The California Applicants’ Attorneys Association (CAAA) joined Assemblywoman Lorena Gonzalez (D-San Diego) for the first ever Women in the Workplace Day at the State Capitol. The day was centered around Governor Brown’s veto of the CAAA sponsored AB 305 (Gonzalez, 2015), which sought to ensure that women are not compensated less than men for identical work injuries.
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Wednesday, February 24, 2016
Sunday, November 24, 2013
Obamacare Has a Friend in the Health Care Industry
In the LA Times today, Noam Levey writes that Obamacare has an ace in the hole: the insurance industry. Sure, they have their gripes:
But since 2010, they have invested billions of dollars to overhaul their businesses, design new insurance plans and physician practices and develop better ways to monitor quality and control costs.This is really a crucial point. Like it or not, the entire health care industry has spent the past three years gearing up for the rollout of Obamacare. At this point, they're committed—and doubly so since the Republican Party very clearly has no real alternative for them. This means that all the doom-mongering on Fox... |
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 "... |
Tuesday, November 24, 2009
Congress, Health Care & Unintended Consequences
This past week some very dramatic things happened in the workers’ compensation world. The US Senate moved forward on initiating a floor debate on health care. At the same time, a group of workers’ compensation scholars met in Washington DC to discuss the future of workers’ compensation and the interplay with social security disability.
Highlights of the NASI (National Academy of Social Insurance) conference convened in Washington were findings presented by eminent leaders in the field. Professor John Burton, Rutgers University, pointed out that newly created barriers to workers’ compensation were pushing more injured workers to the Social Security disability system for benefits. This reflects a phenomenon that occurred in the late 1970’s when a study commissioned by the US Department of Labor and conducted by Mt. Sinai Hospitals’ Environmental Sciences Laboratory, revealed that the inadequate benefit delivery system of workers’ compensation for asbestos related illness, was forcing injured workers and their families into the civil justice arena for adequate compensation.
The problems have not changed in decades; they have only gotten worse, maturing into a system that is in critical condition and on life support. In 1980 Irving J. Selikoff, M.D. reported, “There has been widespread acknowledgement of significant problems with disability compensation for workers in the United States. One major area of concern has been the shortcomings with regard to occupational disease. Whatever the suitability of current workers’ compensation systems in the 50 states for injuries and work accidents, there has been little disagreement about the inadequacies of such systems for workers who become disabled by illness or, if they die, for their surviving dependents.”
Complex questions continue to exist between the scientific and legal communities as to the path to be taken. Barriers placed into the path of recovery, including pre-existing and co-existing conditions, which result in limited or delayed recovery and major shifting of the economic responsibility upon the public/private benefit systems need to be removed. The unspoken social consequences continue as a silent epidemic as families and survivors struggle in silence.
Looking backward over the noble experiment in California which turned sour, Tom Rankin, former President of the California Labor Federation, AFL-CIO, expressed his regret of the reform. The former Labor leader theorized that the results were “unintended consequences.” Indeed he is looking forward to solutions springing forth in a “public option” embedded into the national health care legislation.
Some participants at the NASI conference alleged a major shortcoming of the California workers’ compensation legislative reform effort. Doug Kim, a lobbyist for the claimant’s attorneys, disclosed that the injured workers’ advocates were not invited to partake in the discussion that lead up to crafting the initial drafts of the 2004 California reform legislation SB 899.
History reveals, that when the theoretical reforms were practically applied, the injured workers suffered serious setbacks. If these were in fact “unintended consequences,” then one must consider the active involvement of all stakeholders when looking forward to solutions. The courts in California have consistently upheld challenges to the inequitable results, pointing to the legislative intent to reduce costs. Absent from the discussions of the presenters were practical systemic applications to improve the present system. The “blood and guts” of the traumatic, delay and denial, struggles of navigating in a crippled workers’ compensation system, in California and elsewhere, is verification that change is mandated.
As North Carolina attorney, Valerie A. Johnson, so eloquently remarked, “workers’ compensation is supposed to be a simple system.” The process has now been obstructed by encroaching elements of fault, contributory negligence, apportionment of pre-existing conditions and difficulties of the element of time, manifested by latent diseases unknown to the fathers of the system a century ago. The advance of medical science has brought forth new and innovated modalities that have contributed to soaring medical costs. The convergence of these issues has generated higher administrative costs.
