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Showing posts sorted by date for query second injury fund. Sort by relevance Show all posts

Thursday, February 13, 2014

Missouri Further Defines Permanent Total Disability

"The PTD test is whether the worker can compete in the open labor market.
Schussler, 393 S.W.3d at 96. A worker who cannot return to any normal or
reasonable employment is totally disabled; she need not be inert or completely
inactive. Id. “The key question is whether any employer in the ordinary course of
business would reasonably be expected to hire the worker in his or her current
physical condition.” Id. "

 MARLENE STEWART, Respondent vs. CLINT ZWIEFEL, TREASURER OF THE STATE OF MISSOURI AS CUSTODIAN OF THE SECOND INJURY FUND, Appellant
No. SD32827 )  FILED: February 10, 2014 

Tuesday, December 3, 2013

NJ COLA Bill - Legislative Hearing Scheduled

The NJ Senate Budget and Appropriations Committee will hold a public hearing on a pending COLA bill S613 to increase benefits on 12/5/2013 1:00:00 PM.

The Senate Labor Committee report

The Senate Labor Committee reports favorably and with

committee amendments Senate Bill No. 613.

As amended by the committee, this bill provides, from July 1, 2013

forward, an annual cost of living adjustment (COLA) in the weekly

workers' compensation benefit rate for any worker who has become

totally and permanently disabled from a workplace injury at any time

after December 31, 1979 and for the surviving dependents of any

worker who died from a workplace injury after December 31, 1979.

The COLA would be an amount such that, when added to the

workers' compensation weekly benefit rate initially awarded, the sum

will bear the same percentage relationship to the maximum benefit rate

at the time of the adjustment that the initial rate bore to the maximum

rate at the time of the initial award, except that:

1. The bill reduces the amount of the adjustment as much as

necessary to ensure that the sum of the adjustment and the amount

initially awarded does not exceed the amount which would cause any

reduction of disability benefits payable under the Federal Old Age,

Survivors and Disability Act; and

2. The bill reduces the supplemental workers’ compensation

benefits (but not regular workers’ compensation) for claimants injured

after 1979 by the amount of any Social Security benefits (other than

Social Security disability benefits and any increases in Social Security

benefits due to federal statutory changes after May 31, 1980), Black

Lung benefits, or the employer’s share of disability pension payments

received from or on account of an employer, except that if the worker's

original workers' compensation award was already reduced under

current law, there would be no further reduction of the supplemental

benefits under the bill.

These reductions parallel the reductions provided under current

law for claimants who were injured before 1980. The bill also

provides that no supplemental benefits would be paid in any case

where they are calculated to be less than $5 per week.

Current law requires such annual adjustments in the rate of

workers' compensation benefits for death and permanent total

disability to be paid from the Second Injury Fund (SIF), but only for

cases of injury or death occurring before January 1, 1980. The bill

extends the adjustments paid from the SIF to claims originating after

December 31, 1979, although the adjustments would apply only to

benefits paid on those claims after July 1, 2013, thus avoiding a

backlog of retroactive benefits.

The bill provides that supplemental payments will commence only

after SIF assessments are sufficient to pay them without using General

Fund money. The supplemental benefit payments would start on July

1, 2013 and the Department of Labor and Workforce Development is

required to take into account the supplemental benefits when

calculating the amount of the Second Injury Fund assessment which

starts on January 1, 2013, thus avoiding the need for any General Fund

appropriation.

To avoid an abrupt fiscal impact on the workers’ compensation

system, the bill provides that one third of the supplemental benefit rate

be paid during the first year, two thirds of the rate be paid during the

second year and the full amount be paid during the third and

subsequent years.

The bill sets time limits for workers’ compensation insurers and

self-insured employers to notify the SIF when supplemental workers’

compensation benefits are required under the bill. An insurer or selfinsured

employer is required to provide the notice not more than 60

days after the supplement is awarded or voluntary payment is to begin.

If a failure to notify results in the payment of an incorrect amount of

benefits, the liability for the payment of the supplemental benefits is

transferred from the SIF to the insurer or employer until the required

notice is provided.

