Oil Spill Workers Hazards May Cause Health Hazards The National Institute of Medicine held a hearing yesterday, continuing today, in New Orleans.

Heat, exposure to chemicals and changes caused by the disaster, yield a recipe for serious medical conditions, so reported a group of presenters at the National Institutes of Medicine conference in New Orleans. Those conditions include lung, kidney and liver function.

June 22, 2010

8:00 a.m. Registration
8:30 a.m. Welcome Harvey V. Fineberg, President, IOM
8:40 a.m. Charge to the IOM
Nicole Lurie, Assistant Secretary for Preparedness and Response, Department of Health and Human Services
8:50 a.m. Introductory Remarks
Planning Committee Chair: Nancy E. Adler, University of California, San Francisco
9:00 a.m. The Compelling Need to Understand the Effects of Oil Spills on Human Health

• Bernard D. Goldstein, University of Pittsburgh
• Blanca Laffon, University A Coruna
• Edward B. Overton, Louisiana State University

9:45 a.m. The Response of the Federal Government to Health ConcernsJohn Howard, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
SESSION I. AT-RISK POPULATIONS AND ROUTES OF EXPOSURE

10:00 a.m. Panel Discussion. Taking Stock: Who Is at Risk and How Are They Exposed?
Moderator: Linda Rosenstock, University of California, Los Angeles

• Routes of Exposure and At-Risk Populations - Paul J. Lioy, Rutgers University
• Residents of Affected Regions: General and Special Populations - Maureen Y. Lichtveld, Tulane University
• Occupational Risks and Health Hazards: Workers and Volunteers - Scott Barnhart, University of Washington

SESSION II. SHORT- AND LONG-TERM EFFECTS ON HUMAN HEALTH

11:10 a.m. Panel Discussion. The Here and Now: What are the Short-term Effects on Human Health?
Moderator: Linda A. McCauley, Emory University

• Short-term Physical Effects - Nalini Sathiakumar, University of Alabama at Birmingham
• Short-term Psychological Stress - Howard Osofsky, Louisiana State University 
• Heat Stress and Fatigue - Thomas E. Bernard, University of South Florida

12:20 p.m. LUNCH (on your own)

1:30 p.m. Panel Discussion. The Need to Know: What Are the Potential Delayed and Long-term Effects on Human Health?
Moderator: Kenneth Olden, Hunter College of the City University of New York

• Neurological, Cancer, and Other Chronic Conditions - Peter Spencer, Oregon Health & Science University
• Human Reproduction - Brenda Eskenazi, University of California at Berkeley
• Impact on Health and Vulnerabilities of Children - Irwin Redlener, National Commission on Children and Disasters
• Stress - Sheldon Cohen, Carnegie Mellon University
• Lessons Learned from Previous Oil Spills - Lawrence A. Palinkas, University of Southern California

SESSION III. STRATEGIES FOR COMMUNICATING RISK
3:00 p.m. Engaging the Public, Protecting Health
Presenter: David Abramson, Columbia University
3:20 p.m. Dialogue with Workshop Participants
Moderator: Mike Magee, Healthy-Waters.org

• Brief Invited Remarks - Community Perspectives:
  - Myra Lewis
  - Diem Nyugen- Wilma Subra
  - John Hosey (invited) 
• Open Dialogue with Audience

4:20 p.m. Day 1 Closing Remarks
Nancy E. Adler, University of California, San Francisco
4:30 p.m. ADJOURN

June 23, 2010

8:30 a.m. Registration
9:00 a.m. Recap of Day 1 Discussions and Overview of Day 2Nancy E. Adler, University of California, San Francisco
9:10 a.m. Remarks from the Surgeon General of the United States Public Health ServiceVice Admiral Regina M. Benjamin
SESSION IV. OVERVIEW OF HEALTH MONITORING ACTIVITIES
9:20 a.m. Panel Discussion. How are State Governments Currently Monitoring the Effects of the Gulf of Mexico Oil Spill on Human Health?
Moderator:  LuAnn E. White, Tulane University

• Jimmy Guidry, Louisiana State Health Officer
• Mary Currier, Mississippi State Health Officer
• Ana M. Viamonte Ros, Florida State Surgeon General
• Donald E. Williamson, Alabama State Health Officer
• Bruce Clements, Director of the Community Preparedness Section, Texas Department of State Health  Services

