(c) 2018 Jon L Gelman, All Rights Reserved.

Friday, November 27, 2009

Social Security's Inconsistencies

The News Journal of Delaware has reported broad statistical inconsistencies in the Social security claims determination process. In an 11 part series entitled, "Shut Out of Social Security," the paper analyzed statistical data from all states, hearing office and administrative law judges revealing variances in percentages of workloads and denial rates for disability benefits.

To read more about Social Security and productivity reports click here.

OSHA Sets H1N1 Flu Employer Responsibility Standard for Health Care Workers

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has  issued a compliance directive that clearly establishes a level of employer responsibility to health care workers to prevent the spread of H1N1 flu. The establishment of the standard may allow some injured workers to circumvent "the exclusivity doctrine" in workers' compensation and hold employers responsible in the civil justice system for resultant injury or death should the employer's fail to comply with is directive.

The "exclusivity doctrine" in workers' compensation limits an employers' responsibility to only scheduled workers' compensation benefits for harm caused to workers that "arises out of" and occurs "within the course of employment." Those benefits have become increasingly difficult to obtain for a multitude of reasons.

The OSGA directive closely follows the prevention guidance issue by The Centers for Disease Control (CDC) to prevent the spread of H1N1 flu. The purpose of the compliance directive is "to ensure uniform procedures when conducting inspections to identify and minimize or eliminate high to very high risk occupational exposures to the 2009 H1N1 influenza A virus."

The CDC has reported that the H1N1 flu activity continues to be widespread in the US and remains above epidemic in proportion for the seventh consecutive week. Over 99% of all subtyped A viruses being reported to the CDC were 2009 influenza A (H1N1) viruses. A total of 171 deaths in children associated with the 2009 influenza A (H1N1) virus infection have been reported to the CDC.

OSHA announced, "In response to complaints, OSHA inspectors will ensure that health care employers implement a hierarchy of controls, and encourage vaccination and other work practices recommended by the CDC. Where respirators are required to be used, the OSHA Respiratory Protection standard must be followed, including worker training and fit testing. The directive also applies to institutional settings where some workers may have similar exposures, such as schools and correctional facilities."

"OSHA has a responsibility to ensure that the more than nine million frontline health care workers in the United States are protected to the extent possible against exposure to the virus," said acting Assistant Secretary of Labor for OSHA Jordan Barab. "OSHA will ensure health care employers use proper controls to protect all workers, particularly those who are at high or very high risk of exposure."

To read more about workers' compensation and the H1N1 Flu click here.

Tuesday, November 24, 2009

Congress, Health Care & Unintended Consequences

This past week some very dramatic things happened in the workers’ compensation world. The US Senate moved forward on initiating a floor debate on health care. At the same time, a group of workers’ compensation scholars met in Washington DC to discuss the future of workers’ compensation and the interplay with social security disability.

 Highlights of the NASI (National Academy of Social Insurance) conference convened in Washington were findings presented by eminent leaders in the field. Professor John Burton, Rutgers University, pointed out that newly created barriers to workers’ compensation were pushing more injured workers to the Social Security disability system for benefits. This reflects a phenomenon that occurred in the late 1970’s when a study commissioned by the US Department of Labor and conducted by Mt. Sinai Hospitals’ Environmental Sciences Laboratory, revealed that the inadequate benefit delivery system of workers’ compensation for asbestos related illness, was forcing injured workers and their families into the civil justice arena for adequate compensation.

The problems have not changed in decades; they have only gotten worse, maturing into a system that is in critical condition and on life support. In 1980 Irving J. Selikoff, M.D. reported, “There has been widespread acknowledgement of significant problems with disability compensation for workers in the United States. One major area of concern has been the shortcomings with regard to occupational disease. Whatever the suitability of current workers’ compensation systems in the 50 states for injuries and work accidents, there has been little disagreement about the inadequacies of such systems for workers who become disabled by illness or, if they die, for their surviving dependents.”