Pecuniary Industry motives have worked adversely to improving safety in the workplace. The need for workers’ compensation would be minimized by adopting a safer occupational environment. Under reporting of workplace accidents continue as the Government Accountability Office announced. Nebraska Appleseed reveals that workers feel intimidated and are apprehensive to report injuries and unsafe work conditions. This is scenario is compounded by the fact that undocumented workers, who have even less job security, work in jobs with higher risk. The Bush Administration did not make efforts to allow OSHA to heighten enforcement efforts. All of these ingredients combine to create a recipe that just doesn’t work.
The US Senate advanced the health care legislation to a floor debate in an unusual late Saturday night session. This action may indeed provide an opportunity for the stakeholders in workers’ compensation to all join in the debate and look for solutions to the delivery of appropriate medical care in an efficient and timely fashion. To avoid “unintended consequences” yet again, injured workers and their advocates will need to be active participants and engage in the debate now.
.......
To read more about workers’ compensation and universal health care solutions click here.
Highlights of the NASI (National Academy of Social Insurance) conference convened in Washington were findings presented by eminent leaders in the field. Professor John Burton, Rutgers University, pointed out that newly created barriers to workers’ compensation were pushing more injured workers to the Social Security disability system for benefits. This reflects a phenomenon that occurred in the late 1970’s when a study commissioned by the US Department of Labor and conducted by Mt. Sinai Hospitals’ Environmental Sciences Laboratory, revealed that the inadequate benefit delivery system of workers’ compensation for asbestos related illness, was forcing injured workers and their families into the civil justice arena for adequate compensation.
The problems have not changed in decades; they have only gotten worse, maturing into a system that is in critical condition and on life support. In 1980 Irving J. Selikoff, M.D. reported, “There has been widespread acknowledgement of significant problems with disability compensation for workers in the United States. One major area of concern has been the shortcomings with regard to occupational disease. Whatever the suitability of current workers’ compensation systems in the 50 states for injuries and work accidents, there has been little disagreement about the inadequacies of such systems for workers who become disabled by illness or, if they die, for their surviving dependents.”
Complex questions continue to exist between the scientific and legal communities as to the path to be taken. Barriers placed into the path of recovery, including pre-existing and co-existing conditions, which result in limited or delayed recovery and major shifting of the economic responsibility upon the public/private benefit systems need to be removed. The unspoken social consequences continue as a silent epidemic as families and survivors struggle in silence.
Looking backward over the noble experiment in California which turned sour, Tom Rankin, former President of the California Labor Federation, AFL-CIO, expressed his regret of the reform. The former Labor leader theorized that the results were “unintended consequences.” Indeed he is looking forward to solutions springing forth in a “public option” embedded into the national health care legislation.
Some participants at the NASI conference alleged a major shortcoming of the California workers’ compensation legislative reform effort. Doug Kim, a lobbyist for the claimant’s attorneys, disclosed that the injured workers’ advocates were not invited to partake in the discussion that lead up to crafting the initial drafts of the 2004 California reform legislation SB 899.
History reveals, that when the theoretical reforms were practically applied, the injured workers suffered serious setbacks. If these were in fact “unintended consequences,” then one must consider the active involvement of all stakeholders when looking forward to solutions. The courts in California have consistently upheld challenges to the inequitable results, pointing to the legislative intent to reduce costs. Absent from the discussions of the presenters were practical systemic applications to improve the present system. The “blood and guts” of the traumatic, delay and denial, struggles of navigating in a crippled workers’ compensation system, in California and elsewhere, is verification that change is mandated.
As North Carolina attorney, Valerie A. Johnson, so eloquently remarked, “workers’ compensation is supposed to be a simple system.” The process has now been obstructed by encroaching elements of fault, contributory negligence, apportionment of pre-existing conditions and difficulties of the element of time, manifested by latent diseases unknown to the fathers of the system a century ago. The advance of medical science has brought forth new and innovated modalities that have contributed to soaring medical costs. The convergence of these issues has generated higher administrative costs.
Pecuniary Industry motives have worked adversely to improving safety in the workplace. The need for workers’ compensation would be minimized by adopting a safer occupational environment. Under reporting of workplace accidents continue as the Government Accountability Office announced. Nebraska Appleseed reveals that workers feel intimidated and are apprehensive to report injuries and unsafe work conditions. This is scenario is compounded by the fact that undocumented workers, who have even less job security, work in jobs with higher risk. The Bush Administration did not make efforts to allow OSHA to heighten enforcement efforts. All of these ingredients combine to create a recipe that just doesn’t work.
