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

Monday, June 5, 2017

Chaos for Workers' Compensation Programs--The Elimination of Social Security Numbers?

The Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security Numbers (SSN) from Medicare cards to help combat identity theft and safeguard taxpayer dollars. The question remains whether the elimination will cause chaos in state workers' compensation programs since the SSNs have historically been utilized as personal identifiers.

Saturday, February 11, 2017

Chaos in Workers' Compensation - Raising Medicare's Eligibility Age to 67

A new issue for workers' compensation programs is  emerging as  the Republicans push forward on their legislative agenda to reform Medicare. Uncertainty over the impact of raising the eligibility age for Medicare from 65 to 67 may seriously and adversely impact the nation's network of fragile workers' compensation schemes. Furthermore, looming in the background is also the elimination of The Affordable Care Act and the consequence of a large pool of uninsured again seniors.

Friday, December 2, 2016

Insurance Rating Company Increases Estimate for Net Ultimate U.S. Asbestos Losses to $100 Billion

A.M. Best has increased its estimate for losses that U.S. property/casualty insurers can ultimately expect from third-party liability asbestos claims by approximately 18% to $100 billion. The $15 billion increase to the net ultimate asbestos loss estimate comes as insurers are incurring approximately $2.1 billion in new losses each year while paying out nearly $2.5 billion on existing claims. The updated figures are contained in a new Best’s Special Report, titled “A.M. Best Increases Estimate for Net Ultimate Asbestos Losses to $100 Billion.” The report also states that A.M. Best is not making any change to its $42 billion estimate on net ultimate environmental losses; therefore, A.M. Best’s view of ultimate industry losses for asbestos and environmental (A&E) is now $142 billion.

Saturday, September 17, 2016

Senator Boxer Calls for Expedited TSCA Asbestos Evaluation

Senator Barbara Boxer (D-CA), Ranking Member of the Environment and Public Works Committee, sent a letter today to Gina McCarthy, the Administrator of the Environmental Protection Agency (EPA), urging the Agency to move quickly to act on all forms of asbestos under the new Toxic Substances Control Act (TSCA).  EPA is required to select 10 chemicals that will be evaluated and then regulated if they are shown to present unreasonable risks. The full text of the letter is below.

August 26, 2016

Dear Administrator McCarthy:

I am sure you share my strong interest in maximizing the success of the new Toxic Substances Control Act (TSCA) and are working to identify positive early actions that demonstrate the Agency’s commitment to bold and effective implementation.

The first important decision EPA must make under the law is to select the initial 10 chemicals that will be evaluated and then regulated if they are shown to present unreasonable risks.  This decision must be made by mid-December of this year.  The chemicals selected will drive EPA’s agenda for the next several years. To build confidence in the agency’s ability to deliver meaningful results for our children and families, EPA must consider all forms of asbestos in this initial list of chemicals it acts on.

In 1989, EPA issued a comprehensive rule under TSCA banning and phasing out the major uses of asbestos.  Despite the extensive record compiled by the agency, the Fifth Circuit Court of Appeals overturned the rule.  The court’s decision paralyzed EPA’s existing chemicals program for the next two decades.  Asbestos became a poster child for the inadequacy of the law and a major impetus for TSCA reform.  As President Obama said when he signed the TSCA reform bill into law, “the system was so complex, it was so burdensome that our country hasn’t even been able to uphold a ban on asbestos….”

During the development of TSCA reform legislation, numerous members of Congress cited asbestos as an example of why the law must be revamped and emphasized that the new TSCA legislation would remove the roadblocks that stymied EPA’s first attempt to regulate asbestos.  Congress was also clear in the recently-passed legislation that regulating asbestos should be one of EPA’s top priorities -- the bill directs EPA to give priority to chemicals like asbestos that are known human carcinogens and have high acute and chronic toxicity.

Now that the impediments in the original TSCA law are gone, completing the job started by EPA in 1989 would send a strong signal that the new law can be effective in addressing the most dangerous chemicals in commerce.

