Today's post is authored by Peter Rousmaniere and shared from workcompcentral.com The Florida 11th Circuit Court decision on Aug. 13 appears to be the first state court decision in many years to declare an entire workers’ compensation statute as unconstitutional. The fingerprints of the Dean of Workers’ Compensation Research John Burton are all over Judge Jorge Cueto’s reasoning. Since the 1970s, Burton, with a law degree and PhD in economics, has been the leading academic scholar in workers’ compensation, even now years after his retirement from a faculty position at Rutgers University. Burton surely thinks that this decision is long coming. So, what’s his complaint? Cueto wrote that through the years, the state has cut back permanent partial disability benefits so severely that the state “no longer provides any benefits for this class of disabled worker.” Burton’s writings indicate that he holds that whatever permanent disability benefits there are in Florida, they are so low and PPD so significant, that the entire workers’ comp system in Florida is inadequate. Cueto agrees. He cites National Council on Compensation Insurance estimates that legislative changes in 1979, 1990, 1994 and 2003 cut PPD benefits severely. Per Burton, Florida “eviscerated the permanent partial benefit system.” The current benefits are “less than available during the 1970s and markedly lower than... |
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Monday, August 25, 2014
The Father of the 11th Circuit Court Decision
Sunday, January 5, 2014
Video: AAJ President Discusses Generic Drugs
Nearly 80 percent of all prescriptions in the U.S. are filled with the generic version of a drug. The price tag can be appealing, but taking a generic drug can also have dangerous consequences because generic drug manufacturers are not accountable for the safety of drugs they produce.Accountability is a key incentive to ensure drug companies monitor and adequately warn patients about the safety of drugs. Despite what many may think, the FDA does not test drugs, but instead relies on testing provided by the drug companies. FDA approval of a drug does not guarantee safety. In the above video, American Association for Justice President Burton LeBlanc talks about the accountability imbalance between generic drugs and name-brand drugs and how the lack of accountability can put consumers at risk. “What you may not know is that unlike brand-name manufacturers, generic drug manufacturers cannot be held accountable if their drugs injure or kill Americans. And we all know too well, if no one is accountable, no one is safe,” LeBlanc said. To view the video in its entirety, click here. Here’s where you can help. Join the growing number of over 20,000 consumers who have already signed a petition calling on the FDA to restore accountability. Safety is an issue that can’t be overlooked.
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Saturday, December 14, 2013
AIA to Urge Renewal of TRIA to Workers Compensation
The American Insurance Association (AIA) will highlight the importance of renewing the Terrorism Risk Insurance Act (TRIA) at the National Association of Insurance Commissioners' (NAIC) 2013 Fall National Meeting, underscoring TRIA's role in the workers' compensation marketplace. The NAIC meeting will take place December 14-18 in Washington, D.C.
"Workers' compensation insurers are particularly affected by a terrorist attack," said J. Stephen ("Stef") Zielezienski, AIA senior vice president and general counsel. "By definition, workers' compensation policies must cover all risks, including terrorism, because workers' compensation covers all injuries and deaths that are deemed under a state's law as work-related without distinguishing the source of the injury." Coupled with the nature of a terrorist attack, this makes the risk difficult to manage without the partnership provided by TRIA."
Zielezienski will appear before the Workers' Compensation (C) Task Force on Tuesday, December 17. In his presentation, Zielezienski will focus on the expected impact on employers, insurers and state regulators should TRIA sunset at the end of 2014.
"Without TRIA, workers' compensation insurers would have to make difficult decisions on how to manage their aggregated exposure, particularly for geographically-concentrated risks like terrorism," said Zielezienski. "If an insurance company elects to reduce their exposure by not offering as much capacity, then state residual markets and workers' compensation pools would have to absorb the risk. Ultimately, workers' compensation insurers would be responsible for these losses because they reinsure these residual market risks, but the extreme losses from catastrophic terrorism could stress the private markets and create economic uncertainty."
Zielezienski will also focus on what responsibilities state governments might assume for workers' compensation should TRIA not be reauthorized. Both AIA and the NAIC are advocating for the long-term reauthorization of TRIA. The NAIC passed a resolution at its 2013 Summer National Meeting in Indianapolis urging Congress to reauthorize the successful program.