The bill makes no change in the provisions of sections 1 and 9 of

P.L.1980, c.83 (C.34:15-95.4 and 34:15-95.5), which provide for the

reduction of certain portions of workers' compensation benefits by the

amount of Social Security disability benefits paid. In addition, the bill

expressly states that the supplemental benefits shall not be paid in a

manner which in any way changes or modifies the provisions of those

sections. The bill, therefore, will have no effect on existing provisions

of State and federal law regarding offsets between workers'

compensation and federal Social Security disability benefits.

The committee amendments provide that the application of the cost

of living adjustment commence on July 1, 2013, instead of July 1,

2011.

This bill was pre-filed for introduction in the 2012-2013 session

pending technical review. As reported, the bill includes the changes

required by technical review, which has been performed.

….
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.

Saturday, November 30, 2013

Hip Replacement Lawsuit: ASR Settlement ($2.5 Billion) Benefits Announced

The settlement terms of the ASR HIp Implant lawsuit have been announced:

The ASR Settlement provides for three basic areas of compensation. 

The first is a Base Payment to all ASR Claimants (XL and resurfacing) who have undergone a revision surgery, removing the 
acetabular cup, prior to August 31, 2013. 

The second is for Claimants who have undergone a revision surgery in both their left and right hips (Bilateral Claimants). 

The third addresses patients who have suffered a variety of medical complications following a revision surgery (Extraordinary Injury Fund).

 In addition, the Settlement provides for the resolution of healthcare insurance liens for 
medical costs that are directly associated with the revision surgery, at no additional cost to the 
claimant. 

Click here to read the complete press release issued by the Settlement Oversight Committee

Click here to read about the lawsuit.

Tuesday, November 26, 2013

NJ Workers Compensation Rates 2014

Revision of Rates and Rating Values – Effective January 1, 2014

The Commissioner of Banking and Insurance (“Commissioner”) has approved a 3.6%
increase in rates and rating values applicable to New Jersey workers compensation and employers
liability insurance effective January 1, 2014 on a new and renewal basis. The rating components of the increase are summarized below.

PREMIUM AND LOSS EXPERIENCE

Analysis of data for the latest two complete policy years and the latest calendar-accident
year, following adjustment to present premium and benefit levels, using paid and incurred losses
separately, indicates a premium level adjustment factor of 0.979 (-2.1%) due to experience.

A trend factor of 1.055 (+5.5%) is included to recognize changing exposures and losses.

BENEFIT CHANGES

Effective January 1, 2014, the maximum weekly benefit with respect to all types of injuries,
except permanent partial disabilities, will be changed from $826 to $843. The minimum weekly benefit will be changed from $220 to $225. In cases involving permanent partial disabilities, the present maximum weekly benefits ranging from $220 to $826, varying on the basis of duration of disability, will be changed to $225 and $843, respectively. The minimum weekly benefit for permanent partial injuries will remain at $35. The effect of the changes to the minimum and maximum weekly benefits results in a premium level adjustment factor of 1.007 (+0.7%) due to benefits.
EXPENSES

 There is need for decreases in the provisions for Loss Adjustment Expense, the Security
Fund and Bureau Expense. The changes to the expense provisions result in a premium level adjustment factor of 0.996 (-0.4%).

OVERALL PREMIUM/RATE LEVEL CHANGE

The combined effect of the above adjustment factors results in an indicated premium level
adjustment factor of 1.036 (+3.6%). The rate level adjustment is also an increase of +3.6%.

CATASTROPHE PROVISIONS

 A Terrorism Premium Charge of $0.03 per unit of exposure applies to all policies except
for the exclusions in 3:9-2 and 3:9-5 of the Manual. Upward deviation from the $0.03 rate is
permissible.

 A Catastrophe (Other than Certified Acts of Terrorism) Premium Charge of $0.01 per
unit of exposure applies to all policies except for the exclusions in 3:9-9 and 3:9-12 of the Manual.

