Workers' Compensation

Wednesday, October 9, 2013

Today's Nobel Prize Winner Had His Research Funding Cut By The NIH

Protecting workers from disease is crucial. Medical monitoring and medical research are crucial factors to saving lives and lowering costs. This morning, James Rothman, Randy Schekman, and Thomas Sudhof got phone calls from Geneva. They learned that their basic research into how cells work gained them the recognition from the Nobel Committee for the 2013 Nobel Prize In Medicine Or Physiology.

Their prize is the example of how basic research into the nature of the world around us is can be incredibly important in treating disease. These tiny actions of a normally functioning cell seem irrelevant to the larger world, but that all changes when things go wrong.
Südhof told the Lancet in 2010 that this basic science, is not a "field, but an approach: 'solid descriptive science,' like neuroanatomy or biochemistry, disciplines that cannot claim to immediately understand functions or provide cures, but which form the basis for everything we do."
Sadly in the budget fights and government show down, federal funding for these basic research projects are being defunded and cut. This has even recently impacted one of today's winners: Rothman lost his NIH funding for the research he won the award for.He told the AP that he hopes that the Nobel Prize will mean his grants will get funded in the future if he re-applies.
Award winning research
All spent decades unraveling different parts of the cellular transport system. We might sometimes see cells as we did in middle school, as a dish shaped blob with a center nucleus as the command center and multiple other static organs.
But that's not really the case. Our...

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Family Makes the Difference

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

Mom and Dad are late in their years. Mom is 89 and has moderate dementia. Dad just turned 91 and was in excellent physical health despite a history of heart disease and bypass surgeries.
"Was" is the critical verb in the prior sentence.
Dad is the decision maker, always has been. A retired dentist who had a successful practice, he is a leader and is used to being in charge.
Also a faithful husband and family man, Dad made a personal commitment to himself years ago to take care of his wife to the end.
He will also admit that he is the world's worst planner ... except for when it came to vacations.
He didn't count on disability.
Having elderly parents, seeing their travails on a weekly basis (my commitment to them was to visit at least once a week), and watching them sunset physically and mentally, provides some awareness of the disabled state.
Dementia is a terrible disease. It progresses gradually, taking elements of memory away from daily functioning in a cruel manner. At Mom's stage, she forgets sometimes just how to walk, so she falls and then can't get back up.
Dad thought he could deal with this. He thought wrong.
Dad has sciatica and pain radiates down his leg. This started a few months ago.
A shot of cortisone every once in a while alleviates the symptoms and he goes about his days with good energy and strength. But when he has to wait because of dosing issues, or just access issues, he can't move much without a walker.
This past week was a seminal week in my father's...

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NJ Police Officer Indicted for Misclassification and Workers' Compensation Fraud

Today's post was shared from www.trentonian.com

A Trenton police officer and his father were indicted last week on charges of false swearing and workers compensation fraud.
Trenton Police officer Gaetano Ponticiello, 42, and his father Filippo Ponticiello, 65, were indicted last week by a Mercer County grand jury on fourth-degree charges of false swearing and workers compensation fraud. Each offense carries a maximum penalty of 18 months in prison and a $10,000 fine.
According to prosecutors in the case, on Feb. 23, 2009, both Gaetano and Filippo made false statements under oath regarding workers compensation claims. Prosecutors say the false or misleading statements included a misclassification of employees for the purpose of evading the full payment of benefits or premiums.
Both father and son are scheduled to appear in Mercer County Superior Court Oct. 25.
Gaetano Ponticiello has been with the Trenton Police Department for at least 15 years. Lt. James Slack of the Trenton Police Department internal affairs told The Trentonian in July that Ponticiello has been suspended without pay.

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California limits workers' comp sports injury claims

Today's post shared from The LA Times.

After more than a year of intense lobbying by professional sports leagues, California has slammed the door on most athletes looking to file injury claims in the state, including those with serious brain injuries.