The evidence regarding the dangers of asbestos is overwhelming. As EPA found in its 1989 rulemaking, “[it] is well-recognized that asbestos is a human carcinogen and is one of the most hazardous substances to which humans are exposed in both occupational and non-occupational settings.”  OSHA has similarly said it is “aware of no instance in which exposure to a toxic substance has more clearly demonstrated detrimental health effects on humans than has asbestos exposure.” OSHA has also emphasized that “[t]here is no "safe" level of asbestos exposure for any type of asbestos fiber [and] [a]sbestos exposures as short in duration as a few days have caused mesothelioma in humans.”

Asbestos continues to exact a high toll in disease and death on Americans.  According to the Asbestos Disease Awareness Organization (ADAO), the estimated annual number of asbestos-related disease deaths is nearly 15,000 in the U.S., including nearly 11,000 deaths from lung cancer.

Though asbestos production has ceased in the U.S. and its use has generally declined, significant imports for a range of applications persist and exposures continue to occur with alarming regularity.  According to a detailed study by the Environmental Working Group, from 2006 to 2014, 23 ports on the Gulf of Mexico, West Coast and Eastern Seaboard received more than 8.2 million pounds of raw asbestos, as well as hundreds of shipments of hazardous asbestos waste and products made with asbestos.

Similarly, in its annual report on U.S. mineral importation and use, the United States Geological Service states that in 2015:

“Asbestos consumption in the United States was estimated to be 400 tons, based on asbestos imports through July 2014.  The chloralkali industry accounted for an estimated 88% of U.S. consumption.  The remainder was used in coatings and compounds, plastics, roofing products, and unknown applications.”

The World Health Organization (2006) has called for an end to the use of all types of asbestos as the most effective way to eliminate asbestos-related diseases.  From the European Union to the Persian Gulf, from industrial states like Japan to Africa’s developing economies, 56 nations have followed this recommendation and banned asbestos (with limited exceptions), according to the International Ban Asbestos Secretariat.

The combination of well-documented, widespread and serious health effects and ongoing use and exposure provides a strong basis for EPA to act quickly on asbestos.  With the new tools provided by the Frank R. Lautenberg Chemical Safety for the 21st Century Act, the U.S. now has the ability to be a global leader and join the many other nations that have acted to address the harms posed by asbestos.  EPA should seize this opportunity by including asbestos in the first 10 chemicals that it acts on under the new law.

I look forward to learning more about your plans for asbestos.

Sincerely,

Barbara Boxer
Ranking Member
….

Jon L. Gelman of Wayne NJ is the author of NJ Workers’ Compensation Law (West-Thomson-Reuters) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thomson-Reuters). For over 4 decades the Law Offices of Jon L Gelman  1.973.696.7900  jon@gelmans.com  has been representing injured workers and their families who have suffered occupational accidents and illnesses.

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Jan 29, 2010 ... The Toxic Substances Control Act (TSCA) was enacted in 1974 and has not kept up with the time. Of the 80,000 chemical substances in use it ...
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Oct 14, 2013 ... TSCA was passed more than 30years ago and is grossly out of date. ADAO has been a stakeholder in discussions with Congressional ...
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Thursday, June 9, 2016

NJ Supreme Court Allows COLA Pension Freeze

LaVECCHIA, J., writing for a majority of the Court. In this appeal, the Court considers whether the 2011 suspension of State pension cost-of-living adjustments (COLAs), L. 2011, c. 78, contravened a term of the contract right granted under the earlier enacted “non-forfeitable right” statute, L. 1997, c. 113 (presently codified as N.J.S.A. 43:3C-9.5).

Saturday, June 4, 2016

Mesothelioma: Employer Held Liable for Wife's Asbestos Related Death

The Tennessee Valley Authority (TVA) was held liable for the death of an asbestos worker's wife death from mesothelioma. A Federal Court in Alabama held that the the employer held that the employer had a duty to protect the wife a nuclear plant employee from take home asbestos exposure.

Friday, March 4, 2016

The National Association of Workers’ Compensation Judiciary March 2016 Newsletter

I strongly urge you to read The National Association of Workers’ Compensation Judiciary March 2016 Newsletter for cutting edge information concerning national workers' compensation issues.

