JEFFERSON CITY, MO - Legal Newsline reports that, at a hearing on Monday, the Attorney General's office defended the firing of three administrative law judges who decide workers' compensation cases, based on budget cuts, while the attorney for the three judges argued that the judges can only be removed by recommendation of a performance evaluation panel.
PORTLAND, OR - The Daily Journal of Commerce reports that Guinn & Munns, a workers' comp law firm specializing in representing injured workers, has shifted its focus from the construction industry, which has been hit hardest to the recession, to the health care industry, which is one of fastest growing sectors in the state. Injured health care workers make up 12 to 15 percent of the firm's business now.
BATON ROUGE, LA - 2TheAdvocate reports that Governor Bobby Jindal has veteod House Bill 658, which would have allowed injured workers up to three years to claim a workplace injury.
CHEYENNE, WY - The Casper-Star Tribune reports that Wyoming's workers' comp benefits were raised for the first time in 20 years, effective July 1, 2009. Other significant changes include benefits paid to the survivors of workers killed on the job and a cost-of-living adjustment for personal disability benefits.
NEW YORK, NY - The New York Times reports that a federal bankruptcy judge has approved General Motor's restructuring plan, which includes the sale of its best assets to a new, government-backed company.
ALBANY, NY - In a guest editorial published in the Rochester Democrat & Chronicle, Neil Gilberg, the advocate for business, New York State Workers' Compensation Board, Albany, says there's a misperception about New York's workers' comp premium costs, when, in fact, New York ranks 19th among 50 states. According to Gilberg, "[t]he state is working to slash those costs and ensure workers have the protections they deserve, while cracking down on businesses that flout the law and cut into the profits of legitimate employers." He mentions the Board's enforcement program where 2,700 businesses were recently given stop-work orders because of their failure to carry workers' compensation insurance, as well as the Board's fight against businesses that misclassify employees as independent contractors.
SEATTLE, WA - CNN reports that an American Airlines flight attendant has filed a product liability lawsuit against Boeing and McDonnell Douglas for the faulty design of the MD-82 airplane in which she was working and which she says lacked filters and sensors to protect her from the toxic fumes that made her ill. The airline attendant also filed a claim for workers' compensation.
HOUSTON, TX - The Houston Chronicle reports that KBR might ask the federal government to reimburse it for legal bills if a jury finds in favor of KBR's civilian contractors who were injured during a deadly roadside attack in Iraq five years ago.
MONTGOMERY, AL - LegalNewsline reports that Alabama Attorney General Troy King is appealing a part of General Motors' bankruptcy plan that he says will harm 43 former GM employees on workers' compensation.
ALBANY, NY - Business Insurance reports that Governor David Paterson has named Kermitt Brooks the acting superintendent of the New York State Insurance Department, effective July 3, 2009, when superintendent Eric Dinallo resigns to take a position as visiting professor at New York University's Stern School of Business.
According to the Insurance Department, Kermitt Brooks was named First Deputy Superintendent of the Insurance Department in May 2007. As First Deputy, Mr. Brooks was the second in command of the Department, overseeing the functions handled by the Deputy Superintendents of the Department as well as the operations of the agency. In addition, he directly supervised the Life Insurance Bureau.
Mr. Brooks served for almost eight years in the office of New York State Attorney General Eliot Spitzer, joining as Chief of the Claims Bureau in 1999. From 2002 until the beginning of 2007, Mr. Brooks served as Deputy Attorney General for Operations, with responsibility for the day to day operations of the 2,000-employee agency, which has a $220 million budget and 33 offices across the state. In addition to administering the Attorney General’s office, Mr. Brooks also led the investigation into employee benefit insurance, which resulted in settlements with the nation’s largest group disability and insurance carriers and forced a major group insurance broker to refund to clients undisclosed payment made to brokers.
Before joining the Attorney General’s office, Mr. Brooks served as Counsel in the law department at Metropolitan Life Insurance Company in 1998, and as an Associate in the commercial litigation group at Nixon, Peabody LLP from 1989 to 1998.
