In a per curiam opinion, the NJ Appellate Division affirmed that a workers’ compensation insurance company is not required to defend an intentional tort claim following a Section 20 resolution.
Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts
Saturday, July 13, 2024
Friday, October 14, 2022
NJ Issues Stop-Work Orders for Lack of Workers’ Compensation Insurance
Enforce continues at a rapid pace in New Jersey for failure to comply with the state’s labor laws. The New Jersey Department of Labor and Workforce Development (NJDOL) issued stop-work orders to contractor HESP Solar L.L.C. of Montvale and subcontractor Patriot Iron Works of Gaithersburg, Maryland, who were working on a project at Belleville High School.
Wednesday, December 16, 2020
NJ Governor Phil Murphy’s Conditional Veto Message on Senate Bill No. 2354
Pursuant to Article V, Section I, Paragraph 14 of the New Jersey Constitution, I am returning Senate Bill No. 2354 (Second Reprint) with my recommendations for reconsideration.
Thursday, May 28, 2020
Rep. Maloney Joins with Industry and Trade Association Leaders to Introduce the Pandemic Risk Insurance Act
Congresswoman Carolyn B. Maloney (D-NY), senior member of the House Financial Services Committee, today joined with various stakeholders to introduce H.R. 7011, the Pandemic Risk Insurance Act of 2020 (PRIA). This legislation will create the Pandemic Risk Reinsurance Program, a system of shared public and private compensation for business interruption losses resulting from future pandemics or public health emergencies.
Tuesday, May 17, 2016
CMS Publishes Final Rule for MSP Conditional Payments Via Web Portal
This final rule, effective June 16, 2016, specifies the process and timeline for expanding CMS' existing Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act).
Thursday, July 30, 2015
The Plot Thickens As Uber Turns to Leasing Vehicles
Uber is about to change "the rules" yet again by now leasing vehicles to its drivers. While there is great uncertainty of how "employment status" will be interpreted going forward in the new sharing economy, one thing is for certain, the concept will continue to evolve and redefine the traditional workplace.
Thursday, September 4, 2014
More Big Firms Shifting To High-Deductible Health Plans
Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org
The New York Times examines the movement among large employers towards high-deductible plans that shift more health care costs to workers. Meanwhile, The Wall Street Journal looks at how the ACA may affect job-based plans next year.
The New York Times: High-Deductible Health Plans Weigh Down More Employees
Just as employers replaced pensions with retirement savings plans, more large companies appear to be in the midst of a similar cost-sharing shift with health plans. Besides making workers responsible for more of their care, employers hope these plans will motivate employees to comparison-shop for medical services — an admirable goal but one that some say is hard to achieve. ... With high-deductible health plans, consumers pay for all their medical services — at the insurer's negotiated rate — until they meet their deductible. After that, consumers typically pay coinsurance, which is a percentage of each service — say 10 to 35 percent — until they reach the out-of-pocket maximum (Siegel Bernard, 9/1).
The Wall Street Journal: Get Ready For Health-Insurance Enrollment
If you get health insurance through your workplace, you'll probably have a chance this fall to make important decisions about your coverage and costs. Because many corporate health plans hold their annual open-enrollment periods in October and November, many employees can expect to get a packet of benefits, or instructions for... |
Wednesday, August 27, 2014
The Word Didn't Get There
| Problems with the national workers' compensation system are addressed in today guest post authored by David DePaola and shared from http://daviddepaolo.blogspot.com/ Then I get an email from a former claims professional turned auditor that completely deflates my enthusiasm and makes me angry. The emailer has been in the process of auditing some cases on behalf of an insurance carrier whose cases are administered by a Third Party Administrator. This is a pretty typical arrangement. Carriers are very good at "writing the paper" and all the processes involved from brokerage administration to determining the risk (underwriting) and marketing. Then the job of actually handling the claims gets outsourced to specialized companies: TPAs. The auditor writes she's appalled; outraged at the lack of any sense of urgency, the lack of responsiveness to defense attorneys, not to mention applicant's attorneys. She's astounded at the failure to pay temporary total disability, the failure to advance permanent disability a year after the Agreed Medical Examiner's findings are undisputed to a person who's getting $500.00 a month from Social Security. She's offended that the TPA lets the defense attorneys handle the files, lets cases linger until a pinky finger from 2008 ends up turning into hand, arm, neck, back, internal, sleep, psyche, etc., etc. - on a case that was really ready to settle no less than 4 years ago. She asks, "Why would these cases still be open (excluding those with obvious complex if not catastrophic issues) when the file reflects many opportunities for settlement that slipped away?" Of... |
Monday, August 25, 2014
Restoring Faith
Today's post was shared by WorkCompCentral and comes from daviddepaolo.blogspot.com