Gov. Jerry Brown on Tuesday signed legislation that significantly limits workers' compensation claims by pro players. It's a significant victory for the National Football League, which has been trying to reduce its financial exposure to concussions and other brain injuries that former players allege are the result of repeated blows to the head.
In August, the league agreed to a $765-million settlement with more than 4,500 former players. They had sued the NFL in federal court over the lasting effects of concussions, which have been linked to dementia and other debilitating illnesses. That landmark deal was viewed as a bargain for the league, considering the gravity of the injuries and the bad publicity the lawsuit generated for the sport.
The NFL's legislative win in Sacramento could be far more valuable over the long term. It allows the league to sidestep exposure to thousands of serious head and brain trauma claims by out-of-state players who are no longer eligible to file in California.
The bill, signed without comment by the governor, was the subject of nearly 18 months of lobbying by the NFL, Major League Baseball and other major sports leagues and workers' compensation insurers. It ultimately found the backing of nearly every member of the Legislature;...

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UN rights expert urges EU to focus on migrants' rights

Today's post is shared from Jurist.org

The UN Special Rapporteur on the human rights of migrants [official website] Francois Crepeau urged [press release] the EU on Monday to adopt a new approach to migration that focuses on the rights of migrants. The discussion was centered around last week's sinking of the Lampedusa [BBC report] off the coast of Italy, which claimed the lives of 194 Eritrean and Somali migrants. Crepeau visited Italy in May to study the external border management of the EU and its impact on human rights of migrants and urged [JURIST report] EU member states to prioritize human rights in the development of their migration policies. "This tragedy reminds us of the importance of that recommendation," Crepeau stated. "If countries continue to criminalize irregular migration, without adopting new legal channels for migration, especially for low-skilled migrants ... the number of migrants risking their lives on dangerously overcrowded and unseaworthy vessels over perilous sea routes can only increase." Last month UN High Commissioner for Human Rights Navi Pillay [official profile] called on governments [JURIST report] to create human rights-based policies addressing migration. In May Crepeau visited both sides of the border in Turkey, Greece, Tunisia and Italy [official reports] to... [Click here to see the rest of this post]

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Federal Court Deems CMS Interpretation of the MSP Act Impenetrable

A UD District Court has denied a health provider's challenge to CMS's interpretation of the to the Medicare Secondary Act. CMS's formula for reimbursement was upheld.

"The Court finds this line of argument unpersuasive for several reasons. Most significantly, Allina's heavy reliance on the above-cited cases is unavailing because none of those decisions directly dealt with the precise issue before this Court–i.e., the phrase “entitled to benefits under Part A.” Rather, all of those courts were called upon to interpret the other component of the Medicaid fraction's numerator–the requirement that patients be “eligible” for Medicaid. For this very reason, our Court of Appeals “declined to follow” those same cases, characterizing those courts' discussion of the phrase “entitled to benefits” as dicta. Northeast Hosp., 657 F.3d at 12 n.7. This Court agrees with that assessment and follows the lead of our Circuit. Those decisions do not lend any meaningful support to Allina's arguments here. Moreover, the D.C. Circuit has rejected the substance of this “eligible” versus “entitled” argument as unpersuasive in any event, observing in Northeast Hospital that “the fact that the DSH factions speak of ‘eligibility’ for Medicaid but ‘entitlement’ to Medicare” was not “enlightening.” Id. at 12. Instead, as the Circuit went on to state, “the Secretary's interpretation of ‘entitled’ as ‘meeting the statutory criteria for entitlement’ ... does not actually collapse the terms.” Id. (explaining that an individual could be “ ‘eligible’ for, but not ‘entitled’ to, Part A benefits because one has not yet ‘enrolled’ in the program”). This Court concurs. The Secretary's reading of the statute at issue here does not equate these two terms, and Allina's insistence otherwise lacks merit."

Allina Health System v. Sebelius,

--- F.Supp.2d ----, 2013 WL 5530609, D.D.C., October 08, 2013 (NO. 09-CV-1889 (RLW))

Case Remanded to Compensation Court to Determine Employment Status

A NJ Appellate Court has remanded a negligence case from Superior Court to the Division of Workers' Compensation to determine when an employee held joint employment and subject to the Exclusivity Bar.