Mr. Brooks earned a Bachelor of Arts degree with a major in international relations from the
University in 1986. He earned his law degree in 1989 from the University of Michigan School of Law where he was a contributing editor to the Michigan Law Review.
BATON ROUGE, LA - Commissioner of Insurance Jim Donelon announced a successful legislative session for insurance bills in the 2009 Regular Session of the Louisiana Legislature. The Department of Insurance (DOI) saw 20 out of 21 proposed insurance bills successfully pass in this session, which will bring about needed changes in the insurance industry. “I am delighted to know that nearly all of the insurance bills we requested were approved by both the House and Senate. With support from many legislators we have been able to make positive revisions to the insurance code, creating a benefit to consumers across the state,” said Commissioner Donelon.
The Single Named Storm Deductible bill, HB 333, is one such example. “We realized the need for this bill after we experienced two major hurricanes impacting nearly the same areas last year with Hurricanes Gustav and Ike,” said Donelon. This bill requires the application of a single named storm deductible when a policy includes a separate named storm, hurricane or wind & hail deductible. If multiple named storm events occur in a calendar year, the full amount of the named storm/hurricane/wind & hail deductible will be applied, only once, to the aggregate loss across all named storm events causing damage under the policy. “Now property owners will not be threatened with paying more than one hurricane deductible per season, which will give not only a financial savings, but also peace of mind,” Commissioner Donelon added.
The Citizens Rate Making Authority bill, SB 130, should cause Citizens’ property and casualty insurance rates to stabilize in the coastal areas,” said Donelon. This legislation reforms the rate setting methodology for Citizens policies. Currently, rates are set based on the rates of the top 10 insurance writers in an area or parish. Companies writing very few policies often have the highest rates, unfairly affecting the rate making process. SB 130 rules out this negative rate impact by allowing for the inclusion of carriers to the rate making process with a market share of at least two percent. Language is also included to provide that the rates be above any company that wrote 25 additional policies in a program or parish during the previous year.
Two bills passed bringing
Louisiana into compliance with the National Association of Insurance Commissioners (NAIC) standards, which is a positive step for our state,” said Donelon. SB 318 provides changes to the Louisiana Life and Health Insurance Guaranty Association law based on a recently updated NAIC model act. The bill increases the coverage limits for annuities to $250,000 and the coverage limits for health to $500,000. SB 156 updates producer licensing and continuing education requirements. Several of the changes in the licensing process include the allowance of pre-licensing education online or self study, an increase of continuing education hours to 24 hours for all major lines of authority, abolishment of the Insurance Education Advisory Council, and allowance for the Commissioner of Insurance to require fingerprints for all new licensure applicants.
The other bills in the DOI legislative package that passed include the following:
Property and Casualty
Louisiana Dept. of Insurance
OKLAHOMA CITY, OK - House Speaker Chris Benge announced the approval of 120 interim studies that will be conducted over the summer and fall prior to the next legislative session. The studies cover a wide variety of issues, including a workers' compensation 24 hour pilot insurance program, government modernization, health care, public safety, education and economic development.
Read the list of interim studies
Read the proposal for the workers' comp 24 hour pilot insurance program
SALEM, OR - Thje Oregon Workers' Compensation Division has issued a bulletin to update worker leasing companies' reporting requirements. The bulletin provides information on coverage responsibility, worker leasing notices, endorsements, termination notices, notice of compliance posting requirements, and forms revised June 2009.
Read the bulletin here
AUSTIN, TX - The Dallas Morning News reports that the Texas Senate has passed a bill to extend the life of several key agencies, including the Texas Dept. of Insurance, through Sept. 1, 2011.
ALBANY, NY - Governor David A. Paterson has appointed Robert E. Beloten as the Chairman of the New York State Workers' Compensation Board, effective July 15, 2009. Since Beloten currently serves on the Board as a commissioner, he does not need Senate confirmation. His current term expires 2015.
Mr. Beloten has been a presiding law judge at the New York State Workers' Compensation Board from 1988-1996 and 2000-2009. From 1996-2000, he was a Senior Law Associate at the law firm of Keating and Klein of Syosset,
New York a firm specializing in health care law.
