Category: Daily News

An Adelanto man who claimed he was bitten by a pit bull and injured while working as a cable installer has been charged with felony workers’ compensation fraud.

On March 27, 2008, Dario Rudas-Ortega, 53, reported that he had sustained an injury during the course of his employment. According to Senior Investigator Hector Vidal, Rudas-Ortega claimed he was bitten by a pit bull on his hands and forearms, and later alleged he sustained a left knee injury during the same attack. “Rudas-Ortega is charged with making a false statement in support of this claim for benefits, as well as failing to disclose information regarding his prior medical condition and prior medical treatment to the same body part,” Vidal said. It is alleged that as a result of his false statements and omissions, Rudas-Ortega received workers’ compensation benefits to which he was not entitled.

The case was referred to the San Bernardino County District Attorney’s Worker’s Compensation Fraud Unit in 2012 by the Zenith insurance company, after the company’s internal investigation concluded that false statements were made.Felony charges were filed April 14, 2014 (see attached complaint), and Rudas-Ortega was taken into custody by District Attorney Investigators and transported to West Valley Detention Center in Rancho Cucamonga where he was released on his own recognizance.

If convicted on all counts, Rudas-Ortega faces more than five years in County Prison. Arraignment is scheduled for June 19 in San Bernardino Superior Court. The case is being prosecuted by Deputy District Attorney David Simon of the Workers’ Compensation Insurance Fraud Unit.

Mobile medicine is helping chronic pain patients cope with and manage their condition thanks to new smartphone apps, which can track patients from a distance and monitor pain, mood, physical activity, drug side effects, and treatment compliance.

According to Robert Jamison, PhD, professor of anesthesia and psychiatry at Harvard Medical School and pain psychologist with Brigham and Women’s Hospital, smartphone apps are helping the shrinking ranks of pain specialists treat and monitor rapidly increasing populations of chronic pain sufferers. “Today the ratio is one pain specialist for every 10,000 patients, but mobile technology allows for easy time-effective coverage of patients at a low cost, offering significant opportunities to improve access to health care, contain costs, and improve clinical outcomes,” Jamison explained.

At the American Pain Society annual meeting, Jamison presented results of his research on smartphone apps, developed at Brigham and Women’s, for monitoring pain patients. He found that internet-based cognitive behavioral therapy could significantly decrease pain levels, improve function, and decrease costs compared to standard care.  “Online networks, for example, can promote communication, distraction, information sharing, self expression and social support,” Jamison said.  “We also believe online networks decrease feelings of withdrawn behavior and instill a greater willingness to return for treatment.” Jamison added that electronic diaries maintained by patients are more effective than paper diaries for evaluating pain levels, daily activities, treatment compliance and mood. Jamison said that while few studies have been conducted on text messaging as a pain management tool, texting has proven to be effective for managing patients with diabetes, hypertension, asthma, smoking cessation and weight loss.

In his ongoing research, Jamison is studying 60 patients with chronic cancer and non-cancer pain who use a pain management smartphone app. “We hypothesized that the pain management smartphone app will help providers track patients and reduce emergency department visits and hospitalizations by 50 percent,” said Jamison.

A key feature of the pain management app is daily pain tracking in which patients are asked five questions about their pain, activity interference, sleep, mood, and overall status on a sliding scale of 1 to 10, and compare these with baseline ratings. Should pain ratings significantly increase from baseline or reach 9 or 10, the patient gets an immediate response that the pain specialist has been contacted.  “The pain management smartphone app can deliver non-pharmacological, cognitive behavioral treatment as well as prompt patients to stay active, comply with therapy, and develop pain coping skills,” Jamison reported. He added that the smartphone data can be summarized and transmitted every day into the patient’s electronic medical record.

Jamison noted that the average response rate to text messages to pain patients is 70 to 90 percent and that high responders show improved pain levels.

U.S. doctors said on Wednesday they have succeeded in coaxing the regeneration of muscle tissue lost in people who suffered traumatic injuries, including wartime bomb wounds, with a new type of treatment that uses material from a pig’s bladder. Implanting the pig material at the wound site enticed the patient’s own stem cells – master cells that can transform into various kinds of cells in the body – to become muscle cells and regenerate tissue that had been lost, the researchers said.

According to the report in Reuters Health, the study was small, involving only five male patients, but its results suggested that this procedure could offer new hope to a category of patients, including troops who suffered major war injuries, with scant good treatment options, they added. All five patients, including two U.S. soldiers hurt by bombs planted by insurgents, had badly damaged leg muscles. The research was backed by $3 million in funding over five years from the U.S. Defense Department, said Dr. Stephen Badylak of the University of Pittsburgh, who led the study.

