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(c) 2010-2026 Jon L Gelman, All Rights Reserved.

Saturday, April 4, 2009

US Supreme Court Hears Challenge to Manville Asbestos Bankruptcy Plan

The US Supreme Court once again hear oral argument in a claim arising out of "the longest running tort" in the nation's history, asbestos litigation. The case played to a full house as the Court revisited the 1986 Johns Manville Bankruptcy program and questioned whether the the process that paid out more than $2.8 Billion could be challenged yet again. Plaintiff lawyers, not party to a settlement mediated by former NY Governor Mario Cuomo, argued that they should be allowed to sue various insurers including Travelers Insurance Company.

Travelers Indemnity Co. v. Bailey

Color X-Rays to Beam in on Asbestos Disease


A new radiography technique has been announced to diagnose asbestos related disease. Dr. Michael Harbut, co-director of the National Center for Vermiculite and Asbestos-Related Cancers at the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan reported a new method to assist the diagnose of workers who have been exposed to asbestos, coal dust, beryllium and other heavy metals.

“If we can identify the ’sentinel’ or first cases of asbestosis or lung cancer at an early stage, then we can help identify asbestos exposures in places where it might not have previously been suspected,” said Harbut, who is also chief of the Center for Occupational and Environmental Medicine at Wayne State University.

Friday, April 3, 2009

CMS/MSP Not Going To Require Pre 12/5/1980 Exposure Reporting, BUT....

CMS will not require reporting of claim data where the exposure occurred prior to 12/5/1980 (Effective date of the MSP Act), but if exposure continues after that date, that is another story.

"We were asked about the 12/5/80 date for liability and no fault and the date of incident. Yes we say that in general CMS is determined that it won’t pursue recovery if the date of CMS defined date of incident is prior to 12/5/1980. But then we give an example of a situation with a continuing DOI specifically with respect to exposure.

"If it’s easier for you to think of it that way, if you have a situation with exposure and that exposure continues on or after 12/5/80 it’s really like you’ve got a series of continuous multiple DOIs and we only require you to report the first DOI but yes we do have a recovery claim in that situation.
Transcript of Teleconference 3/24/1980, page 12

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 about deceased beneficiaries, were they covered under the reporting; yes they are. If someone is a Medicare beneficiary or was a Medicare beneficiary at any of the time period issue the claim has to be reported if it meets the other criteria."
Transcript of Teleconference 3/24/09, page 5

Death benefits to dependents, are those reportable? Again you go back to what we’ve referenced in the manual where something that doesn’t claim or release or have the effect of releasing medicals with respect to the beneficiary does not need to be reported. But if it does any other those things then yes it needs to be reported.
Transcript of Teleconference 3/24/09, page 12

Tuesday, March 31, 2009

NY Times Series Calls The Compensation System "A Costly Legal Swamp"

In another of a series of articles, the NY Times highlights the serious procedural and emotional issues involved in navigating the present workers' compensation system.

“This is a terrible thing to say,” said Dr. Robin Herbert, co-director of the occupational and environmental division at Mount Sinai Medical Center, “but if I had a health problem at work, I’m not sure I’d file a workers’ comp claim. It’s the Wild West of health insurance.”

http://tinyurl.com/dyp4c7

Monday, March 30, 2009

Nationalizing Workers’ Compensation Medical Delivery

Recently the Obama Administration invited the medical insurance industry to the White House to discuss possible future scenarios on the delivery of health care. A planted floated at the meeting was one that President Obama advocated in h campaign. That proposal was allow the Federal government to sell health care coverage.

Obama remains committed that employees and employers, as well as the Federal government, should participate in the program. Does that mean that workers compensation insurance coverage is also going to be an element of the plan? The next obvious step would be to allow the Federal government to sell workers’ compensation insurance coverage.

Representative Jan Schakowsky (D-IL), a probable author of the legislations, stated, “We're not trying to figure out what represents the interests of private insurers, we're trying to come up with a plan that makes sure all Americans have health care…”

 The Federal Government is ultimately going to set the stage for the change in health care delivery. The incentive will be the $19 Billion dollars it has set aside for health information technology. Where the road to health care reform takes the ailing workers’ compensation medical delivery system in this era of struggling industrial growth still remains uncertain

Sunday, March 29, 2009

Administration in California Requests Judges to Vacate Their Decision Against AMA Guides

California Administration officials have written to the California Appellate Judges and requested that they vacate their decision setting aside the AMA Guides.  The letter, an unprecedented action, has not yet received a response from the California Workers' Compensation Appellate Court.

However, Todd McFarren, a California attorney and President of the California Applicants Attorneys Association, has remarked that the the Judges, will “...still be handcuffed by the administration’s inadequate permanent disability schedule.”  “The administration has not addressed the fundamental flaws in its disability rating schedule. We’ve been waiting more than a year for the governor to approve his own administration’s proposal to restore a small percentage of the permanent disability compensation he cut by 50% to 70%.”