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- Oklahoma workers' compensation opt-out provisions spark judicial questions (workers-compensation.blogspot.com)
- The Workers' Compensation Nuclear Option: Detroit officially enters bankruptcy (workers-compensation.blogspot.com)
- Fee Schedules and Value (workers-compensation.blogspot.com)
- The Next Wave: N.H.L. Players Sue League Over Head Injuries (workers-compensation.blogspot.com)
- Trickle Down Stagnation (workers-compensation.blogspot.com)
- Wah, Wah, Wah (workers-compensation.blogspot.com)
Friday, December 13, 2013
Simple Solutions for Home Building Workers
Home building is physically demanding work and manual material handling may be the most difficult part of the job. Manual material handling includes all of the tasks that require you to lift, lower, push, pull, hold or carry materials. These activities increase the risk of painful strains and sprains and more serious soft tissue injuries.Soft tissues of the body include muscles, tendons, ligaments, discs, cartilage and nerves. Soft tissue injuries cause workers pain, suffering and lost income. They can also restrict non-work activity, like sports and hobbies. Builders’ and employers’ costs include loss of productivity and high workers’ compensation insurance premiums.Simple Solutions for Home Building Workers provides basic information about readily available work practices and equipment that can help both new and experienced workers, contractors and builders prevent serious manual material handling injuries. Simple Solutions for Home Building Workers [PDF - 2.6 MB] To Print the Document as a BookletThis publication was designed to be printed as a booklet on 8.5 x 11 inches paper. Proceed with printing the document as recommended below:
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Wednesday, December 11, 2013
Oklahoma workers' compensation opt-out provisions spark judicial questions
Law a high priority The law was a high priority of Gov. Mary Fallin and Republican legislative leaders, who have said it will help businesses by reducing workers' compensation costs. Opponents claim cost savings will come at the expense of injured workers. Oklahoma City attorney John McMurry, who is challenging the law on behalf of two state lawmakers and the Professional Fire Fighters of Oklahoma, argued that not all Oklahoma employers and employees would be treated equally under the law. Employees of companies that opt out of the system would have “fewer rights” than employees of companies that participate in the administrative system, McMurry argued. An employee of an opt-out company who is dissatisfied with the way the employer has handled a claim would first have to appeal to a panel of three persons appointed by the employer, McMurry said. Eventually, the employee would be able to appeal a series... |
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Tuesday, December 10, 2013
Delay Or Deny At Your Risk
There are so many reasons why both employers and workers feel that workers' compensation is "broken" or doesn't work.
Peter Rousmaniere, who is beginning work this week for WorkCompCentral, suggests in his column reviewing two studies on perceived delays in medical treatment that delay may arise as much from indifferent doctoring skills as days elapsing on the calendar. An employer consultant relayed to me a factual scenario indicating another cause of this perception - standard claims administration protocol, which is defensive in nature as opposed to being aggressively pro-active. Rousmaniere cites a couple of studies in his column. A Texas Department of Workers' Compensation survey of injured workers documents wide discrepancy in perceptions, but also notes that up to 50% of all survey respondents complained of some delay in receipt of treatment. Another study cited by Rousmaniere conducted by Harbor Health, which specializes in designing workers’ compensation provider networks, looked for differences in claims outcome, including medical cost and litigation rates, and if surgical treatment happened early or late in the course of treatment. Harbor Health found that early surgery in carpal tunnel cases (earlier than recommended by treatment guidelines) produced slightly more cost in medical expense but much less cost in indemnity expense. Let's put these findings into context. Assume a 28 year old male worker who complains of "... |
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Friday, December 6, 2013
Keeping privacy in focus
Confidentiality has been the hallmark of Workers' Compensation since the inception of the program. Has been challenged federally through the portability act concerning the privacy of medical records. All that reach was bad enough, a data breach from and a governmental site is even worse. It is becoming more than obvious, but the weak financial infrastructure, of the patchwork of worker's Compensation systems for the country are creating serious challenges. Instead of attempting to run 50 different programs throughout the country, it is probably A good idea to start looking inward, and establishing a single solid system that can meet the needs required to run A multibillion-dollar benefit system the rep country and also maintain the confidentiality and privacy that the parties participating in it require. Today's post shared from therepublic.com
