| KHN Staff Writer Consumers getting government subsidies for health insurance who are later found ineligible for those payments will owe the government, but not necessarily the full amount, according to the Treasury Department. The clarified rule could affect some of the 300,000 people facing a Sept. 5 deadline to submit additional documents to confirm their citizenship or immigration status, and also apply broadly to anyone ultimately deemed ineligible for subsidies. First reported by the newsletter Inside Health Policy on Thursday, the clarification worries immigration advocates, who say many residents are facing website difficulties and other barriers to meeting the deadline to submit additional details. Those who don’t know about the deadline, or can’t meet it because of glitches, could be deemed ineligible for subsidies and lose their coverage. “We’re very concerned about the implications of this on hundreds of thousands of low-income individuals who are likely eligible, but have encountered significant difficulties with the website, uploading or sending documents,” said Mara Youdelman, managing attorney at the National Health Law Program. If found ineligible, residents could owe thousands of dollars. Under the health law, people who earn between 100 percent and 400 percent of the federal poverty level, about $11,670 to $46,680 for an individual this year, are eligible for premium... |
Copyright
Thursday, September 4, 2014
Consumers Will Owe Uncle Sam If They Got Health Insurance Subsidies Mistakenly
J&J’s Pinnacle Hips Face First Trial on Poisoned Patients
Johnson & Johnson (JNJ), which set aside $2.5 billion last year to resolve claims that 8,000 of its artificial hips were defective, faces a new round of lawsuits over another line of hip implants blamed for poisoning patients.
J&J’s DePuy unit is starting its first trial of allegations that the metal-on-metal version of the Pinnacle hip was defectively designed and caused metal debris to leech into patients’ bloodstreams. The cobalt-and-chromium material caused an infection that forced Kathleen Herlihy-Paoli to have her artificial hips surgically removed, she said in court filings.
Jury selection began today in Herlihy-Paoli’s suit, the first of more than 6,000 cases over the devices to be weighed by a jury. The cases have been consolidated before U.S. District Judge Ed Kinkeade in Dallas for pretrial information exchanges. Kinkeade will preside over Herlihy-Paoli’s trial.
“The first trials in any of these consolidated litigations set the tone for the following cases,” Carl Tobias, who teaches product-liability law at the University of Richmond in Virginia, said in an interview. “If J&J loses the first couple of these Pinnacle trials, they better start seriously thinking about coming up with a settlement similar to what they signed off on for the ASR hips.”
Ultamet Line
J&J said studies have shown the Pinnacle Ultamet line of devices restores mobility and reduces pain for patients in need of hip replacement.
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Chamber spending tops $40M as election nears
Today's post is shared from thehill.com
The Chamber of Commerce spent more than $40 million on advocacy in the first half of 2014, as it stepped up its involvement in the midterm elections.
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More Big Firms Shifting To High-Deductible Health Plans
Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org
The New York Times examines the movement among large employers towards high-deductible plans that shift more health care costs to workers. Meanwhile, The Wall Street Journal looks at how the ACA may affect job-based plans next year.
The New York Times: High-Deductible Health Plans Weigh Down More Employees
Just as employers replaced pensions with retirement savings plans, more large companies appear to be in the midst of a similar cost-sharing shift with health plans. Besides making workers responsible for more of their care, employers hope these plans will motivate employees to comparison-shop for medical services — an admirable goal but one that some say is hard to achieve. ... With high-deductible health plans, consumers pay for all their medical services — at the insurer's negotiated rate — until they meet their deductible. After that, consumers typically pay coinsurance, which is a percentage of each service — say 10 to 35 percent — until they reach the out-of-pocket maximum (Siegel Bernard, 9/1).
