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Showing posts sorted by relevance for query medical privacy. Sort by date Show all posts
Showing posts sorted by relevance for query medical privacy. Sort by date Show all posts

Sunday, February 8, 2009

Privacy Went Out the Window

Privacy, a core element in the workers’ compensation system, is rapidly become a thing of the past. Both the State and Federal governments have not considered it a key ingredient in the program.

States, in their to conversion to electronic claims record keeping, have eliminated privacy. The State of California electronically released workers’ compensation claim data concerning Nadya Suleman, the mother who gave birth to eight babies last week. This was after months of complaints by claimants and attorneys that the California electronic claims system was flawed.

Likewise the Federal law, HIPPA [The Health Care Personal Information Non-Disclosure Act of 1998] governing medical records specifically excludes workers’ compensation medical information. Final Health Insurance Privacy Regulations that were published by the Department of Health and Human Services on December 28, 2000, establishing standards for privacy of individually identifiable health information records eliminate privacy in compensation claims. While the regulations cover health plans, health care clearinghouses and certain other providers who use computers to transmit claims information, workers' compensation insurance carriers are exempted.

The Institute of Medicine (IOM) committee has recently recommended the Congress and health agencies develop a new approach to protecting privacy in health research. In a 316 page report released by their Committee on Health Research and the Privacy of Health Information it concluded that HIPPA does not protect privacy.

As the country embarks on a new economic recovery program, including national health care, the Federal government must rebuild the national system of workers’ compensation system. Privacy should not be thrown out the windows when administering a workers' compensation benefit delivery system.

Saturday, January 24, 2009

2009 Supplement to Workers' Compensation Law - Order Now

Jon L. Gelman's 2009 supplement to the 3 volume hard bound practice series has been published. Now available for order.

The newly enacted statutory changes to the New Jersey Workers’ Compensation Act permitting Emergent Medical Care Motions, new registration requirements for insurers, and new judicial enforcement powers of Judges of Compensation, including sanctions and contempt powers, are contained in this supplemental material.

The mandatory reporting requirements of the SCHIP Extension Act of 2007 are described as well as the appeal procedure under the reimbursement provision of the Medicare Secondary Payer Act.

These pocket parts provide information concerning the requirements for medical monitoring in workers’ compensation claims. It discusses. the Asbestos Fund, which has been established for those entities where workers’ compensation coverage cannot be established. The newly designed forms that need to be utilized in filing for benefits are included. Also, the recently modified Motion for Temporary and Medical Benefits, including a form Certification, is provided and discussed.

The newly revised Judgments for Total and Permanent Disability are provided in this pocket part. The Judgments include new refinements in offsets for pensions and Social Security disability benefits. Reviewed also is the “intentional wrong exception” to the Exclusivity Bar which has been the subject of new workers’ compensation insurance policy language and regulation.

The recently promulgated administrative rules governing the disposition of Temporary Disability Benefits are discussed. The non-duplication of benefits provisions are reviewed including the multiple agency adjudication process. An expansion of benefits available to Federal public safety officers is reviewed in this supplement.

Collateral medical benefit issues are discussed in light of the recent Supreme Court decision concerning this matter. The pocket parts include a Motion to Join the Collateral Health Carrier and provide sample Certifications to be used in support of the application.

Additionally, these pocket parts provide information concerning the new rules of the Division of Workers’ Compensation embodying electronic filing requirements and new procedures involving both formal and informal proceedings, motion practice, post judgment process, and judicial performance. The expanded Medicare secondary reporting requirements and the mandatory coordination of benefits are reviewed in this supplement. The recovery aspects of Medicare conditional payments as well as future medical provisions are updated and discussed. The new Child Support Lien distribution forms, computation worksheets and judgments are provided and explained in depth. The NJ Supreme’ Court ruling and the legislative enactments are discussed concerning same sex couples and the availability of workers’ compensation benefits.

This supplement reviews the newly promulgated Rules concerning the Uninsured Employers’ Fund and audio and video coverage of workers’ compensation proceedings. The horrific tragedy of September 11th, 2001 and the impact it has upon the Workers’ Compensation system is discussed. This supplement reviews the newly enacted Smallpox Emergency Protection Act as well as recent court decisions concerning acts of terrorism. The subsequent legislative changes enacted in response to potential terrorist threats are reviewed, including the Public Safety Officers’ Benefit Act as well as the liberalized legislative enactments involving rescue workers and medical personnel.

