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Thursday, June 20, 2013

Making The Path More Difficult for Asbestos Victims

The House Judiciary Committee has marked-up and passed legislation that will make it more difficult for asbestos victims to obtain benefits. Ironically these perennial legislative efforts make it more difficult  for those who served the US in various capacities, including military service.


The legislation, entitled, Furthering Asbestos Claim Transparency Act (FACT) of 2013, allows asbestos companies and their insurers to go on a fishing expedition, to make it more difficult to obtain even reduced benefit payments. 

The NY Times, in an Editorial, wrote, "The bill would also increase the burden on claimants to supply information. But it puts virtually no burdens on asbestos companies, like disclosing the settlements they have reached with plaintiffs or requiring them to reveal where their products were used and when, so that workers know which companies or trusts might be liable for their injuries."

Wednesday, June 19, 2013

NIOSH Makes Ladder Safety Easier Through an App

The National Institute for Occupational Safety and Health (NIOSH) announces the availability of a new Ladder Safety smart phone application (app). This new app uses visual and audio signals to make it easier for workers using extension ladders to check the angle the ladder is positioned at, as well as access useful tips for using extension ladders safely. The app is available for free download for bothiPhone and Android devices.

Falls from ladders are a common source of preventable construction injuries. Misjudging the ladder angle is a significant risk factor for a fall. If the ladder is set too steep it is more likely to fall back or away during use, and if it is set too shallow then the bottom can slide out. 


“The ladder safety app is an innovative way to help keep workers safe and a tool to reduce these preventable injuries,” said NIOSH Director John Howard, M.D. “The development of this smart phone app also demonstrates how we are constantly working to make science-based practical information accessible to workers and employers in a way they need and can easily use.”

The app provides feedback to the user on positioning the extension ladder at the optimal angle. It also provides references and a safety guide for extension ladder selection, inspection, accessorizing, and use. It was developed with input from the ANSI A14 committee on Ladder Safety, the American Ladder Institute, and other stakeholders.

NIOSH collaborated with DSFederal on the final development and testing of the app before release. The app is based on a multimodal inclination indicator for ladder positioning that has been recently awarded a US patent. To learn more and download the Ladder Safety app visithttp://www.cdc.gov/niosh/topics/falls/ and to learn about the campaign to prevent falls in construction go to http://www.cdc.gov/niosh/construction/stopfalls.html. NIOSH is the federal agency that conducts research and makes recommendations for preventing work-related injuries, illnesses, and deaths. For more information about our work visithttp://www.cdc.gov/niosh/.

.Related articles

Monday, June 17, 2013

Overpayment Of Unemployment Due To Payment of Workers’ Compensation Benefits – NOW WHAT?!?

Today's post comes from guest author Kit Case from Causey Law Firm.

Injured workers transition from time loss compensation under their workers’ compensation claim to unemployment compensation when they are released to return to work but do not have a job available to them. In many cases, disputes arise as to whether the release to work and termination of workers’ compensation payments is appropriate. Often, the worker tries to find physically-appropriate work while collecting unemployment compensation during the dispute process but, once their attorney secures payment of back benefits under the workers’ compensation claim, an overpayment of unemployment benefits has occurred due to the overlap between the two systems. When this happens, workers should:
  1. Notify the unemployment insurance system that they are continuing to seek payment from the workers’ compensation system, but that they are involved in an appropriate job search during the dispute process.
  2. Immediately share with the workers’ compensation attorney any notices or orders received from the unemployment insurance system. These are usually NOT mailed to the attorney of record in a workers’ compensation claim and the notices often have limited time periods within to file a protest or request for reconsideration of the determination.
  3. Hold in savings from the workers’ compensation payment the claimed unemployment overpayment amount during the dispute process until a final overpayment notice has been issued, or have the workers’ compensation attorney hold this amount in their trust account. If this is not possible, be prepared to enter into a repayment agreement with the unemployment insurance system once a final overpayment figure has been determined.
  4. Seek assistance from the workers’ compensation attorney to document all attorney fees and costs paid as part of the effort to obtain back benefits under the workers’ compensation claim. Submit this documentation to the unemployment insurance system and request a reduction in the claimed overpayment to take these attorney fees and costs into account.
  5. Continue to send any notices or orders to the workers’ compensation attorney.
  6. Once the overpayment has been repaid, check to see if the receipt of workers’ compensation back benefits changes your tax obligations. In many states, workers’ compensation payments are not taxable income, but unemployment benefits are taxable. If there is a significant payment of back benefits under the workers’ compensation claim, it may be worthwhile to file an amended tax return with the IRS to document the lower taxable income figure.
Read more about "benefits" and workers' compensation:
Jun 13, 2013
It is fairly common for an injured worker to receive Social Security disability benefits and also receive a settlement for workers' compensation. According to Social Security, “If you receive workers' compensation or other public ...
Apr 08, 2013
Truckers are frequently entitled to benefits from multiple states for an injury. Each state sets rules for applying its workers' compensation laws. Virtually all states cover accidents that happen in that state. Many states allow ...
Jun 16, 2013
Accordingly, the Department's regulations implementing the Black Lung Benefits Act allow the submission of radiographs in connection with benefit claims and set out quality standards for their performance. These standards ...
Jun 13, 2013
Legislation sponsored by Assembly Democrats Annette Quijano, Valerie Vainieri Huttle, Jason O'Donnell, Ruben Ramos and Nelson Albano to provide lifetime workers' compensation benefits to surviving spouses of fire and ...