SESSION V. RESEARCH METHODOLOGIES AND DATA SOURCES
10:30 a.m. Panel Discussion. Critical Thinking: What Research Methodologies and Data Sources Could Be Used in Surveillance and Monitoring Activities?
Moderator: John C. Bailar III, University of Chicago

• Overview of Research Methodologies and Data Collection - Lynn R. Goldman, Johns Hopkins Bloomberg School of Public Health
• Surveillance and Monitoring - Thomas D. Matte, Hunter College, City University of New York
• Environmental Assessment, Risk, & Health - William H. Farland, Colorado State University
• Mental Health - Howard Osofsky, Louisiana State University
• Biomedical Informatics and Registries - Daniel R. Masys, Vanderbilt University School of Medicine

12:20 p.m. LUNCH (on your own)
SESSION VI. FUTURE DIRECTIONS AND RESOURCE NEEDS
1:30 p.m. Panel Discussion. Looking Ahead: How Do We Develop Effective Surveillance and Monitoring Systems?
Moderator: David A. Savitz, Mount Sinai School of Medicine

• Nancy E. Adler, University of California, San Francisco
• John C. Bailar III, University of Chicago
• Lynn R. Goldman, Johns Hopkins Bloomberg School of Public Health
• Maureen Y. Lichtveld, Tulane University
• Linda A. McCauley, Emory University
• Kenneth Olden, Hunter College of the City University of New York
• Linda Rosenstock, University of California, Los Angeles

3:20 p.m. Closing RemarksNancy E. Adler, University of California, San Francisco
3:30 p.m. ADJOURN

California Workers' Compensation $25 Million Medical Fraud: US Attorney Charges Providers

San Diego Nov 10 2015: Eight medical professionals and associates are charged in federal grand jury indictments with buying and selling patients in a bribery scheme involving $25 million in improper claims for medical services and devices which were then billed to California Workers’ Compensation insurance companies.

FBI agents along with investigators from the California Department of Insurance and the San Diego County District Attorney’s Office served five search warrants and three seizure warrants today at locations in San Diego, Chula Vista, National City, Murietta and Los Angeles. Authorities arrested five people, including a radiologist, a chiropractor, a medical equipment provider, a medical clinic administrator and a so-called medical marketer. An attorney and a medical service provider were summoned to appear in federal court on Thursday.  One indicted defendant, Gonzalo Paredes, remains a fugitive and a warrant has been issued for his arrest.

These defendants, plus six corporations, are charged in three federal grand jury indictments unsealed today with conspiracy and honest services mail fraud. The indictments allege that these players either paid or received tens of thousands of dollars to buy or sell hundreds of patients, without the patients’ knowledge - therefore depriving those patients of their right to their doctors’ honest services.

“Today’s indictments are only the first wave of charges in what we believe is rampant corruption on the part of some physicians and chiropractors in their dealings with the health care system in general, and California’s Workers’ Compensation System in particular,” said U.S. Attorney Laura Duffy. “A patient puts his trust, and his very life, into the hands of his physician. A doctor’s decisions should never, under any circumstances, be influenced by anything other than the patient’s best interest.”

“Today's indictments show how the defendants in this case allowed greed and corruption to influence their patient care decisions and treated their patients as a commodity to be bought and sold,” said FBI Special Agent in Charge Eric S. Birnbaum. “The FBI will continue to use our intelligence and investigative expertise to identify, disrupt and dismantle sophisticated criminal conspiracies that unlawfully enrich individuals at the expense of patient care. The FBI and our law enforcement partners are committed to rooting out corruption in our health care system.”

“This criminal network bought and sold patients like cattle,” said District Attorney Bonnie Dumanis. “They cashed in on people who trusted them with their health and they conspired to illegally game the system on a level that we’ve not seen before. But, the game is over.”

“Our detectives from the California Department of Insurance worked closely with the FBI, United States Attorney's Office and San Diego District Attorney's office to investigate and arrest these medical providers for insurance fraud, which adds crippling costs to California's workers compensation system,” said Department of Insurance Commissioner Dave Jones. “These are not victimless crimes. When medical providers defraud insurers, those costs are passed on to California businesses and consumers, who already are struggling to make ends meet.”

