The problem with workers' compensation being funded and managed by private interests is that there is simply too much temptation to do the wrong things for the wrong reasons - usually those reasons involve profiting at the expense of everyone else.
And so it seems in New York where an associate attorney in the State Workers' Compensation Board General Counsel's Office said in an affidavit filed in New York Supreme Court Friday that improper cost-shifting by the state's workers' compensation carriers has caused the liabilities of the state's Reopened Case Fund to "spiral exponentially," of course at the expense of employers. After the historical reform of New York's system by then Gov. Eliot Spitzer, that imposed the state's first duration caps on permanent partial disability benefits, carriers began settling the indemnity portion of claims, leaving medical treatment open. Three years after the indemnity payments run out, carriers can then file claims with the fund providing medical evidence that the workers' condition has changed, thereby shifting the cost of medical care for injured workers over to the Fund. The lawsuit in which the affidavit was filed was initiated by Liberty Mutual Insurance Co. and 19 of its sister insurers to block a section of Gov. Andrew Cuomo's 2013-2014 budget the close the fund on Jan. 1, 2014. Coumo made closing the fund part of the "Business Relief Act" included in his $141.3 billion budget and predicted that closing the fund will save New York... |
Copyright
(c) 2010-2026 Jon L Gelman, All Rights Reserved.
Wednesday, October 16, 2013
Too Much Temptation To Do the Wrong Thing
Tuesday, October 15, 2013
What a Government Default Will Do To Workers' Compensation
With only hours left, and the politicians in Washington DC still unsettled about how to resolve a US credit default, the focus turns to the impact on workers' compensation programs throughout the country.
Expanding on the problems besieging compensation programs following the US Government Shutdown, things are going to get much worse and very quickly. Social Security will stop paying benefits, its contractors and medical providers. Closing down those contributions will literally suffocate transactional information concerning integration of Medicare Secondary Payer Act benefits and reimbursement. Calculating offsets and reverse offsets will become an impossibility. Insurance companies in reverse offset states will be required to fund more dollars into the system as application flow into the state systems to modify prior awards still being paid.
Employers dependent upon government payments, including funding and contracts, will be unable to pay workers and insurance company premiums. Cascading financial distress will implode the economy and unemployment will become rampant.
Additional burdens will be placed upon injured workers who even already are struggling to make ends meet and obtain medical treatment with absolutely no Federal safety net in place to catch them. Injured workers with pending claims will be unable to seek medical and pharmaceutical benefits from collaterally funded programs.
Federal dollars actually fund over 70% on state rehabilitation programs. These programs will quickly dry up, and the those injured workers who are seeking placement in a new job through rehabilitation will be locked out of the states.
Workplaces will continue to be unregulated as OSHA (The Occupational Health Administration) will be unable to financially fund enforcement programs, new safety programs and even review comments for pending regulations, ie. The Smart Act.
Investigations requirement Federal records, including prior military records, will become increasingly difficult to secure. Stalling this process will delay completed workers' compensation medical records, expert evaluation opinions and the adjudication of workers' compensation claims.
Quite a mess! Not a pleasant prospect to look forward to, as the clock keeps clicking down
Expanding on the problems besieging compensation programs following the US Government Shutdown, things are going to get much worse and very quickly. Social Security will stop paying benefits, its contractors and medical providers. Closing down those contributions will literally suffocate transactional information concerning integration of Medicare Secondary Payer Act benefits and reimbursement. Calculating offsets and reverse offsets will become an impossibility. Insurance companies in reverse offset states will be required to fund more dollars into the system as application flow into the state systems to modify prior awards still being paid.
Employers dependent upon government payments, including funding and contracts, will be unable to pay workers and insurance company premiums. Cascading financial distress will implode the economy and unemployment will become rampant.
Additional burdens will be placed upon injured workers who even already are struggling to make ends meet and obtain medical treatment with absolutely no Federal safety net in place to catch them. Injured workers with pending claims will be unable to seek medical and pharmaceutical benefits from collaterally funded programs.
Federal dollars actually fund over 70% on state rehabilitation programs. These programs will quickly dry up, and the those injured workers who are seeking placement in a new job through rehabilitation will be locked out of the states.
Workplaces will continue to be unregulated as OSHA (The Occupational Health Administration) will be unable to financially fund enforcement programs, new safety programs and even review comments for pending regulations, ie. The Smart Act.