CLASSIFICATION RATES

 The adjustment of classification rate relativity is based on the policy experience for 2006
through 2010, as reported through the Statistical Plan. The changes in the rates for the individual
classifications including those in the Admiralty and Federal Employers Liability Act coverage are
supported by, and derived from, the experience.

There are 572 classifications in the Manual effective January 1, 2014 including the codes to
accommodate Federal employments. Eight classifications carry no rate assignment. Of the remainder, 381 will experience increased rates, the rates for 167 classes will decrease, and 16 are unchanged. There are no changes to the annual policy charges for private estate or residence employees as set forth in 3:5-12 of the Manual.

In order to comply with the decision of the Commissioner, changes in manual rates for any
classification have been limited to an increase of 15% from last year’s rate. The increase percentage applicable to non "F" classifications when coverage is provided under the United States Longshore and Harbor Workers Compensation Act remains unchanged at 50%.

MINIMUM PREMIUM FORMULA

 The minimum premium multiplier is increased from 100 to 150 and the maximum
minimum premium is increased from $850 to $900. The change to premium resulting from the new
rating values in the minimum premium formula is minimal and does not impact the overall rate level.
Special minimum premiums applicable to private residence classifications and to classifications subject  to Maritime or Federal Employers Liability Act coverage are not affected.

SURCHARGES

 New Jersey law mandates application of separate policyholder surcharges to finance the
Second Injury and Uninsured Employers’ Funds. Based on the Department of Labor and Workforce
Development’s estimate of 2014 Fund requirements, the policyholder surcharge percentages effective January 1, 2014, on a new and renewal basis to be applied to the modified premium are:
Second Injury Fund 6.56%
Uninsured Employers’ Fund 0.00%

Monday, July 15, 2013

Administration Urges Rate Changes for US FELA Benefits

Gary Steinberg, Acting Director Office of Workers' Compensation Programs,  U.S. Department of Labor Acting testified before the Subcommittee on Workforce Protections Committee on Education and the Workforce, U.S. House of Representatives,  on July 10, 2013

"Thank you for inviting me to this important hearing today. As you know, the Department of Labor's
Gary Steinberg, 
Acting Director Office of Workers'
Compensation Programs, 
U.S. Department of Labor,
(DOL) Office of Workers' Compensation Programs (OWCP) administers a number of workers' compensation programs, including the Federal Employees' Compensation Act (FECA) program, which covers 2.7 million Federal and Postal workers and is one of the largest self-insured workers' compensation systems in the world.

I appreciate the opportunity to discuss legislative reforms to FECA that would enhance our ability to assist FECA beneficiaries to return to work, provide a more equitable array of FECA benefits, and generally modernize the program and update the statute. Almost 97 years ago, on September 7, 1916, Congress enacted FECA to provide comprehensive Federal workers' compensation coverage to all Federal employees and their survivors for disability or death due to an employment injury or illness.

Sunday, June 23, 2013

NJ Uninsured Fund Cracks Down on Uninsured Employers

It has been reported tat the NJ Uninsured Fund is vigorously seeking reimbursement for assessments and penalties from employers who do not have workers' compensation insurance. 

In a recent case, a former employer was required to reach a deal with the NJ Attorney
General's Office to repay $111,813.00. It was reported that the former employer had to mortgage his house for repayment in order to avoid a potential 18 month prison term and a $10,000 fine in addition to the assessment.

Click here to read: Franklin Lakes business owner must mortgage home to avoid jail in workers compensation case

Sunday, February 17, 2013

The Missouri Compromise - 2013

It looks like Missouri is not going to ditch their Second Injury Fund (SIF) after all. The Missouri Senate did a turn around and passed legislation to fund the insolvent SIF.

Part of the compromise was to limit liability of occupational disease claims against employers and re-establish the exclusivity bar. Albiet, the SIF would provide additional monetary benefits to those exposed at work.

