- Help Wanted: Spray Polyurethane Foam Insulation Research. We urged you to help us collect on-site air samples during SPF installation. The response was fantastic! Thank you!
- Worker Exposure to Crystalline Silica During Hydraulic Fracturing highlighted a newly-identified hazard in the fracking industry, provided prevention information and asked for assistance with future efforts.
- Hair Formaldehyde and Industrial Hygiene, from the Center for Research on Occupational and Environmental Toxicology (CROET) at Oregon Health and Science University, summarized the campaign to inform stylists of the risks related to formaldehyde-containing hair straighteners and the need for proper protection.
- Sleep and Work. In honor of National Sleep Awareness Week we summarized sleep and work issues in this blog and highlighted NIOSH research in the companion blog NIOSH Research on Work Schedules and Work-related Sleep Loss(#6).
- Stress and Health in Law Enforcement highlighted research from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study and from related studies of morbidity and mortality among police officers.
- See #4 above
- Brain Injury in the NFL discussed new research finding that National Football League (NFL) players may be at a higher risk of death associated with Alzheimer’s and other impairments of the brain and nervous system than the general U.S. population.
- Safer and Healthier at any Age: Strategies for an Aging Workforce presented strategies for preparing your workplace to accommodate an older workforce.
- All-terrain Vehicles and Work highlighted the risks associated with ATVs and identified safe practices for use in the workplace.
- Respiratory Protection for Workers Handling Engineered Nanoparticles. While this blog was technically posted in December of 2011 we included it anyway. This blog provided an update on the science and rationale behind NIOSH’s recommendations for the use and selection of respirators against engineered nanoparticles.
- Sleep Pain and Hospital Workers, from colleagues at Harvard, examined the question: Does lack of sleep increase pain and limit function among hospital care workers?
- Safety and Health in the Theater: Keeping Tragedy Out of the Comedies… and Musicals…and Dramas discussed the often overlooked hazards in the theater.
Copyright
(c) 2010-2026 Jon L Gelman, All Rights Reserved.
Friday, January 11, 2013
NIOSH Announces the Top 10 Science Blog Posts in 2012
The list shows the vast array of topics covered by NIOSH. Of note this year, the third and eleventh most viewed blogs were written by external partners.
Downton Abbey and Workers' Compensation
| Highclere Castle (Photo credit: Wikipedia) |
The PBS series, Downton Abbey, has many parallels to the nation's workers' compensation system and reflects how outdated the present benefit system is to meet current needs of injured workers.
The critically acclaimed fictional British TV series, that begins a 3rd broadcast season this month in the US. The first season was set in 1912, with the sinking the RMS Titanic and the outbreak of World War I.
The drama concerns itself with non-working aristocratic elite who had amassed multitudes of wealth and were land barrons. The post-Edwardian era Crawley family had a large entourage of servants, who worked
"downstairs," at low pay and no benefits, providing services to the heirs of Downton Abbey, a lavish estate in England.
It mirrors the era of the enactment of the original European, and thereafter adopted US, workers' compensation programs. The system provided an administrative remedy to provide a summary, remedial system of benefits to workers in lieu of a trial by jury in the civil justice system.
While workers' compensation is not explicitly mentioned in the TV series, the viewer can gain an understanding of the perspective of the oppressed employees who devoted their lives to the land owning family and considered it an honor and privilege to stay in their employ. Dedication to the employer resulted in lifelong career positions with little complaint of working conditions and lack of benefits.
The British aristocracy system portrayed in the Downton Abbey soon fell into economic ruin, as did the entire British workers' compensation system, yielding to a better medical delivery system and socialized benefits.
It mirrors the era of the enactment of the original European, and thereafter adopted US, workers' compensation programs. The system provided an administrative remedy to provide a summary, remedial system of benefits to workers in lieu of a trial by jury in the civil justice system.