Complex questions continue to exist between the scientific and legal communities as to the path to be taken. Barriers placed into the path of recovery, including pre-existing and co-existing conditions, which result in limited or delayed recovery and major shifting of the economic responsibility upon the public/private benefit systems need to be removed. The unspoken social consequences continue as a silent epidemic as families and survivors struggle in silence.

Looking backward over the noble experiment in California which turned sour, Tom Rankin, former President of the California Labor Federation, AFL-CIO, expressed his regret of the reform. The former Labor leader theorized that the results were “unintended consequences.” Indeed he is looking forward to solutions springing forth in a “public option” embedded into the national health care legislation.

Some participants at the NASI conference alleged a major shortcoming of the California workers’ compensation legislative reform effort. Doug Kim, a lobbyist for the claimant’s attorneys, disclosed that the injured workers’ advocates were not invited to partake in the discussion that lead up to crafting the initial drafts of the 2004 California reform legislation SB 899.

History reveals, that when the theoretical reforms were practically applied, the injured workers suffered serious setbacks. If these were in fact “unintended consequences,” then one must consider the active involvement of all stakeholders when looking forward to solutions. The courts in California have consistently upheld challenges to the inequitable results, pointing to the legislative intent to reduce costs. Absent from the discussions of the presenters were practical systemic applications to improve the present system. The “blood and guts” of the traumatic, delay and denial, struggles of navigating in a crippled workers’ compensation system, in California and elsewhere, is verification that change is mandated.

As North Carolina attorney, Valerie A. Johnson, so eloquently remarked, “workers’ compensation is supposed to be a simple system.” The process has now been obstructed by encroaching elements of fault, contributory negligence, apportionment of pre-existing conditions and difficulties of the element of time, manifested by latent diseases unknown to the fathers of the system a century ago. The advance of medical science has brought forth new and innovated modalities that have contributed to soaring medical costs. The convergence of these issues has generated higher administrative costs.

Pecuniary Industry motives have worked adversely to improving safety in the workplace. The need for workers’ compensation would be minimized by adopting a safer occupational environment. Under reporting of workplace accidents continue as the Government Accountability Office announced. Nebraska Appleseed reveals that workers feel intimidated and are apprehensive to report injuries and unsafe work conditions. This is scenario is compounded by the fact that undocumented workers, who have even less job security, work in jobs with higher risk. The Bush Administration did not make efforts to allow OSHA to heighten enforcement efforts. All of these ingredients combine to create a recipe that just doesn’t work.

The US Senate advanced the health care legislation to a floor debate in an unusual late Saturday night session. This action may indeed provide an opportunity for the stakeholders in workers’ compensation to all join in the debate and look for solutions to the delivery of appropriate medical care in an efficient and timely fashion. To avoid “unintended consequences” yet again, injured workers and their advocates will need to be active participants and engage in the debate now.


To read more about workers’ compensation and universal health care solutions click here.

Friday, November 20, 2009

Proposed System in Oklahoma to Bifurcate Medical

Legislation has been proposed in Oklahoma to dismantle the present workers' compensation system and replace it with an administrative system designed to reduce costs and litigation. The medical component would removed entirely from the workers' compensation litigation system and placed into the hands of a commission who would appoint administrative hearing officials to decide disputes. 

The Chamber of Commerce supports the proposal that would dismantle the present workers' compensation court system in a systematic fashion as cases resolve before the present judicial system.

State Representative Mark McCullock said, "By separating the legal and the medical, we can reduce the adversarial nature of the process, get people treated and back to work, and reduce costs for employers. This reform will ensure medical ratings are handled in a professional, independent fashion and drain the fever swamps of litigation.”

Asbestos Exposure Continues Needlessly

Despite all the knowledge of the hazards of asbestos fiber in the workplace, asbestos is still  mined throughout the world and continues to be used in the United States.  For decades asbestos has been recognized as the cause for asbestosis, lung cancer and mesothelioma. Asbestos is not banned in the US.