" It is well settled in this jurisdiction that for workers ' compensation purposes

an employee may be simultaneously employed by more than one employer, either because

of the employee's separate contracting with multiple employers or because

his general employer has “lent” him to a special employer. The question to be

determined in the dual employment situation is whether, at the time of the injury,

the petitioner was, as a factual matter, the employee of one or the other

or both of the employers.

In determining which among multiple employers are liable for workers ' compensation ,

this court has noted the indicia of employment that ordinarily require

evaluation, including the existence of a separate agreement between the employee

and each employer, the determination of whose work is being done at the time of

the compensable injury, which has the right to control the details of the work,

which pays, and which has the power to hire, discharge or recall the employee.

The relative weight to be accorded these factors and the manner in which they

are to be balanced are not, however, ... subject to mechanical or automatic application.

Rather, the criteria determinative of the employment relationship

must be “rationalized and applied so that each case may be considered and determined

upon its own particular facts.” And, ...in the dual employment situation,

the most significant inquiry is the determination of “whose interest the

employee was furthering at the time of the accident. ”

CHALMERS and FRED CHALMERS, Plaintiffs–Appellants,

STEPHEN J. SWARTZ

--- A.3d ----, 2013 WL 5525694 (N.J.Super.A.D.) October 9, 2013

Tuesday, October 8, 2013

When It Comes To Brain Injury, Authors Say NFL Is In A 'League Of Denial'

Today's post was shared by The Health Care Blog and comes from www.npr.org

The casket bearing the body of former Pittsburgh Steelers center Mike Webster is surrounded by flowers, after funeral services in Pittsburgh in September 2002. Mark Fainaru-Wada and Steve Fainaru, authors of League of Denial, point to Webster's autopsy as one of the most significant moments in the history of sports.

When the Pittsburgh Steelers won four Super Bowls in the 1970s, you could argue that no one played a bigger role than Mike Webster. Webster was the Steelers' center, snapping the ball to the quarterback, then waging war in the trenches, slamming his body and helmet into defensive players to halt their rush.

He was a local hero, which is why the city was stunned when his life fell apart. He lost all his money, and his marriage, and ended up spending nights in the bus terminal in Pittsburgh. Webster died of a heart attack, and on Sept. 28, 2002, came the autopsy.

"His body ends up in the Allegheny County coroner's office," ESPN investigative reporter Mark Fainaru-Wada tells NPR's David Greene. "And there's a young junior pathologist there named Bennet Omalu. He makes this decision sort of on the spur of the moment to study Mike Webster's brain."

Fainaru-Wada and his brother, Steve Fainaru, have written a new book called League of Denial, which was also turned into a Frontline documentary on PBS. They take an exhaustive look at how the NFL has dealt with allegations that playing football can lead to brain damage. They interviewed...

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Judge denies jury trial in Chevron RICO case

The federal judge overseeing a fraud lawsuit filed by Chevron Corp. has decided to deny the defendants in the case a jury trial.

Is Workers' Compensation Just a Promise That Can't Be Kept?

Over a century ago, Labor and Industry made a promise to each other called Workers' Compensation. It was summary, remedial, inexpensive administrative process that provided benefits to injured workers through a social insurance program for work-related accidents and diseases. The shifting of wealth in the US has now made the workers' compensation program a target for reform and elmination. Today's post is shared from the opinion pages of the NYTimes.com.

As bad as things in Washington are — the federal government shutdown since Tuesday, the slim but real potential for a debt default, a political system that seems increasingly ungovernable — they are going to get much worse, for the United States and other advanced economies, in the years ahead.

From the end of World War II to the brief interlude of prosperity after the cold war, politicians could console themselves with the thought that rapid economic growth would eventually rescue them from short-term fiscal transgressions.

The miracle of rising living standards encouraged rich countries increasingly to live beyond their means, happy in the belief that healthy returns on their real estate and investment portfolios would let them pay off debts, educate their children and pay for their medical care and retirement. This was, it seemed, the postwar generations’ collective destiny.

But the numbers no longer add up. Even before the Great Recession, rich countries were seeing their tax revenues weaken,...

