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

Tuesday, August 13, 2013

Speedway owner accused of workers comp fraud

Employer fraud is a major problem for workers' compensation programs. Today's post was shared by WCBlog and comes from www.pressconnects.com


The Tioga County Sheriffs Office, in cooperation with the New York State Workers Compensation Board, charged a 37-year-old Rochester man Thursday with 26 felony counts of offering a false instrument for filing.

Jason M. Bonsignore, of Edgemere Drive, was also charged with four counts each of failure to secure compensation for employees and fraudulent practice, also felonies under the New York State Workers Compensation Law.

The charges are the result of an investigation of Bonsignores business, Champion Speedway on Old Narrows Road in the Town of Owego.

Bonsignore was arraigned in the Town of Owego Court in front of Justice John Schumacher and released on his own recognizance.

Anyone who has any information on potential workers compensation fraud violations can visit www.wcb.ny.gov or call toll free at (888) 363-6001.
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Lead paint manufacturers facing California challenge

Today's post was shared by WCBlog and comes from www.dailynews.com

In April, the U.S. Centers for Disease Control and Prevention raised to 535,000 its estimate of the number of American children with potentially dangerous levels of lead in their blood.

But for U.S. communities combating the lead hazards, there might never be any money from the group some say is most responsible for creating the problem: The companies that made lead pigment used in the old, flaking paint still coating millions of dwellings.

The industry could be on the verge of defeating the last major legal assault by municipalities and states seeking damages to fund lead removal. Apart from one settlement, the industry has successfully defended roughly 50 lawsuits by states, cities, counties and school districts over the last 24 years.

Now, in a bench trial underway in San Jose, the industry is seeking a final victory in a case brought by 10 public agencies, including Los Angeles and Santa Clara counties and the cities of San Francisco, Oakland and San Diego. The suit seeks to force the defendants to inspect more than 3 million California homes, and to remove any lead paint hazards that are discovered, at an estimated cost of more than $1 billion.

Lead lawsuits once were expected by some experts to follow the path of tobacco litigation. States that sued to recover smoking-related health care costs wrested a $248 billion settlement in 1998 from cigarette makers.

As in the tobacco cases, public agencies in California and elsewhere hired

private law firms, including veterans of...

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Legal Fees and Reform

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

Take a look at

WorkCompCentral job ads

.

What do you see?

Lots of employment opportunities for lawyers, primarily those on the insurance/employer defense end.

Some firms are even taking out full display ads for recruitment days and other practices that are typically the province of Corporate America.

Indeed, this does appear to be anecdotal evidence of a larger trend in California workers' compensation - as recent Workers' Compensation Insurance Rating Bureau data shows, spending on lawyers this past year totaled $1.2 billion and has been increasing at a dramatic rate, particularly for defense legal fees.

That's a lot of legal fees, which represents a lot of benefit contestation.

Break it down even further, though, and the anecdote of job ads for lawyers becomes even more salient - defense fees are double what applicant attorney fees are.

Here's the graphical depiction based on the WCIRB numbers:



The chart is interesting in a couple of aspects.

Note that following the 2004 reform, SB 899, defense fees skyrocket from $368 million in 2003 to nearly double at $642 million in 2006, while applicant attorneys, whose fees are largely pegged to permanent disability indemnity, lost some ground, but essentially remained flat.

Things stabilize a bit after 2006 until 2011 when the lawyers on both sides, start taking home a bit more pay, such that 2012 legal fees are double what they were in 2002 for both defense and applicant.

Compare to the Consumer Price Index rate of inflation - $100 in 2002...

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The Trend to Supersize Hospitals

The trickle down effect of the current trend to supersize hospitals through mergers and acquisitions may far reaching unintended consequences on medical costs for employers, insurance companies and injured workers. An consequence of the Affordable Care Act is to encourage hospitals to keep people healthy and avoid hospital admissions.