Investigations requirement Federal records, including prior military records, will become increasingly difficult to secure. Stalling this process will delay completed workers' compensation medical records, expert evaluation opinions and the adjudication of workers' compensation claims.
Quite a mess! Not a pleasant prospect to look forward to, as the clock keeps clicking down
Related articles
- Study: Calif. workers compensation overhaul too new to parse (workers-compensation.blogspot.com)
- The Government Shutdown is a Kick-In-Gut to Workers' Compensation (workers-compensation.blogspot.com)
- Safety Violations Matter: Wisconsin Court Reaffirms Basis for Employer Safety Penalties (workers-compensation.blogspot.com)
- Is Workers' Compensation Just a Promise That Can't Be Kept? (workers-compensation.blogspot.com)
- Social Security raise to be among lowest in years (workers-compensation.blogspot.com)
- Workers compensation rates to decline in Oregon in 2014 (workers-compensation.blogspot.com)
- Electronic Filing: The Ideal System for Workers' Compensation (workers-compensation.blogspot.com)
- Government Shutdown: Day 8 - Injured Workers Are Being Held for Ransom (workers-compensation.blogspot.com)
Monday, October 14, 2013
California To Regulate New Home Care
| Injured workers have been receiving home health care at increased rates as hospitals and rehabilitation cnters are releasing recuperating workers quickly under discharge protocols. Today's post is shared from the NY Times. California has become the latest state to tighten oversight of home health agencies that provide custodial care — help with bathing, dressing, toileting and other basic tasks — to older adults and people with disabilities. Gov. Jerry Brown on Sunday signed the Home Care Services Consumer Protection Act of 2013, which will require agencies to conduct background checks on workers, provide five hours of training, list aides in an online registry and obtain a license certifying their compliance with basic standards. Home health agencies had opposed the bill’s training and background check requirements. The governor vetoed a similar bill last year; this year’s version dropped a requirement that aides hired from referral agencies or directly by seniors get background checks and be listed in the online registry. Mr. Brown also asked for a delay in putting the legislation in place until January 2016. Critics have long argued that the home care industry has been too lightly regulated. According to a new study in the Journal of Applied Gerontology, only 15 states require training for home care workers or on-site supervision of their activities. Altogether, 29 states mandate that agencies be licensed. The move to tighten industry... |
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- Work Comp Steps Up to ACA (workers-compensation.blogspot.com)
- Study: Calif. workers compensation overhaul too new to parse (workers-compensation.blogspot.com)
- Senior Care Workers Are Victims of Wage Violations (workers-compensation.blogspot.com)
- Senior Care Workers Are Victims of Wage Violations (workers-compensation.blogspot.com)
- Bill limiting workers' comp claims by athletes is sent to governor (workers-compensation.blogspot.com)
Hank Patterson Receives the 2013 Lifetime Achievement Award
This week, Henry “Hank” N. Patterson, Jr. was presented with the 2013 Lifetime
Achievement Award at the annual dinner of the Workplace Injury and Advocacy
Group (WILG), in Palm Beach, Florida. For
his entire career, Hank has zealously advanced the rights of workers. He has held
leadership positions in national legal organizations, including the American
Bar Association, and helped establish the College of Workers Compensation Lawyers.
Hank
graduated from the University of North Carolina in 1963 and from UNC Law School
in 1966, where he was elected to the Order of the Coif. Before entering private
practice, he served as law clerk to the Honorable J. Braxton Craven, Jr., of
the U.S. Court of Appeals for the Fourth Circuit and worked as an attorney in
Region 11 of the National Labor Relations Board.
He
has served on legislative study commissions and as Chair of the Workers’ Rights
Section of the North Carolina Academy of Trial Lawyers, Co-Chair of the North
Carolina Bar Association’s Workers’ Compensation Committee, and member of the
Advisory Council to the Chair of the North Carolina Industrial Commission. Hank
is a Board Certified Specialist in Workers’ Compensation Law. His practice is
limited to the areas of workers’ compensation, labor and employment, and
disability entitlements.
