Months of heavy lobbying by the National Football League and other professional sports team owners paid off when lawmakers gave final passage to a bill to limit most workers' compensation claims by out-of-state professional athletes.
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.
The Los Angeles Times says that last week, the measure received an overwhelming endorsement in the state Senate with a 34-2 vote. Perea's proposal, which was opposed by the NFL Players' Assn. and the AFL-CIO, would close a provision in California law that allowed players from out of state to file workers' compensation claims for so-called cumulative trauma, including head injuries that manifested themselves years after their careers had ended.
Many of those players may have participated in just a handful of games in California over the course of their careers.
During the bill's eight-month transit through the Legislature, team owners argued that California had become a de facto forum for claims filed against football, baseball, basketball, hockey and soccer franchises and their insurance companies.
Players unions countered that the employers don't want to be responsible for their former workers' head injuries and other ailments.
Former athletes have filed more than 4,400 claims involving head and brain injuries since 2006. This bill would not affect pending claims. Provisions that initially would have had a retroactive effect were removed by a September 5 amendment to the bill. The bill now contains language in paragraph 3600.5 (h) tat says "the amendments made to this section by the act adding this subdivision apply to all claims for benefits pursuant to this division filed on or after September 15 2013." The previous version of the bill had provisions that would have applied retroactively to all pending claims not yet adjudicated. Thus thousands of these claims already in the system will continue to move forward.
Pundits say that Governor Brown will sign this bill into law. The governor has until Oct. 13 to sign or veto the bill ...
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.
The Los Angeles Times says that last week, the measure received an overwhelming endorsement in the state Senate with a 34-2 vote. Perea's proposal, which was opposed by the NFL Players' Assn. and the AFL-CIO, would close a provision in California law that allowed players from out of state to file workers' compensation claims for so-called cumulative trauma, including head injuries that manifested themselves years after their careers had ended.
Many of those players may have participated in just a handful of games in California over the course of their careers.
During the bill's eight-month transit through the Legislature, team owners argued that California had become a de facto forum for claims filed against football, baseball, basketball, hockey and soccer franchises and their insurance companies.
Players unions countered that the employers don't want to be responsible for their former workers' head injuries and other ailments.
Former athletes have filed more than 4,400 claims involving head and brain injuries since 2006. This bill would not affect pending claims. Provisions that initially would have had a retroactive effect were removed by a September 5 amendment to the bill. The bill now contains language in paragraph 3600.5 (h) tat says "the amendments made to this section by the act adding this subdivision apply to all claims for benefits pursuant to this division filed on or after September 15 2013." The previous version of the bill had provisions that would have applied retroactively to all pending claims not yet adjudicated. Thus thousands of these claims already in the system will continue to move forward.
Pundits say that Governor Brown will sign this bill into law. The governor has until Oct. 13 to sign or veto the bill ...
Huntington Park resident Rosa Maria Barajas, the wife of injured worker Jesus Barajas, was arrested for allegedly continuing to cash workers' compensation structured settlement benefits after her injured husband died. She was receiving approximately $18,000 per month, each month after his death in May 2010.
Jesus Barajas suffered an industrial accident in October of 1997 when he fell from a scaffold while working for Aramark Uniform Services. As a result of his accident and serious injuries, Jesus was comatose and declared legally brain dead. Due to his condition, Rosa was appointed his legal guardian in April of 1998 by the Workers' Compensation Appeals Board and placed in charge of all his financial dealings and pending workers' compensation suit.
New York Life contacted the California Department of Insurance in January of 2013 to report that Barajas was continuing to collect on her deceased husband's workers' compensation structured settlement. Barajas had been receiving monthly payments of over $18,000 that would continue only while Jesus Barajas was alive according to the September 2000 Workers' Compensation Appeals Board Order. As part of the agreement Rosa Barajas was directed to notify New York Life in the event of the demise of her husband, but according to the investigators she failed to do so when Jesus Barajas died in May of 2010.
Bail has been set at $505,341. If convicted, Barajas faces up to five years in state prison and a fine in excess of $500,000 ...
Jesus Barajas suffered an industrial accident in October of 1997 when he fell from a scaffold while working for Aramark Uniform Services. As a result of his accident and serious injuries, Jesus was comatose and declared legally brain dead. Due to his condition, Rosa was appointed his legal guardian in April of 1998 by the Workers' Compensation Appeals Board and placed in charge of all his financial dealings and pending workers' compensation suit.
New York Life contacted the California Department of Insurance in January of 2013 to report that Barajas was continuing to collect on her deceased husband's workers' compensation structured settlement. Barajas had been receiving monthly payments of over $18,000 that would continue only while Jesus Barajas was alive according to the September 2000 Workers' Compensation Appeals Board Order. As part of the agreement Rosa Barajas was directed to notify New York Life in the event of the demise of her husband, but according to the investigators she failed to do so when Jesus Barajas died in May of 2010.
Bail has been set at $505,341. If convicted, Barajas faces up to five years in state prison and a fine in excess of $500,000 ...
