Copyright
Tuesday, October 7, 2008
A Time For Congress to Provide Compensation to 9-11 First Responders
Saturday, October 4, 2008
The Politics of Asbestos – US Government Failed the People Declares Senator Baucus
“EPA was going to let people know, but they were changed from their direction. A Public Health Emergency definitely would have helped--- it would have provided media and public attention. Without a Public Health Emergency, asbestos has not become a public health issue. That’s the politics of asbestos."Libby Montana was the former vermiculite mine site of W.R.Grace & Company. Vermiculite is a form of asbestos, a known carcinogen. Grace recently agreed to globally settle all of its asbestos claims for $3 Billion.
The exposure to asbestos has been long linked to several disease including, asbestosis, lung cancer and mesothelioma. Asbestos exposure occurs when the toxic particles are ingested or inhaled into the body. When asbestos articles attach themselves to the lining of the lung, pleural mesothelioma, a fatal disease, results. The fibers may also attach themselves to the mesothelioma linings surrounding the heart and abdomen.
Libby Montana was declared a Federal Superfund site in 1999. Following that declaration, the Federal government has poured millions of dollars into cleaning up the asbestos-contaminated site. The failure to declare the site a public health emergency limited the Federal government’s role in providing even more extensive cleanup operations and healthcare to those residents who innocently suffered the avoidable exposure to asbestos.
Wednesday, October 1, 2008
Proposed CMS Legislation Cannot be Resuscitated Following the Wall Street Bailout
The efforts of the insurance industry to revive the previously fatally ill CMS reform legislation can be declared over and the life support disconnected following the Congressional actions to bailout Wall Street. The bill had been given a bounce, like a dead cat thrown against the ground, by the insurance industry, and some misinformed stakeholders, but economics and public opinion will not support the effort any longer.
The combination of the nationalization of AIG and the need for the US government to raise $700 Billion, makes it extremely doubtful that the Federal government is going to give the insurance industry another break other than to reinforce the country's need to insure banks and their spreadsheets.
CMS made it absolutely clear on a national teleconference on October 1st that it was holding workers’ compensation insurance carriers as sole Responsible Reporting Entities (RRE) and it wasn’t going to let them just walk away and re-delegate responsibility to others. CMS declared that workers’ compensation conditional medical payments remained a “pay and chase” proposition and that CMS was not allowing the responsibility of reporting to be shifted by the insurance industry.
The tightening of governmental scrutiny is now a predominate theme as the socialization of the insurance industry becomes more apparent and the existence of workers' compensation as a State based program becomes ever more threatened. Both sides of the political aisle are now being encouraged to look at insurance programs in a new light and make major adjustments as the economic viability of the country remains threatened. Giving the insurance industry another break by allowing them to shift responsibility back to CMS just isn't on the horizon and the idea can be finally buried.
Monday, September 29, 2008
Liberty Mutual's Rating Falls as the Workers' Compensation Industry Continues to Tremble
Saturday, September 27, 2008
CMS Begins to Roll Out Details of The Mandatory Insurance Carrier Registration Progress-Teleconference Oct. 1, 2008
A Hurricane Over Florida Fees
Is It Time For A Delay Of Game Penalty in Workers' Compensation?
A worker was seriously injured when he was struck by a forklift and was pinned against the wall by the machinery. An MRI indicated that the injured worker suffered a right hip anterior labral tear and the worker was conservatively treated with injections and chiropractic care. After nine months lost time he was able to return to work part time with a restricted limit to lifting of 20 pounds..
Six months after his return to work while merely walking through deep snow and he suffered a re-occurrence of the right hip pain and limitation of motion of the limb. Arthroscopic hip surgery was required. Prior to surgery, the workers' compensation carrier denied responsibility and refused to provide medical care.
The worker was required to file a notice of motion to seek reimbursement for medical treatment and temporary disability benefits. The respondent denied causal relationship raising the defense of an intervening superseding event. The respondent also claimed that the motion was moot since medical treatment had already occurred. The Division Workers' Compensation, issued a written decision in December 2007, 22 months after the respondent refused to provide medical treatment. An appeal was taken in nine months later, before the Appellate Division of the state New Jersey and the trial court decision was affirmed. The process took 29 months.
The Appellate Division in its decision did not address the issue of why the system takes a long, but it did comment upon the fact that the defenses raised by the respondent did not meet the threshold level to reverse the trial ltrial court's decision. The Appellate Division indicated that the motion was not moot merely because the medical treatment was subsequently rendered and that the employer did not establish that the injured workers suffered an independent and subsequent injury in February of 2006.
This case highlights the fact that the workers' compensation process has a major failing. While the State of New Jersey has perennially attempted to address these issues legislation has not been enacted to improve the system. The process itself is fraught with problems and does not keep up with the advancements in medical science and delivery of modern medical care in an expeditious and efficient manner.
The hurdles that the injured worker has to j navigate provide substantial barriers for injured workers and their advocates. In a system that was supposed to be remedial, efficient and summary, has now turned into a dilatory litigation machine utilized by employers in an effort to defeat claims. The same employers who complain that reimbursement of medical benefits through secondary payers such as the Centers for Medicare and Medicaid Services, have now made a simple process into a complex and painfully slow remedy. The practice of snowing the court with meritless defenses, without penalty, i.e. pre-judgment interest, contributes to further destruction in workers’ compensation program.
Cuccineillo v Sports Authority, 2008 WL 4329874 (N.J. Super. App. Div.) Decided September 24, 2008.