Most people don’t remember her name, but we regularly hear reference to the injury event, even after 20+ years. This report from the New York Times shatters the myth of a “windfall” settlement. WATCH THE VIDEO – – WOW. – kc
In 1992, Stella Liebeck spilled scalding McDonald’s coffee in her lap and later sued the company, attracting a flood of negative attention. It turns out there was more to the story.
More than 20 years ago, 79-year-old Stella Liebeck ordered coffee at a McDonald’s drive-through in Albuquerque, N.M. She spilled the coffee, was burned, and one year later, sued McDonald’s. The jury awarded her $2.9 million. Her story became a media sensation and fodder for talk-show hosts, late-night comedians, sitcom writers and even political pundits. But cleverness may have come at the expense of context, as this Retro Report video illustrates. A consumer affairs reporter for The Times reflects on how the world has changed since the lawsuit.
Today’s post was shared by WC CompNewsNetwork and comes from www.workerscompensation.com
Today, July 1, 2015, CMS issued an alert which states that come October 2015, the Benefits Coordination and Recovery Contractor will be transitioning some of its recovery caseload to a new contractor which will be known as the Commercial Repayment Center (CRC). The CRC will be handling conditional payment recovery where CMS is pursuing recovery directly from a liability insurer (including a self-insured entity), no-fault insurer or workers’ compensation (WC) entity as the identified debtor. The BCRC will continue to handle conditional payment recovery where CMS is pursuing recovery from the Medicare beneficiary.
CMS notes that webinars and town halls will be scheduled in the comings months to provide additional information on this new process.
The alert also provides that come January 1, 2016, CMS will be utilizing ORM information to determine whether Medicare is able to make payment for those claims. CMS further notes that insurers and workers’ compensation entities that notify Medicare that they have ORM are strongly encouraged to report accurate ICD-9 or ICD-10 codes and that Medicare’s claims processing contractors will use this information to pay accordingly.
Today’s post was shared by Workers Compensation and comes from www.propertycasualty360.com
Hydrocodone acetaminophen—marketed as Vicodin—is one of the most over-prescribed and over-used opioid pain relievers. (Photo: Shutterstock/David Smart)
Chronic pain is by far the most debilitating—and for claims payers the most costlycompensable condition in workers’ compensation, according to a new special report from WorkCompCentral.
The report chronicles the way opioid use greatly expanded in workers’ comp over the last 20 years, then halted and is now in retreat as a result of increased criticism and research into its efficacy. The report also provides practical suggestions to rethink the approach to chronic pain—that is, pain that persists beyond expected healing time.
Opioids are defined as medications that relieve pain by reducing the intensity of pain signals reaching the brain, for example, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), morphine and fentanyl. Although some use the term “narcotics” to refer to these drugs, it’s a less precise term.
Startling statistics
Generally, most medical care for injured workers poses “trivial” or no iatrogenic risk (risk that medical treatment will inadvertently cause illness or death). This is not the case when opioids are used for ongoing treatment, however. According to the report, workers on a medium-to-high dose of opioids for a year experience about 1.75 deaths per 1,000 patients per year. By comparison, the riskiest jobs in the U.S., such as logging…
Ports of Tacoma, Seattle honored for air, water and habitat improvements.
The sustainability commitments of the ports of Seattle and Tacoma have once again earned Inbound Logistics Green Supply Chain Partner honors.
Two of seven U.S. ports selected, Tacoma and Seattle were recognized for their efforts to reduce seaport-related emissions through the Northwest Ports Clean Air Strategy, restore habitat and find innovative solutions to manage stormwater runoff.
The trade magazine honored 75 organizations from various trade sectors, including ports, truckers, railroads, shipping lines, freight forwarders and air cargo carriers.
“The 75 Green Supply Chain Partners is a very select group, and we found the ports of Seattle and Tacoma to be among those companies that are truly ‘walking the walk’ when it comes to supply chain sustainability,” said Felecia Stratton, editor of Inbound Logistics. “The G75 list represents 75 visionaries who have demonstrated a long-standing history of driving efficiencies in their customers’ operations and an internal commitment to be as lean and green as possible. Inbound Logistics is proud to honor the port of Tacoma and Seattle among this important group of industry-changing leaders.”
The complete list of honored partners is featured in the magazine’s June issue.