In addition between 1996-2000, Mr. Beloten, also served as a part-time hearing officer in the New York Supreme Court in Mineola, New York conducting hearings on property assessments on residential properties in Nassau County and was an arbitrator and mediator for the Workers' Compensation Alternative Resolution Panel for the Construction Trade in Albany, New York.
From 1985-1988, was an assistant counsel For the New York State Racing and Wagering Board. He instituted Administrative proceedings to ascertain violations of statues, rules and regulations governing racing and pari-mutuel wagering which include the administering of controlled and/or prohibited substances to horses, as well as the failure of employers to provide their employees with required workers' compensation insurance.
Mr. Beloten clerked for New York Civil Court Judges Herbert A. Posner and Pearle Appelman from 1981-1984, in
Gardens. He has lectured extensively throughout New York on medical law and workers' compensation.
He earned his law degree from the Hofstra University School of Law, and a Bachelor of Arts degree from the
College Park with concentrations in History, Government and Politics and Zoology.
Source: New York State Workers' Compensation Board
DENVER, CO - The Colorado Division of Workers' Compensation has given notice of a public hearing on August 7, 2009, to afford all interested persons an opportunity to be heard prior to the adoption of proposed amendments to the Workers’ Compensation Rules of Procedure, 7 C.C.R. 1101-3.
The topics to be considered are:
Revisions to language and standard terminology, revisions to or clarification of administrative procedures and requirements necessary to implement the Division Medical Treatment Guidelines and Medical Fee Schedule.
Revisions to clarify or update the language of the Medical Fee Schedule; revisions to the medical billing codes systems; update of fees and relative values; revisions to medical requirements, procedures and payments as they relate to the Medical Fee Schedule.
Proposed rule revisions will be available at the Department’s website on or before July 1, 2009. Copies of the proposed rules, the proposed statement of basis and purpose, and a regulatory analysis will also be available no later than July 31, 2009, at the Division’s Customer Service Office, 633 17th Street, 4th Floor, Denver, Colorado, or on the website.
Colorado Div. of Workers' Compensation
SIOUX FALLS, SD - The Indoor Football League has completed its investigation regarding workers compensation compliance issues for two teams and has decided not to take away any wins from the two teams. Instead, the IFL penalized the two teams in the sum of $2,500 each.
Read the article here
COLUMBIA, SC - The South Carolina Legislative Audit Council, in response to an audit requested two years ago by Senate President Pro Tem Glenn McConnell to examine the increasing rates for workers' compensation insurance and coastal insurance, has released a report indicating that South Carolina consumers may be paying more insurance than necessary and that the Dept. of Insurance needs to do a better job of documenting reasons for approval of rate increases.
Read the report here
BATON ROUGE, LA - The Property Casualty Insurers Association of America (PCI) sent a letter to Gov. Bobby Jindal requesting a veto of legislation (HB 658) that increases the likelihood of fraudulent claims, an insurer's exposure to lawsuits, and the need for insurers to maintain higher reserves. These conditions could lead to higher workers compensation rates for businesses.
House Bill 658 changes the "prescriptive period," or time limits for filing a claim, for
Louisiana workers compensation claims. Under this legislation, the prescriptive period of workers compensation claims expands from two to three years.
“Our members in Louisiana have serious concerns about this legislation that could increase costs and expand their exposure in an economy that needs stabilization,” said Greg LaCost, assistant vice president and regional manager for PCI. “Essentially, a claim would not have to be filed under
Louisiana law until almost three years post occurrence and still say that it was related to some incident at work. The opportunity for fraud is exponentially increased with this substantial modification of the law. We’re urging Gov. Jindal to veto this bill because it will hurt both businesses and consumers.”
The increase in exposure would force insurance companies to set aside additional reserves and that could lead to less ability to write policies in the state or diminish the size of the policies that they can write. This may also affect availability with consumer businesses having fewer options to choose.