Edward Frazier, a peace officer with the Department of Corrections, had a presumptive (L.C. 3212.1 0) industrial heart trouble with diagnosed hypertensive heart disease accompanied by mild left ventricular hypertrophy.
The AME, Dr. Ng, provided an analysis that in his opinion that under the American Medical Association Guides to the Evaluation of Permanent Impairment, Fifth Edition,Table 4-2, (Criteria for Rating Permanent Impairment Due To Hypertensive Cardiovascular Disease AMA 5lh edition) would require a finding that he has a 30% Whole Person Impairment. l
However, the AME was of the opinion that this WPI while appropriate is not an accurate representation of the injured worker's impairment. Doctor Ng referred to the new AMA Guides 6th Edition as a "standard text or recent research data" to support his conclusion that 30%WPI was too high. He concluded the writers of this recent publication decided that the 30% WPI was too high for asymptomatic mild ventricular hypertrophy. The 6th edition he states shows that for a gentleman with the same mild left ventricular hypertrophy an impairment of 23% WPI is recommended. He concludes that the authors of the AMA guides sixth edition have recognized the accuracy problem (in the 5th edition) and reduced the whole person impairment to a rating of 24% for left ventricular hypertrophy. By inference it is his clinical judgment this lower WPI is more accurate.
In conclusion the AME chose 24% as the most accurate description of this injured workers impairment. This percentage was a combination of his consideration of the analysis of the writers of the AMA 6th edition, his clinical judgment as well as his analogizing with the Coumadin paragraph 9.6C of the AMA 5th edition which has a lower impairment for asymptomatic conditions with serious health risks.
The 24% impairment after the formal rating resulted in a permanent partial disability of 44% which was awarded by the WCJ.
The WCAB denied reconsideration in the panel decision of Edward Frazier v State of California, CDCR - Correctional Training Facility ...
The AME, Dr. Ng, provided an analysis that in his opinion that under the American Medical Association Guides to the Evaluation of Permanent Impairment, Fifth Edition,Table 4-2, (Criteria for Rating Permanent Impairment Due To Hypertensive Cardiovascular Disease AMA 5lh edition) would require a finding that he has a 30% Whole Person Impairment. l
However, the AME was of the opinion that this WPI while appropriate is not an accurate representation of the injured worker's impairment. Doctor Ng referred to the new AMA Guides 6th Edition as a "standard text or recent research data" to support his conclusion that 30%WPI was too high. He concluded the writers of this recent publication decided that the 30% WPI was too high for asymptomatic mild ventricular hypertrophy. The 6th edition he states shows that for a gentleman with the same mild left ventricular hypertrophy an impairment of 23% WPI is recommended. He concludes that the authors of the AMA guides sixth edition have recognized the accuracy problem (in the 5th edition) and reduced the whole person impairment to a rating of 24% for left ventricular hypertrophy. By inference it is his clinical judgment this lower WPI is more accurate.
In conclusion the AME chose 24% as the most accurate description of this injured workers impairment. This percentage was a combination of his consideration of the analysis of the writers of the AMA 6th edition, his clinical judgment as well as his analogizing with the Coumadin paragraph 9.6C of the AMA 5th edition which has a lower impairment for asymptomatic conditions with serious health risks.
The 24% impairment after the formal rating resulted in a permanent partial disability of 44% which was awarded by the WCJ.
The WCAB denied reconsideration in the panel decision of Edward Frazier v State of California, CDCR - Correctional Training Facility ...
Steroid shots for carpal tunnel syndrome may help some sufferers in the short term, but most people end up having surgery whether or not they get the shots, according to a small new study reported by Reuters Health.
Researchers in Sweden found that one year after diagnosis, three quarters of carpal tunnel patients who tried steroid shots and other treatments first had opted for surgery while more than 90 percent of those who did not get the shots had the surgery. "We did not know how effective steroid injections are so we were not expecting any particular result," said lead author Dr. Isam Atroshi of Hässleholm Hospital.
According to this study, steroids usually don't help enough to avoid surgery, which is "somewhat surprising" since many doctors routinely order the shots, Atroshi told Reuters Health. It's estimated that one in 20 adults in the U.S. will experience carpal tunnel syndrome, as a result of pressure on the median nerve that runs from the arm into the hand, through the so-called carpal tunnel formed by bones and ligaments of the wrist. If ligaments forming the tunnel, or tendons that also run through the tunnel, become swollen, pressure on the nerve can cause tingling, weakness or pain in the wrist and hand. The condition, which can affect one or both hands, is initially treated with wrist splints, then if rest doesn't bring improvement, with steroid shots. When neither splints nor steroids seem to help, the next step is surgery, an effective but costly remedy.
Atroshi and his coauthors gave injections of 80 milligrams methylprednisolone, or 40 milligrams of the steroid or a dummy shot to 111 carpal tunnel syndrome patients between 18 and 70 years old who had already tried wrist braces with no luck. Ten weeks later, patients who had received the steroids were less likely to report pain, numbness or tingling than those who got a placebo. At the one-year mark, however, 73 percent of the patients who got the 80 mg steroid shots had the surgery, as did 81 percent of patients who got the lower steroid dose and 92 percent of those who had a placebo shot. Though patients who got the highest dose of steroids were less likely to have surgery by one year, there were no differences between the three groups in reported pain at that point, according to the results published in the Annals of Internal Medicine.