Proposed Medicare Payment Reductions Will Impact Workers' Compensation Costs

A government Medicare advisory panel reported on Friday that sweeping changes should be implemented to reduce increasing medical costs, including higher costs associated with hospital purchased physician practices. The impact of those proposed adjustments will significantly impact the national workers' compensation systems because of both direct and indirect links between the two programs, including medical fee schedules, and Medicare Secondary Payment reimbursements.


The Medicare Payment Advisory Commission (MedPAC)  releases its June 2013 Report to the Congress: 
Medicare and the Health Care Delivery System.

According to Commission Chair Glenn Hackbarth, “This report can inform a dialogue about future 
directions for the Medicare program, as well as about technical refinements to existing Medicare 
payment policy. Whether broad or narrow, the Commission’s work aims to balance the interests of 
Medicare beneficiaries, health care providers, and tax payers.”

Redesigning the Medicare benefit. In the report, the Commission continues its discussion of 
possible ways to redesign the Medicare benefit by focusing on the concept we refer to as competitively
determined plan contributions (CPC). Under CPC, Medicare beneficiaries could receive care through
either a private plan or traditional fee-for-service (FFS), but the premium paid by the beneficiary might
vary depending on the coverage option they choose. How much the federal government pays for a 
beneficiary’s care would be determined through a competitive process comparing the costs of available 
options for coverage. The report identifies key issues to be addressed if the Congress wishes to pursue a 
policy option like CPC. These include how benefits could be standardized for comparability, how to 
calculate the Medicare contribution, the role FFS, and the structure of subsidies for low-income 
beneficiaries.

Reducing Medicare payment differences across sites of care. Medicare’s payment rates often 
vary for similar services provided to similar patients, simply because they are provided in different sites of 
care. For example, Medicare pays 141 percent more for one type of echocardiogram when done in a
hospital outpatient department than when it is done in a freestanding physician’s office. If Medicare pays a 
higher rate for a service in one setting over another, program spending increases and beneficiaries pay 
more in cost sharing without a corresponding increase in quality of care. 

The Commission previously recommended reducing the rate Medicare pays for basic office visits from the 
payment rate in the outpatient setting to the physician office rate. Using similar criteria, this report identifies
additional services that may be eligible for equalizing or narrowing payment differences across settings. 
Bundling post-acute care services. Each year, about one-quarter of Medicare beneficiaries receive 
care following a hospitalization from a post-acute care provider, such as a skilled nursing facility, home 
health agency, or inpatient rehabilitation facility. However, nationwide the use of these services varies 
widely, for reasons not explained by differences in beneficiaries’ health status. Under traditional 
Medicare, the program pays widely varying rates for different settings and—characteristic of FFS—pays 
based on the volume of care provided, without regard to quality or resource use. 

Medicare has begun to explore the possibility of bundling services as a way to encourage providers to 
coordinate and furnish needed care more efficiently. In this report, the Commission explores the 
implications for quality and program spending for different design features of the bundles, such as the 
services included, the length of time covered by the bundle, and the method of payment.

