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(c) 2010-2024 Jon L Gelman, All Rights Reserved.

Thursday, June 21, 2012

CMS and Future Medicals: New Rules Proposed

The Centers for Medicare and Medicaid Services (CMS) is proposing several options to efficiently and effectively handle issues concerning the payment of future medicals.


"This advance notice of proposed rulemaking solicits comment on standardized options that we are considering making available to beneficiaries and their representatives to clarify how they can meet their obligations to protect Medicare's interest with respect to Medicare Secondary Payer (MSP) claims involving automobile and liability insurance (including self-insurance), no-fault insurance, and workers' compensation when future medical care is claimed or the settlement, judgment, award, or other payment releases (or has the effect of releasing) claims for future medical care."
***
"We are issuing this advance notice of proposed rulemaking (ANPRM) to solicit public comments on standardized options that beneficiaries and their attorneys or other representatives will be able to use to resolve MSP obligations related to settlements, judgments, awards, or other payments (hereinafter, for ease of reference in this document and unless otherwise indicated, “settlement(s)”) involving future medical care while protecting Medicare's interest."


Click here to read the Federal Register Notice.

NIOSH Warns of Flavoring-Related Lung Disease

The National Institute of Occupational Safety and Health (NIOSH) is now providing information to healthcare providers to assist them to identify and treat flavoring-related lung disease. Workers who breathe flavoring chemicals containing diacetyl, such as butter flavoring, may be at risk of severe obstructive lung disease.



Who is at risk? 


Workers who make, use, or work near flavoring chemicals containing diacetyl or 2,3-pentanedione may be at risk. Settings where these exposures may occur include:
  • Flavoring plants 
  • Microwave popcorn plant
  •   Commercial and retail bakeries
  •   Snack food and candy plants
  •   Dairy products and packaged vegetable oil plants (e.g., margarine, cooking oil)
  •   Other flavored food production plants.Exposures in the flavoring industry and in microwave popcorn production have caused workers to have severe lung disease. The burden of hazardous exposures and risk to workers in other settings remains unclear. However, it is important to consider the possibility of flavoring-related lung disease in workers who have been exposed to diacetyl or similar flavoring chemicals and have respiratory symptoms

About Symptoms


Symptoms are not present in all cases. When present, symptoms can range in severity. The main respiratory symptoms experienced by workers include:
  • Cough (usually without phlegm)
  • Shortness of breath on exertion
  • Wheezing
Other symptoms experienced by some workers include: 
  • Fever, night sweats, or weight loss
  • Frequent or persistent eye, nose, throat, or skin irritation
In cases of flavoring-related lung disease, respiratory symptoms do not typically improve when the worker goes home at the end of the workday, on weekends, or on vacations. The symptoms often have a gradual onset but can occur suddenly. Work-related exposure to butter flavoring chemicals  might also lead to asthma or exacerbate pre-existing asthma.

Related Topics

Aug 18, 2011
For public review and comment, the draft document summarizes current scientific knowledge about the occupational safety and health implications of the food flavorings diacetyl and 2,3-pentanedione, and recommends ...

Dec 22, 2010
Diacetyl is a substance widely used in food and beverage flavorings. Diacetyl is used in a wide variety of food flavorings, although flavor manufacturers have begun to reduce or eliminate the amount of diacetyl in some kinds ...

California Becomes First State to Set Safety Guidelines for Flavoring
Dec 04, 2010
Cal/OSHA continues to be a national leader in worker safety by implementing a new standard today to protect employees who work with diacetyl, a chemical commonly used to give food flavorings a buttery taste. Cal/OSHA, a...

Legislation to Protect Food Flavoring ...
Sep 27, 2000The legislation would force the U.S. Occupational Safety and Health Administration to issue rules limiting workers' exposure to diacetyl, a chemical used in artificial food flavoring for microwave popcorn and other foods.

Candy Makers Found to Have Popcorn Lung - Flavoring Illness
Apr 07, 2009
It has been reported by, Andrew Schneider, investigative reporter, that severe cases of "popcorn lung" caused by exposure to diacetyl butter are now being reported in candy makers as well. Five cases of severe lung disease ...
Sep 06, 2010
A jury in the Chicago area awarded a local factory worker $30.4 Million for a pulmonary illness resulting from exposure to popcorn flavoring, diacetyl. The verdict is considered to be largest ever in the US for an individual claim ...

