Author Archives: Edgar Romano

Medicaid Home Care Cuts Are Unjust, Lawsuit Says

Today’s post was shared by The Workers’ Injury Law & Advocacy Group and comes from www.nytimes.com

A federal class action lawsuit filed late Tuesday accuses New York State health officials of denying or slashing Medicaid home care services to chronically ill and disabled people without proper notice, the chance to appeal or even an explanation, protections required by law.

The lawsuit, filed in United States District Court for the Southern District of New York, names three plaintiffs: an impaired 84-year-old woman living alone in Manhattan, a frail 18-year-old Brooklyn man with severe congenital disabilities, and a 65-year-old Manhattan man with diabetes and a schizoaffective disorder. But it was brought by the New York Legal Assistance Group on behalf of tens of thousands of disabled Medicaid beneficiaries who need home health care or help with daily tasks like bathing and eating.

It represents a challenge to an ambitious Medicaid overhaul by Gov. Andrew M. Cuomo that shifted $6 billion in public spending on long-term services, including home care, to private managed care companies that are paid a fixed sum for each enrollee. The goal of the overhaul, which was set in motion in 2011, was saving money and improving the coordination of care. But advocates for aged and disabled people have complained that in the scramble for the most lucrative enrollees, companies are shunning frail people with the greatest needs and signing up those who could be given minimal services.

The lawsuit, filed against the state commissioners of the Department of Health and the Office of…

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Top 10 Careers For College Grads To Consider

Today’s post was shared by US Labor Department and comes from storify.com

Top 10 Careers For College Grads To Consider

As recent grads are hitting the job market, many are asking, "What career paths are offering the best opportunities for me right now?" All of these careers were selected based off of our Bureau of Labor Statistics’ data on median annual salary, current employment, projected growth through 2020.

byU.S. Department of Labor@usdol

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OFCCP Opening Doors General Audience Short

Today’s post was shared by US Labor Department and comes from www.dol.gov

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Occupational Disease: New Cancer Study and Firefighters

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

Worker’s compensation has provided benefits or coverage for occupational diseases for generations.  In Wisconsin an occupational disease is one acquired as a result of working in an industry over an extended period of time. An occupational disease cannot result from a single incident, but rather it is the result of a disease process. Wisconsin has not excluded any occupational diseases from its worker’s compensation benefit provisions. One of those disease processes is cancer. 

Studies are done regularly to determine the cause of disease as medical science advances. A recent study concludes that smoke and chemical exposure by firefighters may cause higher rates of cancer among firefighters. Firefighters, while usually healthier than the general population, have a higher incidence of cancer. A presumption of employment connected cancer exists for firefighters in Wisconsin. The statute applies to any State, County, or municipal firefighter who has worked for ten years with at least two-thirds of the working hours as a firefighter who has cancer of the skin, breast, central nervous system, or lymphatic, digestive, hematological, urinary, skeletal, oral, or reproductive symptoms. For that firefighter whose disability or death is caused by cancer, the finding is presumptive evidence that the cancer was caused by employment. Note, however, no presumption exists for firefighters who smoke cigarettes or use tobacco products for claims after January 1, 2001. Benefits for firefighters include Temporary Total Disability, Permanent Partial Disability, and if the disease (either heart or lung) precludes a return to work, duty disability payable at 75% of the firefighter’s salary, may also apply. 

As medicine and science evolve, there may be more recognized “occupational” diseases and more workers and their families compensated for harm caused by the workplace.

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“No Trauma” Does Not Mean No Injury

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

I’ve been investigating Wisconsin and national fraud statistics in worker’s compensation to prepare for a national presentation I am making in Cape Cod in July. One fascinating and recurring basis for denial of worker’s comp claims (and potential claims against employees for fraud) stems from an insurance carrier’s review of the initial medical report.

