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According to a press release issued by the Kentucky Department of Insurance, the owner of a Georgetown roofing company will be arraigned Thursday in Montgomery District Court on charges that he provided fake certificates of workers’ compensation insurance coverage to potential clients.
Kendall Hampton, owner of Hampton Roofing, allegedly gave the fake certificates to a construction company, a builder and an individual in order to obtain roofing jobs. He was arrested Aug. 14 in Montgomery County and was charged with three felony counts of insurance fraud. The case was investigated by the Kentucky Department of Insurance (DOI) Fraud Investigation Division.
If found guilty on all three counts, Hampton faces a maximum prison sentence of 15 years, a $30,000 fine, or both.
“Workers’ compensation insurance is a necessary business expense,” said Sharon P. Clark, DOI commissioner. “When a business owner fails to obtain the proper coverage, the workers and clients both are placed in a vulnerable position.”
The Department of Insurance is an agency of the Public Protection Cabinet.
In UEF v. Gussler, a recent opinion of the Kentucky Court of Appeals designated to be published, the Court addresses the definition of agriculture under KRS 342 and, specifically, whether logging qualifies as an agricultural and, thus, exempt activity per the agricultural exemption of KRS 342.0011( 18 ) , KRS 342.630(1), and KRS 342.650(5).
The facts before the ALJ established that in 1999, Gussler began working for Ray Williams whose business was described by him as “farming” (Williams did operate a farm) and the “timber business.” Gussler would cut timber for Williams, and Williams would sell the timber to local sawmills. Gussler testified that ninety-nine percent of his time was spent cutting timber for Williams. Williams testified that he primarily earned a living from logging his 804 acres composed almost entirely of timber.
On November 9, 2004, Gussler suffered serious injury when he was struck in the left side of the head by a large branch. At the time of the accident, Williams did not carry workers’ compensation insurance.
The matter was submitted to ALJ Thomas Davis on the issues of average weekly wage and whether Gussler’s work activities fell within the Act’s agricultural 
exemption of KRS 342.0011(18), KRS 3432.630(1) and KRS 342.650(5). The ALJ dismissed Gussler’s claim against both Williams and the UEF, essentially finding that logging “was purely a function of harvesting and farming” and was, therefore, a protected agricultural enterprise under the agricultural exemption embodied by KRS 342.0011(18 ), KRS 342.630(1), and KRS 342.650(5).
Gussler appealed to the Workers’ Compensation Board,who reversed and remanded to the ALJ, holding, among other things, that the logging work performed by Gussler did not fall under the definition of “agriculture” as that term is defined by KRS 342.0011(18).
The UEF then appealed to the Kentucky Court of Appeals.
The arguments on appeal pivoted specifically on the statutory interpretation of what constitutes “agriculture” under KRS 342. As the Court of Appeals noted, KRS 342.0011( 18 ) defines agriculture as:
. . . the operation of farm premises, including the planting, cultivation, producing, growing, harvesting, and preparation for market of agricultural or horticultural commodities thereon, the raising of livestock for food products and for racing purposes, and poultry thereon, and any work performed as an incident to or in conjunction with the farm operations, including the sale of produce at on-site markets and the processing of produce for sale at on-site markets. It shall not include the commercial processing, packing, drying, storing, or canning of such commodities for market, or making cheese or butter or other dairy products for market.
The Court concurred with the Board, noting:
KRS 246.010(5) and KRS 337.010(2)(b) are the other two areas of the Kentucky Revised Statutes in which agriculture is specifically defined. Both of these statutes expressly include raising or producing timber or lumbering operations within their respective definitions of agriculture, in contrast to the workers’ compensation provision which we are now asked to interpret. In finding as it did, the Board reasoned that as the legislature had specifically included logging in the other two definitions of agriculture and did not include it in the workers’ compensation act; the omission was presumed deliberate.
The Court of Appeals affirmed the Board’s order based on the evidence Gussler’s logging was “not incident to farming” and “[a]lthough it occurred on a farm, it is clearly evident from the testimony of all parties that the logging was not connected to the day to day operations of the farm itself.”
All concurred.
BEFORE: CAPERTON AND VANMETER, JUDGES. GUIDUGLI, SENIOR JUDGE.
ATTORNEYS:
C.D. Watson
Counsel for Appellant
Frankfort, Kentucky
Robert G. Miller, Jr.
Counsel for Appellee
Paintsville, Kentucky
The DWC has released the workers’ compensation benefit schedule for 2009. You can access the schedule at Roland Niemi Law Group’s website.
From the DWC:
The Department of Workers’ Claims has recently filed two emergency and ordinary regulations amending 803 KAR 25:089, Physician’s Fee Schedule, and 803 KAR 25:091, Hospital Fee Schedule.
Two people have requested these hearings; therefore, the hearings will be held on August 22, 2008, at 10:00 a.m. at the Department of Workers’ Claims, 657 Chamberlin Avenue, Frankfort, KY 40601.
Please note, an original filing had a different hearing date, but that has been changed and notice was sent out for August 22, 2008. Please contact Carla Montgomery at carla.montgomery@ky.gov if you plan to attend the hearing.
Written comments may be submitted to the Department of Workers’ Claims at the above address until close of business on September 2, 2008.
Brigham and Associates (impairment.com) recently announced it will be offering a complimentary teleconference on the ins and outs of Chapter 16, the Upper Extremities, of the AMA Guides, 5th Edition. Participants will also be able to ask questions.
If you attend:
Time: 1 p.m. PST
Conference Dial-In: 1-218-486-1300
Conference Bridge: 605808
Moderator: Aimee McEntire, CIR
Physician Expert: Kenneth Subin, M.D., CIR
The August 3, 2008, edition of The Lexington Herald-Leader revisited an issue raised several weeks ago when the paper reported on the disciplinary action taken against two central Kentucky physicians accused of over-prescribing narcotic medications. The recent suspensions of Lexington physicians, Dr. Charles Grigsby and Dr. James Heaphy, spotlighted not only a large scale social problem, but one specifically impacting the workers’ compensation community as the costs associated with increased narcotic use for pain management continue to escalate.
Sunday’s front-page story, “Treatment for pain divides physicians,” focused on the debate arising from two schools of thought on the use of narcotics for pain treatment. One school of thought “holds that pain essentially is an illness in its own right that should be treated aggressively, up to and including the use of powerful narcotic drugs. The other side contends that doctors must be much more conservative, offering narcotics only when they’re absolutely sure patients actually need the potentially addicting drugs and are not seeking them to abuse them.”
To read the complete article click here.
Also of interest: The Kentucky Board of Medical Licensure’s Guidelines for the use of narcotics in pain treatment.