Monday, January 18, 2016

Sanders Proposes Universal Health Care: The Path to Federalization


Presidential candidate Bernie Sanders has announced a plan to move forward with a Universal Medical Care program in the US. The concept will absorb the nation's ailing the medical workers' compensation delivery system into a universal care system.

Thursday, June 25, 2015

The Path to Federalization: US Supreme Court Again Validates the Affordable Care Act

The US Supreme Court again affirmed the validity of The Affordable Care Act. The Obamacare program, as it has been nicknamed, will continue to lead to a medical delivery program than eventually will have major repercussions on the antiquated and ineffective medical care system of the existing patch work of state workers' compensation insurance acts.

Friday, May 22, 2015

Compensable Mental Stress and Conflict of Law Decisions Posted

The NJ Division of Workers' Compensation [NJDWC] today published 3 Court of Compensation trial level decisions. All were favorable to the injured workers and their dependents.

1. Mental Stress: Stress (harassment) particular to employment results in compensable psychiatric claim
Ross v. City of Asbury Park
06–28659; decided July 28, 2008 by the Honorable Leslie A. Berich
Petitioner alleged compensable injury as a result of mental stress created by prolonged exposure to a hostile work environment. Respondent denied these allegations. After applying the Goyden test along with other relevant legal principles, the Judge of Compensation found that there were objectively stressful working conditions peculiar to the petitioner’s working environment which entitled the petitioner to workers compensation benefits.

2. Mental Stress: Specific event (Hurricane) results in compensable suicide claim
Wilde v. Township of Cranford
99–40680; decided January 17, 2008 by the Honorable Leslie A. Berich
Petitioner filed a claim for dependency benefits for herself and her two children by asserting that her husband suffered a stress-induced occupational suicide. The respondent defended against the claim by contending that the work of the deceased, including his work as a policeman during Hurricane Floyd, was not causally related to his suicide. After careful consideration of the evidence, the Judge of Compensation awarded dependency benefits based on her finding that the work of the deceased as a policeman during this storm "lead to a loss of normal rational judgment that resulted in his suicide".

3. Conflict of Laws: NJ law applied where a special state interest existed
Spiros v. Atlantic Ambulatory Anesthesia Assocs. & Shrewsbury Surgical Center
12–22032; 13-1069 decided October 27, 2014 by the Honorable Leslie A. Beric
Medical providers filed applications for payment/reimbursement of medical expenses, which alleged that the insurance carrier for the employer unreasonably reduced the petitioner’s bills for services rendered. The carrier filed an answer in which it denied liability and jurisdiction, asserting the petitioner’s bills could be paid only at a contractual rate highly limited by Tennessee statute. The carrier also filed motions to dismiss the medical provider claims. In analyzing whether New Jersey has a special state interest in cases where medical providers provide services in New Jersey to injured workers, the Judge of Compensation found that N.J.S.A. 34:15-15 gives New Jersey’s Division of Workers’ Compensation exclusive subject matter jurisdiction and New Jersey law applies where the workers’ compensation benefits were provided in this state. Accordingly, the carrier’s motions to dismiss the medical providers’ claims were denied.

Summaries were provided by the NJ DWC.

Wednesday, May 6, 2015

Professor John F Burton Jr: Illinois Proposed Changes Are Obectionable

The former chair of the 1972 National Commission on Workers' Compensation told the Illinois legislature yesterday that the proposed changes to the Illinois Workers' Compensation Act will degrade the system and reduce benefits to injured workers. Profession Emeritis John F. Burton, Jr., yesterday presented a statement to the Committee of the Whole before the Illinois House of Representatives.
Professor John F. Burton Jr.