Fifteen workers will receive more than $100,000 in back pay from a firm testing and treating utility poles in Grant and Franklin counties.
The payment is part of a settlement with the Washington State Department of Labor & Industries (L&I) and Intec Services Inc. The Fort Collins, Colo., company paid workers below the prevailing wage as part of public works contracts, according to agency notices of violation that Intec appealed.
Under the settlement reached in late May, Intec will be allowed to move ahead with a Seattle City Light contract. The firm will test and treat some 65,900 wood utility poles, and treat an additional 15,900 wood poles under a six-year, $6.27 million contract.
“We want to make sure that workers receive the pay they’re entitled to for the work they do on public projects,” said L&I’s Jim Christensen, Prevailing Wage Program manager. “The settlement provides these workers with the wages owed to them under the law and allows the company to proceed with work on a large contract with a better understanding of prevailing wage.”
The state’s prevailing wage act protects workers on taxpayer-funded projects by assuring they’re paid at specific rates for specific types of work.
L&I works to ensure all employers comply with the prevailing wage law and have a level playing field in obtaining public contracts, Christensen said. Under the settlement, Intec does not admit to any wrongdoing on how it classified and paid its employees.
In October and November 2014, L&I issued Intec separate notices of violation for utility pole work the company did for the public utility districts in Franklin and Grant counties. For the Franklin County PUD, Intec will pay nine workers $15,990.80 in wages owed for work done under a 2011 contract. For the Grant County PUD, Intec will pay $92,017.25 to six workers for work in 2011 and ’12.
Intec paid workers as “laborers,” a lower pay level than the correct “power line construction electrician” and “groundperson” wages. The settlement includes an agreement that clarifies how Intec will structure its crews in compliance with state prevailing wage law for its contract with Seattle City Light.
The agreement calls for Intec to use a crew of up to four workers with its Seattle City Light contract. The crew would include a working supervisor, paid wages of a journeyman power line construction electrician. Assistants will be paid groundperson wages under the same job heading.
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.
Jail time for Spokane-area man who used Seahawks’ names to get drugs
A Spokane Valley man has been sentenced to six months in jail for faking on-the-job injuries and using Seahawks players’ names to get narcotics and other prescription drugs.
Spokane County Superior Court Judge Harold Clarke also ordered Jeffory Leonard Mock to repay the eight Spokane-area hospitals and clinics that he scammed to get drugs. Restitution to the facilities, and to the Department of Labor & Industries, is estimated at nearly $17,500. The 34-year-old pleaded guilty in April to four felony counts of obtaining a controlled substance by fraud.
The Washington Attorney General prosecuted the case based on a Washington State Department of Labor & Industries (L&I) investigation.
Fake workplace injuries to back, buttocks
Mock visited the medical facilities at least 17 times from March 2013 to May 2014, where he obtained Valium, hydrocodone and other prescription drugs, charging papers said. Each time, he falsely claimed he was working when he injured his back, buttocks or another part of his body.
As part of the scheme, Mock wrote sham names on L&I workers’ compensation forms that he completed at the hospitals and clinics. He used variations on his first name or another first name that usually started with “J.” For the last name, he typically signed the surname of a Seattle Seahawk or another pro ball player or coach.
Mock names included Sherman, Okung, Bledsoe and Largent
Among the last names of football players and coaches he used were: Harvin, Largent, Sherman, Mora, Richardson, Hollenbeck, Robinson, Okung, Marino, Bledsoe and Henderson.
Mock would claim he was injured while working for a moving, roofing or interior design company or retirement home. However, L&I investigators found that four of the employers he listed on forms didn’t exist.
L&I began investigating the case when a real business listed on a form said the reports might have been filed by a former employee: Mock. A handwriting expert examined the bulk of the injury accident reports, and confirmed that each one matched samples of Mock’s writing.
For most workers injured before July 1, 2014, time-loss and pension benefit payments will increase by 4.168 percent based on the change in the state’s average wage, as announced by the Department of Employment Security on June 24.
State law requires that benefits be recalculated each year to reflect the change in the state’s average wage from the previous calendar year.
The increase also applies to pension benefits paid to family members of those who died because of a work-related accident or disease.
As a result of the increase, the new maximum monthly benefit will be $5,482.90, or 120 percent of the state’s average monthly wage. Less than 4 percent of L&I claimants receiving wage-replacement benefits collect the maximum.
