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

Tuesday, March 3, 2015

2016 Budget Proposal Would Require Reporting of Workers’ Compensation Benefits to Social Security Administration

The Social Security Administration (SSA) has been vocal in the past about its difficulty in obtaining information about workers’ compensation benefits. The primary reason that the SSA has been seeking this information is to reduce social security benefits by way of an SSDI/WC offset. The SSDI/WC offset is a calculation used by the SSA to reduce a beneficiary’s SSDI benefit amount if the person is also receiving workers’ compensation benefits. The SSDI/WC offset is different in every state and applies only when the individual's combined monthly amounts of SSDI and workers' compensation are greater than 80% of individual's pre-disability "average current earnings.”

The SSA currently has to rely on beneficiaries to report to the SSA when they receive workers’ compensation or public disability benefits. President Obama’s 2016 budget proposal includes a provision to establish a new federal requirement that workers’ compensation and public disability benefit information be provided by states, local governments, and private insurers to the SSA.

The budget proposal summary includes the narrative below:

Establish Workers’ Compensation Information Reporting. Current law requires SSA to reduce an individual’s Disability Insurance (DI) benefit if he or she receives workers’ compensation (WC) or public disability benefits (PDB). SSA currently relies upon beneficiaries to report when they receive these benefits. This proposal...


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Patients with workers' compensation have inferior outcomes after hip arthroscopy

Patients with worker’s compensation claims had inferior functional outcomes after hip arthroscopy compared with a non-workers’ compensation group, according to study findings.

Over a 2-year period, researchers compared the outcomes of 26 patients with workers’ compensation claims who underwent hip arthroscopy with those of 30 patients who did not have a workers’ compensation claim. All of the patients had at least 6 months’ worth of follow-up data available.

The researchers used the Hip Outcome Score and the modified Harris Hip Score to assess patients’ postoperative functional outcomes.

Wilcoxon test results showed patients in the workers’ compensation group had a significantly lower Hip Outcome Score than the non-workers’ compensation group (66.5 vs. 89.4). However, the between-group difference for modified Harris Hip Score was not considered significant (72.5 vs. 75.6), according to the researchers.

Patients in the workers’ compensation group had an average time between injury to surgery of 11 months, and four patients required additional surgery. One complication, deep venous thrombosis, was diagnosed in the workers’ compensation group at 1 week postoperatively, but this was treated with oral anticoagulation. The non-workers’ compensation group required no additional surgery, nor were any complications reported.

At the most recent follow-up, 15 patients in the workers’ compensation group were able to go...

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Nurse Who Contracted Ebola in the U.S. Sues Her Hospital Employer

The nurse who was the first person to contract Ebola in the United States filed suit on Monday against the Dallas hospital where she worked, saying it knowingly left workers without the training or equipment needed to handle the disease.

The nurse, Nina Pham, 26, was one of two at Texas Health Presbyterian Hospital who were infected while treating Thomas Eric Duncan, who had the virus when he arrived from the West African country of Liberia.

Ms. Pham’s suit, filed in State District Court in Dallas, accuses the hospital’s parent company, Texas Health Resources, of negligence, fraud and invasion of privacy. Not only did the hospital expose her to a deadly disease, she contends, it also made false statements about her condition and released video of her without her permission.

A Texas Health spokesman, Wendell Watson, said Ms. Pham was “still a member of our team,” and declined to address the specific claims. He added, “We remain optimistic that we can resolve this matter.”

Ms. Pham has been free of Ebola for months, but she has lingering medical and emotional problems, and the long-term consequences remain unclear, said her lawyer, Charla Aldous.

“She still has fatigue and body aches,” and has not been able to return to work, Ms. Aldous said. “She’s been having some liver problems. Her hair started falling out.”

Mr. Duncan went to the hospital’s emergency room on Sept. 25 with fever, nausea and abdominal pain,...


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Union, Environmental Group Say Dozens of Nuclear Workers Suffering from Toxic Materials Exposure

Evidence “strongly suggests a causal link between chemical vapor releases and subsequent health effects" at a Washington facility, according to a recent report. (Ellery / Wikimedia Commons)

Since March 2014, nearly 60 workers at the Hanford Nuclear Reservation in Washington state have sought medical attention for on-the-job exposure to chemical vapors released by highly toxic waste stored at the site, some as recently as August. At a public meeting held Wednesday in Pasco, Washington, Hanford workers described symptoms that include chronic headaches, respiratory problems, nerve damage and bloody urine.

