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

Thursday, February 27, 2014

No Teeth, No Respect

Today's post was shared by WorkCompCentral and comes from daviddepaolo.blogspot.com
One of the topics that was discussed at the 11th Annual National Workers' Compensation Insurance ExecuSummit held at the Mohegan Sun Convention Center & Hotel in Uncasville, CT was the deterrent effect workers' compensation could have over and above safety regulations on worker safety.

The theory goes (and I'm sure has some validity) that when properly educated an employer would see the light be providing a more safe work place and instigate work safety initiatives and incentives.

Some employers don't care.

Alas, an administrative law judge's appeal decision last month upheld serious citations issued by Cal OSHA to San Francisco-based adult film employer Treasure Island Media Inc. for inadequate protection of employees during production of adult film videos.

Serious citations are those that can cause death or serious physical injury. The final penalty for the safety violations was $8,670, lowered on administrative appeal from Cal OSHA's proposed penalty of $20,485.

The allegations were that Treasure Island Media performers were featured having sex with multiple partners without mandated controls to prevent exposure to bloodborne pathogens, including HIV, and Hepatitis B and C. The bloodborne pathogen standard for workplaces was adopted to prevent workers from exposure to blood or other potentially infectious materials.

The first serious violation alleged that Treasure Island lacked an exposure control plan to limit employee contact with infectious bodily materials during...
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Wednesday, February 26, 2014

The World Trade Center Health Fund Will Seek Reimbursement of Workers' Compensation Payments

The World Trade Center (WTC) Health Program established under the 9-11 Health Claim Program (Zadroga Act) will identify and seek recoup funds from workers’ compensation when available. The program imposes duties on Responders, Clinical Centers of Excellence, Workers’ Compensation Insurers and other employers providing illness and injury benefits to Responders.

The WTC Health Program is delaying the effective date for the component of the policy and procedures relating to recoupment from lump sum settlements of workers’ compensation cases. The policy was originally scheduled to apply to any lump sum settlement entered into after September 1, 2013. The recoupment policy will now apply to proposed settlement agreements filed with the New York Workers’ Compensation Board (NY WCB) on or after October 1, 2013. Any proposed settlement filed with the NY WCB on or after October 1, 2013, and which releases an employer/insurer’s liability for any future medical expenses must be reviewed by the WTC Health Program or the parties may be financially responsible for treatment expenses. The effective date for the policy as it relates to active workers’ compensation cases where the claimant has not filed a lump sum settlement remains September 1, 2013.

General Recoupment Scheme

1. The WTC Health Program will seek to recoup from medical providers of the WTC
Health Program and from WC insurers. The Program does not anticipate that it will be
necessary to seek recoupment directly from individual WTC responders, unless the
Responder accepts a lump sum settlement from WC and the settlement either releases
or has the effect of releasing the WC insurer from its obligation to pay future medical
expenses. 42 U.S.C. § 1395y(b)(2)(B)(iii) incorporated in 42 U.S.C. § 300mm-41(b)(1).

2. If the primary payer seeks to shift costs onto the WTC Health Program, and the
Program cannot recover WC payments voluntarily, it may seek double damages from
the payer in a recoupment action.

This means that if either a medical provider or a Responder receives payment from a WC insurer for services already paid for by the WTC Health Program, the Program has a duty to reduce further payments or recoup funds from that medical provider who received funds from the WC insurer.42 U.S.C. § 300mm-41(b)(1).

3. If evidence suggests that a WC insurer has improperly shifted WC costs onto the WTC
Health Program, the Program may recommend that a recoupment action be filed
against an insurer, even if the insurer has already paid the claim. 42 U.S.C. § 1395y(b)(2)(B)(iii) incorporated in 42 U.S.C. § 300mm-41(b)(1).

Click here to read the entire WTC Health Fund Policy Statement
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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 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.