Reducing hospital readmissions. In 2008, the Commission recommended a hospital readmissions 
reduction program to improve patient experience and reduce Medicare spending. In 2012, Medicare 
began such a program, penalizing hospitals that have high rates of Medicare beneficiaries being 
readmitted to the hospital within 30 days of discharge. The readmission penalty has given hospitals a 
strong incentive to improve care coordination across providers, and for that reason Medicare should 
continue to implement the policy. In this report, the Commission suggests further refinements to 
improve incentives for hospitals and generate program savings through reduced readmissions rather than 
higher penalties. 

Payments for hospice services. The Medicare hospice benefit provides beneficiaries an important 
option for end-of-life care. At the same time, the Commission has identified several problems in the way 
Medicare pays for hospices that may lead to inappropriate use of the benefit. The report presents 
information on the prevalence of long-stay patients and the use of hospice services among nursing home 
patients—both of which may inform policy development in the hospice payment system in the future. It 
also presents further evidence to support the Commission’s March 2009 recommendations to revise the 
hospice payment system.

Improving care for dual-eligible beneficiaries. Beneficiaries eligible for both Medicare and 
Medicaid—many of whom have complex medical and social needs—often have trouble accessing 
services and receive little care coordination, resulting in poorer health outcomes and higher spending 
relative to other beneficiaries. Programs that coordinate dual-eligible beneficiaries’ Medicare and 
Medicaid benefits have the potential to improve care for this population. In the report, the Commission 
notes that federally qualified health centers and community health centers may be uniquely positioned to 
coordinate care for dual-eligible beneficiaries because they provide primary care, behavioral health
services, and care management services, often at the same clinic site.

Mandated reports. The report includes three chapters that fulfill Congressional mandates: one on 
Medicare ambulance add-on payments, a second on geographic adjustment of fee schedule payments for 
the work effort of physicians and other health professionals, and a third on Medicare payment for 
outpatient therapy services. In each case, the Commission considers the existing policies—which are not 
permanent statutory provisions—and examines the effect of their continuation or termination on 
program spending, beneficiaries’ access to care, and the quality of care beneficiaries receive, as well as 
their potential to advance payment reform. 

The three congressionally mandated reports are described in further detail in separate fact sheets, posted 
on MedPAC’s website. The full report can be downloaded from MedPAC’s website:
http://medpac.gov/documents/Jun13_EntireReport.pdf

Read more about Medicare and Workers' Compensation
May 18, 2013
A NJ Superior Court deemed a proposed Medicare Set-Aside Agreement to be satisfactory to protect Medicare's interests and granted a Motion to Enforce a Pending Settlement. This action by the Court was taken after CMS ...
Mar 29, 2013
A new Workers' Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has been posted and is available to be downloaded on the CMS (Centers for Medicare & Medicad Services) website.
Jan 11, 2013
"The legislation changes the way Medicare collects money from people whose negligence caused a patient to incur medical bills. Murphy said the new law will streamline an outdated process, making it easier to close cases ...

Sunday, June 16, 2013

Black Lung Benefits Act: Standards for Chest Radiographs

A Proposed Rule by the Labor Department on 06/13/2013

Physicians and adjudicators use chest radiographs (X-rays) as a tool in evaluating whether a coal miner suffers from pneumoconiosis (black lung disease). Accordingly, the Department's regulations implementing the Black Lung Benefits Act allow the submission of radiographs in connection with benefit claims and set out quality standards for their performance. These standards are currently limited to film radiographs. In recent years, many medical facilities have phased out film radiography infavor of digital radiography. This proposed rule would update the existing film-radiograph standards and provide parallel standards for digital radiographs. The proposed rule would also update outdated terminology and remove certain obsolete provisions.

