Workers' Compensation

Saturday, July 30, 2011

National Analysis of Workers Compensation Medical Benefits

The just published, Issue 3 of the Workers’ Compensation Resources Research Report (WCRRR) provides 23 years of information on cash benefits, medical benefits, and total (cash plus medical) benefits per 100,000 workers for up to 47 jurisdictions each year. Workers’ compensation benefits per 100,000 workers varied significantly nationally over these years.

In the most recent six years, total benefits per 100,000 workers increased by less than one percent in two years and declined in the other four years. There also typically are wide differences among jurisdictions in the generosity of benefits in a particular year. In 2007, for example, total benefits per 100,000 workers were more than fifty percent about the national average in five states and more than fifty percent below the national average in one jurisdiction. Over the 23 years, the differences among states have narrowed for cash benefits, medical benefits, and total benefits, although the differences among states in medical benefits have increased since 1998.

The WCRRR is edited by John F. Burton, Jr. Additional information about Issue 3 and an order form are available at www.workerscompresources.com.
Related articles

FECA Maybe Getting a Tuneup After 40 Years

A recent Congressional hearing concerning the Federal workers' Compensation program for injured workers reveals insight into the dramatic problems facing the nation's benefit program. The program has not had any major revisions in the last 40 years.

Senator Daniel K. Akaka remarked:

"One of FECA’s core principles is that workers and their families should be no better or worse off than they would have been if the worker had not been injured."

Member Statements
Senator Daniel K. Akaka [view statement]

Witnesses
Panel 1
The Honorable Christine M. Griffin [view testimony]
Deputy Director
U.S. Office of Personnel Management

Mr. Gary Steinberg [view testimony]
Acting Director, Office of Workers’ Compensation Programs
U.S. Department of Labor

Panel 2

Mr. Andrew Sherrill [view testimony]
Director, Education, Workforce, and Income Security
U.S. Government Accountability Office

Mr. Joseph Beaudoin [view testimony]
President
National Active and Retired Federal Employees Association

Mr. Ronald Watson [view testimony]

Consultant
National Association of Letter Carriers, AFL-CIO

Dr. Gregory Krohm [view testimony]
Executive Director
International Association of Industrial Accident Boards and Commissions

Cell Phones and Cancer: The Static in the Debate

A recently published European study boldly and with much confusion declares that children are not at an increased risk of cancer as a result of cell phone use. Knowledgeable commentators has questioned the reliability of the data and analysis resulting in questioning the veracity of the European study altogether.

Microwave News reported:

'The first study to look at brain tumors among children and teenagers who have used cell phones came out today and it shows no increased risk. Well, actually, the study, known as CEFALO, does indicate a higher risk —the problem is that it found a higher risk for all the kids who used a phone more than once a week for six months, regardless of how much time they spent on the phone. Because the risk does not go up with more use, the CEFALO team argues that the results argue against a true association.

Professor Franklin E. Mier, PhD, CID, Environmental and Occupational Health SciencesCUNY School of Public Health at Hunter College, commented:

"A study may provide "evidence for," or more rarely, evidence against an increased risk associated with an exposure. The exposure should be further characterized by level and duration. The evidence might further be characterized as "clear," "some" or "equivocal." In studies of people, either single studies or a collections of studies, "chance, bias, and confounding" must be evaluated, which impacts the strength of the evidence derived from the study. Studies failing to find an association should be characterized as "null" rather than "negative."

"Each newly published study should be characterized in the context of previous studies, evaluated as a group. IARC characterized the body of evidence previous to the study reported here as "limited." Those who wish to make their own evaluation should read the IARC monograph in detail. Personally, I don't think the body of evidence will ever advance beyond "limited" evidence. Also, resources and media attention will continue to be devoted to restudying this exposure (as opposed to other exposures of concern) because rich people use cell phones.

Dramatically conflicting studies are now surfacing. The signal is not yet clear and the static will have to resolve before the causal connection between cell phone use and cancer can be ruled out.

Thursday, July 28, 2011

Asbestos Disease Claims Continue to Surge

A recent analysis reveals that mesothelioma claims continue to surge. Insurance companies such as Hartford and AIG forced to increase reserves. Exposures from the 1970's are now manifesting in disease and claims for benefits.

