AMA Urges Trump Administration to Clarify Immigration Executive Order

A major element of workers' compensation benefits is medical treatment and that will be impacted the Donald Trump's recent ban on immigration. An adequate number of physicians must be available to provide medical care to cure and relieve  a work related medical condition. The American Medical Association (AMA) sent the following letter today to the U.S. Department of Homeland Security regarding the Administration’s executive order issued last week,“Protecting the Nation from Foreign Terrorist Entry into the United States:”

Declining Earnings Capacity - A Retrogressive Penalty for Ill Workers

The decline of the earning capacity of ill workers prior to stopping work has an impact on both workers' compensation benefits as well as Social Security disability benefits. It is  a retrogressive penalty for chronically ill workers.

The Social Security Administration in a recent report objectively reports this phenomena.

Takata Corporation Agrees to Plead Guilty and Pay $1 Billion in Criminal Penalties for Airbag Scheme

Tokyo-based Takata Corporation, one of the world’s largest suppliers of automotive safety-related equipment, agreed to plead guilty to wire fraud and pay a total of $1 billion in criminal penalties stemming from the company’s fraudulent conduct in relation to sales of defective airbag inflators. An indictment was also unsealed charging three Takata executives with wire fraud and conspiracy in relation to the same conduct.

U.S. Attorney Barbara McQuade of the Eastern District of Michigan, Chief Andrew Weissmann of the Fraud Section of the Justice Department’s Criminal Division, Special Agent in Charge David P. Gelios of the FBI’s Detroit Field Office and Inspector General Calvin L. Scovel III of the U.S. Department of Transportation Office of Inspector General made the announcement.

“Automotive suppliers who sell products that are supposed to protect consumers from injury or death must put safety ahead of profits,” said U.S. Attorney McQuade. “If they choose instead to engage in fraud, we will hold accountable the individuals and business entities who are responsible.”

“For more than a decade, Takata repeatedly and systematically falsified critical test data related to the safety of its products, putting profits and production schedules ahead of safety,” said Fraud Section Chief Weissmann. “This announcement is the latest in the automotive industry enforcement actions the Fraud Section has taken to protect U.S. consumers against fraud.”

“Today’s criminal charges of the Takata Corporation and three of its employees should be a reminder to other corporations and their employees that if they commit fraud, the FBI and its law enforcement partners will ensure they are held accountable for their actions,” said Special Agent in Charge Gelios. “Whether it is the manipulation of test results which impact customer safety, defective product development or any other type of fraud, we will continue to aggressively investigate corporate fraud allegations to protect consumers in the United States and elsewhere.”

“I offer my deepest sympathies to the families and friends of those who died and to those who were injured as a result of the Takata Corporation’s failure to fulfill its obligation to ensure the safety of its airbag systems,” said Inspector General Scovel. “Because safety is and will remain the highest priority for my office, we will continue to work tirelessly with our law enforcement and prosecutorial partners in pursuing those who commit criminal violations of transportation-related laws and regulations. Along with similar settlements with General Motors in September 2015 and Toyota in March 2014, today’s agreement makes clear to all auto manufacturers and parts suppliers their duty in keeping the public safe.”

According to the company’s admissions, in the late 1990s, Takata began developing airbag inflators that relied upon ammonium nitrate as their primary propellant. From at least in or around 2000, Takata knew that certain ammonium nitrate-based inflators were not performing to the specifications required by the auto manufacturers. Takata also knew that certain inflators had sustained failures, including ruptures, during testing. Nevertheless, Takata induced its customers to purchase these airbag systems by submitting false and fraudulent reports and other information that concealed the true condition of the inflators. This fraudulent data made the performance of the company’s airbag inflators appear better than it actually was, including by omitting that, in some instances, inflators ruptured during testing. Takata employees – including a number of key executives – routinely discussed the falsification of test reports being provided to Takata’s customers in email and in verbal communications. Even after the inflators began to experience repeated problems in the field – including ruptures causing injuries and deaths – Takata executives continued to withhold the true and accurate inflator test information and data from their customers.

addition, Takata took no disciplinary actions against those involved in the falsification of test data until 2015, despite the fact that senior executives had been made aware of the fraudulent conduct years earlier.

Takata has agreed to plead guilty to a one-count criminal information filed today in the Eastern District of Michigan and assigned to U.S. District Judge George Caram Steeh, charging the company with one count of wire fraud. Under the terms of the agreement, Takata will pay a total criminal penalty of $1 billion, including $975 million in restitution and a $25 million fine. Two restitution funds will be established: a $125 million fund for individuals who have been physically injured by Takata’s airbags and who have not already reached a settlement with the company, and a $850 million fund for airbag recall and replacement costs incurred by auto manufacturers who were victims of Takata’s fraud scheme. A court-appointed special master will oversee administration of the restitution funds. Takata has also agreed to implement rigorous internal controls, retain a compliance monitor for a term of three years and cooperate fully with the department’s ongoing investigation, including its investigation of individuals.