Saturday, January 24, 2015

The Cold Winds of Workers' Comp Reform Are Blowing in Wisconsin

Today's post is shared brom Bob Wilson at workerscompenstion.com

I have it on excellent authority that major changes to the Wisconsin workers’ compensation system will be proposed with the release of the state’s budget bill on February 3, 2015. The rumored changes are said to be significant, with some viewing it as a complete dismantling of the current workers’ comp system there. In the absence of the release of the actual budget and proposals, it still sounds like the most dramatic reforms to hit a state since Tennessee and Oklahoma conducted complete overhauls of their WC systems.

Currently in Wisconsin, the Workers’ Compensation Division is part of the larger Department of Workforce Development (DWD). On January 12, 2015, WC Division managers apparently learned of this proposal from the DWD Secretary’s office. It is believed that the person behind this effort is DWD Secretary, Reggie Newsom. Under Newsom’s proposal, the Worker’s Compensation Division would be entirely removed from the auspices of DWD. Other agencies would absorb some of the functions, while some current practices and procedures would cease to exist.

One group that appears to be subject to the greatest changes would be Wisconsin’s current Administrative Law Judges. Under the proposed changes, they would only be responsible for trying cases.  They would not manage claims functions or act in any advisory role for industry stakeholders. They would...

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Thursday, January 8, 2015

Rubio signals his thoughts about benefits: Votes NO on TRIA

Today's post is shared from tampabay.com

Sen. Marco Rubio was one of only four members of his chamber to vote today against a federal terrorism insurance program, which had earlier passed the House by a near unanimous vote.

As the Associated Press describes it, “The program provides a backstop in which the government steps in to cover the bulk of losses after the first $200 million in damages from a terrorist attack, up from $100 million previously.”

It was the first bill to clear the 114th Congress and President Obama is expected to sign it to law.

So why did Rubio join liberals including Bernie Sanders and Elizabeth Warren?

“The Terrorism Risk Insurance Program has become just another big corporate welfare handout,” Rubio spokeswoman Brooke Sammon wrote in a statement. “Senator Rubio had hoped that more would be done to reform this program and allow the private market to evolve. Thankfully, the insurance program has never been triggered. It’s his hope our nation continues to be protected from another terrorist attack by the brave men and women serving America and that the six year authorization will never have to be utilized.”

Sunday, December 28, 2014

Gov. Chris Christie and NJ Workers' Compensation: Declining Approval

What has NJ Gov. Chris Christie done for Workers' Compensation? It appears that he has done little to nothing except, complain it needs reform.

NJ continues with high unemployment, a failing infrastructure, steep taxes, a mass migration of both Industry and Labor out-of-the state, high debt, and declining public pension reserves. The State continues with a spiraling rate of income inequality that reflects high and almost unobtainable maximum workers' compensation rates for the vast majority of low and middle income wage earners.

The State's antiquated workers' compensation system continues with a reverse social security offset that favors insurance companies to the detriment of the nation's taxpayers. NJ administratively refuses to allow COLA increases under the Triennial Redetermination Social Security program to those totally disabled workers who receive benefits and NJ continues to allow insurance companies and employers to reap benefits at the detriment of injured employers. NJ still maintains an antiquate, objectionable, obsolescent and costly Second Injury Fund for pre-existing injuries when the vast majority of states have terminated such programs.

Additionally, NJ, that lacks a medical provider fee schedule, continues to control medical treatment by requiring injured workers to obtain only employer authorized medical care and prohibits injured workers freedom to choose their own medical providers.

Unproductive bullying of the public at the NJ Governor's "town hall meetings" has become a trademark of his administration. The excitement and approval of "the entertainment value" of those events in the past caught the attention of the public at the emergence of his administration and allowed him to gain popularity. That has now faded has Governor Christie's public approval, according to recent polls in NJ, is declining.



In the meantime, Gov. Christie criticizes NJ workers' compensation and lacks an announced plan to correct the ailing system.

“'We’re  going to be coming up with a package of proposals that’s going to work both sides of that,' Christie told a caller on his monthly NJ 101.5 FM radio show tonight.

'The employers who may not be stepping up and meeting their obligations and also the employees who are committing fraud on the worker’s comp system,' he said."



