Government Shutdown Simulates “Small Government”

The US Senate again set the stage for another governmental shutdown. The Republican's blogged the nominations of President Obama's nominee for the the US Court of Appeals for the District of Columbia and the nominee for the head of the Federal Housing Agency. This strategic move puts into play the potential of another filibuster and how far a minority party can thwart the majority party.  Today's post comes from guest author Kit Case, from Causey Law Firm of The State of Washington.

Every news program announces the ongoing shutdown of non-essential federal government services.  News articles delve into the possible consequences.  Republicans and Democrats fight over whether the other is willing to negotiate.  Members of the Republican Party bicker within their ranks about the shutdown. 

Everyone should take note that what we are experiencing with the current shutdown provides us all with a practice-run for the level of government desired by the Tea Party members of the Republican Party.

Wikipedia notes that the current "small government" movement in the United States is largely a product of Ronald Reagan's presidency from 1980–88. The Tea Party movement is a modern reflection of this belief in small government. 

They claim that in the past the United States had a small government, and that it has turned away from that ideal. Some members of the Republican Party advocate small government, especially its libertarian wing, which includes politicians such as Ron Paul and his son Rand Paul. 

The Libertarian party, a third party, supports small government. A 2013 poll showed that the majority (54%) of Americans think the government is trying to do too much.

We now have an opportunity to define “essential” services.

Although 54% is only just a majority, Americans can now ponder the concept of small government and what the effect of shrinking the government would have on federal, state and local jurisdictions.  The “non-essential” services now halted would likely have to be replaced by those jurisdictions, where possible, were the federal government to be stripped down to the vision of the Tea Party and Libertarian Party members.  We now have an opportunity to define “essential” services.

Cities across the country will feel the pinch of the shutdown, particularly if it drags out beyond a few days. Furloughs of non-essential federal employees won't just affect D.C. and its Maryland and Virginia suburbs. Cities around the country host full-time, non-Post Office federal employee populations. New York is home to 26,696 federal employees; Atlanta is home to 23,718; Philadelphia is home to 19,940; Chicago has 16,069; Houston has 15,530; and Los Angeles has 14,689. The list of the top 50 cities with the highest federal employment is here.¹

The Government Shutdown is a Kick-In-Gut to Workers' Compensation

Workers' Compensation programs will be impacted by a Government shutdown because of both the offset provisions of the Social Security Act and the Medicare Secondary Payer Act (MSP). Even The SMART Act, recently enacted to hopefully establish a more efficient collection process will be derailed.

As the US House of Representatives, under Republican leadership influenced by The Tea Party, likened in Aaron Sorkin's HBO program, The Newsroom, as "The American Taliban," passed legislation to shutdown the US Government this Tuesday, serious concern exists as to the consequences of the shutdown on workers' compensation programs throughout the nation. 

In many States, whether or not a reverse offset exists, it is essential to determine what a claimant's Average Current Earnings (ACE) are to calculate, and reach a final determination of temporary and permanent disability, in a state workers' compensation claim. The access to those numbers will become difficult to obtain because of administrative rollbacks, and anticipated further delays in claims processing. Even though Federal payments will be forthcoming under protective measures, the claims process will be derailed.

Likewise, the process to obtain conditional payment information will be delayed or non-existent. The provisions of the Medicare Secondary Payer Act mandating reimbursement to The Center for Medicare and Medicaid Services (CMS) will be put on hold. Similarly, reviews for future medical compromises embodied in the Workers' Compensation Medicare Set-aside Agreements (WCMSA) will be delayed just because of administrative cutbacks in the claims system, including the appeals process.

The recently enacted provisions of The SMART Act. long sought by a coalition of cottage industries, and compensation parties, to the reimbursement process itself, will face its first major challenge to implementation as the Internet web-portable becomes non-functional. Recently proposed final Rules will face delay in implementation as the exchange of comments under the rulemaking process become further delayed in the process of submission and response.

Overall, the workers who most need the system to function, and who waited the longest time, in waiting for final adjudication of their claims, will become victim of the process. No matter how long the shutdown extends, the Federal action will highlight the continued deterioration of the complex patchwork process know as workers' compensation. The now antiquated, and once expeditious and remedial insurance system, will have suffered yet another devastating blow in its attempt to survive in a radically changing economic and socio-political system.
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  have been representing injured workers and their families who have suffered occupational accidents and illnesses.

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Santorum: Selling Health Care the Apple Way

Source: NY Times

As the Republican presidential primary keeps rolling along, it is becoming more apparent that under the Republican platform injured workers are going to get stuck under the wheels of the bus for health care.

In Woodland Park, Colorado, at a campaign stop Rick Sanatorium policy The National Journal reported:

"A young boy asked the former U.S. senator from Pennsylvania what he would do to keep prescription drugs affordable. Another woman in the audience chimed in that she couldn't afford her $900-a-month prescription.

"Santorum compared the costs to buying an iPad. "People have no problem going out and buying an iPad for $900,” he said. “But paying $200 for a drug they have a problem with -- that keeps you alive. Why? Because you've been conditioned in thinking health care is something you should get and not have to pay for."

This conservative dogma ironically conflicts with the social, economic and moral philosophy of the majority of Americans. It is one thing to reduce benefits due to austerity measures, it is quite another thing to just eliminate them outright because of a conservative doctrine. 

The path toward federalization will not be an easy one. There will be those who argue for elimination based on ideology, religion and cost. Workers' Compensation programs initially were met with such challenges, and those issues were surmounted. 


Comparing the purchase of life-saving drugs to the purchase of an iPad, is just wrong.  Those living in abject poverty don't buy iPads monthly. They need their prescription drugs to live. The companies that exposed workers to toxins, and then deny them workers' compensation benefits when they become ill, should not then pull the medical safety-net from under them. It is immoral to deny poverty-stricken ill workers medical care.


