Legislation has been reintroduced to provide workers’ compensation benefits for certain public safety workers who developed an occupational illness or injury flowing from the September 11, 2001, terrorist attacks. A closer look at the legislation reveals that it removes defenses such as causal relationship, statute of limitations, and jurisdiction. Complicated statutory and regulatory challenges may ultimately offset the benefits offered.
Showing posts sorted by date for query reverse offset. Sort by relevance Show all posts
Showing posts sorted by date for query reverse offset. Sort by relevance Show all posts
Tuesday, January 30, 2024
Tuesday, March 8, 2022
Rules Adopted to End NJ Pension Cost Shifting
The New Jersey Department of Labor and Workforce Development [DLWD] adopted Rules embracing the recommendations of NJ State Comptroller concerning NJ State Pensions. A February 2021 investigative report by the NJ State Comptroller raised critical issues common to other state and national collateral social insurance programs challenged by current fiscal limitations. The rules are effective as of March 7, 2022. 54 N.J.R.448(a). The Rules were adopted without change and have retroactive application.
Wednesday, September 1, 2021
Social Security to be Depleted by 2033
The Social Security Board of Trustees today released its annual report on the long-term financial status of the Social Security Trust Funds. The combined asset reserves of the Old-Age and Survivors Insurance and Disability Insurance (OASI and DI) Trust Funds are projected to become depleted in 2034, one year earlier than projected last year, with 78 percent of benefits payable at that time.
Thursday, August 19, 2021
Rules Proposed to End NJ Pension Cost Shifting
The New Jersey Department of Labor and Workforce Development [DLWD] has proposed Rules that will adopt the recommendations of NJ State Comptroller. A February 2021 investigative report by the NJ State Comptroller raised critical issues common to other state and national collateral social insurance programs challenged by current fiscal limitations. The deadline for written comments is October 15, 2021.
Tuesday, June 22, 2021
NJ Court Upholds Bar on Implementing Triennial Determination
Disability Benefits before age 62 are not entitled to a COLA (Cost of Linving) increase in benefits, a “triennial determination.” The Court reasoned that the 1980 NJ statute allowing for a “reverse offset,” one in which the employer takes the Social Security Disability Offset, also permits NJ law to pre-empt Federal law that mandates such a recalculation.
Tuesday, March 2, 2021
Supplement Benefit Bill for Surviving Dependents of Essential Coronavirus Workers Passed by NJ Legislature
The NJ Legislature has now passed S2476. It provides supplemental benefit payments to the dependents of essential employees who died in the course of employment due to the contraction of coronavirus disease 2019.
Sunday, February 7, 2021
Investigative Report Raises Issues
The tension between public pension systems and workers' compensation programs was highlighted in a recent investigative report by the NJ State Comptroller. The report raises additional critical issues common to other state and national collateral social insurance programs challenged by current fiscal limitations.
Tuesday, May 14, 2019
Governor Conditionally Vetoes NJ Supplemental Benefits Bill
The NJ supplemental workers' compensation bill has been conditional vetoed by NJ Governor Murphy. In the conditional veto message the Governor notes that the legislation's unintended consequences would jeopardize NJ's "reverse offset," shift the cost responsibility and not provide an economic benefit to the injured workers. The NJ Senate then took action.
Thursday, April 4, 2019
Trump Administration Proposes Elimination of the Reverse Offset
The Trump Administration in its proposed FY 2020 Budget has proposed elimination of the workers’ compensation reverse offset. The elimination will act as a cost saving measure and will level the playing field for all workers’ compensation system throughout the United States.
Monday, March 4, 2019
Watered down NJ supplemental benefits heads to the Governor
A watered-down version of the original NJ supplemental workers’ compensation benefits bill has been approved by the Legislature. It now heads to the NJ Governor Murphy for review.
Wednesday, September 5, 2018
Totally Injured Workers Maybe Getting an Increase in Benefits
The proposed Trump Administration 2019 Budget (p. 115) may allow NJ workers’ compensation beneficiaries to receive an increase in benefits. By eliminating the Social Security “reverse offset,” totally and permanently injured NJ workers will receive a triennial annual COLA increase.
“The Budget includes a re-proposal to eliminate reverse offsets in fifteen states where Workers' Compensation (WC) benefits and temporary disability insurance benefits (TDI) are offset instead of DI benefits."
Saturday, October 14, 2017
2018 Social Security Changes - COLA Increases
The Social Security Administration has announced based on the increase in the Consumer Price Index (CPI-W) from the third quarter of 2016 through the third quarter of 2017, Social Security and Supplemental Security Income (SSI) beneficiaries will receive a 2.0 percent COLA for 2018.