Related articles
- Study: Calif. workers compensation overhaul too new to parse (workers-compensation.blogspot.com)
- Safety Violations Matter: Wisconsin Court Reaffirms Basis for Employer Safety Penalties (workers-compensation.blogspot.com)
- To cut costs, New York will close workers' comp hearing sites (workers-compensation.blogspot.com)
- Electronic Filing: The Ideal System for Workers' Compensation (workers-compensation.blogspot.com)
- Social Security raise to be among lowest in years (workers-compensation.blogspot.com)
- The Government Shutdown is a Kick-In-Gut to Workers' Compensation (workers-compensation.blogspot.com)
- Is Workers' Compensation Just a Promise That Can't Be Kept? (workers-compensation.blogspot.com)
- Careful What You Wish For: Denying Worker's Compensation for Undocumented Workers (workers-compensation.blogspot.com)
National Survey: Working Longer—Older Americans’ Attitudes on Work and Retirement
The Associated Press-NORC Center for Public Affairs Research has released the results of a major new survey exploring the views of older Americans about their plans for work and retirement. It provides in-depth information about a rapidly growing segment of the population that by choice or circumstance is working longer. The Great Recession has had a marked impact on retirement plans.
“The survey illuminates an important shift in Americans’ attitudes toward work, aging, and retirement,” said Trevor Tompson, director of the AP-NORC Center. “Retirement is not only coming later in life, it no longer represents a complete exit from the workforce. The data in this survey reveal strikingly different views of retirement among older workers today than those held by the prior generation.”
With funding provided by the Alfred P. Sloan Foundation, the Associated Press-NORC Center for Public Affairs Research conducted a national survey of 1,024 adults ages 50 and over. It is a segment of the population that is not only growing rapidly in numbers, but is also becoming substantially healthier. Projections show that the U.S. population age 65 and over will increase to 19 percent of the population by 2030, up from 13 percent in 2010, an estimated 72 million people. At the same time, people age 55 and over comprise the fastest growing segment of the workforce. By 2020, approximately one fourth of American workers will be...
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- Health Spending Over The Coming Decade Expected To Exceed Economic Growth (workers-compensation.blogspot.com)
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In Washington State, Home of Highest Minimum Wage, a City Aims Higher
Washington already has the highest state minimum wage in the country, at $9.19 an hour. Soon, voters in this tiny city south of Seattle will decide whether to push the local minimum even higher.
If a majority of the voters here say yes to a referendum known as Proposition 1 when their mail-in ballots start arriving this week, a minimum wage of $15 an hour would be required for many businesses in SeaTac, more than twice the federal minimum of $7.25.
The measure would lift wages for thousands of workers at one of the nation’s busiest airports, Seattle-Tacoma International, which is within city limits. But business and labor leaders say the economic and political implications, with local democracy going where state and federal legislators mostly fear to tread, could be equally profound.
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Foxconn admits labour violation at China factory
Foxconn, the world's biggest contract electronics maker, has admitted student interns worked shifts at a factory in China that were in violation of its company policies.
It had admitted to hiring underage interns at the same unit last year. Foxconn said actions had been taken to bring the factory "into full compliance with our code and policies". "There have been a few instances where our policies pertaining to overtime and night shift work were not enforced," the company said in a statement. The manufacturing giant is owned by Taiwanese group Hon Hai Precision and employs about 800,000 workers around the globe. Foxconn, while not a household name in itself for many consumers, is used by most of the big technology giants around the world, including Apple, Sony, Microsoft, HP, and Nokia. It first came under scrutiny for its labour practices when 13 employees committed suicide at its Chinese plants in 2010. The incidents raised concerns over working conditions at its units in China and drew attention to growing labour strikes. For its part, Foxconn responded by raising wages, shortening working hours and employing counsellors on site. It also installed suicide nets to factory living-quarters at its Shenzhen factory. Also in 2010, Foxconn temporarily shut down a unit in India after 250 workers fell sick. And in May 2011, two people were killed after... |
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U.S. asbestos imports condemned by health experts, activists
The United States isn’t one of them. Last year, according to the U.S. Geological Survey, 1,060 metric tons — more than 2.3 million pounds — came into the country, all of it from Brazil. “Based on current trends,” the USGS says, “U.S. asbestos consumption is likely to remain near the 1,000-ton level …” Public health experts and anti-asbestos activists find this distressing. Linda Reinstein, who lost her husband to mesothelioma, an especially virulent form of cancer tied to asbestos exposure, said she’s “appalled and disgusted that the United States still allows the importation of asbestos to meet so-called manufacturing needs. |