The impact of the newly promulgated Federal rules and regulations concerning medical record privacy and compliance with the Health Insurance Portability and Accountability Act (HIPPA) medical authorization requirements are reviewed in this supplement and model forms are furnished. The recently enacted statutory workers' compensation coverage options available to proprietors and partners are discussed. The supplement reviews the recent court decisions expanding the responsibility of the Second Injury Fund for pre-existing medical conditions in cases in which latent diseases become manifest during retirement. The statutory enactments concerning State Temporary Disability Benefits are reviewed. The recently amended Energy Employees Occupational Illness Compensation Act is explained in detail and forms are furnished and discussed.

The recent Supreme Court decisions concerning the high judicial threshold for evaluation of scientific evidence are analyzed. The requirements for proof of scientific evidence in complex workers’ compensation cases are discussed including the admissibility of testimony from non-physicians experts. Furthermore, the evolving and expanding issues concerning medical monitoring are reviewed.

This pocket part also discusses recent changes in the application for counsel fees. The supplement includes the newly promulgated administrative directive embodying those changes.

Tuesday, February 28, 2012

Workers Compensation Law 2012 Now Shipping

Highlights Include:
Electronic Discovery s.22.33
Medicare Conditional Payments 29.32 and 29.33

Jon L. Gelman's 2012 supplement to the 3 volume hard bound practice series, Workers' Compensation Law 3rd Ed.,  has been published. Order these important supplements now. The supplement provide almost a quarter of a century continuing and unparalleled analysis on workers' compensation law. The volumes and supplements are integrated into the Westlaw(R), part of Thomson Reuters system for "Better Results Faster."
The newly enacted statutory changes to the New Jersey Workers’ Compensation Act and promulgated Rules permitting Emergent Medical Care Motions, new registration requirements for insurers, and new judicial enforcement powers of Judges of Compensation, including sanctions and contempt powers, are contained in this supplemental material.An analysis of the newly adopted procedures for the reimbursement of conditional payments established by Medicare and the protocols to co-ordinate  workers’ compensation claims with the Centers for Medicare and Medicaid Services is contained in this supplement. The materials also provide the authorizations required to obtain conditional payment  information from the Coordinator of Benefits. Debt collection referral to the Department of the Treasury is also reviewed.
The new Community and Worker Right to  Know material has been incorporated into this supplement. The current hazardous substance lists and the substances that have been deemed extremely dangerous are provided.The supplement reviews new case law concerning electronic cancellation of coverage as well as the standard for claims to be considered casually related to the employment.The mandatory reporting requirements of the SCHIP Extension Act of 2007 are described as well as the appeal procedure under the reimbursement provision of the Medicare Secondary Payer Act.These pocket parts provide information concerning the requirements for medical monitoring in workers’ compensation claims. It discusses. the Asbestos Fund, which has been established for those entities where workers’ compensation coverage cannot be established.  
The newly designed forms that need to be utilized in filing for benefits are included.  Also, the recently modified Motion for Temporary and Medical Benefits, including a form Certification, is provided and discussed.The newly revised Judgments for Total and Permanent Disability are provided in this pocket part.  The Judgments include new refinements in offsets for pensions and Social Security disability benefits. Reviewed also is the “intentional wrong exception” to the Exclusivity Bar which has been the subject of new workers’ compensation insurance policy language and regulation.The recently promulgated administrative rules governing the disposition of Temporary Disability Benefits are discussed. The non-duplication of benefits provisions are reviewed including the multiple agency adjudication process.
An expansion of benefits available to Federal public safety officers is reviewed in this supplement.Collateral medical benefit issues are discussed in light of the recent Supreme Court decision concerning this matter.  The pocket parts include a Motion to Join the Collateral Health Carrier and provide sample Certifications to be used in support of the application.Additionally, these pocket parts provide information concerning the new rules of the Division of Workers’ Compensation embodying electronic filing requirements and new procedures involving both formal and informal proceedings, motion practice, post judgment process, and judicial performance. The expanded Medicare secondary reporting requirements and the mandatory coordination of benefits are reviewed in this supplement.
The recovery aspects of Medicare conditional payments as well as future medical provisions are updated and discussed. The new Child Support Lien distribution forms, computation worksheets and judgments are provided and explained in depth. The NJ Supreme’ Court ruling and the legislative enactments are discussed concerning same sex couples and the availability of workers’ compensation benefits.This supplement reviews the newly promulgated Rules concerning the Uninsured Employers’ Fund and audio and video coverage of workers’ compensation proceedings.  The horrific tragedy of September 11th, 2001 and the impact it has upon the Workers’ Compensation system is discussed.
This supplement reviews the newly enacted Smallpox Emergency Protection Act as well as recent court decisions concerning acts of terrorism.
The subsequent legislative changes enacted in response to potential terrorist threats are reviewed, including the Public Safety Officers’ Benefit Act as well as the liberalized legislative enactments involving rescue workers and medical personnel. The impact of the newly promulgated Federal rules and regulations concerning medical record privacy and compliance with the Health Insurance Portability and Accountability Act (HIPPA) medical authorization requirements are reviewed in this supplement and model forms are furnished.  The recently enacted statutory workers’ compensation coverage options available to proprietors and partners are discussed. The supplement reviews the recent court decisions expanding the responsibility of the Second Injury Fund for pre-existing medical conditions in cases in which latent diseases become manifest during retirement.  The statutory enactments concerning State Temporary Disability Benefits are reviewed.  