Saturday, June 25, 2016
The Social Security Financial Report: An Insight Into the Future
Change is coming to the Social Security Disability program based upon the The 2016 Trustees Report that was published this week. It projects that the future finances of the Social Security Disability Trust Fund will require additional funding to remain solvent.
Thursday, May 7, 2015
NJ State Bar Association Opposes Workers' Compensation COLA Bill
"The New Jersey State Bar Association respectfully has concerns with S-929 (Sweeney) which concerns
certain workers' compensation supplemental benefits.
The New Jersey State Bar Association opposes this legislation in order to preserve the “Reverse Offset”
provision in New Jersey, visa vie Social Security, which provides for a reduction of the workers'
compensation benefit of a worker also receiving disability insurance. Enacting this legislation has the
potential of harming the economic integrity of New Jersey’s current cost effective system by allowing for
a double recovery of disability benefits and workers’ compensation benefits, which will in turn increase
the cost of doing business in New Jersey. A potential alternative that would limit these adverse
consequences would be to limit the application of the bill to survivor/death benefits.
For the reasons set for above, the New Jersey State Bar Association respectfully opposes this bill."
Monday, March 9, 2015
Is The Reserve Offset Heading for Extinction?
The Obama Administration is proposing stricter collection of workers' compensation payments data of Social Security beneficiaries.
Social Security-Budget Estimates and Related Information
Budget Overview, February 2015
"10. Establish Workers’ Compensation Information Reporting. Current law requires SSA to reduce an individual’s Disability Insurance (DI) benefit if he or she receives workers’ compensation (WC) or public disability benefits (PDB). SSA currently relies upon beneficiaries to report when they receive these benefits. This proposal would improve program integrity by requiring states, local governments, and private insurers that 23 administer WC and PDB to provide this information to SSA. Furthermore, this proposal would provide for the development and implementation of a system to collect such information from states, local governments, and insurers."
FY 2016 BUDGET OVERVIEW, p. 22
http://www.ssa.gov/budget/FY16Files/2016BO.pdf
With that information, the SSA can determine if the Federal Government is accurately calculating the Federal SSA/Workers' Compensation setoff.
The obvious inequity, cost shifting, exists in those states where a reverse offset is taken. In those states, ie. NJ, the workers' compensation insurance company takes the offset credit, and NOT the Federal Government (SSA).
The collection and publication of this data will verify the inequity between States and the cost shifting to the Federal government in some states and not others. A demand for the elimination of this inequity may result in the extinction of the Reverse Offset.
See: The Gift That Keeps Giving: The SSA Reverse Offset
Social Security-Budget Estimates and Related Information
Budget Overview, February 2015
"10. Establish Workers’ Compensation Information Reporting. Current law requires SSA to reduce an individual’s Disability Insurance (DI) benefit if he or she receives workers’ compensation (WC) or public disability benefits (PDB). SSA currently relies upon beneficiaries to report when they receive these benefits. This proposal would improve program integrity by requiring states, local governments, and private insurers that 23 administer WC and PDB to provide this information to SSA. Furthermore, this proposal would provide for the development and implementation of a system to collect such information from states, local governments, and insurers."
FY 2016 BUDGET OVERVIEW, p. 22
http://www.ssa.gov/budget/FY16Files/2016BO.pdf
With that information, the SSA can determine if the Federal Government is accurately calculating the Federal SSA/Workers' Compensation setoff.
The obvious inequity, cost shifting, exists in those states where a reverse offset is taken. In those states, ie. NJ, the workers' compensation insurance company takes the offset credit, and NOT the Federal Government (SSA).
The collection and publication of this data will verify the inequity between States and the cost shifting to the Federal government in some states and not others. A demand for the elimination of this inequity may result in the extinction of the Reverse Offset.
See: The Gift That Keeps Giving: The SSA Reverse Offset
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."
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.
Tuesday, October 15, 2013
What a Government Default Will Do To Workers' Compensation
With only hours left, and the politicians in Washington DC still unsettled about how to resolve a US credit default, the focus turns to the impact on workers' compensation programs throughout the country.
Expanding on the problems besieging compensation programs following the US Government Shutdown, things are going to get much worse and very quickly. Social Security will stop paying benefits, its contractors and medical providers. Closing down those contributions will literally suffocate transactional information concerning integration of Medicare Secondary Payer Act benefits and reimbursement. Calculating offsets and reverse offsets will become an impossibility. Insurance companies in reverse offset states will be required to fund more dollars into the system as application flow into the state systems to modify prior awards still being paid.
Employers dependent upon government payments, including funding and contracts, will be unable to pay workers and insurance company premiums. Cascading financial distress will implode the economy and unemployment will become rampant.
