Workers' Compensation

Wednesday, October 23, 2013

The Aggressor Rule Sometimes Makes Good Sense

In some jurisdictions, the one who initiates an assault is denied workers' compensation benefits. In others, it is not a bar to a claim as in California. One would expect that yet another change will be coming to the law in California. One would think that the conduct of this police officer gives rise to rethinking the concept of compensability. Today's post is shared from davisenterprise.com

The University of California and the former police officer who pepper-sprayed Occupy UC Davis protesters have reached a workers’ compensation settlement totaling $38,059.

John Pike, 40, of Roseville, suffered depression and anxiety brought on by death threats to him and his family that followed the Nov. 18, 2011, confrontation at an encampment on the Quad.

Administrative Law Judge Harter approved the settlement agreement on Oct. 16.

“This case has been resolved in accordance with state law and processes on workers’ compensation,” university spokesman Andy Fell said in an email message. Pike’s Sacramento attorney, Jason Marcus, declined to comment on Wednesday.

Bernie Goldsmith, a Davis attorney supportive of the student protesters, called it “interesting to see a dollars-and-cents compensation for universal revilement.”

“This sends a clear message to the next officer nervously facing off with a group of passive, unarmed students: Go on ahead. Brutalize them. Trample their rights. You will be well taken care of,” Goldsmith said.

The state’s Disability Evaluation Unit determines permanent disability ratings based on doctors’ reports. Richard Lieberman, a Piedmont psychiatrist acting as the agreed-upon expert, rated Pike ’s disability as “moderate,” according to a Jan. 5 psychiatric report released by the State Department of Industrial Relations in response to a public records request.

Pike faced...

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

Florida rejects workers' compensation rate hike

Workers' compensation insurance has been stressed under the on going US economic downturn. lower premiums, which are based on payrolls, and increasing medical costs, are significant causes. Despite the pressure of NCCI to increase the cost dramatically, FL has officially rejected that proposal. Today's post is shared from naplesnews.com.

Florida regulators are rejecting a proposed 1 percent hike in workers compensation insurance rates.
Insurance Commissioner Kevin McCarty on Wednesday announced that he won't approve the hike that had been requested by insurers that provide coverage for on-the-job injuries.
But McCarty says that his office would approve a slightly lower hike 0.7 percent if insurers resubmitted their request.
That hike on employers would take effect on Jan. 1.
If the hike is ultimately approved it would make the fourth straight year that workers' compensation insurance rates have increased.
The rate hike proposal was submitted by the National Council on Compensation Insurance. The council is a rating and data collection agency owned by insurance companies. It submits rate filings on their behalf.

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Woman was texting and driving when she caused fatal crash with trucker

Texting while driving creates an enhanced risk to millions of workers who carefully drive on the roads. While the Federal government has strictly enforced the no texting while driving rule, the states maintain a patchwork of confusing regulations and statutory prohibitions. Today's post is shared from nj.com.

A Rahway woman who crashed into a pick-up on Routes 1&9 two weeks ago, killing the truck’s driver, has became the first person in Essex County to be charged with vehicular homicide allegedly caused by texting, Acting Essex County Prosecutor Carolyn Murray said.

Jennifer Sahoye, 35, was initially charged with causing the Oct. 10 death of Carlos Carvalho, 58, while driving on a suspended license. But prosecutors say witnesses saw Sahoye texting when her Volvo sedan veered from the southbound express lanes of Routes 1&9, near the Route 78 interchange, into the southbound local lanes, striking Carvalho’s Ford pickup

Carvalho, a welder, was on his way home from work. He was ejected from the truck after it flipped over and was pronounced dead at the scene.

Prosecutors say their investigation, aided by witnesses who stopped after the crash, confirmed Sahoye was texting at the time of the crash.

"A vehicle is a dangerous thing and driving requires the full attention of the driver," said Thomas Fennelly, the chief assistant prosecutor for Essex County. "Texting can take one's eyes off the road."
Carvalho's family did not find out Sahoye was alleged to be...

