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

Monday, September 2, 2013

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
NFL brain injuries

Saturday, August 31, 2013

Is Big Sugar the Next Liability Target?

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Vik Khanna

Growing paranoia is the hallmark of the aging process for me.  Although I am a generally affable sort (I know, it doesn’t always seem that way from my writing), I am also a fairly suspicious person.  I am starting to think that all the food industry’s sweet talk about the innocence of sugar is really just icing on a toxic cake and that we’ve all been sold a bill of goods.  In particular, I wonder — and part of me hopes — that Big Sugar might soon replace Big Tobacco as the favorite target of our most underappreciated and misunderstood national resource…the plaintiff’s bar.

 There is no question we eat way too much sugar and that the increase in consumption has coincided nicely with both our rise in obesity and decline in health status even though we are living longer.

Not that I think the Tobacco Settlement (TS) was great social policy.  You can read my full view here; but, to summarize, as an immigrant and a person of color, a part of me resents the TS because all it did is push the burden of fulfillment of the financial terms into the hearts and lungs of people in Africa, Asia, and Latin America.  The smug satisfaction of tobacco opponents in the US and their glib dismissal of the impact on predominantly poor people of color around the world is first order racism.
Any analogous move against Big Sugar (BS) could be quite interesting.  There is, of course, the delectable duality of...
[Click here to see the rest of this post]


Wednesday, August 21, 2013

Senate fails to revive workers' comp bill for first responders

The NJ Senate has been unable change the burden of proof required for First Responders to prove compensability. While some jurisdictions have multiple "presumptions of compensability" statutorily enacted, NJ has consistently maintained a minimal number. Today's post was shared by WCBlog and comes from www.nj.com


State Senate Democrats have failed to override Gov. Chris Christie's recent veto of a bill that would have made it easier for emergency first responders to obtain workers' compensation coverage when they get injured or contract a disease on the job during a terrorist attack or another catastrophic event.

The bill would have required the employer to challenge any work-related injuries and illness, shifting the burden away from nurses, firefighters, police officers, rescue squad members and other first responders who have to prove how and when they were hurt or sickened under the current system.

Wages and medical benefits would be paid if "any death or disability, including post traumatic stress disorder, arises from the physical or psychological impact of stress or injury experienced by the public safety worker during response to a terrorist attack, epidemic or other catastrophic emergency," according to the bill sponsored by Sen. Linda Greenstein (D-Middlesex).
Christie said while the state is grateful for the heroic work of its first responders, New Jersey can't afford this legislation.

Thursday, August 15, 2013

ICD-10 will impact workers comp, non-HIPAA entities, too

ICD codes are ruling workers' compensation and the lives and claims of injured workers. Today's post was shared from /ehrintelligence.com.


"They might not have to play by all the same rules, but healthcare providers shouldn’t forget the impact ICD-10 will have on non-HIPAA covered entities such as workers compensation, nursing homes, and home health agencies.  While non-HIPAA entities are not mandated to switch to the new code set on October 1, 2014, the changing tide will sweep them along with the complex transition whether they like it or not.  Medical providers should be aware of the struggles of their non-HIPAA partners, especially as the care coordination spectrum expands to include more and more external organizations that may not always be on the same page.
"t may seem like those entities that are allowed to stick with ICD-9 would be happy to do so.  But in fact, staying with the old code set, which will not be maintained or updated after 2014, might be more trouble than it’s worth.  Technically, workers compensation insurance could demand all provider claims to contain ICD-9 codes for as long as they please, but the undue hardship that would place on medical professionals has been deemed too great by some large insurance plans such as the Ohio Bureau of Workers Compensation (OBWC), which is planning to use ICD-10 after the implementation date.
Non-HIPAA entities could also choose to accept ICD-10 codes from providers but crosswalk them back to ICD-9 if they don’t want to upgrade their systems.  But the extra work to create accurate and reliable mappings from a very detailed code to a broader ICD-9 one seems a little pointless.  “Even though claims professionals don’t have to be immediately fluent in ICD-10, they should be forward-thinking and follow the market in the direction it’s headed,” suggests John Sarich, VP of Strategy for VUE Software in a post for Claims Journal. “It will require some upfront investment, but will ultimately outweigh the lost time that accompanies translating every medical record you encounter.”
"And payers such as workers compensation and property and casualty insurance (P&C) do have a vested interest in the detail and specificity provided by ICD-10, mandate or no.  They will spend less time pestering physicians for more and more documentation to validate a claim for an injury, reducing the administrative burden for everyone involved – assuming payer claims processors are properly trained in the new code set and don’t need to return to the provider to ask for clarification.