Hackers gained access to the personal information of about 26,000 Pennsylvanians who use debit cards to receive jobless and workers' compensation benefits, the Pennsylvania Treasury Department said Thursday. The incident was part of a wider security breach affecting 465,000 holders of JPMorgan Chase & Co. prepaid cash cards nationwide. The breach affects only cardholders who used the JPMorgan Chase UCard Center website between mid-July and mid-September, the Treasury Department said. Michael Fusco, a spokesman for JPMorgan, said the bank found no evidence any information was used improperly. JPMorgan first contacted the Pennsylvania Treasury Department on Tuesday, agency spokesman Gary Tuma said. JPMorgan has referred the matter to law enforcement and would not explain details of how the breach occurred, the Treasury Department said. The Pennsylvania agency wants details from JPMorgan Chase about the bank's response to the breach, including an explanation for any delay in notifying it and the additional measures it will undertake to protect against a recurrence. The department said most of the personal information that might have been viewed includes card numbers, dates of birth, user IDs, email addresses. Information on external bank accounts might have been exposed, as well, if a cardholder completed a transaction to it, the department said. Cardholders are being contacted by letter with instructions and are being urged by JPMorgan Chase in the meantime to... |
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Thursday, December 5, 2013
The Road toward Fully Transparent Medical Records
Jan Walker, R.N., M.B.A., Jonathan D. Darer, M.D., M.P.H., Joann G. Elmore, M.D., M.P.H., and Tom Delbanco, M.D. December 4, 2013DOI: 10.1056/NEJMp1310132
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Wednesday, December 4, 2013
Coal industry pays lawyers, doctors to lie and let workers to die penniless
Today's post is shared from workerscomphub.org Photo by Earl DotterIn a devastating must-read set of reports, the Center for Public Integrity and ABC News describe how coal companies have fought a cutthroat campaign of secrecy, misinformation, false diagnoses, and defiance of court orders to stop workers from getting workers’ compensation for black lung disease. The coal industry’s tactics mirror those of Big Tobacco, the lead and soda industries, the NFL, and pulp and paper giant Georgia-Pacific, which is conducting secret research and selectively withholding information to cast doubt on more than 60,000 legal claims filed by construction workers and others who Georgia-Pacific exposed to asbestos in the 1960s and ‘70s and are developing mesothelioma, a cancer nearly always caused by asbestos, today. Black lung, a disease caused by inhaling coal dust over time, scars and shrinks the lungs and can be highly debilitating and deadly. In its severe form, black lung is supposed to automatically qualify miners for workers’ compensation. Yet in a series of three in-depth reports, the Center for Public Integrity reveals how the coal industry and its lawyers have fought tooth and nail to hide information on workers’ health from doctors, courts, and patients themselves in order to maintain doubt about people's’ eligibility for compensation. ABC News interviewed Dr. Paul Wheeler, head of The Johns Hopkins Hospital’s black... |
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Workers' Compensation Board hosts meetings to help improve services
New York state's Workers' Compensation Board has started a sweeping effort to examine the system, and look at how it could more effectively meet the needs of injured workers and employers. It's in the midst of holding sessions where injured workers can express their opinions.
The second of three sessions was held yesterday in Syracuse, and allowed injured workers to chime in on the discussion in central New York. Fidel, Alejandro Velacqueis Perez was among those telling stories. His ankle was shattered on the job at a stone cutting company in Delaware County. While waiting four months for a Workers' Compensation hearing, he's basically homeless. "I need help," Perez said. "I don't have any resources. I don't have money to buy food. I don't have money to get a phone and reach my family." Interpreting for Perez is Rebecca Fuentes of the Workers Center of Central New York. She says immigrant voices especially need to be heard, but part of the problem is that many don't even know Workers' Compensation exists. An answer to that would be more outreach from the agency. "People in this building need to get out," Fuentes said. "We want to see them out at events, tabling. We need to see them everywhere. Because workers are getting injured, and they're not having equal access to this right." Fuentes says among other things, some immigrants lose their jobs after an injury because they apply for Workers' Compensation. She says it is a serious issue that the Workers' Compensation Board... |
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Formaldehyde Spill At Southern Ocean Medical Center; Three Treated For Inhalation
A formaldehyde spill at Southern Ocean Medical Center on Monday caused three hospital employees to be treated for inhalation of the known carcinogen.
