DOGE Changes: Workers' Comp Costs Rise?

Changes within the Department of Government Efficiency (DOGE) could have negative economic repercussions for states that rely on a loophole that allows workers' compensation insurance carriers to benefit from Social Security Disability payments through reverse offsets. 

DOGE and Medicare Set Aside Agreements

This is the first in a series of posts concerning the potential impact of the US Department of Government Efficiency (DOGE) on the nation's patchwork of workers' compensation systems.

CDC Disruption: Workplace Health at Risk

The recent disruption of the US Centers for Disease Control and Prevention (CDC)'s activities has raised concerns about the potential negative impacts on public health, particularly regarding the identification and treatment of infectious diseases and occupational exposures. Here's how this disruption could negatively impact employees, employers, and ultimately increase the cost of workers' compensation claims:

Mercury Exposure in Recycling

A recent report highlights a concerning case of occupational mercury exposure at an electronics waste and lamp recycling facility in Ohio in 2023. This incident serves as a crucial reminder of the ongoing risks associated with mercury exposure in various workplaces, particularly those involved in recycling and handling electronic devices.

Medicare's Magic Number: $750 for Workers' Compensation 2025

The Centers for Medicare and Medicaid Services (CMS) has announced that it will maintain the current threshold of $750 for workers' compensation settlements in 2025. This threshold determines when settlements must be reported to Medicare and conditional payments must be repaid. Let's dive into what this means and how CMS made this decision.

Heat Illness: A Firefighter's Fight

A recent study highlights a concerning trend: increasing rates of heat-related illnesses among firefighters in the Golden State. As climate change intensifies, extreme heat events are becoming more frequent and severe, posing significant risks to those who bravely battle wildfires and other emergencies. This raises crucial questions about worker safety and the availability of adequate workers' compensation benefits.

Long COVID: Back to Work Challenges

A recent report from the Centers for Disease Control and Prevention (CDC) sheds light on the prevalence and impact of Long COVID across the United States. 

NJ Supreme Court Limits Employer Insurance Coverage for Worker Injuries

In a recent decision, the New Jersey Supreme Court clarified the scope of insurance coverage for employers facing lawsuits from injured workers. The case Dionicio Rodriguez v. Shelbourne Spring LLA addresses whether an employer's liability insurance policy covers claims of gross negligence, recklessness, and intentional misconduct brought by an employee who has already received workers' compensation benefits.

The High Cost of Injury

The National Council on Compensation Insurance (NCCI) recently released a comprehensive study examining "mega claims" in workers' compensation insurance. These are claims with reported losses exceeding $2 million, representing a small fraction of total claims but a significant portion of total loss dollars. The study covers accident years 2001-2021, providing valuable insights into trends and patterns within this high-cost category.

Legal Help Boosts Workers' Compensation Benefits

A recent study about the impact of legal representation on workers' compensation benefits found that having an attorney representing an injured worker increases benefits. 

When Skeptics Lead: The Next Pandemic Challenge

As the United States faces the possibility of another presidential transition, the recent announcement of Donald Trump's health agency nominees has sent ripples of concern through the medical and public health communities. With a potential new administration on the horizon, the critical question emerges: Are we prepared for the next infectious disease challenge in the workplace?

Chevron's Fall: Medicare Set-Asides Face Legal Shake-Up

The recent U.S. Supreme Court decision in Loper Bright Enterprises v. Raimondo (2024), which overturned the Chevron doctrine established in Chevron U.S.A., Inc. v. Natural Resources Defense Council, Inc., is likely to have significant impacts on how the Centers for Medicare & Medicaid Services (CMS) operates regarding the Medicare Secondary Payer (MSP) Act, including conditional payments and Medicare Set-Aside (MSA) agreements. 

Google Antitrust Ruling: Reshaping Workers' Comp Tech Landscape

On Monday, a federal judge ruled that Google had acted illegally to maintain a monopoly in online search. This landmark decision strikes at the power of tech giants in the modern internet era and may fundamentally alter how they do business.

NJ’s COVID-19 Response: Key Lessons and Future Steps

The Independent Review of New Jersey’s Response to the COVID-19 Pandemic, conducted by Montgomery McCracken Walker & Rhoads LLP. This comprehensive review, released on March 7, 2024, evaluates New Jersey’s preparedness, response, and lessons learned during the pandemic. It also provides recommendations to enhance future emergency management.

Medical Evidence Falls Short

A workers’ compensation medical report offered was insufficient to establish a direct causal link between the accident and the alleged concussion and subsequent stroke. The medical report was precluded from admission by a Federal Court in a personal injury case.

Senate Blasts Amazon Over High Injury Rates

According to an interim investigation report by Senator Bernie Sanders and the Senate HELP Committee into Amazon's warehouse safety practices, warehouse workers continue to suffer excessive occupational injuries. The report focuses on peak seasons like Prime Day and the holiday season.

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.

The Predicted Active Hurricane Season Stirs Trouble

An active hurricane season can significantly impact the workers' compensation system in terms of claims and losses. 

Fracture of Silicone Breast Implant Held Not to be Compensable

In an unpublished decision, the NJ Appellate Division upheld the dismissal of a workers' compensation claim for the repair of a ruptured breast implant. 

$10 Million Punitive Damage Award for Workplace Discrimination Upheld

Unlike the NJ workers' compensation claims, there is no cap on punitive damages available for claims under the NJ Law Against Discrimination.