While workers' compensation is not explicitly mentioned in the TV series, the viewer can gain an understanding of the perspective of the oppressed employees who devoted their lives to the land owning family and considered it an honor and privilege to stay in their employ. Dedication to the employer resulted in lifelong career positions with little complaint of working conditions and lack of benefits.
The British aristocracy system portrayed in the Downton Abbey soon fell into economic ruin, as did the entire British workers' compensation system, yielding to a better medical delivery system and socialized benefits.
On the other side of "the pond," in the US, the program has just persisted with more money going to the richest individuals, reflected in with major compensation packages. On the other hand, working Americans have lost jobs, benefits, and income as the nation's economy continues to decline. The US needs to adjust the benefit system to approach what the European Economic Union has achieved.
The second Obama Administration is beng recomposed with a Cabinet to achieve a better funded and structured benefit system. Hopefully a better benefit system will be formulated for injured workers and their families.
The second Obama Administration is beng recomposed with a Cabinet to achieve a better funded and structured benefit system. Hopefully a better benefit system will be formulated for injured workers and their families.
Related articles
- The New Reality |As goes the Labor market, so goes workers compensation (workers-compensation.blogspot.com)
- Workers' Compensation May Indeed Fall Off the Fiscal Cliff (workers-compensation.blogspot.com)
- Hospital Controlled Physician Access and Workers' Compensation (workers-compensation.blogspot.com)
- The Devil is in the Details California Style (workers-compensation.blogspot.com)
Obama signs MSP Medicare bill
"The legislation changes the way Medicare collects money from people whose negligence caused a patient to incur medical bills. Murphy said the new law will streamline an outdated process, making it easier to close cases and bring money into the Medicare program."
Read more: http://thehill.com/blogs/healthwatch/medicare/276621-obama-signs-medicare-bill#ixzz2HehBHham
Questions remain on the practicalities of implementation as regulations need to be promulgated.
The NEW law will be discussed at the Hot Topics in Workers' Compensation Law 2013 Seminar (NJ ICLE Jn 29, 2013)
Read more: http://thehill.com/blogs/healthwatch/medicare/276621-obama-signs-medicare-bill#ixzz2HehBHham
Questions remain on the practicalities of implementation as regulations need to be promulgated.
The NEW law will be discussed at the Hot Topics in Workers' Compensation Law 2013 Seminar (NJ ICLE Jn 29, 2013)
Related articles
- Legislation Goes to President Obama on CMS Condition Payment Procedures (workers-compensation.blogspot.com)
- "Doc Fix" Extended But More Overpayments at Risk (patsoshealthlawblog.com)
- White House Calls for Healthcare Cuts, Permanent SGR Fix. (listahit.wordpress.com)
- NJ rejects state-based health exchange - The Hill's Healthwatch (rightcoast.typepad.com)
- Workers' Compensation 2013 - What Happens on the Other Side of The Fiscal Cliff? (workers-compensation.blogspot.com)
Thursday, January 10, 2013
OSHA posts results of sampling for contaminants at Sandy cleanup areas in New York and New Jersey
Employers reminded they must protect their workers from exposure to health hazards
The U.S. Department of Labor's Occupational Safety and Health Administration has posted results of its initial industrial hygiene sampling of locations in New York and New Jersey where recovery work in connection with Hurricane Sandy is being performed. The results are posted on OSHA's website at: http://www.osha.gov/sandy/sample_results.html.
The purpose of the sampling is to measure potential or actual employee exposure to potential health hazards during recovery operations. Sampling was conducted in a variety of locations throughout the storm affected areas. The results of this first round of sampling show that while some contaminants were present, such as carbon monoxide, asbestos and silica, they have so far not exceeded any of OSHA's Permissible Exposure Limits, which can be found at: http://www.osha.gov/dsg/topics/pel/index.html.
