Healthcare Costs Crush Workers' Compensation

The cost of medical treatment is not just rising — it is accelerating. And nowhere is this felt more sharply than in the workers' compensation system, where medical payments now constitute a dominant and growing share of every claim. What was a slow-burning crisis a decade ago has become an urgent structural challenge for employers, insurers, policymakers, and injured workers alike.

Are Generic Drugs Equally Safe?

Understanding Quality, Safety, and Cost in Workers' Compensation Cases

WCMSA Gap Widens Dramatically

The Centers for Medicare & Medicaid Services (CMS) has released its fiscal year 2025 statistics for Workers' Compensation Medicare Set-Aside Arrangements (WCMSAs), revealing a striking trend that should concern workers' compensation professionals: the gap between what parties propose and what CMS recommends is at an all-time high.

Older Workers Fall Risk

The aging workforce faces a hidden but deadly threat: workplace falls. Recent data reveal that fall-related deaths among older adults have more than tripled in the past 30 years, with over 41,000 Americans aged 65 and older dying from falls in 2023 alone. This alarming trend extends beyond the home into workplace environments, where employers must urgently address the unique vulnerabilities of their aging employees.

Tariff Hikes: Work Comp Costs Rising?

The ripple effects of recent and potential pharmaceutical tariffs are sending shivers through the US healthcare system, and the workers' compensation insurance industry is no exception. Experts warn that these tariffs, essentially taxes on imported drugs and medical supplies, could significantly inflate the cost of workers' compensation coverage soon.

FTC Report Strikes at the High Cost of Drugs

The US Federal Trade Commission [FTC] report "Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies" examines the influence of Pharmacy Benefit Managers (PBMs) in the pharmaceutical industry.

American Screening LLC issues a Voluntary Nationwide Recall of American Screening Hand Sanitizer Packaged in 8 oz Bottles Because They Resemble Beverage Containers

American Screening LLC of Shreveport, Louisiana is voluntarily recalling 153,336 units of Hand Sanitizer, containing 70% ethyl alcohol gel to the consumer level. The hand sanitizer is packaged in 8 oz. containers that resemble water bottles posing a risk of consumption.

NY Attorney General James Announces Proposed $26 Billion Global Agreement with Opioid Distributors/Manufacturer

New York Attorney General Letitia James today announced a historic proposed $26 billion agreement that will help deliver desperately needed relief to communities across New York and the rest of the nation struggling with opioid addiction. 

Cannabis Legislation Enacted in NJ

Today the NJ Legislature approved, and Governor Phil Murphy signed sweeping legislation to legalize the sale of recreational marijuana. Today's action follows the legislative enactment of medical marijuana laws in NJ and case law approving medical marijuana for the treatment of work-related injuries.

The COVID-19 Advisory Board and the Future of Workers’ Compensation

Today, the Biden-Harris Transition announced the formation of the Transition COVID-19 Advisory Board, a team of leading public health experts who will advise President-elect Biden, Vice President-elect Harris, and the Transition’s COVID-19 staff. The Transition COVID-19 Advisory Board will be led by co-chairs Dr. David Kessler, Dr. Vivek Murthy, and Dr. Marcella Nunez-Smith. Dr. Beth Cameron and Dr. Rebecca Katz are serving as advisors to the Transition on COVID-19 and will work closely with the Advisory Board.

Lessons from Asbestos Litigation Apply to COVID Claims

The rapid emergence of COVID-19 creates new challenges for the nation’s patchwork of state run workplace benefit delivery systems. This paper draws a comparison between COVID claims and asbestos claims, the “Largest and Longest” wave of occupational disease claims in the United States. The comparison offers insight into avoiding past economic, administrative and benefit delivery pitfalls. The lessons from asbestos claims provide an insight into maintaining a sustainable workers’ compensation system to meet the surge of COVID claims.

Coronavirus (COVID-19) - The workers' compensation community should support TTSI

The workers' compensation community should play an active role to contain the spread of COIVD-19. Labor, Industry and insurance companies must be encouraged to participate in contact tracing, testing and supported isolation [TTSI]. All reports of illness and incidents of COVID-19 should trigger reportable investigations that are co-ordinated with local and state health agencies. Communication with employees should be encouraged for testing, isolation and expansion of contact testing.