Complications are unlikely with either treatment, Atroshi said. "Surgery is effective because, by dividing the ligament that forms the roof of the tunnel, or ‘opening' the carpal tunnel, there will be a rapid dramatic decrease in the pressure and symptom relief, and the effect is usually durable," he said.
The cause of carpal tunnel syndrome is not completely known, but it's not surprising that surgery is more effective than shots, according to Dr. Charles Leinberry, a hand surgeon at the Rothman Institute in Philadelphia. Steroids temporarily reduce local swelling and relieve pressure in the tunnel, but surgery actually makes the tunnel bigger and is a permanent solution, said Leinberry, who was not involved in the study. "Surgery adds approximately 25 percent to the volume of the carpal tunnel area and provides more room for the tendons and nerves present in the tunnel," he said.
Experts didn't think the new study's results would change the way carpal tunnel syndrome is treated. Most doctors first recommend splints, which can be very effective when used early, and take a medical image of the wrists to determine how severe the diseases is, Leinberry said. Steroids can help control pain for a short while if the disease is not severe, but can probably be skipped if the carpal tunnel syndrome is severe and requires surgery, he said ...
Researchers in Sweden found that one year after diagnosis, three quarters of carpal tunnel patients who tried steroid shots and other treatments first had opted for surgery while more than 90 percent of those who did not get the shots had the surgery. "We did not know how effective steroid injections are so we were not expecting any particular result," said lead author Dr. Isam Atroshi of Hässleholm Hospital.
According to this study, steroids usually don't help enough to avoid surgery, which is "somewhat surprising" since many doctors routinely order the shots, Atroshi told Reuters Health. It's estimated that one in 20 adults in the U.S. will experience carpal tunnel syndrome, as a result of pressure on the median nerve that runs from the arm into the hand, through the so-called carpal tunnel formed by bones and ligaments of the wrist. If ligaments forming the tunnel, or tendons that also run through the tunnel, become swollen, pressure on the nerve can cause tingling, weakness or pain in the wrist and hand. The condition, which can affect one or both hands, is initially treated with wrist splints, then if rest doesn't bring improvement, with steroid shots. When neither splints nor steroids seem to help, the next step is surgery, an effective but costly remedy.
Atroshi and his coauthors gave injections of 80 milligrams methylprednisolone, or 40 milligrams of the steroid or a dummy shot to 111 carpal tunnel syndrome patients between 18 and 70 years old who had already tried wrist braces with no luck. Ten weeks later, patients who had received the steroids were less likely to report pain, numbness or tingling than those who got a placebo. At the one-year mark, however, 73 percent of the patients who got the 80 mg steroid shots had the surgery, as did 81 percent of patients who got the lower steroid dose and 92 percent of those who had a placebo shot. Though patients who got the highest dose of steroids were less likely to have surgery by one year, there were no differences between the three groups in reported pain at that point, according to the results published in the Annals of Internal Medicine.
Complications are unlikely with either treatment, Atroshi said. "Surgery is effective because, by dividing the ligament that forms the roof of the tunnel, or ‘opening' the carpal tunnel, there will be a rapid dramatic decrease in the pressure and symptom relief, and the effect is usually durable," he said.
The cause of carpal tunnel syndrome is not completely known, but it's not surprising that surgery is more effective than shots, according to Dr. Charles Leinberry, a hand surgeon at the Rothman Institute in Philadelphia. Steroids temporarily reduce local swelling and relieve pressure in the tunnel, but surgery actually makes the tunnel bigger and is a permanent solution, said Leinberry, who was not involved in the study. "Surgery adds approximately 25 percent to the volume of the carpal tunnel area and provides more room for the tendons and nerves present in the tunnel," he said.
Experts didn't think the new study's results would change the way carpal tunnel syndrome is treated. Most doctors first recommend splints, which can be very effective when used early, and take a medical image of the wrists to determine how severe the diseases is, Leinberry said. Steroids can help control pain for a short while if the disease is not severe, but can probably be skipped if the carpal tunnel syndrome is severe and requires surgery, he said ...
The Imperial Valley Press claims that past behavior of City Council members of the city of Calexico has put the city in some hot water with the California Joint Powers Insurance Authority, which issued the city a warning letter earlier this year.
The California Joint Powers Insurance Authority is an organization that provides members with coverage such as liability protection, a workers’ compensation program, property insurance program and more.
In a letter to City Manager Oscar Rodriquez, California JPIA Assistant Executive Officer Norman A. Lefmann wrote, "It has come to our attention that members of the City Council may be inserting themselves into the interactive process for workers’ compensation claims which is inconsistent with good governance."
The California JPIA periodically reviews members’ risk management practices as part of the authority’s Loss Control Action Plan program. The city was evaluated in June 2009 and the action plan was presented in March 2010. However, "the city has made very little effort in reducing the number of action items," Lefmann wrote in the letter.