This article, published by Mother Jones, sheds light on the real stories behind the SCOTUS appeal decided on June 25th allowing subsidies under the Affordable Care Act to continue. – KC
When I saw the white stretch limousine parked out front, I knew I’d found the right place. I walked down the gravel driveway toward the white single-level house with trepidation; the owner’s Facebook page had suggested the possibility of pit bulls. But I was greeted at the door by David King, a garrulous 64-year-old self-employed limo driver who has lent his name to what may be the weightiest case to come before the Supreme Court in years. I’d come unannounced to King’s modest home in Fredericksburg, Virginia, to learn why he’d agreed to headline a legal assault that, if successful, could hobble the Affordable Care Act and result in millions of Americans losing their health insurance.
Asked what he might get out of King v. Burwell, the burly, mustachioed Vietnam vet replied that the only benefit he anticipated was the satisfaction of smashing the signature achievement of the president he loathes. Obamacare, King explains, bilks hardworking taxpayers to support welfare recipients. Those people who might end up without insurance? He didn’t care, because “they’re probably not paying for it anyway.”
Of course, you can’t challenge a law simply because you hate it. Legally, King’s case rests on his claim that he has been personally harmed by the law, specifically its subsidies to help people buy health insurance. He alleges that the subsidies are illegal in states without insurance exchanges and put him in a position where he must get health insurance or pay a penalty.
If five Supreme Court justices buy this argument, the stakes are huge: More than 13 million people could lose their subsidies and about 8 million could lose their health insurancealtogether. Public health experts estimate that nearly 10,000 of them could die every year as a result. Premiums for some plans could skyrocket by as much as 256 percent. The insurance markets in more than 30 states could implode.
The case is the work of the Competitive Enterprise Institute, a libertarian think tank funded by pharmaceutical firms, the Koch brothers, and Google, among others. While the legal logic behind the suit is obtuse (much of it hinges on what one appeals judge called “a tortured, nonsensical” interpretation of two sentences in the law), its goal is simple: As the center’s then-chairman declared in 2010, Obamacare “has to be killed as a matter of political hygiene.”
But first CEI had to recruit real people who could claim they had been harmed by the Affordable Care Act. That led them to King and his three fellow plaintiffs, one man and two women. The four had been largely absent from coverage of the lawsuit, but after the Supreme Court agreed to hear the case this spring, I set out to find out just how Obamacare would hurt them.
King’s situation was typical of what I found. He wouldn’t say whether he currently had health coverage, but he was adamant that he would never take advantage of Obamacare, no matter what. Last year, according to court filings, his income was $39,000. With an Obamacare subsidy, he could have purchased a health plan for as little as $275 a month (or less, if he weren’t a smoker). Without the subsidy, the same plan would cost $648 a month. Most importantly, for purposes of the case, King wasn’t actually required to buy coverage at all: Under the law, he qualifies for a financial hardship exemption because the cost of subsidized insurance is more than 8 percent of his income.
Plaintiff No. 2 was Brenda Levy, a 64-year-old substitute teacher who lives outside of Richmond, Virginia. With her wild, frizzy hair and earthy clothes, Levy looks like an aging hippie. When I met her at her log-cabin-style house, she mentioned that she’d once belonged to the Sierra Club and used to read Mother Jones. Levy insisted she leads “a quiet life,” but she is politically active. She’s donated to conservative causes and has been involved in opposing gay rights. In 2013, she helped organize a rally to protest the Boy Scouts’ plan to admit gay kids.
Surprisingly, she didn’t recall exactly how she had been selected as a plaintiff in the case. “I’m gonna have to ask them how they found me,” she said. When I talked to her in January, more than a year after the case was filed, she’d still never met the lawyers handling it. Asked if she realized that her lawsuit could potentially wipe out health coverage for millions, she looked befuddled. “I don’t want things to be more difficult for people,” she said. “I don’t like the idea of throwing people off their health insurance.” She was under the impression that expanding Medicaid might help anyone who lost their insurance—unaware that Medicaid expansion was actually part of Obamacare, or that the same groups backing her lawsuit have opposed this expansion in her state.
