COVID is the most extensive occupational exposure event in the history of the United States. Workplaces are now primed for a massive wave of compensation claims due to the Omicron variant. A recent study provides a potential opportunity for employers and insurance companies to reduce their risk exposure through early sequencing and treatment proactively.
Showing posts with label medical delivery. Show all posts
Showing posts with label medical delivery. Show all posts
Wednesday, January 5, 2022
Friday, April 8, 2016
The Difficult Task of the Florida Supreme Court
The Florida Supreme has before it a constitutional challenge once again concerning workers’ compensation. The scope of the controversy remains undefined and the ultimate impact equally uncertain. I have found over the years that one cannot predict the outcome of a case by merely watching an oral argument.
Friday, July 3, 2015
NJ Senate Passes Workers' Compensation Collective Bargaining Legislation
The NJ Senate passed an historic legislative proposal that will change the way benefits are delivered in work related injuries in NJ. S2447 provides for a collective bargaining arrangement that allows for delivery of benefits without the necessity of formal intervention before the NJ Division of Workers' Compensation, that will however remain an option in the process.
Wednesday, August 6, 2014
Doctor On Demand Raises $21 Million as Telemedicine Heats Up
Medical delivery is constantly changing in light of new technology. Workers' compensation insurance carriers could possibly implement thisdeliver system in an effort to contain costs. Today's post is shared from recode.net
[Click here to see the rest of this post]
| Doctor On Demand, one of the growing number of companies offering physician consultations via mobile video chat, has raised $21 million. Venrock led the Series A round, with participation from Shasta Ventures and Virgin Group Chairman Sir Richard Branson. On top of the financing news, Doctor On Demand said: Venrock Partner Bryan Roberts joined the company’s board, the $40-per-visit service is now available on desktop computers and Comcast will offer it to U.S. employees. (Comcast owns NBCUniversal, which is a minority investor in Re/code.) |
Saturday, April 12, 2014
Too Big To Pay For: Workers' Compensation's Struggle To Cover Medical Care
Political machinations create the complexity we know as workers' compensation law.
California is the prime example, with several bills moving around the legislature that bestow special treatment to certain classes of workers. One bill, Assembly Bill 1035 by House Speaker John A. Pérez, D-Los Angeles, would allow dependents to file claims for deaths caused by cancer, tuberculosis, methicillin-resistant Staphylococcus aureus infections and other bloodborne infectious diseases up to 420 weeks from the date the disease is diagnosed. Similar bills in the past had made it through the legislature but Gov. Jerry Brown had vetoed them ostensibly because he was waiting for reports from the National Institute for Occupational Safety and Health and the California Commission on Health Safety and Workers' Compensation. AB 1373, which passed in 2013 and AB 2451, which passed in 2012 differed in that both extended the limitations period to 480 weeks. And the new bill includes a sunset provision that would allow the governor and Legislature to revisit the appropriateness of the new time frame in five years. Supporters say AB 1035 is necessary because with advances in medical science, safety officers who develop cancer and other diseases through their employment are living longer. The emotional appeal is that these brave public servants fight for their lives, only to succumb to the disease after the death benefits limitation period expires so dependents can not collect the benefits. Of... |
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Sep 19, 2013
Medical Costs Still Treading Upward. The cost of medical treatment in workers' compensation claims, despite a resumed trend in lower claims, is continuing to increase. View complete report: NCCI Workers Compensation ...
Nov 20, 2013
A major component of the Workers' Compensation benefits system is now the cost of medical care. Workers' Compensation insurance is not alone in experiencing this phenomena. Soaring medical costs pervades the entire ...
Nov 01, 2012
Planned changes by Mitt Romney to Medicare and Medicaid will have a dire effect on the regulations of the future cost of workers' compensation medical treatment. Proposed changes to the Federal program will indirectly ...
Tuesday, August 13, 2013
Fresno workers' compensation case highlights statewide problems
A workers' compensation company is being criticized for failing to provide medical care for a Fresno woman injured on the job more than 10 years ago.
The employee, Guadalupe Ortega, spoke out with her lawyer Tuesday morning during a press conference held by the California Applicants Attorneys Association across the street from her former employer, Lyons Magnus, a major food processor in Fresno.
Although doctors and Lyons Magnus confirmed her injuries are work related, the company's insurance carrier, Sedgwick Claims Management Services, only provided two years of temporary disability compensation — even though a qualified medical evaluator confirmed she is 70% disabled, Ortega said.
