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(c) 2010-2024 Jon L Gelman, All Rights Reserved.

Wednesday, February 5, 2014

The Rule of Law and The Media's Role

Today's post is authored by David DePaolo and shared from workcompcentral.com
Those not living in California are befuddled by our system. Heck, even those living in California are befuddled...

Yesterday was also the start of the 21st annual California Division of Workers' Compensation Educational Conference in Los Angeles, CA, where the weather is a bit warmer than it is here in CT.

So too has the activity been a bit warmer in California - at the Educational Conference Acting Administrative Director Destie Overpeck gave an overview of what has been going on with the division since the directive of SB 863 to implement numerous changes to the system.

The list of work that the division has been engaged in is impressive, and demonstrates just how vast the changes were in SB 863:
  1. New rules to reduce payments to ambulatory surgery centers from 120% of Medicare’s outpatient rate to 80%;
  2. A new fee schedule for providers based on a Resource Based Relative Value Scale;
  3. A lien fee system (currently partially in abeyance due to legal challenges which also adds to the division's work load);
  4. New statute of limitations for lien filers;
  5. New Independent Medical Review process and procedures;
  6. New Independent Medical Bill review process and procedures;
  7. Revised Medical Provider Network approval and renewal process and rules;
  8. Pending fee schedule for copy services;New penalties for failures in notifications and standards for MPNs.
This is all in addition to the normal work load...
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Mining firm sentenced in workers' comp scheme

Today's post is shared from wvgazette.com
Leads continue to develop out of an investigation into a multimillion-dollar scheme aimed at lowering workers' compensation premiums for contract firms that provided workers to some of the state's largest coal producers, an assistant U.S. Attorney said Tuesday.
U.S. District Court Judge John Copenhaver said the "scam here has been extraordinary" before sentencing Aracoma Contracting LLC to three years probation and ordering restitution be paid.
The scheme involved former BrickStreet Mutual Insurance Co. auditor, Arville Sargent, who took bribes to help contract companies save millions in workers' compensation premiums by paying workers in cash and falsifying payroll records.
It involved four mining contract firms  -- Aracoma Contracting LLC, Christian Contracting, T&W Services LLC, and Newhall Contracting. The companies were controlled by Jerome Eddie Russell, Frelin Workman and his son, Randy Workman.
The four companies were "employee leasing" services that supplied miners for coal companies, including Alpha Natural Resources and Patriot Coal, under arrangements common in the state's mining industry.
Acting on behalf of Aracoma, its principals Russell, 50, of Williamson and Frelin R. Workman, 58, of Belfrey, Ky., formed a relationship with the Bank of Mingo, and one of its employees at the bank's Williamson branch.
Aracoma, Sargent and Workman must jointly pay back about $4.7 million in restitution. Aracoma must also...
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Tuesday, February 4, 2014

Lead and Crime: It's a Brain Thing

Today's post was shared by Mother Jones and comes from www.motherjones.com

When I wrote my big piece last year about the connection between childhood exposure to lead and rates of violent crime later in life, one of the big pushbacks came from folks who are skeptical of econometric studies. Sure, the level of lead exposure over time looks like an inverted U, and so does the national rate of violent crime. But hey: correlation is not causation.
I actually addressed this in my piece—twice, I think—but I always felt like I didn't address it quite clearly enough. The article spent so much time up front explaining the statistical correlations that it made the subsequent points about other evidence seem a bit like hasty bolt-ons, put there mainly to check off a box against
possible criticism. That's not how I intended it,1 but that's how it turned out.
For that reason, I'm pleased to recommend Lauren Wolf's "The Crimes Of Lead," in the current issue of Chemical & Engineering News. It doesn't ignore the statistical evidence, but it focuses primarily on the physiological evidence that implicates lead with higher levels of violent crime:
Research has shown that lead exposure does indeed make lab animals—rodents, monkeys, even cats—more prone to aggression. But establishing biological plausibility for the lead-crime argument hasn’t been as clear-cut for molecular-level studies of the brain. Lead wreaks a lot of havoc on the central nervous system. So pinpointing one—or even a few—molecular switches by...
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Elmwood Park's Sealed Air pays $930 million in cash to asbestos trust : page all - NorthJersey.com

Today's post is shared from northjersey.com

Elmwood Park's Sealed Air pays $930 million in cash to asbestos trust 
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Monday, February 3, 2014

Goodbye to the Doctor’s White Coat?