Related articles

Trucking Companies Under OSHA Scrutiny


Alabama trucking company cited by US Department of Labor's OSHA for serious safety violations and other hazards; $56,700 proposed in penalties

Transportation injuries at work lead the list of industrial accidents and OSHA is now enforcing safety procedures to hopefully reduce trucking injuries. Historically the trucking and transportation industry has take a "hard line" position in defending workers' compensation claims of truckers. Truckers suffer many work-related claims because of the requirements to lift and carry objects in awkward positions.

The U.S. Department of Labor's Occupational Safety and Health Administration has cited trucking company Alabama Motor Express Inc. in Ashford for 17 safety violations. OSHA opened an inspection in March under the agency's Site-Specific Targeting Program, which directs enforcement resources to workplaces with higher-than-average rates of injuries and illnesses. Proposed penalties total $56,700.

Thirteen serious violations include failing to perform a personal protective equipment hazard assessment; provide an eyewash station for workers exposed to corrosive chemicals; provide fire extinguisher training; provide training for forklift operators; provide guarding on a bench grinder and around an open pit; reduce the pressure on an air hose to less than 30 pounds per square inch for cleaning; store oxygen and acetylene cylinders at least 20 feet apart; and provide a hazard communication program. Additional violations include the improper use of electrical equipment, a missing inner electrical panel and failing to provide weatherproof enclosures for outlets in damp and wet locations. A serious violation occurs when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known. The citations carry $55,800 in penalties.

Four other-than-serious violations involve failing to maintain the OSHA 300 log properly for reporting injuries and illnesses, establish a respiratory protection program, and protect electrical conductors from abrasion and close unused openings in the electrical panel. An other-than-serious violation is one that has a direct relationship to job safety and health, but probably would not cause death or serious physical harm. The citations carry $900 in penalties.

"Employers cannot wait for an OSHA inspection to identify the hazards that expose workers to serious injury," said Joseph Roesler, OSHA's area director in Mobile. "It is good business to implement preventive programs to ensure that such hazards are identified and corrected as part of the company's day-to-day operations."

Alabama Motor Express, a trucking company, provides logistics, maintenance and fleet services. The company has 15 business days from receipt of the citations and proposed penalties to comply, request a conference with OSHA's area director or contest the findings before the independent Occupational Safety and Health Review Commission.

To ask questions, obtain compliance assistance, file a complaint, or report workplace hospitalizations, fatalities or situations posing imminent danger to workers, the public should call OSHA's toll-free hotline at 800-321-OSHA (6742) or the agency's Mobile Area Office at 251-441-6131.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA's role is to ensure these conditions for America's working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit http://www.osha.gov.

Wednesday, June 20, 2012

Federal Pre-emption Of Pain Drugs

Senator Joe Manchin III
As state workers' compensation reformers continue to be sidetracked with alleged prescription drug pain-killer abuse, the US Congress has entered the fray with proposed Federal legislation. It has been reported today by Robert Pear in the NY Times today, that, "Senator Joe Manchin III, a West Virginia Democrat who led the push for new controls, said it appeared that his proposal was falling victim to the financial interests of drugstores and related businesses."

It is anticipated that following the US Supreme Court decision on the pending health care legislation, prescription drugs will again gain Federal legislative attention. The issue of dispensing, costs and abuse, and legalization of medical marijuana,  will receive attention and may pre-empt state activities.

Tuesday, June 19, 2012

Too Old For Comp Statute Upheld

An Appellate  Court in Florida has upheld a state law that limits workers' compensation benefits due to age. The Court held:



Section 440.15(1)(b), Florida Statutes (2003),  classifies  the entitlement to PTD benefits by age of the claimant, providing:. . . If the accident occurred on or after the employee reaches age 70, benefits shall be payable during the continuance of  [PTD], not to exceed 5 years following the determination of PTD. . . .Regarding age classifications in section 440.15, the Florida Supreme Court has stated, “[t]he ‘rational basis’ test is the proper standard of review. There is no 3basis to conclude that an  elevated standard of review is appropriate.” 


