Author: WorkCompAcademy

Workers’ compensation benefits as a share of payroll for injured workers continue to decline even as employment grows and overall employer costs increase, according to a new report from the National Academy of Social Insurance.

Historically, cash benefits have been a larger share of workers’ compensation benefits than medical payments to injured workers. Due to rising health care costs during the last 30 years, medical benefits now account for an increasing share of total workers’ compensation benefits, from 29 percent in 1980 to more than 50 percent in 2013. About 33 states currently spend more than half of their workers’ compensation spending on medical care for injured workers. California pays 54.7% of costs as medical benefits.

Despite the growth in employment following the Great Recession – and the significant uptick in employees eligible to receive workers’ compensation – benefits per $100 of covered payroll dropped to $0.98 in 2013, a 5 percent decrease from 2009. At the same time, the growing workforce has translated into rising workers’ compensation costs for employers – now $1.37 per $100 of covered payroll, a 5 percent increase from 2009.

Workers’ compensation benefits as a share of payroll were lower in 2013 than during almost any period in the last three decades, according to the report Workers’ Compensation: Benefits, Coverage, and Costs, 2013. Total workers’ compensation benefits in 2013 were $63.6 billion, while employer costs were $88.5 billion.

Benefits as a percent of payroll declined in 39 states between 2009 and 2013, continuing a national trend in lower benefits relative to payroll that began in the 1990s. “The decline is due to a drop in workplace injuries as well as changes in many state laws that made it more difficult for workers’ to qualify for benefits,” said John F. Burton, Professor Emeritus, Rutgers and Cornell University. “These state laws include more stringent compensation rules, the reduction of coverage for certain medical diagnoses, and new legal requirements that make it more difficult for workers to succeed in their claims for benefits.”

Years of construction fraud and grand theft by scamming consumers out of thousands of dollars for asphalt driveway paving work will keep Alexander Pike Mitchell behind bars at least two additional years. Mitchell, who has a history of contracting without a license and abandoning jobs once he’s secured a down payment, pled guilty to three additional felony grand theft counts (Penal Code §487a) with a Harvey Waiver* on all dismissed accounts in Riverside Superior Court. Under a Harvey Waiver, the offender is required to pay restitution on all counts connected with the plea. Restitution orders are to be imposed based on the victim’s losses and benefits paid by the Victim Compensation Program.

The Contractors State License Board (CSLB) added Mitchell to its Most Wanted List in April 2013 after the San Diego County District Attorney’s Office issued a warrant for his arrest that included five counts of grand theft, diversion of funds, and two counts of elder abuse. Mitchell was suspected of scamming consumers in Santa Clara, Santa Cruz, Riverside, and San Diego counties.

On June 17, 2013, Mitchell pled guilty to two counts of grand theft in San Diego County Superior Court and agreed to pay victim restitution. He received a four-year sentence with a 50/50 split of the time, meaning he must serve two years in San Diego County Jail and two years on mandatory supervision. He was ordered to pay $9,300 in victim restitution in that case.

Shortly after that ruling, an additional 40-month state prison sentence was added to the term he already was serving for theft by false pretenses, operating without a contractor license with prior convictions, and a workers’ compensation insurance violation. Overall, Mitchell has been sentenced to serve a total of nine years and four months for all of his convictions.

“CSLB investigators find unscrupulous people like Alex Pike Mitchell every day,” said CSLB Registrar Cindi Christenson. “This is why we encourage everyone to check our website or call our toll-free line to make sure any contractor you’re considering is licensed and in good standing with CSLB.”

CSLB’s Most Wanted List was created as an added measure to protect California consumers from dishonest operators.

53 year old Marc Terbeek, an Oakland workers compensation attorney, is allegedly involved in a massive corruption case filed by the FBI’s Public Corruption and Civil Rights Squad and unsealed this week. What is known are allegations only and are not considered to be true until proven in a court of law. The FBI and IRS raided Terbeek’s office in January 2015 and since then he has been cooperating with investigators.Tarbeek has been informed by the US Attorney that he is also a target of the investigation and is “likely to be prosecuted.” The sworn Affidavit signed by FBI Special Agent Roahn Wynar attached to the criminal complaint against Daniel Rush, a cannabis union leader who faces serious federal charges involving bribery and other matters, claims the following scenario occurred.

Daniel Rush was an official with the United Food and Commercial Workers Union that had established a “Cannabis Division” to organize dispensary employees. He was also closely involved in Measure D, the process to regulate medical marijuana dispensaries in Los Angeles, and also connected to legalization’s most prominent pitchman: Lt. Gov. Gavin Newsom.