This is how the schemes worked:

Patients who said they were injured on the job filed a workers’ compensation claim with the state of California and sought treatment for their injury. In this round of indictments, the workers sought help from a chiropractor.

The chiropractors were the gateway to a wide-array of health care fraud. In these cases alone they prescribed medical equipment, referred the patients for MRIs and X-Rays, and ordered specialized treatments such as Shockwave therapy.

As alleged in one of the indictments, Los Angeles radiologist Ronald Grusd paid bribes to a San Diego chiropractor in exchange for patient referrals. The bribes were funneled to the chiropractor via Grusd’s corporation, Willows Consulting, a shell company. The checks were labeled “professional services,” but this was a sham.

In order to further hide the illegal kickbacks, checks were issued to intermediaries - defendants Alexander Martinez and his father, Ruben - through their front companies, “Line of Sight” and “Desert Blue Moon.” The Martinezes took their “cut” and then, in turn, paid off the chiropractor.
Grusd’s practice, California Imaging Network Medical Group, has clinics in San Diego, Los Angeles, Beverly Hills, Fresno, Rialto, Santa Ana, Studio City, Bakersfield, Calexico, East Los Angeles, Lancaster, Victorville and Visalia.

In another indictment, a second San Diego chiropractor, Dr. George Reese, with offices on El Cajon Boulevard, referred patients to a Los Angeles area medical service provider (controlled by attorney Lee Mathis and Fernando Valdes, president of Foremost Shockwave Solutions ) in return for bribes. The bribes were set by the conspirators at $100 per patient and paid through an intermediary. After taking a cut amounting to $25 per patient, the intermediary would pay the remaining $75 per patient to Reese.

Although disguised as “office rent” payments, the illegal bribes were paid in cash during clandestine exchanges in restaurants and parking lots. For example, $6,000 in cash was delivered to Reese in the parking lot of the Jolly Roger in Oceanside, hidden in a gift bag. Other times, it was passed in envelopes or stashed inside newspapers.

According to the indictment, Reese and his codefendants generated and submitted bills to insurers totaling in the tens of millions of dollars. Most of these treatments involved the providing of “Shockwave therapy,” which uses low energy sound waves to initiate tissue repair. Proceeds from the insurance claims generated through this scheme were paid to Mathis and Valdes.

In the final indictment, a San Diego chiropractor referred patients to a licensed provider of durable medical equipment, Julian Garcia. In return Garcia paid the chiropractor $50 for each patient – in cash, to disguise the kickbacks. Garcia then improperly billed Workers Comp insurers millions for hot and cold packs for patients who had been secured by bribes.

Workers Compensation Pharmaceuticals Targeted For Reform

Ritalin (Photo credit: Wikipedia)

An insurance based research organization, the Workers Compensation Research Institute (WCRI), has published a report concerning newly adopted State regulations limiting the prices paid for doctor-dispensed drugs (repackaging) and comparison costs between prescription medication and similar, less costly, over-the-counter (OTC) drug costs. WCRI also reports on the costs between brand-name drugs and generic prescriptions.

The study examines the results of a change to the California statute that has become a model for many other states. Critics of the regulations express concern that many patients will not get needed medications if they do not get them at the physicians’ offices.

The study, Physician Dispensing in Workers’ Compensation, examines physician dispensing before and after a 2007 change in the California statute that governed the prices paid to physician-dispensers. Prior to the statutory change, physicians typically charged much higher prices than pharmacies for the same medication. For example, for the most common drug, Vicodin®, physicians were paid $0.85 per pill compared to $0.43 for pharmacies—nearly double the price. After the reforms, physicians were paid $0.52 per pill compared to $0.48 for pharmacies. After the law changed, physicians were paid prices for prescription medications that were similar to those paid to pharmacies for the same medication.

This study finds that:

· physician-dispensed drugs became increasingly common in most states that permit physician dispensing;

· prices paid for physician-dispensed drugs were often substantially higher than if the same drugs were dispensed by a retail pharmacy;

· prices paid to dispensing physicians rose rapidly for medications that were commonly dispensed by physicians, while the prices paid to pharmacies for the same drugs changed little or fell.