Levy claimed Obamacare gives the government control over Americans’ medical treatment and had caused insurance premiums to rise. She told me her monthly premiums, purchased outside the exchange, were more than $1,500, which she attributed to health woes, including two hip replacements and two craniotomies. “I’ve had some holes drilled in my head,” she quipped. Levy hadn’t checked out the plans she qualifies for under Obamacare, but an affidavit filed by the government in King v. Burwell indicates that she could have purchased a low-cost plan on the federal exchange for $149 a month.
Tracking down the third plaintiff wasn’t so easy. The home address 56-year-old Rose Luck had provided in legal filings turned out to be an extended-stay motel on a commercial strip in Petersburg, Virginia. When I finally reached her by phone, Luck hung up on me. Contacted via Facebook, she responded, “Please leave me alone.” But social media and public records provide a snapshot of her life. On her Facebook page, she has called Obama the “anti-Christ” and voiced her belief that he came to power because “he got his Muslim people to vote for him.” She has warned that Obamacare will cost people $77,000 a year.
Since the late 1990s, Luck and her husband have faced legal judgments for nearly $5,000 in unpaid medical bills, something that typically happens to people with inadequate or no insurance. (The judgments have since been paid off.) Luck’s Facebook page also made clear that she had experienced serious health problems, raising questions about her insistence that she would prefer to go uninsured or buy high-deductible catastrophic coverage. According to government filings, the cheapest plan available to her on the exchange would cost $333 per month. And like King, she is eligible for a hardship waiver.
The final plaintiff was Doug Hurst, another Virginian in his early 60s. According to bankruptcy filings, Hurst and his wife had more than $8,500 in out-of-pocket medical expenses in 2009. His insurance premiums in 2010 were $655 a month. Under Obamacare, Hurst could have purchased a bronze health plan for $62 a month. I never spoke with him, but I reached his wife, Pam, on the phone. She declined to talk about the case or her family’s experiences with the health care system. (In 2009, her 37-year-old daughter died following a long struggle with schizoaffective disorder.) She told me angrily, “I’m very well aware of my situation. You are not. You are not aware of extenuating circumstances. I don’t have to justify my life, the loss of my child, which included the loss of a business, to anyone, do you understand?”
The weakness of the King plaintiffs’ individual claims of injury—particularly given the fact that Obamacare would likely help, not hurt, them—suggests that it wasn’t easy to find people to join CEI’s lawsuit. When I mentioned this to Michael Carvin, the plaintiffs’ lead lawyer, he bristled. “Linda Brown was the only plaintiff in Brown v. Board of Education,” he retorted, invoking the Supreme Court case that led to school desegregation. “Does that suggest there weren’t a lot of people who supported her point of view?” (In fact, Linda Brown’s father was one of 13 original plaintiffs in that case, which was filed as a class action.)
During the oral arguments before the Supreme Court in March, Justice Ruth Bader Ginsburg quizzed Carvin about whether his clients actually had the legal standing to bring the case. “At least one plaintiff has to have a concrete stake in these questions,” she said. “They can’t put them as ideological questions.” Carvin responded that the lower courts had accepted his clients’ qualifications. Ginsburg wasn’t deterred from probing further. “The court has an obligation to look into it on its own,” she said.
Today’s post was shared by Workers Compensation and comes from www.businessinsurance.com
(Reuters) — A federal judge has approved $53.8 million in settlements for 82 unionized cleanup workers who claimed they were made ill by exposure to toxic dust near the World Trade Center site, court papers showed.
The workers were among roughly 1,000 to seek compensation in federal court in Manhattan for alleged injuries stemming from their cleanup work at more than 100 privately owned buildings in downtown Manhattan.
While a few hundred other workers have also settled, the settlements approved on Tuesday night by U.S. District Judge Alvin Hellerstein in Manhattan offers a new window into the payouts, which typically have not been made public.
Payouts to the 82 workers will average $656,119, and range from $25,000 to $1.45 million. They reflect such factors as injury severity, lost earnings, age and smoking history. One worker still has claims against two related defendants.
Most litigation stemming from the Sept. 11, 2001, attacks has been completed. Judge Hellerstein has handled much of that litigation.
According to court papers, the latest settlement covers members of Laborers International Union of North America Local 78, which represents asbestos, lead and hazardous waste handlers in New York City, Long Island and New Jersey.
They claimed to suffer respiratory and digestive diseases, psychological injuries and cancer after the defendant building owners and contractors failed to provide equipment to keep them from inhaling toxic dust in about 71 buildings near Ground…