Tuesday, February 25, 2014

Throw The Book At 'Em

There seems to be no limit in the amount of fraudulent conduct that transpires within the workers' compensation system. If employer fraud is not enough, the system is constantly undergoing abuse from business interests, ie. medical provo\iders, who abuse the system. The Federal Governments role in enforcement is ever increasing and expansion is trending wider. The gobal expanssion nationally of a universal program for monitoring and enforcement of medical fraud is encouraging. Today's post is shared from David DePaolo http://daviddepaolo.blogspot.com/

It's a shame that hundreds, if not thousands, of injured workers underwent unnecessary spinal fusion surgeries and must live with the debilitating aftermath of significant disability because of people whose greed overrides the well being of fellow humans.

I had learned about Michael Drobot and Pacific Hospital of Long Beach, and their co-conspirators, preying on workers' compensation patients some time ago.

On Friday though, Federal prosecutors announced that Michael D. Drobot faces up to 10 years in prison after he pleaded guilty to paying kickbacks in a $500 million fraud scheme relating to spinal fusions and admitted to bribing state Sen. Ron Calderon to delay legislation to repeal the separate reimbursement for spinal hardware.

Calderon, D-Montebello, was indicted one day earlier on 24 charges, including bribery, money laundering, wire fraud and filing a false tax return. His brother, former...

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Read more about "Federalization of Workers' Compensation"
Jul 05, 2012
United States Supreme Court has taken a giant leap forward to facilitate the Federalization of the entire nation's workers' compensation system. By it's recent decision, upholding the mandate for insurance care under the ...
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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 ...
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Jun 14, 2012
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 .


Monday, February 24, 2014

Freeing Workers From the Insurance Trap

Removing major medical coverage from a condition of employment will ultimately improve working condition. Today's post was shared by Steven Greenhouse and comes from www.nytimes.com

The Congressional Budget Office estimated on Tuesday that the Affordable Care Act will reduce the number of full-time workers by 2.5 million over the next decade. That is mostly a good thing, a liberating result of the law. Of course, Republicans immediately tried to brand the findings as “devastating” and stark evidence of President Obama’s health care reform as a failure and a job killer. It is no such thing.

The report estimated that — thanks to an increase in insurance coverage under the act and the availability of subsidies to help pay the premiums — many workers who felt obliged to stay in a job that provided health benefits would now be able to leave those jobs or choose to work fewer hours than they otherwise would have. In other words, the report is about the choices workers can make when they are no longer tethered to an employer because of health benefits. The cumulative effect on the labor supply is the equivalent of 2.5 million fewer full-time workers by 2024.

Some workers may have had a pre-existing condition and will now be able to leave work because insurers must accept all applicants without regard to health status and charge premiums unrelated to health status. Some may have felt they needed to keep working to pay for health insurance, but now new government subsidies will help pay premiums, making it more possible for them to leave their jobs.

The report clearly stated that health reform would not produce an increase in...


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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 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.

Sunday, February 23, 2014

F.D.A. Orders 4 Bidi Cigarette Brands Removed From Shelves

The Food and Drug Administration on Friday ordered four tobacco products removed from the market, the first time the agency has done so since being given the legal authority in 2009.

“It’s a big deal,” said Matthew L. Myers, the president of the Campaign for Tobacco-Free Kids, an advocacy group. “This is first time the F.D.A. has ever ordered a product to be removed from the market for broad public health concerns.”

“It’s also significant that they did so because the manufacturer was unable or unwilling to provide sufficient evidence that the product didn’t raise new or different concerns for public health,” he added.

Since June 2013, the F.D.A. has rejected 13 new tobacco products because agency scientists believed they posed health risks above and beyond comparable products already on the market.

Agency officials said that four cigarette brands made by Jash International may no longer be domestically sold, distributed or imported. They are Sutra Bidis Red, Sutra Bidis Menthol, Sutra Bidis Red Cone and Sutra Bidis Menthol Cone. In 30 days, the F.D.A. will begin seizing any goods that remain on shelves.

The unconventional cigarettes are bidis — thin, hand-rolled cigarettes stuffed with tobacco, wrapped in leaves from a tendu tree and sometimes tied with a colorful string. Popular in India, bidis are not widely smoked here, but their novelty appeals to some adolescents.

In 2012, the Centers for Disease Control and...

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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 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.