The US Senate advanced the health care legislation to a floor debate in an unusual late Saturday night session. This action may indeed provide an opportunity for the stakeholders in workers’ compensation to all join in the debate and look for solutions to the delivery of appropriate medical care in an efficient and timely fashion. To avoid “unintended consequences” yet again, injured workers and their advocates will need to be active participants and engage in the debate now.
.......
To read more about workers’ compensation and universal health care solutions click here.
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... |
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... |
Monday, November 25, 2013
Workers Compensation For Firefighters Discussed
 Representatives of the organization made their case in Frankfort on Thursday (Nov. 21) before House and Senate members of the Interim Joint Committee on Labor and Industry. They were joined by Doctor Virginia Weaver, a physician and professor of Occupational Medicine at Johns Hopkins University. She says the National Institute for Occupational Safety and Health is doing some important research on the hazards of firefighting. “They’re looking at firefighters from three major cities in the U.S., comparing risk for cancer in firefighters with the general U.S. public, and found an increased overall risk for all cancer, an increased individual risk focused in the digestive tract and the respiratory tract.” –Virginia Weaver The bill that’s being proposed in Kentucky would only apply to professional firefighters who’ve been on the job at least five years. It would also exclude those who smoke. |
Friday, November 22, 2013
New Scrutiny for Medical Devices
 Metal-on-metal replacement hips remain high-risk, but other devices are to be downgraded. Another medic performed CPR for a few minutes, and then used a medical device that delivered cardiac compressions mechanically for 64 minutes, until Mr. Schneider’s heart started beating normally on its own. “I’m not sure people would have been able to sustain manual CPR for so long,” said Mr. Schneider, 57. “I’m a lucky guy.” |
Saturday, July 30, 2011
National Analysis of Workers Compensation Medical Benefits
The just published, Issue 3 of the Workers’ Compensation Resources Research Report (WCRRR) provides 23 years of information on cash benefits, medical benefits, and total (cash plus medical) benefits per 100,000 workers for up to 47 jurisdictions each year. Workers’ compensation benefits per 100,000 workers varied significantly nationally over these years.
In the most recent six years, total benefits per 100,000 workers increased by less than one percent in two years and declined in the other four years. There also typically are wide differences among jurisdictions in the generosity of benefits in a particular year. In 2007, for example, total benefits per 100,000 workers were more than fifty percent about the national average in five states and more than fifty percent below the national average in one jurisdiction. Over the 23 years, the differences among states have narrowed for cash benefits, medical benefits, and total benefits, although the differences among states in medical benefits have increased since 1998.
The WCRRR is edited by John F. Burton, Jr. Additional information about Issue 3 and an order form are available at www.workerscompresources.com.
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Friday, November 22, 2013
Income Growth Has Stalled for Most Americans
Yesterday the Census Bureau released its latest income data, confirming what millions of Americans already know: The recession may be over, but the recovery has yet to trickle down. Specifically, the Census reported that median household incomes didn't budge between 2011 and 2012.
Digging deeper into the new data reveals more evidence of the widening income gap between the rich and the rest. The only bright side of stalled incomes is that they are no longer experiencing the steep decline that started in 2007 before the recession hit. But that's hardly cause for celebration: At $51,017, the real median household income in 2012 is even less than it was at the end of the '80s, and it's down 9 percent from its high in 1999.    |
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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.
Thursday, August 23, 2007
Drop in California Spending Lowers U.S. Workers' Compensation Benefits and Costs
August 22, 2007
WASHINGTON, DC—U.S. workers’ compensation payments for medical care and cash benefits for workers disabled by workplace injuries or diseases declined in 2005, according to a study released today by the National Academy of Social Insurance (NASI).
The drop in payments in 2005 (the most recent year with data) reflects large declines in California payments, as reforms enacted in 2003 and 2004 took effect. Nationally, workers’ compensation payments for injured workers fell by 1.4 percent to $55.3 billion in 2005. The payments include $26.2 billion to providers of medical care and $29.1 billion in cash wage replacement benefits for injured workers. California payments fell by 12.2 percent; a change made up of a 16.0 percent decline in medical payments and an 8.6 percent decline in cash payments. “The reduced spending for benefits and medical care reflects the initial stages of cost containment measures that were put in place in 2003 and 2004 reforms to the California system,” according to NASI member Christine Baker, who directs the California Commission on Health and Safety and Workers’ Compensation, a nonpartisan labor-management group that advises state policymakers.
