Category Archives: Government

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What is Workers’ Compensation?

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

This is the first installment of a series that will educate workers and their families about injury, disease and death resulting from work. The most basic question is: What is workers’ compensation?

Workers’ compensation is a legal system established in all 50 states, Washington, D.C., and for federal employees. Workers’ compensation laws began in the United States in 1912. The laws are different in each state, but the basics of the law are quite similar in all states.

If a worker is injured, contracts a disease or dies as a result of work activities, all of the medical and burial expenses are to be paid by the employer. The employer is also responsible to pay for lost wages, physical disability, and mental disability. Workers’ compensation does not pay for pain and suffering and is generally limited in duration of payments, although some states pay lifetime benefits.

The balance of this series will go through the basic steps of how to obtain workers’ compensation benefit. The goal is to inform, which helps victims of workplace injury, disease or death receive proper compensation.

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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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Stop Work Orders In Massachusetts Created $1.4 Million In Fines And Obtained Coverage For Over 5,000 Workers

Today’s post comes from guest author Leonard Jernigan, from The Jernigan Law Firm.

The Massachusetts Workers’ Compensation Advisory Council has released its Fiscal Year 2014 Annual Report (PDF link). This report contains some eyebrow-raising statistics. Between 2008 and 2014, Massachusetts was able to help over 50,000 workers receive coverage due to Stop Work Orders (SWOs). In 2014 alone the Agency was able to obtain insurance for over 5,000 workers who previously had no workers’ compensation coverage.

Stop Work Orders are issued to employers who are operating without workers’ compensation insurance. An investigator is sent to the worksite and if an order is issued, the employer must cease business operations immediately. Fines will then be given starting at $100 per day until penalties are paid and the company secures insurance.

In Fiscal Year 2014, there were 5,785 Field Investigations resulting in 2,150 SWOs issued and $1,430,599 in fines collected. While SWOs are in effect, employees are still paid for the first ten days out-of-work due to the order and the days missed are considered “days worked.” In addition to the fines that the employer receives, they will be added to a debarment list preventing them from bidding or participating in any state or municipal contracts for three years.

 

Original post on www.mass.gov/lwd/workers-compensation in April 2015.

 

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Poverty And Social Insurance

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

My business-owning friends harp constantly about “entitlements,” which, they say, cost them money in taxes and premiums. I routinely reply that these programs are a social safety net, the small price we pay to live together relatively peacefully  in a “civilized” nation.

My friend and Iowa workers’ comp colleague Paul Mc Andrew sent me an email that sums up this concept succinctly:

Did you know that in 2013, there were more than 25 million reasons to give thanks for social insurance? According to Census Bureau data released this fall, more than 45 million people in the U.S., or 14.5% of the nation, lived in poverty in 2013. The good news? Three vitally important social insurance programs – Social Security, unemployment insurance (UI), and workers’ compensation – and a related program, Supplemental Security Income (SSI), kept the poverty rate from being much higher. Together, these four programs kept more than 25 million people out of poverty.

Workers’ Compensation alone lifted 87,000 people out of poverty in 2013, including:

  • 16,000 children; and
  • 60,000 non-elderly adults; and
  • 11,000 elderly adults aged 65+

−−Elisa Walker, National Academy of Social Insurance

We workers’ comp lawyers can only help one injured workers at a time, but collectively…..

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Alternatives to Workers’ Comp: Paranoia or Possibility

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

I joined a national organization of lawyers representing injured workers (the Work Injury Law and Advocacy Group) twenty years ago when it was first formed. Then, I heard horror stories about legislators messing with an otherwise stable workers’ compensation system after every election cycle. My colleagues in other states were constantly fighting battles over workers’ compensation “deform.” 

I thought we were insulated in Wisconsin because we had a workers’ compensation advisory council composed of labor and management who every two years fought out a compromise bill and submitted it to the legislature, which automatically rubber-stamped the proposed bill without changes. That changed in Wisconsin in 2014. For the first time in nearly 50 years, the Republican legislature rejected the “agreed upon” bill proposed by the workers’ compensation advisory council, despite the approval of the bill by management members.

Governor Scott Walker’s most recent budget contains a provision to dismantle the workers’ compensation system as we know it. Those of us representing injured workers (and those rational members on the management side) are busy lobbying to remove the workers’ compensation dismantling provisions from the budget.

It is no secret that many major corporations dislike workers’ compensation, despite statistics indicating premiums are at their lowest for employers, and profits at their highest for insurers. However, nearly two dozen major corporations including Wal-Mart, Nordstrom’s and Safeway are behind a multi-state lobbying effort to make it harder for workers hurt on the job to collect workers’ compensation benefits. The companies have financed a lobbying group the Association for Responsible Alternatives to Workers’ Compensation (ARAWC) that has already helped write legislation designed to have employers “opt out” of a State workers’ compensation system. ARAWC has already helped write legislation in Tennessee. That group’s executive director Richard Evans told an insurance journal in November that the corporations ultimately want to change workers’ compensation laws in all fifty states. Lowe’s, Macy’s, Kohl’s, SYSCO Food Services, and several insurance companies are also part of the effort. The mission of ARAWC is to pass laws allowing private employers to opt out of the traditional workers’ compensation plans that almost every state requires businesses to carry. Employers who opt out would still be compelled to purchase workers’ compensation plans, but would be allowed to write their own rules governing when, for how long, and for which reasons an injured employee can receive medical benefits and wages. Two states, Texas and Oklahoma, already allow employers to opt out of State-mandated workers’ comp. In that state, for example, Wal-Mart has written a plan that allows the company to select the physician and the arbitration company that hears disputes. A 2012 survey of Texas companies with private plans found that less half the companies offered benefits to seriously injured employees or the families of workers who died in workplace accidents. 

