Saturday, September 28, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (5/13/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/COMMUNITY/WORKERSCOMPENSATIONLAW/blogs/newsheadlines/archive/2013/05/13/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-5-13-2013.aspx
Thursday, September 26, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (6/10/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/COMMUNITY/WORKERSCOMPENSATIONLAW/blogs/newsheadlines/archive/2013/06/10/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-6-10-2013.aspx
Monday, September 23, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (3/4/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/COMMUNITY/WORKERSCOMPENSATIONLAW/blogs/newsheadlines/archive/2013/03/04/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-3-4-2013.aspx
Friday, September 20, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (3/18/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/Community/workerscompensationlaw/blogs/newsheadlines/archive/2013/03/18/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-3-18-2013.aspx
Wednesday, September 18, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (5/13/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/COMMUNITY/WORKERSCOMPENSATIONLAW/blogs/newsheadlines/archive/2013/05/13/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-5-13-2013.aspx
Tuesday, September 17, 2013
How To Report Workers' Compensation Fraud
Workers comp cheaters must be caught
It's a form of theft that some employers, employees or medical providers use to get money not due them. Workers' compensation is for legitimate on-the-job employee injuries; fraud hurts the small-business owner because it often results in higher premium fees. In most states, when you suspect workers' compensation fraud, you must follow specific steps to report it. Fraud Definition Workers' compensation fraud occurs when an employee, medical provider or an employer lies to get workers' compensation benefits he is not entitled to. Medical providers who bill for services not rendered and an employee who fakes an injury to get benefits are both defrauding the system by accepting money or medical benefits to which they are not entitled. Workers' compensation benefits involve a no-fault system for the sole purpose of covering the medical expenses and lost wages for an employee's on-the-job injury. Red Flags Because workers' compensation fraud is a serious charge, it's important to review the red flags that indicate a potential fraudulent claim. When you suspect fraud, these red flags can validate your suspicions.
For the original version including any supplementary images or video, visit http://yourbusiness.azcentral.com/report-workers-compensation-fraud-16426.html
Management members of the workers comp council are proposing a fee schedule as a way to control costs, setting prices at 175 percent of what Medicare pays. They argue that cash payments cant decline forever and medical costs are expected to continue going up. But the nonvoting medical industry representatives on the council objected. A fee schedule, they argue, could lead to fewer doctors taking workers comp patients, resulting in reduced access, more time away from work and higher costs to the system. Labor members of the council havent supported the fee schedule, but for the first time agree that something needs to be done to control the medical costs, said Stephanie Bloomingdale, secretary-treasurer of the Wisconsin AFL-CIO. What we would like to see is more money going into workers pockets, Bloomingdale said.
For the original version including any supplementary images or video, visit http://lacrossetribune.com/news/local/legislators-consider-workers-comp-changes/article_f1354284-1dba-11e3-b7c0-0019bb2963f4.html
Workers' Comp Plan Sought for Gulfstream
Romans spends about $140,000 a year combined for workers' compensation coverage in Florida, Kentucky, and New York, Vaccarezza said. Trainer Milt Wolfson, now based at Gulfstream, has four employees and 10 horses. He is paying $14,000 this year for workers' compensation coverage even though he has a low claims rate. Vaccarezza and Wolfson are among the horsemen who expect that paying for group coverage would be less expensive than what trainers now pay for finding their own policies. Over the past two months Vaccarezza has evolved from being an outspoken critic of some Florida HBPA policies, especially those related to Gulfstream, to his current role of working with the organization on some projects.
For the original version including any supplementary images or video, visit http://www.bloodhorse.com/horse-racing/articles/80633/workers-comp-plan-sought-for-gulfstream
Md. physicians put high mark-up on workers comp pain-killers
They also taped her using a wheelchair for a visit to the doctor, then getting out of it after she left. She was convicted of fraud and sentenced to a year in prison. The two were ordered to pay $173,332 in restitution. Sometimes, the SID gets help from working Ohioans fed up with workers' compensation fraud by people they know. One man used his cell phone to videotape a coworker bragging about faking an injury so he could collect workers' compensation. Outrageous stories about workers' compensation fraud are more than just anecdotes.