The US Geological Survey reports that asbestos production in 2008 (metric tons) continues at alarming rates around the world:
1. Russia.................1,017,000
2. China.....................238,000
3. Brazil.....................225,000
4. Kazakhstaan...........230,000
5. Canada...................180,000

The US continues to import 1,460 metric tons of asbestos at a raw product cost of $1,090,000. It exports and reports  many asbestos and asbestos based products including: cement products, friction products, gaskets, paper and millboard, all valued at $33,200,000.

"U.S. consumption of asbestos was 1,460 t in 2008, a 16% decrease from 1,730 t in 2007. Coating and compounds accounted for 36% of U.S. consumption; roofing products, 34%; and other, 30%. Most of the asbestos reported under “coating and compounds” probably was used in roofing products. Consequently, roofing applications, which comprised bituminous roof coatings and roof sealants, accounted for 65% to 70% of the total U.S. asbestos end-use market."

While U.S. imports and sales continues to decline, the legacy of asbestos disease lives on, continuing to generate unnecessary disease, suffering  and death. An efficient and expeditious compensation system for those workers who have been exposed and suffer disease has become increasing complicated and difficult to navigate. Another recent report indicates that the workers' compensation system continues to shift responsibility to the social security system as the path for benefits becomes more litigious and difficult to navigate. A good first step to solve the problem would be for Congress to ban asbestos entirely in the U.S.

Thursday, November 19, 2009

Montana Cuts Off Benefits For Retirees

The Montana Supreme Court reiterated that the right to receive Workers' Compensation benefits is not a fundamental right and it could be terminated at retirement age.  The Court rationalized that the receipt of permanent partial disability [PPD] benefits was conditioned upon the ability to return to work. Therefore, an individual should not receive workers' compensation partial disability benefits if the worker retires due to age.

"PTD [permanent partial disability] benefits are not meant to supplement a claimant’s wages rather they are intended to assist the worker who will never be able to return to work."

"It is well established that the control of workers’ compensation costs is a legitimate government interest that may constitutionally be pursued by the legislature."

Shifting Occupational Claim Responsibility to Social Security

Recent Workers' Compensation reforms enacted in the 1990's are more likely to effect older workers  who are then more likely to to apply for Social Security Disability Benefits (SSDI). The reforms are now causing an enormous increase in number of denials of workers' compensation claims. At a recent conference hosted by NASI (National Academy of Social Insurance), Professor John F. Burton Jr. reported on the results of his recent study that has been submitted for publication.

Professor Burton reported that in 1999 between 80% to 93.8% of occupationally disease medical costs were not considered compensable and the costs were being shifted to the SSDI program. He concluded that, "...a substantial infusion of research funds are necessary to clarify the relationships between the Workers' Compensation and SSDI Programs."

To read more about Professor Burton and workers' compensation on the blog, click here.

Wednesday, November 18, 2009

Policy Holders at NJM Get Dividends

New Jersey Manufacturers Insurance Company announced that it is  continuing its tradition, as it has done since 1918, of paying dividends to policyholders.

"Workers' Compensation policies issued by NJM are receiving a Regular Dividend of 15% of their premiums. NJM's Board of Directors has approved increasing the rate to 20% for policies expiring January through March 2009. Meanwhile, New Jersey Re-Insurance Company Workers' Compensation policyholders are seeing a return of 5% of their premium."

Compensation Benefits for Smokers

On the eve of the annual Great American Smokeout one needs to reflect on the inadequacy of the national workers' compensation to assist in this effort. For decades, the addictive habit of smoking has been treated as a non-compensable cause and a pre-existing condition. See The Health Consequences of Smoking: Cancer and Chronic Lung Disease in the Workplace: A Report of the Surgeon General. 

Like obesity, workers' compensation insurance carriers have considered it as a risk not associated with work condition even though it has been a synergistic agent in many occupational cancers, ie. asbestos exposure and smoking results in an enormous risk increase for lung cancer. 

To make the workplace safer and end the epidemic of occupational cancers, the compensation system should embrace the effort to eliminate smoking in the workplace and provide assistance to workers to stop smoking.