The recently amended Energy Employees Occupational Illness Compensation Act is explained in detail and forms are furnished and discussed.The recent Supreme Court decisions concerning the high judicial threshold for evaluation of scientific evidence are analyzed. The requirements for proof of scientific evidence in complex workers’ compensation cases are discussed including the admissibility of testimony from non-physicians experts. Furthermore, the evolving and expanding issues concerning medical monitoring are reviewed.This pocket part also discusses recent changes in the application for counsel fees.
The supplement includes the newly promulgated administrative directive embodying those changes. 

Tuesday, October 27, 2009

HIPPA Privacy Modifications Under Presidential Emergency H1N1 Flu Order

Under the emergency declaration for H1N1 flu signed by President Obama on October 24, 2009, the HIPPA Privacy rule is not waived according to Federal HHS interpretation; however, "the Secretary of HHS may waive certain provisions of the Rule under the Project Bioshield Act of 2004 (PL 108-276) and section 1135(b)(7) of the Social Security Act."
 
Those modifications are:
 
"If the President declares an emergency or disaster and the Secretary declares a public health emergency, the Secretary may waive sanctions and penalties against a covered hospital that does not comply with certain provisions of the HIPAA Privacy Rule:


  •  the requirements to obtain a patient's agreement to speak with family members or friends involved in the patient’s care (45 CFR 164.510(b)) 
  • the requirement to honor a request to opt out of the facility directory (45 CFR 164.510(a)) 
  • the requirement to distribute a notice of privacy practices (45 CFR 164.520) 
  • the patient's right to request privacy restrictions (45 CFR 164.522(a)) 
  • the patient's right to request confidential communications (45 CFR 164.522(b)) 
"If the Secretary issues such a waiver, it only applies:

1. In the emergency area and for the emergency period identified in the public health emergency declaration.


   2. To hospitals that have instituted a disaster protocol.  The waiver would apply to all patients at such hospitals.
   3. For up to 72 hours from the time the hospital implements its disaster protocol.
"When the Presidential or Secretarial declaration terminates, a hospital must then comply with all the requirements of the Privacy Rule for any patient still under its care, even if 72 hours has not elapsed since implementation of its disaster protocol. 
"Regardless of the activation of an emergency waiver, the HIPAA Privacy Rule permits disclosures for treatment purposes and certain disclosures to disaster relief organizations. For instance, the Privacy Rule allows covered entities to share patient information with the American Red Cross so it can notify family members of the patient’s location.  See 45 CFR 164.510(b)(4)."

Thursday, April 11, 2013

Digital Identification: Is Your Employer Going to Take Your Digital Finger Prints, Iris Scans or Face ID

The technology to digitally capture and store an individual's personal biometric identifiable information is growing at a rapid pace. Employers, medical providers and even government agencies have become frustrated by the outlawed use of Social Security numbers as means of identification.