For the original version including any supplementary images or video, visit http://www.mariettatimes.com/page/content.detail/id/554159/Workers-comp-cheaters-must-be--caught.html?nav=5004
Rating bureau recommends 6.9 percent increase in California workers' comp rates
It found in many instances that average prices paid to physician-dispensers for prescription drugs are more than double the prices paid at pharmacies. Physician dispensing makes up about 40% of workers compensation prescriptions, but about 55% of the payments, according to the report. The report focused only on workers compensation payments, though physicians also dispense medication to patients whose bills are covered through other payors such as private insurance. Cost per pill: $0.37 compared to $1.46 One example in the report was that Vicodin cost $1.46 per pill when dispensed by a physician, compared to $0.37 at a pharmacy, according to a press release on the study. The report finds the trend even held true with over-the-counter medications for instance, Zantac costs $0.35 per pill at Walgreens, compared to $3.40 per pill dispensed by Maryland physicians, nearly 10 times as much. Data for the report came from payors in Maryland that represented 37% of the claims in the states workers compensation system. The system is paid for by employers through legally mandated insurance. Included were 16,860 claims where workers missed more than seven days of lost pay with injuries between Oct.
For the original version including any supplementary images or video, visit http://baltimorepostexaminer.com/md-physicians-put-high-mark-up-on-workers-comp-pain-killers/2013/09/17
Legislators consider workers' comp changes
Insurance Commissioner Dave Jones can accept, reject or modify the proposed rate increase after hearings this fall. Insurers often follow the commissioner's pure-premium rate recommendations, but aren't required to do so. The proposed rate "reflects insurer loss and loss adjustment experience" as of June 30, WCIRB said in a statement, but doesn't include "any provision" for the impact of medical fee schedule changes being considered by the state Division of Workers' Compensation. The advisory group's governing committee will meet Oct. 23 to consider how those changes might affect typical workers' compensation rates and "whether an amendment" to these proposed rate increases is justified. Pure premium rates are average base rates.
For the original version including any supplementary images or video, visit http://www.bizjournals.com/sanfrancisco/blog/2013/09/workers-compensation-rate-filing.html
Sunday, September 15, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (4/22/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/COMMUNITY/WORKERSCOMPENSATIONLAW/blogs/newsheadlines/archive/2013/04/22/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-4-22-2013.aspx
Saturday, September 14, 2013
Bill Limiting Workers' Comp Claims By Athletes Is Sent To Governor
Call Atlanta Workers' Compensation Attorneys, Cummings & Middlebrooks, for Aggravation of Injury or Pre-existing Condition
The bill, AB 1309 by Assemblyman Henry T. Perea (D-Fresno), cleared the Assembly on a 66-3 vote and was sent to Gov. Jerry Brown . The governor is expected to sign the bill into law, Perea's office said. Last week, the measure received an overwhelming endorsement in the state Senate with a 34-2 vote.
For the original version including any supplementary images or video, visit http://www.latimes.com/business/la-fi-athletes-comp-bill-20130910,0,5033688.story
Texas marks centennial anniversary of workers' compensation laws
It is a good idea to contact an attorney as soon as possible since it could take a long time to get benefits started, especially if litigation is necessary, and to avoid statute of limitations problems. Under state law, Atlanta workers' comp lawyers cannot charge a fee for representing a client in a workers' compensation case unless they recover income benefits. That means clients do not pay anything unless -- and until -- they receive workers' comp benefits. In discussing their expertise in the field of workers' compensation, Will Cummings, Partner at Cummings & Middlebrooks, notes, "My partner Tray Middlebrooks and I both began our careers working for insurance companies. That experience gave us unique insight into the methods those companies use to avoid paying claims. We can accurately anticipate their arguments and are prepared to address any defense they assert. This enables us to successfully represent our clients." For information on the Atlanta workers' compensation attorneys , and to schedule a free consultation, call (404) 250-3292 or visit http://www.cmlawllp.com/index.php . About Cummings & Middlebrooks: Cummings & Middlebrooks is a worker's compensation and personal injury law firm serving metro Atlanta and most of central and north Georgia. They specialize in helping people who have been injured at work or by the negligence of others.
For the original version including any supplementary images or video, visit http://www.24-7pressrelease.com/press-release/call-atlanta-workers-compensation-attorneys-cummings-amp-middlebrooks-for-aggravation-of-injury-or-preexisting-condition-360706.php
Report workers' comp fraud
Yet SID investigators got tape of her walking around, using both her arms and legs. They also taped her using a wheelchair for a visit to the doctor, then getting out of it after she left. She was convicted of fraud and sentenced to a year in prison. The two were ordered to pay $173,332 in restitution. An Akron woman was ordered to repay $88,000 in benefits after she was caught running the clothing store she owned, apparently without difficulty.