| That was just one work comp group and happened to be the most prolific. Plenty of other comments have been made in other venues. I never in my wildest dreams would have imagined that my little, slightly sarcastic, muse on being both an employee and employer dealing with the same work injury and ultimately deciding that work comp was the worst of all worlds for dealing with it would create such interest, controversy, engagement and interaction. But it did. Some disputed that it could be labeled industrial since it was only a back sprain. Others said to stay out of the work comp system at all costs. And others simply demonstrated a lack of understanding of work comp, at least relative to California law. No one, though, said that I should file a claim as an employee or report the claim as an employer. Perhaps that's because everyone is a professional in the system, an insider, and everyone knows that once a claim comes into the system both the employer and the employee lose control to the gaming that every single vendor - insurance company, doctor, lawyer, etc. - will engage in to "do the right thing" according to their special interest. Certainly there were more "claim denied" or "services denied" responses than I thought would occur. Just like real life work comp. The California Workers' Compensation Appeals Board on Thursday designated a case a "Significant Panel Opinion" because a carrier that had approved nurse case manager services prior... |
Friday, August 22, 2014
Are Your Medical Records Vulnerable To Theft?
| This KHN story also ran in . It can be republished for free. (details) A decade ago almost all doctors kept paper charts on every patient. That is changing quickly as laptops become as common as stethoscopes in exam rooms. Recent hacking attacks have raised questions about how safe that data may be. Here are some frequently asked questions about this evolution underway in American medicine and the government programs sparking the change. Are my medical records stored electronically? At least some of the information you share with your doctor or any hospital or clinic where you’ve been treated is probably stored on a computer. It's pretty common for most hospitals, clinics and doctors’ offices to digitally store your basic information including your name, address and insurance company, the same way many retailers do. It's also likely that at least some information about your specific medical conditions is linked to that data. Health care providers have been using computers to help them get paid for decades. That means many computer-generated bills sent to you and/or your insurance company contain medical details like the conditions you were treated for, prescriptions and referrals to specialists. Where things are really changing quickly is in the use of electronic records for day-to-day patient care. Until recently, most doctors used paper charts to record information generated during patient visits. But the 2009 economic stimulus package offered doctors and... |
Why More, Not Fewer, People Might Start Getting Health Insurance Through Work
| In an earnings call last week, Walmart announced that its workers were signing up for health insurance en masse. The news was bad for the company’s shareholders, since the added $500 million it will cost to cover them will eat into expected profits. But it also means that many more low-income families have health insurance now than did last year. The change didn’t come because of a more generous company policy. Walmart has long offered health insurance to its full-time workers for relatively low premiums — about $18 every two weeks for its lowest-paid workers. It came because many more workers decided to take advantage of the offer. It’s early yet to be sure of a strong trend, but the Walmart experience mirrors evidence from early polls and the historical experience of Massachusetts, which enacted a law similar to the Affordable Care Act in 2006. More people may be signing up for employer-based coverage than did before. When we talk about the effect of the Affordable Care Act on health insurance, we often focus on people who were shut out of the market before, either because a prior illness made insurance inaccessible to them or because a high premium put coverage out of their financial reach. What Walmart’s experience reminds us is that there were also uninsured people who simply chose not to buy coverage before there was a law requiring them to do so. Now they may be changing their minds.This increase, if it is permanent, is going to cost... |
Groundbreaking Measure Gives Female First Responders Equal Protection
The California Applicants’ Attorneys Association (CAAA), whose members represent Californians hurt at work, and the California Nurses Association’s (C.N.A.) measure to eliminate gender bias against female first responders in California workers’ compensation insurance passed the Assembly today by a vote of 46 - 23. AB 2616 goes now to the governor for action. AB 2616 (Skinner) is the first measure passed by the Legislature to extend any of the fifteen existing presumptions that male first responders enjoy to first responder occupations dominated by women. “California recognizes that some jobs are so inherently dangerous that those workers should not have to prove that certain injuries were job related,” said CAAA Women’s Caucus Co-Chair Christel Schoenfelder. “First responders like firefighters and police officers who are required to protect the public are presumed to be injured on the job when they get cancer or an infectious disease. There is one group of first responders who do not receive this protection from dangerous conditions. These are hospital employees, 80% of whom are female. Like police officers and firefighters, they are routinely exposed to conditions that can lead to major health problems.” AB 2616 intends to correct this gender imbalance by extending a presumption covering MRSA skin infections to hospital employees who provide direct patient care. MRSA infections are a major health problem in hospitals around the world.