"These initial results should not be taken by employers as an "all clear" signal regarding potential exposure to health hazards," said Robert Kulick, OSHA's regional administrator in New York. "It is important that each employer continually ensure that workers are not overexposed. Employers can accomplish this by performing site assessments to determine potential hazards and institute effective measures to protect workers against exposure to toxic substances such as asbestos, lead and mold."
OSHA will continue to conduct industrial hygiene monitoring on a rotating basis at various locations where recovery work is being performed. The results will be posted on OSHA's website. The monitoring is one element of OSHA's ongoing efforts to protect the safety and health of workers cleaning up after Sandy.
Since the storm struck, OSHA has been conducting daily briefings, safety and health field interventions and other outreach activities to identify and remove employees from hazards and to provide Sandy cleanup workers and employers with safety and health information. To date, OSHA has conducted over 4,400 briefings and interventions, reaching nearly 61,000 workers and employers performing recovery work in Sandy-impacted areas. OSHA's work is ongoing. Guidance, fact sheets and other information can be found on OSHA's Hurricane Sandy web page, located at www.osha.gov/sandy/.
The purpose of the sampling is to measure potential or actual employee exposure to potential health hazards during recovery operations. Sampling was conducted in a variety of locations throughout the storm affected areas. The results of this first round of sampling show that while some contaminants were present, such as carbon monoxide, asbestos and silica, they have so far not exceeded any of OSHA's Permissible Exposure Limits, which can be found at: http://www.osha.gov/dsg/topics/pel/index.html.
"These initial results should not be taken by employers as an "all clear" signal regarding potential exposure to health hazards," said Robert Kulick, OSHA's regional administrator in New York. "It is important that each employer continually ensure that workers are not overexposed. Employers can accomplish this by performing site assessments to determine potential hazards and institute effective measures to protect workers against exposure to toxic substances such as asbestos, lead and mold."
OSHA will continue to conduct industrial hygiene monitoring on a rotating basis at various locations where recovery work is being performed. The results will be posted on OSHA's website. The monitoring is one element of OSHA's ongoing efforts to protect the safety and health of workers cleaning up after Sandy.
Since the storm struck, OSHA has been conducting daily briefings, safety and health field interventions and other outreach activities to identify and remove employees from hazards and to provide Sandy cleanup workers and employers with safety and health information. To date, OSHA has conducted over 4,400 briefings and interventions, reaching nearly 61,000 workers and employers performing recovery work in Sandy-impacted areas. OSHA's work is ongoing. Guidance, fact sheets and other information can be found on OSHA's Hurricane Sandy web page, located at www.osha.gov/sandy/.
Related articles
- OSHA urges hurricane recovery workers to protect themselves against hazards (workers-compensation.blogspot.com)
- Repeated Fall Injuries Results in OSHA Fines of $58,000 to NJ Employer (workers-compensation.blogspot.com)
- SeaWorld Safety Investigation Expanded by OSHA (workers-compensation.blogspot.com)
- OSHA cites New York contractor for exposing workers to fall and other hazards (workers-compensation.blogspot.com)
Curing the Profit Motive in Health Care
Soaring medical costs have afflicted the workers' compensation industry with economic distress and have severely impacted the efficient and effective delivery of medical care to injured workers. Both increased costs/profits and a related spike in mortality addresses the need for more governmental control in the United States.
A study "...found that patients’ mortality rates spiked when nonprofit hospitals switched to become profit-making, and their staff levels declined."
Read "Health Care and Profits, a Poor Mix" NYTimes
A study "...found that patients’ mortality rates spiked when nonprofit hospitals switched to become profit-making, and their staff levels declined."