"We believe that good governance is about the City Council largely being policy setting in terms of their actions and concerns and to leave it to the city administration to manage the affairs of the operations, including hiring and firing employees, reviews of workers compensation injuries, how they respond to claims, etc," Lefmann explained. He did not cite any particular City Council member or specific action but said "when we see that the City Council is interfering with best practices and recruiting a police chief and creating potential divisiveness on who might replace the police chief," there’s "another concern as potential claims may arise."
The hiring of Police Chief Pompeyo Tabarez earlier this year was the end of a controversial hiring process that in many ways further divided the council.
Lefmann did say that the city has generally made a good effort to respond to the issues brought up and the city and the California JPIA is moving ahead to work more closely to address these kinds of concerns. Mayor Bill Hodge said Rodriquez has informed the council of the situation and "it has happened because of a series of incidents."
He specifically cited "a lot of workman’s compensation claims" and the sexual harassment claims filed by council member Maritza Hurtado against councilmen Luis Castro, Joong Kim and Hodge. He said he was "surprised" by the reference to the police chief selection process. "It was an option for us as council people to participate in selection of a new chief which we did but they’re citing that also," he said.
California JPIA representatives will be meeting with City Council members individually, he said, but added that he’s "not exactly sure what plans are to be carried out." ...
The California Joint Powers Insurance Authority is an organization that provides members with coverage such as liability protection, a workers’ compensation program, property insurance program and more.
In a letter to City Manager Oscar Rodriquez, California JPIA Assistant Executive Officer Norman A. Lefmann wrote, "It has come to our attention that members of the City Council may be inserting themselves into the interactive process for workers’ compensation claims which is inconsistent with good governance."
The California JPIA periodically reviews members’ risk management practices as part of the authority’s Loss Control Action Plan program. The city was evaluated in June 2009 and the action plan was presented in March 2010. However, "the city has made very little effort in reducing the number of action items," Lefmann wrote in the letter.
"We believe that good governance is about the City Council largely being policy setting in terms of their actions and concerns and to leave it to the city administration to manage the affairs of the operations, including hiring and firing employees, reviews of workers compensation injuries, how they respond to claims, etc," Lefmann explained. He did not cite any particular City Council member or specific action but said "when we see that the City Council is interfering with best practices and recruiting a police chief and creating potential divisiveness on who might replace the police chief," there’s "another concern as potential claims may arise."
The hiring of Police Chief Pompeyo Tabarez earlier this year was the end of a controversial hiring process that in many ways further divided the council.
Lefmann did say that the city has generally made a good effort to respond to the issues brought up and the city and the California JPIA is moving ahead to work more closely to address these kinds of concerns. Mayor Bill Hodge said Rodriquez has informed the council of the situation and "it has happened because of a series of incidents."
He specifically cited "a lot of workman’s compensation claims" and the sexual harassment claims filed by council member Maritza Hurtado against councilmen Luis Castro, Joong Kim and Hodge. He said he was "surprised" by the reference to the police chief selection process. "It was an option for us as council people to participate in selection of a new chief which we did but they’re citing that also," he said.
California JPIA representatives will be meeting with City Council members individually, he said, but added that he’s "not exactly sure what plans are to be carried out." ...
The California Department of Industrial Relations (DIR) announced that the Division of Workers’ Compensation’s Lien Fee Collection System for the Electronic Adjudication Management System (EAMS) has won a 2013 Digital Government Achievement Award.
"This award recognizes our dedicated staff’s use of innovative technology to create efficiencies in California’s workers’ compensation system while implementing the reforms of SB 863," said DIR Director Christine Baker.
"Allowing the public to access critical services without inconvenience continues to be one of our main goals," said DWC Acting Director Destie Overpeck. "This award is well deserved. Special thanks to OIS for helping to get this developed and implemented without a hitch."
The award was presented by the Center for Digital Government, a national research and advisory institute on information technology policies and best practices in state and local government. DIR was honored in the "Driving Digital Government" State Government category for its outstanding implementation of one of the directives in Senate Bill 863.
Among the changes SB 863 made to California’s workers’ compensation system was regarding the filing of liens. SB 863 mandated a fee for certain liens filed after January 1, 2013, and specified that these must be paid electronically. DWC and DIR’s Office of Information Services (OIS) added functionality to the EAMS public information search tool allowing lien filers to file liens and pay fees in one integrated process.
EAMS was developed in 2008 as a seamless case management process for different, but interrelated units of the workers’ compensation system. EAMS also allows external users to file documents over the Web and compiles information that helps move cases through the workers’ compensation court system without delay ...
"This award recognizes our dedicated staff’s use of innovative technology to create efficiencies in California’s workers’ compensation system while implementing the reforms of SB 863," said DIR Director Christine Baker.
"Allowing the public to access critical services without inconvenience continues to be one of our main goals," said DWC Acting Director Destie Overpeck. "This award is well deserved. Special thanks to OIS for helping to get this developed and implemented without a hitch."
The award was presented by the Center for Digital Government, a national research and advisory institute on information technology policies and best practices in state and local government. DIR was honored in the "Driving Digital Government" State Government category for its outstanding implementation of one of the directives in Senate Bill 863.