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Electronic Filing in Workers Compensation: One National System

By Jon Gelman from Jon L Gelman LLC

Pennsylvania is down, New Jersey is up, and Florida is just ahead of the curve, on workers’ compensation docketing and statistical reporting programs. Reliability, accuracy and utility and necessary components to a model system.

Costs from development to deployment, to upgrade and usage become compounded by glitches and downtime. Redeveloping the wheel for every software browser upgrade and development merely adds to the cost and loss of time.

Nationally the best system has been the Federal Court Electronic Filing System (EFS) along with the public access system PACER. Handling a universal docket of civil, criminal and bankruptcy actions the system is stellar, and gets better with every new software upgrade

Even though there are many unique local District Courts, and Circuit Court of Appeals Rules, that require adherence, the system integrates functionality that makes it easy and consistent in filing and handling claims.

A universally consistent protocol for handling court related data would allow integration throughout all jurisdictions national. While workers’ compensation has its own particular issues in each jurisdiction, the basic theory and practice is essentially the same.

While some integration of data is universally being proposed under The Smart Act regulations, and other Medicare Secondary Payer Act requirements, the processes are national and universal data integration with an uniform patchwork of claims processes, is tedious and difficult to adoption by local jurisdictions at the present time.

Integration of information is not unusual. The major credit reports companies already have collected national individual data. Likewise, The Index Bureau collects data nationally on injuries and claims for the insurance companies. In fact, Federal agencies like the Social Security Administration already access this data.

The writing is obviously on the wall, and has been since CMS initially promulgated the Patel memorandum July 16, 2001, concerning both collection procedures and future medical allowances.

The tedium of prosecuting a Workers’ Compensation claim, and it’s ultimate adjudication, is an onerous task that seems to be getting much worse because of collection of data requirements and a transient population and multi-jurisdictional employers. Dual jurisdiction claims, collateral liens, pre-existing medical conditions, and the collection of medical data are also problematic. Cottages industries are now emasculating the workers’ compensation premium dollar by offering individual State solutions.

It is is time for the establishment of a national workers’ compensation docket system and case filing program that would integrate all jurisdictions and help the system stay an efficient, summary and remedial system that its crafter envisioned a century ago.

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Questioning Statins for Older Patients

Limiting medication can reduce overall patient care costs. The efficacy of controlling cholesterol in the "very old" population is now being discussed. Today's post was shared from the NYTimes.com.

Should older adults take statins if they have elevated cholesterol but no evidence of heart disease? It’s a surprisingly controversial question, given the number of seniors taking statins.

Recently AMDA, a professional group representing physicians working in nursing homes, highlighted the issue in a list of five questionable medical tests and treatments. The list was drawn up as part of the national “Choosing Wisely” campaign, which alerts consumers to inappropriate or overused medical interventions, an effort that caregivers would do well to follow.

The standout item on the AMDA list: “Don’t routinely prescribe lipid-lowering medications in individuals with a limited life expectancy.” That means anyone older than 70, according to the medical society.

Dr. Hosam Kamel, an Arkansas geriatrician who is vice chair of AMDA’s clinical practice committee, said that there is scarce scientific evidence supporting the use of statins by 70- or 80-year-olds without pre-existing cardiovascular disease. Only a handful of studies have focused on outcomes (heart attacks, strokes, premature death) in this older population.

Most of the data on the benefits of statin use come from larger studies that looked at adults of varying ages. The results...

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Steel company fined $115,400 by US Labor Department's OSHA for failing to abate workplace hazards

The U.S. Department of Labor's Occupational Safety and Health Administration has cited Jersey Shore Steel for four violations, including three failure-to-abate citations, at its Jackson facility. Proposed penalties total $115,400 after OSHA's follow-up inspection opened in April.

