When is healthcare like a box of chocolates? Find out over at Colorado Long Term Care Insider, where Louise & Jay Norris host an excellent Valentine’s Week Edition of Health Wonk Review.
Other news of note:
Tasers & cop claims – Roberto Ceniceros of Comp Time has an interesting post on how taser use by police is reducing injury rates and comp claims because it provides a low-impact way to subdue suspects. But tasers are also used on cops-in-training, sometimes resulting in serious injuries.
The straight dope – Joe Paduda has a do-not-miss post on narcotic opioids in workers comp and Cephalon’s role, in which he discusses how drugs like Fentora & Actiq, which are FDA approved only for cancer patients, are being promoted to workers comp patients. (One court ruling stated, “data suggested that more than 80% of patients using Actiq did not have cancer,” and “oncologists accounted for only 1% of Actiq prescriptions filled at retail pharmacies in the U.S.”) Cost is a huge issue, but Joe points out that it is not all about the money: Actiq has been linked to dozens of deaths from overdose.
Medical marijuana – Last week, Michigan court rulings dealt a double blow to medical marijuana. One of the Michigan rulings upheld the firing of a Walmart employee who had been proscribed the drug to control symptoms of his brain cancer, a case we posted about last year: Walmart: Shopping for Souls in Aisle Three. (Also see our recent post: Medical Marijuana in the Workplace: Dude, Lock Me Out!.)
Insurer market share – Cyril Tuohy of Risk & Insurance offers a short journey through the latest insurance industry statistics, including some great stats about market share: This Just in: Known and Lesser Known Facts About the Industry
Not something you see every day – CompNewsNetwork informs us that the Ohio Bureau of Workers’ Compensation has recently snagged a record $830,000 in restitution from a prior fraud conviction. The case was truly egregious – an anesthesiologist who bilked the system for $60 million in fraudulent claims – while contributing to at least two deaths in the process. Dr. Jorge Martinez was sentenced to life in prison for “the first known conviction involving a criminal charge of health care fraud resulting in death after the overdose of two patients seeking treatment for work related injuries.”
Illegal immigrant update – Peter Rousmaniere’s Working Immigrants blog is your in-the-know source for tracking the latest issues and stats on the topic. Via the Pew Hispanic Center, he informs us that the 2010 illegal population in 2010 remains about the same as in 2009: about 11.2 million, of which 8 million are in the workforce, and 58% of which are Mexicans. See more detail: Estimate of illegal immigrant population in 2010.
Good WC bookmark – We are adding WorkCompWire as a bookmark in our sidebar and you should keep it handy too. It’s a good source of news and opinion – check it out!
Savings on complex care – Yvonne Guilbert points out that overlooking simple facts can add significant costs to a claim very quickly. She asks carriers what they are missing on complex claims that might be costing them money.
Market pulse – At PropertyCasualty360, Caroline McDonald talks about why buyers shouldn’t get too comfortable with low workers comp rates. One of the primary sources for the article is our friend Mark Walls of Safety National – who is also well know as the founder of LinkedIn’s Work Comp Analysis Group.
Diversity – Jared wade posts that 18 insurance firms are among the best companies for LGBT employees to work for – “scoring a perfect 100% as a Best Place to Work for their ‘support equality for lesbian, gay, bisexual and transgender employees,’ according to HRC.”
Distracted driving in NY – A sign of things to come? In New York, drivers will get two points for talking on hand-held cell phones. A two-point penalty has already been in place for texting while driving. At that rate, auto insurance sure could get expensive quickly for compulsive phone-o-philes.
Mental health – CCOHS, the Canadian counterpart of OSHA, makes the case for why employers should care about mental health at work.
Posts Tagged ‘Michigan’
Health Wonk Review, Valentine’s week edition, and other news of note
Thursday, February 17th, 2011Two farmworking teens killed in silo; media is mystified
Tuesday, July 13th, 2010From Michigan, we learn the tragic news of the silo-related deaths of two teens on a farm. Victor Perez, 18, was a recent high school graduate who had worked on the farm for about 4 years. His co-worker Francisco Mendez Martinez, 17, had been on the job for about a month.