When your symptoms don't tell the whole story
Instead of asking you to talk about the pain in your foot, or the ache in your chest, health care workers are starting to ask you about...your story. There’s an emerging idea in health care that social and psychological conditions -- like poverty and chronic stress -- change how your body and brain work, and that can have damaging long-term effects on your health. Doctors and nurses from northern California to Camden, N.J., are beginning to see that the first step in treating these patients is often treating the part of the illness that’s not on the surface. Patients like 30-year-old Elizabeth Philkill. |
Asbestos Can Take Your Breath Away, Forever
Today's post was shared by Linda Reinstein and comes from blog.saferchemicals.org
| The time is now for the Senate to unanimously support the passage of the Safe Chemicals Act (S.847). We need to do more to protect our children from BPAs, fire retardants and other dangerous toxins in our world. What many don’t realize is that asbestos is still legal and lethal in theUnited States, tragically impacting families. I know because it happened to us. I remember the day when my husband AlanAlan Was diagnosed with malignant pleural mesothelioma as if it were yesterday. We had never heard of mesothelioma, and we were devastated when we learned that there is no cure. Our daughter was only ten years old when we began our arduous family battle to fight mesothelioma and work with Congress To ban asbestos. |
Asbestos victims speak out
By Linda Reinstein, Asbestos Disease Awareness Organization
"Out of the hottest fire comes the strongest steel." Chinese ProverbTSCA was passed more than 30years ago and is grossly out of date. ADAO has been a stakeholder in discussions with Congressional leadership since 2004. You can read my personal journey, and how I came to advocate for this issue here. As I Remind Congress,“History is a great teacher to those who listen.” Science And technology have made exponential advancements. As a mother and mesothelioma widow, I know the Safer Chemicals, Healthy FamilyFamily Coalition’s efforts will improve lives if Congress can draft and pass legislation to protect public health and our environment. I see hope on the horizon, but we have stalled. Bipartisan support is essential in getting a bill to the President’s desk, but we face a hurdle with the Chemical Safety Improvement Act (CSIA). ADAO opposes the current language of CSIA, due to deep concerns that the bill as currently written does not deliver meaningful reform to TSCA and does not adequately protect Americans from the worst... |
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What we know about football and repetitive brain trauma
Brain tissue images, with tau protein in brown. The brain on the left is from a normal subject, the brain in the middle is from a former football player, and the brain on the right is from a former boxer.Courtesy of the Boston University Center for the Study of Traumatic Encephalopathy.
League of Denial, a PBS Frontline documentary about the NFL's response (or lack thereof) to concussions and long-term brain injuries among its players, airs tonight. The investigation attempts to hash out what the league really knew about player safety while it downplayed the ill effects the sport has on its athletes. But what exactly are those effects, and what about them made thousands of former players sue the NFL over their injuries? While the symptoms of a concussion—dizziness, vomiting, memory loss—can be felt immediately, the long-term impacts of repeated brain trauma have been harder to study. Research points to chronic traumatic encephalopathy, or CTE, as one of the major outcomes. CTE is caused by a buildup of tau, a protein that strangles brain cells and degenerates brain tissue, which is caused by repetitive brain trauma like the hits football players endure. This leads to depression, increased aggression, lack of impulse control, and eventually dementia, which may not manifest until years or even decades after the brain injuries took place. While CTE can only be definitively identified after a patient dies, a pilot study at the University of... |
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Lawsuit claims chemical spill at Armstrong caused worker's neurological disorder
Today's post is sahred from inpews.com
Sandra Cooper remembers the exact date her life started to turn upside down: Sept. 25, 2003. She'd gotten home from her job as an art teacher at Garden Spot High School around 4 p.m. that day. Her husband, Gene, who was on shift work at Armstrong World Industries floor plant, arrived home a short time later. She heard him coming. "I could hear the coughing even before he came up the sidewalk," Sandra Cooper said. "I've never heard anybody cough like that." |
Sunday, October 13, 2013
Social Security raise to be among lowest in years
Social Security payments are tightly kinked to workers' compensation disability payments. When there are increases in benefits, some "reverse offset" states are liberal in passing along the adjustments to injured workers'. The State of New Jersey does NOT pass along the benefit increase and the workers' compensation insurance company does NOT increase the disability award payment to the injured workers. Today's post is shared from the dallasnews.org.
[Click here to see the rest of this post]

For the second straight year, millions of Social Security recipients, disabled veterans and federal retirees can expect historically small increases in their benefits come January.