Special Independence Day Event - Music and Experts - Veterans Administration

Special Independence Day Event

Injured Workers Pharmacy Enters into $11 Million Opioid Settlement for Illegal Dispensing and Sales

Massachusetts Attorney General Maura Healey announced a $11 million settlement with an Andover mail-order pharmacy resolving allegations that it failed to implement adequate safeguards against unlawful and dangerous dispensing, resulting in the shipment of thousands of potentially illegitimate controlled substance prescriptions across the country.

Medical Marijuana and the Supremacy Clause

“Change is the law of life. And those who look only to the past or present are certain to miss the future.” -John F. Kennedy

An unsettled area of the law has emerged between, the widespread adoption by the states to permit prescribed marijuana to relieve certain medical conditions and the strict federal law mandating the substance as a Schedule 1, Controlled Substance [CSA]. With an estimated 43.3 million Americans using the elicited drug, and the challenges of the “opioid epidemic” creating massive addiction and fatal results, the nation’s workers’ compensation system has been challenged to provide adequate authorized medical treatment.

NJ Offers Tax Credits to Employers to Offset Minimum Wage Increases for Workers with Impairments

A $10 million tax credit program put into effect for the 2019 tax year will help offset payroll cost increases for employers of workers with impairments.

The program was created through the minimum wage law signed by Governor Murphy in 2019 to ease the transition for businesses to a $15 minimum wage, and is administered by the New Jersey Department of Labor and Workforce Development. It is designed to help bridge the economic gap for employers as the minimum wage rises by $1 per hour each year until it reaches $15 per hour in 2024 for most employees.

Employers of workers with impairments will be able to claim credit for the cost of the wage increases and corresponding increases in payroll taxes that the employer pays on those workers’ wages.

“Every hardworking New Jerseyan working full-time deserves a fair, livable wage,” said Governor Phil Murphy. “With this new program, we are committed to providing individuals with disabilities the opportunity to fully participate in our society and economy while ensuring the viability of businesses in New Jersey.”

“While it is critical for workers to be able to earn a living wage, we must also continue to support our business community, especially those who provide employment for hard-to-place workers,” said Labor Commissioner Robert Asaro-Angelo.

The program is part of Gov. Murphy’s Jobs NJ, a multi-pronged initiative to grow New Jersey’s talent pool to meet the needs of businesses into the future. It is part of the governor’s over-arching goal of providing equitable opportunities in the workforce and building a stronger, fairer economy for all. To learn more about Jobs NJ, click here.

Qualifying employees are those who earn at least minimum wage and whose work capacity is “significantly impaired by age or physical or mental deficiency or injury” and who are found by the state to be eligible for personal assistance or prescribed drugs to be able to perform the essential tasks of the job.

Eligible employers must complete an Application for Certification, which can be found here.

To read more about "minimum wage" and workers' compensation, click here.

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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Workplace Deaths Rise

Work is getting more dangerous in the US. The US Bureau of Labor Statistics reports, there were 5,250 fatal work injuries recorded in the United States in 2018, a 2 percent increase from the 5,147 in 2017. 

Noise Induced Health Threats

Excessive noise that has dominated the workplace throughout time is now associated as causing a plethora of serious health conditions. A recent article in the New York Magazine by David Owen focusses on occupational induced noise pollution and the ailments it affects.

New Opioid Prescription Regulations

Attorney General Gurbir S. Grewal and the New Jersey Division of Consumer Affairs, together with the New Jersey Coordinator for Addiction Responses and Enforcement Strategies ("NJ CARES"), today announced a series of regulatory actions that will advance the State’s battle to end the opioid epidemic, including proposed rules that will expand access to the prevention and treatment of opioid use disorder through telemedicine.

The Oklahoma Opioid Settlement: A Promising Impact on Workers’ Compensation

The first major settlement in the nation’s massive litigation effort against the manufacturers of opioids may present an outline of how the effort will affect workers’ compensation programs throughout the United States. The settlement outlines a substantial contribution to assist those individuals negatively affected by opioid addiction. 