Today's post was shared by The New York Times and comes from well.blogs.nytimes.com

A scene from “Grey’s Anatomy,” ABC's long-running hospital drama.
A scene from “Grey’s Anatomy,” ABC's long-running hospital drama.
Ron Tom/ABC A scene from “Grey’s Anatomy,” ABC’s long-running hospital drama.
New recommendations on what health care workers should wear may mean an end to the doctor’s white coat.
The Society for Healthcare Epidemiology of America, a professional group whose mission is to prevent and control infections in the medical workplace, has issued guidance on what health care workers should wear outside of the operating room.
The paper, in the February issue of Infection Control and Hospital Epidemiology, suggests that to minimize infection risk, hospitals might want to adopt a “bare below the elbows” policy that includes short sleeves and no wristwatch, jewelry or neckties during contact with patients.
The authors also recommend that if the use of white coats is not entirely abandoned, each doctor should have at least two, worn alternately and laundered frequently. And even if they wear the coat at other times, they should be encouraged to remove it before approaching patients.
The authors emphasize that the recommendations are based more on the biological plausibility of transmitting infection through clothing than on strong scientific evidence, which is limited.
The lead author, Dr. Gonzalo Bearman, a professor of medicine at Virginia Commonwealth University, said that hand washing, bathing patients with antibacterial soap, and checklists for inserting...
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Substantial Credible Evidence Remains the Rule

Despite the informality of  a workers compensation hearing, the evidence relied upon by the hearing official must be substantially credible in order to meet the burden of proof to assess disability. When the claimant has had a history of a multitude of back injuries, sorting out the claims maybe a complicated and difficult process. The compensation judge is compelled to ascertain which accident  is the ultimate triggering incident that resulted in permanent disability. 

The last back claim of a worker did not meet the evidential standards to sustain a claim for disability when the diagnostic tests, as interpreted by the treating physician, did not support the evidential requirements to establish the assessment of permanent disability. 

A worker in New Jersey, who has a long history of back injuries, both at work and at home, was unable to meet the evidential requirements to to establish a case for increased disability. An MRI, interpreted by the treating physician, demonstrated no change in the injured workers medical condition following the last incident at work.

Accordingly, The NJ Appellate Division sustained the ruling by the compensation judge, who had held that proofs offered at trial were insufficient to meet the requirement of the statutory credible evidence standard. The trial judge was held to have correctly relied upon the treating physician’s diagnostic MRI taken subsequent to the last accident to rule out the final incident as the triggering episode that generated the claimant’s disability. 

Beausejour v Chamberlin Plumbing & Heating, Inc.,  2014 WL 300929 (N.J. Super. A.D.), Jan. 29, 2014

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Friday, January 31, 2014

Football: The Business of Uncompensated Injuries

It is hard to image that any other Industry that denies its employees workers’s compensation benefits for known work-connected injuries would be bragging about a mere 13% reduction in head injuries. That is what the NFL is doing this week in advance of it’s annual mayhem ritual called the Super Bowl.
Sports entertainment is just big business. A major distraction to the routine of boring and tedious daily activities the NFL has found an addictive niche market, feed by high TV rating (ESPN) and fueled by gambling. A common denominator of public distraction. 
The pawns in the system are those young “student-athletes” who take a risk as unpaid talent to carry on the dream for riches and fame as cheap (free) talent for the cause of school spirit and the hope of landing an NFL contract. The tragic risks exist even at that level of are more than obvious as I saw a Rutgers player crack his neck on the MetLife Stadium field in the Rutgers v Army game a couple of years ago.
Todays post is shared from the nytime.com/.
 As the professional sports conglomerates spread their political influence from state house to state house demolishing the basic tenants of workers’ compensation.They continue their effort to bar injured players from seeking basic workers’ compensation benefits for known occupational risks,.They are now bragging about a mere 13% reduction. What about the other 87%? The injured players they can go uncompensated?
The...
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