Category Archives: government

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“Independent” Medical Examinations in Workers’ Compensation (Anything but “Independent”)

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

“I thought their doctor Independent Medical Report was the last word on my case. I didn’t know any better.” 

This statement from a client I just met sums up the experience of many injured workers unfamiliar with the workers’ compensation process in Wisconsin (and many other states).

An insurance company or self-insured employer may request an injured worker submit to reasonable examinations by a physician, chiropractor, psychologist, dentist, podiatrist, physicians assistant, or Advanced Practice Nurse Practitioner of its choice. Wis. Stat. §102.17(1)(b). This examination is usually referred to as an Independent Medical Examination or “IME” although “adverse medical examination” more accurately reflects the process.  An Independent Medical Examination may be requested by the insurance company or self-insured employer in order to determine whether the claim is compensable and the extent of the disability or the necessity and type of treatment. 

Since only about one in ten injured workers in Wisconsin is represented by an attorney, nine out of ten unrepresented workers are not aware that the insurance company’s “IME” is actually an adverse exam by a doctor hired by and paid by the insurance company to issue his report. Although IME examiners would deny they routinely render an opinion in favor of the insurance carrier, my forty years of experience suggests just that. For many years lawyers representing injured workers have been proposing the terminology “Adverse Medical Examination” apply to give represented and unrepresented workers a more fair assessment of the process. Many IMEs make hundreds of thousands of dollars annually performing these examinations. At one of these examinations, my client overheard the IME physician (who had rented a motel room) speaking to a prospective young doctor trying to convince that doctor to perform IMEs. “This is a great practice.” He said.  “All you have to do is review the medical records, meet with the worker for a few minutes, and deny the claim. And for that you can charge $1,500.” Although my client’s testimony to this effect was barred, the underlying accuracy of his testimony is undisputable.

Beware the “Independent” Medical Examination.

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Examining Workers’ Compensation Costs to Employers

Source: Bureau of Labor Statistics National Compensation Survey 1991 – 2014 (Credit: Sisi Wei/ProPublica)

Today’s post comes from guest author Rod Rehm, from Rehm, Bennett & Moore.

Business and insurance interests are bombarding state legislatures every day of the week to take workers’ rights away by complaining how most states’ workers’ compensation systems are too expensive.

Recently, ProPublica and NPR produced a very detailed explanation of the state of workers’ compensation, focusing, rightly so, on injured workers. This article, which was the first in the series, included an interactive graphic that showed that even though business are complaining about rising premius, workers’ compensation insurance coverage is generally at its lowest rate in 25 years, “even as the costs of health care have increased dramatically,” according to the article.

As examples, using the average premium cost to the employer per $100 of workers’ wages, Nebraska employers paid $1.93 in 1988, while they actually paid $.15 less for the premium in 2014, for a total of $1.78 per $100 of workers’ wages, according to the chart. Iowa was more dramatic, with the price of workers’ compensation insurance $2.79 per $100 of workers’ wages in 1988. It went down $.91 to $1.88 per $100 of workers’ wages in 2014.

By scrolling down in the article, a person finds another graphic that shows how employer costs have risen for other categories, but have fallen for workers’ compensation. Most notably, the cost of workers’ compensation insurance coverage (per $100 of workers’ wages) went from $2.71 in 1991 to $2.00 in 2014. During the same timeframe, the cost of health insurance went from $8.55 to $12.52 and the cost of retirement benefits went from $5.50 to $7.29, all per $100 of workers’ wages, according to the chart in the article.

The offices of Rehm, Bennett & Moore and Trucker Lawyers are located in Lincoln and Omaha, Nebraska. Six attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 90 years of practice representing injured workers and truck drivers in Nebraska and Iowa in state-specific workers’ compensation systems. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers’ Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), and the Nebraska Association of Trial Attorneys (NATA).  We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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Small Increase Predicted for Social Security COLA

Today’s post comes from guest author Todd Bennett, from Rehm, Bennett & Moore.

Social Security benefits are slated to go up, but not by much. “The cost-of-living adjustment in Social Security for 2014 is likely to be very small, marking the fourth year in the last five that recipients receive little or no increase in benefits,” according to a recent CNNMoney article

The American Institute for Economic Research estimates the increase to be 1.4% to 1.6%.  Last year’s increase was 1.7%, and the 2012 increase of 3.6% was the only “significant rise in benefits in recent years,” according to the article.

If there are questions about your specific legal situation, please contact the firm.