While it sounds nice on paper, the problem, of using a band-aide to permanently correct the overall concerns of both Industry and Labor, will not work in the long-run. Actually this has been tried before and already failed. Employers notoriously dodge the bullet and delay and deny occupational claims even though they are difficult to defend against.

When the going gets tough, down the road, Industry will end up further restricting the benefit flow to injured workers, and medical delivery will then remain non-existent. Consequentially, the end result is that the general taxpayer and not the consumer, ends up paying for the continued unsafe work practices of Industry.

The Missouri Compromise 2013 is only a first step in recognizing a problem exists. It demonstrates that legislators from different parties can reach a compromise. The real fix would be even greater OSHA enforcement of safety procedures, new Federal regulation and, a universal health care system.

Monday, January 21, 2013

Boston Globe: Teen Work Related Injuries a “Major Problem”

Today's post comes from Deborah Kohl from Deborah G. Kohl Law Offices of Massachusetts. 

A recent article published in the Boston Globe cites injuries to teenagers are, “A major problem,” according to the Massachusetts Department of Public Health. The article can be found here. The article further goes on to state that rules are often “flouted” for minors. The majority of injuries to teenagers take place in retail jobs or those in the the food preparation and service industry.

The article reports that the injuries are often serious ones such as cuts from deli/meat slicers and back/neck pain as a result heavy lifting in service and landscaping jobs. The article also reported, “One local teen, who asked not to be identified fearing retaliation from his boss, described going onto a highway to retrieve supermarket carts.” Everyone, regardless of age, has the right to expect nothing less than a safe working environment.

If you are injured at work, do not hesitate to immediately report the injury to your employer. If you feel that your rights have been violated with respect to an injury you sustained on the job, please contact us to discuss your situation.

Read more abut child labor.

Dec 14, 2012
The U.S. Department of Labor's Bureau of International Labor Affairs today introduced Reducing Child Labor and Forced Labor: A Toolkit for Responsible Businesses, the first guide developed by the U.S. government to help ...
Sep 14, 2012
The US Library of Congress has just posted digital images o child labor that are in it s collection. Workers' Compensation benefits are but one instance that enforce penalties when child labor laws are not followed.
Jan 03, 2013
Other reforms included workplace safety regulations, child labor laws, and enhanced fire inspections, among others. There is a growing effort by worker groups to demand safety reforms in Bangladesh where factory fires have ...
Nov 22, 2011
He has announced that he will offer radical proposals including the elimination of child labor laws. For decades child labor laws and penalties have been integrated into state workers' compensation acts acting as a safety ...

Monday, January 14, 2013

Second Injury Fund: Missouri Auditor Says Fund It, or Shut It Down

"The fund is currently insolvent, with unpaid liabilities totaling over $28.1 million, and no means to pay the benefits required by statute. To remedy this situation, the Governor and legislature need to work together to determine whether the fund's statutory purpose remains the state public policy or the program should be reduced or eliminated. If it is decided the program should be continued, a plan should be adopted to re-capitalize the fund and ensure future revenues are adequate to cover statutorily required benefits in the future."

Thomas A. Schweich, MO State Auditor (Jan. 11, 2013)

Click here to read to report

Read more about "Second Injury Funds" and workers' compensation


Mar 20, 2012
Workers' Compensation: Are Second Injury Funds Going to be History Soon? As the Second Injury Fund debate in Missouri becomes more heated, one must consider the underlying issues challenging its existence. Whatever ...
Apr 21, 2010
The Missouri legislature failed to pass legislation that would rescue the state's Second Injury Fund (SIF) from financial collapse. The SIF has been long targeted for extinction by Industry in Missouri. The Attorney General order ...
Jan 25, 2010
NJ Second Injury Fund Is In Financial Trouble. Governor Christie's transition team reported that the NJ Second Injury Fund (SIF) is insolvent. Several options were presented, if the SIF is going continue to operate. The SIF was ...
May 09, 2011
In an editorial it declares that injured workers should receive benefits that they have been awarded un the Missouri workers' compensation Second Injury Fund which is now underfunded and unable to meet payment.