NJ Gov. Christie, April 2013

Today's post is shared from nytimes.com/

When the Chris Christie-for-president chatter first started, in 2011, voters in his home state of New Jersey took pride in having a celebrity governor. As Nancy Reagan escorted Mr. Christie to his speech at her husband’s presidential library, and hedge fund billionaires, The Weekly Standard and The Wall Street Journal’s editorial pages urged him to run, his approval ratings jumped. Voters told pollsters the national attention made him more effective, and improved their state’s long-maligned image.

Four years later, with Governor Christie again considering a run for president, his constituents appear to be tiring of the whole routine.

Polls taken over the last three months reveal a list of home-state complaints: Mr. Christie’s favorability is at its lowest point, with more voters disapproving than approving of his job performance. New Jersey residents think he is making decisions with an eye on his national standing rather than on what is good for their state. They do not think he should run for president — they are, as the slogan goes, ready for Hillary — but most expect he will, and want him to resign if he does. Political talk in New Jersey centers less on Mr. Christie running for president and more on which one of three Democrats quietly seeking to succeed him will win — even though that election is three years away.

Click here to read the entire NY Times article.

Saturday, December 27, 2014

Overtime bonanza at Port Authority; 13 officers set to make more than agency’s director

Wages in workers' compensation determine the rat of workers' compensation payments. Today's post is shared from northjersey.com/
Three years after New York State issued a scathing report criticizing what it characterized as excessive overtime at the Port Authority, 131 of the agency’s employees worked so much overtime in the first nine months of this year that they already more than doubled their annual base salaries.
Thirteen agency police officers received more in salary, overtime and other payments in that period than did Executive Director Patrick Foye, whose annual salary is $289,000.

Most of the top overtime earners are police officers, including one who has been averaging an estimated 100 hours of work a week this year, including 60 hours of overtime. That is the equivalent of working more than 14 hours a day, seven days a week. The top 10 overtime earners are averaging an estimated 46 extra hours each week, a workload that experts say raises questions about efficiency and public safety, and is quite high even in a profession where significant overtime is routine.
The legislatures in both New Jersey and New York have passed identical bills that call for sweeping changes in the way the agency operates, but neither Governor Christie nor New York Gov. Andrew Cuomo has indicated whether he will sign the legislation.
Cuomo faces a critical deadline: He must decide by Saturday. Christie must decide by mid-January. Both states...
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Wednesday, December 24, 2014

Where the Workers' Compensation Medical Dollar Goes in Florida


"Medical cost drivers, particularly in the areas of drugs, hospital inpatient, hospital
outpatient and ambulatory surgical centers (ASC) are noticeably higher in Florida than a
countrywide average. Legislative reform in the reimbursement of these services could
produce substantial savings for Florida employers. "
Florida Office of Insurance Regulation, Workers’ Compensation Annual Report December 2014

Saturday, December 20, 2014

TRIA Non-Renewal: No Loss to Workers

Todays guest post is shared from workcompwire.com and is authored by Peter Rousmaniere.

The failure to renew the Terrorism Risk Insurance Act (TRIA) – first enacted in 2002, renewed in 2005 and 2007 – raises two questions: Who would have benefited from renewal, and who is harmed by non-renewal, with regards to workers’ compensation?

Workers did not benefit from TRIA. They may benefit from its non-renewal. For them, TRIA was useless.

For workers’ compensation insurers, TRIA simplified their management of risk and now they have to work harder. TRIA was, when you peel away the onion, about insurers taking care of their markets. Every other consideration appears to be secondary.

The impact of non-renewal on employers is ambiguous. Their risk management is now trickier, but they may come to see how poor a deal the federal backstop was for their employees.

TRIA mandated no expansion, clarification or revision of state workers’ compensation statutes, in coverage and process. After claim payers incurred a specified threshold of losses, the Federal Government was to begin to help fund further losses. (This is a very simplified but I think fair summary.)