The Wall Street Journal: Get Ready For Health-Insurance Enrollment
If you get health insurance through your workplace, you'll probably have a chance this fall to make important decisions about your coverage and costs. Because many corporate health plans hold their annual open-enrollment periods in October and November, many employees can expect to get a packet of benefits, or instructions for... |
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$1.4 Billion in Penalties Is Sought in California Gas Blast
| Today's post is shared from nytimes.com/ Four years after a natural gas explosion tore through a neighborhood of San Bruno, Calif., killing eight people and injuring dozens of others, some of them seriously, the Pacific Gas & Electric Company has been hit with a proposed $1.4 billion penalty for suspected safety violations. It is the largest safety penalty proposed to the California Public Utilities Commission. In the decisions announced on Tuesday, a pair of administrative law judges said that the company committed 3,798 violations of state and federal laws, rules, standards or regulations in connection with its pipeline. Under the proposal, still subject to the approval of the commission, the bulk of the proposed penalty, $950 million, will go into the state’s general fund, while $400 million will pay for pipeline improvements and about $50 million to enhance pipeline safety. The deadly explosion in 2010 raised concerns about the care and maintenance of underground pipelines as the use of natural gas has boomed as a coal alternative. The utility has already spent hundreds of millions of dollars settling claims by the victims and their families and contributing to the recovery efforts in San Bruno, a suburb of San Francisco, where the gas and electric company is based. PG&E also faces charges by federal prosecutors in San Francisco, who earlier this year accused the company of “knowingly and willfully” violating the Pipeline Safety Act and of obstructing a federal investigation into the... |
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The Risk of Melanoma in Airline Pilots and Cabin Crew
| Airline pilots and cabin crew are occupationally exposed to higher levels of cosmic and UV radiation than the general population, but their risk of developing melanoma is not yet established. Objective To assess the risk of melanoma in pilots and airline crew. Data Sources PubMed (1966 to October 30, 2013), Web of Science (1898 to January 27, 2014), and Scopus (1823 to January 27, 2014). Study Selection All studies were included that reported a standardized incidence ratio (SIR), standardized mortality ratio (SMR), or data on expected and observed cases of melanoma or death caused by melanoma that could be used to calculate an SIR or SMR in any flight-based occupation. Data Extraction and Synthesis Primary random-effect meta-analyses were used to summarize SIR and SMR for melanoma in any flight-based occupation. Heterogeneity was assessed using the χ2 test and I2 statistic. To assess the potential bias of small studies, we used funnel plots, the Begg rank correlation test, and the Egger weighted linear regression test. Main Outcomes and Measures Summary SIR and SMR of melanoma in pilots and cabin crew. Results Of the 3527 citations retrieved, 19 studies were included, with more than 266 431 participants. The overall summary SIR of participants in any flight-based occupation was 2.21 (95% CI, 1.76-2.77; P < .001; 14 records). The summary SIR for pilots was 2.22 (95% CI, 1.67-2.93; P... |
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Wednesday, September 3, 2014
CMS To Publish Financial Interactions Between Industry and Physician and Teaching Hospitals
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GAO Report on Adding Cancers to WTC Covered Conditions
Today's post is shared from cdc.gov
- According to these experts, a hazard-based approach focuses on identifying whether particular “hazards”—sources of potential harm—are associated with certain health conditions, and does not attempt to quantify the risks of developing those health conditions. The Administrator’s approach used four methods to determine whether there was an association between a September 11 exposure and a specific cancer, and thus, whether to add that cancer to the list.
- The experts considered the approach reasonable given the WTCHP certification process for enrollees to obtain coverage for treatment for a condition on the list, the lack of data related to exposure levels and risks, and the use of similar approaches by previous federal compensation programs.
- The experts indicated the approach could have been communicated more clearly. For example, the description of the approach in rulemaking did not clearly articulate how decisions would be made when evidence under one method supported adding a cancer type to the list, and evidence under a different method did not. The Administrator noted that this omission was an oversight. Since the Administrator plans to use the same approach in future cancer-related decision making, the absence of a clear description can lead to questions about the credibility and equity of the program.
- According to the experts, an independent peer review process similar to that used in other federal compensation programs could improve the approach. According to the Administrator, this was not feasible due to time constraints imposed by law. A process through which an independent party assesses the validity of the information upon which decisions are being made and that rationales for decisions are clearly described could help ensure the credibility of the Administrator’s approach.
Stop Whining, Do Something
| Cost shifting remains a major factor in the degradation of the the nation's workers' compensation system. Today's post authored by David Depaolo focusses upon this issue and is shared from http://daviddepaolo.blogspot.com/ The Labor Day holiday weekend gave me a couple extra days to think and write - excuse the length of this entry.