The meeting, hosted by the United Association (U.A.) of Plumbers and Steamfitters Local 598 and Hanford Challenge, a Seattle-based environmental watchdog group, was convened following the February 10 release by Department of Energy contractor Washington River Protection Services (WRPS) of a “corrective action implementation plan.” This plan was developed in response to recommendations in a report from the Savannah River National Laboratory released in October 2014.

Commissioned in response to worker exposures at Hanford’s tank farms, the Savannah River report found ongoing emissions of toxic chemical vapors from waste tanks, inadequate worker health and safety procedures and evidence that “strongly suggests a causal link between chemical vapor releases and subsequent health effects.”

The underground storage tanks—known as...

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Exxon Mobil Refinery Blast Comes As US Industries Grapple With Safety Concerns: Union, Enviro Groups Say

A Feb. 18 explosion at Exxon Mobil Corp.'s refinery in Torrance, California, is raising new concerns about high risks, weak standards and lax regulatory oversight in the oil refining sector. Reuters

An explosion this week at an Exxon Mobil Corp. refinery near Los Angeles is the latest in a spate of fires to strike U.S. oil plants in the past few years. The refining sector is beset by high risks, weak standards and lax regulatory oversight, labor and environmental groups say, despite recent efforts by U.S. and California officials to clamp down on safety concerns.

“There are inherent hazards in a refinery, but the idea is to keep the risks as low as possible. We don’t think that’s happening sufficiently in the industry,” said Michael Wright, director of health, safety and environment for the United Steelworkers. The Pittsburgh-based union is leading a refinery strike over safety-related and pay disputes.

The blast Wednesday at Exxon’s refinery in Torrance shattered a section of the facility, rained down ash and rattled nearby homes with earthquake-like tremors. Four contract workers suffered minor injuries. The company said it is still investigating the cause of the accident, though initial reports suggest the problem might have started in an ultra-hot cracking unit, which turns crude oil into gasoline.

"The safety and health of our employees, contractors and neighbors remain our top priority," Todd Spitler, an Exxon...




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Saturday, February 28, 2015

Study Urges Greater Financial Disclosure by Nonprofit Integrated Health Systems

WASHINGTON, D.C.—Based on publicly available information, there is scant evidence to back up claims by large, nonprofit integrated health systems that they deliver higher quality care more efficiently, according to a new study released today from the nonpartisan National Academy of Social Insurance (NASI). The report will be discussed at a 2pm panel on trends in provider consolidation during a Federal Trade Commission / Department of Justice live webcasted workshop on “Examining Health Care Competition.”

Along with a comprehensive review of the academic literature, the study included an analysis of publicly available quality and financial information from 15 of the largest nonprofit integrated delivery networks (IDNs) across the country, including Henry Ford Health System in Detroit; North Shore-LIJ Health System in suburban New York; Intermountain Healthcare in Utah/Idaho; Sutter Health in Northern California; BayCare Health System in Tampa/St. Petersburg; and Geisinger Health System in Central Pennsylvania.

The study defined IDNs as vertically integrated health services networks that include hospitals, physicians, post-acute services and sometimes health plans with a stated purpose to coordinate care across the continuum of health services and to manage population health; or fully integrated provider systems inside a health plan (e.g. with no other source of income than premiums).

"Some of the nation’s finest hospitals and clinical staffs can...


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Lawyer at Top of Huge Fraud Pleads Guilty

A Long Island lawyer who led a huge scheme to defraud the Social Security Administration pleaded guilty on Friday, receiving a reduced sentence in return for promising to help federal investigators find other people cheating the disability insurance system, prosecutors said.

The lawyer, Raymond Lavallee, entered an agreement with the Manhattan district attorney’s office to plead guilty to one count of fourth-degree conspiracy and to pay $2 million in restitution and fines.

Mr. Lavallee, 84, of Massapequa, N.Y., also agreed to cooperate with investigators at the Social Security Administration who are seeking to recover money from others who filed false claims as part of the scheme, which involved scores of retired police officers and firefighters who feigned mental illnesses to get benefits.

He faced a maximum sentence of 25 years on the top charge of grand larceny, had he gone to trial. In return for his assistance, he was promised a sentence of one year in jail by Justice Daniel P. FitzGerald in State Supreme Court in Manhattan.

Mr. Lavallee and three other men were charged last year with bilking the federal government out of millions in disability benefits. The scheme involved more than 131 police officers, firefighters and other city workers who falsely claimed they had been psychologically scarred. Many pretended they had suffered post-traumatic stress because of the Sept. 11, 2001, terrorist attacks.

More than 100 of the applicants have pleaded guilty. A majority...


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