System Fails to Provide Appropriate Care for Non-Catastrophic Injuries

Todays post is authored by Melissa Brown* of the California Bar.

The October issue of the American Journal of Industrial Medicine confirms what our clients have been experiencing since the California legislature began “reforming” medical treatment access in 2003: the system fails to provide appropriate care for non-catastrophic injuries. (See Franklin, G., et al., “Workers’ Compensation: Poor Quality Health Care and the Growing Disability Problem in the United States,” American Journal of Industrial Medicine, October 2014). The reforms, which include reliance on “evidence-based” medicine and utilization review, often results in increased permanent disabilities and a shift of compensation to Social Security, Medicare and other state and federal disability systems.

The authors note a 75% increase in those receiving Social Security Disability benefits for working age people during the period 2000 and 2012. The basis of the inability to work has shifted from cardiovascular to musculoskeletal, arguably injuries that could have been prevented with safer work practices.

Our experience at Fraulob, Brown, Gowen & Snapp is consistent with these findings. Just today, one of our client’s reported that the expert medical evaluator in his case, agreed to by the insurance company, advised him that had his neck surgery been approved when his doctor requested, rather than going through the utilization review process, he would have had less residual disability. This of course does not even address the pain and suffering he endured waiting for approval; pain and suffering which is not paid by workers’ compensation.

The only way to change this system is through legislation. Which means that people need to vote and need to make it their mission to contact their legislators and the governor with their horror stories.

.....

*Melissa C. Brown is a frequent lecturer at legal conventions and seminars. Ms. Brown has been recognized in America’s Top Attorneys for over 20 years. She has studied Mediation at the World Intellectual Property Organization in Geneva, Switzerland.

Ms. Brown is a certified specialist in Workers’ Compensation as well as a national expert on Social Security Disability , Elder Law, Health Care Planning and decision-making. She is a law professor and published author.

Her practice includes serving as a court appointed and agreed upon Arbitrator for Workers’ Compensation matters. Her legal treatise, Advising the Elderly or Disabled Client, is utilized by law schools throughout America as well as Elder Law, Disability and Personal Injury attorneys. She been retained as an expert witness by the NFL Players association regarding compensation for brain and other serious injuries sustained by professional athletes.

Related articles

• New Study Shows Earnings Losses Persist Much Longer After Work-Related Injury, Even for Minor Injuries (workers-compensation.blogspot.com)
• America's top execs seem ready to give up on U.S. workers (workers-compensation.blogspot.com)
• MisLead: America's Secret Epidemic (workers-compensation.blogspot.com)
• Calling America: Hello? Hello? Hello? Hello? (workers-compensation.blogspot.com)
• EPA Proposes First Guidelines to Cut Carbon Pollution from Existing Power Plants (workers-compensation.blogspot.com)
• House Considers Bills to Limit Americans' Rights (workers-compensation.blogspot.com)
• US 6th Circuit Holds Loss Of Employee Benefits Not Actionable Under RICO (workers-compensation.blogspot.com)

Let’s get rid of (the term) entitlements

Is Workers' Compensation thought to be an "entltlement?" Today's post was shared by Steven Greenhouse and comes from www.washingtonpost.com

Let’s drop the whole notion of “entitlement.” Just eliminate it. Politicians, pundits and academics who talk about entitlements would then have to name the actual programs and argue their merits and demerits. This would encourage clarity and candor. Of course, that’s why it won’t happen. Generally, Americans don’t want clarity and candor in their fiscal debates. We blame our leaders for budget brawls — this latest was a doozy — but forget that our leaders are largely governed by public opinion, which is awash in contradictions. So the government is “open” and the immediate threat of default has lifted. Great. But the political stalemate remains. Americans oppose excessive government spending and persistent deficits. Yet they also support the individual benefit programs (a.k.a. “entitlements”), led by Social Security, that drive spending and deficits. Until the 1980s, entitlement wasn’t part of everyday language. Ronald Reagan was apparently the first president to use the term extensively. He may have “tired of getting beaten up every time he mentioned Social Security, and wanted a broader and more neutral term,” political scientist Norman Ornstein has suggested. Entitlement is a bland label. To say there’s an “entitlement problem” shrewdly avoids connecting it explicitly with popular programs. President Obama evasively speaks of entitlements in this way; so do most...