Read "Health Care and Profits, a Poor Mix" NYTimes
Related articles
- Workers' Compensation 2013 - What Happens on the Other Side of The Fiscal Cliff? (workers-compensation.blogspot.com)
- Workers' Compensation Is About Relationships (workers-compensation.blogspot.com)
- Our Journey Forward on Occupational Medical Care (workers-compensation.blogspot.com)
- Hospital Controlled Physician Access and Workers' Compensation (workers-compensation.blogspot.com)
Wednesday, January 9, 2013
Oil, Cancer and The Promised Land
John P. Smol, Professor Department of Biology, Queen’s University Canada Research Chair
|
"The development of Alberta’s oil sands has increased levels of cancer-causing compounds in surrounding lakes well beyond natural levels, Canadian researchers reported in a study released on Monday. And they said the contamination covered a wider area than had previously been believed."
Read: "Oil Sands Industry in Canada Tied to Higher Carcinogen Level" NYTimes
Related articles
Monday, January 7, 2013
Are You Suffering From Symptoms Of Chronic Stress? Take the Stress Test!
Today's post comes from guest author Kit Case from Causey Law Firm.
Cognitive symptoms
• Memory problems
• Inability to concentrate
• Poor judgment
• Pessimistic approach or thoughts
• Anxious or racing thoughts
• Constant worrying
Emotional symptoms
• Moodiness
• Irritability or short temper
• Agitation, inability to relax
• Feeling overwhelmed
• Sense of loneliness and isolation
• Depression or general unhappiness
Physical symptoms
• Aches and pains
• Diarrhea or constipation
• Nausea, dizziness
• Chest pain, rapid heartbeat
• Loss of sex drive
• Frequent colds
Behavioral symptoms
• Eating more or less
• Sleeping too much or too little
• Isolating oneself from others
• Procrastinating or neglecting responsibilities
• Using alcohol, cigarettes, or drugs to relax
Take the Stress Test for Adults:
Thomas Holmes and Richard Rahe in 1967, examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive correlation was found between their life events and their illnesses.
Their results were published as the Social Readjustment Rating Scale (SRRS), known more commonly as the Holmes and Rahe Stress Scale.
To measure stress according to the Holmes and Rahe Stress Scale, the number of "Life Change Units" that apply to events in the past year of an individual's life are added and the final score will give a rough estimate of how stress affects health.
Note: the table, below, is from the Wikipedia page on this subject. For a fee of $5.00, you can go directly to Dr. Rahe's website and obtain the full test materials as well as background information and details of this and other products and services available.
To measure stress according to the Holmes and Rahe Stress Scale, the number of "Life Change Units" that apply to events in the past year of an individual's life are added and the final score will give a rough estimate of how stress affects health.
Score of 300+: At risk of illness.
Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).
Score 150-: Only have a slight risk of illness.
| Life event | Life change units |
|---|---|
| Death of a spouse | 100 |
| Divorce | 73 |
| Marital separation | 65 |
| Imprisonment | 63 |
| Death of a close family member | 63 |
| Personal injury or illness | 53 |
| Marriage | 50 |
| Dismissal from work | 47 |
| Marital reconciliation | 45 |
| Retirement | 45 |
| Change in health of family member | 44 |
| Pregnancy | 40 |
| Sexual difficulties | 39 |
| Gain a new family member | 39 |
| Business readjustment | 39 |
| Change in financial state | 38 |
| Death of a close friend | 37 |
| Change to different line of work | 36 |
| Change in frequency of arguments | 35 |
| Major mortgage | 32 |
| Foreclosure of mortgage or loan | 30 |
| Change in responsibilities at work | 29 |
| Child leaving home | 29 |
| Trouble with in-laws | 29 |
| Outstanding personal achievement | 28 |
| Spouse starts or stops work | 26 |
| Begin or end school | 26 |
| Change in living conditions | 25 |
| Revision of personal habits | 24 |
| Trouble with boss | 23 |
| Change in working hours or conditions | 20 |
| Change in residence | 20 |
| Change in schools | 20 |
| Change in recreation | 19 |
| Change in church activities | 19 |
| Change in social activities | 18 |
| Minor mortgage or loan | 17 |
| Change in sleeping habits | 16 |
| Change in number of family reunions | 15 |
| Change in eating habits | 15 |
| Vacation | 13 |
| Christmas | 12 |
| Minor violation of law | 11 |
Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).