The three Takata executives – Shinichi Tanaka, 59; Hideo Nakajima, 65; and Tsuneo Chikaraishi, 61, all Japanese citizens – were each charged in an indictment filed on Dec. 7, 2016, in the Eastern District of Michigan with one count of conspiracy to commit wire fraud and five counts of wire fraud for their alleged conduct in connection with the above-described fraud scheme.

The department reached this resolution based on a number of factors, including Takata’s extensive cooperation with the government’s investigation. However, the company did not receive more significant mitigation credit, either in the penalty or the form of resolution, because of the nature of the conduct to which the company is pleading guilty, including the approximate 15-year duration of the fraud, the pervasiveness of the scheme into the executive level of management and the potential risk the fraud posed to drivers and passengers.

Court Documents:
Takata Information
Takata Plea Agreement
Tanaka et al Indictment

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Medicare Advantage Organization Allowed to Sue Law Firm and Lawyer Over Conditional Payments

A Federal Court has ruled that a Medicare Advantage Organization (MAO) is permitted under the law to sue a law firm and a lawyer for the failure to reimburse conditional medical expenses arising out of an accident. 

US District Court Judge, Henry E. Hudson, ruled that the Medicare Secondary Payer statute created a private cause of action to pursue recovery for conditional payments that it made on the beneficiary's behalf for medical expenses resulting from an automobile accident.

"Although not binding precedent, this Court finds persuasive the Third Circuit's determination that a MAO may pursue recovery pursuant to the private right of action in § 1395y(b)(3)(A). Section 1395y(b)(2)(A)'s plain language establishes a private right of action to recover double damages where a primary plan fails to pay. Absent from the plain language of the statute is any restriction upon who may utilize that private right of action."

Humana Insurance Co. v Paris Blank LLP, 197 F. Supp. 3d 676 (E.D. Virginia 2016)

NJ Braces For Winter Weather --- Snow

Workers traveling the NJ highways tonight and tomorrow need to stay informed of the weather service announcements closely as an urgent Winter Weather Message has been issued for an anticipated winter storm.

URGENT - WINTER WEATHER MESSAGE 

NATIONAL WEATHER SERVICE MOUNT HOLLY NJ 

355 PM EST THU JAN 5 2017 

 ...LIGHT SNOW TO AFFECT THE AREA TONIGHT...FOLLOWED BY A POTENTIAL FOR A MORE SIGNIFICANT WINTER STORM PARTICULARLY NEAR THE COAST IN SOUTHERN PORTIONS OF DELAWARE AND NEW JERSEY LATE FRIDAY NIGHT INTO SATURDAY..."

OSHA has made the following suggestions to employers and employees to prepare for winter weather hazards:

Winter Driving

Although employers cannot control roadway conditions, they can promote safe driving behavior by ensuring workers: recognize the hazards of winter weather driving, for example, driving on snow/ice covered roads; are properly trained for driving in winter weather conditions; and are licensed (as applicable) for the vehicles they operate. For information about driving safely during the winter, visit OSHA's Safe Winter Driving page.

Employers should set and enforce driver safety policies. Employers should also implement an effective maintenance program for all vehicles and mechanized equipment that workers are required to operate. Crashes can be avoided. Learn more at: Motor Vehicle Safety (OSHA Safety and Health Topic’s Page).

Employers should ensure properly trained workers' inspect the following vehicle systems to determine if they are working properly:

• Brakes: Brakes should provide even and balanced braking. Also check that brake fluid is at the proper level.
• Cooling System: Ensure a proper mixture of 50/50 antifreeze and water in the cooling system at the proper level.
• Electrical System: Check the ignition system and make sure that the battery is fully charged and that the connections are clean. Check that the alternator belt is in good condition with proper tension.
• Engine: Inspect all engine systems.
• Exhaust System: Check exhaust for leaks and that all clamps and hangers are snug.
• Tires: Check for proper tread depth and no signs of damage or uneven wear. Check for proper tire inflation.
• Oil: Check that oil is at proper level.
• Visibility Systems: Inspect all exterior lights, defrosters (windshield and rear window), and wipers. Install winter windshield wipers.

