Claims Adjuster, TPA Could Face Criminal Charges for Worker Fatality

Today's post was shared by WCBlog and comes from www.propertycasualty360.com

The egregious ­mismanagement of a California workers’ compensation claim is being blamed for an injured worker’s severe infection and resultant death. The ongoing case is drawing ire from various associations, including the California Applicants’ Attorneys Association (CAAA), which is lobbying that criminal charges be filed against Sedgwick Claims Management Services, the third-party administrator involved in the claim, as well as one of its adjusters. The initial workers’ compensation claim originated when Charles Romano injured his shoulder and cervical spine on Dec. 20, 2003 while stocking shelves at a Ralph’s grocery store (part of The Kroger Co.) in Camarillo, Calif. After undergoing surgery for the resultant injuries on August 29, 2005, Romano contracted methicillin-resistant straphylococcus aureus (MRSA), which not only caused renal and pulmonary failure but also paralysis below the shoulders (from C8 down). Romano later sought treatment for the serious infection at the Ventura County Medical Center, where he had no choice but to use Medi-Cal—the state’s version of Medicaid—because Sedgwick refused to authorize treatment. In fact, Medi-Cal paid for Romano’s medical bills dating from November 2005 through February 2007, ultimately picking up a tab for $300,000. Fatal Consequences On October 25, 2006, a workers’ compensation judge issued an amended findings and award,ruling that the MRSA infection was a...

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After West disaster, News study finds U.S. chemical safety data wrong about 90 percent

Today's post was shared by WCBlog and comes from share.d-news.co

Even the best national data on chemical accidents is wrong nine times out of 10. A Dallas Morning News analysis of more than 750,000 federal records found pervasive inaccuracies and holes in data on chemical accidents, such as the one in West that killed 15 people and injured more than 300. In fact, no one at any level of government knows how often serious chemical accidents occur each year in the United States. And there is no plan in place for federal agencies to gather more accurate information. As a result, the kind of data sharing ordered by President Barack Obama in response to West is unlikely to improve the government’s ability to answer even the most basic questions about chemical safety. “We can track Gross National Product to the second and third decimal, but there is no reliable way of tracking even simple things like how many [chemical] accidents happen,” said Sam Mannan, a nationally recognized expert on chemical safety who recently testified before a congressional hearing on West. “This is just scandalous.” After the West explosion in April, The News asked a simple question: How often do serious or potentially serious industrial chemical accidents occur in Texas and nationwide? After scouring the four federal databases with the most comprehensive information available on chemical safety, The News concluded that there was no way to know. For a recent four-year period, the paper managed to confirm at least 24...

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Measuring the Global Burden of Disease

Today's post was shared by NEJM and comes from www.nejm.org

It is difficult to deliver effective and high-quality care to patients without knowing their diagnoses; likewise, for health systems to be effective, it is necessary to understand the key challenges in efforts to improve population health and how these challenges are changing. Before the early 1990s, there was no comprehensive and internally consistent source of information on the global burden of diseases, injuries, and risk factors. To close this gap, the World Bank and the World Health Organization launched the Global Burden of Disease (GBD) Study in 1991.

Although assessments of selected diseases, injuries, and risk factors in selected populations are published each year (e.g., the annual assessments of the human immunodeficiency virus [HIV] epidemic, the only comprehensive assessments of the state of health in the world have been the various revisions of the GBD Study for 1990, 1999–2002, and 2004.

The advantage of the GBD approach is that consistent methods are applied to critically appraise available information on each condition, make this information comparable and systematic, estimate results from countries with incomplete data, and report on the burden of disease with the use of standardized metrics.

The most recent assessment of the global burden...

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Christopher J.L. Murray, M.D., D.Phil., and Alan D. Lopez, Ph.D.
N Engl J Med 2013; 369:448-457August 1, 2013DOI: 10.1056/NEJMra1201534

Related articles

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Fashion Safety: Charges of Child Labor Confront Walmart and The GAP

Child labor infractions and workplace safety conditions in Bangladesh have been raised against Walmart and The GAP by Al Jazeera America in a report aired in its initial week of broadcasting.

Children as young as 12 make clothes with
Old Navy tags in a Dhaka factory with no fire exit or fire extinguishers.

"Fault Lines repeatedly asked for on-camera interviews with representatives of Walmart and Gap, but by our deadline, both companies had denied our requests. Instead, they issued written comments in response to the reporting in our investigative film, "Made in Bangladesh," which examines some of the practices of U.S. retailers in Bangladesh's garment industry. Walmart's comments come in the form of a Q&A we did with a company spokesperson, while Gap issued a statement in response to our findings in Bangladesh that we outlined to them. Both statements are posted in full."

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Who Is Paying the Bills for Occupational Illnesses and Disease?

A recently published study from the US Department of Health and Human Services (NIOSH) reports that 45% of emergency room medical expenses for occupational illnesses and disease are not expected to be paid by workers' compensation insurance coverage.

Click here to read the complete report: Use of Workers’ Compensation Data for Occupational Safety  and Health: Proceedings from  June 2012 Workshop (May 2013) Identifying Workers’ Compensation as the Expected Payer in  Emergency Department Medical Records,  Larry L. Jackson, PhD, Susan J. Derk, MA, Suzanne M. Marsh, MPA, Audrey A. Reichard, OTR, MPH  National Institute for Occupational Safety and Health

Jobs are coming back, but they don't pay enough

Workers' Compensation benefits are usually based on an individual's wages and limited by the State Average Weekly Wage (SAWW). Likewise, premiums paid by employers are also determined by payroll costs. As medical costs soar, wage are not keeping up with wages, therefore premiums must rise. The result is a push by employers to limit workers' compensation claims through regulation and statutory reforms. Today's post was shared by Steven Greenhouse and comes from www.baltimoresun.com

The good news as Labor Day approaches: Jobs are returning. The bad news: Most of them pay lousy wages and provide low, if not nonexistent, benefits. The trend toward lousy wages began before the Great Recession. According to a new report from the Economic Policy Institute, weak wage growth between 2000 and 2007, combined with wage losses for most workers since then, means that the bottom 60 percent of working Americans are earning less now than 13 years ago. This is also part of the explanation for why the percentage of Americans living below the poverty line has been increasing even as the economy has started to recover — from 12.3 percent in 2006 to around 14 percent this year. More than 35 million Americans now live below the poverty line. Many of them have jobs. The problem is that these jobs just don't pay enough to lift their families out of poverty.

Has the Internet Raised or Lowered Healthcare Costs?

The next trip to see the company doctor my be by computer. Today's post was shared by Mother Jones and comes from www.motherjones.com

Matt Yglesias writes about the awesome power of information technology to diagnose illnesses and save a trip to the doctor: I was having a kind of weird problem with my left thumb over the course of the past few days....Finally I figured out that it looked to me like an infection of the cuticle....That brought me to a Wikipedia page...."paronychia"....led to a bit more Googling....typically happens to habitual fingernail biters (guilty) or people who've recently been in the water a lot (swimming pool on vacation). Everyone basically agrees that this isn't a huge deal and that you can obtain some physical relief by occasionally soaking the thumb in hot water while waiting for it to clear up. I took that advice starting yesterday morning, and today I feel a lot better....So there we have it. In a small but real way, information technology reduced the cost of this particular health care service. Productivity for the win. Obviously there are lots of things we aren't going to treat in this way, but I'm quite optimistic that information technology in the health care sector is going to do us a lot of good.