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Government Shutdown Simulates “Small Government”

Every news program announces the ongoing shutdown of non-essential federal government services.  News articles delve into the possible consequences.  Republicans and Democrats fight over whether the other is willing to negotiate.  Members of the Republican Party bicker within their ranks about the shutdown.  Everyone should take note that what we are experiencing with the current shutdown provides us all with a practice-run for the level of government desired by the Tea Party members of the Republican Party.

Wikipedia notes that the current “small government” movement in the United States is largely a product of Ronald Reagan‘s presidency from 1980–88. The Tea Party movement is a modern reflection of this belief in small government. They claim that in the past the United States had a small government, and that it has turned away from that ideal. Some members of the Republican Party advocate small government, especially its libertarian wing, which includes politicians such as Ron Paul and his son Rand Paul. The Libertarian party, a third party, supports small government. A 2013 poll showed that the majority (54%) of Americans think the government is trying to do too much.

We now have an opportunity to define “essential” services.

Although 54% is only just a majority, Americans can now ponder the concept of small government and what the effect of shrinking the government would have on federal, state and local jurisdictions.  The “non-essential” services now halted would likely have to be replaced by those jurisdictions, where possible, were the federal government to be stripped down to the vision of the Tea Party and Libertarian Party members.  We now have an opportunity to define “essential” services.

Cities across the country will feel the pinch of the shutdown, particularly if it drags out beyond a few days. Furloughs of non-essential federal employees won’t just affect D.C. and its Maryland and Virginia suburbs. Cities around the country host full-time, non-Post Office federal employee populations. New York is home to 26,696 federal employees; Atlanta is home to 23,718; Philadelphia is home to 19,940; Chicago has 16,069; Houston has 15,530; and Los Angeles has 14,689. The list of the top 50 cities with the highest federal employment is here.1

Look around your city, your state.  What federal services are you willing to have disappear?  Is your state able to take over those services?  Are your local and state governments under pressure to also shrink?  The mantra that smaller government will cure what ails us rings through the air.  Before joining the chorus, each of us should think about and prepare for the ripple effects if those singing are to succeed.

1The Atlantic, What the Government Shutdown Will Look Like Where You Live, Mike Riggs, Sep 30, 2013

Photo credit: estherase / Foter / CC BY-NC-SA

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WA State Budget Passed and Signed

No Transit Funding = Unhappy Riders

Governor Inslee issued a letter noting that he had signed the budget into law, averting the shut-down of government offices and services that had been slated to occur as of July 1.  Although we are quite pleased that the shut-down was averted, just the threat of a shut-down caused a ridiculous number of man-hours to be spent preparing for the worst with ripple effects across our cases.  Frankly, some of those ripples were positive as the Claims Managers at the Department of Labor and Industries focused their attention on getting time loss compensation set up for claimants that were not already in the system to receive automatic payments.  We greatly appreciate the efforts put forth by many of the Claims Managers to address our requests for benefits before the deadline.  However, we did have negative impacts, as well, with cases in ligitation where depositions were rescheduled or notification received that, if there were a shut-down, no attorney from the Office of the Attorney General would appear on behalf of the Department.

Unfortunately, one issue that is of great importance to our clientele – transportation funding – did not get the attention it needed during the special legislative session.

Unfortunately, one issue that is of great importance to our clientele – transportation funding – did not get the attention it needed during the special legislative session.  Without a funding plan, King County’s METRO Transit will now be implementing plans for a 17% reduction in service.  This is at a time when ridership is at a peak, returning to levels not seen since the start of the recent recession, and when the need for inexpensive and effective transportation by unemployed, undereployed and disabled people is great.  It has been rumored that another special session may be called by Governor Inslee to address transportation funding.

Photo credit: TheeErin / Foter.com / CC BY-ND

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Reversing A Century Of Progress – Are We Back In Upton Sinclair’s Jungle?

Many workers no longer have paid sick days.

Today’s post comes from guest author Rod Rehm from Rehm, Bennett & Moore.

Health Care Is Just The Beginning

At a time when a flu epidemic is exploding out of control, killing thousands of people, forty-two million Americans have no sick leave. Many of these people are lower paid, often work part time, and continue to work when ill because they can’t stay home to recover without losing their income. I am shocked and dismayed that many hard-working folk are forced to work when sick because staying home is not economically possible. Making matters even worse, these highly vulnerable workers often have no employer-provided health insurance so even serious illnesses go untreated, putting us all at a higher risk for infection from a contagious worker, like a server in a restaurant, for whom taking an unpaid day off is impossible.