[Click here to see the rest of this post]

Found on

Related articles

• The Future of Workers' Compensation (workers-compensation.blogspot.com)
• Social Security raise to be among lowest in years (workers-compensation.blogspot.com)
• What a Government Default Will Do To Workers' Compensation (workers-compensation.blogspot.com)
• What Does That Stand For? Commonly Used Acronyms in Workers' Compensation Cases (workers-compensation.blogspot.com)
• The Government Shutdown is a Kick-In-Gut to Workers' Compensation (workers-compensation.blogspot.com)
• Parma considering following Cleveland in suing Ohio Bureau of Workers' Compensation over inflated premiums (workers-compensation.blogspot.com)
• Hank Patterson Receives the 2013 Lifetime Achievement Award (workers-compensation.blogspot.com)

The Affordable Care Act, brought to you by ……… the Republicans!

Many might now welcome a Nixon ticket.

Today's post comes from guest author Jay Causey, from Causey Law Firm.

     Looking for information in the media that is supportive of the nation’s transition to the Affordable Care Act (ACA), aka “Obamacare?”  At the moment Republican and right wing noise is drowning out much of the lower–decibel cheerleading by the Administration on why this is a good thing.

In 1974, Pres. Richard Nixon proposed what is essentially the 2010 healthcare act – all but the smallest employers would provide medical insurance to their employees or pay a penalty, expansion of Medicaid would insure the poor, and subsidies would be provided to low–income citizens and small employers.

     In a recent op-ed piece, former Secretary of Labor under President Clinton and leading economic expert, now at the University of California, Berkeley, Robert Reich summed up the history of the origin of “Obamacare,” pointing out the irony of the right wing’s fuss over it.
     In 1974, Pres. Richard Nixon proposed what is essentially the 2010 healthcare act – all but the smallest employers would provide medical insurance to their employees or pay a penalty, expansion of Medicaid would insure the poor, and subsidies would be provided to low–income citizens and small employers. While private insurers liked this plan, Democrats favored a system more like Social Security and Medicare, so there was no consensus.
     Fast-forward to 1989, and the right–leaning Heritage Foundation proposed a plan that would mandate all households obtaining adequate insurance. This plan worked its way into several bills introduced by Republicans in 1993, supported by Senators Hatch (R–Utah) and Grassley (R–Iowa), along with subsequent Speaker of the House, Newt Gingrich, all now vocal opponents of the ACA.
     When in 2004 Massachusetts Gov. Mitt Romney made the original Nixon plan the law in his state, with the same mandate to buy private insurance, he said, “we got the idea of an individual mandate from Newt Gingrich, and he got it from the Heritage Foundation.”
     Health insurance companies, now retooling their policies around the individual mandate, are jubilant about the possibilities of long–term membership growth through the insurance exchanges. These giant corporations have traditionally supported conservative and Republican politics.
     So as Reich notes – – why are Republican spending so much energy trying to sabotage the ACA, and act they designed and about which a huge sector of their patrons are wildly enthusiastic? The answer: it is the singular achievement of the Obama Administration, the head of which is still considered by a large segment of the right to Illegitimately occupy the White House.
     Reich goes on to observe that had the Democrats prevailed on the idea of a system built on the Social Security and Medicare model – – cheaper, simpler, and more widely accepted by the citizenry – – Republicans would nevertheless be making the same noise.

Found on

Related articles

• November 22, 1963 - A Personal Reflection and Alternative History If JFK Had Lived (workers-compensation.blogspot.com)
• Obamacare Has a Friend in the Health Care Industry (workers-compensation.blogspot.com)
• A Day In The Life Of Ted the Tea-Partier (workers-compensation.blogspot.com)
• The High Price of Gas - Mileage Reimbursement for Injured Workers (workers-compensation.blogspot.com)
• Illinois Employer to Pay $10K Penalty for Lack of Workers' Comp Insurance (workers-compensation.blogspot.com)
• "Lamestream Media" Enables Right-Wing Talking Points About Social Security Disability (workers-compensation.blogspot.com)

It is All The Same Apple

Another challenge to the Medicare Secondary Payer Act (MSP) has been introduced (H.R. 1063 in Congress. This is yet another attempt to bounce the dead cat on the floor.

The legislation is the third reiteration by insurance companies, and the cottage industry that has emerged to service conditional payment resolution. It is most likely doomed to failure reflecting the quick death of its predecessors and the worsening economic times.