Among the changes SB 863 made to California’s workers’ compensation system was regarding the filing of liens. SB 863 mandated a fee for certain liens filed after January 1, 2013, and specified that these must be paid electronically. DWC and DIR’s Office of Information Services (OIS) added functionality to the EAMS public information search tool allowing lien filers to file liens and pay fees in one integrated process.
EAMS was developed in 2008 as a seamless case management process for different, but interrelated units of the workers’ compensation system. EAMS also allows external users to file documents over the Web and compiles information that helps move cases through the workers’ compensation court system without delay ...
The California Division of Workers’ Compensation (DWC) issued a notice reminding claims administrators that failure to provide a necessary interpreter at a medical treatment appointment may constitute a failure to provide medical treatment. Examples of a failure to provide medical treatment include a situation where the lack of an interpreter’s services prevents the exam from going forward or inhibits the injured worker’s ability to communicate with the primary treating physician. Such conduct could also result in penalties and/or sanctions against the claims administrator.
The notice goes on to say "It has come to DWC’s attention that some claims administrators are not responding timely to requests for provisional certification of interpreters, and not arranging for other interpreters to attend medical treatment appointments. As a result, some appointments are not going forward as scheduled."
Labor Code Section 4600(g) provides that injured workers who cannot communicate effectively in English with their primary treating physician are entitled to the services of a qualified interpreter at all medical treatment appointments.
"Qualified interpreters" for purposes of medical treatment appointments may be, but are not required to be, formally certified. They can be provisionally certified by agreement of the employer prior to providing interpreting services. Employers are not required to pay for the services of interpreters who are not formally or provisionally certified.
Interpreters certified for medical treatment appointments or medical legal exams qualify through successfully passing the Certification Commission for Healthcare Interpreters (CCHI) exam or by passing the National Board of Certification for Medical Interpreters (National Board). Interpreter services FAQs and information on recently approved interpreter services regulations are posted on DWC’s website ...
The notice goes on to say "It has come to DWC’s attention that some claims administrators are not responding timely to requests for provisional certification of interpreters, and not arranging for other interpreters to attend medical treatment appointments. As a result, some appointments are not going forward as scheduled."
Labor Code Section 4600(g) provides that injured workers who cannot communicate effectively in English with their primary treating physician are entitled to the services of a qualified interpreter at all medical treatment appointments.
"Qualified interpreters" for purposes of medical treatment appointments may be, but are not required to be, formally certified. They can be provisionally certified by agreement of the employer prior to providing interpreting services. Employers are not required to pay for the services of interpreters who are not formally or provisionally certified.
Interpreters certified for medical treatment appointments or medical legal exams qualify through successfully passing the Certification Commission for Healthcare Interpreters (CCHI) exam or by passing the National Board of Certification for Medical Interpreters (National Board). Interpreter services FAQs and information on recently approved interpreter services regulations are posted on DWC’s website ...
Christine Baker, Director of the Department of Industrial Relations (DIR), today announced that Juliann Sum will serve as the Acting Chief of Cal/OSHA. Sum will head the Division of Occupational Safety and Health following the resignation of Ellen Widess. Cal/OSHA is a division of DIR.
Widess expressed her appreciation of the men and women of the Division and their commitment to ensuring workplace safety. She will continue as Special Advisor to Director Baker.
Juliann Sum has worked for over 26 years to help workers understand and exercise their legal rights through numerous educational materials, training workshops, and consultation with legal aid groups that assist low-wage and immigrant workers. She joined DIR in May 2012 as a Special Advisor to Director Baker. Sum served at UC Berkeley from 1994 to 2012 as Project Director with the Institute for Research on Labor and Employment, and Consulting Attorney and Industrial Hygienist with the Labor Occupational Health Program. Her extensive experience includes work as an Associate Attorney with the Environmental Law Foundation and Industrial Hygienist and Business Representative with the International Brotherhood of Electrical Workers Local 1245.
Sum earned a law degree (with honors) from UC Hastings College of the Law, a Master of Science degree in environmental health sciences from the Harvard School of Public Health, and a Bachelor of Science degree in biophysics from Brown University.
"Juliann’s focus will be on prevention - strong enforcement, compliance, outreach and education," said DIR Director Christine Baker. "I thank Ellen for her dedicated service and look forward to her knowledgeable advice in her new role. I am confident that Juliann’s extensive background and experience will further the Administration’s commitment to a comprehensive Cal/OSHA program." ...
Widess expressed her appreciation of the men and women of the Division and their commitment to ensuring workplace safety. She will continue as Special Advisor to Director Baker.
Juliann Sum has worked for over 26 years to help workers understand and exercise their legal rights through numerous educational materials, training workshops, and consultation with legal aid groups that assist low-wage and immigrant workers. She joined DIR in May 2012 as a Special Advisor to Director Baker. Sum served at UC Berkeley from 1994 to 2012 as Project Director with the Institute for Research on Labor and Employment, and Consulting Attorney and Industrial Hygienist with the Labor Occupational Health Program. Her extensive experience includes work as an Associate Attorney with the Environmental Law Foundation and Industrial Hygienist and Business Representative with the International Brotherhood of Electrical Workers Local 1245.