Because it is a large state – accounting for nearly 20 percent of national benefit payments in 2005 –California altered national trends. Outside California, total workers’ compensation payments rose by 1.7 percent, an increase driven by a 4.1 percent increase in payments to medical providers. Cash payments to injured workers outside California showed a small decline (0.3 percent).
The costs to employers for workers’ compensation are what they pay each year. For employers who buy insurance, costs are premiums they pay to insurance companies plus benefits they pay under deductible arrangements in their insurance policies. For employers who insure their own workers, costs are the benefits they pay plus administrative costs. In 2005, employers paid a total of $88.8 billion nationwide for workers’ compensation. A sharp drop in California employers’ costs (of 9.8 percent) held down the national increase in employer costs to 2.3 percent. Outside California, employer costs for workers’ compensation rose by 6.5 percent.
The new report tracks trends since 1989 in workers’ compensation benefits and employer costs relative to total wages of workers covered by the program. Relative to wages, cash benefits in 2005 were the lowest in 17 years ($0.56 per $100 of wages). Nationally, total benefits (cash plus medical) and employer costs fell relative to wages in 2005. Cash and medical benefits combined were $1.06 per $100 of covered wages in 2005, a drop of $0.07 from 2004, while employer costs were $1.70 per $100 of wages in 2005, down $0.05 from 2004.
Outside California, benefits per $100 of wages fell by a smaller amount ($0.03) and employer costs per $100 of wages rose slightly (by $0.02). According to John F. Burton, Jr., chair of the panel that oversees the study, “The relative stability of benefits outside the Golden State reflects a rough balance between the declining frequency of workplace injuries and higher expenditures for medical benefits.”
The new report, Workers’ Compensation: Benefits, Coverage and Costs, 2005, is the tenth in a NASI series that provides the only comprehensive national data that covers all types of employers. The study provides estimates of workers’ compensation cash and medical payments for each state, the District of Colombia, and federal programs.
To download the full report, click here.
To download a PDF of this release, click here.
WASHINGTON, DC—U.S. workers’ compensation payments for medical care and cash benefits for workers disabled by workplace injuries or diseases declined in 2005, according to a study released today by the National Academy of Social Insurance (NASI).
The drop in payments in 2005 (the most recent year with data) reflects large declines in California payments, as reforms enacted in 2003 and 2004 took effect. Nationally, workers’ compensation payments for injured workers fell by 1.4 percent to $55.3 billion in 2005. The payments include $26.2 billion to providers of medical care and $29.1 billion in cash wage replacement benefits for injured workers. California payments fell by 12.2 percent; a change made up of a 16.0 percent decline in medical payments and an 8.6 percent decline in cash payments. “The reduced spending for benefits and medical care reflects the initial stages of cost containment measures that were put in place in 2003 and 2004 reforms to the California system,” according to NASI member Christine Baker, who directs the California Commission on Health and Safety and Workers’ Compensation, a nonpartisan labor-management group that advises state policymakers.
Because it is a large state – accounting for nearly 20 percent of national benefit payments in 2005 –California altered national trends. Outside California, total workers’ compensation payments rose by 1.7 percent, an increase driven by a 4.1 percent increase in payments to medical providers. Cash payments to injured workers outside California showed a small decline (0.3 percent).
The costs to employers for workers’ compensation are what they pay each year. For employers who buy insurance, costs are premiums they pay to insurance companies plus benefits they pay under deductible arrangements in their insurance policies. For employers who insure their own workers, costs are the benefits they pay plus administrative costs. In 2005, employers paid a total of $88.8 billion nationwide for workers’ compensation. A sharp drop in California employers’ costs (of 9.8 percent) held down the national increase in employer costs to 2.3 percent. Outside California, employer costs for workers’ compensation rose by 6.5 percent.
The new report tracks trends since 1989 in workers’ compensation benefits and employer costs relative to total wages of workers covered by the program. Relative to wages, cash benefits in 2005 were the lowest in 17 years ($0.56 per $100 of wages). Nationally, total benefits (cash plus medical) and employer costs fell relative to wages in 2005. Cash and medical benefits combined were $1.06 per $100 of covered wages in 2005, a drop of $0.07 from 2004, while employer costs were $1.70 per $100 of wages in 2005, down $0.05 from 2004.