Several said I need to stop picking on the insurance companies and claims administrators, some wanted to know more information about who, what and when, presumably for some legal attention. One person even said they were going to cancel their WorkCompCentral subscription because I was being too hard on insurance companies. And some said I was being too soft - that quite simply the insurance or third party administrator folks are just capitalists doing their jobs maximizing profits for shareholders so they're not to blame; and they're also not to be relied upon for corrective leadership either. "You can stop bitching at the professionals that participate in the System to ‘do better,'" I was told. "They are all Capitalist and their job is to maximize their profits. It is the job of the government to regulate what is ‘fair and reasonable’." On the heels of that, another insurance professional contacted me to point out that a big travesty of the workers' compensation system is how the law permits the shifting of system liabilities on to greater tax payer funded systems. In California, for instance, there is a capitation on the maximum amount of temporary total disability time - in general it is 104 weeks (unless... |
CVS Stores Stop Selling All Tobacco Products
Today's post is shared from nytimes.com At a CVS store near Times Square, the shelves are notable for what they no longer display: cigarettes. Now the only smoking products to be found are those that could help customers quit. As of midnight on Tuesday, all 7,700 CVS locations nationwide will no longer sell tobacco products, fulfilling a pledge the company made in February, as it seeks to reposition itself as a health care destination. The rebranding even comes with a new name: CVS Health. The decision to stop selling cigarettes is a strategic move as pharmacies across the country jockey for a piece of the growing health care industry. Rebranding itself as a company focused on health could prove lucrative for the drugstore as it seeks to appeal to medical partners that can help it bridge the gap between customers and their doctors. “CVS is really trying very hard to position themselves as the winner in that marketplace,” said Skip Snow, a health care analyst at Forrester Research. “If they can be perceived as a place to go to receive health care, and buy health care products, as opposed to the place to go to buy a bottle of whiskey or get your film developed, then they can capture more of the retail medicine dollars.” CVS already operates 900 walk-in medical clinics, or “minute clinics,” where customers can get relatively simple services like blood pressure tests and flu vaccines. By dedicating space for these services, CVS and other major retailers like Walmart are diving into... |
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Tuesday, September 2, 2014
OSHA Fines Concrete Systems Inc $52K for Exposing Workers to Hazardous Falls
"Concrete Systems Inc. was previously cited twice for exposing workers to fall and other safety and health hazards at work sites in Kearny and Cranford, New Jersey," said Kris Hoffman, director of OSHA's Parsippany Area Office. "Falls are the leading cause of death in the construction industry. It is imperative that this company immediately implement an effective fall protection program to ensure the safety of its employees."
The repeat hazard, with a $13,860 penalty, was cited because employees were exposed to a 25-foot fall hazard without the proper protection. The company was previously cited for the same violation in 2012. 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.
The serious violations, carrying a $38,610 penalty, were cited almost entirely for violations of fall safety standards. Employees were exposed to fall hazards of up to 25 feet while accessing scaffold platforms without using a ladder. Employees were exposed to fall hazards in excess of 16 feet or 25 feet without the proper fall protection while working from scaffolding. In addition, the company failed to ensure employees were properly tied off on boom lifts and to adequate anchorage points. Concrete Systems also failed to properly train workers on the use of fall protection equipment.
Employees were also exposed to impalement hazards due to rebar ends that were not properly guarded. 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.
OSHA has created a Stop Falls Web page with detailed information in English and Spanish on fall protection standards. The page offers fact sheets, posters and videos that vividly illustrate various fall hazards and appropriate preventive measures.
Concrete Systems, based in Stirling, has 15 business days from receipt of the citations to comply, ask for an informal conference with OSHA's area director, or contest the citations and proposed penalties before the independent Occupational Safety & Health Review Commission.
Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA's role is to ensure these conditions for America's working men and women by setting and enforcing standards, and providing training, education and assistance.