“While the bill may sound consumer friendly, it will have unintended consequences to the businesses and consumers of
Louisiana that far exceed any possible benefit that may be derived,” said LaCost. “House Bill 658 was allegedly drafted to cover injuries that could not be treated within two years. During the legislative process, the bill was altered to simply expand the prescriptive period of workers compensation claims. If the trial lawyers wanted to address a problem, then they should have done exactly that instead of asking for the 50 percent extension of a prescriptive period.”
PCI is composed of more than 1,000 member companies, representing the broadest cross-section of insurers of any national trade association. PCI members write over $176 billion in annual premium, 35.9 percent of the nation’s property casualty insurance. Member companies write 43.8 percent of the
automobile insurance market, 29.6 percent of the homeowners market, 32.8 percent of the commercial property and liability market, and 38.4 percent of the private workers compensation market.
OAKLAND, CA - The Division of Workers’ Compensation (DWC) has recently received inquiries regarding whether the Medicare payment rules apply when paying for medical costs under the
California official medical fee schedule (OMFS).
Labor Code section 4600 provides that reasonably required medical treatment to cure or relieve the effects of the injury, means treatment based upon the medical treatment utilization schedule (MTUS) guidelines adopted by the administrative director.
The MTUS, not Medicare coverage rules, apply to determine what treatment is reasonably required. If a question arises regarding whether a treatment is medically reasonable and necessary, the claims administrator should use the workers’ compensation utilization review procedures to determine the issue, as required by Labor Code section 4610 and title 8, California Code of Regulations section 9792.6 et seq.
Medical providers and payers should examine the various fee schedules in the OMFS to determine which Medicare fee-related payment rules have been adopted. For example, DWC has adopted the Medicare ambulance fee schedule fact sheet for CY 2009.
The official medical fee schedule and administrative director’s update orders can be found on the DWC Web site at http://www.dir.ca.gov/dwc/OMFS9904.htm.
Claims administrators are also reminded to pay all undisputed amounts in a timely manner as required by Labor Code section 4603.2.
Source: Calif. Div. of Workers' Compensation
SAN JOSE, CA - The California Court of Appeal, Sixth Appellate District, has granted writ of review in case dealing with whether Labor Code § 4659(c) entitles applicants to increased permanent disability or life pension payments beginning the first January 1 after the date of injury, no matter when the first payment is received, to protect the injured worker from inflation.
Read the original blog about XYZZX SJO2
Download the DIR's petition for writ of review
TALLAHASSEE, FL - The Florida Division of Workers' Compensation has published the assessment rates for the Workers' Compensation Administration Trust Fund (WCATF) and Special Disability Trust Fund (SDTF), in Informational Bulletin DFS-03-2009 and Assessment Rate Orders number 105011-09-WC and 105012-09-WC. The assessment rate for the WCATF will be 0.80% for calendar year 2010. For the 2009-2010 fiscal year, the SDTF assessment rate remains at 4.52%. These documents are available on the Department's web site at: http://www.myfloridacfo.com/wc/pdf/DFS-03-2009.pdf
Florida Division of Workers' Compensation
OAKLAND, CA - The Division of Workers' Compensation (DWC) has posted an order adjusting the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) section of the Official Medical Fee Schedule to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.
Effective July 1, 2009, the order is the Medicare quarterly update for the current year. The update includes all changes identified in change request number 6511.
The order adopting the adjustments can be found at http://www.dir.ca.gov/DWC/OMFS9904.htm.
Source: Calif. Division of Workers' Compensation
MEMPHIS, TN - Sedgwick Claims Management Services, Inc. (Sedgwick CMS) has established a new clinical consultation service for its workers’ compensation claims administration clients as an optional program enhancement. The telephonic nurse triage service makes qualified medical guidance readily available to workers who suffer occupational injuries, no matter when or where the incident occurs.
The Sedgwick CMS clinical consultation program benefits employers, employees and supervisors alike:
Clinical consultation begins as soon as a worker reports an injury to a supervisor. The supervisor and employee together call the
Center and speak directly with a registered nurse. The employee then continues the call privately with the nurse, who evaluates the injured worker’s medical condition, recommends immediate steps ranging from first aid to urgent care, and when indicated makes an appointment with a pre-qualified network medical provider in the worker’s vicinity. With the injured individual’s permission, the nurse also shares information from the consultation with the medical provider in order to expedite treatment at the time of the appointment.