Additional burdens will be placed upon injured workers who even already are struggling to make ends meet and obtain medical treatment with absolutely no Federal safety net in place to catch them. Injured workers with pending claims will be unable to seek medical and pharmaceutical benefits from collaterally funded programs.
Federal dollars actually fund over 70% on state rehabilitation programs. These programs will quickly dry up, and the those injured workers who are seeking placement in a new job through rehabilitation will be locked out of the states.
Workplaces will continue to be unregulated as OSHA (The Occupational Health Administration) will be unable to financially fund enforcement programs, new safety programs and even review comments for pending regulations, ie. The Smart Act.
Investigations requirement Federal records, including prior military records, will become increasingly difficult to secure. Stalling this process will delay completed workers' compensation medical records, expert evaluation opinions and the adjudication of workers' compensation claims.
Quite a mess! Not a pleasant prospect to look forward to, as the clock keeps clicking down
Expanding on the problems besieging compensation programs following the US Government Shutdown, things are going to get much worse and very quickly. Social Security will stop paying benefits, its contractors and medical providers. Closing down those contributions will literally suffocate transactional information concerning integration of Medicare Secondary Payer Act benefits and reimbursement. Calculating offsets and reverse offsets will become an impossibility. Insurance companies in reverse offset states will be required to fund more dollars into the system as application flow into the state systems to modify prior awards still being paid.
Employers dependent upon government payments, including funding and contracts, will be unable to pay workers and insurance company premiums. Cascading financial distress will implode the economy and unemployment will become rampant.
Additional burdens will be placed upon injured workers who even already are struggling to make ends meet and obtain medical treatment with absolutely no Federal safety net in place to catch them. Injured workers with pending claims will be unable to seek medical and pharmaceutical benefits from collaterally funded programs.
Federal dollars actually fund over 70% on state rehabilitation programs. These programs will quickly dry up, and the those injured workers who are seeking placement in a new job through rehabilitation will be locked out of the states.
Workplaces will continue to be unregulated as OSHA (The Occupational Health Administration) will be unable to financially fund enforcement programs, new safety programs and even review comments for pending regulations, ie. The Smart Act.
Investigations requirement Federal records, including prior military records, will become increasingly difficult to secure. Stalling this process will delay completed workers' compensation medical records, expert evaluation opinions and the adjudication of workers' compensation claims.
Quite a mess! Not a pleasant prospect to look forward to, as the clock keeps clicking down
Sunday, October 13, 2013
Social Security raise to be among lowest in years
Social Security payments are tightly kinked to workers' compensation disability payments. When there are increases in benefits, some "reverse offset" states are liberal in passing along the adjustments to injured workers'. The State of New Jersey does NOT pass along the benefit increase and the workers' compensation insurance company does NOT increase the disability award payment to the injured workers. Today's post is shared from the dallasnews.org.
[Click here to see the rest of this post]
For the second straight year, millions of Social Security recipients, disabled veterans and federal retirees can expect historically small increases in their benefits come January.
Preliminary figures suggest a benefit increase of roughly 1.5 percent, which would be among the smallest since automatic increases were adopted in 1975, according to an analysis by The Associated Press. Next year's raise will be small because consumer prices, as measured by the government, haven't gone up much in the past year. The exact size of the cost-of-living adjustment, or COLA, won't be known until the Labor Department releases the inflation report for September. That was supposed to happen Wednesday, but the report was delayed indefinitely because of the partial government shutdown. The COLA is usually announced in October to give Social Security and other benefit programs time to adjust January payments. The Social Security Administration has given no indication that raises would be delayed because of the shutdown, but advocates for... |
Sunday, September 29, 2013
The Government Shutdown is a Kick-In-Gut to Workers' Compensation
Workers' Compensation programs will be impacted by a Government shutdown because of both the offset provisions of the Social Security Act and the Medicare Secondary Payer Act (MSP). Even The SMART Act, recently enacted to hopefully establish a more efficient collection process will be derailed.
As the US House of Representatives, under Republican leadership influenced by The Tea Party, likened in Aaron Sorkin's HBO program, The Newsroom, as "The American Taliban," passed legislation to shutdown the US Government this Tuesday, serious concern exists as to the consequences of the shutdown on workers' compensation programs throughout the nation.
In many States, whether or not a reverse offset exists, it is essential to determine what a claimant's Average Current Earnings (ACE) are to calculate, and reach a final determination of temporary and permanent disability, in a state workers' compensation claim. The access to those numbers will become difficult to obtain because of administrative rollbacks, and anticipated further delays in claims processing. Even though Federal payments will be forthcoming under protective measures, the claims process will be derailed.