High Health Plan Deductibles Weigh Down More Employees
Today's post is shared from nytime.com Anita Maina was working on an arts and crafts project she found on Pinterest — creating a table out of wood and cork — when she ripped off a fingernail while removing staples from a piece of wood. “It is one of those things that really hurt, and I thought I should go to urgent care,” said Ms. Maina, 27. But she ultimately skipped the visit since she had not met the $6,000 deductible on her health plan, and she knew she probably did not have much left in her health savings account, a type of tax-advantaged savings vehicle that is often used with high-deductible plans to help defray out-of-pocket costs. Ms. Maina, an associate in a health and human services consulting agency, said her employer added the high-deductible plan earlier this year; though her monthly premiums are only $34, these plans require employees to pay for a greater share of their medical expenses upfront, before the plan starts making payments. Next year, even more corporate workers are likely to be offered high-deductible plans — sometimes known more benignly as consumer-directed plans — and at a rising share of large companies, it will be the only option remaining. “You can’t sugarcoat this,” said Paul B. Ginsburg, a professor of the practice of health policy and management at the University of Southern California’s Sol Price School of Public Policy. “This is a more challenging situation for consumers and it’s a reflection of how... |
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Obama Calls for Minimum Wage Rise and Equal Pay as Elections Approach
MILWAUKEE — President Obama on Monday renewed his call to raise the federal minimum wage and to protect the right to equal pay for women as the midterm elections come into sight. In spite of opposition from Republicans, Mr. Obama said, addressing a crowd of about 6,000 people gathered in Milwaukee at a festival hosted by the local A.F.L.-C.I.O., his goal is to make sure all Americans can meet simple goals, like being able to pay their bills and send their children to school. “There is no denying the simple truth: America deserves a raise,” he said. Hailing examples set by employers like Kentucky State University, whose president took a pay cut to give raises to his lowest-paid workers, Mr. Obama said Congress needed to catch up to the businesses and other institutions — as well as 13 states and the District of Columbia — that have already acted to raise their minimum wage. Mr. Obama also referred to his executive order in February requiring that federal contractors in 2015 increase their minimum hourly wage to $10.10 from $7.25. Countering arguments that raising the minimum wage would reduce jobs, Mr. Obama said states that had not waited for the federal government to raise their wages had seen more job growth than those that had not raised their wages. During his brief stop — he was in Milwaukee for about two hours — Mr. Obama expressed optimism about the nation’s economic recovery, emphasizing the progress made since the 2008... |
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Oklahoma Firefighter Widow Wins Workers' Compensation Case
| Today's post is shared from newson6.com The widow and son of a Bartlesville man who died during firefighting training have been awarded more than $503,000 in federal and state death benefits despite testimony that the man never was really with any fire department. Rusty Topping, 28, died in 2008 after registering at a state training facility as a volunteer for the Barnsdall fire department. But Barnsdall's fire chief, Pete O'Dell, testified in workers' comp court that Topping wasn't actually a volunteer. The Oklahoman reports the court said Topping was a firefighter based on a letter of recommendation O'Dell wrote. But O'Dell told the court none of it was true. |
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Monday, September 1, 2014
The Rise And Fall Of The 40-Hour Workweek
| "Eight hours for work, eight hours for sleep, eight hours for what we will." During the Industrial Revolution, that was one slogan of workers who rallied for the eight-hour workday — the 40-hour, five-day week that's become the standard for Americans. On Sept. 5, 1882, the first Labor Day march took place in New York City, and one of the key concerns of workers was cutting down hours. Side note — Labor Day celebrations were moved to Sept. 1 two years later. Henry Ford was the first to implement the change in all his Ford factories — moving away from 48-hour, six-day workweeks without changing wages. In 1926, Ford spoke with World's Work magazine, explaining why he made the change. Interestingly, more rest for workers wasn't exactly his reasoning. He's quoted as saying: "A workman would have little use for an automobile if he had to be in the shop from dawn until dusk. ... The automobile, by enabling people to get about quickly and easily, gives them a chance to find out what is going on in the world-which leads them to a larger life that requires more food, more and better goods, more books, more music -- more of everything." In 1938 President Franklin D. Roosevelt signed the Fair Labor Standards Act into law — providing for the 40-hour workweek across the U.S. The formation of labor unions played a large hand in getting the act passed. Unions helped prompt the Great Sit-Down of 1937, protesting the working conditions... |
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The high cost of labor efficiency — and the ‘Good Jobs’ alternative
