Copyright

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

Friday, May 22, 2015

Compensable Mental Stress and Conflict of Law Decisions Posted

The NJ Division of Workers' Compensation [NJDWC] today published 3 Court of Compensation trial level decisions. All were favorable to the injured workers and their dependents.

1. Mental Stress: Stress (harassment) particular to employment results in compensable psychiatric claim
Ross v. City of Asbury Park
06–28659; decided July 28, 2008 by the Honorable Leslie A. Berich
Petitioner alleged compensable injury as a result of mental stress created by prolonged exposure to a hostile work environment. Respondent denied these allegations. After applying the Goyden test along with other relevant legal principles, the Judge of Compensation found that there were objectively stressful working conditions peculiar to the petitioner’s working environment which entitled the petitioner to workers compensation benefits.

2. Mental Stress: Specific event (Hurricane) results in compensable suicide claim
Wilde v. Township of Cranford
99–40680; decided January 17, 2008 by the Honorable Leslie A. Berich
Petitioner filed a claim for dependency benefits for herself and her two children by asserting that her husband suffered a stress-induced occupational suicide. The respondent defended against the claim by contending that the work of the deceased, including his work as a policeman during Hurricane Floyd, was not causally related to his suicide. After careful consideration of the evidence, the Judge of Compensation awarded dependency benefits based on her finding that the work of the deceased as a policeman during this storm "lead to a loss of normal rational judgment that resulted in his suicide".

3. Conflict of Laws: NJ law applied where a special state interest existed
Spiros v. Atlantic Ambulatory Anesthesia Assocs. & Shrewsbury Surgical Center
12–22032; 13-1069 decided October 27, 2014 by the Honorable Leslie A. Beric
Medical providers filed applications for payment/reimbursement of medical expenses, which alleged that the insurance carrier for the employer unreasonably reduced the petitioner’s bills for services rendered. The carrier filed an answer in which it denied liability and jurisdiction, asserting the petitioner’s bills could be paid only at a contractual rate highly limited by Tennessee statute. The carrier also filed motions to dismiss the medical provider claims. In analyzing whether New Jersey has a special state interest in cases where medical providers provide services in New Jersey to injured workers, the Judge of Compensation found that N.J.S.A. 34:15-15 gives New Jersey’s Division of Workers’ Compensation exclusive subject matter jurisdiction and New Jersey law applies where the workers’ compensation benefits were provided in this state. Accordingly, the carrier’s motions to dismiss the medical providers’ claims were denied.

Summaries were provided by the NJ DWC.

Memorial Day

Harry S. Truman speaking at Memorial Day services at the
Amphitheatre of Arlington National Cemetery. May 30, 1948.



Monday, May 18, 2015

Bill delays compensation for asbestos victims, puts privacy at risk

Washington, D.C. — The following is a statement from American Association for Justice CEO Linda Lipsen on today’s markup of the Furthering Asbestos Claims Transparency (FACT) Act (H.R. 526) in the U.S. House of Representatives Committee on the Judiciary:

“Asbestos is still legal in the United States, and with 12,000 to 15,000 Americans suffocating to death every year from asbestos diseases, Congress should act to protect the public by demanding transparency from asbestos corporations. Instead, the FACT Act will grant a handout to the very corporations that poisoned and killed hundreds of thousands of Americans, while doing nothing to prevent further exposure to this deadly toxin.

“The asbestos industry is the only supporter of the FACT Act, and to date, this committee has refused to hear testimony from people who have experienced the ravages of asbestos diseases. Americans should be outraged that this markup will go forward without consideration of the people who will shoulder the entire burden of this one-sided bill – asbestos victims and their families."

The Role Workers’ Compensation Plays in the Amtrak Train 188 Derailment

The unfortunate crash of Amtrak 188 left 8 people dead and injured over 200 people. Compensation benefits for victims and their families face a host of complex and conflicting legal remedies. The National Transportation Safety Board is investigating an Amtrak derailment in Philadelphia, Pa.

Today's post is by guest author Brianne Rohner Erickson of the Nebraska Bar.