Outside California, benefits per $100 of wages fell by a smaller amount ($0.03) and employer costs per $100 of wages rose slightly (by $0.02). According to John F. Burton, Jr., chair of the panel that oversees the study, “The relative stability of benefits outside the Golden State reflects a rough balance between the declining frequency of workplace injuries and higher expenditures for medical benefits.”
The new report, Workers’ Compensation: Benefits, Coverage and Costs, 2005, is the tenth in a NASI series that provides the only comprehensive national data that covers all types of employers. The study provides estimates of workers’ compensation cash and medical payments for each state, the District of Colombia, and federal programs.
To download the full report, click here.
To download a PDF of this release, click here.
Monday, November 25, 2013
California Workers' Compensation Rates Going Up in 2014
Despite the fact that recent legislation in California limited access to the Worker's Compensation system even further, and imposed medical treatment review procedures without the availability of an adversary system, worker's Compensation rates are increasing in 2014.
Insurance Commissioner Dave Jones today adopted an advisory average pure premium rate of 2.70 dollars per 100 dollars of employer payroll for workers compensation rates effective January 1, 2014.
The adopted amount is lower than that proposed by the Workers' Compensation Insurance RatingBureau of California's (WCIRB). The WCIRB's proposed advisory average rate was $2.75 per $100 of payroll.
The WCIRB's proposed advisory average pure premium rate is 8.7% ($2.75 per $100 of payroll) above the industry's average filed rates as of July 1, 2013 and the adopted pure premium rate ($2.70 per $100 of payroll) is 6.7% above the industry's average filed rates as of July 1, 2013.
Commissioner Jones, the WCIRB and the public members' actuary all agree that the overall impact of SB 863 (2012) continues to result in savings for the workers' compensation system.
The California Department of Insurance continues to observe that medical and indemnity losses are outpacing wage growth and consequently, the average advisory pure premium will increase in 2014.
Media Note:
- The commissioner's pure premium decision is advisory only. Pursuant to California law, the commissioner does not set or have authority over workers' compensation insurance rates. The commissioner's advisory pure premium rate is not predictive of what an individual insurance company may charge its policyholders because the review of pure premium rates is just one component of insurance pricing.
- Workers' Compensation Insurance Rating Bureau of California
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... |
Thursday, June 14, 2012
National Experts Call Workers Compensation System Irrational and Unjust
National workers' compensation experts, Law school Dean Emily A. Spieler and Professor John F. Burton, in a recently published article in the American Journal of Industrial Medicine conclude that the present that the present workers' compensation systems is "irrational" and "unjust."
Characterizing the program as "....dizzying and frustrating in its complexity, and apparent irrationality," they conclude that "a substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits." They review such alternatives as universal medical care, "providing healthcare to workers regardless of the source of injuries or disease."
Related Articles on Alternative Compensation Programs
Dec 23, 2010
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally ...
Feb 15, 2011
In December 2010 US Congress passed and President Obama signed, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program.
Jul 05, 2010
The trend toward Federalization of workers' compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and ...
Jul 13, 2010
As The Path To Federalization expands, this debate will expand. A recent study by the Center for American Progress addresses these concerns. "Health threats from the oil spill may linger unseen, perhaps for more than a ...
Mar 16, 2011
Historically The Federal government's role has been to rise to the occasion and walk further down a path to federalization. On a smaller scale than the potential consequences of the Japanesse debacle, the US was first in line ...
Mar 05, 2011
Nationally, advocates to improve the delivery of medical benefits to injured workers have urged federalization of the medical delivery system into a single payer approach through universal health care. ... Compensation Claim Draws Major Public Attention (workers-compensation.blogspot.com); Vermont Governor Sets Out to Lead U.S. to True Universal Coverage (huffingtonpost.com); The World Trade Center Health Program Expands The Path to Federalization ...
Friday, May 2, 2008
Diagnosing and Curing the Ailing NJ Workers' Compensation System
On the eve the NJ Senate's investigation into New Jersey's workers' compensation system, the question lingers on how to evaluate its health. New Jersey has always had a very large and very dedicated workforce A recent newspaper series by Star-Ledger reporters Dunstan McNichol and John P. Martin revealed that the system is serious flawed and that it is in need of a “complete overhaul.”