Hospital have been not only purchasing other hospitals reducing the number of independent hospitals in the US from 5,000 to 1,000, but it has also accelerated the trend for hospitals to purchase lucrative medical practices to earn income from diagnostic tests and to control the flow of hospital admissions.

An unintended consequence of this path may actually increase hospital costs because fewer hospital facilities exist, or the lack of competition may just lead to a universal medical care system. Workers' compensation insurance programs may therefore be required higher fees to hospitals.

"Hospitals across the nation are being swept up in the biggest wave of mergers since the 1990s, a development that is creating giant hospital systems that could one day dominate American health care and drive up costs."

Read the complete article, "New Laws and Rising Costs Create a Surge of Supersizing Hospitals" (NY Times)

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Monday, August 12, 2013

Pending NJ Supreme Court Workers' Compensation Cases

The following is a list of Workers' Compensation cases pending before the NJ Supreme Court as of August 12, 2013.

Off-Premises: Parking Lot Case
A-59-12 Cheryl Hersh v. County of Morris (071433)
Did this employee’s injuries, which occurred when she was struck by a car while walking across a public street to her place of employment from a privately owned garage in which she parked her car at her employer’s expense, arise out of the course of her employment entitling her to benefits under the Workers’ Compensation Act, N.J.S.A. 34:15-1 to -142?
Certification granted: 5/9/13
Posted: 5/13/13
Argued:
Decided:

Conflict of Laws: Preemption
A-130-11 Jersey Central Power & Light Co. v. Lempke (070649)
Was defendant's workers' compensation proceeding in New Jersey a "first-filed litigation" that preempts her Pennsylvania lawsuit against multiple parties over the work-related accident that caused her husband's death?
Certification granted 7/12/12
Posted: 7/13/12
Argued:
Decided:

Cardiovascular: Causal Relationship
A-71-11 James P. Renner v. AT&T (068744)
Does the record support this workers' compensation claim under N.J.S.A. 34:15-7.2, which sets the standard of proof governing claims based on injury or death from cardiovascular causes?
Certification granted: 2/14/12
Posted: 2/14/12

Decided:

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CMS Releases Revised List of Workers Compensation Set-Aside Contacts

The Centers for Medicare and Medicaid Services has released a revised list of contacts for Workers' Compensation Set-Aside Contacts. The contacts have been centralized in 6 areas of the US.

Click here to download the PDF version of the revised list of contacts.

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Bloomberg Sees Higher Costs in a Union-Friendly Mayor

How government looks at the distribution of health care benefits is insightful as to predicting the future of workers' compensation. The change of delivery mechanism implied in the comments of NYC's Mayor, Mike Bloomberg, sketch out a potential future blueprint.Today's post was shared by Steven Greenhouse and comes from www.nytimes.com

Warning of the fiscal danger if New York City fails to rein in its spiraling pension and health care costs, Mayor Michael R. Bloomberg on Tuesday challenged his would-be successors to take a tough line in negotiations with the city’s unions, while worrying aloud that whoever is elected will be too beholden to labor.

“We can’t wake up tomorrow morning — the day after the election — and find that some candidate has made a back-room deal with one of the unions that sets the pattern for all the other unions that will eventually lead to stopping the growth in this city,” Mr. Bloomberg said, departing from his prepared remarks at the end of a speech in Brooklyn on the city’s economy and fiscal situation.

“We cannot afford certain things,” he continued. “It’s tough to say no. It’s particularly tough to say no when nobody wants anybody to get hurt. But the bottom line: this is the taxpayers’ money, and this is our future.”

Mr. Bloomberg’s speech, delivered at a former Pfizer manufacturing plant that is now home to some two dozen small companies, producing everything from 3D printers to kimchi, was in part an attempt to burnish his record of fiscal stewardship, which is hotly debated. He argued that he has determinedly tried to reform pensions and health care but has been stymied by unions.

Fiscal watchdogs note that his administration presided over a 40 percent increase in the city budget, and in his second term handed out raises without demanding concessions on pensions and...

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