California Poised To Adopt Workers' Comp Limits For Athletes

Workers Comp Regulations

Nearly three-quarters of all new claims made in California now include alleged brain injuries. Most of these claims come from former pro football players, brought by superstars such as Joe Theismann, Tony Dorsett and Earl Campbell, as well as unheralded practice squad players. The claims represent a huge financial risk for National Football League teams. Research suggests that repeated head trauma from violent contact can lead to dementia , Parkinson's disease and other incurable conditions. A complete list of claims by football players, culled from millions of filings from the Division of Workers' Compensation, is posted at the L.A. Times' website. Now the NFL and five other professional sports leagues are close to limiting their liability drastically for such workers' comp claims. They have lobbied for state legislation that would bar athletes who played for out-of-state teams from filing in California. The state Senate is expected to approve the bill Tuesday; the Assembly already has.
For the original version including any supplementary images or video, visit http://www.latimes.com/business/la-fi-nfl-brain-injuries-20130831,0,2692807.story

Department of Insurance plans hearing for workers' comp changes

Since the early 1980s, an estimated $747 million has been paid out to about 4,500 players, according to an August study commissioned by major professional sports leagues. California taxpayers are not on the hook for these payments. Workers' compensation is an employer-funded program. Now a major battle is brewing in Sacramento to make out-of-state players ineligible for these benefits, which are paid by the leagues and their insurers. They have hired consultants and lobbyists and expect to unveil legislation next week that would halt the practice. "The system is completely out of whack right now," said Jeff Gewirtz, vice president of the Brooklyn Nets formerly the New Jersey Nets of the National Basketball Assn. Major retired stars who scored six-figure California workers' compensation benefits include Moses Malone, a three-time NBA most valuable player with the Houston Rockets, Philadelphia 76ers and other teams.
For the original version including any supplementary images or video, visit http://articles.latimes.com/2013/feb/23/business/la-fi-proathletes-workers-comp-20130223

Athletes cash in on California's workers' comp

In California, for example, the "Notice to Employees" poster that identifies the workers' comp program the business maintains on behalf of employees must be available in a conspicuous place such as in the lunchroom, male and female bathrooms or other place where employees are sure to read it. New York requires a similar poster, a "Notice of Compliance for Workers' Compensation," be made available to employees. Deadlines When an employee files a claim of injury at work, the employer must file the claim within a specific period or face fines and penalties. While these fines vary state-to-state, in Florida, for example, penalties increase from $100 for a one-to-seven-days-late filing, on up to $500 for more than 28 days of untimely filing. Once the claims examiner accepts the claim, any temporary disability payments must occur after the state's designated waiting period, in some cases after 7 or 14 days, depending upon the state. The state's weekly average wage and a calculation similar to that used by unemployment departments helps determine how much an employee receives while the injury heals. Late payments also receive fines and penalties, typically paid to the injured worker. No-Fault System Workers' compensation insurance operates on a no-fault system, finding neither fault nor blame on behalf of the employer or employee for the injury. The establishment of this program eliminated the need for a "tort" system where employees had to sue employers to receive benefits for work-related injuries.
For the original version including any supplementary images or video, visit http://yourbusiness.azcentral.com/workers-comp-regulations-23215.html

The Perception Series Part I: Workers' Comp is a Problem for the Uninitiated and Unaware

The problem is that clubs in Ohio or Texas might spend only $500,000 on workers comp while franchises in California might spend as much as $4 million. That's a net loss of $3.5 million for the California owners, who argue that if player costs are going increase across the board in things like salaries, retirement benefits and medical care, the expenses should be shared evenly by clubs -- particularly when it comes to workers comp, which is among the largest expenses. "It's a fairly big competitive issue when year after year the California teams are spending so much more on workers comp," said a high-ranking official for a California team. "If a player spends most of his career on a team outside the state, we shouldn't be paying his workers comp claims." Reggie Williams shows off the damage done to his knee from his days in the NFL. Jim Trotter/SI The official admitted that workers comp is one of the talking points when his team is weighing whether to sign an out-of-state free agent who might be at the end of his career but could still contribute for a year or two. "We're less likely to bring in a guy like that (under the current system), and that's what we're trying to take off the table," said the official. "We don't want California teams to not be a destination for some players because of workers comp.
For the original version including any supplementary images or video, visit http://sportsillustrated.cnn.com/nfl/news/20130507/workers-comp-california/