Preliminary figures suggest a benefit increase of roughly 1.5 percent, which would be among the smallest since automatic increases were adopted in 1975, according to an analysis by The Associated Press. Next year's raise will be small because consumer prices, as measured by the government, haven't gone up much in the past year. The exact size of the cost-of-living adjustment, or COLA, won't be known until the Labor Department releases the inflation report for September. That was supposed to happen Wednesday, but the report was delayed indefinitely because of the partial government shutdown. The COLA is usually announced in October to give Social Security and other benefit programs time to adjust January payments. The Social Security Administration has given no indication that raises would be delayed because of the shutdown, but advocates for... |
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The Soaring Cost of a Simple Breath
Cost in the US for pharmaceutical medications are a stressor for all including workers' compensation carriers. The blame is targeted to injured workers for causing the problem. In actuality it appears that big pharma maybe the problem. Perhaps Federal legislation should allow cheaper rates for workers' compensation programs. Today's post is shared from nytimes.com.
[Click here to see the rest of this post]

The kitchen counter in the home of the Hayes family is scattered with the inhalers, sprays and bottles of pills that have allowed Hannah, 13, and her sister, Abby, 10, to excel at dance and gymnastics despite a horrific pollen season that has set off asthma attacks, leaving the girls struggling to breathe.
Asthma — the most common chronic disease that affects Americans of all ages, about 40 million people — can usually be well controlled with drugs. But being able to afford prescription medications in the United States often requires top-notch insurance or plenty of disposable income, and time to hunt for deals and bargains. The arsenal of medicines in the Hayeses’ kitchen helps explain why. Pulmicort, a steroid inhaler, generally retails for over $175 in the United States, while pharmacists in Britain buy the identical product for about $20 and dispense it free of charge to asthma patients. Albuterol, one of the oldest asthma medicines, typically costs $50 to $100 per inhaler in the United States, but it was less than $15 a decade ago, before it was repatented. “The one that... |
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- Also Too, Still Too Damn Expensive (brainiac-conspiracy.typepad.com)
Saturday, October 12, 2013
Where's the New Jersey Conference?
| There's going to be lots of press surrounding the latest CompScope Benchmarks Study released by the Workers' Compensation Research Institute, as there always is, and should be. After all, the WCRI is one of the top research groups in our industry and the leadership and staff there work hard to provide as complete and unbiased data as possible. What is unique about the latest study of 16 states is one common theme - controlling costs has more to do with instituting price schedules for medical services than any other single factor. The premier example is Illinois, which, after reducing medical fees by 30% across the board on Sept. 1, 2011, saw all medical payments for claims with seven days of lost time declined by 5% for injuries arising in 2011 and evaluated as of 2012. Prices paid for non-hospital services dropped by 24% between 2010 and 2012. And Texas' claim costs, which ranked the highest in the nation prior to a set of reforms passed in 2005, are now typical of the states studied, according to WCRI , with medical costs per claim 17% lower than the 16-state median for 2009 claims evaluated in 2012. The Institute expects costs to decline further in Texas with the prescription drug formulary that became effective 9/1/2011. The state's claim cost growth rate is also slowing. Claims costs in Texas grew by between 3% and 6% per year between 2006 and 2011. Costs per claim for the 2010/2012 study period were $5,829 – slightly higher than the $5,354 median. The flip side is... |
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- OK's True Cost Control Feature (workers-compensation.blogspot.com)
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Scientific improprieties in the asbestos industry funded research of McGill professor
Asbestos research, and its validity, is a much debated quesstion. Today's post is shared from Kathleen Ruff, RightOnCanada.ca
Here is a powerful, detailed and damning scientific analysis of improprieties in the research of Prof. J.C. McDonald on Quebec asbestos miners – The Past is Prologue, Universities in Service to Corporations: The McGill-QAMA Asbestos Example. This analysis was presented by Prof. David Egilman at the McGill asbestos conference on October 1, 2013. It is clearly presented and well worth reading. At the conference, no response was provided to the damning information that Prof. Egilman put forward. Prof. McDonald’s research was financed with one million dollars by the Quebec Asbestos Mining Association (QAMA). Prof. McDonald used his research to promote the use of chrysotile asbestos around the world. His research continues today to be used by the global asbestos industry to promote the sale and use of chrysotile asbestos. It was used, for example, by the global asbestos lobby at the May 2013 Rotterdam Convention conference to help defeat the listing of chrysotile asbestos as a hazardous substance. McGill continues to state that Prof. McDonald’s research was conducted “according to the rigorous scientific standards for which McGill is known”. McGill has not however addressed the detailed and damning evidence that Prof. Egilman has put forward. Prof. Egilman and other scientists have called on McGill to carry out an... |
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