Click here to read the entire article.

Wednesday, August 14, 2013

Anti-Smoking Battle Moves Outdoors

Today's post was shared by RWJF PublicHealth and comes from abcnews.go.com


First it was bars, restaurants and office buildings. Now the front lines of the "No Smoking" battle have moved outdoors.

City parks, public beaches, college campuses and other outdoor venues across the country are putting up signs telling smokers they can't light up. Outdoor smoking bans have nearly doubled in the last five years, with the tally now at nearly 2,600 and more are in the works.

But some experts question the main rationale for the bans, saying there's not good medical evidence that cigarette smoke outdoors can harm the health of children and other passers-by.

Whether it is a long-term health issue for a lot of people "is still up in the air," said Neil Klepeis, a Stanford University researcher whose work is cited by advocates of outdoor bans.
Ronald Bayer, a Columbia University professor, put it in even starker terms.

"The evidence of a risk to people in open-air settings is flimsy," he said.

There are hundreds of studies linking indoor secondhand smoke to health problems like heart disease. That research has bolstered city laws and workplace rules that now impose smoking bans in nearly half of the nation's bars, restaurants and workplaces.

Tuesday, August 13, 2013

Fresno workers' compensation case highlights statewide problems

The activities of Sedgwick Claims continue to draw attention in California as the issue of inadequate delivery of medical care to injured workers becomes more acute. Workers' Compensation was intended as social remedial legislation providing benefits to injured workers in an efficient and effective manner. The system just isn't working any longer as the economics of reform emasculated the benefit program. Today's post was shared by Workers Comp Brief and comes from www.fresnobee.com


A workers' compensation company is being criticized for failing to provide medical care for a Fresno woman injured on the job more than 10 years ago.

The employee, Guadalupe Ortega, spoke out with her lawyer Tuesday morning during a press conference held by the California Applicants Attorneys Association across the street from her former employer, Lyons Magnus, a major food processor in Fresno.

Although doctors and Lyons Magnus confirmed her injuries are work related, the company's insurance carrier, Sedgwick Claims Management Services, only provided two years of temporary disability compensation — even though a qualified medical evaluator confirmed she is 70% disabled, Ortega said.

Ortega's plight highlights a larger problem for injured workers statewide who have run into more roadblocks over the past eight years to receive workers' compensation, said Ortega's lawyer, Brett Grove of Keeling Grove Law Offices in Fresno.

"Unfortunately, her experiences are not unique in the workers' compensation arena," Grove said.
Ortega's severe neck, shoulder and back injuries resulted in her losing her job, she said. Ortega became homeless, and her children were taken away from her.

"Sedgwick has turned my life into a living hell," Ortega said. "How can the state of California allow this insurance company to fail to pay legitimate claims?"

Sedgwick officials were unavailable for comment. The company is based in Memphis, Tenn., and calls itself the leading North American provider for...
[Click here to see the rest of this article]

Garlock trial winds down; judge closes courtroom again

Asbestos bankruptcies have been problematic for injured workers and their families. The bankruptcies have drastically reduced benefits paid to individuals who have been exposed to asbestos fiber. Betting on time and delay, asbestos companies have utilized bankruptcy procedure to shield themselves from the economic consequences of asbestos disease: asbestosis, lung cancer and mesothelioma.Today's post was shared by Legal Newsline and comes from legalnewsline.com

CHARLOTTE, N.C. (Legal Newsline) — The ongoing bankruptcy trial for Garlock Sealing Technologies wound down Monday with attorneys for the gasket manufacturing company and those representing asbestos claimants calling their last few witnesses with the judge closing the courtroom one more time during a lawyer’s testimony.

The bankruptcy trial, which began in July at the U.S. Bankruptcy Court for the Western District of North Carolina and is expected to end later this month after a week-and-a-half break, will determine the estimated liability of the company for current and future asbestos claims. One of the central questions that will help establish how much Garlock will owe the claimants revolves around whether Garlock products, many removed decades ago, and no other sources of asbestos, led to cases of mesothelioma. Judge George Hodges will ultimately decide the estimated liability of the company for current and future asbestos claims and how much money the company will need to devote to a trust to escape bankruptcy.

David Glaspy, a California lawyer who has defended Garlock on more than 25,000 asbestos claims, testified that having disclosure of exposure information claimants against the company would have helped the company significantly in their defense.