…the trend toward low pay, long hours and few benefits is getting stronger.

I fear that if the current trends continue, the lives of the millions of Americans who struggle at low-paying jobs will remain miserable, desperate and be lacking in real hope. It appears that the trend toward low pay, long hours and few benefits is getting stronger. At the turn of the 20th century when Upton Sinclair wrote “The Jungle,” describing immigrants struggling in Chicago, the jobs were more physical, dangerous and just plain disgusting. However, millions of “New Jungle” workers still struggle and suffer today.

Class Warfare

After over 100 years of progress, the American middle and lower classes are under constant attack. The efforts to limit rights of workers are ongoing and supported by big business. Every day I read of measures being introduced in state legislatures to limit access to and decrease the benefits of workers’ compensation. The right to collective bargaining is being attacked as well. Local elections are overrun by anonymous innocent-sounding Super PACs funded by 21st Century versions of robber-barons who are using their wealth and power to squeeze out a few more dollars in profits to add to the tens of billions of dollars already sitting in their bank accounts. These are not job creators, they are their own personal wealth creators. Income equality is at an all-time low in the United States, and the trends are getting worse.

How can this be happening in 21st century America? How can we call ourselves civilized? Can we really allow such maltreatment of workers and disregard public health in what we call an “advanced,” “modern,” and frequently, an “exceptional” county?

A Path Forward

We are not without hope, though. Crusaders like Senator Elizabeth Warren are working hard to reverse the trends and preserve the American Dream for future generations. But our protectors are few. We cannot assume that someone else is looking out for us. We must engage with government at the local, state and federal levels so that the voices of regular working folk are not drowned out by a cabal of rogue billionaires trying to keep score by increasing their own personal fortunes at the expense of working people. I fear that if we sit by passively, our children will all be working in the New Jungle, America will have lost its middle class, and with it, the American Dream will be a distant memory. The time to act is now.

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Let OSHA Do Its Job

OSHA is being prevented from fulfilling its mission.

Today’s post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

In 1970, Congress passed the Occupational Safety & Health Act (the Act), which created the Occupational Safety & Health Administration (OSHA). Among other things, the Act requires every employer to provide a safe workplace. To help employers reach this goal, OSHA promulgated hundreds of rules in the decade after it was created. OSHA’s rulemaking process has, however, slowed to a trickle since then.

While the National Institute for Occupational Safety & Health recently identified over 600 toxic chemicals to which workers are exposed, in the last 16 years OSHA has added only two toxic chemicals to its list of regulated chemicals. This is because Congress, Presidents and the courts have hamstrung OSHA. For example, in March 2001 the Bush Administration and a Republican Congress effectively abolished OSHA’s ergonomics rule, a rule the agency had worked on for many years.

These delays and inactions have caused more than 100,000 avoidable workplace injuries and illnesses.

These delays and inactions have caused more than 100,000 avoidable workplace injuries and illnesses. Workers are being injured and killed by known hazardous circumstances and OSHA can’t act.

Congress and the President need to break this logjam – we need to free OSHA to do its job of safeguarding workers.

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Unsafe Workplaces Equal More Injuries.

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

Washington State has a similar program for filing claims of discrimination when a worker is punished for reporting unsafe work conditions. Contact one of us to discuss your case if you have suffered such discrimination.

The connection between unsafe workplaces and the increased frequency of work injuries seems like a no brainer. A study released by NCCI Holdings indicated worker’s compensation claims rose by 3% during 2010 (the first rise in frequency in over a dozen years). The study attributed the increased frequency to several factors

Because of these repeat violations,OSHA cited United Contracting and placed the firm on its “Severe Violator Enforcement Program”

including increases in employment since the onset of the recession in 2008, workers possibly being less fearful of losing their jobs for filing claims, and a lack of light duty jobs to which injured workers could return because of the poor economy.

One factor not referenced is the connection between increasingly unsafe work environments and work injuries. Two recent news stories in Wisconsin underscored this connection. OSHA fined a Wisconsin contractor $150,000

for violations while working on two bridges along highways in Wisconsin. The violation is more alarming because the contractors were working under a State contract to repaint the bridges. OSHA charged that the company did not have proper scaffolding at the bridges exposing workers to falls, and in fact one worker was injured in June after falling from a scaffold at one of the bridges. Because of these repeat violations, Continue reading