A simple and easily used application has now become available to collect this data through an iPhone. Balacing workers' privacy against the administration of a workers' compensation system has certainly become even more challending. The use of national and international databases for the collection, dissemination and use of this type of data publically, strikes fear in the hearts of injured workers and they become even more reluctant to report both saftey concerns and injuries to employers for fear of discrimination and retaliation.

"The California-based company AOptix rolled out a new hardware and app package that transforms an iPhone into a mobile biometric reader. As first reported by Danger Room in February, AOptix is the recipient of a $3 million research contract from the Pentagon for its on-the-go biometrics technology."

Read he Complete Article::  Now Your iPhone Can Read Fingerprints, Scan Irises and ID Your Face (Wired)

Monday, May 7, 2012

Facebook, Organ Donations and Medical Privacy of Workers' Compensation

ÄŒesky: Logo Facebooku English: Facebook logo E...
 (Photo credit: Wikipedia)
The announcement of Facebook to allow for the public listing of organ donors of it social media site, albiet with good intentions, raises concerns about the privacy of workers' compensation claims as the organs could become a public commodity. The ramifications of commercialization of the process has raised issues on whether the privacy of organ beneficiaries can be maintained. Visions of yet another workers' compensation cottage industry emerging in human organ trade abound, adding yet another unregulated tier of potential dissemination of medical data.

Click here to read "Facebook’s New “Organ Donor” Feature: Many Applaud It, but Some Raise Possible Concerns About Protecting Private Health Information"
Related articles

Monday, September 2, 2013

Media Portrays Social Security as an Avenue to Benefits for the Unemployed - WRONG! It's Not That Simple...

The Social Security Administration turns down many worthy applicants when they first apply.
Photo credit: Thomas Hawk / Foter.com 
Today's post comes from guest author Susan C. Andrews, from Causey Law Firm.

There is a lot in the news these days about the Social Security Disability Program, with some pundits suggesting people are getting on benefits simply because they are unemployed, or because they claim to be injured or ill when in fact they are able-bodied and fully capable of working. Every day, all day, I work with people filing for Social Security Disability benefits. 

So I work with the program’s rules - yes, there are rules for deciding these cases – it is not enough just to claim to be disabled. And I come face to face with individuals who are struggling, sometimes with a major health issue such as cancer, or rheumatoid arthritis, or Multiple Sclerosis

Other folks have multiple health problems that have combined to force them from the labor market. All of them have medical records, often reams of them, documenting diagnoses, chronicling surgeries and other treatment regimens. This is one big thing I think the general public does not know: a person must have one or more diagnoses from a qualified physician that could account for the symptoms and limitations he or she is reporting to Social Security. 

Thursday, December 5, 2013

The Road toward Fully Transparent Medical Records

Privacy of medical data in the workers' compensation system does not exist. Federal portability act excluded worker's Compensation claims. In some jurisdictions, claimants are able to seek declaratory relief to shield the records. The processes costly, onerous, and incompatible with the underlining summary and remedial legislative intent of a viable Worker's Compensation program. Today's post was shared by NEJM and comes from www.nejm.org

Perspective
Jan Walker, R.N., M.B.A., Jonathan D. Darer, M.D., M.P.H., Joann G. Elmore, M.D., M.P.H., and Tom Delbanco, M.D.
December 4, 2013DOI: 10.1056/NEJMp1310132
Article
Forty years ago, Shenkin and Warner argued that giving patients their medical records “would lead to more appropriate utilization of physicians and a greater ability of patients to participate in their own care.”1 At that time, patients in most states could obtain their records only through litigation, but the rules gradually changed, and in 1996 the Health Insurance Portability and Accountability Act entitled virtually all patients to obtain their records on request. Today, we're on the verge of eliminating such requests by simply providing patients online access. Thanks in part to federal financial incentives,2 electronic medical records are becoming the rule, accompanied increasingly by password-protected portals that offer patients laboratory, radiology, and pathology results and secure communication with their clinicians by e-mail.
One central component of the records, the notes composed by clinicians, has remained largely hidden from patients. But now OpenNotes, an initiative fueled primarily by the Robert Wood Johnson Foundation, is exploring the effects of providing access to these notes.3 Beginning in 2010, at Beth Israel Deaconess Medical Center (which serves urban and suburban Boston), Geisinger Health System (in rural Pennsylvania), and Harborview Medical Center (Seattle's...
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Wednesday, August 31, 2011

Surveillance Crosses the Privacy Line

Surveillance in workers compensation matters creates sensitive issues regarding privacy. The bright-line of what is public versus private becomes even more acute as employers and insurance companies investigate fraud concerns. When companies cross the line the consequences can be serious.