Berman v. Dillard's and ESIS, Case No. 1D11-4653 (FL 1st DCT APP) Decided June 14, 2012

OSHA Fines Norfolk Southern Railway $800,000 for Terminating Injured Workers

Norfolk Southern 8921 GE C40-9W (Dash 9-40CW)
Norfolk Southern 8921 GE C40-9W (Dash 9-40CW) (Photo credit: Wikipedia)

Investigation found violations of Federal Railroad Safety Act whistleblower provisions
The U.S. Department of Labor's Occupational Safety and Health Administration has found that Norfolk Southern Railway Co. violated the whistleblower protection provisions of the Federal Railroad Safety Act and consequently has ordered the company to pay three whistleblowers $802,168.70 in damages, including $525,000 in punitive damages and attorneys' fees. Additionally, the company has been ordered to expunge the disciplinary records of the whistleblowers, post workplace notices regarding railroad employees' whistleblower protection rights and provide training to its employees about these rights.
Three concurrent investigations were completed by OSHA's offices in Columbia, S.C.; Nashville, Tenn.; and Harrisburg, Pa. The investigations revealed reasonable cause to believe that the employees' reporting of their workplace injuries led to internal investigations and, ultimately, to dismissals from the company.
A laborer based in Greenville, S.C., was terminated on Aug. 14, 2009, after reporting an injury as a result of being hit by the company's gang truck. The railroad charged the employee, a laborer, with improper performance of duties. OSHA found that the employee was treated disparately in comparison to four other employees involved in the incident. The laborer was the only employee injured and, thus, the only employee who reported an injury. He also was the only employee terminated. OSHA has ordered the railroad to pay punitive damages of $200,000 as well as compensatory damages of $110,852 and attorney's fees of $14,325.
In Louisville, Ky., an engineer at a Norfolk Southern facility was terminated on March 31, 2010, after reporting an injury as a result of tripping and falling in a locomotive restroom. The railroad, after an investigative hearing, charged the employee with falsifying his injury. OSHA found that the investigative hearing was flawed and orchestrated to intentionally support the decision to terminate the employee. OSHA has ordered the railroad to pay the employee $150,000 in punitive damages, $50,000 in compensatory damages and $7,375 in attorney's fees.
On July 22, 2010, a railroad conductor based in Harrisburg, Pa., was terminated after reporting a head injury sustained when he blacked out and fell down steps while returning from the locomotive lavatory. The company, after an investigative hearing presided over by management officials, found the employee guilty of falsifying a report of a work-related injury, failing to promptly report the injury, and making false and conflicting statements. The day before the injury, the employee had been lauded for excellent performance, highlighted by no lost work time due to injuries in his 35-year career. OSHA found that the investigative hearing was flawed, and there was no evidence the employee intended to misrepresent his injury. OSHA is ordering the railroad to pay the employee $175,000 in punitive damages, $76,623.27 in back wages plus interest and $17,993.43 in compensatory damages, as well as all fringe benefits.
"Firing workers for reporting an injury is not only illegal, it also endangers all workers. When workers are discouraged from reporting injuries, no investigation into the cause of an injury can occur," said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. "To prevent more injuries, railroad workers must be able to report an injury without fear of retaliation. The Labor Department will continue to protect all employees, including those in the railroad industry, from retaliation for exercising these basic worker rights. Employers found in violation will be held accountable."
These actions follow several other orders issued by OSHA against Norfolk Southern Railway Co. in the past year. OSHA's investigations have found that the company continues to retaliate against employees for reporting work-related injuries and has effectively created a chilling effect in the railroad industry.
Any party to this case can file an appeal with the Labor Department's Office of Administrative Law Judges.
Norfolk Southern Railway Co. is a major transporter/hauler of coal and other commodities, serving every major container port in the eastern United States with connections to western carriers. Its headquarters are in Norfolk, Va., and it employs more than 30,000 union workers worldwide.
OSHA enforces the whistleblower provisions of the FRSA and 20 other statutes protecting employees who report violations of various securities laws, trucking, airline, nuclear power, pipeline, environmental, rail, maritime, health care, workplace safety and health regulations, and consumer product safety laws.
Under the various whistleblower provisions enacted by Congress, employers are prohibited from retaliating against employees who raise various protected concerns or provide protected information to the employer or to the government. Employees who believe that they have been retaliated against for engaging in protected conduct may file a complaint with the secretary of labor for an investigation by OSHA's Whistleblower Protection Program. Detailed information on employee whistleblower rights, including fact sheets, is available online at http://www.whistleblowers.gov.
Note: The U.S. Department of Labor does not release names of employees involved in whistleblower complaints.


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."


Related Articles on Alternative Compensation Programs
Dec 23, 2010
Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally ...
Feb 15, 2011
In December 2010 US Congress passed and President Obama signed, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program.
Jul 05, 2010
The trend toward Federalization of workers' compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and ...
Jul 13, 2010
As The Path To Federalization expands, this debate will expand. A recent study by the Center for American Progress addresses these concerns. "Health threats from the oil spill may linger unseen, perhaps for more than a ...

Mar 16, 2011
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 ...