To try and limit the company’s liability, Garlock attorneys are asserting that some plaintiffs, taking advantage of confidentiality provisions enacted for special trusts established to pay claimants who...
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Monday, August 12, 2013

Pending NJ Supreme Court Workers' Compensation Cases

The following is a list of Workers' Compensation cases pending before the NJ Supreme Court as of August 12, 2013.

Off-Premises: Parking Lot Case
Did this employee’s injuries, which occurred when she was struck by a car while walking across a public street to her place of employment from a privately owned garage in which she parked her car at her employer’s expense, arise out of the course of her employment entitling her to benefits under the Workers’ Compensation Act, N.J.S.A. 34:15-1 to -142?
Certification granted: 5/9/13
Posted: 5/13/13
Argued:
Decided:

Conflict of Laws: Preemption
Was defendant's workers' compensation proceeding in New Jersey a "first-filed litigation" that preempts her Pennsylvania lawsuit against multiple parties over the work-related accident that caused her husband's death?
Certification granted 7/12/12
Posted: 7/13/12
Argued:
Decided:

Cardiovascular: Causal Relationship
A-71-11 James P. Renner v. AT&T (068744)
Does the record support this workers' compensation claim under N.J.S.A. 34:15-7.2, which sets the standard of proof governing claims based on injury or death from cardiovascular causes?
Certification granted: 2/14/12
Posted: 2/14/12

Decided:

CMS Releases Revised List of Workers Compensation Set-Aside Contacts

The Centers for Medicare and Medicaid Services has released a revised list of contacts for Workers' Compensation Set-Aside Contacts. The contacts have been centralized in 6 areas of the US.

Click here to download the PDF version of the revised list of contacts.

The 10 Top Workers Compensation Blog Posts This Month (July-Aug 2013)


The 10 Top Workers Compensation Blog Posts This Month 
(July-Aug 2013) 
In order of popularity


Jul 25, 2013,

Jul 20, 2013,

Jul 18, 2013,

Aug 2, 2013,

Jul 17, 2013,

Jul 14, 2013,

Aug 5, 2013,

Jul 26, 2013,

Jul 12, 2013,

Jul 28, 2013,

Friday, August 9, 2013

Move Over: Obesity as a medical condition is coming to workers' compensation

The recent action by the American Medical Association to recognize obesity as a medical condition is going to have a super-sized impact on workers' compensation systems throughout the nation. Today's post is shared from insurancejournal.com

Report: Obesity Monkier to Impact California Workers’ Comp
"The recognition of obesity as a disease may have a significant impact on workers’ compensation claims in California, a group said in a report on Thursday.

The group issued the report following a decision in June by the American Medical Association House of Delegates to reclassifying obesity as “a disease state.”

In the past obesity in workers’ comp went largely unreported because it was not considered a condition that needed to be addressed to treat most work related injuries or illnesses, according to the report from the California Workers’ Compensation Institute.

But with obesity reclassified as a disease medical providers may feel a greater responsibility to counsel obese patients about their weight, or if treatment for a compensable injury causes significant weight gain, CWCI stated in its report........


Read the entire article

Thursday, March 28, 2013

Official Disabilities Guidelines Now Covers Diabetes

Today's post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

While diabetes is not a work injury or illness, it can have a serious impact on the rate at which an injured worker recovers. For instance, people with diabetes may have a much harder time healing from a foot or leg injury.

The latest edition of the annual Official Disabilities Guidelines (ODG) has been released, including the latest ODG volume on treating patients. ODG Treatment is the nationally recognized standard for medicine in determining the scope and duration of medical treatment in workers’ compensation.

Friday, March 15, 2013

Workers' Compensation is Riding on the Road to Wellville with Obama Care

As Obama Care [The Affordable Care Act] launches, workers' compensation programs will start to undergo subtle changes   The innovation of wellness programs and new treatment protocols will eventually cause major shifts to the delivery of workplace medicine.

Workers' compensation's future, ironically, has actually been viewed primarily in a rearview mirror. The shift to break with old habits has been a major struggle. The inertia will give way to a creative future based on new technologies and socio-economic challenges.

In a recent article by The Honorable David B. Torrey, Judge of Workers' Compensation ["The Affordable Care Act and Effects on the Workers' Compensation System, (7 PAWCSNL 114 at 30, March 2013)], the significance of  Obama Care is reported.  Judge Torrey recognizes that even those with major pecuniary interests in the compensation business have been unable to halt the momentum of change.

The Painful Knee: A Genetic Issue

Recent reports indicate that the pace at which aging knees deteriorate maybe a function genetics and that conservative treatment might indeed be the best approach.