Great American Smokeout ---

November 19, 2009

Although the United States has made great strides toward reducing the prevalence of smoking, approximately 46 million adults (20.6% of the population) still smoke (1), and every day, another 1,000 young persons become new smokers (2). Annually, smoking results in 440,000 deaths and $193 billion in health-care costs and lost productivity (3). November 19 marks the 33rd anniversary of the American Cancer Society's Great American Smokeout. This annual event challenges smokers to quit for at least 1 day and provides information resources to help them quit permanently.
Quitting smoking has immediate and long-term benefits, including reduced risk for heart disease and certain cancers. Successful quitting often takes several tries. To improve success, smokers should use proven cessation treatments and services, including health-care guidance, approved medications, and cessation counseling. Combining counseling and medications can more than double cessation success. More information about the Great American Smokeout is available at, and free help for quitting smoking is available by calling 800-QUIT-NOW (800-784-8669) or visiting


  1. CDC. Cigarette smoking among adults and trends in smoing cessation---United States, 2008. MMWR 2009;58:1227--32.
  2. Substance Abuse and Mental Health Services Administration. Results from the 2008 National Survey on Drug Use and Health: detailed tables, 4-10A and 4-11A. Rockville, MD: US Department of Health and Human Services, Office of Applied Studies; 2009. Available at Accessed November 4, 2009.
  3. CDC. Smoking-attributable mortality, years of potential life lost, and productivity losses---United States, 2000--2004. MMWR 2008;57:1226--8.

Tuesday, November 17, 2009

Compensating Sick Workers at Home with H1N1 Flu

While the United States has established a national protocol to meet the medical challenges H1N1 flu pandemic, there remains a void on how to pay workers who are ill and have been encouraged by the government to stay home.  The litigious workers' compensation adversarial system may provide benefits ultimately for those who can demonstrate that their illness "arose out of and occurred in the course of the employment," after months, if not years, of delay. 

Some states have temporary disability programs, fraught with bureaucratic delay and red tape, while the issues of denial in the workers' compensation claims become identified. If held to be compensable, reimbursement is then sought by the temperate disability plan, public or private, 

The issues of a lack of an efficient wage replacement system for those workers affected by the H1N1 flu will be addressed by Congress shortly. The chorus of advocacy is increasing as this debate advances. The following is a recent post from the occupational-environmental mailing list setting forth a pretty persuading argument to establish a plan to pay sick workers with H1N1 flu.

Sick At Work

When the first cases of the H1N1 virus (swine flu) were confirmed in America back in April, the Centers for Disease Control and Prevention advised that sick individuals stay home from work or school. "Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people," the CDC said."If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them." However, for many Americans, staying home from work due to illness -- or to care for a sick child -- is an impossibility because of a lack of job-protected paid sick days. In response to the threat posed by H1N1, Rep. George Miller (D-CA) has proposed legislation that would "guarantee five paid sick days to employees at businesses with 15 or more workers who are directed to stay home by management." However, Miller's plan sunsets in two years and gives employers, not employees, the right to decide when leave is taken. Plus, under Miller's plan, employees cannot use leave time to care for a sick child. The Healthy Families Act (HFA), which is also before Congress, would guarantee seven paid sick days per year to all workers at firms with 15 or more employees. "Paid sick days has always been a good, common sense idea, but, in light of the recent H1N1 epidemic, it has also become a necessary one," said Rep. Rosa DeLauro (D-CT), an HFA sponsor. "Right when more and more workers are feeling economically vulnerable and afraid to even miss one workday, we face an extraordinarily serious health risk that spreads much more quickly if the sick do not stay at home." Last week, the Obama administration officially agreed, and endorsed the HFA.