For the original version including any supplementary images or video, visit http://www.tribune-chronicle.com/page/content.detail/id/592930/Report-workers--comp-fraud.html?nav=5007
In observance of this centennial date, Commissioner of Workers Compensation Rod Bordelon released this statement: For a Limited Time receive a FREE HR Report "Critical HR Recordkeeping." This exclusive special report covers hiring records, employment relationships, termination records, litigation issues, electronic information issues, tips for better recordkeeping, and a list of legal requirements. Download Now "The Texas workers' compensation system has played a pivotal role in the economic development of the Lone Star State over the last century by providing a safety net http://attorney-in-temecula.com/more-information/workers-compensation/ for employees who are injured on the job and lawsuit protections for employers," Bordelon said. "Our state-based statutory system provides injured employees with medical and income benefits on a no-fault basis while encouraging employees to return to work as quickly and safely as possibleand that keeps our workforce active and productive." The Texas Department of Insurance, Division of Workers Compensation (TDI-DWC) is the agency responsible for administering the Texas workers' compensation system. To find out more information about workers compensation, contact the TDI-DWC through one of its local field offices throughout the state or visit the agencys website at http://www.tdi.texas.gov/wc/indexwc.html .
For the original version including any supplementary images or video, visit http://hr.blr.com/HR-news/HR-Administration/Workers-Workmen-Compensation/Texas-marks-centennial-anniversary-of-workers-comp
Thursday, September 12, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (3/25/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/Community/workerscompensationlaw/blogs/newsheadlines/archive/2013/03/24/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-3-25-2013.aspx
Okla. Gov Makes Workers' Comp Team Appointment
The new law is intended to overhaul the state's workers' compensation system. Kirschner will join Troy Wilson Sr. on the transition team. Wilson was previously appointed by the governor as chairman of the new workers' compensation commission. Wilson and Kirschner will develop rules by Nov. 1 for the new system.
For the original version including any supplementary images or video, visit http://www.businessweek.com/ap/2013-09-09/okla-dot-gov-makes-workers-comp-team-appointment
The Importance of Medical Bill Review in Workers Compensation
Often, durable http://theworkerscompensationdirectory.com/ medical equipment will not fit into the state fee schedule, or if it is covered in the fee schedule, it is under a miscellaneous code. The medical bill review company should be able to verify the cost is proper for durable medical equipment. Turn Around Time Should be Prompt Turn-around time on medical bill processing should be prompt as some states impose penalties for late payment of medical, California for example. As there are often delays with the medical provider sending the bill and delays in the mail, the medical bill review company needs to act quickly on reviewing and adjudicating the bill. The medical bill review company should have a turn-around time of 7 days or less. If you need assistance in the identification or selection of an excellent medical bill review company, please contact us.
For the original version including any supplementary images or video, visit http://www.workerscompensation.com/compnewsnetwork/mobile/workers-comp-blogwire/17453-the-importance-of-medical-bill-review-in-workers-compensation.html
Fallin makes workers' comp transition team appointment
Kirschner will join Troy Wilson Sr., who previously was appointed by the governor as chairman of the new workers compensation commission, on the transition team. They will work to implement changes in the workers compensation court system called for in Senate Bill 1062. The measure is intended to overhaul the workers compensation system, which has been called a detriment to business and industry to the state. Wilson and Kirschner will develop rules by Nov. 1 for the new system, which is to be up and running by Feb. 1. Wilson will serve as a commission chairman for the new system and Kirschner will be one of the systems administrative law judges. As the executive director of the Commerce Department, a business lawyer and civic leader, Jonna Kirschner understands how important it is for Oklahoma to have a business friendly environment, Fallin said.
