CMS Announces New WCMSA Re-Evaluation Procedure

February 12, 2013

Effective immediately, if a WCMSA proposal amount was originally submitted via the web-portal,  a re-evaluation of an approved WCMSA amount can be requested through the WCMSA web portal, if the claimant or submitter believes that a CMS determination:

• contains obvious mistakes, such as mathematical errors or a failure to recognize that medical records already submitted show a surgery CMS priced has already occurred, or
• misinterpreted evidence previously submitted, a re-evaluation maybe requested.  

Please refer to  Question # 12 of the July 11, 2005, procedure memorandum located in the “downloads” section of this page for detailed information regarding when a  re-evaluation request maybe submitted.  The CMS Regional Offices will continue to review the requests submitted through the portal.

Posted on CMS Workers Compensation Agency Services

Read more about WCMSA and workers' compensation 

Workers' Compensation: Annual Reporting of WCMSA Account ...

Jan 03, 2012

Address for submitting annual accounting documentation to CMS' Medicare Secondary Payer Recovery Contractor (MSPRC). Please send your completed annual Workers' Compensation Medicare Set-aside Arrangement ...

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

 

Workers' Compensation: CMS Publishes WCMSA Operating Rules

Dec 19, 2008

The Centers for Medicare and Medicaid Services (CMS) has now published a copy of its Operating Rules regarding the evaluation of set-aside proposals. CMS cited that distribution of this material may reduce review time by ...

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

 

Workers' Compensation: CDC in Reviewing WCMSA Limits Review ...

Jun 06, 2008

CDC in Reviewing WCMSA Limits Review to One Life Expectancy Table. Effective July 1, 2008 the Centers for Medicare and Medicad (CMS) will exclusively use the Centers for Disease Control (CDC) Table 1 (Life Table for ...

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

 

Workers' Compensation: CMS Lists How to Avoid 10 Top WCMSA ...

Sep 10, 2009

CMS Lists How to Avoid 10 Top WCMSA Errors. The Centers for Medicare and Medicaid Services has now posted the 10 top errors on Workers' Compensation Set Aside Agreement submissions and how to avoid them: 1.

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

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All Forms of Asbestos Cause Cancer

In a joint statement the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) again declared all forms of asbestos cause cancer.

Joint WHO/IARC Statement
19 February 2013

In response to allegations in the recent Lancet article, IARC in the dock over ties with asbestos industry (The Lancet, doi:10.1016/S0140-6736(13)60152-X), WHO and IARC (International Agency for Research on Cancer) state the following:

• All forms of asbestos are carcinogenic to humans (IARC Monographs Volume 100C) and stopping the use of all forms of asbestos is the most efficient way to eliminate asbestos-related diseases (WHO Fact Sheet No 343).
• The study on cancer in chrysotile workers in Asbest, Russian Federation, for which IARC is providing its epidemiological expertise, will supply important scientific information to better quantify the risk of cancers already known to be related to chrysotile as well as additional cancers suspected to be related to chrysotile, the asbestos fibre is the most commonly produced.
• WHO and IARC take conflict of interest seriously and use a rigorous process to protect our research and development of norms, standards and guidelines from undue influence.
• IARC confirms the completeness and accuracy of all data and statements of scientific results published in the British Journal of Cancer (Estimating the asbestos-related lung cancer burden from mesothelioma mortality, doi:10.1038/bjc.2011.563) and presented at a conference in Kiev.

IARC, as WHO’s cancer research agency, remains committed to providing the most reliable, independent scientific evidence on which public health decisions can be based.

When Should A Disabled Worker Take Social Security Benefits

Disabled workers are faced with complex decisions on when they should take Social Security benefits. The senario is complicated with the addition of  workers' compensation benefits and pensions, especially if they are married and/or have dependent children.

Answers to maximizing Social Security benefits are now available on-line as reported by the PBS Newshour. Several versions, including a free basic version, of software is available from Laurence Kotlikoff, Professor of Economics at Boston University. A version called, Maximize My Social Security is available for a licensing fee of $40.00 per year.

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.

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• Silica Linked to a Fatal and Compensable Lung Cancer (workers-compensation.blogspot.com)

George Washington, Born February 22, 1732

"Labour to keep alive in your breast that little spark of celestial fire, called conscience."
GEORGE WASHINGTON, Rules of Behavior

The Father of Our Country

George Washington (22 February 1732 – 14 December 1799) was the  Commander-in-Chief of the Continental Army in theAmerican Revolutionary War from 1775 to 1783, and later became the first President of the United States, an office to which he was elected, unanimously, twice and remained in from 1789 to 1797. 

Obama to Increase Workers' Compensation Benefits

President Obama announced a plan this week that will increase benefits paid to injured workers though workers' compensation insurance. Obama intends to increase the minimum wage from $7.25 to $9.00 per hour and "index" future increases.

The majority the nation's patchwork of workers' compensation systems are based on a payment scheme linked to wages. The State Average Weekly Wage (SAAW) establishes the foundation upon which temporary disability and permanent disability payments are determined. As wages increase so will benefits.

President Barack Obama
Delivering The State of The Union
White House Photo: Chuck Kennedy

A White House spokesperson announced that, "The President’s plan strengthens the middle class by making America a magnet for jobs, equipping every American with the skills they need to do those jobs, and ensuring hard work leads to a decent living."

"The President believes that no one who works fulltime should have to raise their family in poverty. But right now, a full-time minimum wage worker makes $14,500 a year – which leaves
too many families struggling to make ends meet, with a family of four with a minimum wage worker still living below the poverty line. That’s why the President is calling on Congress to raise the Federal minimum wage for working Americans in stages to $9 in 2015 and index it to inflation thereafter."

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• Why The Minimum Wage Should Actually Be $21.72 (huffingtonpost.com)
• Downton Abbey and Workers' Compensation (workers-compensation.blogspot.com)
• Jobs, Growth & Universal Healthcare (workers-compensation.blogspot.com)

Just Published - 2013 Update to Gelman on Workers' Compensation Law

Jon Gelman’s newly revised and updated treatise on Workers’ Compensation Law has just been published by West Group of Egan, MN. The treatise is the most complete work available on NJ Workers’ Compensation law.

The work offers an in-depth and insightful analysis that provides a quick and accurate guidance to those who practice workplace injury law. Time-saving comments and instructions shorten the claims process and expedite handling of issues.

Gelman on Workers’Compensation Law is exclusively integrated into the entire world-wide leading legal research network of West Group-Reuters-Thomson publications.

It is now available, in print, on CD-Rom and online via Westlaw™ and WestlawNext™.

Click here now to order your copy.

Jon L. Gelman is nationally recognized as an author, lecturer and skilled trial attorney in the field of workers’ compensation law and occupational/environmental disease litigation. Over a career spanning more than three decades he has been involved in complex litigation involving thousands of clients challenging the mega-industries of: asbestos, tobacco and lead paint. Gelman is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). He is the former Vice-President of The Workers Injury Law & Advocacy Group (WILG) and a charter member of The College of Workers' Compensation Lawyers. Jon is a founder of the Nancy R. Gelman Foundation Inc., which seeks to fund innovative research to cure breast cancer. He is also an avid photographer. jon@gelmans.com -www.gelmans.com