Thousands of American troops have been left with serious physical impairments after sustaining wounds involving major loss of muscle tissue in roadside bombings and other incidents since 2001 in the wars in Iraq and Afghanistan. When a large amount of muscle is lost in vehicle crashes, industrial accidents, bomb blasts or other traumas, the body is unable to replace it and the site forms scar tissue that lacks the functionality of the lost muscle.

Existing treatments include surgery to remove scar tissue or replace it with muscle from somewhere else in the body, but these methods do not yield satisfying results and are hard on patients, the researchers said. “Nothing has ever worked. There’s been multiple things tried: the hype and the hope of stem cell therapy, new surgical techniques,” Badylak said.

This study, published in the journal Science Translational Medicine, demonstrated for the first time the regeneration of functional muscle tissue in people with major muscle loss. “While the number of patients was small, we were very encouraged by the data. And we were seeing very dramatic improvements in quality of life for some of our patients,” added Dr. J. Peter Rubin of the University of Pittsburgh School of Medicine, another of the researchers.

The doctors implanted material from a pig’s urinary bladder called “extracellular matrix” – the non-cellular component including collagen present within all tissues and organs – to serve as scaffolding for the rebuilding of lost muscle mass. This material acted as a “homing device” to recruit existing stem cells in the body to rebuild healthy muscle tissue at the site of the injury, the researchers said.Pig parts have been used for years in surgical procedures. Pig bladder “extracellular matrix” has been used in hernia repair and fixing chest wall defects after cancer removal.

Before trying the procedure in people, the researchers said they successfully tested it in mice with muscle injuries.

The voluminous report on state (and Canadian province) workers compensation benefits was issued Wednesday by the Massachusetts-based Workers Compensation Research Institute and the International Association of Industrial Accident Boards and Commissions. While the report covers all cash, medical and therapy benefits, the disparity between California and other states in “permanent partial” disabilities is particularly evident and could fuel the Capitol’s perennial political jousting over workers compensation costs and benefits.

The debate almost always focuses on the “permanent partial” aspect of the multi-billion-dollar, employer-financed program because it is the most prevalent and cumulatively most expensive of the various benefits.

Roughly once a decade, the Legislature overhauls the multi-billion-dollar system, and it last occurred in 2012 as employers and labor unions combined forces. The 2012 bill raised cash benefits but tightened other aspects of the program enough to offset the cost of the benefit increase.

Even so, it set a $290 per week maximum (as of this year) for workers deemed to have “permanent partial” disabilities in California. The new report indicates that it’s lower than those of all but two other states, Alabama and Rhode Island.

“Permanent partial” benefits are as high as $1,441.80 per week in Washington, D.C., and $1,419 in Iowa.

The report is available only by purchase here.

Travelers will more than double its network of patented ConciergeCLAIM(R) Nurse sites to 30 locations across the United States, helping facilitate convenient access to care for injured employees with the personal assistance of a Travelers nurse to guide them through the workers compensation process.

Placing a Travelers nurse in a care provider’s clinic makes it easier for patients to focus on their treatment and return to work, while the nurse helps patients understand the workers compensation system, reviews their diagnosis and treatment plan and assists with referrals and other components of their care regimen.

“Businesses of all sizes face increases in medical expenses as a portion of their overall loss costs, particularly in workers compensation,” said Jim Wucherpfennig, Vice President of Travelers’ workers compensation claim services. “Increased demands on the healthcare system, an aging population and a limited supply of physicians could mean increased time out of work for injured workers because of longer waits to access medical care. The local and responsive nature of the ConciergeCLAIM Nurse program helps employees return to work sooner and reduces employers’ workers compensation-related costs.”

ConciergeCLAIM Nurse is part of Travelers Medical Advantage(SM) . This multifaceted program packages more than a decade of investments in infrastructure, specialized expertise, and data and analytics to effectively manage medical costs for Travelers’ customers across all casualty lines of business, including workers compensation, general liability and auto.

Travelers initially conducted a pilot of the ConciergeCLAIM Nurse program in 2010 and steadily opened additional sites in recent years in order to assess the model’s long-term sustainability and effectiveness. Early results achieved in the first phase of the program were impressive, including a 24 percent quicker return-to-work time for injured employees, a 29 percent increase in the use of network care providers, and five percent reduction in loss costs for employers.

The Association of American Medical Colleges (AAMC) projects that the aging population and influx of newly insured individuals under the Affordable Care Act will contribute to an expected shortage of nearly 92,000 physicians by 2020. Stationing Travelers nurses within local care provider’s clinics streamlines the entire process, from assessing the injury and helping arrange for care on-site within the clinic or with other in-network medical providers, to providing assistance navigating the workers compensation claim process.

Wucherpfenning added, “Helping an injured employee navigate the workers compensation process is a huge benefit. A more personalized approach can help drive better health outcomes and simplify the claim process for both the injured worker and their employer.”