Since the enactment of the  MSP in 1980, there has been a slow, yet pervasive and effective effort by the US government to stop the shifting ofmedical costs from the workers’ compensation system onto the  shoulders of the Medicare system.

Medicare has its own solvency problems, not withstanding cost-shifting by the workers’ compensation system. Medicare is trying to serve a growing constituency as costs soar and the base of available of income to tax dwindles. Medicare costs have become a major target for the “Super Committee” in Congress for cost reduction.

Statistics also reveal that the aging workforce is continuing to fall apart physically and file for Social Security Disability Insurance in lieu of workers' compensation at a greater rate than ever..  Even though more attention is now directed to major diseases such as cardio-vascular, cancer and diabetes, the aging bodies of the senior citizen population continue to need more medical care due to wear and tear alone. The barriers established through so-called reformed efforts have blocked the follow of new occupational disease cases into the workers' compensation system.

The aging workforce looks to Social Security Disability Benefits and Medicare as a more effective remedy, and one that takes precedence over applications for workers’ compensation. Fewer seniors, and those approaching that age, opt for workers’ compensation benefits. This pattern even puts more fiscal strain on the present Social Security and Medicare system. 

Medicare is really not a free-ride for seniors and the government. While workers and their employers have made contributions for a lifetime, the system consume a large portion of the nation's economic wealth. Two major hospitalizations by a beneficiary exhaust all the individual and employer economic contributions completely from the reserves, and the government is stuck covering excess bills for the individual's lifetime.

As the US government continues to mandate stricter reporting and payment procedures the state workers’ compensation programs as the state programs to become further stressed by the Centers for Medicare and Medicar Services (CMS) reimbursement procedures. Both the federal and state systems have the same goal of providing assistance to disabled workers and their families.

As each continue to battle for a resolution of their own economic issues, they are merely shooting each other in the foot and weakening the entire purpose of each of their noble missions. Until a more unified system is established, it is incumbent upon both programs to direct their efforts to designing a more non-contentious system of resolution. 

The mandatory arbitration of the cost medical reimbursement would be an interim step so that the workers’ compensation administrative process could go forward unimpeded. The problem of funding medical costs for the population should be considered one apple, and taking bites at it from every direction will merely result in a total deterioration of the entire process.

Related articles

• Government Appeals Case Involving CMS Statute of Limitations (workers-compensation.blogspot.com)
• Bad Faith Claims Maybe Going to the Jury (workers-compensation.blogspot.com)
• Genetic Pre-Disposition to Mesothelioma (workers-compensation.blogspot.com)
• Why is the US Still in the Asbestos Business? (workers-compensation.blogspot.com)

Aging Activities: Managing someone else’s money

As America's workforce ages new concerns are emerging for the growing aging population. From time to time we will be focussing on Aging Activities and issues, by providing information and commentary. Today's post is shared from consumerfinance.gov Millions of Americans are managing money or property for a loved one who is unable to pay bills or make financial decisions. This can be very overwhelming. But, it’s also a great opportunity to help someone you care about, and protect them from scams and fraud. We are releasing four easy-to-understand booklets to help financial caregivers. The Managing Someone Else’s Money guides are for agents under powers of attorney, court-appointed guardians, trustees, and government fiduciaries (Social Security representative payees and VA fiduciaries.) The guides help you to be a financial caregiver in three ways: They walk you through your duties. They tell you how to watch out for scams and financial exploitation, and what to do if your loved one is a victim. They tell you where you can go for help. You can also order free print copies (including bulk orders) online soon. We’re working hard to empower older Americans to have a secure financial future. Sometimes family members, caregivers and others in the community must pitch in. We’re here to help you, too. 4 Comments » | Categories: Featured | Fraud | Older Americans | Scams

[Click here to see the rest of this post]

Found on

Related articles

• National Survey: Working Longer - Older Americans' Attitudes on Work and Retirement (workers-compensation.blogspot.com)
• What a Government Default Will Do To Workers' Compensation (workers-compensation.blogspot.com)
• "Lamestream Media" Enables Right-Wing Talking Points About Social Security Disability (workers-compensation.blogspot.com)
• Senior Care Workers Are Victims of Wage Violations (workers-compensation.blogspot.com)
• Questioning Statins for Older Patients (workers-compensation.blogspot.com)
• Most Americans accumulating debt faster than they're saving for retirement - The Washington Post (workers-compensation.blogspot.com)
• Social Security raise to be among lowest in years (workers-compensation.blogspot.com)

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.