At 10:14 a.m., Stafford Township Police responded to a report of a hazardous material spill at SOCH on Route 72 in Stafford Township. Investigation revealed that a small quantity of formaldehyde was spilled in a utility closet located in the Labor and Delivery area of the hospital. The spill was contained to the utility closet and no evacuations were necessary, police said. No patients were injured in this incident but three hospital employees were treated for minor inhalation injuries and released, police said. Responding agencies included the Stafford Township and Barnegat Township Volunteer Fire Companies as well as Stafford Township EMS. The Berkeley Township Haz-Mat Unit responded and neutralized and contained the spill which is being cleaned up by a private contractor engaged by Southern Ocean Medical Center. Questions concerning this release may be directed to Capt. Thomas Dellane at 609-597-1189 ext. 8299. |
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
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Tuesday, December 3, 2013
Are Smokers Really the ACA’s Biggest Losers?
On November 25, Fox News put it best: “Obamacare Policies Slam Smokers,” , noting that “smokers are the only group with a pre-existing condition that Obamacare penalizes.” THCB itself has headlined: Smokers Face Tough New Rules under Obamacare.
And these headlines are absolutely accurate — meaning that, with the possible exception of the e-cigarette, ACA is the best thing that has happened to employed smokers ever.
Here is how we arrive at this conclusion. The data is mixed on whether smokers incur much higher healthcare costs or just slightly higher healthcare costs during their working ages than non-smokers do. None of the data shows that their costs are lower, but let’s say there is no impact on health spending.
Nonetheless, the following is incontrovertible: smokers take smoking breaks.Remarkably, there are no laws specifically governing smoking breaks, and like most other quantifiable human resources issues, no one has quantified them. But we all observe these breaks, and about a fifth of us participate in them. They reduce productivity. By definition, if you are outside smoking, you are not inside... |
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NJ COLA Bill - Legislative Hearing Scheduled
The NJ Senate Budget and Appropriations Committee will hold a public hearing on a pending COLA bill S613 to increase benefits on 12/5/2013 1:00:00 PM.
The Senate Labor Committee report
The Senate Labor Committee reports favorably and with
committee amendments Senate Bill No. 613.
As amended by the committee, this bill provides, from July 1, 2013
forward, an annual cost of living adjustment (COLA) in the weekly
workers' compensation benefit rate for any worker who has become
totally and permanently disabled from a workplace injury at any time
after December 31, 1979 and for the surviving dependents of any
worker who died from a workplace injury after December 31, 1979.
The COLA would be an amount such that, when added to the
workers' compensation weekly benefit rate initially awarded, the sum
will bear the same percentage relationship to the maximum benefit rate
at the time of the adjustment that the initial rate bore to the maximum
rate at the time of the initial award, except that:
1. The bill reduces the amount of the adjustment as much as
necessary to ensure that the sum of the adjustment and the amount
initially awarded does not exceed the amount which would cause any
reduction of disability benefits payable under the Federal Old Age,
Survivors and Disability Act; and
2. The bill reduces the supplemental workers’ compensation
benefits (but not regular workers’ compensation) for claimants injured
after 1979 by the amount of any Social Security benefits (other than
Social Security disability benefits and any increases in Social Security
benefits due to federal statutory changes after May 31, 1980), Black
Lung benefits, or the employer’s share of disability pension payments
received from or on account of an employer, except that if the worker's
original workers' compensation award was already reduced under
current law, there would be no further reduction of the supplemental
benefits under the bill.
These reductions parallel the reductions provided under current
law for claimants who were injured before 1980. The bill also
provides that no supplemental benefits would be paid in any case
where they are calculated to be less than $5 per week.
Current law requires such annual adjustments in the rate of
workers' compensation benefits for death and permanent total
disability to be paid from the Second Injury Fund (SIF), but only for
cases of injury or death occurring before January 1, 1980. The bill
extends the adjustments paid from the SIF to claims originating after
December 31, 1979, although the adjustments would apply only to
benefits paid on those claims after July 1, 2013, thus avoiding a
backlog of retroactive benefits.