Score 150-: Only have a slight risk of illness.
Recommended methods for relieving chronic stress include exercise (which can be modified to accommodate physical restrictions after an injury), meditation, music therapy, breathing techniques, and such simple things as companionship - from a pet, friend or family member.
Friday, January 4, 2013
Repeated Fall Injuries Results in OSHA Fines of $58,000 to NJ Employer
The U.S. Department of Labor's Occupational Safety and Health Administration has cited Beno Stucco Systems of Rochelle Park with six safety violations – including five repeat – involving fall and scaffolding hazards while employees were applying stucco to a commercial building in Westwood, N.J.
OSHA's June investigation was initiated as a result of an imminent danger fall hazard. Proposed penalties total $61,600.
The repeat violations, with $58,520 as the proposed penalty, were cited for exposing workers to fall and scaffolding hazards, and for failing to provide workers with protective helmets to prevent injuries from falling objects. A repeat violation is issued 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. Similar violations were cited in 2007, 2009 and 2011.
One serious violation, with a $3,080 proposed penalty, was cited for failing to have a competent person inspect scaffolds and scaffold components for visible defects before each work shift and after any occurrence that could affect a scaffold's structural integrity. Additionally, the company did not conduct an inspection of the job site, materials and scaffold components, to prevent employees from working without full planking, fall protection and scaffold access. A serious citation is issued when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.
"This company repeatedly neglected to implement basic, common-sense and legally-required safeguards to ensure that scaffolds were erected properly and fall protection was provided for employees working at heights of 10 feet or more," said Lisa Levy, director of OSHA's area office in Hasbrouck Heights, N.J. "OSHA will not tolerate employers jeopardizing the safety and health of workers."
OSHA and the National Institute for Occupational Safety and Health are working with trade associations, labor unions, employers, universities, community and faith-based organizations and consulates to provide employers and workers–especially vulnerable, low-literacy workers–with education and training on common-sense fall prevention equipment and strategies that save lives. OSHA has also created a new fall prevention Web page at http://www.osha.gov/stopfalls that includes detailed information in English and Spanish on fall protection standards.
Beno Stucco Systems has 15 business days from receipt of its citations and proposed penalties to comply, meet with OSHA's area director or contest the findings before the independent Occupational Safety and Health Review Commission.

OSHA's June investigation was initiated as a result of an imminent danger fall hazard. Proposed penalties total $61,600.
The repeat violations, with $58,520 as the proposed penalty, were cited for exposing workers to fall and scaffolding hazards, and for failing to provide workers with protective helmets to prevent injuries from falling objects. A repeat violation is issued 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. Similar violations were cited in 2007, 2009 and 2011.
One serious violation, with a $3,080 proposed penalty, was cited for failing to have a competent person inspect scaffolds and scaffold components for visible defects before each work shift and after any occurrence that could affect a scaffold's structural integrity. Additionally, the company did not conduct an inspection of the job site, materials and scaffold components, to prevent employees from working without full planking, fall protection and scaffold access. A serious citation is issued when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.
"This company repeatedly neglected to implement basic, common-sense and legally-required safeguards to ensure that scaffolds were erected properly and fall protection was provided for employees working at heights of 10 feet or more," said Lisa Levy, director of OSHA's area office in Hasbrouck Heights, N.J. "OSHA will not tolerate employers jeopardizing the safety and health of workers."
OSHA and the National Institute for Occupational Safety and Health are working with trade associations, labor unions, employers, universities, community and faith-based organizations and consulates to provide employers and workers–especially vulnerable, low-literacy workers–with education and training on common-sense fall prevention equipment and strategies that save lives. OSHA has also created a new fall prevention Web page at http://www.osha.gov/stopfalls that includes detailed information in English and Spanish on fall protection standards.