"But in the end, genetics, and the kind of cartilage you got from your parents, may play the biggest role. It is a little like buying tires, said Dr. Frederick M. Azar, chief of staff of the Campbell Clinic in Memphis and an official with the American Academy of Orthopaedic Surgeons. “You can get nice treads or you can get retreads,” he said."

Read the complete report: Why Do My Knees Hurt? (NYTimes 3.15.13)

Saturday, January 12, 2013

Medical Outcome Based Compensation - Essentially a Workers' Compensation Concept Already

Outcome Based Medicine Being Adopted by NYC
The idea of compensation medical providers for the end result, or benefits of medical care provided, is not a new concept as it is already embraced theoretically by the workers' compensation system. Employers, who usually control the delivery of medical benenfits, not only pay for medical benenfits, but also compensate the injured worker for the outcome through permanent disability awards.

In actuality the workets' compensation system rewards the employer for the most favorable outcomes by theoretically awarding lower permanent disabillity benenfits to those with the most favorable outcomes.
Adopting this concept to the nation's entire medical care system, is a wise step and one that is being advanced in the New York City Hospital system.

"In a bold experiment in performance pay, complaints from patients at New York City’s public hospitals and other measures of their care — like how long before they are discharged and how they fare afterward — will be reflected in doctors’ paychecks under a plan being negotiated by the physicians and their hospitals."

Click here to read New York Ties Doctors’ Pay to Quality of Care (NY Times)
Nov 09, 2012
On Tuesday, the American people expressed its support for a unified medical care program that will embrace all aspects of life, including industrial accidents and diseases. They validated, as did the Supreme Court, the ...
Jan 10, 2013
Soaring medical costs have afflicted the workers' compensation industry with economic distress and have severely impacted the efficient and effective delivery of medical care to injured workers. Both increased costs/profits ...
Nov 16, 2012
Adopt the new carpal tunnel syndrome (CTS) medical treatment guidelines (MTG) as the standard of care for the treatment of injured workers with carpal tunnel syndrome;; Modify current MTGs to include new maintenance ...
Jan 01, 2013
Medical costs continue to be shifted to other programs including employer based medical care systems and the Federal safety net of Medicare, Medicaid, Veterans Administration and Tricare. While a trend continues to ...

Tuesday, January 1, 2013

Workers’ Compensation 2013 – What Happens on the Other Side of The Fiscal Cliff?

The fiscal reality is that workers’ compensation is in greater jeopardy than ever before as the debate in Washington is not about the deficit at all. The debate is about government spending which includes health care.

Overall health care devours 18 percent of the US economy and amounts to 25% of the Federal budget.

Medical treatment for injured workers continues to be delayed, denied and limited under current workers’ compensation programs. Medical costs continue to be shifted to other programs including employer based medical care systems and the Federal safety net of Medicare, Medicaid, Veterans Administration and Tricare.

While a trend continues to emerge to offer “Opt Out” and “Carve Out Programs,” they are not global enough to solve the critical budget deficit issues. The latest emerging trend is for employers to utilize ERISA based medical care plans to efficiently delivery medical care. In NJ a limited alternate dispute-resolution procedure between unions and employers has been introduced. See “NJ Care Outs –Another Evolutionary Step” authored by David DePaolo.

The US economy continues to be very weak. This in an ominous signal for the nation’s workers’ compensation program which is starved for premium dollars. Premiums are based upon salaries and real median incomes continued their dramatic decline over the last decade from $54,841 in 2000 to $50,054 in 2011. There just may not be enough dollars available in the workers’ compensation programs to pay for present and lifetime medical care.

Even the present Federal system leaves much to be desired. Whether Federal rationing medical care becomes a reality is unknown. Physicians are under economic scrutiny as the “Doc Fix” to limit provider fees continues as a cloud over all medical programs. The agreement reached by Congress still does not resolve the 26.5% percent cut reimbursement cut to physicians who treat Medicare patients. The law merely "freezes" payment to physicians.

Workers’ compensation programs presently structured provide no real economic incentive to monitor and compensate for more favorable medical outcomes. On the other hand, the Federal government, with broad and sweeping regulatory ability, is able to continue to make strides in many areas including present incentives to hospitals and proposed incentives to physicians to provide medical treatment with fewer complications and ultimate better outcomes


Steven Ratner in the NY Times points out the dramatic increase in the nation’s health care costs. He wrote, “…no budget-busting factor looms larger than the soaring cost of government-financed health care, particularly Medicare and Medicaid.”