Throughout the history of statute, including the legislative debates and published studies, few, if any, took the time to ask some fundamental questions:
What nature of conditions could arise from a terrorist attack?
Do workers’ compensation statutes cover these conditions?
For conditions that are covered, is there a reasonable chance that affected workers will obtain adequate benefits?
...
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Friday, December 19, 2014

Medicare penalizes 23 New Jersey hospitals over errors, infections

Hospital acquired infections (HAI) are a major problem and take a toll on injured workers and employers. The Federal Government in its expanding roll to provide better services at les cost is now enforcing HAI rules by imposing penalties. Today's post is shared from northjersey.com/
The federal government will reduce its Medicare payments to 23 hospitals in the state — including six in North Jersey — in a crackdown on hospital errors and infections.
The list of hospitals, released Thursday, includes Hackensack University Medical Center, St. Mary’s Hospital in Passaic and Bergen Regional Medical Center in Paramus. In all, 721 hospitals nationwide will see their Medicare payments cut by 1 percent for the year that began Oct. 1.
New Jersey was one of 10 states where a third or more of the hospitals were penalized.
The financial incentives and public reporting are a two-pronged strategy under the health care reform law known as Obamacare aimed at reducing harm to patients from hospital stays. Hospital errors are estimated to cost Americans more than $17 billion a year and contribute to the deaths of 180,000 Medicare patients alone.
And because Medicare, the federal insurance program for those over 65, is one of the largest sources of hospital revenue, even a 1 percent reduction can have a sizable impact on health care facilities.
For example, Hackensack University Medical Center, with $1.2 billion in revenue in 2012, had more than $263 million in Medicare payments that year. So a reduction of 1 percent would cost it nearly $3 million.
Reached on Thursday night, hospital spokeswoman Nancy Radwin said that Hackensack “remains committed to reducing its hospital-acquired condition rates. As evidenced...
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Read more about hospital acquired infections and workers compensation
Aug 15, 2008
The patient was admitted for the installation of a pacemaker and a resulting hospital acquired infection resulted in the loss of his right leg a portion of his left foot, a kidney and his a majority of his hearing. The award was ...
May 09, 2013
Some infections are contracted during treatment such as infection that are acquired during hospital stay. Those are called Hospital Acquired Infections (HAI). These infection are expensive to treat and are a major concern to .
Mar 26, 2014
Hospital Acquired Infections are a compensable condition and significantly raise treatment costs and time to recuperate from a work related accident or disease. Today's post is shared from the US CDC. On any given day, ...
May 31, 2013
Some infections are contracted during treatment such as infection that are acquired during hospital stay. Those are called Hospital Acquired Infections (HAI). These infection are expensive to treat and are a major concern to .

Saturday, December 13, 2014

UPDATED: House passes extension of terrorism insurance

Update 12-18-2014: Note: US Senate failed to pass companion legislation before adjournment. See subsequent post for more information. The TRICA has received more media attention in light of the hacking attack and threatened reprisals on Sony pictures and the alleged connection to North Korea.

Today's post is shared from thehill.com/

The House on Wednesday passed legislation to extend the terrorism risk insurance program through 2020 despite objections from Democrats over the inclusion of unrelated provisions to change the Dodd-Frank financial overhaul.
The measure passed overwhelmingly by a vote of 417-7. All of the seven votes in opposition were from Republicans.
Congress created the Terrorism Risk Insurance Act (TRIA) in 2002 as a temporary program following the Sept. 11 attacks. It allows for the federal government to recoup costs for businesses after a terror attack in which the damage exceeds $100 million.
House Financial Services Committee Chairman Jeb Hensarling (R-Texas) and Sen. Chuck Schumer (D-N.Y.) negotiated a six-year reauthorization and doubled the damage threshold to $200 million.
It's unclear if the bill will die in the Senate as Schumer has suggested, though the near-unanimous vote in the House could make it harder for the upper chamber to ignore.
Senate Democrats and the White House oppose an amendment that they say would weaken the 2010 Dodd-Frank Wall Street reform law. The provision would no longer require non-financial institutions — dubbed "end users" — from following the same regulations as big banks.
The White House said it "strongly opposes" the Dodd-Frank reforms included in the measure, but stopped short of a veto threat.
Republicans — along with 181 House Democrats who supported a House version of the "end users"...
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