For the original version including any supplementary images or video, visit http://www.edmondsun.com/local/x250210797/Fallin-makes-workers-comp-transition-team-appointment
Monday, September 9, 2013
Workers’ Compensation Resources Research Report, Issue 6 May 2013
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/Community/workerscompensationlaw/blogs/newsheadlines/archive/2013/05/08/workers-compensation-resources-research-report-issue-6-may-2013.aspx
Ten Current And Former U.s. Postal Service Employees And Two Doctors Arrested And Indicted In Workers’ Compensation Fraud Scheme
Workers' Compensation Loss Costs Going Down Again in Kentucky
The employees claim and supporting medical evidence is then evaluated by the OWCP to determine the claimants medical impairments and the effect of the impairment on the claimants ability to work on a sustained basis. The investigation initially focused on Faura-Clavell and the medical documentation he completed to support the permanent disability of USPS claimants. Subsequently, the investigation revealed that Faura-Clavell and Madrid-Guzman would evaluate and diagnose the claimants in an effort to justify a non-existent injury in order to deceive and persuade the OWCP to award the claimants with workers compensation benefits. The doctors would charge fees ranging up to $1,650 for the preparation of the fraudulent medical reports. During the investigation, additional evidence revealed six of the 10 aforementioned OWCP claimants also fraudulently received Social Security Administration disability benefits. The defendants who illegally received the workers compensation benefits are: Bernardo Brito-Franco; Rodolfo Vazquez-Soto; Felix Ortiz-Vazquez; Miguel Plaza-Nieves; Wilma T.
For the original version including any supplementary images or video, visit http://www.fbi.gov/sanjuan/press-releases/2013/ten-current-and-former-u.s.-postal-service-employees-and-two-doctors-arrested-and-indicted-in-workers-compensation-fraud-scheme
Workers' Compensation Task Force meets
Hammer videos and served as the inspiration for Jaime Foxx's Willie Beamen character in the 1999 film "Any Given Sunday." On Thursday, The Los Angeles Times revealed that Sanders filed a workers' compensation claim in California in 2010, claiming he suffered head trauma and other injuries while playing with the Dallas Cowboys. During the pregame show before February's Super Bowl, however, Sanders had different thoughts about such claims as an NFL Network analyst. "The game is a safe game," the Hall of Fame cornerback said. "I don't buy all these guys coming back with these concussions. I'm not buying all that.
For the original version including any supplementary images or video, visit http://money.msn.com/now/should-deion-sanders-get-workers-comp
The loss cost figures show an average reduction of 7.9 percent for the 590 industrial classes used in Kentucky, the same decrease as in 2012. The industrial classes include manufacturing, office and clerical, contracting, and goods and services. For coal classes, surface mining decreased 4.9 percent and underground mining costs decreased 4.8 percent. Sharon Clark, state insurance commissioner, said her department approved the loss costs filing effective Oct. 1. The figures are submitted by the advisory organization, the National Council on Compensation Insurance Inc. (NCCI), on behalf of all workers compensation carriers writing in the state. We recently heard from NCCI management that the countrywide outlook for workers comp rates has changed from conflicted to encouraging, said Clark. Kentucky workers and employers have enjoyed eight consecutive decreases, lowering loss costs on average 46.8 percent.
For the original version including any supplementary images or video, visit http://www.insurancejournal.com/news/southeast/2013/09/09/304527.htm
Workers' Compensation Extended for Spouses of Emergency Personnel
Four months earlier, the task force presentation an 18-point plan to reform the states increasing workers compensation. The plan was translated to legislation and signed into law in June. We have had some developments since we issued our report, said Lt. Gov. Matthew Denn, the chairman of the 20-member task force. Since 2007, the state has been working to cut back on high premium rates. Insurance legislation enacted in 2007, Senate Bill 1, included provisions to create a Health Care Advisory Panel (consisting mostly of health care personnel) to reform the payment system and develop practice guidelines for the most common workplace injuries, as well as create a Data Collections Committee. The reforms passed helped the state facilitate nearly a 40 percent decrease http://attorney-in-temecula.com/more-information/workers-compensation/ in rates, jumping from having the nations third most expensive workers compensation premiums in 2006 to the 34th most expensive by 2010, according to the Oregon Workers Compensation Premium Rate Ranking Summary.
For the original version including any supplementary images or video, visit http://delaware.newszap.com/centraldelaware/125353-70/workers-compensation-task-force-meets
This lump sum has now been canceled in favor of permanent payments to surviving spouses. The law takes effect immediately but is not retroactive, so spouses who have already remarried and received a lump sum payment will not receive any additional funds. Other dependents may also qualify for compensatory payments. The program covers funeral expenses of the deceased officer as well. Workersa compensation precludes the right to sue Workers compensation is designed to reimburse injured employees or the family of a person who died because of a work accident. Generally, all those who receive workers compensation forgo their rights to sue employers or co-employees for injuries sustained in work-related accidents, except in those rare circumstances known as intentional harm cases. The New Jersey law firm of Hoffman DiMuzio has been advising employees and their families on workers compensation claims for more than 35 years. If you have a workers compensation claim, make an appointment with one of our experienced attorneys. Your consultation is free of charge.