Several Montana attorneys have sought relief from a Court for what they call a breach of the privacy of the injured workers whom they represent. The attorneys allege that insurance fraud investigators, on behalf of a Montana insurance fund, have violated the privacy rights of their client by recording surveillance videos  and giving them to examining physicians, in order to facilitate reports that the injured workers are malingering.

The attorneys represent that  in over 800 instances, over the past several years, criminal surveillance tapes were unilaterally provided to defense medical experts to the detriment of their client's right to privacy. Harassment of injured workers creates fear that deters claims to benefit of employers and their insurance carriers. Inured workers have limited resources to fight such unscrupulous behavior. The attorneys in Montana had done a great pro bono and public service to take on Goliath on behalf of David. Hopefully the courts will balance the playing field and protect the rights of the injured worker from such tactics.

Workers' compensation was designed as a simple and equitable system. It was intentionally designed for the benefit of all the parties who participate in it. It is important that when the system becomes unbalanced that all the participants join in the effort equally to both redesign and rebalance the program.

Tuesday, March 9, 2010

US Supreme Court to Review Employee Privacy Issues

The US Supreme Court has granted certiorari in a case involving the application of the constitutional right to informational privacy to an employee questionnaire. NASA, et al. v. Nelson, Robert M., et al. No. 09-530, March 8, 2010.


The Supreme Court will be reviewing a 9th Circuit Court of Appeals decision involving contract employees of the Jet PropulsionLaboratory (JPL) who filed suit against the National Aeronautics and Space Administration (NASA) and others. The suit claims that contract employees in non-sensitive or “low risk” positions should not be required to submit to in-depth background investigations.


The Circuit Court below held:
We have repeatedly acknowledged that the Constitution protects an “individual interest in avoiding disclosure of personal matters.” In re Crawford, 194 F.3d 954, 958 (9th Cir.1999). This interest covers a wide range of personal matters, including sexual activity, Thorne v. City of El Segundo, 726 F.2d 459 (9th Cir.1983) (holding that questioning police applicant about her prior sexual activity violated her right to informational privacy), medical information,Norman-Bloodsaw v. Lawrence Berkeley Lab., 135 F.3d 1260, 1269 (9th Cir.1998) (“The constitutionally protected privacy interest in avoiding disclosure of personal matters clearly encompasses medical information and its confidentiality.”), and financial matters, Crawford, 194 F.3d at 958 (agreeing that public disclosure of social security numbers may implicate the right to informational privacy in “an era of rampant identity theft”). If the government's actions compel disclosure of private information, it “has the burden of showing that its use of the information would advance a legitimate state interest and that its actions are narrowly tailored to meet the legitimate interest.” Crawford, 194 F.3d at 959 (internal quotation marks omitted). We must “balance the government's interest in having or using the information against the individual's interest in denying access,” Doe v. Att'y Gen., 941 F.2d 780, 796 (9th Cir.1991), weighing, among other things:
“the type of [information] requested, ... the potential for harm in any subsequent nonconsensual disclosure, ... the adequacy of safeguards to prevent unauthorized*878 disclosure, the degree of need for access, and whether there is an express statutory mandate, articulated public policy, or other recognizable public interest militating towards access.”
Id. (quoting United States v. Westinghouse Elec. Corp., 638 F.2d 570, 578 (3d Cir.1980)) (alteration in original).
Both the SF 85 questionnaire and the Form 42 written inquiries require the disclosure of personal information and each presents a ripe controversy."

".....The balance of hardships tips sharply toward Appellants, who face a stark choice-either violation of their constitutional rights or loss of their jobs. The district court erroneously concluded that Appellants will not suffer any irreparable harm because they could be retroactively compensated for any temporary denial of employment. It is true that “monetary injury is not normally considered irreparable,” L.A. Mem'l Coliseum Comm'n v. Nat'l Football League, 634 F.2d 1197, 1202 (9th Cir.1980), and the JPL employees who choose to give up their jobs may later be made whole financially if the policy is struck down. "




Wednesday, July 24, 2013

Shifting the Blame: Doctors Look To Others To Play Biggest Role In Curbing Health Costs

Blame for increased medical costs is getting tossed around like a political football. Those deeply entrenched into the system are pointing their finger at "the other" party to shift responsibility. This reminds one of when CMS in 1980 urged the passage of the Medical Secondary Payer Act. 