Read more about "Smoking and Workers' Compensation:"
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The 1964 U.S. Surgeon General's report on smoking — the first official acknowledgment by the federal government that smoking kills — was an extraordinarily progressive document for its time. It swiftly led to a federal law that ...
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City parks, public beaches, college campuses and other outdoor venues across the country are putting up signs telling smokers they can't light up. Outdoor smoking bans have nearly doubled in the last five years, with the tally ...
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2 seriously injured after falling from scaffolding

Today's post was shared by CAAA and comes from www.mercurynews.com


SAN FRANCISCO—San Francisco fire officials say two workers are suffering from potentially life threatening injuries after falling from scaffolding at a skyscraper under construction.

Fire spokeswoman Mindy Talmadge says the workers were installing scaffolding when it collapsed, sending one worker falling 40 feet and another 30 feet shortly after 2 p.m. Thursday at the 27-story office building under construction in the city's South of Market neighborhood.

Talmadge says parts of the scaffolding fell on the workers as firefighters worked to remove the workers from some rubble. The workers were taken to San Francisco General Hospital with life threatening injuries.

She did not know the extent of their injuries. Their names have not been released.

Talmadge says the California Division of Occupational Safety and Health will investigate the incident.

The workers are from Webcor Builders in San Francisco, said Len Veprone, a senior vice president. He confirmed that the workers were at the hospital, but he did not disclose their conditions. He said the builders are the Kilroy Realty Corp. and that the site has been under construction since April.

A telephone message left with OSHA officials was not immediately returned.

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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 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.

Read more about "Scaffolding Accidents and Workers' Compensation"
Feb 23, 2014
Fire spokeswoman Mindy Talmadge says the workers were installing scaffolding when it collapsed, sending one worker falling 40 feet and another 30 feet shortly after 2 p.m. Thursday at the 27-story office building under ...
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The repeat violations, with a $67,760 penalty, include an unsecured scaffold missing cross braces, exposing workers to scaffold collapse and failing to fully plank and provide guardrails or other means of fall protection on ...
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The U.S. Department of Labor's Occupational Safety and Health Administration has cited Beno Stucco Systems of Rochelle Park with six safety violations – including five repeat – involving fall and scaffolding hazards while ...

Detroit Files Financial Restructuring Plan

Today's post was shared by WSJ Law Blog and comes from blogs.wsj.com

DETROIT—The city of Detroit submitted its financial restructuring plan to federal court Friday, a move likely to set off a new round of jockeying among creditors asked to take a haircut in the nation’s largest municipal bankruptcy.

The plan seeks to restructure an estimated $18 billion in long-term obligations by paying secured creditors in full, paying pension funds a reduced amount, and giving other unsecured creditors just a fraction—about 20 cents on the dollar—of the outstanding debt the city still owes.

“There is still much work in front of all of us to continue the recovery from a decadeslong downward spiral,” Detroit Emergency Manager Kevyn Orr said in a statement Friday. “We must move swiftly to emerge from bankruptcy so that the financial distress harming the City can end.”

As part of the plan, city officials said they would set aside $1.5 billion over 10 years for capital improvements, blight removal, and equipment and technology upgrades to make the city safer, cleaner and more efficient. Up to $500 million of that will be dedicated to blight removal over the next five years, officials said. Read the full WSJ story here.

Michigan Gov. Rick Snyder, who steered the city into a bankruptcy filing in July, called on many city creditors who have been reluctant to settle to reconsider.

“Let’s use this plan as a call to action for a voluntary settlement as part of the mediation process to resolve the...

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Jon L. Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 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.

Read more about "Bankruptcy and Workers' Compensation"
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Public entity bankruptcies have placed the stability of workers' compensation and other benefits into a grey area. As the Detroit bankruptcy resolution continues to stumble the consistency necessary for critical benefit delivery ...
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The bankruptcy of the city of Detroit reflects not only an economic and social tragedy for America, but it also marks a failure of basic disability and compensation programs for the US workers. It is a sentinel event marking the ...
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The company — Montreal, Maine and Atlantic Railway — filed for Chapter 11 bankruptcy protection in United States and Canadian courts, citing debts to more than 200 creditors after the July disaster in Lac-Mégantic, Quebec.