(c) 2015 Jon L Gelman, All Rights Reserved.

Wednesday, November 18, 2015

NJ Medical Payments Stabilize - But Why?

A recent study by an insurance based data organization has reported that NJ is experiencing a leveling of medical costs. The real question is "why?" Are declining medical benefits caused by fewer claims based on a shift of challenging employment status in the shared economy or a shift of medical costs under Obamacare to the private sector? 
Medical payments per workers’ compensation claim in New Jersey were stable from 2010 to 2013, in contrast to rapid growth in the 2008 to 2010 period, according to a recent study by the Workers Compensation Research Institute (WCRI).
The report, CompScope™ Medical Benchmarks for New Jersey, 16th Edition, indicates results for New Jersey differed from those of other states WCRI studied, many of which experienced moderate to rapid growth in medical payments per claim.
The study found the following to be contributing factors: 
  • Increased use of networks, which may be linked to a decrease in prices paid for non hospital care. In recent years, two-thirds of total medical payments came from non hospital services.
  • Flat or decreasing trends in utilization of many non hospital services.
  • Slower growth in hospital outpatient payments per service.
  • A continued decrease in the percentage of claims that had hospital inpatient care.
“From 2010 to 2013, medical payments per claim with more than seven days of lost time rose less than 2 percent per year in New Jersey,” said Ramona Tanabe, executive vice president and counsel for WCRI. “From 2008 to 2010, payments rose nearly 10 percent per year.”
WCRI studied medical payments, prices, and utilization in 17 states, including New Jersey, looking at claim experience through 2014 on injuries that occurred in 2013 or earlier. WCRI’s CompScope™ Medical Benchmark studies compare metrics of medical costs and care from state to state and across time.

On-Premises Injury While Cashing Payroll Check Held Not Compensable

Injured worker, a supermarket employee, was held not acting within the scope of his employment when he was injured after slipping on a granular substance on the floor of the checkout area. Petitioner, clad in what appeared to be his pajamas, had come to the store several hours before his scheduled shift to cash his paycheck. He used some of the cash to buy a lottery ticket from the courtesy desk, handed the ticket to a friend working at a separate register, and was in the process of walking away when he fell.

Miller v Shoprite, N.J. App. Div. (2015) 2015 WL 7031636 Decided November 13, 2015 (Unpublished Decision)

Monday, November 16, 2015

CMS MSP FInal Conditional Payments Portal To Open

Upcoming Updates to the Medicare Secondary Payer Recovery Portal (MSPRP) Modification for Inclusion of Final Conditional Payment (CP) Process Functionality

As part of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act), the MSPRP will be modified to include Final CP process functionality by January 1, 2016.  This new functionality will permit authorized MSPRP users to notify CMS that a recovery case is 120 days (or less) from an anticipated settlement and request that the recovery case be a part of the Final CP process.
When the Final CP process is requested, any disputes submitted through the MSPRP will be resolved within 11 business days of receipt of the dispute.  Once all disputes have been resolved, and the case is within 3 days of settling, the beneficiary or their authorized representative will be able to request a Final Conditional Payment Amount on the MSPRP.  Once calculated, this amount will remain the Final Conditional Payment Amount as long as:
  1. The case is settled within 3 calendar days of requesting the Final Conditional Payment Amount, and
  2. Settlement information is submitted through the MSPRP within 30 calendar days of requesting the Final Conditional Payment Amount.

Friday, November 13, 2015

Demolition of Paterson NJ Armory Highlights Present Danger of Asbestos

The emergency demolition of the decades old Paterson NJ Armory, an historic site, highlights that asbestos, a known carcinogen, remains a hazard to workers when older buildings require renovation or demolition.
asbestos remains a clear and present danger to workers. Despite the fact that asbestos may not be used as a new construction material,

Asbestos, a naturally occurring mineral, was used for years as a construction material because of its fire retardant and heat insulation properties.

The hazards of asbestos are well known. Exposure to asbestos may cause the latent development of: asbestosis, lung cancer and mesothelioma.

The Paterson NJ Armory caught fire several days ago and resulted in  a major North Jersey fire alarm requiring the participation of firefighters to be called in from multiple jurisdictions to be be brought under control. Unable to reach and extinguish some parts of the fire, the Paterson Fire Department ordered that the historic building be demolished on an emergency basis.

Despite the knowledge of the fatal hazards of asbestos use, it  has yet to be banned in the United States.

Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thompson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson-Reuters). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

Thursday, November 12, 2015

Known Iraq & Afghanistan Burn Pit Locations

Breathing dust, fumes and other and other toxic substances, exposed troops deployed overseas, and those who worked for government contractors abroad and other civilians, to a serious hazards. Some of the chemicals were very toxic carcinogens and are deadly.