The Oklahoma Attorney general yesterday announced an historical settlement in the pending state’s opioid litigation. Attorney General Mike Hunter and Oklahoma State University leaders  announced an historic settlement with Purdue Pharma that will establish a nearly $200 million endowment at the Oklahoma State University’s Center for Wellness and Recovery, which will go toward treating the ongoing addiction epidemic nationwide. 

“‘The addiction crisis facing our state and nation is a clear and present danger,’ Attorney General Hunter said. ‘Last year alone, out of the more than 3,000 Oklahomans admitted to the hospital for a non-fatal overdose, 80 percent involved a prescription opioid medication. Additionally, nearly 50 percent of Oklahomans who died from a drug overdose in 2018 were attributed to a pharmaceutical drug. Deploying the money from this settlement immediately allows us to decisively treat addiction illness and save lives.” 

Joseph F. Rice, Esq., of Motley Rice LLC, co-lead counsel and a member of the Plaintiffs’ Executive Committee for the National Prescription Opiate Multidistrict Litigation, coordinated in the Northern District of Ohio, commented, “This is a significant step in the effort of the governmental entities around the country to address the opioid epidemic. Purdue Pharma and the Sackler family, by entering into this settlement, have taken a step forward to address what has been alleged as decades of misinformation, inappropriate marketing and efforts to grow the use of opioids, some of the most addictive narcotic drugs in our society.” 

The US Centers for Disease Control [CDC] has reported that from 1999-2017 almost 400,000 people died from an overdose involving any opioids, including prescription and illicit opioids. On the average, 130 Americans dies every day from an opioid overdose. 

Treatment of work related injuries and the resulting pain have produced an epidemic of opioid related addiction and fatalities. The CDC issued guidelines in 2016 for the prescription of opioids. New safety warnings were also added to all prescription opioid medications. State laws were enacted to add restrictions and limitation on opioid prescriptions. The NJ Attorney General has filed a lawsuit against a subsidiary of NJ based Johnson and Johnson seeking reimbursement for workers' compensation costs resulting from deceptive opioid advertising. At least 33 states have sued the opioid manufacturers. This is a significant action as Johnson and Johnson is a major player in New Jersey's economy. 

An unintended consequence of the restrictions placed on the prescription of opioids has been the inability of injured workers to obtain adequate pain relief. Suicide rates have increased, John Heubusch, a cancer patient, writing in the Washington Post stated, “ We have reached the point where doctors believe the next prescription they write for opioids to treat chronic pain might be their last. In my own case, I’ve had to undergo countless unsuccessful procedures and near superhuman efforts to be granted barely enough medication to try to live a normal life. Even those doctors with the courage to prescribe them for chronic pain sufferers are finding the hurdles established by federal and state reporting requirements so onerous that they are simply turning patients away.”…..”Opioid prescriptions have shrunk substantially, but Washington’s goal now is to cut their number by a further one-third. In a bitter irony, opioid overdose deaths continue to hover at an all-time high. Many chronic pain patients, denied prescriptions, are self-medicating on the street, using synthetic drugs such as fentanyl, 50 times more powerful than heroin. There, danger and overdose lurk around every corner. Even worse, some who have lost all hope for pain relief are choosing to end their pain by ending it all. The risk of suicide among patients with chronic pain is twice that of those without it." 

The Oklahoma settlement is an staring effort to the resolution of the opioid epidemic and the its consequences. Hopefully, this will bring those responsible for the opioid problem to the table to discuss sensible solutions so that injured workers’ can be provided medical care to relieve their pain without resulting addiction and death. This promising future would economically benefit employers, workers’ compensation insurance companies, and public entities that medically treat workplace injuries. All stakeholders involved in the workers’ compensation system hopefully can look to a more promising future.

See also:
New York Sues Sackler Family Members and Drug Distributors (NY Times 3/29/2019)
New York State 1st Amended Complaint (3/28/2019)

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Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

Updated: 3/29/2019