Our sympathies go out to all of the friends and families of the victims of Tuesday’s Amtrak passenger train derailment in Philadelphia, as well as a wish for the recovery of those injured. The latest news reports indicate that, as of Friday morning, the crash has left at least eight dead and more than 200 injured.

Thursday, May 7, 2015

NJ State Bar Association Opposes Workers' Compensation COLA Bill

"The New Jersey State Bar Association respectfully has concerns with S-929 (Sweeney) which concerns certain workers' compensation supplemental benefits. The New Jersey State Bar Association opposes this legislation in order to preserve the “Reverse Offset” provision in New Jersey, visa vie Social Security, which provides for a reduction of the workers' compensation benefit of a worker also receiving disability insurance. Enacting this legislation has the potential of harming the economic integrity of New Jersey’s current cost effective system by allowing for a double recovery of disability benefits and workers’ compensation benefits, which will in turn increase the cost of doing business in New Jersey. A potential alternative that would limit these adverse consequences would be to limit the application of the bill to survivor/death benefits. For the reasons set for above, the New Jersey State Bar Association respectfully opposes this bill."

Wednesday, May 6, 2015

Professor John F Burton Jr: Illinois Proposed Changes Are Obectionable

The former chair of the 1972 National Commission on Workers' Compensation told the Illinois legislature yesterday that the proposed changes to the Illinois Workers' Compensation Act will degrade the system and reduce benefits to injured workers. Profession Emeritis John F. Burton, Jr., yesterday presented a statement to the Committee of the Whole before the Illinois House of Representatives.
Professor John F. Burton Jr.

Tuesday, May 5, 2015

Look Who Is Prescribing What

As part of the Administration’s goals of better, care, smarter spending, and healthier people, the Centers for Medicare & Medicaid Services announced the availability of new, privacy-protected data on Medicare Part D prescription drugs prescribed by physicians and other health care professionals in 2013. This data shows which prescription drugs were prescribed to Medicare Part D beneficiaries by which practitioners.
“This transparency will give patients, researchers, and providers access to information that will help shape the future of our nation’s health for the better,” said acting CMS Administrator Andy Slavitt. “Beneficiaries’ personal information is not available; however, it’s important for consumers, their providers, researchers, and other stakeholders to know how many prescription drugs are prescribed and how much they cost the health care system, so that they can better understand how the Medicare Part D program delivers care.”

The new data set contains information from over one million distinct health care providers who collectively prescribed approximately $103 billion in prescription drugs and supplies paid under the Part D program. The data characterizes the individual prescribing patterns of health providers that participate in Medicare Part D for over 3,000 distinct drug products. For each prescriber and drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost paid by beneficiaries, Part D plans, and other sources.

CMS created the new data set using drug claim information submitted by Medicare Advantage Prescription Drug plans and stand-alone Prescription Drug Plans. With this data, it will be possible to conduct a wide array of prescription drug analyses that compare drug use and costs for specific providers, brand versus generic drug prescribing rates, and to make geographic comparisons at the state level.

The Administration has set measurable goals and a timeline to move Medicare toward paying providers based on the quality, rather than the quantity, of care they give patients. This is part of a wide set of initiatives to achieve better care, smarter spending and healthier people through our health care system. Open sharing of data securely, timely and more broadly supports insight and innovation in health care delivery.

Today’s Part D prescriber data availability adds to the unprecedented information previously released on services and procedures provided to Medicare beneficiaries, including hospital charge data on common impatient and outpatient services as well as utilization and payment information for physicians and other healthcare professionals. In addition, under the Qualified Entity (QE) program, CMS releases Medicare data to approved entities for the purposes of producing public performance reports on physicians, hospitals, and other providers. To date, CMS has certified 11 regional QEs and one national QE.

To view a fact sheet on the Medicare Part D prescriber data, visit: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Part-D-Prescriber.html

Updated: May 15, 2015

Related articles
How Proposed Part D Changes Are Playing On Capitol Hill (workers-compensation.blogspot.com) 

Study: Cancer costs 'skyrocketed' despite drug cuts (workers-compensation.blogspot.com)