Wednesday, December 19, 2012

NJ Workers Compensation Premiums Go Up for 2013

NJ Compensation Rating and Inspection Bureau has announced rate increases for 2013 as follows:

Revision of Rates and Rating Values – Effective January 1, 2013

The Commissioner of Banking and Insurance (“Commissioner”) has approved an 8.3%
increase in manual rates and rating values applicable to New Jersey workers compensation and employers liability insurance effective January 1, 2013 on a new and renewal basis.

SURCHARGES

New Jersey law mandates application of separate policyholder surcharges to finance the

Second Injury and Uninsured Employers’ Funds. Based on the Department of Labor and Workforce Development’s estimate of 2013 Fund requirements, the policyholder surcharge percentages effective January 1, 2013, on a new and renewal basis to be applied to the modified premium are:

Second Injury Fund 6.76%

Uninsured Employers’ Fund 0.00%

Read more about "premiums" and Workers' Compensation:

Sep 21, 2011
The team also discovered that for the entire 35-year timeframe of the study, rising premium rates were closely linked with the Dow Jones Industrial Average or Treasury bonds. As either the Dow or interest rates on Treasury ...
Jul 18, 2012
Governor Andrew M. Cuomo today announced that for the first time in four years, New York State employers will see a reduction in workers' compensation premium rates. The Governor asked for a reconsideration of the ...
Nov 13, 2012
The study, of what it calls "skyrocketing rates" yielding higher premiums, reveals that higher premiums are instead associated with decreases in the Dow Jones Industrial Average and interest rates on U.S. Treasury bonds.

....
Jon L.Gelman of Wayne NJ, helping injured workers and their families for over 4 decades, is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). 

Saturday, November 24, 2012

The "New Normal," Special Compensation Funds and Viability

An Arizona Appeals Court has ruled that Special Funds [Second Injury Fund] used to pay workers' compensation benefits and fund the administrative agency, can be transferred to the state’s general treasury and used to fund the state’s general liabilities.

The Court , in allowing $4.7 Million to be transferred by the state Legislature to the general treasury, held that the special fund was funding source subject to legislative review and appropriation.  “….Because the legislature set the  percentage rate of premiums from the  State  Compensation Fund and private carriers to be placed in the Special Fund, the funds are public monies,” and is therefore a public fund.

Second Injury Funds have been phased out throughout the US. Major industrial states have eliminated them over the past several decades, a move historically supported as employers, insurance companies and the American Bar Association.

New Jersey still has such a fund, ie., The Second Injury Fund. It has been decimated economically after the economic downturn and a series of similar repeated raids by the legislature. While a constitutional amendment has been enacted to prohibit raids, the economy has not increased enough to withstand the fiscal challenges.

Other states face similar problems. Missouri’s fund has not been able to pay beneficiaries for decades as it heads for extinction. New York’s fund has been challenged since assessments are soaring beyond what Industry feels are sustainable in the week economy.

The real challenge facing the nation’s patchwork of workers’ compensation programs is how to fund them generally in light of increased medical costs, lack of premiums due to unemployment and the “new normal” now emerging across  the nation.

Read the decision: Industrial Commission of Arizona, et al. v. Janice K. Brewer, Governor, et al. , 1 CA-CV 11-0119 , (AZ App 2012), decided 11/23/2012.


Friday, October 5, 2012

October Is National Disability Awareness Month


Presidential Proclamation -- National Disability Employment Awareness Month, 2012