Solving the economic gridlock of the country will require an approach to re-invent a medical program for injured workers. A global single-payer program under Federal control will eliminate duplicative administrative State and private efforts. The Federal government has the clout to provide efficient enforcement and co-ordination.

Now that we are on the other side of the fiscal cliff, the opportunity to be creative is possible. The US needs to transition to a single-payer health care system subsuming a medical care program for injured and ill workers who suffer both traumatic and occupational conditions.

Read more about the "single-Payer System" and workers' compensation

Workers' Compensation: A Single Payer System Will Solve the ...
Nov 29, 2012
The question is whether the nation will recognize that the US needs tol take the bold step previously taken by the European Community, finally adopt a single payer medical care program. The perpetual cost generator that ...
http://workers-compensation.blogspot.com/

NJ Urged to Adopt Single Payer System for Workmens Comp
Jun 06, 2011
NJ Urged to Adopt Single Payer System for Workmens Comp. A coalition that has been formed in NJ is urging that the Garden State follow the lead of Vermont and establish a single-payer system. Single-payer movements ...
http://workers-compensation.blogspot.com/

Vermont Single Payer System Called the Dawn of A New Era
Apr 03, 2011
The proposed state based Vermont Single-Payer health care system, that would embrace workers' compensation medical care, is gaining momentum. A recent article in the New England Journal of Medicine, citing increased ...
http://workers-compensation.blogspot.com/

RICO Issues Can Be Cured With A Single Payer Medical System
Mar 22, 2011
Vermont's proposed single payer system would seperate medical care from indemnity. Vermont's single proposed single-payer system would likely also provide a primary care doctor to every resident of Vermont. This would ...
http://workers-compensation.blogspot.com/
Related articles

Thursday, December 27, 2012

Who Calls The Shots, Your Employer-Selected Doctor Or The Insurance Company?


Insurance companies sometimes tell doctors that they will not pay for procedures that the doctor says are medically appropriate.

Today's post comes from guest author Nathan Reckman from Paul McAndrew Law Firm.

In Iowa, employers have the right to control an injured worker’s medical care. This means that if you are injured at work, your employer gets to send you to a doctor of their choosing. The doctors chosen by the employer are called “authorized treating physicians.” In theory, after an employer chooses their authorized treating physician, they are required to pay for any care that doctor believes is necessary to treat the work injury. In practice, the employer and their workers’ compensation insurance company often try to interfere with the care the injured worker is entitled to by refusing to pay for procedures or tests recommended by their handpicked doctor.

Typically, when an authorized doctor suggests an expensive course of care (like surgery) the first thing the doctor will do is check with the insurance company to make sure the surgery is going to be paid for. Instead of immediately scheduling the needed surgery, the doctor will wait until the insurance carrier agrees to pay for the procedure. Doctors do this so they don’t have to worry about how they are going to be paid. Asking for this unneeded authorization from the insurance company means the insurance company now has a say in determining what individual procedures are proper for the care of the work injury.

We often see injured workers whose injury was initially accepted by the employer until the doctor requests authorization for an expensive surgery. When faced with the additional cost of surgery, the insurance carrier denies the work injury hoping the injured worker will either forego surgery or try to pay for the surgery through other means, such as their personal health insurance.

This situation may also arise when the authorized doctor recommends expensive diagnostic procedures, like CT scans, or refers the injured worker to a specialist, for example a psychiatrist for depression related to the work injury.

To make sure your rights are protected, it’s often helpful to have an experienced workers’ compensation attorney on your side if you’re facing a situation where your employer is trying to interfere with the decisions of their handpicked doctor. Injured workers should get the care that their doctor, not an insurance company, determines is medically appropriate.

Read more about "medical treatment" and workers' compensation.


Nov 16, 2012
New York Worker's Compensation Board's proposed new medical treatment guidelines that will modify 2010 previously implemented. Adopt the new carpal tunnel syndrome (CTS) medical treatment guidelines (MTG) as the ...
Nov 09, 2012
On Tuesday, the American people expressed its support for a unified medical care program that will embrace all aspects of life, including industrial accidents and diseases. They validated, as did the Supreme Court, the ...
Nov 01, 2012
Planned changes by Mitt Romney to Medicare and Medicaid will have a dire effect on the regulations of the future cost of workers' compensation medical treatment. Proposed changes to the Federal program will indirectly ...
Jan 22, 2011
The court held that the failure of the employer/insurance carrier to provide medical care for out-of-state treatment, even though requested by the employee, was deemed a refusal of the employer to provide adequate medical ...

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