The bill provides that supplemental payments will commence only
after SIF assessments are sufficient to pay them without using General
Fund money. The supplemental benefit payments would start on July
1, 2013 and the Department of Labor and Workforce Development is
required to take into account the supplemental benefits when
calculating the amount of the Second Injury Fund assessment which
starts on January 1, 2013, thus avoiding the need for any General Fund
appropriation.
To avoid an abrupt fiscal impact on the workers’ compensation
system, the bill provides that one third of the supplemental benefit rate
be paid during the first year, two thirds of the rate be paid during the
second year and the full amount be paid during the third and
subsequent years.
The bill sets time limits for workers’ compensation insurers and
self-insured employers to notify the SIF when supplemental workers’
compensation benefits are required under the bill. An insurer or selfinsured
employer is required to provide the notice not more than 60
days after the supplement is awarded or voluntary payment is to begin.
If a failure to notify results in the payment of an incorrect amount of
benefits, the liability for the payment of the supplemental benefits is
transferred from the SIF to the insurer or employer until the required
notice is provided.
The bill makes no change in the provisions of sections 1 and 9 of
P.L.1980, c.83 (C.34:15-95.4 and 34:15-95.5), which provide for the
reduction of certain portions of workers' compensation benefits by the
amount of Social Security disability benefits paid. In addition, the bill
expressly states that the supplemental benefits shall not be paid in a
manner which in any way changes or modifies the provisions of those
sections. The bill, therefore, will have no effect on existing provisions
of State and federal law regarding offsets between workers'
compensation and federal Social Security disability benefits.
The committee amendments provide that the application of the cost
of living adjustment commence on July 1, 2013, instead of July 1,
2011.
This bill was pre-filed for introduction in the 2012-2013 session
pending technical review. As reported, the bill includes the changes
required by technical review, which has been performed.
The Senate Labor Committee report
The Senate Labor Committee reports favorably and with
committee amendments Senate Bill No. 613.
As amended by the committee, this bill provides, from July 1, 2013
forward, an annual cost of living adjustment (COLA) in the weekly
workers' compensation benefit rate for any worker who has become
totally and permanently disabled from a workplace injury at any time
after December 31, 1979 and for the surviving dependents of any
worker who died from a workplace injury after December 31, 1979.
The COLA would be an amount such that, when added to the
workers' compensation weekly benefit rate initially awarded, the sum
will bear the same percentage relationship to the maximum benefit rate
at the time of the adjustment that the initial rate bore to the maximum
rate at the time of the initial award, except that:
1. The bill reduces the amount of the adjustment as much as
necessary to ensure that the sum of the adjustment and the amount
initially awarded does not exceed the amount which would cause any
reduction of disability benefits payable under the Federal Old Age,
Survivors and Disability Act; and
2. The bill reduces the supplemental workers’ compensation
benefits (but not regular workers’ compensation) for claimants injured
after 1979 by the amount of any Social Security benefits (other than
Social Security disability benefits and any increases in Social Security
benefits due to federal statutory changes after May 31, 1980), Black
Lung benefits, or the employer’s share of disability pension payments
received from or on account of an employer, except that if the worker's
original workers' compensation award was already reduced under
current law, there would be no further reduction of the supplemental
benefits under the bill.
These reductions parallel the reductions provided under current
law for claimants who were injured before 1980. The bill also
provides that no supplemental benefits would be paid in any case
where they are calculated to be less than $5 per week.
Current law requires such annual adjustments in the rate of
workers' compensation benefits for death and permanent total
disability to be paid from the Second Injury Fund (SIF), but only for
cases of injury or death occurring before January 1, 1980. The bill
extends the adjustments paid from the SIF to claims originating after
December 31, 1979, although the adjustments would apply only to
benefits paid on those claims after July 1, 2013, thus avoiding a
backlog of retroactive benefits.
The bill provides that supplemental payments will commence only
after SIF assessments are sufficient to pay them without using General
Fund money. The supplemental benefit payments would start on July
1, 2013 and the Department of Labor and Workforce Development is
required to take into account the supplemental benefits when
calculating the amount of the Second Injury Fund assessment which
starts on January 1, 2013, thus avoiding the need for any General Fund
appropriation.