The State has a history of being a heavily industrialized state with a huge legacy of pollution from asbestos to petrochemical. Dr. Irving J. Selikoff, of Paterson, NJ, began his landmark studies on asbestos workers in New Jersey. In 1911, almost a century ago, NJ adopted an administrative system known as workers' compensation and it was the intent of the Legislature to provide a speedy and cost effective system of delivering statutorily defined benefits to injured workers while passing the costs onto the consumers of products and services.
This will be the first major evaluation of the workers’ compensation system in 30 years. The last one resulted in a fraud report from the NJ State Commission of Investigation and subsequent statutory change.
Much has changed from the past. In 1911 modern medicine was unknown and so were the diseases that it now treats. The program’s benefits were meager and the conditions eligible for compensation were few and far between. More Americans have died from occupational disease in the United States of America in the past 40 years than in all wars dating back to 1776. Hearings on S.79 before the Subcomm. of Labor and Human Resources of the Senate Comm. on Labor and Human Resources, 100th Cong. 1st Session, S.Hrg. 100-56, pt. 1, at page 1 (1987). Collateral benefit programs did not exist: major medical insurance, long term disability, social security and pension programs.
We are experiencing a struggling economy today. Former Labor Secretary Robert Reich stated, “Fifty years ago, when over a third of the American workforce was unionized and most big industries were oligopolies, it was fairly easy for unionized workers to get higher wages and benefits without putting any individual company at a competitive disadvantage. The higher wages and benefits were merely passed on to consumers in the form of higher prices or came out of profits that would otherwise go to investors. Today, though, most companies are in fierce competition because new technologies combined with globalization have destroyed the old oligopolies and allowed many new entrants.”
Today the workers’ compensation process is confronted with the complexity of the causal relationship of new diseases to synergistic occupational exposures to complex substances as well as traumatic events. Multiple bureaucratic benefits programs that are not formally connected burden the system with claims and liens. Revenue is limited by fewer manufacturing facilities and it is more costly to provide medical treatment and pharmaceutical protocols that result in miraculous recoveries as well as serious and fatal unfortunate results. Benefits must be paid out longer since the average person has a greater life expectancy, ie 1911 – 50 yrs of age and 2007 – 78 years of age.
As in medicine, one must look at both subjective complaints and objective findings to guide its evaluation of the workers’ compensation system. One can hear the cry’s of injured workers “Waiting in Pain,” and of the injured workers and the families of those who did not survive the compensation system. Stories of frustration and outrage are reported in the press. Testimony to the NJ Senate will come from the stakeholders who have economic interests in the system and those who are organized representatives of those who are unable to speak any longer. Those voices must be heard and evaluated. It is important to heed to words and wisdom of all and evaluate them in the context of self-motivation.
The compensation system has been portrayed as, “a dead elephant in the room,” and one that fails to carry out the legislative intent of 1911. Professor Emeritus, John F. Burton, Jr., of Rutgers University of the School of Management and Labor Relations, describes the NJ system as, "It's kind of a sleepy system…” that is “…not particularly worker-friendly."
Unlike The Constitution, the workers' compensation act deals not in the theoretical and vague general concepts of Democracy. The compensation act is a document, which within its four comers, speaks with certainty, specifics and details.
The program has failed because under the present system the Legislative intent cannot be carried out. One cannot drive a 1911 model car on the NJ Turnpike today. Workers' Compensation should be viewed in that context, and not as a cash cow for any interest parties.
The Act can no longer provide medical treatment in an efficient and effective manner consistent with the legislative intent to provide social remedial benefits through a liberal and summary social insurance program. Medical coverage has become acute in NJ and in other jurisdictions. Almost a majority of workers will soon be uninsured for major medical coverage. NJ should take the initiative, as other states have, to provide for universal health care. NJ should combine workers' compensation medical coverage with a universal employer based medical care program and have a single payer system. A single payer system will be cost effective, efficient and provide more appropriate delivery of medical care.
The workers' compensation system began in 1911 with the noble mission as a social remedial system providing an efficient and certain system of benefits to injured workers. Today, the system struggles to protect employees as the rapidly evolving landscape is demanding increased attention to reconsideration of an IHC system in light of the consequences of the program's costs and the consequences of being uninsured for healthcare benefits. The participants in the current program, including employees and employers , will require a more balanced and certain medical delivery system. The lack of healthcare coverage takes an enormous toll on the uninsured, which results in avoidable deaths each year, poorly managed chronic conditions, undetected or under treated cancer and untried life-saving medical procedures. An Integrated Health Care plan is a potential national shift to reduce costs so that a healthcare safety net can be maintained for workers and their families.