Mesothelioma is a rare but fatal condition caused by exposure to asbestos fiber. It is a condition that they remain dormant for as long as 30 years or more before manifesting symptoms.

Asbestos was used as an insulation product and for structural support i many products including ceiling title and other construction material. It was used to insulate boilers and other heat generating devices.

For over 3 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.

Deal or No Deal: Judge Relies on Court Appointed Physician

An Appellate Court has rule that a Judge of Compensation can select an independent physician to review the need for medical treatment. It doesn't matter whether or not the parties agreed formally or informally as to the binding effect of the physician's opinion as to causal relationship and the need for treatment.

The Court has discretion to merely rely upon the physician's opinion and reach a reach a decision based upon the report. The cost of the evaluation is to be paid for by the employer /insurance carrier. Furthermore, the Court need not hold a hearing for oral argument on the issue and can reach a binding on the papers alone.

Thompson v. Quality Et al., 2011 WL 3107767, Docket No. A-1177-10T1 (NJ App. Div.) decided July 27, 2011.

Tuesday, July 26, 2011

NIOSH Fails to Link Cancer as Zadroga Fund Compensable

The National Institute for Occupational Safety and Health (NIOSH) published a report concluding that cancer is not a compensable disease for the Zadroga World Trade Center Victims Compensation Fund.

The report concludes:
"Based on the scientific and medical findings in the peer-reviewed literature reported in this first periodic review of cancer for the WTC Health Program, insufficient evidence exists at this time to propose a rule to add cancer, or a certain type of cancer, to the List of WTC-Related Health Conditions. "

Although a determination cannot be made to propose a rule to add cancer, or a type of cancer, to the List of WTC-Related Heath Conditions at this time, it is important to point out that the current absence of published scientific and medical findings demonstrating a causal association between the exposures resulting from the September 11, 2001, terrorist attacks and the occurrence of cancer in responders and survivors does not indicate evidence of the absence of a causal association.

"It is expected that the second periodic review of cancer for the WTC Health Program will be conducted in early to mid-2012 to capture any emerging findings about exposures and cancer in responders and survivors affected by the September 11, 2001, terrorist attacks.

7 Problems Facing Work Comp in a Credit Default

White House Photo, Pete Souza, 7/25/11

Workers' Compensation payments are so intertwined with the national system of workers' compensation that a potential US credit fault will impact the system significantly. Workers' Compensation is social remedial legislation and as the US government leaders struggle to find a political solution to the nation's financial crisis concern becomes focussed on how a shutdown will impact the national workers' compensation system.

The consequences of a US credit default will be significant. President Obama stated, "If that happens, and we default, we would not have enough money to pay all of our bills -– bills that include monthly Social Security checks, veterans’ benefits, and the government contracts we’ve signed with thousands of businesses. "

1. Centers for Medicare and Medicaid Services (CMS) and their contractor will be unable to provide conditional payment information under the Medicare Secondary Payer Act. Negotiations in workers compensation matters will come to halt.

2. CMS will be unable to approve compromises and releases in advance of workers' compensation disposition thereby halting the State systems.

3. CMS and their agents will be unable to review Medicare Set-Aside Agreements thereby stopping workers' compensation dispositions by compromise.

4. Chaos will erupt in those States where Social Security takes a reverse offset on permanency payments. Workers' compensation insurance companies and employers will become responsible for the entire amount to be paid.

5. The Veterans' Administration will be unable to provide information concerning medical treatment. Records will he held-up and will delay evaluations in adjudications in workers' compensation cases.

6. Tricare and other federal insurance providers will be unable to provide benefit information. The lack of reimbursement data will stymie evaluation of medica reimbursement issues slowing the disposition and settlements of workers' compensation claims.

7. The US Military will be unable to provide Personnel Records and prior medical treatment and claim information.

The potential fiscal impact of a US debt crisis is enormous. Hopefully, the politicians in Washington will reach a compromise and the this crisis will be resolved and everyone can creatively focus on making the compensation system less complicated and more efficient.

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