Overpayment Of Unemployment Due To Payment of Workers’ Compensation Benefits – NOW WHAT?!?

Today's post comes from guest author Kit Case from Causey Law Firm.

Injured workers transition from time loss compensation under their workers’ compensation claim to unemployment compensation when they are released to return to work but do not have a job available to them. In many cases, disputes arise as to whether the release to work and termination of workers’ compensation payments is appropriate. Often, the worker tries to find physically-appropriate work while collecting unemployment compensation during the dispute process but, once their attorney secures payment of back benefits under the workers’ compensation claim, an overpayment of unemployment benefits has occurred due to the overlap between the two systems. When this happens, workers should:

1. Notify the unemployment insurance system that they are continuing to seek payment from the workers’ compensation system, but that they are involved in an appropriate job search during the dispute process.
2. Immediately share with the workers’ compensation attorney any notices or orders received from the unemployment insurance system. These are usually NOT mailed to the attorney of record in a workers’ compensation claim and the notices often have limited time periods within to file a protest or request for reconsideration of the determination.
3. Hold in savings from the workers’ compensation payment the claimed unemployment overpayment amount during the dispute process until a final overpayment notice has been issued, or have the workers’ compensation attorney hold this amount in their trust account. If this is not possible, be prepared to enter into a repayment agreement with the unemployment insurance system once a final overpayment figure has been determined.
4. Seek assistance from the workers’ compensation attorney to document all attorney fees and costs paid as part of the effort to obtain back benefits under the workers’ compensation claim. Submit this documentation to the unemployment insurance system and request a reduction in the claimed overpayment to take these attorney fees and costs into account.
5. Continue to send any notices or orders to the workers’ compensation attorney.
6. Once the overpayment has been repaid, check to see if the receipt of workers’ compensation back benefits changes your tax obligations. In many states, workers’ compensation payments are not taxable income, but unemployment benefits are taxable. If there is a significant payment of back benefits under the workers’ compensation claim, it may be worthwhile to file an amended tax return with the IRS to document the lower taxable income figure.

Read more about "benefits" and workers' compensation:

Compensation Settlements Affect Social Security Benefits - Workers ...

Jun 13, 2013

It is fairly common for an injured worker to receive Social Security disability benefits and also receive a settlement for workers' compensation. According to Social Security, “If you receive workers' compensation or other public ...

http://workers-compensation.blogspot.com/

Workers' Compensation: Truckers are often entitled to benefits from ...

Apr 08, 2013

Truckers are frequently entitled to benefits from multiple states for an injury. Each state sets rules for applying its workers' compensation laws. Virtually all states cover accidents that happen in that state. Many states allow ...

http://workers-compensation.blogspot.com/

Workers' Compensation: Black Lung Benefits Act: Standards for ...

Jun 16, 2013

Accordingly, the Department's regulations implementing the Black Lung Benefits Act allow the submission of radiographs in connection with benefit claims and set out quality standards for their performance. These standards ...

http://workers-compensation.blogspot.com/

Democratic Bill to Provide Lifetime Workers' Compensation Benefits ...

Jun 13, 2013

Legislation sponsored by Assembly Democrats Annette Quijano, Valerie Vainieri Huttle, Jason O'Donnell, Ruben Ramos and Nelson Albano to provide lifetime workers' compensation benefits to surviving spouses of fire and ...

http://workers-compensation.blogspot.com/

Related articles

• Workers' Compensation Has Become A Territorial Fight
• The Scarlet Letter - Workers' Compensation Style
• State Law Does Not Preempt State Medical Authorization Criteria
• Oklahoma Opt-Out Workers' Compensation Law Enacted
• NJ Court Approves Medicare Set-Aside Agreement Lacking CMS Review
• Cancer Alley: NJ Meadowlands to be Tested for Cancer Causing Substances

CMS to Provide Query Access Through Mandatory Reporting

At a recently moderated telephone conference session CMS announced that beneficiary verification would be available through a query function on its new database system to determine eligibility Medicare beneficiary status. The system will be in response to new insurance carrier mandatory reporting procedures that have been Congressionally imposed. The query will be based on 4 basic criteria including: Social Security number; data birth; name or gender. The verified Social Security information will be provided for all criteria except Social Security numbers and a corrected format.