An emergency kit with the following items is recommended in vehicles:

• Cellphone or two-way radio
• Windshield ice scraper
• Snow brush
• Flashlight with extra batteries
• Shovel
• Tow chain
• Traction aids (bag of sand or cat litter)
• Emergency flares
• Jumper cables
• Snacks
• Water
• Road maps
• Blankets, change of clothes

Work Zone Traffic Safety

Workers being struck by vehicles or mobile equipment lead to many work zone fatalities or injuries annually. Drivers may skid, or lose control of their vehicles more easily when driving on snow and/or ice covered roads. It is therefore, important to properly set up work zones with the traffic controls identified by signs, cones, barrels, and barriers, to protect workers. Workers exposed to vehicular traffic should wear the appropriate high visibility vest at all times, so that they can be visible to motorists (OSHA Letter of Interpretation, dated, August 5, 2009).

Learn more at: Work Zone Traffic Safety* (OSHA QuickCard™) and Highway Work Zones and Signs, Signals, and Barricades (OSHA Safety and Health Topics Page).

Stranded in a Vehicle

If you are stranded in a vehicle, stay in the vehicle. Call for emergency assistance if needed, response time may be slow in severe winter weather conditions. Notify your supervisor of your situation. Do not leave the vehicle to search for assistance unless help is visible within 100 yards. You may become disoriented and get lost in blowing and drifting snow. Display a trouble sign by hanging a brightly colored cloth on the vehicle’s radio antenna and raising the hood. Turn on the vehicle's engine for about 10 minutes each hour and run the heat to keep warm. Also, turn on the vehicle's dome light when the vehicle is running as an additional signal. Beware of carbon monoxide poisoning. Keep the exhaust pipe clear of snow, and open a downwind window slightly for ventilation.

Watch for signs of frostbite and hypothermia. Do minor exercises to maintain good blood circulation in your body. Clap hands and move arms and legs occasionally. Try not to stay in one position for too long. Stay awake, you will be less vulnerable to cold-related health problems. Use blankets, newspapers, maps, and even the removable car mats for added insulation. Avoid overexertion since cold weather puts an added strain on the heart. Unaccustomed exercise such as shoveling snow or pushing a vehicle can bring on a heart attack or make other medical conditions worse.  

Shoveling Snow

Shoveling snow can be a strenuous activity, particularly because cold weather can be tasking on the body. There is a potential for exhaustion, dehydration, back injuries, or heart attacks. During snow removal in addition to following the tips for avoiding cold stress, such as taking frequent breaks in warm areas, there are other precautions workers can take to avoid injuries. Workers should warm-up before the activity, scoop small amounts of snow at a time and where possible, push the snow instead of lifting it. The use of proper lifting technique is necessary to avoid back and other injuries when shoveling snow: keep the back straight, lift with the legs and do not turn or twist the body.

Using Powered Equipment like Snow Blowers

It is important to make sure that powered equipment, such as snow blowers are properly grounded to protect workers from electric shocks or electrocutions. When performing maintenance or cleaning, make sure the equipment is properly guarded and is disconnected from power sources.

Snow blowers commonly cause lacerations or amputations when operators attempt to clear jams with the equipment turned on. Never attempt to clear a jam by hand. First, turn the snow blower off and wait for all moving parts to stop, and then use a long stick to clear wet snow or debris from the machine. Keep your hands and feet away from moving parts. Refuel a snow blower prior to starting the machine; do not add fuel when the equipment is running or when the engine is hot.

Clearing Snow from Roofs and Working at Heights

Employers must evaluate snow removal tasks for hazards and plan how to do the work safely. Workers should be aware of the potential for unexpected hazards due to the weather conditions, for example, layers of ice can form as the environmental temperature drops, making surfaces even more slippery. A surface that is weighed down by snow must be inspected by a competent person to determine if it is structurally safe for workers to access it, because it may be at risk of collapsing. Snow covered rooftops can hide hazards such as skylights that workers can fall through. Electrical hazards may also exist from overhead power lines or snow removal equipment.

Employers can protect workers from these hazardous work conditions, for example, by using snow removal methods that do not involve workers going on roofs, when and where possible. Employers should determine the right type of equipment (ladders, aerial lifts, etc.) and personal protective equipment (personal fall arrest systems, non-slip safety boots, etc.) for the job and ensure that workers are trained on how to properly use them. For more information, see OSHA's Hazard Alert: Falls and Other Hazards to Workers Removing Snow from Rooftops and Other Elevated Surfaces*.

Preventing Slips on Snow and Ice

To prevent slips, trips, and falls, employers should clear walking surfaces of snow and ice, and spread deicer, as quickly as possible after a winter storm. In addition, the following precautions will help reduce the likelihood of injuries:

• Wear proper footwear when walking on snow or ice is unavoidable, because it is especially treacherous. A pair of insulated and water resistant boots with good rubber treads is a must for walking during or after a winter storm. Keeping a pair of rubber over-shoes with good treads which fit over your street shoes is a good idea during the winter months.
• Take short steps and walk at a slower pace so you can react quickly to a change in traction, when walking on an icy or snow-covered walkway.