Likewise, the process to obtain conditional payment information will be delayed or non-existent. The provisions of the Medicare Secondary Payer Act mandating reimbursement to The Center for Medicare and Medicaid Services (CMS) will be put on hold. Similarly, reviews for future medical compromises embodied in the Workers' Compensation Medicare Set-aside Agreements (WCMSA) will be delayed just because of administrative cutbacks in the claims system, including the appeals process.
The recently enacted provisions of The SMART Act. long sought by a coalition of cottage industries, and compensation parties, to the reimbursement process itself, will face its first major challenge to implementation as the Internet web-portable becomes non-functional. Recently proposed final Rules will face delay in implementation as the exchange of comments under the rulemaking process become further delayed in the process of submission and response.
Overall, the workers who most need the system to function, and who waited the longest time, in waiting for final adjudication of their claims, will become victim of the process. No matter how long the shutdown extends, the Federal action will highlight the continued deterioration of the complex patchwork process know as workers' compensation. The now antiquated, and once expeditious and remedial insurance system, will have suffered yet another devastating blow in its attempt to survive in a radically changing economic and socio-political system.
....
As the US House of Representatives, under Republican leadership influenced by The Tea Party, likened in Aaron Sorkin's HBO program, The Newsroom, as "The American Taliban," passed legislation to shutdown the US Government this Tuesday, serious concern exists as to the consequences of the shutdown on workers' compensation programs throughout the nation.
In many States, whether or not a reverse offset exists, it is essential to determine what a claimant's Average Current Earnings (ACE) are to calculate, and reach a final determination of temporary and permanent disability, in a state workers' compensation claim. The access to those numbers will become difficult to obtain because of administrative rollbacks, and anticipated further delays in claims processing. Even though Federal payments will be forthcoming under protective measures, the claims process will be derailed.
Likewise, the process to obtain conditional payment information will be delayed or non-existent. The provisions of the Medicare Secondary Payer Act mandating reimbursement to The Center for Medicare and Medicaid Services (CMS) will be put on hold. Similarly, reviews for future medical compromises embodied in the Workers' Compensation Medicare Set-aside Agreements (WCMSA) will be delayed just because of administrative cutbacks in the claims system, including the appeals process.
The recently enacted provisions of The SMART Act. long sought by a coalition of cottage industries, and compensation parties, to the reimbursement process itself, will face its first major challenge to implementation as the Internet web-portable becomes non-functional. Recently proposed final Rules will face delay in implementation as the exchange of comments under the rulemaking process become further delayed in the process of submission and response.
Overall, the workers who most need the system to function, and who waited the longest time, in waiting for final adjudication of their claims, will become victim of the process. No matter how long the shutdown extends, the Federal action will highlight the continued deterioration of the complex patchwork process know as workers' compensation. The now antiquated, and once expeditious and remedial insurance system, will have suffered yet another devastating blow in its attempt to survive in a radically changing economic and socio-political system.
....
Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
Friday, April 5, 2013
Obama Administration Proposed Social Budget Cut Places More Stress on Workers' Compensation
It has been reported that the Obama Administration will soon propose budgetary cuts in social welfare programs. Those cuts may produce further economic stress on the nation's financially beleaguered workers' compensation system.
A reduction or rationing of medical care through Medicare will remove the safety net available to
injured workers who have been denied workers' compensation benefits initially and are delayed in the administrative/adjudicatory process.
In those states when there is a "reverse offset." the workers' compensation insurance carrier takes an offset when combined benefits exceed the ACE (Average Current Earning) before the onset of lost time, reduction of COLA (Cost of Livening Assessment) the carriers will be required to pay more dollars.
"President Obama next week will take the political risk of formally proposing cuts to Social Security and Medicare in his annual budget in an effort to demonstrate his willingness to compromise with Republicans and revive prospects for a long-term deficit-reduction deal, administration officials say."
Click here to read the complete article: "Obama Budget Reviving Offer of Compromise With Cuts" NYT
A reduction or rationing of medical care through Medicare will remove the safety net available to
In those states when there is a "reverse offset." the workers' compensation insurance carrier takes an offset when combined benefits exceed the ACE (Average Current Earning) before the onset of lost time, reduction of COLA (Cost of Livening Assessment) the carriers will be required to pay more dollars.
"President Obama next week will take the political risk of formally proposing cuts to Social Security and Medicare in his annual budget in an effort to demonstrate his willingness to compromise with Republicans and revive prospects for a long-term deficit-reduction deal, administration officials say."
Click here to read the complete article: "Obama Budget Reviving Offer of Compromise With Cuts" NYT
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