CMS will not provide outstanding conditional payments or other data by use of the reporting system. Individual beneficiaries may be able to find this information upon governmental website that allows for individual beneficiary access through http://www.mymedicare.gov/. That site is accessible only by beneficiaries.

The federal is agency is planning for the release of a User Guide prior to the actual date of mandatory deployment and activation of the federal reporting site. Activation is anticipated in July 2009.

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

Related articles

• 2016 Budget Proposal Would Require Reporting of Workers' Compensation Benefits to Social Security Administration (workers-compensation.blogspot.com)
• CMS: "The Smarter Act" Introduced in the US Senate (workers-compensation.blogspot.com)

In the name of privacy...

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

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

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

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

CMS announced today:

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

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

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

Related articles

• 2016 Budget Proposal Would Require Reporting of Workers' Compensation Benefits to Social Security Administration (workers-compensation.blogspot.com)
• Trickle Down Stagnation (workers-compensation.blogspot.com)
• CMS Comments: "No Comment" on The Forthcoming Smart Act Regulations (workers-compensation.blogspot.com)
• CMS Posts Sample Notice To Beneficiaries Regarding Appeal Rights (workers-compensation.blogspot.com)
• On-Demand Labor - Is Workers' Compensation Ready for Flex-Time Employment? (workers-compensation.blogspot.com)
• Is The Reserve Offset Heading for Extinction? (workers-compensation.blogspot.com)
• Coordination of Benefits and Non-Group Health Plan Recovery Transition (workers-compensation.blogspot.com)

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.

2016 Budget Proposal Would Require Reporting of Workers’ Compensation Benefits to Social Security Administration

The Social Security Administration (SSA) has been vocal in the past about its difficulty in obtaining information about workers’ compensation benefits. The primary reason that the SSA has been seeking this information is to reduce social security benefits by way of an SSDI/WC offset. The SSDI/WC offset is a calculation used by the SSA to reduce a beneficiary’s SSDI benefit amount if the person is also receiving workers’ compensation benefits. The SSDI/WC offset is different in every state and applies only when the individual's combined monthly amounts of SSDI and workers' compensation are greater than 80% of individual's pre-disability "average current earnings.”

The SSA currently has to rely on beneficiaries to report to the SSA when they receive workers’ compensation or public disability benefits. President Obama’s 2016 budget proposal includes a provision to establish a new federal requirement that workers’ compensation and public disability benefit information be provided by states, local governments, and private insurers to the SSA.

The budget proposal summary includes the narrative below:

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...


[Click here to see the rest of this post]

Found on

Congress, Health Care & Unintended Consequences

This past week some very dramatic things happened in the workers’ compensation world. The US Senate moved forward on initiating a floor debate on health care. At the same time, a group of workers’ compensation scholars met in Washington DC to discuss the future of workers’ compensation and the interplay with social security disability.

 Highlights of the NASI (National Academy of Social Insurance) conference convened in Washington were findings presented by eminent leaders in the field. Professor John Burton, Rutgers University, pointed out that newly created barriers to workers’ compensation were pushing more injured workers to the Social Security disability system for benefits. This reflects a phenomenon that occurred in the late 1970’s when a study commissioned by the US Department of Labor and conducted by Mt. Sinai Hospitals’ Environmental Sciences Laboratory, revealed that the inadequate benefit delivery system of workers’ compensation for asbestos related illness, was forcing injured workers and their families into the civil justice arena for adequate compensation.

The problems have not changed in decades; they have only gotten worse, maturing into a system that is in critical condition and on life support. In 1980 Irving J. Selikoff, M.D. reported, “There has been widespread acknowledgement of significant problems with disability compensation for workers in the United States. One major area of concern has been the shortcomings with regard to occupational disease. Whatever the suitability of current workers’ compensation systems in the 50 states for injuries and work accidents, there has been little disagreement about the inadequacies of such systems for workers who become disabled by illness or, if they die, for their surviving dependents.”

Complex questions continue to exist between the scientific and legal communities as to the path to be taken. Barriers placed into the path of recovery, including pre-existing and co-existing conditions, which result in limited or delayed recovery and major shifting of the economic responsibility upon the public/private benefit systems need to be removed. The unspoken social consequences continue as a silent epidemic as families and survivors struggle in silence.

Looking backward over the noble experiment in California which turned sour, Tom Rankin, former President of the California Labor Federation, AFL-CIO, expressed his regret of the reform. The former Labor leader theorized that the results were “unintended consequences.” Indeed he is looking forward to solutions springing forth in a “public option” embedded into the national health care legislation.

