In a novel decision the NJ Appellate Division decided the custom the workers’ compensation insurance company of “filling the gaps” between periods of temporary disability with permanent disability payments was an unauthorized acceleration and did not step up the final date of payments for purposes of the statue of limitations. The petitioner was permitted to file an application to review and modify his former award for increased benefits two years from the payment of benefits that would have been paid had they not been accelerated by the insurance carrier. Pollock v. Tri State Motor Transit, Inc. , No. A-6224-06T1, NJ App. Div. Decided August 15, 2008.
http://www.judiciary.state.nj.us/opinions/a6224-06.pdf
Showing posts with label periodic payments. Show all posts
Showing posts with label periodic payments. Show all posts
Monday, August 18, 2008
Monday, December 10, 2007
24 Hour Care Emerging as Good Medicine for the Ailing Workers Compensation System and CMS Conflicts
All the national political candidates are now framing the health care issue as a cure-all to the ailing American system. One must take a look back in time. History is known to repeat itself and turning the page back a decade in time reveals that the Clinton I plan considered a merger between the ailing workers' compensation system and a national health care proposal.
Insurance carriers are now rapidly moving into coalitions to unify under 24 hour care proposals.
The initially proposed Clinton II proposal lacks sufficient detail to determine whether the proposal is yet again included. One would think that the real answer to complexities brought about through reimbursement demand of CMS (Centers for Medicare and Medicaid Services) and long avoided reimbursement issues, would be the merger of both workers' compensation systems (all multiple and unmanageable entities) into a single payer system thus avoid the duplications of costs and litigation expenses. Congress already rejected proposals offered by some interested parties to circumvent the system last legislative term.
Integrated health care would put workers' compensation back on the track of maintaining its philosophical integrity of maintaining the concept 'of "periodic payments" for disability and thus avoiding the "buy outs" of medical services in "lump sum" packages thereby circumventing the periodic payment/wage replacement nature of workers' compensation payments. Injured workers would be able to continue to receive medical monitoring and evaluation through diagnostic care and observation.
The lump sum "buy outs," encouraged by insurance carriers, merely defeat the public policy issues of workers' compensation periodic payments and abrogate their responsibility and the integrity of the workers' compensation system(s) while shifting yet again the responsibility to the taxpayers and an overburdened Medicare/Medicaid system.
A program of 24 hour care will remove from controversy medical coverage and would eliminate unnecessary litigation and administrative costs while keeping benefits to workers on a periodic basis which was the foundation of the workers’ compensation systems.
Insurance carriers are now rapidly moving into coalitions to unify under 24 hour care proposals.
The initially proposed Clinton II proposal lacks sufficient detail to determine whether the proposal is yet again included. One would think that the real answer to complexities brought about through reimbursement demand of CMS (Centers for Medicare and Medicaid Services) and long avoided reimbursement issues, would be the merger of both workers' compensation systems (all multiple and unmanageable entities) into a single payer system thus avoid the duplications of costs and litigation expenses. Congress already rejected proposals offered by some interested parties to circumvent the system last legislative term.
Integrated health care would put workers' compensation back on the track of maintaining its philosophical integrity of maintaining the concept 'of "periodic payments" for disability and thus avoiding the "buy outs" of medical services in "lump sum" packages thereby circumventing the periodic payment/wage replacement nature of workers' compensation payments. Injured workers would be able to continue to receive medical monitoring and evaluation through diagnostic care and observation.
The lump sum "buy outs," encouraged by insurance carriers, merely defeat the public policy issues of workers' compensation periodic payments and abrogate their responsibility and the integrity of the workers' compensation system(s) while shifting yet again the responsibility to the taxpayers and an overburdened Medicare/Medicaid system.
A program of 24 hour care will remove from controversy medical coverage and would eliminate unnecessary litigation and administrative costs while keeping benefits to workers on a periodic basis which was the foundation of the workers’ compensation systems.
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