One of the chief concerns expressed by supporters of physician dispensing (in California and in other states) was that doctors would stop dispensing needed prescriptions when it became less profitable. However, the California post-reform experience shows that physicians continued to dispense prescriptions, even when the prices paid were lower. Before the reforms, 55 percent of all prescriptions were dispensed at physician offices. Three years after the reforms, 53 percent of all prescriptions in California were physician-dispensed so patients had similar access to physician dispensed medications, but at a much lower cost.

Robert Ceniceros, a reporter for Business Insurance, reported, "...But critics contend such price regulations may discourage doctors from dispensing drugs and discourage patients from getting the prescription drugs they need."

The report also examines several other concerns expressed by supporters of physician dispensing. One is that spending on prescription drugs might increase if a California-type reform were adopted. They argue that physicians almost always dispense less expensive generic versions of drugs, while pharmacies dispense both brand names and generics. The study found that for the specific medications commonly dispensed by physicians, generics were almost always dispensed by both physicians and pharmacies. In many states, when generic drugs were dispensed, physician-dispensers were paid much higher prices per pill than pharmacies for the same prescription.

The data used for this study include nearly 5.7 million prescriptions paid under workers’ compensation for approximately 758,000 claims from 23 states over a period from 2007/2008 to 2010/2011. The 23 states in this study represent over two-thirds of the workers’ compensation benefits paid in the United States. These states include Arkansas, Arizona, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. Several of the states in this study (Arizona, California, Georgia, South Carolina, and Tennessee) recently adopted reforms aimed at reducing the prices of physician-dispensed drugs.

The WCRI is selling the report in electronic format for $45.00.

Related Blogs on drugs and workers' compensation

The High Price of Drugs: Upscale Pricing By Doctors

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Prescription drugs have become an increasingly important issue in workers' compensation law. Their use in workers' compensation claims has resulted in both a major direct financial cost to the system, and has had .

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Workers' Compensation: Federal Pre-emption Of Pain Drugs

Jun 20, 2012

As state workers' compensation reformers continue to be sidetracked with alleged prescription drug pain-killer abuse, the US Congress has entered the fray with proposed Federal legislation. It has been reported today by ...

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Workers' Compensation: Sidetracked By Drugs

May 04, 2012

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Workers' Compensation: Drugs, Alcohol and Mauling Bears

Mar 30, 2011

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The Top 10 Drugs Prescribed For Workers Compensation Claims

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The Top 10 Drugs Prescribed For Workers Compensation Claims. A recent study by NCCI Holdings, Inc. reports the top 10 most popular drugs prescribed for workers' compensation claims. OXYCONTIN®; LIDODERM ...

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Dec 05, 2011

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Citing Violations Medicare Ends Contract with Fox Insurance

Mar 09, 2010

After an onsite review of the plan and its services, CMS determined that the plan's significant deficiencies – not meeting Medicare's requirements to provide enrollees with prescription drugs according to recognized standards ...

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Workers' Compensation: Health Benefits, US Supreme Court and ...

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Nurses to Jerry Brown: California isn’t ready for Ebola

Today's post was shared by CAAA and comes from www.sacbee.com

The state’s largest nurses union said Tuesday that no California hospital is prepared to treat an Ebola patient, pressing Gov. Jerry Brown to require increased training and protective equipment for nurses. The union’s call – and a rebuttal from the California Hospital Association – came as Brown met privately with nurses, public health officials and medical providers to discuss Ebola. Though there are no known cases of Ebola in California, the virus has gripped public attention since an outbreak in West Africa and the infection of two nurses treating an Ebola patient who died in Texas earlier this month. The Brown administration issued no mandates but said in a prepared statement that “officials are taking steps to help ensure health care workers, hospitals and first responders are prepared to treat and care for patients with Ebola.” RoseAnn DeMoro, executive director of the California Nurses Association and National Nurses United, said California hospitals have failed to provide adequate training or equipment to nurses, a claim hospitals disputed. “None of the hospitals in California are prepared,” DeMoro said after meeting with Brown. “We cannot name a hospital that we feel comfortable with, for patients in the state of California to attempt to have the appropriate response in an Ebola situation.” Speaking at a news conference outside Brown’s offices at the Capitol, DeMoro said, “The deficiencies in the...