Ortega's plight highlights a larger problem for injured workers statewide who have run into more roadblocks over the past eight years to receive workers' compensation, said Ortega's lawyer, Brett Grove of Keeling Grove Law Offices in Fresno.
"Unfortunately, her experiences are not unique in the workers' compensation arena," Grove said.
Ortega's severe neck, shoulder and back injuries resulted in her losing her job, she said. Ortega became homeless, and her children were taken away from her.
"Sedgwick has turned my life into a living hell," Ortega said. "How can the state of California allow this insurance company to fail to pay legitimate claims?"
Sedgwick officials were unavailable for comment. The company is based in Memphis, Tenn., and calls itself the leading North American provider for...
[Click here to see the rest of this article]The employee, Guadalupe Ortega, spoke out with her lawyer Tuesday morning during a press conference held by the California Applicants Attorneys Association across the street from her former employer, Lyons Magnus, a major food processor in Fresno.
Although doctors and Lyons Magnus confirmed her injuries are work related, the company's insurance carrier, Sedgwick Claims Management Services, only provided two years of temporary disability compensation — even though a qualified medical evaluator confirmed she is 70% disabled, Ortega said.
Ortega's plight highlights a larger problem for injured workers statewide who have run into more roadblocks over the past eight years to receive workers' compensation, said Ortega's lawyer, Brett Grove of Keeling Grove Law Offices in Fresno.
"Unfortunately, her experiences are not unique in the workers' compensation arena," Grove said.
Ortega's severe neck, shoulder and back injuries resulted in her losing her job, she said. Ortega became homeless, and her children were taken away from her.
"Sedgwick has turned my life into a living hell," Ortega said. "How can the state of California allow this insurance company to fail to pay legitimate claims?"
Sedgwick officials were unavailable for comment. The company is based in Memphis, Tenn., and calls itself the leading North American provider for...
Friday, January 11, 2013
Downton Abbey and Workers' Compensation
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| Highclere Castle (Photo credit: Wikipedia) |
The PBS series, Downton Abbey, has many parallels to the nation's workers' compensation system and reflects how outdated the present benefit system is to meet current needs of injured workers.
The critically acclaimed fictional British TV series, that begins a 3rd broadcast season this month in the US. The first season was set in 1912, with the sinking the RMS Titanic and the outbreak of World War I.
The drama concerns itself with non-working aristocratic elite who had amassed multitudes of wealth and were land barrons. The post-Edwardian era Crawley family had a large entourage of servants, who worked
"downstairs," at low pay and no benefits, providing services to the heirs of Downton Abbey, a lavish estate in England.
It mirrors the era of the enactment of the original European, and thereafter adopted US, workers' compensation programs. The system provided an administrative remedy to provide a summary, remedial system of benefits to workers in lieu of a trial by jury in the civil justice system.
While workers' compensation is not explicitly mentioned in the TV series, the viewer can gain an understanding of the perspective of the oppressed employees who devoted their lives to the land owning family and considered it an honor and privilege to stay in their employ. Dedication to the employer resulted in lifelong career positions with little complaint of working conditions and lack of benefits.
The British aristocracy system portrayed in the Downton Abbey soon fell into economic ruin, as did the entire British workers' compensation system, yielding to a better medical delivery system and socialized benefits.
It mirrors the era of the enactment of the original European, and thereafter adopted US, workers' compensation programs. The system provided an administrative remedy to provide a summary, remedial system of benefits to workers in lieu of a trial by jury in the civil justice system.
While workers' compensation is not explicitly mentioned in the TV series, the viewer can gain an understanding of the perspective of the oppressed employees who devoted their lives to the land owning family and considered it an honor and privilege to stay in their employ. Dedication to the employer resulted in lifelong career positions with little complaint of working conditions and lack of benefits.
The British aristocracy system portrayed in the Downton Abbey soon fell into economic ruin, as did the entire British workers' compensation system, yielding to a better medical delivery system and socialized benefits.
On the other side of "the pond," in the US, the program has just persisted with more money going to the richest individuals, reflected in with major compensation packages. On the other hand, working Americans have lost jobs, benefits, and income as the nation's economy continues to decline. The US needs to adjust the benefit system to approach what the European Economic Union has achieved.