“Nurses and other hospital employees are required to assume great risk, but unlike public safety officers we are not given the same legal protections when we get sick on the job,” said Redding Registered Nurse Kathryn Donahue in a statement urging the governor to sign AB 2616. “MRSA is a virulent antibiotic-resistant staph infection. It’s a job hazard for nurses providing direct patient care in acute care hospitals. MRSA can kill you. Just like police officers and firefighters, nurses put our lives on the line everyday. We don’t know if the patient we are treating has HIV, or MRSA, that we could be exposed to. We just do our job.”
“Assembly member Skinner deserves credit for doggedly pursuing this bill year after year and finally succeeding in her final year,” said Schoenfelder. “Thanks must also go to C.N.A. for making this a priority.”
“Assembly member Skinner deserves credit for doggedly pursuing this bill year after year and finally succeeding in her final year,” said Schoenfelder. “Thanks must also go to C.N.A. for making this a priority.”
One out of every six deaths in the US can be attributed to an infection acquired in a hospital. A first responder has an obligation to perform their duties in an emergency. Female workers are often forced to testify to personal details of their lives in an effort by insurance companies to deny claims. As female workers experience this, it has a chilling effect on the willingness of other female workers to come forth with their claims.
“If nurses or other hospital workers who provide direct patient care get MRSA, we have to prove that it didn’t come from any place but our work,” said Donahue. “That’s an almost impossible burden to meet. It exposes nurses to invasive questioning about our personal lives – even our sexual lives – by insurers’ defense attorneys trying to defeat our claims for medical care and disability compensation.”
Schoenfelder said, “The lack of equal protection for health care workers is, in part, due to gender inequity. Public safety first responders are a predominantly male workforce, but hospital employees providing patient care are a predominantly female workforce. The Labor Code currently provides 15 categories of presumptions for various first responders, and all of them are for male dominated workforces. There is not one presumption for first responders like nurses, which is primarily a female workforce. AB 2616 intends to address this gender imbalance by extending equal protection to female-dominated hospital first responder jobs.”
For more information on AB 2616 Support including a video from a Registered Nurse and an applicant’s attorney perspectives can be viewed here.
Tuesday, August 19, 2014
Florida Businesses, Insurers to Fight Ruling Overturning Workers’ Comp System
| The battle lines are being drawn in the State of Florida as the challenge to the FL workers' compensation law continues following a judicial ruling that the act was unconstitutional because it has been emasculated by Industry reform and its effectiveness diminished to point of rendering the act void. Today's post is shared from .insurancejournal.com A Florida circuit court judge has ruled that the state’s workers’ compensation law is unconstitutional because it no longer provides adequate benefits to injured workers giving up their right to sue. Florida 11th Circuit Court Judge Jorge Cueto handed down the ruling in a case (Padgett v. State of Florida No. 11-13661 CA 25) that could upend the state’s nearly 80-year workers’ compensation law. The case has its genesis in a 2012 instance where a state government worker, Elsa Padgett, sustained an on-the-job injury. After a fall, Padgett had to have a shoulder surgically replaced and was forced to retire due to complications. Padgett, along with several trial bar groups, argued that her workers’ compensation benefits were inadequate and the law unfairly blocked her constitutional right to access the court. The workers’ compensation system is by law the “exclusive remedy” for injured workers. Injured workers are provided medical benefits and certain wage-loss benefits in exchange for forgoing the right to sue their employer in court. Cueto, in a 20-page ruling, avoided making any specific comments on the details of Padgett’s case other than to rule in her favor. Instead, Cueto focused on the exclusive remedy provision of the law, finding that due to the many cuts in medical and wage-loss benefits made by lawmakers over the years, the system no longer represents a fair deal for injured workers. Cueto singled-out workers’... |
Thursday, August 7, 2014
ROTTEN IN DENMARK