Rush got in over his head in 2010 when he borrowed $600,000 from Martin Kaufman, a dispensary operator that he could not pay back. In 2014, Rush and workers’ compensation attorney Tarbeek who represented some of the dispensary companies in the area “took steps” to provide “labor benefits” to Kaufman in exchange for forgiveness of the debt. Carl Anderson had an Oakland pot club until 2005, and wanted a new permit in 2010. Anderson tapped Rush and Terbeek for help with the application. Andersen is also cooperating with the FBI.

According to the allegations of paragraph 31 of the Affidavit , Tarbeek admitted to the FBI that he had been paying “kickbacks” to Rush for sending Terbeek legal work since 2004. Rush “encouraged” Terbeek to acquire a workers compensation law practice to litigate cases referred by the Insitutio Laboral de la Raza. In exchange Tarbeek gave Rush a credit card associated with Terbeek’s law firm and Terbeek paid it off routinely. Text messages confirmed this practice continued as late as February 2015. From 2010 to 2015, Rush spent $110,000 on Terbeek’s card, about $2,000 per month, for mostly personal expenses.

Also, Terbeek allegedly agreed to share legal fees with Rush derived from Terbeek’s clients seeking permits to operate dispensaries in California, Nevada, and beyond (Affidavit paragraph 34). After creation of this arrangement, Terbeek paid Rush $5000 as his “share” of the medical marijuana legal fees.

It is likely that this case will become more complex and involve higher level accomplices as it evolves. Only Rush has been charged so far, and others are “cooperating” with authorities, meaning providing information that will lead the FBI on with a complex investigation. The union claims it has fired Rush.

NBC News reports that Bumble Bee Foods will pay $6 million for the 2012 death of an employee who was cooked in an industrial oven with tons of tuna – the biggest settlement ever in a California for workplace safety violations involving a single victim.

Jose Melena, 62, was loading a 35-foot-long oven at the company’s Santa Fe Springs plant before dawn Oct. 11, 2012, when a co-worker, who mistakenly believed Melena was in the bathroom, filled the pressure cooker with 12,000 pounds of canned tuna and it was turned on. His body was found two hours later after the pressure cooker, which reached 270 degrees, was turned off and opened.

The state report, which was filed with the National Institute for Occupational Safety and Health, said the manned oven system was inherently dangerous, finding that the chain that pulls carts of tuna into the ovens would sometimes get snagged, requiring operators to enter the ovens to pull the carts through.

Los Angeles County District Attorney Jackie Lacey said Bumble Bee will pay $3 million to replace all of its outdated tuna ovens with automated ovens and will never require workers to set foot inside the super-heated, pressurized steam cookers. The company will also pay $1.5 million in restitution to Melena’s family, and it will pay the district attorney’s Environmental Enforcement Fund $750,000 for workplace safety programs and $750,000 in fines, penalties and court costs.

In addition, Saul Florez, Bumble Bee’s former safety manager, pleaded guilty to a felony count of willfully violating lockout rules and indirectly causing Melena’s death. He was sentenced to three years’ probation, ordered to complete 30 days of community labor and assessed $19,000 in fines and penalties.

And another co-defendant, Angel Rodriguez, Bumble Bee’s director of plant operations, will be allowed to plead guilty to a misdemeanor in 18 months if he completes 320 hours of community service, pays $11,400 in fines and takes classes on confined space rules.

The National Association of Insurance Commissioners (NAIC) is ratcheting up its efforts to tackle cybersecurity issues. Following up on its adoption of Guiding Principles for Cybersecurity this spring and developing new reporting requirements for insurers to better track cyber insurance policies issued in the marketplace, the NAIC is moving forward with three additional initiatives designed to help protect consumer information and educate the public about cyber risks. The three NAIC initiatives are:

1) The NAIC’s Cybersecurity Task Force released a Consumer Cybersecurity Bill of Rights draft was released for public comment. The bill of rights is intended to set standards for helping consumers if their personal information is compromised. The Task Force expects to adopt these standards this summer;
2) The Cybersecurity Task Force is also coordinating with state insurance regulators to conduct examinations of insurance companies to verify companies are taking appropriate steps to protect sensitive data, including confidential personal information;
3) The NAIC is co-sponsoring a forum with the Center for Strategic and International Studies (CSIS) on September 10 in Washington, D.C., entitled “Cyber Risk Management and Insurance.” Cyber experts, policymakers and business leaders will discuss cyber risks faced by American businesses and consumers, and how best to manage those risks.

“Ramping up our efforts in this critical area will help state insurance departments better address both the threat and responses to cyber breaches,” said Monica J. Lindeen, NAIC President and Montana Insurance Commissioner. “Understanding what regulators, consumers and companies can do to craft best practices will help minimize the impact on insurance consumers and the insurance industry in the long-term.”

“Since before the first major breach of an insurer, the NAIC has been at the forefront of cyber issues,” said Adam Hamm, North Dakota Insurance Commissioner and Cybersecurity Task Force Chair. “We will continue our work at the NAIC to protect consumers and support efforts to improve cybersecurity in the insurance sector.”