Some participants at the NASI conference alleged a major shortcoming of the California workers’ compensation legislative reform effort. Doug Kim, a lobbyist for the claimant’s attorneys, disclosed that the injured workers’ advocates were not invited to partake in the discussion that lead up to crafting the initial drafts of the 2004 California reform legislation SB 899.

History reveals, that when the theoretical reforms were practically applied, the injured workers suffered serious setbacks. If these were in fact “unintended consequences,” then one must consider the active involvement of all stakeholders when looking forward to solutions. The courts in California have consistently upheld challenges to the inequitable results, pointing to the legislative intent to reduce costs. Absent from the discussions of the presenters were practical systemic applications to improve the present system. The “blood and guts” of the traumatic, delay and denial, struggles of navigating in a crippled workers’ compensation system, in California and elsewhere, is verification that change is mandated.

As North Carolina attorney, Valerie A. Johnson, so eloquently remarked, “workers’ compensation is supposed to be a simple system.” The process has now been obstructed by encroaching elements of fault, contributory negligence, apportionment of pre-existing conditions and difficulties of the element of time, manifested by latent diseases unknown to the fathers of the system a century ago. The advance of medical science has brought forth new and innovated modalities that have contributed to soaring medical costs. The convergence of these issues has generated higher administrative costs.

Pecuniary Industry motives have worked adversely to improving safety in the workplace. The need for workers’ compensation would be minimized by adopting a safer occupational environment. Under reporting of workplace accidents continue as the Government Accountability Office announced. Nebraska Appleseed reveals that workers feel intimidated and are apprehensive to report injuries and unsafe work conditions. This is scenario is compounded by the fact that undocumented workers, who have even less job security, work in jobs with higher risk. The Bush Administration did not make efforts to allow OSHA to heighten enforcement efforts. All of these ingredients combine to create a recipe that just doesn’t work.

The US Senate advanced the health care legislation to a floor debate in an unusual late Saturday night session. This action may indeed provide an opportunity for the stakeholders in workers’ compensation to all join in the debate and look for solutions to the delivery of appropriate medical care in an efficient and timely fashion. To avoid “unintended consequences” yet again, injured workers and their advocates will need to be active participants and engage in the debate now.

.......

To read more about workers’ compensation and universal health care solutions click here.

Is The Recovery Of The Workers’ Compensation System An Illusion?

The present economic downturn has been compared to the Great Depression of the 1930’s or the recession of the 1980’s. The factors that existed during those financial cycles need to be compared to the present political and economic dynamic to determine whether or not history is repeating itself. Analysis of those two periods provides an insight as to whether or not there will be a rebound or surge of claims in the future.

The depression of the 1930’s occurred at a time when the workers’ compensation program in the United States was in its infancy. The benefits delivered were very limited. Occupational diseases were not included in most acts, the population had a lower life expectancy, early retirement plans did not exist, social security was not yet enacted, and Medicare was only an idea. The federal government poured dollars into the economy to construct public works [WPA] projects while limiting private debt. A consumer based economy didn’t exist at the time of the Great Depression.

Likewise, the recession of the 1980’s had its own characteristics. During the 1980’s, the populations mostly affected by layoffs were those who were the labor force of post-World War II. The workers of that generation suffered from occupational exposures to many deleterious and carcinogenic substances. The occupational diseases were latent in manifestation and epidemic in proportion. Laid-off workers who became victims of the recession of the 1980’s participated in a surge of litigation, both workers’ compensation claims and third-party actions against the manufacturers of toxic substances. Litigation snowballed against , including asbestos manufacturers, suppliers and distributors because of the minimal money recovered in the ordinary workers’ compensation claim. Asbestos litigation became “the longest mass tort in history.” In the years following the 1980’s the many workers separated from their jobs did not return to employment. Instead they collected both workers’ compensation benefits and Social Security disability.

The medical costs incurred, due to their occupational illnesses, were intentionally shifted from the workers’ compensation program to the Social Security Medicare program. The Medicare Secondary Payer Act was enacted by Congress in 1980 to end the cost shifting tactics by employers and their workers’ compensation insurance companies programs, Medicare and health group coverage, and pension offsets.