The U.S. is currently the only developed nation that does not require some paid sick leave for workers. Nearly 40 percent of private sector workers have no paid sick leave, including 78 percent of hotel workers and 85 percent of food service workers. A survey last year by the National Opinion Research Center at the University of Chicago found that "68 percent of those not eligible for paid sick days said they had gone to work with a contagious illness like the flu." As CAP Senior Fellow Ann O'Leary and Karen Kornbluh, U.S. Representative to the Organisation for Economic Co-operation and Development, pointed out in The Shriver Report: A Women's Nation Changes Everything, "too often, most low- and many moderate-wage workers cannot access even the minimum benefits provided to more highly paid workers." And this is true of paid sick leave, as 88 percent of workers in the top 10 percent of wage earners have it, compared to just 22 percent of workers in the bottom 10. "Hopefully, employers are doing the right thing and not disciplining workers who are out sick as a result of the flu," wrote Center for American Progress Senior Economist Heather Boushey. "But there's no penalty for employers who choose not to pay workers in this situation, or who refuse workers any time off at all."

Big business organizations have panned the notion of required sick leave, with the Chamber of Commerce saying that "
the problem is not nearly as great as some people say," and the National Association of Manufacturers warning that the HFA "would impose an inflexible government mandate on employers, making it more difficult for manufacturers to preserve and create jobs." However, lost productivity due to sick workers attending work and infecting others costs the U.S. economy $180 billion annually. For employers, the cost averages $255 per employee per year and "exceeds the cost of absenteeismand medical and disability benefits." The National Partnership for Women and Families actually found that "while a paid sick days policy would impose modest costs, the estimated business savings total $11.69 per week per worker from lower turnover, improved productivity and reduced spread of illness." The Center for Economic and Policy Research has also concluded that "there is no significant relationship between national unemployment rates and legally-mandated access to paid sick days." "When businesses take care of their workers, they are better able to retain them, and when workers have the security of paid time off, their commitment, productivity and morale increases, and employers reap the benefits of lower turnover and training costs," said National Partnership President Debra Ness.

Two major cities -- San Francisco and Washington, D.C. -- have implemented mandatory paid sick leave policies, while a third -- Milwaukee -- has passed the requirement, only to see it tied up in court. In addition, 15 states have proposed mandatory sick leave laws. 
"We are all being advised by our doctors to stay home if we're sick, but that is a cruel piece of advice if you don't have paid sick time," Maine Senate President Elizabeth Mitchell said. New York City is also looking at mandatory leave, which Mayor Michael Bloomberg has expressed support for, at least for the city's large employers. New York's proposed requirement would also allow workers to stay home in the event their child's school was closed for public health reasons. "Many working parents suffered this past spring because their children's schools were closed even though their children were not sick," said Donna Dolan, chairwoman of the New York State Paid Family Leave Coalition.

To read more about flu and workers' compensation click here.

NIOSH Reports on the Safety of Nanotechnology

The emerging area of nanotechnology has brought with it concerns over worker safety. NIOSH has now released a progress report concerning this technology. NIOSH's goals are:

1. Determine whether nanoparticles and nanomaterials pose risks of work-related injuries and illnesses.
2. Conduct research to prevent work-related injuries and illnesses by ap- plying nanotechnology products.
3. Promote healthy workplaces through interventions, recommendations, and capacity building.
4. Enhance global workplace safety and health through national and international collaborations on nanotechnology research and guidance.

"To date, NIOSH/OEP has committed about $5.3 million dollars to research on applications and implications of nanotechnology. Summaries of the projects funded by NIOSH/OEP are included in Appendix B. NIOSH/OEP plans to continue collaborative efforts with EPA/NCER, NSF, NIH/NIEHS, and other international agencies to support nanotechnology research with occupational safety and health implications. OEP will continue to confer with the NIOSH Nanotechnology Research Center regarding issues, gaps, and future directions.

To read more about nanotechnology click here.

Monday, November 16, 2009

WC Attorney Liable for $359M+ in Legal Malpractice Claim

A NJ workers' compensation attorney who failed to pursue a medical malpractice claim and allowed it to be dismissed was held liable for legal malpractice. The client was injured when a physician punctured the workers' kidney while administering an epidural injection.