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Turmoil Over Immigration Status? California Has Lived It for Decades

Today's post is shared from the nytimes.com
LOS ANGELES — There may be no better place than California to measure the contradictions, crosswinds and confusion that come with trying to change immigration law.
For 30 years, California has been the epicenter of the churn of immigration — legal and not — in the nation. It was California where Pete Wilson, the Republican governor, championed in 1994 a voter initiative known as Proposition 187, which severely restricted services to immigrants here illegally. And it was California where just last year, Gov. Jerry Brown, a Democrat, held a celebratory, dignitary-filled signing of legislation permitting unauthorized workers to obtain driver’s licenses.One-third of the immigrants in the country illegally live in California, which has a 125-mile border with Mexico, much of it guarded by long stretches of border fence. They work on farms in the Central Valley, in manufacturing jobs in Los Angeles, and as housekeepers and gardeners in Silicon Valley, alongside a steady stream of young legal immigrants who hold low-paying, high-skilled jobs in Northern California’s critical tech industry.
Yhey come mostly from Mexico but also from Central America, the Philippines, South Korea and Japan. Commercial boulevards in the heart of Los Angeles are a riot of Korean-language signs, and in many neighborhoods in San Francisco the talk on the street is as likely to be in Spanish or Chinese as it is English.
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California Medical Review: STEVENS WRIT GRANTED

Containment of medical costs remain a major issue in all workers' compensation programs. The California process of "independent medical review" has turned into a nightmare for injured workers, their families and their advocates. The long awaited constitutional challenge to the process is slowly making its way through the California judicial system. Time will tell whether the judicial resolution will emerge as a solution to what was just terrible legislation. Today's post is authored by Julius Young and is shared from workerscompzone.com/ Could the California courts finally be ready to rule on the constitutionality of Independent Medical Review? We may be on the verge of seeing that issue decided. On December 3, 2014, the California Court of Appeal First Appellate District Division One granted the petition for writ of review filed San Francisco attorney Joseph Waxman on behalf of Frances Stevens (the case is Frances Stevens, Petitioner, v. WCAB and Outspoken Enterprises/State Compensation Insurance Fund ADJ1526353). In June 2014 the Court of Appeal had summarily denied a petition for a writ filed by Waxman in April 2014. At that time Waxman had not exhausted his administrative remedies. Waxman did so and then refiled for the writ, which was then granted. The basis facts in the case are important. Stevens had been found permanently and totally disabled (100%) by the workers’ comp judge. Her condition required use of a wheelchair and defendant had provided assistance by a home health aide....

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California Medical Fraud Investigation Continues

"Follow the money." The investigation of fraud in the California Workers' Compensation system continues. Today's post of Julius Young of the California Bar

is shared from workerscompzone.com

You might have thought that news of bad behavior in California’s workers’ comp system was hitting bottom.

After all, could it get worse? Allegations of legislators taking money to help charlatans who profited off of the backs of injured workers (literally). Scads of doctors alleged to have taken kickbacks for prescribing questionable compound medicines one of which allegedly killed a baby.

It appears that law enforcement authorities are now focusing on relationships between some applicant attorney firms and medical groups.

In Southern California the Riverside County DA has executed a search warrant against a workers’ comp firm, California Injury Lawyers (CIL). Apparently this is a result of a long investigation into suspected workers’ comp fraud, targeting operations allegedly connected to an individual named Peyman Heidary who is said to have a financial interest in as many as nine medical clinics in the Los Angeles area.

The details of the alleged bad behavior or fraud is unclear, and it must be noted that any allegations are currently just that, allegations.

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Construction Injuries and Fatalities Cost California’s Economy $2.9 Billion Between 2008 and 2010

California Would Save Money by Using Its Buying Power to Reward Companies With Strong Safety Records

Occupational injuries and fatalities in the construction industry cost California residents $2.9 billion between 2008 and 2010, a new Public Citizen report shows.

The report, “The Price of Inaction: A Comprehensive Look at the Costs of Injuries and Fatalities in California’s Construction Industry,” quantifies the estimated costs of deaths and injuries in the state’s construction industry by considering an array of factors.