The current workforce, now being laid-off, is composed of an entirely different demographic than what existed in the 1930s and the 1980s. The social and political factors at the present time are far different from what was facing the workforce of the prior recession/depression years. The US Bureau of Labor Statistics reported, “In January 2009, the unemployment rate of persons with a disability was 13.2 percent, compared with 8.3 percent for persons with no disability, not seasonally adjusted. The employment-population ratio for persons with a disability was 20.0 percent, compared with 65.0 percent for persons with no disability.” The elderly have now been designated as a “new class of workers” as they return to the labor market out of economic desperation. The numbers of unemployed workers who are 65 years old and older now in the workforce, compared to a decade ago, have increased to 7.3% from 4.7%.

The census of workers currently without employment opportunities include significant numbers of aging baby boomers who were about to seek retirement while looking forward to the "golden years." The erosion of planned retirement savings requires that many older workers now return to work. There is a reluctance to file claims. Therefore, fewer injured workers now seek total disability payments under workers’ compensation. The stagnation of the administration of the workers’ compensation system makes it even more difficult for the elderly who are injured to navigate the system. This only adds to the claimant’s frustration and encourages a greater reluctance to file a formal claim for benefits.

Some workers’ compensation insurance companies now involved in the compensation system have been nationalized by the federal government to the various stimulus and bailout programs. They lack funds to remain economically viable with out further insurgence of capital from the federal government. The federal government is now a stakeholder in the process. Self-insured employers are becoming financially weaker. Corporate assets have been minimized by lack of credit and the massive economic stock value decline. Municipal entities and others involved in joint insurance funds (JIFs) are now having difficulty in maintaining economic viability. Because of the lack of tax revenues and federal support, State and local communities are on the verge of bankruptcy.

The present ills of the American workers’ compensation system mirror the economic woes of the national economy. The last decade has demonstrated an accelerated decline in the functioning of the system. It is reflective of what Paul Krugman, Professor of Economics and International Affairs at Princeton University, commented in the NY Times, that Americans are having financial “illusions.” “The bottom line is that there has been basically no wealth creation at all since the turn of the millennium: the net worth of the average American household, adjusted for inflation, is lower now than it was in 2001.” The workers’ compensation system is so bogged down in increasing medical debt that it is unable to deliver benefits efficiently. The present compensation system can’t be relied upon to rebound.

Compounding this downturn in the financial sector is the fact that workplaces have become safer. Over the years there has been a decline in fatalities as reported Bureau of Labor Statistics National Census of Fatal Occupational Injuries. As the United States becomes more of a service-based economy with a dwindling manufacturing sector, less injury risk exists in the occupational sector. The workplace has become safer and there are fewer serious injuries and less occupational illness.

The corporate downturn has been reflected by the implosion of many defense law firms who have reduced their staffs. Over a thousand lawyers were laid-off in a single day by major defense firms. The legal market restructuring is the result of a domino effect of the downsizing of corporate America. Representing injured workers and defending compensation claims on behalf of corporate America has taken a dramatic downturn. The trend is toward less attorney participation in the present system. Even attorney layoffs have become epidemic as the economic downturn intensifies.

Additionally, workers’ compensation programs have been subject to insurance industry targeted reform. The yet number of claims, eligible for benefits that would require legal representation has declined substantially as the California wave of reform swept towards the east coast. As the economies of the States shrink, so do the dollars available to operate the administrative programs for injured workers. Workers’ Compensation hearing offices in California will be closed two days per month and in New Jersey, a state that has already imposed a hiring freeze, is about to similarly close State offices.

The workers’ compensation system, based upon new national social and economic characteristics is already being re-crafted into a new program requiring less need for litigation support. Unlike the Great Depression of the 1930’s and the recession of the 1980’s, the present downturn in workers’ compensation claims activity is not anti-cyclical. It is an illusion of grandeur to believe that the present workers’ compensation system will recover or rebound in its present format. A national universal medical program will ultimately embrace the compensation delivery system and determine the future destiny of workers compensation.

US Department of Labor Urges Major Changes in the Nation's Workers' Compensation System

As The Path to Federalization of the US workers' compensation system broadens, the US Department of Labor has published a report urging expansion of the Federal role in reforming the entire patchwork of state systems. As the Presidential Election Cycle moves ahead, the ultimate outcome will impact the the nation's struggling workers' compensation scheme. Based on historical statements both "Hillarycare" or "Trump Medical," (lead by his advisor, Former Speaker Newt Gingrich,  will focus on this issue. See  my prior blog posts below.