For the original version including any supplementary images or video, visit http://www.jdsupra.com/legalnews/workers-compensation-extended-for-spous-81184/
Saturday, September 7, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (6/3/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/Community/workerscompensationlaw/blogs/newsheadlines/archive/2013/06/03/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-6-3-2013.aspx
Should Deion Sanders Get Workers' Comp?
Senate approves bill limiting out-of-state athlete compensation
In his prime, "Neon" Deion "Prime Time" Sanders juggled his NFL career with a stint in Major League Baseball , made cameos in M.C. Hammer videos and served as the inspiration for Jaime Foxx's Willie Beamen character in the 1999 film "Any Given Sunday." On Thursday, The Los Angeles Times revealed that Sanders filed a workers' compensation claim in California in 2010, claiming he suffered head trauma and other injuries while playing with the Dallas Cowboys. During the pregame show before February's Super Bowl, however, Sanders had different thoughts about such claims as an NFL Network analyst. "The game is a safe game," the Hall of Fame cornerback said. "I don't buy all these guys coming back with these concussions. I'm not buying all that. Half these guys are trying to make money off the deal." Given how Sanders' compensation case is proceeding, it's likely he considers himself in the other half of that equation. In November 2010, Sanders was deemed 86% disabled by the Division of Workers' Compensation. The four doctors who examined Sanders diagnosed more than a dozen medical conditions, including cognitive impairment, behavioral/emotional disorder, arthritis and "arousal disorder" -- which is a sleep disorder that isn't nearly as humorous as it sounds.
For the original version including any supplementary images or video, visit http://money.msn.com/now/should-deion-sanders-get-workers-comp
Industry group projects reduced workers' comp costs
Sanders called the lawsuit a money grab, but it turns out that Prime Time isnt above making a little cash off the injuries he suffered during his playing days. Documents obtained by the Los Angeles Times indicate that Sanders filed a workers compensation claim in May 2010, alleging a litany of injuries including head trauma suffered while playing for the Cowboys in the late 1990s. According to the documents, the Division of Workers Compensation determinedthe Hall of Famer to be 86 percent disabled, and a team of four doctors diagnosed him with more than a dozen medical conditions, including cognitive impairment and behavioral/emotional disorder. A host of current NFL employees have filed similar claims, the Times reports, including Sanders and six of his fellow NFL Network analysts. It would take the league an estimated $1 billion to resolve the nearly 4,000 claims filed against it in California. Sanders case is currently pending. Scoreboard
For the original version including any supplementary images or video, visit http://nesn.com/2013/09/report-deion-sanders-filed-for-workers-compensation-for-nfl-injuries-despite-bashing-concussion-lawsuit1/
Workers' Compensation Task Force meets
In addition, the lieutenant governor suggested hiring a part-time attorney to represent business during the rate- setting process as well as new system to encourage injured workers to return to work more effectively. Finally the task force advocated for improvements to the state workplace safety program. Despite the legislation, Lt. Gov. Denn said there are still issues that could be addressed concerning the progress of the Health Care Advisory Panel as well as the Delaware Compensation Rating Bureaus 2013 rate filing.
For the original version including any supplementary images or video, visit http://delaware.newszap.com/centraldelaware/125353-70/workers-compensation-task-force-meets
Deion Sanders Filed for Workers' Compensation for NFL Injuries Despite Bashing Concussion Lawsuit
We will delete comments containing inappropriate links, obscenities, hate speech, and personal attacks. Flagrant or repeat violators will be banned. See more about comments here. What You Should Know About Comments on Sacbee.com Sacbee.com is happy to provide a forum for reader interaction, discussion, feedback and reaction to our stories. However, we reserve the right to delete inappropriate comments or ban users who can't play nice. ( See our full terms of service here. ) Here are some rules of the road: Keep your comments civil.