Court OKs workers' comp for kickball injury
| A man who was severely injured during the company kickball game he organized is entitled to workers’ compensation, the S.C. Supreme Court has ruled. The justices reversed the Court of Appeals and the state workers’ comp panel in a Wednesday decision. During a company-sponsored kickball game in 2007, Stephen Whigham jumped and landed awkwardly on his right leg, shattering his tibia and fibula. “He was taken away in an ambulance and eventually underwent two surgeries. His doctor later informed him he would need a knee replacement in the near future,” according to Wednesday’s decision. Whigham was the director of creative solutions at Jackson Dawson Communications in Greenville, described in court records as a marketing, advertising and public relations company. During a meeting with other company leaders, Whigham came up with the idea of having a company kickball game as a team-building activity, and his superior at the company approved it. Supplies cost the company $440. The event was called “Ballad Ball” and “paid tribute to the rock ballads of the 80s,” according to court records. In its decision Wednesday, the Supreme Court focused on whether Whigham’s employer expected him to attend the game. When asked if he would have considered it irresponsible of him not to show up, his boss replied: “I don’t know. I would have thought—he wouldn’t do... |
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GM ignition switch compensation program receives more than 300 claims, including 107 death-related
| DETROIT, MI- The General Motors Co. ignition switch compensation program has received 309 claims through Monday, including 107 related to fatal accidents. Camille S. Biros, of Feinberg Rozen LLP, which is overseeing the program for the Detroit-based automaker, said payments to eligible victims and their families are expected to be finalized by the end of September. She said the number of claims filed has no correlation to the amount of individuals expected to be paid through the program, which could cost GM hundreds of millions of dollars. The voluntary compensation program was announced by GM and renowned compensation attorney Kenneth Feinberg in late-June. There is no financial cap on the program and everyone that meets stringent guidelines set by Feinberg are eligible for the program. Feinberg Rozen started accepting claims Aug. 1. It will continue accepting claims through Dec. 31. GM has linked the faulty ignition switches to at least 13 deaths and 54 crashes, but others, including victims' family members and lawyers, say the death toll is closer to 100. GM has said its numbers could increase based on Feinberg's findings because it only included those involved in front-end collisions. Kenneth Feinberg, the independent claims administrator for the GM Ignition Compensation Program, announces the details of the program, including eligibility, scope, rules for the program, and timing of submitting claims, during a news... |
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Virginia: Delays in workers' comp system hold up treatments
| Today's post is shared from Hamptonroards.com The Virginia Workers' Compensation Commission is an independent state agency with 270 employees and an annual operating budget of nearly $45 million. Disputed cases are heard by one of the 21 deputy commissioners unless the parties agree to mediation. In 2013, "the average turnaround time from the time a case was referred to the hearing docket to the date the hearing was held was 150.9 days" or about five months, said James Szablewicz, who has served as chief deputy commissioner for the past decade. In most cases, the deputy commissioner is supposed to issue a ruling within 21 days of the hearing. After that, a worker or employer's representative may file an appeal to be heard by the three commissioners. The commissioners are considered the equivalent of civil court judges in Virginia. The General Assembly appoints them to renewable six-year terms. Virginia law does not set deadlines for hearings before deputy commissioners or commissioners. One way, however, that the commission expedites the process is to sometimes substitute an "on-the-record" decision for a hearing, Szablewicz said. In cases with smaller-scale disputes that... |
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The Medicare Miracle
| Today's post is shared fromPaul Krugman of the nytemes.com So, what do you think about those Medicare numbers? What, you haven’t heard about them? Well, they haven’t been front-page news. But something remarkable has been happening on the health-spending front, and it should (but probably won’t) transform a lot of our political debate. The story so far: We’ve all seen projections of giant federal deficits over the next few decades, and there’s a whole industry devoted to issuing dire warnings about the budget and demanding cuts in Socialsecuritymedicareandmedicaid. Policy wonks have long known, however, that there’s no such program, and that health care, rather than retirement, was driving those scary projections. Why? Because, historically, health spending has grown much faster than G.D.P., and it was assumed that this trend would continue. But a funny thing has happened: Health spending has slowed sharply, and it’s already well below projections made just a few years ago. The falloff has been especially pronounced in Medicare, which is spending $1,000 less per beneficiary than the Congressional Budget Office projected just four years ago. This is a really big deal, in at least three ways. First, our supposed fiscal crisis has been postponed, perhaps indefinitely. The federal government is still running deficits, but they’re way down. True, the red ink is still likely to swell again in a few years, if only because more baby boomers will retire and start collecting benefits; but, these... |