“Full-time healthcare would save money. Instead of paying for two insurance plans – one to cover healthcare for injuries and illnesses on the job and another for injuries and illness off the job – businesses would buy one plan. As Roger Thompson, former director of Travelers Insurance Workers’ Compensation Strategic Business Unit put it, the present system is ‘like having two trains going down separate tracks and it doesn’t make a lot of sense to have all the administrative costs to maintain these separate systems.’” R. McGarrah, “Full-time Healthcare for America’s Working Families [Draft],” AFL-CIO (August 22, 2003).
In the short run, adopting such concepts, proposed by Senator Stephen M. Sweeney and Assemblyman Neil M. Cohen, would be fine initial steps:
The State has a history of being a heavily industrialized state with a huge legacy of pollution from asbestos to petrochemical. Dr. Irving J. Selikoff, of Paterson, NJ, began his landmark studies on asbestos workers in New Jersey. In 1911, almost a century ago, NJ adopted an administrative system known as workers' compensation and it was the intent of the Legislature to provide a speedy and cost effective system of delivering statutorily defined benefits to injured workers while passing the costs onto the consumers of products and services.
This will be the first major evaluation of the workers’ compensation system in 30 years. The last one resulted in a fraud report from the NJ State Commission of Investigation and subsequent statutory change.
Much has changed from the past. In 1911 modern medicine was unknown and so were the diseases that it now treats. The program’s benefits were meager and the conditions eligible for compensation were few and far between. More Americans have died from occupational disease in the United States of America in the past 40 years than in all wars dating back to 1776. Hearings on S.79 before the Subcomm. of Labor and Human Resources of the Senate Comm. on Labor and Human Resources, 100th Cong. 1st Session, S.Hrg. 100-56, pt. 1, at page 1 (1987). Collateral benefit programs did not exist: major medical insurance, long term disability, social security and pension programs.
We are experiencing a struggling economy today. Former Labor Secretary Robert Reich stated, “Fifty years ago, when over a third of the American workforce was unionized and most big industries were oligopolies, it was fairly easy for unionized workers to get higher wages and benefits without putting any individual company at a competitive disadvantage. The higher wages and benefits were merely passed on to consumers in the form of higher prices or came out of profits that would otherwise go to investors. Today, though, most companies are in fierce competition because new technologies combined with globalization have destroyed the old oligopolies and allowed many new entrants.”
Today the workers’ compensation process is confronted with the complexity of the causal relationship of new diseases to synergistic occupational exposures to complex substances as well as traumatic events. Multiple bureaucratic benefits programs that are not formally connected burden the system with claims and liens. Revenue is limited by fewer manufacturing facilities and it is more costly to provide medical treatment and pharmaceutical protocols that result in miraculous recoveries as well as serious and fatal unfortunate results. Benefits must be paid out longer since the average person has a greater life expectancy, ie 1911 – 50 yrs of age and 2007 – 78 years of age.
As in medicine, one must look at both subjective complaints and objective findings to guide its evaluation of the workers’ compensation system. One can hear the cry’s of injured workers “Waiting in Pain,” and of the injured workers and the families of those who did not survive the compensation system. Stories of frustration and outrage are reported in the press. Testimony to the NJ Senate will come from the stakeholders who have economic interests in the system and those who are organized representatives of those who are unable to speak any longer. Those voices must be heard and evaluated. It is important to heed to words and wisdom of all and evaluate them in the context of self-motivation.
The compensation system has been portrayed as, “a dead elephant in the room,” and one that fails to carry out the legislative intent of 1911. Professor Emeritus, John F. Burton, Jr., of Rutgers University of the School of Management and Labor Relations, describes the NJ system as, "It's kind of a sleepy system…” that is “…not particularly worker-friendly."
Unlike The Constitution, the workers' compensation act deals not in the theoretical and vague general concepts of Democracy. The compensation act is a document, which within its four comers, speaks with certainty, specifics and details.
The program has failed because under the present system the Legislative intent cannot be carried out. One cannot drive a 1911 model car on the NJ Turnpike today. Workers' Compensation should be viewed in that context, and not as a cash cow for any interest parties.