To complicate the claim further, the attorney also failed to report the legal malpractice claim to his insurance carrier on a timely basis. In a separate action the legal malpractice insurance carrier was held not liable for the attorney's malpractice.

The workers' compensation claim was settled for $30,000. The liability claim resulted in a judgment, which was entered following a proof hearing, included an award of damages in the amount of $275,000, plus prejudgment interest of $31,453.20, and counsel fees and costs totaling $52,582.17.

Braime v Popovich DOCKET NO. A-3077-07T23077-07T2 NJ App Div Decided 11.6.09 unpublished.

For more about workers' compensation click here.

Sick Leave Pay Law For H1N1 Advances

US Senator Chris Dodd (D-CT) has announced that he is preparing legislation to pay sick workers 7 days of sick leave for H1N1 flu. While workers' compensation benefits may be paid to disabled H1N1 flu workers, the threat of delay and denial has created an emergency that Senator Dodd indicates requires immediate Congressional attention. 

“This isn’t just a workers’ rights issue – it’s a public health emergency. Families shouldn’t have to choose between staying healthy and making ends meet,” said Dodd. “But if staying home means you don’t get paid, that’s an impossibility, especially for families struggling to make ends meet in this tough economy.”

“Workers should have paid sick leave as a matter of basic fairness,” Dodd continued. “But now sick leave is a matter of keeping Americans safe from this pandemic – and from the next one, whatever it may be.”

He said, "It’s a matter of fairness for workers. It’s a matter of safety."

The CDC reports that H1N1 flu is now widespread in 48 states and may have infected as many as 5.7 million Americans. Fatalities amount to 672 Americans, which includes 129 children.

Thursday, November 12, 2009

APHA Calls for US Asbestos Ban

The American Public Heath Association (APA) has called for a ban by Congress on the manufacture, sale, export, or import of asbestos containing products including products in which asbestos is a contaminant. Asbestos claims 10,000 American lives each year.

“As early as 1898, the British government factory inspectors recognized adverse health effects associated with exposure to asbestos fibers. By the 1930’s the scientific evidence was well established of the association between asbestos exposure and nonmalignant respiratory disease, and with the publication of Dr. Irving Selikoff’s study of insulation workers in 1964, the evidence of carcinogenicity was incontrovertible as well.”
“Despite the concerns of asbestos exporting countries and business interests of the mining industry, the scientific consensus today is that all types of asbestos fibers, including chrysotile, cause asbestosis, lung and other cancers, specifically mesothelioma. The magnitude of the public health problem presented by asbestos and its ubiquitous use during the last 50 years is revealed by death certificate data analyzed by the National Institute for Occupational Safety and Health (NIOSH). NIOSH identified 2,485 deaths in the U.S. in 1999 in which malignant mesothelioma was listed as an underlying or contributing cause of death; and that during 1968--2005, asbestosis was identified as the underlying cause of death for 9,024 decedents, 13% of these were aged 25-64 years. These data undoubtedly underestimate the situation as asbestos-related disease can take 10 to 50 years to present. The estimated portion of lung cancer deaths attributed to asbestos exposure is 2-3 percent.”

During the 1950’s and 1960’s Dr Selikoff would testify in the NJ Division of Workers’ Compensation as a medical expert for injured workers. I had the privilege of knowing him and observing his efforts to assist injured workers and spread his scientific discoveries on the harmful effects of asbestos products.

It is shocking that in 2009 the US permits the use, manufacturing and distribution of asbestos containing products. It is certainly well passed the time to ban asbestos in the US.

Wednesday, November 11, 2009

Federal OSHA to Review State Safety Plans

In recent testimony before Congress, Jordan Barab, acting assistant secretary for the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA), reported that OSHA will be reviewing State safety programs.

"To improve oversight immediately, I sent interim guidance to OSHA regional administrators about the monitoring tools available to them and encouraged more in-depth investigation of potential problems," said Barab. "To ensure that deficiencies similar to those found in Nevada do not exist in any of the other state plans, OSHA will conduct a baseline evaluation, similar to what we conducted in Nevada, for every state that administers its own program. These evaluations will lead to better program performance and consistency throughout all state plans."