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More Workers Are Claiming ‘Wage Theft’
| Week after week, Guadalupe Rangel worked seven days straight, sometimes 11 hours a day, unloading dining room sets, trampolines, television stands and other imports from Asia that would soon be shipped to Walmart stores. Even though he often clocked 70 hours a week at the Schneider warehouse here, he was never paid time-and-a-half overtime, he said. And now, having joined a lawsuit involving hundreds of warehouse workers, Mr. Rangel stands to receive more than $20,000 in back pay as part of a recent $21 million legal settlement with Schneider, a national trucking company. “Sometimes I’d work 60, even 90 days in a row,” said Mr. Rangel, a soft-spoken immigrant from Mexico. “They never paid overtime.” The lawsuit is part of a flood of recent cases — brought in California and across the nation — that accuse employers of violating minimum wage and overtime laws, erasing work hours and wrongfully taking employees’ tips. Worker advocates call these practices “wage theft,” insisting it has become far too prevalent. Some federal and state officials agree. They assert that more companies are violating wage laws than ever before, pointing to the record number of enforcement actions they have pursued. They complain that more employers — perhaps motivated by fierce competition or a desire for higher profits — are flouting wage laws. Many business groups counter that government officials have... |
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Labor Day: Wages and Salaries Still Lag as Corporate Profits Surge
| Today's post is shared from the nytimes.com In the months before Labor Day last year, job growth was so slow that economists said it would take until 2021 to replace the jobs that were lost or never created in the recession and its aftermath. The pace has picked up since then; at the current rate, missing jobs will be recovered by 2018. Still, five years into an economic recovery that has been notable for resurging corporate profits, the number and quality of jobs are still lagging badly, as are wages and salaries. In 2013, after-tax corporate profits as a share of the economy tied with their highest level on record (in 1965), while labor compensation as a share of the economy hit its lowest point since 1948. Wage growth since 1979 has not kept pace with productivity growth, resulting in falling or flat wages for most workers and big gains for corporate coffers, shareholders, executives and others at the top of the income ladder. Worse, the recent upturn in growth, even if sustained, will not necessarily lead to markedly improved living standards for most workers. That’s because the economy’s lopsidedness is not mainly the result of market forces, but of the lack of policies to ensure broader prosperity. The imbalance will not change without labor and economic reforms. For instance, new research from the Economic Policy Institute shows that from the first half of 2013 to the first half of 2014, hourly wages, adjusted for inflation, fell for nearly everyone. An exception was a small gain for the bottom 10... |
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Sunday, August 31, 2014
Florida exclusive remedy ruling may upend workers compensation system
Injured workers in Florida might be able to receive both workers compensation benefits and civil liability damages should an appeal filed last week by the Florida attorney general’s office fail to overturn a ruling that declared the state’s exclusive remedy provision unconstitutional.
That and other litigation challenging workers comp reforms eventually could result in higher comp premiums for employers in the state, experts say.
In the most recent ruling, Judge Jorge E. Cueto of Florida’s 11th Judicial Circuit Court ruled last month in Florida Workers’ Advocates v. State of Florida that the state’s workers comp exclusive remedy is unconstitutional because workers comp reforms have “decimated” comp benefits and “no longer (provide) a reasonable alternative” to allowing workers to sue in civil court.
Exclusive remedy rules in Florida, and in most other states, make workers comp the sole way to recover money for their injuries. Liability lawsuits typically are allowed only in the case of gross negligence by an employer.
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What’s more, employers could see similar cases challenging workers comp laws and exclusive remedy provisions in other states where injured workers feel that workers comp reforms have stripped them of too many benefits, said Charles Davoli, Baton Rouge, Louisiana-based president of the Workers’ Injury Law & Advocacy Group, which is a plaintiff in the Miami-Dade County case.
“Workers comp systems, which are a century old, are in crisis,” Mr. Davoli said. The Miami-Dade case “is what I would term the tip of the (workers comp) ‘deform’ iceberg,” he said, citing states such as Montana and Georgia as ones that could see legal challenges to limits on workers comp benefits.
Click here to read the complete article.
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