The second Obama Administration is beng recomposed with a Cabinet to achieve a better funded and structured benefit system. Hopefully a better benefit system will be formulated for injured workers and their families.
The second Obama Administration is beng recomposed with a Cabinet to achieve a better funded and structured benefit system. Hopefully a better benefit system will be formulated for injured workers and their families.
Tuesday, January 1, 2013
Workers’ Compensation 2013 – What Happens on the Other Side of The Fiscal Cliff?
Overall health care devours 18 percent of the US economy and amounts to 25% of the Federal budget.
Medical treatment for injured workers continues to be delayed, denied and limited under current workers’ compensation programs. Medical costs continue to be shifted to other programs including employer based medical care systems and the Federal safety net of Medicare, Medicaid, Veterans Administration and Tricare.
While a trend continues to emerge to offer “Opt Out” and “Carve Out Programs,” they are not global enough to solve the critical budget deficit issues. The latest emerging trend is for employers to utilize ERISA based medical care plans to efficiently delivery medical care. In NJ a limited alternate dispute-resolution procedure between unions and employers has been introduced. See “NJ Care Outs –Another Evolutionary Step” authored by David DePaolo.
The US economy continues to be very weak. This in an ominous signal for the nation’s workers’ compensation program which is starved for premium dollars. Premiums are based upon salaries and real median incomes continued their dramatic decline over the last decade from $54,841 in 2000 to $50,054 in 2011. There just may not be enough dollars available in the workers’ compensation programs to pay for present and lifetime medical care.
Even the present Federal system leaves much to be desired. Whether Federal rationing medical care becomes a reality is unknown. Physicians are under economic scrutiny as the “Doc Fix” to limit provider fees continues as a cloud over all medical programs. The agreement reached by Congress still does not resolve the 26.5% percent cut reimbursement cut to physicians who treat Medicare patients. The law merely "freezes" payment to physicians.
Workers’ compensation programs presently structured provide no real economic incentive to monitor and compensate for more favorable medical outcomes. On the other hand, the Federal government, with broad and sweeping regulatory ability, is able to continue to make strides in many areas including present incentives to hospitals and proposed incentives to physicians to provide medical treatment with fewer complications and ultimate better outcomes
Steven Ratner in the NY Times points out the dramatic increase in the nation’s health care costs. He wrote, “…no budget-busting factor looms larger than the soaring cost of government-financed health care, particularly Medicare and Medicaid.”
Solving the economic gridlock of the country will require an approach to re-invent a medical program for injured workers. A global single-payer program under Federal control will eliminate duplicative administrative State and private efforts. The Federal government has the clout to provide efficient enforcement and co-ordination.
Now that we are on the other side of the fiscal cliff, the opportunity to be creative is possible. The US needs to transition to a single-payer health care system subsuming a medical care program for injured and ill workers who suffer both traumatic and occupational conditions.
Read more about the "single-Payer System" and workers' compensation
Workers' Compensation: A Single Payer System Will Solve the ...
Nov 29, 2012
The question is whether the nation will recognize that the US needs tol take the bold step previously taken by the European Community, finally adopt a single payer medical care program. The perpetual cost generator that ...
http://workers-compensation.blogspot.com/
NJ Urged to Adopt Single Payer System for Workmens Comp
Jun 06, 2011
NJ Urged to Adopt Single Payer System for Workmens Comp. A coalition that has been formed in NJ is urging that the Garden State follow the lead of Vermont and establish a single-payer system. Single-payer movements ...
http://workers-compensation.blogspot.com/
Vermont Single Payer System Called the Dawn of A New Era
Apr 03, 2011
The proposed state based Vermont Single-Payer health care system, that would embrace workers' compensation medical care, is gaining momentum. A recent article in the New England Journal of Medicine, citing increased ...
http://workers-compensation.blogspot.com/
RICO Issues Can Be Cured With A Single Payer Medical System
Mar 22, 2011
Vermont's proposed single payer system would seperate medical care from indemnity. Vermont's single proposed single-payer system would likely also provide a primary care doctor to every resident of Vermont. This would ...
http://workers-compensation.blogspot.com/
Now that we are on the other side of the fiscal cliff, the opportunity to be creative is possible. The US needs to transition to a single-payer health care system subsuming a medical care program for injured and ill workers who suffer both traumatic and occupational conditions.