For the original version including any supplementary images or video, visit http://www.sacbee.com/2013/09/07/5714423/california-lawmakers-ok-bills.html
Only post comments relevant to the article at hand. If you want to discuss an issue with a specific user, click on his profile name and send him a direct message. Do not copy and paste outside material into the comment box. Don't repeat the same comment over and over. We heard you the first time. Do not use the commenting system for advertising. That's spam and it isn't allowed. Don't use all capital letters. That's akin to yelling and not appreciated by the audience.
For the original version including any supplementary images or video, visit http://blogs.sacbee.com/capitolalertlatest/2013/09/senate-approves-bill-limiting-out-of-state-athlete-compensation.html
California lawmakers OK bills to expand family leave, narrow workers comp for athletes
projects that workers' compensation costs will see double-digit decreases in Oklahoma after state lawmakers passed a bill to do away with the state's workers' compensation court system. Oklahoma Senate President Pro Tem Brian Bingman and others who had advocated for a switch to an administrative workers' compensation system touted the loss cost reduction as a plus for businesses in the state. Workers' compensation costs are noted by employers of all sizes across the state as their top barrier to growth, which is why we passed comprehensive reform, Bingman said in a statement. Lower rates mean more money for investment, expansion, wage increases and job creation for businesses here, and a more competitive economic climate for companies looking to expand and relocate to Oklahoma. Most insurers will use projections on loss costs from the advisory group NCCI to set rates for workers' compensation insurance employers. The National Council predicts overall loss costs will drop 14.6 percent beginning Jan. 1. Oklahoma continues to be a leader by proving to the country that conservative pro-business policies lead to economic growth and prosperity, Oklahoma House Speaker T.W. Shannon said in a statement.
For the original version including any supplementary images or video, visit http://newsok.com/industry-group-projects-reduced-workers-comp-costs/article/3879764
Friday, September 6, 2013
Workers’ Compensation Resources Research Report, Issue 6 May 2013
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/COMMUNITY/WORKERSCOMPENSATIONLAW/blogs/newsheadlines/archive/2013/05/08/workers-compensation-resources-research-report-issue-6-may-2013.aspx
Thursday, September 5, 2013
Stop Workers’ Comp Cheaters
Convergent Announces Case Study with Community Medical Centers on Workers' Compensation Claim Reimbursement
The Special Investigations Department in Ohio's Bureau of Workers' Compensation is among them. During the unit's 20-year history, it has apprehended enough cheats to save the workers' compensation program an estimated $1.5 billion. That's a substantial chunk of change saved for Buckeye State businesses, which pay premiums to provide coverage for their employees. It also is money that helps to ensure workers injured on the job get help. Here are a few of the cases the SID has handled during the past couple of years: Yet SID investigators got tape of her walking around, using both her arms and legs. They also taped her using a wheelchair for a visit to the doctor, then getting out of it after she left. She was convicted of fraud and sentenced to a year in prison. The two were ordered to pay $173,332 in restitution.
For the original version including any supplementary images or video, visit http://www.theintelligencer.net/page/content.detail/id/589436/Stop-Workers--Comp-Cheaters.html?nav=511
Police veteran fighting Ohio workers' comp fraud
29, 2013 photo, Rick Gregory, the new director of the Special Investigations Unit at the Ohio Bureau of Workers' Compensation, poses for a photo in his office in Columbus, Ohio. Gregory says it's not fair that people following workers' comp rules are penalized by those who don't. Photo: Andrew Welsh-Huggins In this Thursday, Aug. 29, 2013 photo, Rick Gregory, the new...
For the original version including any supplementary images or video, visit http://www.sfgate.com/news/crime/article/Police-veteran-fighting-Ohio-workers-comp-fraud-4780827.php
"We reconcile the accounts--the volumes and the dollars that are sent and sent back--we monitor the cash collections and really that is all we do." Convergent handles all of the traditionally difficult tasks associated with workers' compensation follow-up. Working directly from Community's HIS system, the national revenue cycle management firm used its own technology to calculate the expected reimbursement based on California's complex fee schedules, comparing actual payments and identifying underpaid claims. Whenever an underpayment is identified, Convergent provides the appropriate follow-up through phone calls, letters, and litigation if necessary. "Our success at partnering with top performing providers is founded on our ability to quickly and effectively increase reimbursement for healthcare services with the appropriate resources and adherence to regulatory requirements," said Derek Pickell, CEO of Convergent Revenue Cycle Management. Founded in 1992, Convergent's healthcare division serves hundreds of hospitals and healthcare providers across the nation. Their regulatory expertise and patient-focused contact center technology optimize revenue cycle performance, enhances the patient experience, and improves provider relationships. To access the case study, visit www.convergentusa.com/library. About Convergent Revenue Cycle Management, Inc. Convergent Revenue Cycle Management is recognized as the premier niche revenue cycle management company in healthcare, providing innovative solutions across the revenue cycle spectrum including patient access solutions, early out self-pay collections, attorney-powered third party reimbursement and bad debt recovery (through Convergent Healthcare Recoveries, Inc.).