From 2008 to 2010, 168 construction workers were killed in workplace accidents in California. Additionally, the state recorded 50,700 construction-industry injuries and illnesses that required days away from work or a job transfer.

Drawing on a comprehensive 2004 journal article that analyzed the cost of occupational injuries, and combining the paper’s findings with updated fatality and injury data, Public Citizen determined that such incidents cost the state’s economy $2.9 billion during the three-year period.

“The economic picture is quite staggering,” said Keith Wrightson, worker safety and health advocate for Public Citizen’s Congress Watch division. “We now know that construction accidents impose huge economic costs in addition to tremendous pain for individual victims.”

As a partial solution, the report proposes that California pass a law requiring companies to demonstrate adherence to safety standards in order to be eligible to bid for state contracts. Such a solution not only would ensure that public-sector projects are fulfilled by responsible contractors but also would provide incentives for companies to maintain clean records while working on private-sector sites.

The report notes that California already screens construction companies to ensure that they have met performance standards in the past and haven’t violated any laws. The state also incorporates some safety standards in its prequalification system. But the system should be expanded to require construction firms to put greater emphasis on demonstrating that they provide safety training to workers and site supervisors, and that they have not had serious safety violations.

“Implementing a stricter prequalification process for public construction projects would not address all of the industry’s safety problems,” Wrightson said. “However, such a step would help further protect workers while also yielding significant gains to the economy for minimal costs.”

The report can be viewed at http://www.citizen.org/price-of-inaction-california-construction-safety-report.

Read more about "occupational" conditions and workers' compensation

Physician Stress - An Occupational Hazard for Oncologists

Nov 26, 2012

Physician Stress - An Occupational Hazard for Oncologists. Physicians who treat terminally ill patients are reporting occupational stress. A recent article on the NY Times blog describes the problem of oncologists who treat ...

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Our Journey Forward on Occupational Medical Care

Nov 09, 2012

Going forward it is imperative that a universal medical program be established to provide medical treatment for all work-related occupational injuries and exposures. The delay and denial of medical benefits to those who suffer ...

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Breast cancer risk in relation to occupations with - Workers ...

Nov 23, 2012

This exploratory population-based case–control study contributes to one of the neglected areas: occupational risk factors for breast cancer. The identification of several important associations in this mixed industrial and ...

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Workers' Compensation: NIOSH Seeks Occupational History for ...

Jul 05, 2012

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California: WCIRB Report Shows Continued Increase in Claim Frequency

The WCIRB has released an update to its Analysis of Changes in Indemnity Claim Frequency report which was originally published in 2012 and last updated in December 2013. In prior reports, WCIRB researchers explored potential causes for the increases in claim frequency in California that have persisted since 2010 and that differ from the claim frequency experience of other states.

Prior frequency reports have identified a number of factors influencing claim frequency including increases in cumulative injury claims, increases in smaller non-cumulative injury claims that may have been reported as medical-only in the past, increases in the proportion of indemnity claims relative to total claims, and increases in late-reported indemnity claims and the proportion of medical-only claims that later transition to indemnity.

In this latest update, WCIRB researchers studied the influencing factors driving recent claim frequency based on the most up-to-date data available. The WCIRB’s principal findings include:

• Unlike in most other states over the last several years, California indemnity claim frequency has continued to increase as WCIRB data currently indicates increases of 3.2%, 3.9% and 0.9% in 2012, 2013, and 2014, respectively. 
• The number of late reported indemnity claims continues to increase, whereas the percentage of medical only claims reported after 18 months has generally remained stable since 2007. 
• The level of cumulative injury claims has continued to increase. Approximately 13% of indemnity claims are estimated to involve a cumulative injury in 2013 compared to approximately 8% in the 2005 to 2007 period. 
• The growth in cumulative injury claims beginning in 2009 has been concentrated in claims involving more serious injuries and multiple injured body parts. Both the proportion of cumulative injury claims involving indemnity benefits and the proportion involving injuries to multiple body parts have increased significantly since 2010. 

Based on WCIRB surveys of cumulative injury claims, both the proportion of cumulative injury claims involving multiple insurers and the proportion involving attorney representation has increased in recent years. In addition, approximately two-thirds of surveyed claims were initially denied in part or in whole by the insurer and approximately 40% of claims, despite long-standing statutory limitation on the compensability of post-termination claims, were reported post-termination.