Repairing Downed or Damaged Power Lines

Repairing and/or replacing damaged power lines in severe winter weather conditions are especially hazardous. A major hazard is snow, because the moisture can reduce the insulation value of protective equipment, and could cause electrocution. In these conditions de-energized work is safer, but if energized work must be done, qualified workers and supervisors must first do a hazard analysis that includes evaluating the weather conditions and identifying how to safely do the job.

Other potential hazards include:

• Electrocution by contacting downed energized power lines, or contacting objects, such as broken tree limbs, in contact with downed energized power lines.
• Fires caused by an energized line or equipment failure.
• Being struck or crushed by falling tree limbs, collapsing poles, etc.

When working on downed or damaged power lines, electrical utility workers should use safe work practices, appropriate tools and equipment (including personal protective equipment (PPE)). Extra caution should be exercised when working in adverse weather conditions. Learn more at: Contact with Power Lines (OSHA Construction eTool).

Working Near Downed or Damaged power lines

Assume all power lines are energized and stay clear of any downed or damaged power lines. Establish a safe distance from power lines and report any incidents to the responsible authority. Only properly-trained electrical utility workers can handle damaged power lines. Learn more at: Contact with Power Lines (OSHA Construction eTool) and Working Safely Around Downed Electrical Wires* (OSHA Fact Sheet).

Removing Downed Trees

Clearing downed trees is a critical job during severe winter weather conditions. It is usually urgent to remove downed trees that block public roads and damage power lines. Emergency crews are often tasked with clearing downed trees.

Potential hazards include:

• Electrocution by contacting downed energized power lines or contacting broken tree limbs in contact with downed energized power lines. Learn more at: Line Clearance Tree Trimming Operations (OSHA Electric Power eTool).
• Falls from heights.
• Being injured by equipment such as chain saws (Chain Saw Safety* (OSHA QuickCard™)) and chippers (Chipper Machine Safety* (OSHA QuickCard™)).

Workers should wear PPE that protect them from the hazards of the tree removal tasks. Workers using chainsaws and chippers to clear downed trees should use: gloves, chaps, foot protection, eye protection, fall protection, hearing protection and head protection.

Only powered equipment designed for outdoor and wet conditions should be used. Use all equipment and tools (saws, chippers, etc.) properly and for the purpose that they are designed for. Ensure that equipment is always maintained in serviceable condition and inspected before use by a knowledgeable person that can identify any problems with the equipment. Do not use equipment that is not functioning properly. Equipment must have proper guarding (as applicable); safe guards must never be bypassed.  All controls and safety features must function as designed by the manufacturer. Learn more at: Tree Trimming and Removal* (OSHA QuickCard™).

OSHA cites Jersey City Medical Center (St Barnabas) $174,393

OSHA investigation of Jersey City Medical Center worker's fatal fall finds facility exposed employees to dangerous electrical hazardsCitations issued: On Dec. 21, 2016, the U.S. Department of Labor's Occupational Safety and Health Administration issued citations to the medical center for one willful and four serious safety violations.

OSHA began its inspection on June 28, 2016, after the employer notified the Agency that a worker needed to be hospitalized after falling from a ladder as he changed an overhead ballast in a light fixture. The worker later died from his injuries on July 17, 2016.

The agency cited the willful violation because the facility required employees to change ballasts without the proper lockout/tagout training on practices and procedures necessary to disable machinery or equipment to prevent hazardous energy release, as well as other safety hazards and related unsafe practices.

The serious violations involved the medical center's failure to ensure de-energized circuits were locked out, maintain an electrical lockout/tagout program, ensure that only qualified persons worked on live circuits, provide personal protective equipment, and ensure workers did not work on live parts.

"This worker's tragic death was preventable. Jersey City Medical Center did not have basic lockout/tagout safeguards in place to prevent exposure to electrical hazards, and failed to train its maintenance workers on these safeguards. As a result, the worker sustained an electrical shock while changing the ballast, fell approximately 6 feet off a ladder and died from his injuries," said Kris Hoffman, director of OSHA's Parsippany Area Office.

Proposed penalties: $174,593

The citation can be viewed at: https://www.osha.gov/ooc/citations/JerseyCityMedicalCenter_1158589.pdf

The employer has 15 business days from receipt of its 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 amputations, eye loss, 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 Parsippany Area Office at 973-263-1003.

NJ Workers' Compensation Rates Increase in 2017 - Max $896.00

The NJ Workers' Compensation Rating and Inspection Bureau (NJCRIB) reported today 2017 rates effective January 1, 2017.

The Commissioner of Banking and Insurance (“Commissioner”) has approved a 3.0% decrease in rates and rating values applicable to New Jersey workers compensation and employers liability insurance effective January 1, 2017 on a new and renewal basis. The rating components of the decrease are summarized below.