McCrory’s Fraud Statistics Questioned by Experts

Governor Pat McCrory

According to N.C. Governor Pat McCrory, workers’ compensation claims cause the state to spend about $150 million per year. He claims that research by CorVel, the state’s administrator for state employee claims, shows that roughly 40% of the workers’ compensation claims are related to abuse or fraud.

When attorneys, professors, and state employee representatives questioned this number, State Personnel Director Neal Alexander and McCrory spokesman Josh Ellis were unable to provide any statistical support for this claim.

It is uncertain why the Governor would make a serious allegation of this nature without the numbers to back it up, but if the goal is to cut fraud and abuse in the system he may want to start with evaluating why so many employers are “gaming” the system by misclassifying their employees as independent contractors, and not providing any workers’ compensation coverage at all. Taxpayers often end up footing the medical bills for disabled employees because the state has no uninsured fund.

An investigation by The News & Observer newspaper revealed last year that N.C. was losing approximately $467 million a year in lost tax revenue because of employer misclassification. That is real and tangible fraud, and legislation is needed to give state agencies the tools to go after these cheaters. 

For more information please read this article on WRAL by Mark Binker and Cullen Browder.

Being Mortal, a book about end-of-life medical care, by Atul Gawande

All of us need to talk honestly about matters that concern us. Talking honestly about end-of-life choices is essential, and Atul Gawande (a surgeon in Boston) makes that clear in his book Being Mortal. Are the desperate surgical procedures and expensive treatments, which usually reduce the quality of life of a terminally ill patient, worth it? If discussed openly and honestly early in the process, would the patient choose to die in a hospital or at home with his family under the care of hospice?

Once one becomes seriously ill, even at an early age, perceptions change. What becomes important are the people in your life. The same is true as you approach death as an older person, and those last few months or years can be highlights of dignity, or they can turn into medical nightmares. “It’s perception, not age, that matters most.”

Dr. Gawande gives examples including the death of his own father, to illustrate different scenarios and notes that, “25% of all Medicare spending is for the 5% of patients who are in their final year of life, and most of that money goes for care in their last couple of months and is of little apparent benefit.” He readily admits doctors don’t ask the hard questions and he is changing his ways as a surgeon, but he wants the patient and family to get there first. This book is worth reading in order to understand, to contemplate, and to help make wise decisions about end-of-life issues.

For a more in-depth analysis, go to NPR Frontline.

Insult to Injury: Is Income Inequality Tied to Worker Safety?

Today’s post was shared by US Labor Department and comes from blog.dol.gov

guadalupe

Guadalupe González doesn’t know if she’s going to be able to make it much longer.

The East Boston resident used to hold a full time position as a cleaner for Sodexo. Much of her time working was spent on the campus of Lasell College, located in the wealthy Boston suburb of Newton, where she was paid $10.80 an hour for her labor. Weighed down by her buckets and supplies, she would rush, at Sodexo’s insistence, from building to building across the campus often on uneven terrain.

When Guadalupe fell it was devastating; she knew instantly what her mangled ankle meant. She was going to have to take a break from her physically demanding job, a break she just couldn’t afford. Three surgeries later, Guadalupe is no closer to returning to work than the day she was injured. She is in nearly constant pain and requires a cane to walk. Worse yet, Guadalupe now receives a mere 60 percent of her former earnings, making it almost impossible to buy food, pay bills and make rent. Sadly, Guadalupe is not alone. She is one of at least three million workers seriously injured every year in the United States. She is one of many workers who will lose more than 15 percent in wages over ten years because of their injury while bearing nearly 50 percent of its cost. For workers like Guadalupe, the American dream quickly becomes a nightmare. These injuries and illnesses contribute to the pressing issue of income inequality: they force working families out of the middle…

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Drums with hazardous waste removed from industrial ruins near Paterson’s Great Falls

Today’s post was shared by Gelman on Workplace Injuries and comes from www.northjersey.com

By JOE MALINCONICO

Paterson Press

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Paterson Historical Preservation office
ATP site

PATERSON – Federal authorities last month removed storage drums containing hazardous chemical from the abandoned Allied Textile Printing (ATP) site near the Great Falls, a move that local officials hope will eventually lead to the cleanup of all contamination at the location.

A report by the United States Environmental Protection Agency said that at least 12 of the 37 drums among the industrial ruins at the ATP site that were deemed “hazardous for corrosivity.” The drums contained sodium hydroxide, oxidizers and peroxide, the report said.

The seven-acre site about 700 feet downstream from the Falls contains the ruins of what once were dozens mills and other manufacturing buildings, a location that produced Colt revolvers in the 19th century and later was the birthplace of Paterson’s silk industry. The mills were closed more than 30 years ago and were ravaged by fires after that.

"One of my historian friends says that part of the ATP site is for America’s Industrial Revolution the rough equivalent of what the Roman Forum is to government,” said Leonard Zax, chairman of the Paterson Great Falls National Historical Park Advisory Commission.

The ATP area is within the boundaries of the national park at the Great Falls, but federal park officials do not plan on taking over the land until the pollution is cleaned up.