Known Burn Pit Locations
Exposure SiteSite CitySite State/ProvinceSite Country
Bagram AirfieldBagramParvanAfghanistan
Camp KabulKabulKabulAfghanistan
Camp BastionLashkar GahHelmandAfghanistan
Camp DwyerGarmsirHelmandAfghanistan
Camp EggersKabulKabulAfghanistan
Camp PhoenixKabulKabulAfghanistan
Camp SpannMazar-e SharifBalkhAfghanistan
COP BakBakKhowstAfghanistan
COP Tere ZayiTere ZayiKhowstAfghanistan
FOB AirborneKane-EzzatVardakAfghanistan
FOB AsadabadAsadabadKonarAfghanistan
FOB ChapmanKhostKhowstAfghanistan
FOB GhazniGhazni CityGhazniAfghanistan
FOB MaimanehMaimanehFaryabAfghanistan
FOB Orgun-EOrgunePaktikaAfghanistan
FOB QalatQalatZabulAfghanistan
FOB RamrodMalwandKandaharAfghanistan
FOB SalernoKhowstKhowstAfghanistan
FOB ShankGardezLowgarAfghanistan
FOB SharanaSharanaPaktikaAfghanistan
FOB ShindandSabzawarHeratAfghanistan
FOB Tarin KowtTarin KowtUruzganAfghanistan
FOB WaltonKandaharKandaharAfghanistan
ISAF HQKabulKabulAfghanistan
Kandahar AirfieldKandaharKandaharAfghanistan
Camp LemonierDjiboutiDJDjibouti
Al Asad AirbaseAl AsadAl-AnbarIraq
Al Taqaddrum AirbaseAl HabbaniyahAl-AnbarIraq
Ali Air BaseNasiniyahDhi-QarIraq
Baghdad Central PrisonAbu GhraibBaghdadIraq
Camp HopeAl DiweniyahAl-QuadisyyahIraq
Cam Scania`NippurNippurAl-QuadisyyahIraq
Camp AndersonAl DiwaniyahAl-QuadisyyahIraq
Camp AshramAshrafDiyelaIraq
Camp BabylonAl HillahBabilIraq
Camp BaharlaFallujahAn-AnbarIraq
Camp BuccaUmm QasrAl-BasrahIraq
Camp CorregidorRamadiAl-AnbarIraq
Camp DeltaAl KutWasitIraq
Camp DogwoodAl IskandariyahBabilIraq
Camp FalconBaghdadBaghdadIraq
Camp FallujahFallujahAl-AnbarIraq
Camp Freedom IBaghdadDiyelaIraq
Camp IndependenceBaghdadBaghdadIraq
Camp Korean VillageAr RutbahAl-AnbarIraq
Camp ManhattanAl HabbanlyahAl-AnbarIraq
Camp RamadiRamadiAl-AnbarIraq
Camp RustamiyahSadr CityBaghdadIraq
Camp ShieldBaghdadBaghdadIraq
Camp TajiTajiBaghdadIraq
COB BasraBasraAl-BasrahIraq
COB SpectorTikritSalah ad-DinIraq
COP MeadeZambraniyahBaghdadIraq
FOB BernsteinTuzSalah ad-DinIraq
FOB Brassfeld-MoraSamarraSalah ad-DinIraq
FOB CaldwellKirkukKirkukIraq
FOB CourageMosulNinawaIraq
FOB DangerTikritSalah ad-DinIraq
FOB DukeNajafAn-NajafIraq
FOB EchoAl DiwaniyahAl-QuadisyyahIraq
FOB FentyJakakabadNangarharIraq
FOB GabeBaqubahDiyelaIraq
FOB HammerBaghdadBaghdadIraq
FOB HitRamadiAl-AnbarIraq
FOB HotelNajarAn-NajafIraq
FOB KalsuIskandariyaBabilIraq
FOB LimaKarbalaAl-KarbalaIraq
FOB LoyaltyRamadiAl-AnbarIraq
FOB MarezMosulNinawaIraq
FOB McKenzieSamarraSalah ad-DinIraq
FOB MercuryAbu GhraibBaghdadIraq
FOB NormandyMuqdadiyahDiyalaIraq
FOB PeliwodaBaladSalah ad-DinIraq
FOB Q-WestQayyarahNinawaIraq
FOB ScunionBaqubaDiyalaIraq
FOB St, MichaelMahmudiyaSalah ad-DinIraq
FOB SummerallBaijiSalah ad-DinIraq
FOB SykesTal AfarNinawaIraq
FOB UbeydiAl UbaydiAl-AnbarIraq
Green ZoneBaghdadBaghdadIraq
Haditha DamHadithaAl-AnbarIraq
Joint Base BaladBaladSalah ad-DinIraq
Joint Security Station McHenryHewijahKkirkukIraq
JSS Al AwadAl AwadDhi-QarIraq
JSS TarmiyahTarmiyahBaghdadIraq
JSS ThrasherGhazaliyaBaghdadIraq
Kirkuk Air BaseKirkukKirkukIraq
Mosul Air BaseMosulNinawaIraq
Victory Base ComplexBaghdadBaghdadIraq
Ali Al Salam Air Force BaseAli Al Salam AFBAl JahraKuwait
Camp ArifjanKuwait CityAl AsimahKuwait
Camp BuehringUDAIRIUdairiAl JahraKuwait
Camp CoyoteCamp CoyoteAl JahraKuwait
Camp DohaAd DawhahAl JahraKuwait
Camp New YorkUdairiAl JahraKuwait
Camp SpearheadShuaibaAl AhmadiKuwait
Kuwait Naval BaseAl JulaiaAl AhmadiKuwait
Al Udeid Air BaseDohaAd-DawhahQatar
Click here to read more about burn pit exposures in Iraq and Afghanistan.

Click here to read more about burn pit claims for benefits and lawsuits.

Click here to SUBMIT your information now.