Often the physician or emergency room nurse, physicians assistant or First Responder will ask an injured worker “Did you have any trauma?” If the answer to the question is “no”, the medical records will routinely indicate “no trauma”. This information is translated by the insurance carrier as a denial that an injury occurred. The level of medical sophistication for an injured worker is routinely limited. Most of my clients (and based on inquiries with other workers’ attorneys, their clients as well) believe a trauma is something akin to getting hit by a bus. They do not equate the notion of trauma with lifting a heavy object such as a table or a box. The criteria for traumatic injuries in most states, including Wisconsin, is that a single incident or episode caused the injury or aggravated a pre-existing condition beyond a normal progression. In many cases a lack of “traumatic injury” at the initial medical presentation is not an accurate indication of whether a traumatic injury actually occurred.

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What Money Can’t Buy

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

Michael J. Sandel, a professor of government at Harvard, has written an insightful book called What Money Can’t Buy: The Moral Limits of Markets (2012) about the “for-sale” sign that applies to almost everything that has value, from sky boxes in football stadiums to police cars in local communities. These days, everything seems to be fair game. For example, a woman allowed her forehead to be tattooed with a brand name for $10,000. Even the tattoo artist tried to talk her out of it.

Are there any moral limits on what corporations can buy, and what the public is willing to sell? Have we entered a great divide where corporate sponsors sit in heated sky boxes while the rest of us shiver during a heavy snow fall at a football game? Are we losing that sense of community of shared experiences?

Sandel summarizes the problem as follows: “Democracy does not require perfect equality, but it does require that citizens share in a common life. What matters is that people of different backgrounds and social positions encounter one another, and bump up against one another, in the course of everyday life. This is how we learn to negotiate and abide our differences, and how we come to care for the common good.”

Somewhere along the way we (as a community, state and nation) have to decide whether we will continue to be polarized or whether we will work together for the common good. How we make that decision will determine our fate over the next several decades.

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Workers’ Compensation May Cover Weight Loss Treatment, Surgery

Gastric bypass is one type of weight loss surgery

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

Obesity is a disease that affects Americans in many ways.

Workers’ compensation is affected by obesity as well. A work injury or disease, coupled with chronic obesity, frequently becomes much more difficult to deal with. The usual methods of treatment may not be possible for an injured worker living with chronic obesity. 

Thomas A. Robinson, a noted expert on workers’ compensation, recently posted a great discussion on obesity treatment. The well-written article discusses how various state workers’ compensation systems deal with these problems. The short answer is some states award benefits for treating obesity as part of the work injury, and some don’t. Nebraska and Iowa have cases denying gastric bypass surgery based on factual findings that it was not necessary to treat the work injury, but leaving to door open with more proof of medical necessity. 

Our firm has had at least one case where gastric bypass surgery was paid voluntarily when it was apparent the surgery was necessary to enable proper treatment of a serious work injury. A workers’ compensation trial award was entered in early January awarding gastric bypass surgery as necessary to reduce weight so a back surgery could be performed safely. This award reinforces that with proof of medical necessity to treat a work injury, weight loss treatment and surgery may be covered by workers’ compensation in Nebraska.

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Are Firefighter Cancer Deaths an Occupational Disease?

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

Workers’ compensation has provided benefits or coverage for occupational diseases for generations. Occupational disease is defined by Nebraska law as: “a disease which is due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation, process, or employment and excludes all ordinary diseases of life to which the general public is exposed.” This is a typical definition of an occupational disease. Some examples of recognized occupational diseases are black lung disease for miners, mesothelioma for asbestos workers, lung disease for rubber workers, and leukemia for workers exposed to benzene.  

More studies are done to determine the cause of diseases as medical science advances. A recent study concludes that smoke and chemical exposure by firefighters may cause higher rates of cancer among firefighters. Firefighters, while usually healthier than the general population, have a higher incidence of cancer. More studies need to be done to determine if the peculiar exposure to smoke causes or aggravates cancer.

As medicine and science evolve, there may be more recognized “occupational diseases” and more workers and their families compensated for harm caused by the workplace.

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