| July 29 2014 You might have thought that news of bad behavior in California’s workers’ comp system was hitting bottom. After all, could it get worse? Allegations of legislators taking money to help charlatans who profited off of the backs of injured workers (literally). Scads of doctors alleged to have taken kickbacks for prescribing questionable compound medicines one of which allegedly killed a baby. It appears that law enforcement authorities are now focusing on relationships between some applicant attorney firms and medical groups. In Southern California the Riverside County DA has executed a search warrant against a workers’ comp firm, California Injury Lawyers (CIL). Apparently this is a result of a long investigation into suspected workers’ comp fraud, targeting operations allegedly connected to an individual named Peyman Heidary who is said to have a financial interest in as many as nine medical clinics in the Los Angeles area. The details of the alleged bad behavior or fraud is unclear, and it must be noted that any allegations are currently just that, allegations. But this case has the potential to involve a number of Southern California health care providers as well as some lawyers. Meanwhile, last year’s workers’ comp bill AB 1309 seems to be the focus of new allegations in the federal case against State Senator Leland Yee. A grand jury indictment contains allegations that Yee suggested that in... |
Sunday, July 20, 2014
Biggest Insurer Drops Caution, Embraces Obamacare
UnitedHealthcare, the insurance giant that largely sat out the health law’s online marketplaces’ first year, said Thursday it may sell policies through the exchanges in nearly half the states next year. “We plan to grow next year as we expand our offering to as many as two dozen state exchanges,” Stephen Hemsley, CEO of UnitedHealth Group, the insurance company’s parent, told investment analysts on a conference call. He was referring to coverage sold to individuals. The move represents a major acceleration for the company and a bet that government-subsidized insurance, sold online without regard for pre-existing illness, is here to stay. UnitedHealthcare sells individual policies through government exchanges in only four states now. Even analysts who follow the company closely seemed surprised. “You’re making a really big move,” Kevin Fischbeck, an analyst for Bank of America, told the company’s executives. “You’re going to do a couple dozen states. You’ve really moved in. What’s giving you the confidence … that it’s going to be stable next year?” The answer, the bosses said, is that the marketplaces look sustainable, even without some of the reinsurance and risk-spreading backstops put in place for carriers in the first few years. They know the prices now, they said. They know the regulations. They know how consumers are... |
Saturday, July 19, 2014
California Dreamer: Recent Reform Too Good To Be True
 |
| California IMR-Source: CA DIR (7-2014) |
This week the California Division of Industrial Relations (CA DIR) published a report of the implementation status of recent workers' compensation reform legislation commonly referred to as SB 863 (2012 enactment).
The report concludes that it is still too early to determine whether or not the legislation produced a positive impact on the system. If delay and denial of benefits is what was intended, then from what has been heard on The Street, the legislation is a win.
Basically, the latest round of reform, crafted with very little public input and enacted in "the dead of night," was intended to curb and contain costs. The "innovative process" to limit escalating medical costs, probably the largest ticket item in the entire package, was to be limited going forward through a process termed Independent Medical Review (IMR). A theoretically system that removes the medical delivery decision from the adversary system, ie. get rid of the lawyers approach.
While it sounded great on paper, the process turned out to be a constitutionally challenged nightmare that ultimately delayed and denied benefits and added insult to injury for disabled workers. Employers and carriers started to challenge everything. No one wanted to take responsibility for medical care and the system suffered from compounding delay as everything seemed to be tossed in the IMR bucket.
California is particularly important as a model for workers' compensation. It is a national testing ground for innovation. It is a very large and extremely complex system, where even the exceptions to the rule have multiple exceptions. Luckily the California workers' compensation bar is well organized, educated, knowledgeable and skilled. Unfortunately, the numbers of expert workers' compensation lawyers continues to become fewer as firms backout of the system for lack of economic incentive to participate.
The CA DIR report released this week basically answers nothing about whether the system improved since the SB 863 was enacted. A few charts loaded with caveats only reflect a statistical vision of political hope for improvement that is diluted with a conclusion that it is too soon to tell if it is really working as promised.
The "promise" made by Industry to Labor in 1911 for system of remedial social legislation, ie. workers' compensation, seems broken. Recognizably the cycle after cycle in California of repeated efforts to readjust the system through major systemic efforts continue to compound failures.