As this process continues, ultimately the US Government will be the final authority as Medicare ultimately rules the medical billing field and outcome based medicine seems to be the new goal.

Workers' Compensation system will ultimate adapt or be subsumed by the Medicare protocols in one fashion or another.  Special interests  will have little opportunity to cut out their specialized markets.

Today's post was shared by Kaiser Health News and comes from capsules.kaiserhealthnews.org

In a study, published Tuesday in the Journal of the American Medical Association, Mayo Clinic researchers surveyed more than 2,500 doctors to assess their views of different approaches to rein in the nation’s health care costs. The doctors were randomly selected from an American Medical Association database.
When it comes to controlling the country’s health care costs, doctors point their fingers at lawyers, insurance companies, drug makers and hospitals. But well over half acknowledge they have at least some responsibility as stewards of health care resources.

Based on their findings, 59 percent of doctors believed they have some responsibility in holding down  health care costs. Only 36 percent thought they have a major role.

Friday, December 6, 2013

Keeping privacy in focus

Confidentiality has been the hallmark of Workers' Compensation since the inception of the program. Has been challenged federally through the portability act concerning the privacy of medical records. All that reach was bad enough, a data breach from and a governmental site is even worse. It is becoming more than obvious, but the weak financial infrastructure, of the patchwork of worker's Compensation systems for the country are creating serious challenges. Instead of attempting to run 50 different programs throughout the country, it is probably A good idea to start looking inward, and establishing a single solid system that can meet the needs required to run A multibillion-dollar benefit system the rep country and also maintain the confidentiality and privacy that the parties participating in it require. Today's post shared from therepublic.com

Hackers gained access to the personal information of about 26,000 Pennsylvanians who use debit cards to receive jobless and workers' compensation benefits, the Pennsylvania Treasury Department said Thursday.
The incident was part of a wider security breach affecting 465,000 holders of JPMorgan Chase & Co. prepaid cash cards nationwide.
The breach affects only cardholders who used the JPMorgan Chase UCard Center website between mid-July and mid-September, the Treasury Department said. Michael Fusco, a spokesman for JPMorgan, said the bank found no evidence any information was used improperly.
JPMorgan first contacted the Pennsylvania Treasury Department on Tuesday, agency spokesman Gary Tuma said.
JPMorgan has referred the matter to law enforcement and would not explain details of how the breach occurred, the Treasury Department said.
The Pennsylvania agency wants details from JPMorgan Chase about the bank's response to the breach, including an explanation for any delay in notifying it and the additional measures it will undertake to protect against a recurrence.
The department said most of the personal information that might have been viewed includes card numbers, dates of birth, user IDs, email addresses. Information on external bank accounts might have been exposed, as well, if a cardholder completed a transaction to it, the department said.
Cardholders are being contacted by letter with instructions and are being urged by JPMorgan Chase in the meantime to...
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Monday, December 31, 2018

Nebraska Doctor Exposed to New Ebola Outbreak

An American providing medical assistance in the Democratic Republic of Congo recently experienced a possible exposure to the Ebola virus and is in Omaha for monitoring. This person has no Ebola symptoms but will be monitored closely. Should any symptoms develop, the Nebraska Biocontainment Unit would be activated and the person admitted.

Friday, May 11, 2012

Unsustainable

NCCI, a national workers' compensation rating company, reported yesterday that the workers' compensation industry is in trouble and that "NCCI's current analysis shows that the combined ratios for workers compensation remain at unsustainably high levels, and investment returns are not high enough to generate operating returns near the cost of capital." One on the major soaring costs was reported to be medical costs.

Click here to read the entire report: Complete State of the Line Presentation from AIS 2012

Thursday, February 4, 2016

Senator Patrick Leahy Calls For Greater Transparency by Asbestos Companies

Statement of Senator Patrick Leahy Ranking Member, Judiciary Committee Hearing on “The Need for Transparency in the Asbestos Trusts”

Today the Judiciary Committee meets to discuss legislation that purports to promote more transparency in asbestos trusts.  Before we get into a detailed discussion about the merits of the proposed legislation, I want to make sure we all remember why we are here today.  For decades, millions of American workers were secretly poisoned.  Men and women who worked in our Nation’s factories, shipyards, mines and construction sites, and service members in the military, unknowingly inhaled air that was laced with asbestos—a substance so harmful that an individual can become critically ill simply by breathing.