Selling the "option" of health and safety to American workers goes against the basic tenants of the century old system of workers' compensation. Healthcare, including, infections and diseases, impact all Americans. Much more creatively needs to be expressed rather just proposing cost shifting to those who obviously can't pay the cost.

See The New York Times report: Even Critics of Safety Net Increasingly Depend on It
"Dozens of benefits programs provided an average of $6,583 for each man, woman and child in the county in 2009, a 69 percent increase from 2000 after adjusting for inflation. In Chicago, and across the nation, the government now provides almost $1 in benefits for every $4 in other income."

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Merit-Based Workers Compensation: The Romney-Gingrich Plan

The Republican presidential primary battle has inadequately defined the debate guidelines for the future of workers' compensation in the US. While both leading Republican candidates are throwing darts at each other on many points, the basic philosophy of both Mitt Romney and Newt Gingrich is to extinguish the so-called "entitlement society." They claim Barack Obama, "the food stamp president," has accelerated the problem. 


Of course, missing from the debate is that fact that the US has changed, in tandem, with the rest of the world. The nation's manufacturing sector left the auditorium, and with it went jobs and premiums for supporting a viable workers' compensation system. What it left was a legacy of industrial illness and disease that is fatally affecting the nation's medical delivery system and burdening the taxpayers of our nation.


If the political debate is to become credible, the medical treatment delivery system must be addressed rather than just throwing around meaningless political rhetoric. While the safety net is slowing deteriorating, there remains still an opportunity to re-design and advance a credible workers' compensation system. If the debate continues along the present path, the opportunity will be lost and the nation will loose.

See The Republican Myth Of Obama’s “Entitlement Society” By Robert Reich
"But they have cause and effect backwards. The reason for the rise in food stamps, unemployment insurance, and other safety-net programs is Americans got clobbered in 2008 with the worst economic catastrophe since the Great Depression. They and their families have needed whatever helping hands they could get."

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For over 3 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses. 

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Wisconsin and Workers' Comp "Reform"

Guest Blog by Thomas M. Domer  

Headlines screaming for “Workers’ Comp Reform” are blaring in many states (CA,FL, NY, OH, NC, and most recently IL). In Illinois, the state’s much-criticized system is under fire and legislation to totally dismantle the system is proposed. Wisconsin has thus far managed to dodge partisan efforts to scrap the system due in large part to the stabilizing effect of the Wisconsin Workers’ Comp Advisory Council. The Wisconsin Worker's Compensation Advisory Council was created in 1975 to advise the Department and legislature on policy matters concerning the development and administration of the workers' compensation law. The Council aims to maintain the overall stability of the workers' compensation system without regard to partisan changes in the legislative or executive branches of government. The Council provides a vehicle for labor and management representatives to play a direct role in recommending changes in the workers' compensation law to the legislature.

The council, composed of five labor, five management and three non-voting insurance members appointed by the secretary of the Department of Workforce Development and chaired by a department employee, meets regularly at different sites around Wisconsin. It occasionally assigns special topics to study committees on such issues as medical costs, permanent total disability rates and attorney's fees. The medical committee assigned in the mid-1990's to report on minimum permanency percentages for surgical procedures, for example, issued its findings which resulted in the schedule contained in the Administrative Code.

The Council obtains input from various workers' compensation constituents including interested members of the legal, medical, labor, management, insurance and employer communities. Public hearings on proposed changes are held, followed by Advisory Council deliberations. The Council has always produced an “agreed upon bill” which results in annual changes in benefit rates and substantive law. The bill proceeds to the Labor Committees in the Wisconsin Assembly and Senate where, after passage, the Governor signs the bill into law. (Republican Governor Scott Walker’s recent attempt to eviscerate public sector bargaining, which prompted the infamous flight to Illinois of the “Wisconsin 14” Democratic Senators, has had a “spillover” affect even on the Council. Labor members, in response to the Governor’s union-busting efforts, have boycotted the last 2 Council meetings).

Thomas M. Domer practices in Milwaukee, Wisconsin (www.domerlaw.com). He has authored and edited several publications including the legal treatise Wisconsin Workers' Compensation Law (West) and he is the Editor of the national publication, Workers' First Watch. Tom is past chair of the Workers' Compensation Section of the American Association for Justice. He is a charter Fellow in the College of Workers' Compensation Lawyers. He co-authors the nationally recognized Wisconsin Workers' Compensation Experts Blog.

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The Republican Plan: Just End Medicare

This week, the Republicans will offer a proposal that ultimately would end Medicare involvement. The plain is simply end Medicare. The proposal outlined is outlined in the Wall Street Journal today.

"The plan would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills. Mr. Ryan and other conservatives say this is necessary because of the program's soaring costs. Medicare cost $396.5 billion in 2010 and is projected to rise to $502.8 billion in 2016. At that pace, spending on the program would have doubled between 2002 and 2016."

Converting the program for coverage to the poor only would still not end the plans' involvement in workers' compensation and in fact may only increase it. The dichotomy between rich and poor will increase. The numbers of uninsured are growing as well as the working elderly.

It is anticipated that Medicare premium costs will continue to increase under the present plan and wealthy Americans will opt-out. This proposal will merely mean a universal opt-out plan leaving the Federal program strapped for cash. The premium base needs to be increased rather than diminished.

As Peter Rousmaniere, a noted workers' compensation commentator,  recently observed, the workers' compensation program has "leaks in the system."  Occupational disease claims will continue to be denied at increasing rates, and the cost shifting will merely be perpetuated from workers compensation  to the taxpayers. Just ending Medicare will not solve the problems with the Workers' Compensation medical delivery system.

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