It is far time that California stopped dreaming about improvements that appear too good to be true and start thinking creatively on how to craft an innovative system that meets the needs of ALL the stakeholders.
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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thompson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson-Reuters). 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.
Friday, July 18, 2014
Obamacare Fails to Fail
How many Americans know how health reform is going? For that matter, how many people in the news media are following the positive developments?
I suspect that the answer to the first question is “Not many,” while the answer to the second is “Possibly even fewer,” for reasons I’ll get to later. And if I’m right, it’s a remarkable thing — an immense policy success is improving the lives of millions of Americans, but it’s largely slipping under the radar.
How is that possible? Think relentless negativity without accountability. The Affordable Care Act has faced nonstop attacks from partisans and right-wing media, with mainstream news also tending to harp on the act’s troubles. Many of the attacks have involved predictions of disaster, none of which have come true. But absence of disaster doesn’t make a compelling headline, and the people who falsely predicted doom just keep coming back with dire new warnings.
Consider, in particular, the impact of Obamacare on the number of Americans without health insurance. The initial debacle of the federal website produced much glee on the right and many negative reports from the mainstream press as well; at the beginning of 2014, many reports confidently asserted that first-year enrollments would fall far short of White House projections.
Then came the remarkable late surge in enrollment. Did the pessimists face tough questions about why they got it so wrong? Of...
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Monday, April 21, 2014
President of Roofing Company Pleads Guilty to Felony for Scheme to Avoid Paying Hundreds of Thousands of Dollars in Insurance Premiums
Acting NJ Attorney General John J. Hoffman announced that the president of a roofing company pleaded guilty today to providing false and misleading information to the company’s workers’ compensation insurance carrier in order to avoid paying hundreds of thousands of dollars in insurance premiums that he was obligated to pay.
Charles Kelcy Pegler Sr., 56, of Spring Lake, pleaded guilty to third-degree insurance fraud before Superior Court Judge Anthony J. Mellaci in Monmouth County. Pegler was charged in a Dec. 19, 2013 state grand jury indictment.
Judge Mellaci scheduled sentencing for June 6. Under the plea agreement, the state will recommend that Pegler be sentenced to 180 days in county jail as a condition of five years of probation. Pegler previously paid full restitution to New Jersey Manufacturers Insurance Company. The plea agreement also requires Pegler to pay $134,087 to Atain Insurance Company.
“Employers have an obligation to provide full and adequate workers compensation insurance coverage for their employees,” Acting Attorney General Hoffman said. “Because of criminals such as this defendant, honest, hard-working New Jerseyans are forced to pay increased premiums to cover the costs of the fraud.”
“This conviction demonstrates that the Office of the Insurance Fraud Prosecutor stands ready and able to prosecute sophisticated schemes and influential executives, even those at the highest reaches of companies,” Acting Insurance Fraud Prosecutor Ronald Chillemi said.
Pegler was the president of Roof Diagnostics, Inc. (“RDI”), which was located at 2333 Highway 34 in Wall. During the time of the alleged crime, RDI was located at 608 Brighton Avenue in Spring Lake Heights. RDI employs approximately 400 people. In pleading guilty, Pegler admitted that between June 11, 2003 and Oct. 5, 2009, he created the false impression to New Jersey Casualty Insurance Company, which is a subsidiary of New Jersey Manufacturers Insurance Company, that RDI was not a roofing company, that it did not employ roofers and that it did not install, maintain and/or repair roofs. An investigation by the Office of the Insurance Fraud Prosecutor determined that, as a result of the alleged crime, RDI paid $265,044 less in workers’ compensation insurance premiums than it should have.
Pegler further admitted that between Jan. 15 and Dec. 9, 2009, he created the false impression to USF Insurance Company, now called Atain Insurance Company, that all roofing and re-roofing services offered by RDI were performed by subcontractors. Through this fraud, Pegler avoided paying $134,087 in general liability insurance premiums which he owed to the insurance company.
Acting Insurance Fraud Prosecutor Chillemi, Deputy Attorneys General Michael Locke, Bradford Muller and Thomas Tresansky and Detective Natalie Brotherston coordinated the investigation. Acting Insurance Fraud Prosecutor Chillemi represented the state at the guilty plea hearing. Additional investigative assistance was provided by Detective Taryn Kong and Detective Trainee Ryan Kirsh, Analysts Terry Worthington and Terri Drumm and Technical Assistant Ramona Navarro. Acting Insurance Fraud Prosecutor Chillemi thanked the New Jersey Department of Labor and Workforce Development, New Jersey Manufacturers Insurance Company and Atain Insurance Company for their assistance in the investigation.