"By not abating past violations, Jersey Shore Steel keeps its employees vulnerable to hazards that can cause injuries and, possibly, death," said Paula Dixon-Roderick, director of OSHA's Marlton Area Office. "It's vital to correct all hazards immediately to protect workers at the facility."

The failure-to-abate notices, which carry $111,000 in penalties, relate to the company's failure to develop and implement a written lockout/tagout program that prevents inadvertent machine start-up; require fork truck operators to have their performance evaluated at least once every three years; and train workers to use portable fire extinguishers. A failure-to-abate notice applies to a condition, hazard or practice, found upon reinspection, that the employer was originally cited for and failed to correct.

The company was also cited for one repeat violation, with a $4,400 penalty, due to the lack of machine guarding on a press brake. A repeat violation exists when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. A similar violation was cited in November 2012.

The citations can be viewed at: http://www.osha.gov/ooc/citations/jersey_shore_steel_insp_900106_sept30.pdf*.

Jersey Shore Steel has requested an informal conference with the OSHA area director in Marlton.

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Tuesday, October 22, 2013

The Great Coronary Angioplasty Debate: Giving Patients the Right to Speak | The Health Care Blog

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Nortin Hadler, MD
Earlier this month, the editors of THCB saw fit to post my essay, “The End of the Era of Coronary Angioplasty.”
The comments posted on THCB in response to the essay, and those the editors and I have directly received, have been most gratifying. The essay is an exercise in informing medical decisions, which is my creed as a clinician and perspective as a clinical investigator.
I use the recent British federal guideline document as my object lesson. This Guideline examines the science that speaks to the efficacy of the last consensus indication for angioplasty, the setting of an acute ST-elevation myocardial infarction (STEMI). Clinical science has rendered all other indications, by consensus, relative at best. But in the case of STEMI, the British guideline panel supports the consensus and concludes that angioplasty should be “offered” in a timely fashion.
I will not repeat my original essay here since it is only a click away. The exercise I display is how I would take this last consensus statement into a trusting, empathic patient-physician discourse. This is a hypothetical exercise to the extent that little in the way of clear thinking can be expected of a patient in the throes of a STEMI, and not much more of the patient’s caring community.
So all of us, we the people regardless of our credentials, need to consider and value the putative efficacy of angioplasty (with or without stenting) a priori. For me, personally, there is...

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Richland: EPA fines DOE $115,000 over Hanford asbestos issue | Hanford news | Tri-CityHerald.com

Today's post was shared by Linda Reinstein and comes from www.tri-cityherald.com

The Department of Energy is being fined $115,000 for violations related to asbestos management after demolishing Hanford nuclear reservation buildings in 2009 and 2010.
The EPA inspector general issued an early-warning report in December 2011, saying that removal of asbestos in certain ways at Hanford and elsewhere potentially threatened health and safety.
The Hanford violations were discovered as a result of an EPA inspection and evaluation of compliance at Hanford with asbestos management rules that followed in 2012.
In March DOE and its regulators agreed to restrict the use of heavy equipment to demolish buildings that still have asbestos out of concern for worker health.

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Ronald Motley's Legacy Continues

Today's post was shared by Linda Reinstein and comes from www.asbestosdiseaseawareness.org

Earlier this year, Ronald Motley, a South Carolina lawyer, who spearheaded lawsuits against big tobacco and asbestos industries passed away at the age of 68. Mr. Motley was a one-of-a-kind attorney and tireless advocate who, for so many decades, made such a huge difference in the lives of asbestos victims and their families. Today, his legacy proves to continue to have a lasting impact.
Today, on what would have been Motley Rice LLC co-founder Ronald Motley’s 69^th birthday, it was announced that the firm placed on The National Law Journal’s 2013 Plaintiff’s Hot List.
ADAO will continue to honor Mr. Motley’s legacy and his firm’s commitment to truth and justice as we continue our work to help asbestos victims in the United States, Canada, and the world.
Together, change is possible.
Linda Reinstein

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DePaolo's Work Comp World: Genetic Testing?!