House Appropriations Committee Releases Discretionary Labor-HHS Funding Bill

Worker safety and health is a focus of the just released House Committee on Appropriations. The Legislation increases discretionary funding by $11.7 billion from the 2019 level, investing in education, health care, medical research, and job training so people have a better chance at a better life; Bill funds firearm injury and mortality prevention research at CDC for first time in more than 20 years.

Forty Percent Of Workers Made Less Than $20,000 Last Year

Wages set rates and premiums for workers' compensation. Increasing the wages of workers directly increases their benefits. Today's post was shared by Steven Greenhouse and comes from thinkprogress.org

Nearly 40 percent of all workers in the country made less than $20,000 last year, according to data from the Social Security Administration, which doesn’t include figures on benefits such as health insurance or pensions. That’s below the federal poverty threshold for a family of four and close to the line for a family of three. On average, these workers earned just $17,459.55. Meanwhile, more than half of all workers made less than $30,000, not much more to live off of. Wider Opportunities for Women has estimated that a two-income family with two children needs to bring in nearly $72,000 a year to simply reach economic security. Two earners at this level won’t achieve that status. As David Cay Johnston notes, the median wage was $27,519 in 2012, at the lowest level since 1998. That means half of all workers made more and half made less. But the average wage actually grew. “When the average wage grows but the median wage stagnates, it means that, statistically, only workers in the top half of the job market are experiencing increases,” he writes. His analysis shows that most of the wage growth was for the top quarter of earners, or those who make about $50,000 and up. In fact, things are very good at the top. The number of workers making $5 million a year or more jumped by nearly 27 percent over 2011, and their total wages grew 40 percent, or 13 times the increase for all workers. This income...

[Click here to see the rest of this post]

Found on

Related articles

• Social Security raise to be among lowest in years (workers-compensation.blogspot.com)
• OSHA Releases New Resources to Help Employers Protect Workers from Hazardous Chemicals (workers-compensation.blogspot.com)
• Breaking: Wal-Mart workers on strike, defying firings (workers-compensation.blogspot.com)
• "Opting Out" of Worker's Compensation Hurts Workers and Employers (Part 1) (workers-compensation.blogspot.com)
• Workplace Deaths Substantially Unreported (workers-compensation.blogspot.com)
• To cut costs, New York will close workers' comp hearing sites (workers-compensation.blogspot.com)

Aid Programs Helped U.S. Survive the Great Recession

moffitt

The country’s welfare programs scored high marks during the Great Recession, according to a new report by Robert A. Moffitt, the Krieger-Eisenhower professor of economics at Johns Hopkins University.

The report, published this month in The Annals of the American Academy of Political and Social Science, shows the country’s “social safety net” expanded to catch many Americans during the economic downturn, which lasted roughly from 2008 through 2009.

In “The Great Recession and the Social Safety Net,” Moffitt found aggregate safety net spending rose $500 billion from 2007 to 2010. Meanwhile, caseloads rose too, from 276 million to 310 million.

Carrying the bulk of this load, he said, were the Earned Income Tax Credit, Unemployment Insurance and the Supplemental Nutrition Assistance Program. Together, the three programs accounted for about a third of the spending increase.

Other programs that expanded to meet the demand included Medicaid, Medicare and Social Security retirement and disability benefits.

“Our results show that there was a major response from the safety net to the Great Recession,” Moffitt said. “The programs did their job and made a difference – there’s no question about it.”

Spending on SNAP – food stamps – more than doubled, Moffitt found, vaulting from $30 billion in 2007 to $65 billion in 2010. The program was not only helping more people, Moffitt said, but...


[Click here to see the rest of this post]

Found on

Related articles

• Wages Stagnate as U.S. Manufacturers Reap Record Profits (workers-compensation.blogspot.com)
• Social Security's Job (workers-compensation.blogspot.com)
• National Survey: Working Longer - Older Americans' Attitudes on Work and Retirement (workers-compensation.blogspot.com)
• Aging Baby Boomers Continue to Postpone Retirement, Report Finds (workers-compensation.blogspot.com)
• The startling rise of disability in America (workers-compensation.blogspot.com)
• Extension of Benefits for Jobless Is Set to End (workers-compensation.blogspot.com)
• Why The Republicans Should Not Cut Food Stamps (workers-compensation.blogspot.com)