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Sunday, October 6, 2013

Berkshire Hathaway subsidiaries deny, delay asbestos, hazard claims, suits, insiders allege

Asbestos related disease continues to be epidemic. The victims and their families continue to be meet with delay and denial of benefits. Today's post is shared from turnto23.com

For months, mysterious white flakes and construction dust fell on Nancy Lopez’s desk in the Jackson County Courthouse in Kansas City, Mo.
No question the debris was worse after renovation crews worked the weekend. But really, the mess was getting out of hand. On that Monday in 1983, Lopez grabbed a rag and started dusting.

Berkshire_Hathaway_subsidiaries_deny__de_970160000_20131003001057-10946

The impeccably dressed young administrative assistant finished tidying her office and set to work. Unknowingly, she had brushed off her desk, into the air and into her lungs deadly asbestos fibers.
Those tiny fibers stayed with Lopez for decades, and, in 2009, at age 54, she learned she was dying from mesothelioma, an asbestos-caused cancer. She sued the construction company and the county for negligence and punitive damages.
Lopez didn’t realize her suit would eventually pit her against the empire built by acclaimed investor and philanthropist Warren Buffett. Buffett’s Berkshire Hathaway Inc. of Omaha, Neb., has become one of the most powerful forces in asbestos and pollution litigation in the world.
Berkshire’s reach has grown so vast that if you or a loved one files an asbestos- or pollution-related lawsuit in America, like Lopez, you’re likely to encounter a Berkshire subsidiary.
Scripps interviewed more than 20 sources -- some confidential -- reviewed dozens of lawsuits and spoke with former insiders, who all allege the Berkshire-owned companies that...

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2012 ADAO AAC: Joel Shufro, "Left in the Dust Ten Years After the Attack...

The need for better safety and health care and planning is the subject of a talk of Joel Shufro. This post is shared from ADAO.

Oklahoma Chamber of Commerce Seeks to Intervene in Opt-Out Case

In Oklahoma it is now off to the Courts to determine if the Workers' Compensation legislation is really Constitutional. The radical program eliminates the the century old promise between Labor and Industry by transferring the benefit program out of the administrative/judicial adversary system for an employer based insurance scheme. This post is shared from the Oklahoma Chamber of Commerce.
State Chamber President & CEO Fred Morgan comments on the joint chamber Motion to Intervene filed to protect Senate Bill 1062:

“The reforms and restructuring of Oklahoma’s workers’ compensation system that were passed this past legislative session need to be defended,” said Fred Morgan, president and CEO of the State Chamber of Oklahoma. “For the past twenty years, workers’ compensation reform has been the number one economic development issue for Oklahoma. The change to an administrative system, and bringing our benefits back into line with surrounding states, has already seen positive results.”

“We are pleased to join with the Attorney General’s office, Oklahoma City and Tulsa chambers in our fervent defense of these long-needed reforms. Oklahoma businesses need the recently passed reforms to be upheld so we can focus on creating strong, well-paying jobs and developing our growing economy.”

Mike Neal, president and CEO of the Tulsa Regional Chamber also commented on the motion.

“Along with our regional partners, through the OneVoice agenda, we have advocated for appropriate changes to the state's workers' compensation system for many years," said Neal. "We are hopeful the legal challenges can be addressed swiftly so businesses can begin seeing decreased costs and our state will finally realize competitive advantage with a system that works for both employers and employees.”

The Motion to Intervene was filed on behalf of the State Chamber of Oklahoma, Tulsa Regional Chamber, and the Greater Oklahoma City Chamber.

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Claims administrator ordered to halt oil spill claims payments

Today's post was shared by Legal Newsline and comes from legalnewsline.com

U.S. District Judge Carl Barbier has ordered claims administrator Patrick Juneau to immediately stop business-related loss payments connected to the 2010 BP oil spill.

Barbier

Barbier, who is overseeing the case at the Eastern District of Louisiana, made the ruling Friday — a day after the U.S. Court of Appeals for the Fifth Circuit sided with BP concerning the way funds were being paid out under the Court Supervised Settlement Program under the leadership of Juneau.