The clinical consultation process minimizes the risk that care will be delayed or that serious conditions will go unrecognized. It also adds value by identifying alternatives to unnecessary emergency room trips and costly over-treatment of minor cases.
“We have already implemented clinical consultation for several of our major clients with very positive results,” said Sedgwick CMS Medical Director Teresa Bartlett, M.D. “It is making a difference for both employees and employers in the critical early stages of the medical response through prompt and appropriate care and referrals. We believe it also establishes a positive tone for interactions throughout the workers’ compensation process that reinforces a shared focus on healthy recovery.”
Center operates around the clock 365 days a year from offices in San Antonio, Texas and
Memphis, Tennessee .
Source: Sedgwick CMS
SAN ANTONIO, TX - In an address to about 4,000 occupational safety, health and environmental professionals at the opening of American Society of Safety Engineers’ three-day conference here at the convention center, U.S. Department of Labor (DOL) Secretary of Labor Hilda L. Solis said they are ready to get to work to protect workers and thanked the attendees for all that they do to ensure worker safety.
“Thank you all for the work that you do every day to protect workers as it is not easy,” Solis said. “Especially during these difficult economic times. I am also here to tell you that the President believes this government has responsibility to protect workers and protect them from unsafe workplaces.
“The Department of Labor is back in the enforcement business,” Solis continued. “We will be working with all stakeholders because as you know, workplace safety is everyone’s business.”
Solis also announced that the DOL’s Occupational Safety and Health Administration (OSHA) will launch a major construction safety initiative in
Texas to prevent workplace fatalities and injuries. The department noted that
Texas has the highest rate of on-the-job fatalities than any other state. In 2008 there were 67 fatalities, and in 2009 there have been 33. Solis also noted that in 2007 and 2008 more than 3,000 inspections were conducted by OSHA in the southeastern states.
As for naming DOL and OSHA department leaders, Solis noted that there are several people that have been nominated to serve at the DOL in a variety of positions, including the head of OSHA, yet they are still in the pipeline.
“We are ready to get to work as we have a lot to do to prevent workplace injuries and illnesses,” Solis said. “I want OSHA to get back to being active and robust. And I want to make it clear that we want to partner with business to keep workers safe – to partner with safety professionals, businesses and communities.”
To do this, Solis discussed the proposed department budget for the DOL for 2010 of $1.7 billion to go towards programs which include $50.6 million for OSHA, allowing for the hiring of at least 130 more inspectors and an increase by 10 percent the number of inspections.
“Despite these tough economic times, we hope to have this budget approved,” Solis said. “We look forward to working with businesses – large and small – as we have in successful programs in New York and
California . We will also be building on practices that work.
“We want to return respect to OSHA,” Solis said.
The 98-year-old ASSE is the oldest and largest safety society with more than 32,000 occupational safety, health and environmental professional members located worldwide. ASSE is committed to protecting people, property and the environment. The June 28- July 1 ASSE PDC features 225 educational sessions featuring cutting edge issues along with one of the largest occupational safety, health and environmental expositions in the U.S. The expo features 400 companies including 70 new exhibitors. Other key presentations will be made by former Yahoo! Chief Solutions Officer Tim Sanders who will discuss corporate social responsibility and green business practices. U.S. Acting Assistant Secretary for OSHA Jordan Barab will participate in a special Plenary Session today. The last day of the conference features an executive summit of corporate executives discussing what they look for in a successful safety and health program and SH&E practitioners. Key issue roundtables, which provide individual attendees an opportunity to discuss issues and experiences, will also be held during the PDC.
Founded in 1911, the Des Plaines, IL-based ASSE’s members lead, manage, supervise, research and consult on safety, health, transportation and environmental issues in all industries, government, labor, health care and education. For more information please go to www.asse.org/newsroom.