Beno Stucco Systems has 15 business days from receipt of its citations and proposed penalties to comply, meet with OSHA's area director or contest the findings before the independent Occupational Safety and Health Review Commission.
Related articles
Tuesday, January 1, 2013
Workers’ Compensation 2013 – What Happens on the Other Side of The Fiscal Cliff?
Overall health care devours 18 percent of the US economy and amounts to 25% of the Federal budget.
Medical treatment for injured workers continues to be delayed, denied and limited under current workers’ compensation programs. Medical costs continue to be shifted to other programs including employer based medical care systems and the Federal safety net of Medicare, Medicaid, Veterans Administration and Tricare.
While a trend continues to emerge to offer “Opt Out” and “Carve Out Programs,” they are not global enough to solve the critical budget deficit issues. The latest emerging trend is for employers to utilize ERISA based medical care plans to efficiently delivery medical care. In NJ a limited alternate dispute-resolution procedure between unions and employers has been introduced. See “NJ Care Outs –Another Evolutionary Step” authored by David DePaolo.
The US economy continues to be very weak. This in an ominous signal for the nation’s workers’ compensation program which is starved for premium dollars. Premiums are based upon salaries and real median incomes continued their dramatic decline over the last decade from $54,841 in 2000 to $50,054 in 2011. There just may not be enough dollars available in the workers’ compensation programs to pay for present and lifetime medical care.
Even the present Federal system leaves much to be desired. Whether Federal rationing medical care becomes a reality is unknown. Physicians are under economic scrutiny as the “Doc Fix” to limit provider fees continues as a cloud over all medical programs. The agreement reached by Congress still does not resolve the 26.5% percent cut reimbursement cut to physicians who treat Medicare patients. The law merely "freezes" payment to physicians.
Workers’ compensation programs presently structured provide no real economic incentive to monitor and compensate for more favorable medical outcomes. On the other hand, the Federal government, with broad and sweeping regulatory ability, is able to continue to make strides in many areas including present incentives to hospitals and proposed incentives to physicians to provide medical treatment with fewer complications and ultimate better outcomes
Steven Ratner in the NY Times points out the dramatic increase in the nation’s health care costs. He wrote, “…no budget-busting factor looms larger than the soaring cost of government-financed health care, particularly Medicare and Medicaid.”
Solving the economic gridlock of the country will require an approach to re-invent a medical program for injured workers. A global single-payer program under Federal control will eliminate duplicative administrative State and private efforts. The Federal government has the clout to provide efficient enforcement and co-ordination.
Now that we are on the other side of the fiscal cliff, the opportunity to be creative is possible. The US needs to transition to a single-payer health care system subsuming a medical care program for injured and ill workers who suffer both traumatic and occupational conditions.
Read more about the "single-Payer System" and workers' compensation
Workers' Compensation: A Single Payer System Will Solve the ...
Nov 29, 2012
The question is whether the nation will recognize that the US needs tol take the bold step previously taken by the European Community, finally adopt a single payer medical care program. The perpetual cost generator that ...
http://workers-compensation.blogspot.com/
NJ Urged to Adopt Single Payer System for Workmens Comp
Jun 06, 2011
NJ Urged to Adopt Single Payer System for Workmens Comp. A coalition that has been formed in NJ is urging that the Garden State follow the lead of Vermont and establish a single-payer system. Single-payer movements ...
http://workers-compensation.blogspot.com/
Vermont Single Payer System Called the Dawn of A New Era
Apr 03, 2011
The proposed state based Vermont Single-Payer health care system, that would embrace workers' compensation medical care, is gaining momentum. A recent article in the New England Journal of Medicine, citing increased ...
http://workers-compensation.blogspot.com/
RICO Issues Can Be Cured With A Single Payer Medical System
Mar 22, 2011
Vermont's proposed single payer system would seperate medical care from indemnity. Vermont's single proposed single-payer system would likely also provide a primary care doctor to every resident of Vermont. This would ...
http://workers-compensation.blogspot.com/
Now that we are on the other side of the fiscal cliff, the opportunity to be creative is possible. The US needs to transition to a single-payer health care system subsuming a medical care program for injured and ill workers who suffer both traumatic and occupational conditions.