News reports are thin and shrouded in mystery. One refers to the fatalities as a “mishap” (talk about understatement) and quotes a local farmworker as saying that the teens “weren’t doing something particularly dangerous and they knew how to do it.” (Apparently wrong on both counts). Other stories portray this as “just a tragic accident” with authorities quoted as saying they might never be sure what happened because there were no witnesses.
We should really expect better reporting from media whose beat includes farm country. And if the news reports are correct, there is at least one other local farm worker who needs to be alerted to silo dangers and the quoted sheriff needs to take an EMT refresher course.
A cursory Google search on silo deaths will show that there’s nothing particularly mysterious about this “mishap” – unsupervised teen workers + confined space + silos + molasses storage – all should trigger red lights. The danger posed to teens of confined spaces in agriculture should be well known. Instead of breathless reporting about mysterious tragedies (see also “freak accidents“), media could do a huge service to local communities if they did a little research and used such horrific events as a springboard to educate people about a) safety for a high-risk group, teen workers and b) farm worker accident prevention.
The hazards associated with silos are well-recognized. One cited in this link might have been a description of the recent that killed the teens:
The typical scenario involves a worker entering an oxygen-deficient or toxic atmosphere and collapsing. Co-workers notice the collapsed worker and enter the same atmosphere and attempt a rescue; however, if they do not use proper precautions (respirators, ventilator fans, etc.), they also collapse.
Additional resources
Confined Space Hazards a Threat to Farmers
Dangerous Gases and Fires Can Make Silos Death Traps
Silo Gas Dangers
Silo Gas Dangers – from Farm Safety
Preventing Deaths of Farm Workers in Manure Pits
Confined Space Hazards
OSHA: Confined Space
Parental Alert: 2010’s Five Worst Teen Jobs
Cavalcade of Risk #94 and general workers comp news notes
Thursday, December 17th, 2009Cavalcade of Risk #94 is posted at My Wealth Builder. Among the many good posts, our friend Hank Stern offers some good news for the holiday season.
Our fellow blogger Joe Paduda was recently speaking at the Casualty Actuarial Society’s annual meeting on the topic of health reform and its impact on workers comp, and his remarks were covered by Insurance Journal. Paduda noted that, whether or not it gets enacted, health care reform is already having a major impact on workers’ comp. On the same topic, Roberto Ceniceros has a post about how healthcare reform is stalling some return-to-work advancements.
Jon Gelman on Genetics and Workers’ Compensation Claims. Also see our past posts on the topic: Brave new World and Genetic Testing And Workers Comp
Risk & Insurance has posted some interesting case law: In Michigan, a worker establishes asthma as compensable disability and in Colorado, a claim for a bad faith denial of benefits is considered to be separate and distinct from the underlying workers’ compensation entitlement claim and therefore is not precluded. However, an insurer can preclude certain issues in a subsequent proceeding.
We recently touted Mark Wall’s WC forum on LinkedIn as an excellent resource – but one feature that we neglected to mention is an active job board, where members can post a job or find a job. That’s a natural use for LinkedIn, particularly in today’s tough times – register for the Forum.
Winter safety tips from BLR Daily Advisor: Cold Weather Hazards: Are Your Workers at Risk? and Brrr-ing Down the Risk of Cold-Related Injuries
Finally, this item made us wonder if the North Pole’s workers’ comp coverage includes stress?
Racketeering and Comp: When the Denial of an Injury is an Injury
Wednesday, December 9th, 2009Imagine you work as a commercial driver for a long-established trucking firm that self-insures for workers comp. You are injured on the job. You seek benefits under the comp statute. The TPA handling the claim refers you to a company doctor. The doctor determines that the injury is not work related. The adjuster for the TPA denies the claim. End of story?
Not quite. What if you shared your story with five other employees, all of whom filed comp claims, all of whom saw the same doctor (a family practitioner), with the same result: claim denied by the same adjuster at the TPA? A coincidence or a conspiracy?