Shifts to a less hazardous composition of industries in California (“industrial mix”) have historically driven claim frequency downward. The recent economic recovery in higher hazard industries such as construction and manufacturing has had the opposite impact. In 2013, rather than dampening claim frequency, shifting industrial mix is increasing claim frequency by approximately 1%.

The 2010 increase in frequency was greatest in industries that were most impacted by the recession (e.g. construction and real estate). Since 2010, relativities for higher-frequency industries such as agriculture, construction, and entertainment have increased while those for the lower-frequency industries such as real estate, professional services, and finance have declined.

The 2010 indemnity claim frequency increase was generally experienced across all California regions. Since that time, the increases have been concentrated in the Los Angeles area. Indemnity claim frequency increased an estimated 9% in the Los Angeles Basin region from 2010 to 2013 while, similar to the pattern shown in many other states, other California regions showed modest declines. By comparison, indemnity claim frequency in the Bay Area declined by 7% over the same period. The Los Angeles area also has experienced significantly higher numbers of cumulative injury claims and claims involving multiple body parts than other regions of California.

As the economy recovers, newer workers enter the system and are often more likely to be injured on the job than more experienced workers. The proportion of injured workers with less than 2 years of experience at their current job has grown by 8% from 2010 to 2014, suggesting the economic recovery is a significant driver of recent claim frequency increases.

The full Analysis of Changes in Indemnity Claim Frequency—January 2015 Update Report is available in the Research and Analysis section of the WCIRB website.

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California Court of Appeal Upholds Landmark Ruling Affirming $1.5 Billion Judgment Ordering the Removal of Lead Paint From Pre-1951 Homes

After a seventeen year legal battle that broke new legal ground, California’s Sixth District Court of Appeal unanimously upheld a lower court decision ordering three lead paint manufacturers to clean up lead paint inside older homes in the County of Santa Clara and nine other California cities and counties. Today’s ruling holds defendants Sherwin-Williams Company, NL Industries, Inc., and ConAgra Grocery Products Company responsible for the public nuisance created by lead paint inside pre-1951 homes.

Brain injuries a big problem for NFL in California

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

By the thousands, professional athletes from around the country are seeking medical care or money through California's workers' compensation system for brain trauma and other injuries suffered on the playing field. Former athletes have filed more than 4,400 claims involving head and brain injuries since 2006 — seven times more than in the previous 15 years, according to a Times analysis of state records. Nearly three-quarters of all new claims made in California now include alleged brain injuries. Most of these claims come from former pro football players, brought by superstars such as Joe Theismann, Tony Dorsett and Earl Campbell, as well as unheralded practice squad players. NFL brain injuries

JOSÉ DUBON: The Human Face Behind WCAB Decision

Brett Gowen

Today's post by Brett Gowen of the California Bar is shared from fbgslaw.com

Imagine if this was you or your spouse. The California Legislature passed SB 863 and the recent Dubon case has taken the Workers’ Compensation courts out of deciding medical issues. This has effectively denied crucial medical care for thousands if not hundreds of thousands of California citizens. If the Insurance company denies a treatment and does not follow the law, you will likely not get your day in court to challenge the violations. Read the full story from C.A.A.A below:

California Applicants’ Attorneys Association (CAAA): JOSÉ DUBON: The Human Face Behind WCAB Decision; Consequences of Insurers Gaming UR System, Withholding Medical Records

The California Applicants’ Attorneys Association (CAAA), whose members represent Californians injured on the job, today released a UR DENIED story on José Dubon, the injured laborer whose case has resulted in three different Workers’ Compensation Appeals Board decisions, addressing what insurers are required to provide to Utilization Review (UR) to make the UR valid. Insurance carriers’ Utilization Review (UR) denies one in five physicians’ requests for medical treatment – up to 3,500,000 per year. The Dubon v. World Restoration case is an excellent example of the widespread failure of claims administrators to provide adequate medical records to the UR reviewer. “José Dubon’s case has produced a WCAB...

[Click here to see the rest of this post]

Found on

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Congressman Sam Farr Honors N. Michael Rucka

The late N. Michael Rucka was honored by Congressman Sam Farr in remarks before the US Congress. A tribute to the late N. Michael Rucka whose unending devotion to the cause of helping injured workers will remain a living legacy. The following appears in the Congressional Record.