"We want to work together with the states and provide assistance before a state's program becomes deficient and causes worker deaths, injuries and illness," said Barab. "We are not trying to change the nature of our relationship between federal and state OSHA, but we need to speak with one voice and assure American workers they will receive adequate protection regardless of the state in which they work."
The read more about OSHA and workers' compensation click here.

Tuesday, November 10, 2009

The Jungle Called Workers’ Comp

Almost a century ago Upton Sinclair authored, The Jungle. It is the story of the dangerous work of the meat packing industry. In a very comprehensive report, “The Speed Kills You,” published by Nebraska Appleseed 2009, the stark realities of the failures of the workers’ compensation system are exposed.

Nebraska Appleseed (Appleseed) is a nonprofit, nonpartisan, public interest law project.  Their principals: “core values, common ground, and equal justice,” guide their mission. Appleseed recruited many scholars, professionals and community leaders, to assist in the production of the report.

The failings described by the report, while targeted to the Nebraska’s meatpacking industry, have universal application and the consequences dramatically reveal the  domino effect of an imploding system that has been run off the road and been flung into the ditch.

Appleseed reports that in Nebraska, where 20% of the US meat is processed, the workplace remains a jungle.  After conducting an extensive survey, with input from both employers, employees, academicians and practitioners, the non-profit group reported that deadly speed on the meat packaging line has resulted in an increase in the amount of injuries that go unreported because of employees’ fear of harassment by employers.

The meat packers, many undocumented workers, suffer from repetitive motion injures caused by working in awkward positions all day.  Their language barrier, lack of knowledge of legal remedies, unfamiliarity with workers’ compensation benefit procedures, further complicates their ability to seek redress.

The noble goals envisioned by the national workers’ compensation system were to provide a summary and remedial benefit to injured workers. The cost of benefits was to be passed onto to the consumer. Safety was not addressed. Unfortunately, it is not a punitive system geared to make the workplace safer. Since its inception in 1911, it has lacked the necessary elements to create an economic incentive for employers to increase safety in the workplace.

The issues identified by the Nebraska study are mirrored through out the country. Employees lack adequate information about the workers’ compensation, they continue to be subjected to poor ergonomic conditions, inspections by OSHA have been few and far between, and discrimination against employees and a challenge to their dignity continues. There are few penalties imposed against employers for delay and denial of claims. The system has become convoluted, dilatory and litigious in nature. It now forces an employee to battle a system that blames them for getting hurt.

The workers’ compensation jungle described by the Appleseed report  must finally be tamed. Employees should no longer be treated merely as beasts of burden. Injured workers should have their dignity restored. The Appleseed recommendations should be addressed and the entire system, including medical benefit delivery, be improved. To make the workplace jungle safer, employers must be held accountable for the unreasonable actions taken only for their pecuniary gain.
To read more about medical benefits & workers' compensation click here.

Monday, November 9, 2009

Integration of Benefits Anticipated to Save Money

A recent report indicates substantial economic savings if health insurance (a date based system) was merged with workers’ compensation (an event based system) coverage. The report, authored by a study group headed by Frank Neuhauser, and funded by the California Healthcare Foundation, predicts substantial money savings as well as system efficiency would occur upon integration of benefits.

“Integrating occupational medical care into the more efficient group health model would reduce administration to approximately 12% to 13%. We extend these findings to the US and estimate that the 10- year (2011- 2020) savings of integrating coverage would be between $490 billion and $560 billion, sufficient to pay for between 26% and 78% of the incremental cost of universal coverage.”

The study also indicates substantial savings in the costs of medical care would occur through integration of benefits.

“The savings would result from the much greater efficiency with which health insurance delivers care compared to workers’ compensation insurance. A minority of health insurance premiums (12%-14%) go to cover administration and profit. Workers’ compensation turns this ratio on its head, spending the majority (50%-60%) of premiums on these same overhead costs.”