Oklahoma passed an opt out measure in January 2014 and the oil and gas industry along with major retailers such as Hobby Lobby pushed hard for the change. ARAWC wants to take that Texas and Oklahoma model nationwide. Seeing the workers’ compensation provision in Wisconsin’s budget bill as part of this overall “scheme” may seem paranoid, but the history of recent “deform” legislation suggest the connection is at least a possibility. 

See the complete article at http://www.motherjones.com/politics/2015/03/arawc-walmart-campaign-against-workers-compensation.

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Let’s Think About Medical Marijuana for Injured Workers

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

Nebraska, known for its conservative views, is considering legalization of medical marijuana. Sen. Tommy Garrett writes a passionate, persuasive and practical letter to constituents in support of medical marijuana. 

“Bottom line up front: The Cannabis Compassion and Care Act (LB643) is all about making life better for Nebraskans who are sick and ailing. Period! Nothing more … nothing less. This is entirely about helping very sick people in need who deserve the right to a medication that treats their illnesses.” Sen. Tommy Garrett

Sen. Garrett is a retired U.S. Air Force colonel and a registered Republican, and his views may surprise some people. He deserves credit for his advocacy on this issue. 

Relief from chronic pain is one use for medical marijuana. Chronic pain is an all-too-common problem for injured people. Current treatment patterns with strong opiates have reached crisis status. 

The National Conference of State Legislatures reports that 23 states, the District of Columbia and Guam now allow medical marijuana. It seems now is a good time to study and consider adding marijuana as an alternative to the very dangerous opioids. 

Sen. Garrett put it this way. 

“While Washington may be broken, Nebraska is not. States have rights and I trust that the decision makers here in Lincoln will join me in looking at the research and see that cannabis has demonstrated effectiveness in treating cancer, ALS, MS, Dravet’s syndrome and other terminal and debilitating illnesses. I’m doing this because stuff needs fixing.”

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ABLE Act Set to Help Save for Child’s Disability-related Expenses

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

The Achieving a Better Life Experience Act (ABLE) was recently passed by Congress and signed by President Obama.

This legislation matters to us because some clients may have a child or children who qualify for an ABLE account.

“The ABLE Act aims to provide families of a severely disabled child with some peace of mind by allowing them to save for their child’s long-term disability expenses in the same way that families of able bodied children can currently save for college through popular 529 investment plans,” according to information on North Carolina Sen. Richard Burr’s website (link is below).

There are a lot of details available on the internet about the act, and some of it is conflicting, as “passage of legislation is a result of a series of compromises,” as noted in the National Down Syndrome Society’s (NDSS) excellent resource article that is linked to below.

One of those limitations is that a person must have a qualified disability diagnosed before turning 26 to have an ABLE account, according to Sen. Burr’s website.

Here are some more links with information that I thought would be most helpful to those who are looking for more details to see if the act’s passage can help a loved one.

This link has detailed information about the act, including its text and history, from Congress.gov. https://www.congress.gov/bill/113th-congress/house-bill/647 H.R.647 – 113th Congress (2013-2014): ABLE Act of 2014 | Congress.gov | Library of Congress

Sen. Burr was a co-sponsor of the bill, along with Sen. Bob Casey of Pennsylvania. Burr’s link has information that includes details on who is eligible for an ABLE account and what are considered “qualified disability expenses.” http://www.burr.senate.gov/public/_files/ABLE%20Act%20Summary%20–%20NH%2011-19.pdf

“ABLE accounts would be a savings vehicle for disability-related expenses that will supplement, but not supplant, benefits provided through private insurances, the Medicaid program, the supplemental security income program, the beneficiary’s employment, and other sources,” according to the site above.

Via the National Down Syndrome Society (NDSS): Achieving a Better Life Experience (ABLE) Act http://www.ndss.org/Advocacy/Legislative-Agenda/Creating-an-Economic-Future-for-Individuals-with-Down-Syndrome/Achieving-a-Better-of-Life-Experience-ABLE-Act/

I thought the section of “10 Things You Must Know” was most helpful, with more details about the who, what, when, where and why of the accounts.

Via the National Association of Injured and Disabled Workers (NAIDW):  Achieving a Better Life Experience (ABLE) Act https://www.naidw.org/groups/viewdiscussion/1770-achieving-a-better-life-experience-able-act?groupid=144

Via disabilityscoop: The Premier Source for Developmental Disability News: Obama Signs ABLE Act http://www.disabilityscoop.com/2014/12/22/obama-signs-able-act/19935/

“People with disabilities may be able to start opening ABLE accounts as soon as 2015. However, some hurdles remain. While the new law alters federal rules to allow for ABLE accounts, each state must now put regulations in place — much as they have done for other types of 529 plans — so that financial institutions can make the new offering available,” according to the site above.

As is evident from the links above, more groundwork needs to be done to implement the law, so I would encourage those with questions to learn more about the accounts by contacting an accountant or a lawyer who is an expert in life care and special needs.

So if you, a loved one, and/or a friend, are receiving workers’ compensation benefits, but are worried about losing necessary current benefits for your disabled child because of limitations in what you can save or spend, an ABLE account may be just the thing for your situation.

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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.