Sum earned a law degree (with honors) from UC Hastings College of the Law, a Master of Science degree in environmental health sciences from the Harvard School of Public Health, and a Bachelor of Science degree in biophysics from Brown University.
"Juliann’s focus will be on prevention - strong enforcement, compliance, outreach and education," said DIR Director Christine Baker. "I thank Ellen for her dedicated service and look forward to her knowledgeable advice in her new role. I am confident that Juliann’s extensive background and experience will further the Administration’s commitment to a comprehensive Cal/OSHA program." ...
When it comes to reducing one's hospital bills, a key factor is location, location, location. A patient who undergoes joint-replacement surgery in Ada, Oklahoma, might receive a $5,300 hospital invoice for services rendered. But, according to an article in The Atlantic Cities, somebody who gets the same operation in Monterey Park, California, could be staring down the barrel of a much huger bill - $223,000, to be exact.
These were the average lowest and highest prices in 2011 for one particular joint-swapping procedure in the United States, according to federal data. They show in stark light how hospitals charge vastly different amounts for almost identical services, a peculiarity of the American healthcare system that Steven Brill wrote about this year in a Time cover story. Brill spent months investigating how hospitals calculate the bills they stick to patients; here's Time describing one of his findings:
"Hospitals arbitrarily set prices based on a mysterious internal list known as the "chargemaster." These prices vary from hospital to hospital and are often ten times the actual cost of an item. Insurance companies and Medicare pay discounted prices, but don’t have enough leverage to bring fees down anywhere close to actual costs. While other countries restrain drug prices, in the United States federal law actually restricts the single biggest buyer - Medicare - from even trying to negotiate the price of drugs."
While some people have taken issue with Brill's facts, the basic point that hospital pricing is opaque and often unfair is on target. The Centers for Medicare and Medicaid Services seem to be on board with this assessment. After Brill's article appeared, the centers disgorged a trove of information dealing with what hospitals charged and what Medicare actually paid for 100 common procedures in 2011. The data revealed not just major differences among the states, but local variations as well. Reports Health 2.0: "For example, average inpatient hospital charges for services that may be provided to treat heart failure range from a low of $21,000 to a high of $46,000 in Denver, Colo., and from a low of $9,000 to a high of $51,000 in Jackson, Miss."
The higher-value hospitals are clumped in the center of the United States. Two of the best-ranked ones hail from Arkansas - the Surgical Hospital in Little Rock and the Physicians' Specialty Hospital in Fayetteville - followed by medical centers in Villa Rica, Georgia; Grinnell, Iowa; Paola, Kansas; Boise, Idaho; and Wichita.
Some of the lowest-ranked hospitals can be found in California locales like Porterville, Hemet, and Fresno, and in Floridian burgs like Dade City, Fort Myers, and Saint Petersburg, with others in Illinois, Oklahoma, Tennessee, New Mexico and elsewhere: ...
These were the average lowest and highest prices in 2011 for one particular joint-swapping procedure in the United States, according to federal data. They show in stark light how hospitals charge vastly different amounts for almost identical services, a peculiarity of the American healthcare system that Steven Brill wrote about this year in a Time cover story. Brill spent months investigating how hospitals calculate the bills they stick to patients; here's Time describing one of his findings:
"Hospitals arbitrarily set prices based on a mysterious internal list known as the "chargemaster." These prices vary from hospital to hospital and are often ten times the actual cost of an item. Insurance companies and Medicare pay discounted prices, but don’t have enough leverage to bring fees down anywhere close to actual costs. While other countries restrain drug prices, in the United States federal law actually restricts the single biggest buyer - Medicare - from even trying to negotiate the price of drugs."
While some people have taken issue with Brill's facts, the basic point that hospital pricing is opaque and often unfair is on target. The Centers for Medicare and Medicaid Services seem to be on board with this assessment. After Brill's article appeared, the centers disgorged a trove of information dealing with what hospitals charged and what Medicare actually paid for 100 common procedures in 2011. The data revealed not just major differences among the states, but local variations as well. Reports Health 2.0: "For example, average inpatient hospital charges for services that may be provided to treat heart failure range from a low of $21,000 to a high of $46,000 in Denver, Colo., and from a low of $9,000 to a high of $51,000 in Jackson, Miss."
The higher-value hospitals are clumped in the center of the United States. Two of the best-ranked ones hail from Arkansas - the Surgical Hospital in Little Rock and the Physicians' Specialty Hospital in Fayetteville - followed by medical centers in Villa Rica, Georgia; Grinnell, Iowa; Paola, Kansas; Boise, Idaho; and Wichita.
Some of the lowest-ranked hospitals can be found in California locales like Porterville, Hemet, and Fresno, and in Floridian burgs like Dade City, Fort Myers, and Saint Petersburg, with others in Illinois, Oklahoma, Tennessee, New Mexico and elsewhere: ...
Legislation once seeking major reform of the Medical Board of California was gutted and passed by a key Assembly committee last week
The state agency that regulates doctors is facing sunset review this year, meaning it will cease to exist if lawmakers and the governor don’t reauthorize it.