Charles Kelcy Pegler Sr., 56, of Spring Lake, pleaded guilty to third-degree insurance fraud before Superior Court Judge Anthony J. Mellaci in Monmouth County. Pegler was charged in a Dec. 19, 2013 state grand jury indictment.
Judge Mellaci scheduled sentencing for June 6. Under the plea agreement, the state will recommend that Pegler be sentenced to 180 days in county jail as a condition of five years of probation. Pegler previously paid full restitution to New Jersey Manufacturers Insurance Company. The plea agreement also requires Pegler to pay $134,087 to Atain Insurance Company.
“Employers have an obligation to provide full and adequate workers compensation insurance coverage for their employees,” Acting Attorney General Hoffman said. “Because of criminals such as this defendant, honest, hard-working New Jerseyans are forced to pay increased premiums to cover the costs of the fraud.”
“This conviction demonstrates that the Office of the Insurance Fraud Prosecutor stands ready and able to prosecute sophisticated schemes and influential executives, even those at the highest reaches of companies,” Acting Insurance Fraud Prosecutor Ronald Chillemi said.
Pegler was the president of Roof Diagnostics, Inc. (“RDI”), which was located at 2333 Highway 34 in Wall. During the time of the alleged crime, RDI was located at 608 Brighton Avenue in Spring Lake Heights. RDI employs approximately 400 people. In pleading guilty, Pegler admitted that between June 11, 2003 and Oct. 5, 2009, he created the false impression to New Jersey Casualty Insurance Company, which is a subsidiary of New Jersey Manufacturers Insurance Company, that RDI was not a roofing company, that it did not employ roofers and that it did not install, maintain and/or repair roofs. An investigation by the Office of the Insurance Fraud Prosecutor determined that, as a result of the alleged crime, RDI paid $265,044 less in workers’ compensation insurance premiums than it should have.
Pegler further admitted that between Jan. 15 and Dec. 9, 2009, he created the false impression to USF Insurance Company, now called Atain Insurance Company, that all roofing and re-roofing services offered by RDI were performed by subcontractors. Through this fraud, Pegler avoided paying $134,087 in general liability insurance premiums which he owed to the insurance company.
Acting Insurance Fraud Prosecutor Chillemi, Deputy Attorneys General Michael Locke, Bradford Muller and Thomas Tresansky and Detective Natalie Brotherston coordinated the investigation. Acting Insurance Fraud Prosecutor Chillemi represented the state at the guilty plea hearing. Additional investigative assistance was provided by Detective Taryn Kong and Detective Trainee Ryan Kirsh, Analysts Terry Worthington and Terri Drumm and Technical Assistant Ramona Navarro. Acting Insurance Fraud Prosecutor Chillemi thanked the New Jersey Department of Labor and Workforce Development, New Jersey Manufacturers Insurance Company and Atain Insurance Company for their assistance in the investigation.
Monday, February 24, 2014
Freeing Workers From the Insurance Trap
The Congressional Budget Office estimated on Tuesday that the Affordable Care Act will reduce the number of full-time workers by 2.5 million over the next decade. That is mostly a good thing, a liberating result of the law. Of course, Republicans immediately tried to brand the findings as “devastating” and stark evidence of President Obama’s health care reform as a failure and a job killer. It is no such thing.
The report estimated that — thanks to an increase in insurance coverage under the act and the availability of subsidies to help pay the premiums — many workers who felt obliged to stay in a job that provided health benefits would now be able to leave those jobs or choose to work fewer hours than they otherwise would have. In other words, the report is about the choices workers can make when they are no longer tethered to an employer because of health benefits. The cumulative effect on the labor supply is the equivalent of 2.5 million fewer full-time workers by 2024.
Some workers may have had a pre-existing condition and will now be able to leave work because insurers must accept all applicants without regard to health status and charge premiums unrelated to health status. Some may have felt they needed to keep working to pay for health insurance, but now new government subsidies will help pay premiums, making it more possible for them to leave their jobs.
The report clearly stated that health reform would not produce an increase in...
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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.
Wednesday, February 5, 2014
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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