 The comment period that ends on 08/12/2013
You may submit written comments, identified by RIN number 1240-AA07, by any of the following methods.
  • Federal eRulemaking Portal: http://www.regulations.gov. Follow the instructions on the Web site for submitting comments. To facilitate receipt and processing of comments, OWCP encourages interested parties to submit their comments electronically.
  • Fax: (202) 693-1395 (this is not a toll-free number). Only comments of ten or fewer pages, including a Fax cover sheet and attachments, if any, will be accepted by Fax.
  • Regular Mail: Division of Coal Mine Workers' Compensation Programs, Office of Workers' Compensation Programs, U.S. Department of Labor, Room C-3520, 200 Constitution Avenue NW., Washington, DC 20210. The Department's receipt of U.S. mail may be significantly delayed due to security procedures. You must take this into consideration when preparing to meet the deadline for submitting comments.
  • Hand Delivery/Courier: Division of Coal Mine Workers' Compensation Programs, Office of Workers' Compensation Programs, U.S. Department of Labor, Room C-3520, 200 Constitution Avenue NW., Washington, DC 20210.
Instructions: All submissions received must include the agency name and the Regulatory Information Number (RIN) for this rulemaking. All comments received will be posted without change to http://www.regulations.gov, including any personal information provided.
Docket: For access to the docket to read background documents or comments received, go to http://www.regulations.gov.

Thursday, June 13, 2013

Democratic Bill to Provide Lifetime Workers’ Compensation Benefits to Spouses of Police, Fire Personnel Killed in Line of Duty Signed Into Law

Legislation sponsored by Assembly Democrats Annette Quijano, Valerie Vainieri Huttle, Jason O'Donnell, Ruben Ramos and Nelson Albano to provide lifetime workers' compensation benefits to surviving spouses of fire and police personnel who die in the line of duty has was signed into law on Thursday.

"These are dangerous professions with potentially deadly consequences," said Quijano (D-Union). "Police and fire personnel should have the peace of mind that their families will be provided for if they are killed in the line of duty. The work that they do and the risks they take warrants it."

"Police and fire work is inherently dangerous. These firefighters and police personnel have families they have to provide for. In some cases, they may be the main breadwinners," said Vainieri Huttle (D-Bergen). 'Making sure their families are provided for is the least we can do."

"Few other professions involve the daily risks faced by firefighters and police personnel. This is a burden not just on them, but their families," said O'Donnell (D-Hudson). "They should have the comfort of knowing that if their lives are ever claimed by the job, their families will be taken care of."

"This important legislation to the men and women who put their lives on the line every day in our communities," said Ramos (D-Hudson). 'It is the right thing to do for the families of these individuals if a tragedy occurs. For their dedication to our communities, their families should be provided for."

"New Jersey's firefighters and police officers perform an honorable duty in serving our communities," said Albano (D-Cape May/Atlantic/Cumberland). "And sometimes, these individuals pay the ultimate price while on the job. The service of the police and firefighters should be honored by ensuring their families continue to be taken care of in the event of their death."

The new law (A-2756) (S-1252) will provide workers' compensation benefits to surviving spouses of members of the state police or members of fire or police departments or forces who die in the line of duty during the entire period of their survivorship, even if the spouse remarries. Surviving spouses of deceased members of the state police or fire or police departments currently receive a lump sum upon any remarriage which occurs during the first 450 weeks of benefits.

Under the law, a surviving spouse of a state trooper or member of a fire or police department who died in the line of duty will continue to receive weekly workers' compensation benefits as long as the surviving spouse lives, regardless of remarriage. The provisions of the law do not apply to a surviving spouse of a member of the state police or member of a fire or police department who died in the line of duty if that surviving spouse received a lump sum payment or remarried prior to the effective date of the law.

Apple Is Moving Distracted Driving Into High Gear

Transportation accidents account for a high proportion of work-related fatalities, and Apple's announcement with week of increasing the access of iCar-Technology into the automobile is raising serious concerns among safety lobbyists.

Workers' compensation insurance companies in co-ordination with the US Department of
IOS in the Car
Heavy Integration Announced
at Apple Conference
Transportation (DOT) have made major efforts over the last few years to target distracted driving as a major safety issue to avoid serious accidents and ultimately save lives and reduce insurance costs. The DOT reports, "Distracted driving is a dangerous epidemic on America's roadways. In 2011 alone, over 3,000 people were killed in distracted driving crashes."

As of June 2013, 41 state, the District of Columbia, and Guam ban text messaging for all drivers. Also, 11 states, the District of Columbia, and the Virgin Islands, prohibit all drivers from using handheld phones while driving.