Today's post was shared by WorkCompCentral and comes from daviddepaolo.blogspot.com

The reason lawmakers and regulators create rules that seem onerous and ponderous to the vast majority of us is because there are "outliers" that ruin it for everyone else because of indescribably selfish behavior.
There's always someone taking a new angle to take advantage of the liberal rules of workers' compensation for their own profit regardless of the social consequences. This seems particularly acute in California, but nevertheless occurs in other jurisdictions too.
Recently posted in the WorkCompCentral Forums was an inquiry as to whether anyone else in the community is starting to see bills for unsolicited services related to genetic testing for drug addition predisposition.
The author of the post, an attorney for the employer/carrier, says that the case in question had been settled. In preparing the settlement documents a review of California's Electronic Adjudication Management System database was conducted to identify all parties. Nearly all lien claims had been settled, but one remained stubbornly immovable (and I'm not even clear that the parties were ever properly served and/or noticed of this particular vendor until the end of the case).
For this one particular lien the claim file notes apparently show a request for billing and report after discovery of the vendor in the EAMS search. The carrier got fax copies of a bill and report with a demand for payment.
The bill was for $3,626.00 for the genetic testing.
According to the post, the initial report, based on an...

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Jersey City Mayor Signs Country’s Seventh Paid Sick Days Law

Today's post was shared by Steven Greenhouse and comes from thinkprogress.org

On Monday morning, Jersey City, NJ Mayor Steven Fulop signed the city’s paid sick days bill into law, which had been passed by the city council in September. The bill is now the seventh to become law in the country, joining New York City; Portland, OR; San Francisco, CA; Seattle, WA; and Washington, DC as well as the state of Connecticut.
Employers in the city with 10 or more workers will now have to provide them with up to five days of paid sick leave a year, with workers earning a day off for each 30 days worked. Workers at smaller businesses will have the right to earn unpaid sick days. Over 30,000 workers who previously had no access to paid sick leave are expected to benefit.
The push for paid sick days legislation at the state and city level is growing. State-wide efforts are underway in Massachusetts, New Jersey, and Vermont. Newark, NJ and Tacoma, WA are also fighting for such bills, and an effort is underway in Washington, DC to expand the city’s current policy to tipped workers.
The evidence from those places that already have laws on the books shows that they are good for business and the economy. Job growth has been stronger under Seattle’s law and business growth is also strong. San Francisco’s law has strong business support and spurred job growth. Washington DC’s had no negative impact on business, while Connecticut’s has come with little cost and big potential upsides. Meanwhile, lost...

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McDonald's Profit Is Awkwardly Close To What It Costs Taxpayers Every Year

Low wages impact benefits, create more income for the employer and cost taxpayers. Shifting the costs. Today's post was shared by Huffington Post and comes from www.huffingtonpost.com

McDonald's announced Monday that it raked in $1.5 billion in profits in the third quarter, up 5 percent from last year.
The number is strikingly close to the $1.2 billion taxpayers are shelling out each year to help pay public assistance to the McDonald's workforce, according to a report released last week by the National Employment Law Project.

The echoing numbers are simply a coincidence, but underscore the immense profits that the chain continues to pull in while its workers simply struggle to afford food, medical help and housing. The public assistance McDonald's workers receive comes via food stamps, welfare, Medicaid and other federal programs, according to the NELP report.
In a statement to The Huffington Post, McDonald's emphasized that workers get training and the opportunity for career advancement. The company also said that its franchisees pay competitive wages that are based on "local wage laws."
Those wages are stunningly low. Frontline fast-food workers make a median wage of $8.94 an hour, according to a recent Reuters report. "Fast-food workers work only 24 hours a week on average — at $8.94 an hour, this adds up to barely $11,000 a year," wrote Christine Owens for Reuters in August.
With wages that low, front-line fast food workers are more than twice as likely as the typical worker to participate in a government assistance program, according to the NELP report:

The National Restaurant Association, an industry trade group, last week labeled the NELP report...

