vocational rehabilitation, the court said her valid US passport, her social security card and driver's license were sufficient citizenship documentation and noted that an ISO ClaimSearch verified her work status.

As a result, the court found that substantial evidence supported the division's finding that benefits for occupational rehabilitation were erroneously denied to Mrs. Voorhees and that the district court did no wrong in denying court hearings.


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