Five employees of Cassens Transport in Michigan concluded that there was a conspiracy to deny their claims. They filed suit in federal court, alleging a violation of the Racketeer Influenced and Corrupt Organizations Act (“RICO”). A district court dismissed their claims, finding that their individual claims did not constitute a “pattern” of activity and that invocation of the RICO statute would violate the McCarren-Ferguson Act by interfering with state regulation of insurance.
The U.S. Court of Appeals for the 6th Circuit reviewed the case and overturned the district court’s ruling. Now the U.S. Supreme Court, by declining to get involved, has upheld the Appeals Court. The Appeals ruling is a fascinating document which explores the nature and definition of racketeering, the relationship of workers comp benefits to insurance and the roles of state and federal governments. It’s required reading for attorneys and highly recommended for all others.
Criminal Acts?
The district court has been ordered to reconsider the allegations. The five Cassens drivers allege that Cassens, their self-insured employer, Tina Litwiller, a claims adjuster for the TPA Crawford and Co., and Dr. Saul Margules conspired to deny their comp claims. (While you might expect Dr. Margules to be board certified in occupational medicine, he appears to be a family practitioner.) The Appeals Court does not address the substance of the allegations: it simply rules that denial of the workers comp claims might involve a violation of the RICO statute and thus is appropriate fodder for the federal courts.
Some folks are alarmed that the feds are getting involved in what is usually a state issue. That might be a problem, but let’s not lose sight of the delicious prospect before us. During the course of the new hearings, plaintiff attorneys will seek access to some fascinating communication records: between Cassen and Crawford, detailing the status of individual claims; Ms. Litwiller’s claim notes; and communications between Crawford and Dr. Margules, who had so much difficulty finding a connection between a given injury and work. As much as I enjoyed the Appeals Court’s discussion, I am really looking forward to the nitty-gritty details of the proceedings in the district court. (You don’t suppose that some of the written and electronic communications have disappeared, do you?)
At heart, this is a very serious matter. The five employees allege that they have been unlawfully denied the protection of Michigan’s workers comp law through a conspiracy of company, TPA and doctor. If the allegations are proven, if the accused violated the RICO statute, they will face the consequences of a criminal conspiracy. In the Insider’s burgeoning annals of fraud – employee, employer, attorney, doctor, agent, insurer – this case will surely offer one of the more compelling narratives.
Collision course: the potential impact of Chrysler’s bankruptcy & sale on state workers’ comp systems
Tuesday, May 19th, 2009Roberto Ceniceros of Business Insurance has been tracking the potential impact that a Chrysler bankruptcy and sale could have on state workers comp systems. In a story last week, he reports that Michigan Attorney General Mike Cox has taken legal action to protect the state. Cox stated that Michigan’s Self-Insurers’ Security Fund could face insolvency as a result of Chrysler’s bankruptcy and sale.
Now, Ohio state officials are raising concerns about how the Chrysler sale could affect Ohio’s workers comp system. This week, Ohio’s Attorney General Richard Cordray has filed a “limited objection” to the pending sale. “While Chrysler’s bankruptcy filings show the automaker is committed to fulfilling its workers comp obligations, the filings do not hold a new owner to the same conditions, the attorney general said.” According to a news report in Columbus Business First, there are about 5,000 Chrysler workers in the state.
It is likely that this issue is on the radar screen for other stat attorneys general, too. Ceniceros states that, “As of Dec. 31, Chrysler had 38,257 U.S. employees. It purchases workers comp insurance in some states while self-insuring in others, according to various state regulator databases.”
And beyond Chrysler, there is the matter of whether General Motors is another likely candidate for bankruptcy – many expect this to be the case – see key dates in GM run-up to bankruptcy deadline. GM is a much larger company so problems could be multiplied, a matter that we discussed in our December posting about Maryland officials monitoring GM solvency related to workers comp.
For more on the way bankruptcy works for both insured and self-insured entities, see our postings of Robert Auerbach’s three-part series on bankruptcy and workers compensation, part 2, part 3.