Read more about the "single-Payer System" and workers' compensation
Workers' Compensation: A Single Payer System Will Solve the ...
Nov 29, 2012
The question is whether the nation will recognize that the US needs tol take the bold step previously taken by the European Community, finally adopt a single payer medical care program. The perpetual cost generator that ...
http://workers-compensation.blogspot.com/
NJ Urged to Adopt Single Payer System for Workmens Comp
Jun 06, 2011
NJ Urged to Adopt Single Payer System for Workmens Comp. A coalition that has been formed in NJ is urging that the Garden State follow the lead of Vermont and establish a single-payer system. Single-payer movements ...
http://workers-compensation.blogspot.com/
Vermont Single Payer System Called the Dawn of A New Era
Apr 03, 2011
The proposed state based Vermont Single-Payer health care system, that would embrace workers' compensation medical care, is gaining momentum. A recent article in the New England Journal of Medicine, citing increased ...
http://workers-compensation.blogspot.com/
RICO Issues Can Be Cured With A Single Payer Medical System
Mar 22, 2011
Vermont's proposed single payer system would seperate medical care from indemnity. Vermont's single proposed single-payer system would likely also provide a primary care doctor to every resident of Vermont. This would ...
http://workers-compensation.blogspot.com/
Related articles
Saturday, December 1, 2012
Hospital Controlled Physician Access and Workers' Compensation
As hospital consolidation of physician practices by acquisition continues, the question of the impact on control of the cost workers' compensation medical delivery remains uncertain.
Hospitals, supported by private equity, are now buying physician practices at a greater pace than ever before making choices for physician care more limited and at a higher cost. The New York Times reports that physicians who sell their practices hospitals find that they are under pressure to meet economic challenges of hospital targeted fees and are restricted in the referral of patients.
"....the consolidation of health care may be coming at a hefty price. By one estimate, under its current reimbursement system, Medicare is paying in excess of a billion dollars a year more for the same services because hospitals, citing higher overall costs, can charge more when the doctors work for them. Laser eye surgery, for example, can cost $738 when performed by a hospital-employed doctor, compared with $389 when done by an unaffiliated doctor, according to national estimates by the independent Congressional panel that oversees Medicare. An echocardiogram can cost about twice as much in a hospital: $319, versus $143 in a doctor’s office."
Read the complete article: A Hospital War Reflects a Bind for Doctors in the U.S.
Read more about "medical Costs" and workers' compensation
Hospitals, supported by private equity, are now buying physician practices at a greater pace than ever before making choices for physician care more limited and at a higher cost. The New York Times reports that physicians who sell their practices hospitals find that they are under pressure to meet economic challenges of hospital targeted fees and are restricted in the referral of patients.
"....the consolidation of health care may be coming at a hefty price. By one estimate, under its current reimbursement system, Medicare is paying in excess of a billion dollars a year more for the same services because hospitals, citing higher overall costs, can charge more when the doctors work for them. Laser eye surgery, for example, can cost $738 when performed by a hospital-employed doctor, compared with $389 when done by an unaffiliated doctor, according to national estimates by the independent Congressional panel that oversees Medicare. An echocardiogram can cost about twice as much in a hospital: $319, versus $143 in a doctor’s office."
Read the complete article: A Hospital War Reflects a Bind for Doctors in the U.S.
Read more about "medical Costs" and workers' compensation
Nov 01, 2012
Planned changes by Mitt Romney to Medicare and Medicaid will have a dire effect on the regulations of the future cost of workers' compensation medical treatment. Proposed changes to the Federal program will indirectly ...
Nov 22, 2012
A report issued by NCCI concludes that medical costs in Workers' Compensation were higher in some instances than in Group Health Plans. The main findings were: For comparable injuries, when WC pays higher prices than ...
Nov 15, 2012
“While the average medical cost for a workers compensation claim is approximately $6,000, the medical cost of an individual claim can be a few hundred dollars or millions of dollars. In 2010, an NCCI study found that claims ...
Nov 29, 2012
The perpetual cost generator that continues to rage out of control in workers' compensation programs is the medical component. Medical costs are crashing the system to failure across the country, with no hope in sight for ...
Thursday, May 24, 2012
Whose to Blame for Opioid Abuse in Workers' Compensation Claims?
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| (Photo credit: Wikipedia) |
Click here to read more: Opioid death liability falling on employers--Court rulings compel benefits payments
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