BP claims Juneau misinterpreted the settlement agreement and allowed businesses that could show little or no economic damages to receive payments. While business claims will be suspended for the time being, all other claims will be allowed to be processed.

“This order is issued only as an immediate and interim measure until the Court is able to confer with and receive input from the parties in order to confect an appropriate ‘narrowly tailored’ preliminary injunction order as instructed by the Fifth Circuit,” Barbier wrote.

Both BP and the plaintiffs’ steering committee also have been ordered to submit a proposal on how damages for businesses should be handled to eliminate the potential for false claims.
The ruling comes after multiple denials by Barbier to revisit the settlement program at BP’s request.
BP, the plaintiffs’ steering committee and Juneau will meet in a status conference on Oct. 11 to go over potential new...

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Company Is Scolded for Mistakes at Fukushima

Companies need to be honest with both their and employees and the public about safety issues. The age of conspiracy one would think is long passed. This post is shared from the NY Times and highlights the failings of corporate transparency.

In an unusually public scolding, Japan’s nuclear watchdog agency criticized the operator of the crippled Fukushima nuclear plant on Friday for making mistakes that allowed radioactive water to leak into the Pacific Ocean, and ordered it to fix the problems quickly.

The agency, the Nuclear Regulation Authority, summoned the president of the operator, the Tokyo Electric Power Company, to explain the accidents and spills that have plagued the cleanup of the Fukushima Daiichi plant since it suffered a triple meltdown two years ago. In the most recent mishap, workers spilled 114 gallons of contaminated water this week while trying to fill an already overflowing tank, said the company, known as Tepco. It said some of the water might have run into the ocean.

In a public hearing, an official at the regulatory agency, Katsuhiko Ikeda, dressed down Tepco’s president, saying the problems raised serious questions about the company’s ability to operate its other nuclear plants, like the huge Kashiwazaki-Kariwa facility, which Tepco wants to restart.

“That these leaks occurred due to human error is very regrettable,” Mr. Ikeda told the president, Naomi Hirose. “The failure to make rudimentary checks reflects a clear deterioration in the ability to manage the site.”

Mr. Ikeda said Tepco should consider emergency measures like bringing in workers from its other nuclear plants to help improve the cleanup.

Such blunt and direct...

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Saturday, October 5, 2013

Jobs Report Becomes a Casualty of Shutdown

Today's post was shared by The New York Times and comes from www.nytimes.com

On the first Friday morning of almost any other month, from the trading floors of Wall Street to the hushed hallways of the Federal Reserve, all the attention would be focused on two numbers: the latest government estimates for unemployment and job creation.

This Friday, much of the government will be closed. As a result, the economists and statisticians at the Bureau of Labor Statistics will be at home, and everyone from Ben S. Bernanke, the Fed’s chairman, to thousands of traders glued to their Bloomberg screens, will be left without one of the most important clues to the state of the economy.

The mystery is heightened by the question of just how much of an impact the shutdown itself will have. And while the job numbers from last month cannot answer that question, economists almost universally agree that the cost to the economy depends on how long the standoff lasts, and whether the much larger danger of a debt default can be averted.

“If it’s short, it’s barely a blip on the radar,” said Ellen Zentner, senior United States economist at Morgan Stanley. “If a shutdown is prolonged, it’s a whole different story.”

Like many Wall Street economists, Ms. Zentner estimates that each week of the shutdown will shave one-tenth to two-tenths of a percentage point off economic growth in the final quarter of 2013.

That may not sound like much, especially in a $16 trillion economy. And during the last extended shutdown in the mid-1990s...

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Now the Government Shutdown Is Stopping Blood Drives

Today's post was shared by Mother Jones and comes from www.motherjones.com

Here's how the government shutdown may literally be killing people: by causing blood shortages.

For all the scorn heaped on government employees, some people forget that the faceless bureaucrats who populate Washington are often, in fact, a bunch of do-gooders—people who genuinely believe in the notion of public service. As such, they contribute to the public good in a lot of ways that are taken for granted, like their immense contribution to local blood banks. Thirty-eight percent of the population is eligible to give blood, but only 5 percent actually does so. A lot of that 5 percent apparently works for the federal government. Thanks to the shutdown, in just two days, four federal agency blood drives scheduled by one DC-area health care system have been canceled. The regional Red Cross has had to cancel six others in the Washington region.