To avoid an abrupt fiscal impact on the workers’ compensation
system, the bill provides that one third of the supplemental benefit rate
be paid during the first year, two thirds of the rate be paid during the
second year and the full amount be paid during the third and
subsequent years.
The bill sets time limits for workers’ compensation insurers and
self-insured employers to notify the SIF when supplemental workers’
compensation benefits are required under the bill. An insurer or selfinsured
employer is required to provide the notice not more than 60
days after the supplement is awarded or voluntary payment is to begin.
If a failure to notify results in the payment of an incorrect amount of
benefits, the liability for the payment of the supplemental benefits is
transferred from the SIF to the insurer or employer until the required
notice is provided.
The bill makes no change in the provisions of sections 1 and 9 of
P.L.1980, c.83 (C.34:15-95.4 and 34:15-95.5), which provide for the
reduction of certain portions of workers' compensation benefits by the
amount of Social Security disability benefits paid. In addition, the bill
expressly states that the supplemental benefits shall not be paid in a
manner which in any way changes or modifies the provisions of those
sections. The bill, therefore, will have no effect on existing provisions
of State and federal law regarding offsets between workers'
compensation and federal Social Security disability benefits.
The committee amendments provide that the application of the cost
of living adjustment commence on July 1, 2013, instead of July 1,
2011.
This bill was pre-filed for introduction in the 2012-2013 session
pending technical review. As reported, the bill includes the changes
required by technical review, which has been performed.
….
Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
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As Hospital Prices Soar, a Single Stitch Tops $500
Medical delivery costs continue to soar and workers' compensation claims costs are running out of ontrol. Cost for emergency medicare are not usually regulated by workers' compensation prorams, eve where balance cillig is removed from the equation. Todays post is shared from the NYTimes.org With blood oozing from deep lacerations, the two patients arrived at California Pacific Medical Center’s tidy emergency room. Deepika Singh, 26, had gashed her knee at a backyard barbecue. Orla Roche, a rambunctious toddler on vacation with her family, had tumbled from a couch, splitting open her forehead on a table. On a quiet Saturday in May, nurses in blue scrubs quickly ushered the two patients into treatment rooms. The wounds were cleaned, numbed and mended in under an hour. “It was great — they had good DVDs, the staff couldn’t have been nicer,” said Emer Duffy, Orla’s mother. Then the bills arrived. Ms. Singh’s three stitches cost $2,229.11. Orla’s forehead was sealed with a dab of skin glue for $1,696. “When I first saw the charge, I said, ‘What could possibly have cost that much?’ ” recalled Ms. Singh. “They billed for everything, every pill.” In a medical system notorious for opaque finances and inflated bills, nothing is more convoluted than hospital pricing, economists say. Hospital charges represent about a third of the $2.7 trillion annual United States health care... |
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Wednesday, November 27, 2013
Workers’ Comp will cover hijacked UPS driver with PTSD
Risks associated with employment are usually covered under Workers' Compensation claims. Assaults usually are traumatic in nature and having a component of psychological stress manifested in post traumatic stress disorders.Today's post is shared from wvrecord.com The state Supreme Court has ruled that a UPS driver’s post-traumatic stress disorder stemming from a hijacking is a compensable injury in the Workers’ Compensation system. The court made the decision Oct. 25 in UPS’ appeal of a Board of Review decision in Jay Hannah’s case. “The gunman fired a shot in the air near Mr. Hannah’s driver side door. He then threatened Mr. Hannah’s life and forced Mr. Hannah to drive him towards the police station. On the way to the police station, the gunman saw a police cruiser parked at a gas station and forced Mr. Hannah to pull over. “The gunman then took the keys to the truck, stepped out of the passenger side door, and fired a shot at the ground. As the gunman was getting out of the truck, Mr. Hannah was able to escape and hide behind a nearby store. The gunman was subsequently fatally shot by law enforcement.” According to a 2012 report in the Parkersburg News and Sentinel, the hijacking occurred in Elizabeth by Joseph Dennis... |
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