N. Michael Rucka
1939-2014

IN HONOR OF N. MICHAEL RUCKA

HON. SAM FARR of California in the House of Representatives 

Monday, September 8, 2014 

 Mr. FARR. Mr. Speaker, I rise today to honor N. Michael Rucka, an important community leader whose entrepreneurial spirit, tenacity, and ethical standards enriched the lives of his family, law partners, friends, and clients. Mike was a dear friend and wonderful mentor. He was the very essence of life, compassion, generosity, and curiosity. World affairs and domestic politics were always on Mike's mind and he was never shy about sharing his thoughts with me. Mike passed away on July 28, 2014, after struggling with cancer. His passing has left a huge empty space in those of us who knew and loved him. But what we will remember the most is the way he enriched so many lives and made the Monterey Bay Area, and indeed the world, a better place.

Mike was born on October 3, 1939 in Brooklyn, New York. His parents, Nettie and Arthur, soon moved to Los Angeles and then settled in San Francisco. Mike graduated from Lowell High School before attending the University of California, Berkeley. Following his graduation from UC Berkeley and the University of San Francisco School of Law, Michael relocated to the Monterey Peninsula in the 1970s. There, he worked ambitiously alongside his friends Emmet O'Boyle, Alfred Lombardo, and J. Andrew McKenna to develop the Rucka, O'Boyle, Lombardo, and McKenna Law Firm in Salinas, California.

Mike devoted every day to representing injured parties in matters of workers compensation and Social Security disability. Mike won the Granado Case before the California Supreme Court, thus establishing the rule that temporary disability and medical treatment are not subject to apportionment. Thanks to his work, this rule has benefited all injured workers since..

He also served as the President of the California Applicant's Attorneys Association from 1975 to 1976. In 1993, Mike received the Eugene Marias Lifetime Achievement Award.

Mike was uniquely respected both in this community, throughout California, and by his peers throughout the country. In a small block of marble in his office is a short handled hoe, presented to Michael in honor of his instrumental work and help in getting the back-breaking short handled hoe banned from the agricultural fields of California. He donated his time, resources and energy to organizations that are committed to advancing the rights of injured workers and others who need a voice.

Mr. Speaker, I know I speak for the whole House in honoring Mike's lifetime of achievement and in extending our heartfelt condolences to his friends, and family members, including his wife Corry, daughter Brandy, sons Greg and Nick, and his grandchildren.

[Congressional Record Volume 160, Number 127 (Monday, September 8, 2014)] [Extensions of Remarks] [Page E1343] From the Congressional Record Online through the Government Printing Office [www.gpo.gov]

Household Contact COVID Case Status in California Supreme Court

The defense brief has now been submitted to California Supreme Court for review on the question of whether the workers’ compensation act does bars a claim against an employer by a household contact of an employee who contacted COVID at work. The court granted the request, made under California Rules of Court, Rule 8.548, that the court will decide questions of California law presented in a matter pending in the United States Court of Appeals for the Ninth Circuit. 

California Study Reveals Occupational Asthma Is A Major Problem

"It is estimated that over 974,000 adults in California have asthma that has been  caused or aggravated by their work, but work-related asthma (WRA) is often not recognized or diagnosed."

Work-related asthma (WRA) is under-recognized and often undiagnosed, but a new report

estimates that nearly a million adults in California have had work-related asthma. “Asthma in California: A Surveillance Report” tracks asthma data for the state of California, and includes a chapter on WRA. The updated chapter includes rates of WRA by industry and occupation, types of exposure, measures of the impact of WRA, and data on the characteristics of people with WRA, such as gender and age.

View WRA chapter: Work-related asthma (PDF)

View entire report: Asthma in California: A Surveillance Report (PDF, 6 MB)

View executive summary: Asthma in California: Executive Summary (PDF)

For more information on OHB work in this area, see Tracking Work-Related Asthma

......

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.  Click here now to submit a case inquiry.

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Workers' Compensation: A New Wave of Disease - Cleaners Asthma

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Workers' Compensation: EC Publishes Criteria to Diagnose ...

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