Read more about the "single-Payer System" and workers' compensation
Workers' Compensation: A Single Payer System Will Solve the ...
Nov 29, 2012
The question is whether the nation will recognize that the US needs tol take the bold step previously taken by the European Community, finally adopt a single payer medical care program. The perpetual cost generator that ...
http://workers-compensation.blogspot.com/
NJ Urged to Adopt Single Payer System for Workmens Comp
Jun 06, 2011
NJ Urged to Adopt Single Payer System for Workmens Comp. A coalition that has been formed in NJ is urging that the Garden State follow the lead of Vermont and establish a single-payer system. Single-payer movements ...
http://workers-compensation.blogspot.com/
Vermont Single Payer System Called the Dawn of A New Era
Apr 03, 2011
The proposed state based Vermont Single-Payer health care system, that would embrace workers' compensation medical care, is gaining momentum. A recent article in the New England Journal of Medicine, citing increased ...
http://workers-compensation.blogspot.com/
RICO Issues Can Be Cured With A Single Payer Medical System
Mar 22, 2011
Vermont's proposed single payer system would seperate medical care from indemnity. Vermont's single proposed single-payer system would likely also provide a primary care doctor to every resident of Vermont. This would ...
http://workers-compensation.blogspot.com/
Related articles
Saturday, December 29, 2012
Class Action by Medicare Advantage Beneficiares Dismissed By Federal Court
A federal class action, by a group of plaintiffs who alleged that they were a class of Medicare-eligible individuals enrolled in a Medicare Advantage plan, and received benefits under part C of the Medicare program, was dismissed by a federal court under the preemption doctrine. In an action removed to Federal court, the plaintiffs sought to bring a class action in state court alleging that New York state law applied regarding reimbursement for for monetary settlements from third-party tortfeasors.
The court ruled that the interpretation of the secondary payer provision of Medicare part C, 42 USC section 1395W-22 (a)(4), preempted any state law provisions.
Meek-Horton v. Trover Solutions, Inc., No. 11 CV 6054(RPP), 2012 WL 6699776, (SD-NY 2012) Decided December 26, 2012
Read more about "The Medicare Secondary Payer Act" and workers' compensation
The court ruled that the interpretation of the secondary payer provision of Medicare part C, 42 USC section 1395W-22 (a)(4), preempted any state law provisions.
Meek-Horton v. Trover Solutions, Inc., No. 11 CV 6054(RPP), 2012 WL 6699776, (SD-NY 2012) Decided December 26, 2012
Read more about "The Medicare Secondary Payer Act" and workers' compensation
Oct 01, 2012
US Supreme Court Denies CMS-MSP Case - Hadden. 2012 WL 1106757. Supreme Court of the United States. HADDEN, VERNON V. UNITED STATES. No. 11-1197.Oct. 1, 2012. Opinion. The petition for writ of certiorari is ...
Dec 28, 2012
CMS/MSP Requires Deceased Beneficiary Information. CMS has announced that workers' compensation information concerning deceased beneficiaries must be reported by insurance carriers. "We received another question ...
Apr 03, 2009
CMS/MSP Requires Deceased Beneficiary Information. CMS has announced that workers' compensation information concerning deceased beneficiaries must be reported by insurance carriers. "We received another question ...
May 18, 2011
"IT IS FURTHER ORDERED that Defendant's demand for payment of her MSP reimbursement claims, under threat of collection actions before there has been a resolution of an appeal regarding the amount of the Defendant's ...