Workers Compensation Claim Handling Standards

9 proposed that the state change a classification system, use collective bargaining agreements to validate an employeeas hourly wage rate and amend other arcane items. The hearing of more general interest will be a second public hearing related to the Rating Bureauas recommendations, but the Department of Insurance has not yet scheduled one. In early September, the Rating Bureau will submit its recommendation to state regulators on pure premium rates for policies beginning or renewing on Jan. 1 of next year. Then the Department of Insurance will schedule a separate public hearing on the issue of rates. The Rating Bureau said earlier this month that it would recommend that insurers boost their base rates by 3.4 percent above the industry average that insurers were charging as of July 1. The organization recommends that workersa comp insurers file base rates of an average of $2.62 for every $100 of payroll. That is 3.4 percent higher than the industry average of $2.53 as of July 1. The insurance commissioner can accept, reject or modify the base rate that the Rating Bureau recommended.
For the original version including any supplementary images or video, visit http://www.bizjournals.com/sacramento/news/2013/08/27/workers-comp-regulation-changes-insuranc.html

States, ex-players trying to level playing field on workers comp

Litigation Management: All files referred to a defense attorney should contain a referral letter outlining the facts of the claim and providing the defense attorney with instructions on how the adjuster wants the attorney to proceed. The referral letter should also request the defense attorney to provide an analysis of the strong and weak points in defending the claim, along with the attorneys recommendations. The attorney should be required to provide a litigation budget outlining the projected cost of defense. All billings provided by the defense attorney should be reviewed by the adjuster for appropriateness of the charges. Diary: All future handling activity planned by the adjuster should be placed on a diary (calendar) for follow-up on a timely basis. This includes all Plan of Action issues as well as routine file follow up. Claim File Notes: All activities on the file should be documented in the claim file notes sections of the file. This includes all telephone discussions, emails, letters, medical reports, state forms, and any other file developments. If your insurer or TPA is not following the above industry Best Practices, it will have a negative impact on the outcome of your claim files. If you know or suspect that the Best Practices are not being followed, you should arrange for an independent claims auditor to review your claims files. A claim file audit will provide you with the needed insight into your claims, allowing your company to take the necessary steps to improve the claim handling of your work comp claims, lowering your overall workers compensation cost. For assistance in finding a claim files auditor, please contact us. Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50% .
For the original version including any supplementary images or video, visit http://www.workerscompensation.com/compnewsnetwork/workers-comp-blogwire/17369-workers-compensation-claim-handling-standards.html

Many (MANY!) believe that workers' comp in this country is a singular entity, a nebulous yet all controlling concern that runs the entire system. Of course, if there was such an entity, they would have a website. And their domain name would naturally have to be WorkersCompensation.com. We see it all, as people routinely contact us believing we are the government agency/insurance company/claims management/evil operation in charge of their policy or claim. And of course, as the guy who runs the show, I am the one responsible for the denial of their claim. The delay in their settlement. The lack of authorization on their prescriptions, or the one who should know Johnny down the street is committing fraud. This basic lack of awareness or information hurts both the newly injured and the industry established to tend to them. The belief that workers' comp is in any way simple, controlled by one overarching entity, does not leave the injured worker at all prepared for the juggernaut of complexity headed their way.
For the original version including any supplementary images or video, visit http://www.workerscompensation.com/compnewsnetwork/from-bobs-cluttered-desk/17388-the-perception-series-part-i-workers-comp-is-a-problem-for-the-uninitiated-and-unaware.html