“This area is enormously important…

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File a Workers’ Comp Claim – Get Fired

Today’s post comes from guest author Thomas Domer, from The Domer Law Firm.

A new study from the Workers Compensation Research Institute (WCRI) indicates trust or mistrust in the work relationship plays a significant role in the outcome of a workers’ compensation claim.  In a recent benchmark study in Iowa by WCRI, almost four out of ten workers interviewed reported they were concerned they would be fired or laid off after they were injured. 

The Iowa study reflects similar results in Wisconsin and other benchmark states.  All workers who were interviewed received workers’ comp benefits and experienced more than a week of lost work time.  Additional findings noted two-thirds of the injured Iowa workers had other health conditions (having smoked for ten years or had diabetes or lung conditions).  Obviously those with significant pre-existing conditions had predictably worse results.

Injured Texas worker awarded $5.3 million

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In April of 2007 Charles Robison, a worker for Texas-based West Star Transportation, suffered a traumatic brain injury after falling headfirst off an unevenly loaded flatbed trailer. At the time of the accident, West Star had “opted-out” of the Texas workers’ compensation system and forfeited its protection against negligence law suits by its employees.

 Mr. Robison filed a lawsuit in January of 2009 against his employer, and a jury found that West Star’s negligence caused Mr. Robison’s injuries.  He was awarded $5.3 million dollars in damages.

The judgment included: “$3.7 million for Mr. Robison’s past and future medical care, $1 million for past and future physical pain and mental anguish and $400,000 for Ms. Robison’s past and future loss of consortium, as well as additional payments for Mr. Robison’s loss of earning capacity and physical impairment.”

On January 23, 2015 a three-judge panel in the Texas 7th Circuit Court of Appeals unanimously upheld the jury’s decision. Employers who want to be allowed to “opt-out” of workers’ compensation programs need to understand that one of the great benefits to the employer under workers’ compensation is the protection against civil law suits.

 

Original post by Sheena Harrison, writer for www.businessinsurance.com

http://bit.ly/1v4XYkK

 

 

Looking Forward, Looking Back

Today’s post was shared by US Labor Department and comes from blog.dol.gov

There are some days you’ll never forget, and for me, today is one of them. It’s my last day as assistant secretary of labor for disability employment policy, and, as expected, I’m experiencing mixed emotions. While excited about my next adventure, I’m sad to leave my talented and dedicated colleagues and friends at the department.

Kathy Martinez

Since assuming my position in 2009, I have had the privilege of spending my days surrounded by some of the most dedicated people I’ve ever met, and they have taught me so much. It’s not often that one gets to see the inner workings of policy development and how it translates into tangible outcomes with real, lasting impact on people’s lives. I am so proud to have been part of the team that helped implement Executive Order 13548 and the 2014 updates to Section 503 of the Rehabilitation Act — among many other policy efforts — that today are transforming the employment landscape for those of us with disabilities.

But there is another and more personal reason I’ve loved coming to work each day for the past five and a half years. And that’s because I have been able to do so fully. What do I mean by that? I mean that, as an employer, the department reflects the ideals inherent in the policies it puts forward, including those that help strengthen the American workforce through diversity. When I walked through the doors each morning, I knew that my diverse…

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Workers’ Compensation Medicare Set-Aside Accounts and Supplemental Coverage

When an injured worker is a Medicare beneficiary due to age or disability, a Workers’ Compensation Medicare Set-Aside (WCMSA) account will often be required as part of a settlement  of their workers’ compensation claim.  The funds in a WCMSA are set-aside in order to pay for future medical or prescription drug services related to the work related injury, illness, or disease that would normally be covered by Medicare. Once the funds in a WCMSA have been used appropriately, then Medicare can start paying for Medicare-covered services related to the work-related injury, illness, or disease. The WCMSA cannot be used to pay for any medical items or services that Medicare does not normally cover.

Workers’ compensation insurance provides 100% coverage of medical treatment for accepted medical conditions. Medicare, however, requires an 80/20 sharing of medical costs. Without a Medicare supplemental (also called “Medigap”) insurance policy, the injured worker would be required to pay significant co-pays and deductibles.  Supplemental insurance is not required by Medicare, but may be advisable to cover the cost sharing required by Medicare, especially if the beneficiary has other medical conditions that are not related to the work injury, illness or disease. However, the premiums for such supplemental coverage cannot be paid out of the WCMSA funds.

While Medicare does not provide coverage for prescription medications, WCMSA funds can be used to pay for medications related to the work injury, illness or disease. If there is a likelihood that the injured worker will exhaust the funds in their MSA, then purchasing a Medicare Part D prescription drug plan may be advisable to prevent the injured worker from having to pay full price for their medications once the MSA funds are exhausted. However, the financial benefit of having this coverage should be weighed against the cost of plan (2013 national average was $30.00 per month) since the MSA funds cannot be used to pay for the plan itself.

 

For more detailed information about workers’ compensation MSAs and supplemental coverage, visit www.Medicare.gov.