Related articles
Friday, December 28, 2012
Legislation Goes to President Obama on CMS Condition Payment Procedures
Under the proposed legislation time periods for reporting by parties to CMS (The Center for Medeicare and Medicaid Services) are eased, penalities for insurance carriers are reduced, and a 3 year statute of limitations is established.
The legislation was merged into another pending bill for medical services and was rushed to a favorable vote in both the House and Senate in the last moments before Christmas.
What remains to be determined are the regulations that will be established to implement the legislation. In the past, such regulations usually set boundries for such legislation and may in the end further complicate and even prolong resolution of the issues.
Read more about "The Medicare Secondary Payer Act" and workers' compensation
Oct 01, 2012
US Supreme Court Denies CMS-MSP Case - Hadden. 2012 WL 1106757. Supreme Court of the United States. HADDEN, VERNON V. UNITED STATES. No. 11-1197.Oct. 1, 2012. Opinion. The petition for writ of certiorari is ...
Apr 03, 2009
CMS/MSP Requires Deceased Beneficiary Information. CMS has announced that workers' compensation information concerning deceased beneficiaries must be reported by insurance carriers. "We received another question ...
May 18, 2011
"IT IS FURTHER ORDERED that Defendant's demand for payment of her MSP reimbursement claims, under threat of collection actions before there has been a resolution of an appeal regarding the amount of the Defendant's ...
Dec 23, 2008
A formal process exits to obtain a waiver of an Overpayment Recovery request from The Center for Medicare and Medicaid Services [CMS]. If SSA advises you or your client that it has made an overpayment, ie. Medicare ...
Related articles
Thursday, December 27, 2012
Who Calls The Shots, Your Employer-Selected Doctor Or The Insurance Company?

Insurance companies sometimes tell doctors that they will not pay for procedures that the doctor says are medically appropriate.
Today's post comes from guest author Nathan Reckman from Paul McAndrew Law Firm.
Typically, when an authorized doctor suggests an expensive course of care (like surgery) the first thing the doctor will do is check with the insurance company to make sure the surgery is going to be paid for. Instead of immediately scheduling the needed surgery, the doctor will wait until the insurance carrier agrees to pay for the procedure. Doctors do this so they don’t have to worry about how they are going to be paid. Asking for this unneeded authorization from the insurance company means the insurance company now has a say in determining what individual procedures are proper for the care of the work injury.
We often see injured workers whose injury was initially accepted by the employer until the doctor requests authorization for an expensive surgery. When faced with the additional cost of surgery, the insurance carrier denies the work injury hoping the injured worker will either forego surgery or try to pay for the surgery through other means, such as their personal health insurance.
This situation may also arise when the authorized doctor recommends expensive diagnostic procedures, like CT scans, or refers the injured worker to a specialist, for example a psychiatrist for depression related to the work injury.
To make sure your rights are protected, it’s often helpful to have an experienced workers’ compensation attorney on your side if you’re facing a situation where your employer is trying to interfere with the decisions of their handpicked doctor. Injured workers should get the care that their doctor, not an insurance company, determines is medically appropriate.
Read more about "medical treatment" and workers' compensation.
Nov 16, 2012
New York Worker's Compensation Board's proposed new medical treatment guidelines that will modify 2010 previously implemented. Adopt the new carpal tunnel syndrome (CTS) medical treatment guidelines (MTG) as the ...
Nov 09, 2012
On Tuesday, the American people expressed its support for a unified medical care program that will embrace all aspects of life, including industrial accidents and diseases. They validated, as did the Supreme Court, the ...
Nov 01, 2012
Planned changes by Mitt Romney to Medicare and Medicaid will have a dire effect on the regulations of the future cost of workers' compensation medical treatment. Proposed changes to the Federal program will indirectly ...
Jan 22, 2011
The court held that the failure of the employer/insurance carrier to provide medical care for out-of-state treatment, even though requested by the employee, was deemed a refusal of the employer to provide adequate medical ...
Related articles
Monday, December 24, 2012
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