Inova Blood Donor Services projects that the cancelations will result in its projected loss of 300 donations that would have helped 900 patients in DC, Maryland, and Virginia. Inova's donated blood collections supply 24 hospitals, which bank much of the blood for inevitable disasters or, say, terrorist attacks. The Red Cross is suffering from similar disruptions, projecting the loss of 229 donations, each of which could potentially save up to three lives. A single major trauma event can easily deplete a hospital's entire blood store. The longer the shutdown goes on, the...

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Intervening Superseding Event: Turning in Bed Held Not a Bar to Workers' Compensation

A NJ Workers' Compensation Judge has held that turning over in bed did not constitute an intervening superseding event and therefore the claim was held to be compensable.

"....the act of turning in bed to shut off an alarm clock did not constitute an intervening, superseding
event which would free respondent of the liability for petitioner's second back
surgery of September 27, 2007 and I further find that the need for that surgery is
causally related to the work accident of July 12, 2005."
Philip A. Tornetta, Judge of Compensation

IPPOLITO v. COUNTY OF BERGEN ROAD DEPT
2011 WL 11004007 (N.J. Adm.)
CLAIM PETITION NOS. 2007 - 25283, 2010 - 17376 August 1, 2011
(Reported Oct. 5, 2013)

Related articles

New York Second in Nation for Questionable Workers’ Compensation Claims

New York State is second in the nation, only behind California, for questionable workers’ compensation insurance claims. The Empire State jumped to the second place in 2012 from fifth in 2011, the New York Insurance Association noted.

“Workers compensation insurance fraud is a serious problem in New York,” Ellen Melchionni, president of the New York Insurance Association, said. “Fraud drives up workers compensation rates. The state and insurance industry need to remain vigilant in cracking down on those looking to cheat the system.”

The National Insurance Crime Bureau (NICB) analysis shows that the number of New York’s questionable claims reported in 2012 was more than double the questionable claims reported in 2011. There were 344 reported in 2012 versus 161 in 2011.

The NICB analysis also shows that in New York State, questionable claims in 2013 are on pace to exceed the 2012 figure. According to data available for the first half of 2013, 183 questionable claims were reported in the state between January and June.

“The growing rate of questionable workers compensation claims is alarming,” Melchionni said. “Fraud takes away from workers compensation serving its intended purpose of protecting injured workers.”
Source: The New York Insurance Association

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Copyright

Wednesday, October 9, 2013

Today's Nobel Prize Winner Had His Research Funding Cut By The NIH

Family Makes the Difference

NJ Police Officer Indicted for Misclassification and Workers' Compensation Fraud

California limits workers' comp sports injury claims

UN rights expert urges EU to focus on migrants' rights

Federal Court Deems CMS Interpretation of the MSP Act Impenetrable

Case Remanded to Compensation Court to Determine Employment Status

Tuesday, October 8, 2013

When It Comes To Brain Injury, Authors Say NFL Is In A 'League Of Denial'

Judge denies jury trial in Chevron RICO case

Monday, October 7, 2013

Is Workers' Compensation Just a Promise That Can't Be Kept?

Sunday, October 6, 2013

Berkshire Hathaway subsidiaries deny, delay asbestos, hazard claims, suits, insiders allege

2012 ADAO AAC: Joel Shufro, "Left in the Dust Ten Years After the Attack...

Oklahoma Chamber of Commerce Seeks to Intervene in Opt-Out Case

Claims administrator ordered to halt oil spill claims payments

Company Is Scolded for Mistakes at Fukushima

Saturday, October 5, 2013

Jobs Report Becomes a Casualty of Shutdown

Now the Government Shutdown Is Stopping Blood Drives

Intervening Superseding Event: Turning in Bed Held Not a Bar to Workers' Compensation

New York Second in Nation for Questionable Workers’ Compensation Claims