Senate Bill 304 is a vehicle to make changes and unwind or reauthorize the agency. Initially authored by Sen. Curren Price, it is now carried by Sen. Ted Lieu. Price left office to take a seat on the Los Angeles City Council on July 1. This bill includes numerous provisions related to the Medical Board of California (MBC) that emerged during sunset review of the Board in 2012; The bill as it is now written, extends the Medical Board's sunset date until January 1, 2018 and makes MBC subject to review by the appropriate policy committees of the Legislature.
Amendments approved Tuesday eliminated a key enforcement reform that would have moved all staff investigating dangerous doctors to the California Department of Justice. The bill now moves investigative staff to Division of Investigation in the California Department of Consumer Affairs, keeping enforcement split between that department and the medical board staff.
The bill was also amended to extend Medical Board operations for four years. Price had threatened to pull the plug on the agency if serious changes were not made ...
The state agency that regulates doctors is facing sunset review this year, meaning it will cease to exist if lawmakers and the governor don’t reauthorize it.
Senate Bill 304 is a vehicle to make changes and unwind or reauthorize the agency. Initially authored by Sen. Curren Price, it is now carried by Sen. Ted Lieu. Price left office to take a seat on the Los Angeles City Council on July 1. This bill includes numerous provisions related to the Medical Board of California (MBC) that emerged during sunset review of the Board in 2012; The bill as it is now written, extends the Medical Board's sunset date until January 1, 2018 and makes MBC subject to review by the appropriate policy committees of the Legislature.
Amendments approved Tuesday eliminated a key enforcement reform that would have moved all staff investigating dangerous doctors to the California Department of Justice. The bill now moves investigative staff to Division of Investigation in the California Department of Consumer Affairs, keeping enforcement split between that department and the medical board staff.
The bill was also amended to extend Medical Board operations for four years. Price had threatened to pull the plug on the agency if serious changes were not made ...
The Medical Board of California’s Prescription Drug Strike Force arrested Dr. Duke D. Fisher at his San Jose office for allegedly prescribing controlled substances without a legitimate purpose.
The probable cause arrest came after the Board received a complaint alleging that Dr. Fisher would prescribe any medication the customer requested in exchange for cash. Multiple undercover operations were conducted. It was found that Dr. Fisher prescribed controlled substances without a legitimate medical purpose and prescribed controlled substances to a customer who admitted to using heroin and methamphetamines.
Fisher was charged with violations of Health and Safety Code sections 11153, prescribing without a legitimate medical purpose, and 11156, prescribing to an addict; and Business and Professions Code section 725, excessive prescribing of drugs.
Fisher has two offices, one in San Jose and one in Monterey, California. His bail is set at $64,000.
...
The probable cause arrest came after the Board received a complaint alleging that Dr. Fisher would prescribe any medication the customer requested in exchange for cash. Multiple undercover operations were conducted. It was found that Dr. Fisher prescribed controlled substances without a legitimate medical purpose and prescribed controlled substances to a customer who admitted to using heroin and methamphetamines.
Fisher was charged with violations of Health and Safety Code sections 11153, prescribing without a legitimate medical purpose, and 11156, prescribing to an addict; and Business and Professions Code section 725, excessive prescribing of drugs.
Fisher has two offices, one in San Jose and one in Monterey, California. His bail is set at $64,000.
...
Investigators from the Medical Board of California’s Prescription Drug Strike Force along with t he Redding Police Department , arrested Dr. James Gregory White for prescribing drugs without a legitimate purpose, prescribing to a known addict, and excessive prescribing. Dr. White along with his physician assistant , Cheri Hougland , were arrested at his place of business the North Valley Medical Corporation at 473 South Street in Redding, California.
According to a representative from the Medical Board of California, White and Hougland are being charged on nine counts including prescribing a controlled substance without a legitimate purpose, prescribing to a known addict, and excessive prescribing.
After the arrest, the Drug Enforcement Agency, the Office of the Inspector General and the Bureau of Medi-cal Fraud and Elder Abuse served a search warrant on the business and seized medical files. White and Hougland are being accused of aiding and abetting and filing fraudulent claims.
White's medical license was suspended back in May. The California State Medical Board was asked to revoke White's license, citing 18 causes for discipline including gross negligence and over-prescribing pain-killing drugs that led to death.
White is a pain doctor who had his license revoked back in 2005 as well for issues surrounding his prescribing practices ...
According to a representative from the Medical Board of California, White and Hougland are being charged on nine counts including prescribing a controlled substance without a legitimate purpose, prescribing to a known addict, and excessive prescribing.
After the arrest, the Drug Enforcement Agency, the Office of the Inspector General and the Bureau of Medi-cal Fraud and Elder Abuse served a search warrant on the business and seized medical files. White and Hougland are being accused of aiding and abetting and filing fraudulent claims.
White's medical license was suspended back in May. The California State Medical Board was asked to revoke White's license, citing 18 causes for discipline including gross negligence and over-prescribing pain-killing drugs that led to death.