NATIONAL DISABILITY EMPLOYMENT AWARENESS MONTH, 2012
- - - - - - -
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION
In the 22 years since the signing of the Americans with Disabilities Act, we have made significant progress in giving all Americans the freedom to make of our lives what we will. Yet, in times of prosperity as well as challenge, people with disabilities have had fewer opportunities in our workplaces than those without. As we work to revitalize our economy, it is essential that each of us can bring our talents, expertise, and passion to bear in the marketplace. But a stronger economy is not enough; we must ensure not only full participation, but also full opportunity. During National Disability Employment Awareness Month, we recognize the indispensable contributions people with disabilities make in our economy and recommit to building a country where each of us can realize the full extent of our dreams.
Because America's workforce should reflect the diversity of its people -- including people with disabilities -- my Administration remains committed to helping our businesses, schools, and communities support our entire workforce. To meet this challenge, the Federal Government must be a model employer. That is why I was proud to sign an Executive Order in 2010 that called on Federal agencies to increase recruitment, hiring, and retention of people with disabilities. In 2012, the Office of Personnel Management reported on our progress, revealing that we are moving toward meeting our goal of hiring an additional 100,000 people with disabilities into the Federal workforce over 5 years. Today, more people with disabilities work for the Federal Government than at any time in the past 20 years, and we are striving to make it easier to get and keep those jobs by improving compliance with Section 508 of the Rehabilitation Act.
All Americans are entitled to an accessible workplace, a level playing field, and the same privileges, pursuits, and opportunities as any of their family, friends, and neighbors. This month, let us rededicate ourselves to bringing down barriers and raising up aspirations for all our people, regardless of disability, so we may share in a brighter future together.
NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim October 2012 as National Disability Employment Awareness Month. I urge all Americans to embrace the talents
and skills that individuals with disabilities bring to our workplaces and communities and to promote the right to equal employment opportunity for all people.
IN WITNESS WHEREOF, I have hereunto set my hand this first day of October, in the year of our Lord two thousand twelve, and of the Independence of the United States of America the two hundred and thirty-seventh.
BARACK OBAMA

Tuesday, July 3, 2012

Surveillance Video Barred as Belated Evidence

A New Jersey appellate court held that the trial court's decision to bar the admission of a surveillance tape into evidence was appropriate in a total disability claim, where the employer's attorney did not adhere to the administrative of rules concerning the offering of evidence. On the last day of a trial, the employer attempted to introduce a surveillance video of the of the employee on the basis that the tape would refute the injured worker's testimony that he could do nothing at home more than replace a lightbulb.


At the trial, Judge  Kenneth Kovalcik, exercising his judicial discretion, barred the use of the video as evidence. The court relied upon NJAC 12:235-3.11(a)(4)(i) that requires a pretrial memorandum must reflect that a party intends to utilize videos or other electronic media prior to trial. The defense argued that it was unable to comply with the administrative requirement because the video did not exist at the time the pretrial memorandum was submitted and that it was necessary to rebut the petitioner's testimony.

In affirming the trial judge, the appellate court reasoned that it was not an abuse of discretion to bar the use of the video. It reasoned that the belated surveillance tapes could not be admitted unless the employer could show that it was unaware, and could not have become aware, of the circumstances warranting the surveillance video before the hearing.

Marra v. Ryder Transportation Resources & Second Injury Fund, Docket No. A-5274-10T4, 2012 WL 2505731 (N.J.Super.A.D.), decided July 2, 2012.

Thursday, June 14, 2012

National Experts Call Workers Compensation System Irrational and Unjust

National workers' compensation experts, Law school Dean Emily A. Spieler and Professor John F. Burton, in a recently published article in the American Journal of Industrial Medicine conclude that the present that the present  workers' compensation systems is "irrational" and "unjust." 

Characterizing the program as "....dizzying and frustrating in its complexity, and apparent irrationality,"   they conclude that "a substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits." They review such alternatives as universal medical care, "providing healthcare to workers regardless of the source of injuries or disease."


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Dec 23, 2010
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Historically The Federal government's role has been to rise to the occasion and walk further down a path to federalization. On a smaller scale than the potential consequences of the Japanesse debacle, the US was first in line ...
Mar 05, 2011
Nationally, advocates to improve the delivery of medical benefits to injured workers have urged federalization of the medical delivery system into a single payer approach through universal health care. ... Compensation Claim Draws Major Public Attention (workers-compensation.blogspot.com); Vermont Governor Sets Out to Lead U.S. to True Universal Coverage (huffingtonpost.com); The World Trade Center Health Program Expands The Path to Federalization ...