“If near universal coverage becomes a reality, the medical portion of several types of property casualty insurance could be delivered in a much more efficient manner. Absent  near universal coverage, we will likely have to continue relying on the more costly, but  important role of other insurance mode
To read more about workers' compensation and medical benefits click here.

California the Epicenter of Workers Compensation Faces Political Gloom

Workers’ Compensation reform was the central political theme that brought Republican Governor Arnold Schwarzenegger into power. After dramatically deforming that system by reducing access and benefits, compounded by other economic woes, California now faces major political upheaval in the upcoming elections.

A poll, reported in Politico, shows that major political change maybe forthcoming.

“Only a third of all voters approved of voters approved of Republican Gov. Arnold Schwarzenegger’s job leading the state, and 45 percent of voters expressed ‘disappointment’ in him, while another 25 percent felt ‘anger’ or ‘anxiety.’
To read more about workers' compensation and California click here.

Friday, November 6, 2009

High Unemployment Rates & The Future of Workers Compensation

Soaring unemployment rates will continue to have a critical impact upon the nation's workers' compensation system. The US Bureau of Labor Statistics released numbers revealing that The unemployment rate rose from 9.8 to 10.2 percent in October.

"In October, the number of unemployed persons increased by 558,000 to 15.7 million. The unemployment rate rose by 0.4 percentage point to 10.2 percent, the highest rate since April 1983. Since the start of the recession in December 2007, the number of unemployed persons has risen by 8.2 million, and the unemployment rate has grown by 5.3 percentage points."

"Among the marginally attached, there were 808,000 discouraged workers in October, up from 484,000 a year earlier. (The data are not seasonally adjusted.) Discouraged workers are persons not currently looking for work because they believe no jobs are available for them. The other 1.6 million persons marginally attached to the labor force in October had not searched for work in the 4 weeks preceding the survey for reasons such as school attendance or family responsibilities."

While currently disabled workers may continue to collect benefits in most jurisdictions , even if unemployed, lower payrolls will result in lower premium revenues for insurance companies and lower contributions to State workers' copensation funds. The advocacy system will continue to implode with the resulting less revenue to maintain present and generate new infrastructure.

The numbers show a pattern that the "aging workforce", complicated by younger discouraged workers, may have difficulty finding employment in the new market post-recession. While the practice of workers' compensation law may rebound somewhat on the future, it will cetainly take a different path.
To read more about the the furture of workers' compensation click here.

Tuesday, November 3, 2009

The Workers' Compensation Beauty Pageant

The chore of ranking state workers' compensation systems is tougher than judging a national beauty pageant.  Peter Rousamiere made an excellent attempt this week in Risk and Insurance. The real answer is in the eyes of the users of the system and not merely on the commercial factors that industry relies upon to judge value.

Workers' compensation is social, remedial legislation. It is supposed to be a summary proceeding that delivers benefits expeditiously and efficiently to injured workers. The promise made in 1911 was a system removed of fault,  contributory negligence and assumption of the risk. Society has reneged on that agreement and now apportions and allocates disability on pre-existing conditions, prior functional credits and individual habits of workers. Ironically, it is Industry itself that markets items that results in obesity, smoking addiction and many other allegedly non-compensable factors.

The quality of a system is not only factored on rate of benefits, cost of insurance and lost time frequency. It is a system that should be evaluated on the human factors of injured workers' access to benefits and the time required to achieve the result. Justice delayed is indeed justice denied.

Yes, California, Alaska, New Jersey, New York and Montana may all share the bottom of the tank on the Risk and Insurance rating scale. However, horror stories are heard from Massachusetts (#1) concerning "opt-out programs," and in Nevada (#2) from OSHA, concerning the failure to abide by safety regulations. These dismal problems seem to be universal and embrace the entire program as it now exists.

Like the Miss America Pageant, it is time to take a good hard look at how the system presently functions and why it is not meeting expectations, both financial and socially.  Congress should commission an undertaking to figure out how to put the workers back into workers' comp.

To read more about a Congressional Commission click here.