The Act can no longer provide medical treatment in an efficient and effective manner consistent with the legislative intent to provide social remedial benefits through a liberal and summary social insurance program. Medical coverage has become acute in NJ and in other jurisdictions. Almost a majority of workers will soon be uninsured for major medical coverage. NJ should take the initiative, as other states have, to provide for universal health care. NJ should combine workers' compensation medical coverage with a universal employer based medical care program and have a single payer system. A single payer system will be cost effective, efficient and provide more appropriate delivery of medical care.
The workers' compensation system began in 1911 with the noble mission as a social remedial system providing an efficient and certain system of benefits to injured workers. Today, the system struggles to protect employees as the rapidly evolving landscape is demanding increased attention to reconsideration of an IHC system in light of the consequences of the program's costs and the consequences of being uninsured for healthcare benefits. The participants in the current program, including employees and employers , will require a more balanced and certain medical delivery system. The lack of healthcare coverage takes an enormous toll on the uninsured, which results in avoidable deaths each year, poorly managed chronic conditions, undetected or under treated cancer and untried life-saving medical procedures. An Integrated Health Care plan is a potential national shift to reduce costs so that a healthcare safety net can be maintained for workers and their families.
“Full-time healthcare would save money. Instead of paying for two insurance plans – one to cover healthcare for injuries and illnesses on the job and another for injuries and illness off the job – businesses would buy one plan. As Roger Thompson, former director of Travelers Insurance Workers’ Compensation Strategic Business Unit put it, the present system is ‘like having two trains going down separate tracks and it doesn’t make a lot of sense to have all the administrative costs to maintain these separate systems.’” R. McGarrah, “Full-time Healthcare for America’s Working Families [Draft],” AFL-CIO (August 22, 2003).
In the short run, adopting such concepts, proposed by Senator Stephen M. Sweeney and Assemblyman Neil M. Cohen, would be fine initial steps:
- prohibiting the future raiding of revenue on designated workers' compensation funds (CSR-60) should be enacted;
- swifter scheduling and use of continuous trials;
- greater permanent, temporary rate and dependency [A-2499], benefits;
- rate increases [A-2498] should be enacted;
- a review of judicial appointments as recommenced in the 1974 by the State Commission of Investigation report;
- an enhanced in-service judicial training curriculum;
- exclusive jurisdiction of the Division of Workers compensation over medical fee disputes [A-2501];
- a less burdensome Uninsured Employer Fund system to shift the responsibility to the State to locate and serve responsible parties and in the alternative to carryout the mandate of the Legislature to make payment to uninsured workers and asbestos victims expeditiously and even more swiftly in exigent cases;
- an independent oversight commission [A-2503] should continuously evaluate the status and progress of this system that handles trust funds and benefits valued at over $1.8 Billion dollars per year; and
- Data Match with the Centers for Medicare and Medicaid Services to comply quickly with the Medicare Secondary Payer Act which was enacted decades ago.
By evaluating the health of the compensation system thorough an intensive analysis of both the objective findings and subjective complaints, the NJ Senate will have the opportunity to enact modern, creative and innovative solutions that will be able meet the present needs of the workers, the employers and taxpayers of State. The NJ Legislature has the opportunity to craft an up-to-date system that will cure the ailing and antiquated workers’ compensation system and embrace today’s needs and tomorrow’s future and bring the State into a new century.
Thursday, January 15, 2015
Some 4.4 Million People Are About to Get a Raise
U.S. economy Photographer: Andrew Burton/Getty Images Protesters demanding higher wages and unionization for fast food workers block traffic near Times Square on Sept. 4, 2014 in New York City. In his 2014 state of the union address, President Obama kicked off what could unofficially be dubbed the Year of the Minimum Wage. Just a year earlier, he had called for a $9 federal minimum, but there he was in early 2014, saying workers should earn at least $10.10 an hour. The shift shows how coordinated campaigns for higher wages, which started with fast-food workers and spread more broadly, raised expectations of what’s considered fair compensation. Obama’s call to raise the federal minimum may have gone unanswered, but states and cities picked up the torch. In 2014, 13 states passed legislation or initiatives to raise the wage floor, not just in Democratic strongholds but in red states as well. Now the results of those campaigns are starting to come to fruition nationwide. About 4.4 million people will see their pay go up for the new year, according to an analysis of census data by the Economic Policy Institute (EPI), which supports higher minimum pay. EPI’s data show that more than 750,000 workers earn the minimum wage in the 13 states that passed new raises in 2014. About two-thirds of those workers will see their wages go up on Jan. 1, and the rest will see their pay increase later in 2015. EPI estimates that in those 13... |
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