Thursday, September 19, 2013

What is the Date Last Insured, and Why Does it Matter?

Today's post comes from guest author Susan C. Andrews, from Causey Law Firm.

A person who has been out of the labor market for quite some time before he applies for Social Security Disability (SSD) may find that his application for benefits is rejected because he cannot prove he became disabled before his date last insured.  

In order to qualify for benefits in the first place, a person must pay Social Security taxes long enough to have insured status. When the individual stops working and therefore stops paying into the system, eventually he will hit his date last insured and lose his insured status. It is a little like a private insurance policy: when you stop paying the premiums, you no longer are covered by the policy.  For a person who has work steadily in his lifetime, the date last insured is arrived at and insured status lapses about five years after stopping work.
 The Social Security Administration has another program for the medically disabled called Supplemental Security Income (SSI) where there is no date last insured rule, but there are other program requirements and limitations. In a future article, we will explore the differences between the Social Security Disability (SSD) and Supplemental Security Income (SSI) programs.   
     As an example of how the date last insured issue can prevent a person from getting Social Security Disability (SSD) benefits, consider the case of a 35 year-old woman who has worked steadily since her late teens. She and her husband have twins when she is in her mid-30s. There are a lot of late night feedings and diapers to change! She stays home to take care of the twins while her husband continues to work to support the family. When the twins turn five, she begins to think about returning to work, perhaps when they go into first grade a year or so later. Five years has passed, and she reaches her date last insured. She loses her insured status and has not yet returned to work. When the twins turn six, she gears up her job search, but has not yet re-entered the labor market. Then medical catastrophe strikes: she has a very disabling stroke – unusual in a person this young, but not unheard of. She clearly cannot work. She applies for Social Security Disability and is turned down because she did not become disabled before her date last insured. Unlike the Social Security Retirement program, where it is possible to collect Social Security Retirement (SSR) benefits on the earnings record of one’s spouse, the Social Security Disability program only allows for benefits to be paid on the basis of one’s own earnings record.

     Consider another scenario with this family of four. When the twins are three, mom is diagnosed with Multiple Sclerosis. This condition can progress slowly or more quickly. In her case, she suffers a fairly quick progression of symptoms. By the time the twins are six and going into first grade, she is ready to return to work, except that she is suffering a variety of MS symptoms, including the profound fatigue that is experienced by many with this disease. Her combination of symptoms prevents her from working, so she applies for Social Security Disability. She passed her date last insured when the twins turned five. Will she get benefits? That depends. She certainly can apply for benefits after her date last insured, but she must be able to show that her symptoms had become sufficiently severe to prevent her from working before her date last insured. We have handled many cases where the individual is out past his or her date last insured. The key is to obtain all of the medical records that help to document the seriousness of the medical condition before that date last insured. Sometimes these can be buttressed with statements from family members or close friends who were in a position to observe at close range how seriously the person’s medical condition was affecting her functioning prior to the date last insured. In the case above, a statement from the husband likely would be helpful.

     The Social Security Administration has another program for the medically disabled called Supplemental Security Income (SSI) where there is no date last insured rule, but there are other program requirements and limitations. In a future article, we will explore the differences between the Social Security Disability (SSD) and Supplemental Security Income (SSI) programs. 

Photo credit: Јerry / Foter.com / CC BY

Sunday, July 1, 2012

OSHA kicks off summer campaign to prevent heat-related illnesses and fatalities among outdoor workers


The U.S. Department of Labor's Occupational Safety and Health Administration has kicked off a national outreach initiative to educate workers and their employers about the hazards of working outdoors in hot weather. The outreach effort builds on last year's successful summer campaign to raise awareness about the dangers of too much sun and heat.

"For outdoor workers, 'water, rest and shade' are three words that can make the difference between life and death," Secretary of Labor Hilda L. Solis said. "If employers take reasonable precautions, and look out for their workers, we can beat the heat."