For the original version including any supplementary images or video, visit http://www.marketwatch.com/story/convergent-announces-case-study-with-community-medical-centers-on-workers-compensation-claim-reimbursement-2013-09-05
Industry group projects reduced http://cortrightlaw.com/workers-compensation workers' comp costs
projects that workers' compensation costs will see double-digit decreases in Oklahoma after state lawmakers passed a bill to do away with the state's workers' compensation court system. Oklahoma Senate President Pro Tem Brian Bingman and others who had advocated for a switch to an administrative workers' compensation system touted the loss cost reduction as a plus for businesses in the state. Workers' compensation costs are noted by employers of all sizes across the state as their top barrier to growth, which is why we passed comprehensive reform, Bingman said in a statement. Lower rates mean more money for investment, expansion, wage increases and job creation for businesses here, and a more competitive economic climate for companies looking to expand and relocate to Oklahoma. Most insurers will use projections on loss costs from the advisory group NCCI to set rates for workers' compensation insurance employers. The National Council predicts overall loss costs will drop 14.6 percent beginning Jan. 1. Oklahoma continues to be a leader by proving to the country that conservative pro-business policies lead to economic growth and prosperity, Oklahoma House Speaker T.W.
For the original version including any supplementary images or video, visit http://newsok.com/industry-group-projects-reduced-workers-comp-costs/article/3879764
Commission Keeps Claimant's Counsel and Recording Devices out of Employer's Medical Evaluations
submit to an examination by a physician or surgeon of the employers choice... which, the Commission noted, leaves the choice of EME physician exclusively with the employer. A Rule 35 medical evaluation, in contrast, may be ordered by a judge only on motion for good cause shown and upon notice... to all parties and shall specify the time, place, manner, conditions, and scope of the examination and the person or persons by whom it is to be made. The Commission also noted thatLangfeldt-Haaland was a 3-2 decision that explicitly limited its holding to Civil Rule 35 medical evaluations. The majority had argued the importance of allowing counsel to observe shortcomings and improprieties during the examination which could be the subject of inquiries on cross-examination at trial; and ... [to] object to questions posed to the plaintiff during the examination that concern privileged information. The dissenting judges pointed out that adopting such a rule could have a chilling effect on otherwise reputable physicians performing medical examinations. The Commission found the dissents position more persuasive, and also took into account a survey of SIME physicians that showed a significant percentage of the physicians surveyed would decline to perform evaluations if they were required to allow the evaluation to be witnessed and recorded.
For the original version including any supplementary images or video, visit http://www.workerscompensation.com/compnewsnetwork/mobile/workers-comp-blogwire/17415-commission-keeps-claimant-s-counsel-and-recording-devices-out-of-employer-s-medical-evaluations.html
Workers' compensation costs
Success! Your Digital Subscription has been activated. Success! Your Premium Subscription has been activated. Hold on for just a moment while we finish setting up your account.. Note: your login information will be needed the first time you access your subscription on another device (computer, smartphone and tablet). Your Premium Subscription to VCStar is now available.
For the original version including any supplementary images or video, visit http://www.vcstar.com/news/2013/sep/05/workers-compensation-costs/
Tuesday, September 3, 2013
National And State-by-state Workers' Comp News Roundup Powered By Larson's (4/29/2013)
For the original version including any supplementary images or video, visit http://www.lexisnexis.com/COMMUNITY/WORKERSCOMPENSATIONLAW/blogs/newsheadlines/archive/2013/04/29/national-and-state-by-state-workers-comp-news-roundup-powered-by-larson-s-4-29-2013.aspx
Workers Comp Regulations
Workers' comp sees reform; law goes into effect in July 2014
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.