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Let’s get rid of (the term) entitlements

Is Workers' Compensation thought to be an "entltlement?" Today's post was shared by Steven Greenhouse and comes from www.washingtonpost.com

Let’s drop the whole notion of “entitlement.” Just eliminate it. Politicians, pundits and academics who talk about entitlements would then have to name the actual programs and argue their merits and demerits. This would encourage clarity and candor. Of course, that’s why it won’t happen. Generally, Americans don’t want clarity and candor in their fiscal debates. We blame our leaders for budget brawls — this latest was a doozy — but forget that our leaders are largely governed by public opinion, which is awash in contradictions.

So the government is “open” and the immediate threat of default has lifted. Great. But the political stalemate remains. Americans oppose excessive government spending and persistent deficits. Yet they also support the individual benefit programs (a.k.a. “entitlements”), led by Social Security, that drive spending and deficits.

Until the 1980s, entitlement wasn’t part of everyday language. Ronald Reagan was apparently the first president to use the term extensively. He may have “tired of getting beaten up every time he mentioned Social Security, and wanted a broader and more neutral term,” political scientist Norman Ornstein has suggested. Entitlement is a bland label. To say there’s an “entitlement problem” shrewdly avoids connecting it explicitly with popular programs. President Obama evasively speaks of entitlements in this way; so do most...

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Snowden Offers to Fix Healthcare.gov

Do two negatives equal a positive? Today's post was shared by Steven Greenhouse and comes from www.newyorker.com

The N.S.A. leaker Edward Snowden today reached out to the United States government, offering to fix its troubled healthcare.gov Web site in exchange for immunity from prosecution.
Speaking from an undisclosed location in Russia, Mr. Snowden said he hacked the Web site over the weekend and thinks he is “pretty sure what the problem is.”
“Look, this thing was built terribly,” he said. “It’s a government Web site, O.K.?”
Mr. Snowden said that if an immunity deal can be worked out, “I can get to work on this thing right away—I don’t need a password.”
In addition to full immunity, Mr. Snowden said he is requesting that he be allowed to work from home.
At the White House, President Obama offered a muted response to Mr. Snowden’s proposal: “Edward Snowden is a traitor who has compromised our national security. Having said that, if he knows why we keep getting those error messages, that could be a conversation.”
Get the Borowitz Report delivered to your inbox.Photograph: AP.

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Lousy Medicaid Arguments

Having technology that works is critical for operations and public confidence. Whether it be the PA court system or insurance exchanges, that need to work the first time around.Today's post was shared by Steven Greenhouse and comes from www.nytimes.com

For now, the big news about Obamacare is the debacle of HealthCare.gov, the Web portal through which Americans are supposed to buy insurance on the new health care exchanges. For now, at least, HealthCare.gov isn’t working for many users.

It’s important to realize, however, that this botch has nothing to do with the law’s substance, and will get fixed. After all, a number of states have successfully opened their own exchanges, doing for their residents exactly what the federal system is supposed to do everywhere else. Connecticut’s exchange is working fine, as is Kentucky’s. New York, after some early problems, seems to be getting there. So, a bit more slowly, does California.

In other words, the technical problems, while infuriating — heads should roll — will not, in the end, be the big story. The real threat remains the effort of conservative groups to sabotage reform, especially by blocking the expansion of Medicaid. This effort relies heavily on lobbying, lavishly bankrolled by the usual suspects, including the omnipresent Koch brothers. But it’s not just money: the right has also rolled out some really lousy arguments.

And I don’t just mean lousy as in “bad”; I also mean it in the original sense, “infested with lice.”

Before I get there, a word about something that, as far as we can tell, isn’t happening. Remember “rate shock”? A few months ago it was all the rage in...

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Copyright

Wednesday, October 23, 2013

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Tuesday, October 22, 2013

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