Every year, thousands of workers across the country suffer from serious heat-related illnesses. If not quickly addressed, heat exhaustion can become heat stroke, which has killed — on average — more than 30 workers annually since 2003. Labor-intensive activities in hot weather can raise body temperatures beyond the level that normally can be cooled by sweating. Heat illness initially may manifest as heat rash or heat cramps, but quickly can become heat exhaustion and then heat stroke if simple prevention steps are not followed.

"It is essential for workers and employers to take proactive steps to stay safe in extreme heat, and become aware of symptoms of heat exhaustion before they get worse," said Dr. David Michaels, assistant secretary of labor for occupational safety and health. "Agriculture workers; building, road and other construction workers; utility workers; baggage handlers; roofers; landscapers; and others who work outside are all at risk. Drinking plenty of water and taking frequent breaks in cool, shaded areas are incredibly important in the hot summer months."

In preparation for the summer season, OSHA has developed heat illness educational materials in English and Spanish, as well as a curriculum to be used for workplace training. Additionally, a Web page provides information and resources on heat illness — including how to prevent it and what to do in case of an emergency — for workers and employers. The page is available athttp://www.osha.gov/SLTC/heatillness/index.html.

OSHA also has released a free application for mobile devices that enables workers and supervisors to monitor the heat index at their work sites. The app displays a risk level for workers based on the heat index, as well as reminders about protective measures that should be taken at that risk level. Available for Android-based platforms and the iPhone, the app can be downloaded in both English and Spanish by visiting http://s.dol.gov/RI.

In developing last year's inaugural national campaign, federal OSHA worked closely with the California Occupational Safety and Health Administration and adapted materials from that state's successful campaign. Additionally, OSHA is partnering with the National Oceanic and Atmospheric Administration for the second year to incorporate worker safety precautions when heat alerts are issued across the nation. NOAA also will include pertinent worker safety information on its heat watch Web page athttp://www.noaawatch.gov/themes/heat.php.
Read this news release en Español.

Wednesday, April 27, 2016

Privacy: Court Mandates Protective Order for Workers' Compensation Discovery

Plaintiff in mesothelioma case sought production of defendant's (Union Carbide Corp) employees' workers' compensation claim records. The corporate defendant, Union Carbide Corp) sought to restrict access and limit dissemination of the records of the workers' compensation matters sought through discovery.

Confidentiality is a two sided sword. Historically asbestos litigation had its genesis in workers' compensation claims. In this instance the Corporate Defendant sought the utilization of privacy restrictions as a defense.

Monday, February 7, 2022

Order: Workers' Compensation Law 2022 Update

Jon Gelman’s* newly revised and updated treatise on Workers’ Compensation Law can now be ordered from Thomson Reuters®. The treatise is the most complete and research integrated work available on NJ Workers’ Compensation law.

Thursday, May 28, 2015

In the name of privacy...

After the massive US IRS data breach announcement this week, CMS has posted that it is establishing a more secure system for access to Medicare Secondary Payer Information. This is pretty consistent with President Obama's announcement to take Social Security Numbers off of Medicare Cards. 

The real issue is that while workers' compensation records are supposedly confidential in State systems, the Federal government has consistently neglected to insure that privacy whether be: medical records under HIPPA; by integration of  state's motor vehicle or workers' compensation records utilizing Social Security Numbers, or by Medicare Secondary Payer Act electronic data systems. 

Additionally, the Federal government will probably be mandating the reporting workers' compensation payment information, in Federal Income Returns shortly. The batting record of the IRS this week on privacy has been dismal.

Time will only tell whether workers' compensation data can actually be shielded from intruders. 

CMS announced today:

"As part of the Strengthening Medicare and Repaying Taxpayers (SMART) Act, the Centers for Medicare & Medicaid Services (CMS) will be implementing optional MFA services on the MSPRP. MFA is the use of two or more different authentication factors to verify the identity of an end user. Verified users will have access to view unmasked claim data on the Portal.

"Non debtors will still need to have a Verified Proof of Representation or Consent to Release authorization to perform actions on cases. Please note that MFA and the associated identity proofing process will be optional to portal users. Portal users may continue to use the portal without going through the MFA process but will not have the benefit of viewing un-masked data.

"MFA is scheduled to be available beginning on July 13, 2015. Updated user guides and training materials will be available on CMS.gov and within the portal upon implementation.