For the original version including any supplementary images or video, visit http://yourbusiness.azcentral.com/workers-comp-regulations-23215.html
Government workers' compensation payments surge in New Orleans
In the construction or mining industries, however, employers must provide coverage even if there is only one employee. What the employer pays for that insurance depends on each employees classification, how long the employer has been in business, the type of business the employer is in, and the employers total workforce, according to TDLWD. The current workers comp system saw more than 100,000 medical and lost-time claims in the 2011-12 fiscal year. While employers dealt with lost productivity, employees in those claims faced job and financial loss, and physical impairments. There are a lot of difficult claims to manage, Francis said. We had 19 people who went to work [during that year] and did not come home [due to death]. Every year in America, nearly 4 million people suffer a workplace injury, with some never recovering, according to the Tennessee Occupational Safety and Health Administration (TOSHA). The leading causes of occupational injuries, says TOSHA, include sprains, cuts and lacerations, bruises and fractures. A sprain could cost a business more than $60,000 in direct and indirect costs, TOSHA projects. Tennessee, Francis noted, is surrounded by eight Southeast states that have cheaper workers comp coverage rates. Nationally, TDLWD says only Tennessee and Alabama use trial courts to resolve workers comp claims. That situation, the department insists, has led to a litigious system, plus inconsistency and poor timeliness in court rulings. The [Tennessee] Supreme Court has heard some workers comp cases that are 12, 13 years old, Francis said. The employer didnt win, they just outlasted [the case].
For the original version including any supplementary images or video, visit http://www.timesnews.net/article/9066859/workers-comp-sees-reform-law-goes-into-effect-in-july-2014
"That's a no-brainer," Councilwoman Susan Guidry said. "That absolutely should be done. We don't need to study that." "Absolutely," Bagneris agreed. Nick Felton, president of the firefighters' union, said in a later interview that the Fire Department's high level of workers' comp claims is only to be expected, given the nature of the job. "I wouldn't be surprised if those numbers would be a little higher than for people working down at City Hall," he said. "We're running into burning buildings." Felton said he believes firefighters would support a light-duty regimen. The chance to return to work earlier would cut down on the limited amount of paid time off a firefighter can take to recuperate from an injury. State law gives firefighters 365 days of injury leave, although there is a dispute over the interpretation of that statute.
For the original version including any supplementary images or video, visit http://www.nola.com/politics/index.ssf/2013/08/government_workers_compensatio.html
The Perception Series Part I: Workers' Comp is a Problem for the Uninitiated and Unaware
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. Likewise, newly injured are often confused and frightened. They lack much control over what is happening to them, their income and livelihood are at risk, they are handed off to someone they do not know who works for a company they have never heard of, and everyone from the Doctor on down is too busy to answer their many, many questions. It is a recipe for litigation stew, and we are unfortunately excellent cooks. These misperceptions also encourage the disability mindset that we have spent so much time discussing of late .
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
Principal employers' obligations to Worker's Compensation Fund
Section 8 (1) of the Workers Compensation Act guides that where any person, in this section referred to as the principal, in the course of or for the purposes of that persons trade or business, contracts with any other person, in this section referred to as the contractor, for the execution by or under the supervision of the contractor, of the whole or any part of any work undertaken by the principal, any worker engaged on such work shall be deemed to be the worker of the principal unless and until the contractor in respect of the work has been assessed as an employer and has paid all assessments due to the fund. And any reference in this Act to the employer shall be deemed to be a reference to the principal. My readers may also wish to make reference to subsection (3) which guides that the principal shall ensure that any assessment for which the contractor is liable is paid and if the principal fails to do so, that principal shall be personally liable to pay the assessment. And the provisions of this Act with regard to enforcing assessments shall apply to the principal but that the principal shall be entitled to re-imbursement by the contractor of any sum paid out under this subsection. We normally invoke section 8 of the Act as a necessary corrective measure where it is found that an employer is circumventing the law, albeit this is usually one of the last enforcement options. We have brought out this information to guide organisations which may be deemed to be principal employers in order that measures to protect their business interests may be taken as far as they relate to compensation matters. This information is intended to meet needs of business organisations which may be contracting out portions of work without paying attention to workers compensation issues. Our revenue manager has advised that communication to this effect has been made with principal employers in the country and that the subject section will be invoked very soon. We therefore call on principal employers to take necessary measures to comply with the law in terms of their dealings with contractors and suppliers.
For the original version including any supplementary images or video, visit http://www.daily-mail.co.zm/features/22598