White is a pain doctor who had his license revoked back in 2005 as well for issues surrounding his prescribing practices ...
United States Attorney Melinda Haag announced that a billing manager, her billing company, and her son have agreed to pay $1.7 million to settle allegations that they violated the civil False Claims Act in connection with claims submitted to the Department of Labor, Office of Workers’ Compensation Programs (DOL-OWCP).
The settlement resolves a whistleblower lawsuit filed in the United States District Court for the Northern District of California. In July 2012, the United States settled with six other defendants for $3.15 million -- Advanced Physical Medicine and Rehab Group Inc. (located in Oakland, Calif. and Rhonert Park, Calif.), Advanced Occupational Rehabilitation, Inc. (located in Oklahoma), Advanced Medicine and Rehabilitation of Texas, Inc. (located in Texas), Advanced Medicine and Rehabilitation of Texas, P.A. (located in Texas), and the two physicians located in Oakland who own these clinics. The remaining three defendants -- Farideh Heidarpour, her billing company A.B.C. Billing Inc., and her son Ali Heidarpour (who was also her employee) - will pay an additional $1.7 million.
The United States alleges that, from 2005 through 2008, Heidarpour, her company, and her son submitted or caused to be submitted to DOL-OWCP false claims by the clinics for supplies and services not provided, not supported by medical documentation and/or not medically necessary, resulting in millions of dollars of damages to the United States. The majority of the patients at issue were United States Postal Service (USPS) employees claiming work-related injuries.
U.S. Attorney Haag, said. that "this settlement demonstrates this office’s continued commitment to protecting the federal health care programs from fraud and false claims."
A physician who formerly worked at the clinic in Texas filed the case pursuant to the qui tam provisions of the False Claims Act. Under those provisions, private citizens, called "relators," may file lawsuits on behalf of the United States and receive a portion of the proceeds of a settlement or judgment. The relator will receive $323,000 as her share of the government’s recovery from the three defendants. This is in addition to the relator’s share of $598,000 from the earlier settling defendants.
Assistant U.S. Attorneys Sara Winslow and Melanie Proctor handled the matter on behalf of the U.S. Attorney’s Office for the Northern District of California, with assistance from Financial Fraud Investigator Michael Zehr and Legal Assistants Yvette Baird and Kathy Terry. The matter was investigated by DOL-OWCP and the USPS Office of Inspector General ...
The settlement resolves a whistleblower lawsuit filed in the United States District Court for the Northern District of California. In July 2012, the United States settled with six other defendants for $3.15 million -- Advanced Physical Medicine and Rehab Group Inc. (located in Oakland, Calif. and Rhonert Park, Calif.), Advanced Occupational Rehabilitation, Inc. (located in Oklahoma), Advanced Medicine and Rehabilitation of Texas, Inc. (located in Texas), Advanced Medicine and Rehabilitation of Texas, P.A. (located in Texas), and the two physicians located in Oakland who own these clinics. The remaining three defendants -- Farideh Heidarpour, her billing company A.B.C. Billing Inc., and her son Ali Heidarpour (who was also her employee) - will pay an additional $1.7 million.
The United States alleges that, from 2005 through 2008, Heidarpour, her company, and her son submitted or caused to be submitted to DOL-OWCP false claims by the clinics for supplies and services not provided, not supported by medical documentation and/or not medically necessary, resulting in millions of dollars of damages to the United States. The majority of the patients at issue were United States Postal Service (USPS) employees claiming work-related injuries.
U.S. Attorney Haag, said. that "this settlement demonstrates this office’s continued commitment to protecting the federal health care programs from fraud and false claims."
A physician who formerly worked at the clinic in Texas filed the case pursuant to the qui tam provisions of the False Claims Act. Under those provisions, private citizens, called "relators," may file lawsuits on behalf of the United States and receive a portion of the proceeds of a settlement or judgment. The relator will receive $323,000 as her share of the government’s recovery from the three defendants. This is in addition to the relator’s share of $598,000 from the earlier settling defendants.
Assistant U.S. Attorneys Sara Winslow and Melanie Proctor handled the matter on behalf of the U.S. Attorney’s Office for the Northern District of California, with assistance from Financial Fraud Investigator Michael Zehr and Legal Assistants Yvette Baird and Kathy Terry. The matter was investigated by DOL-OWCP and the USPS Office of Inspector General ...
Estill Mitts, 68, who lives near the Miracle Mile district of Los Angeles, recruited homeless people from the "Skid Row" section of Los Angeles as part of a widespread scheme to defraud Medicare and Medi-Cal by providing unnecessary health services. He was sentenced this week to 18 months in federal prison and ordered Mitts to pay more than $9.8 million in restitution. In sentencing Mitts the federal judge stated that Mitts’ conduct was "fueled by greed to enrich himself," and "breeds contempt for, leads to a lack of confidence in, and threatens the stability of" the Medicare program.
The Skid Row "capping" -- or illegal referral -- scheme was discovered in the fall of 2006 after local authorities observed some patients discharged from a local hospital being "dumped" on Skid Row. The patients subsequently reported that they had been paid to go to the hospital.
Mitts "was a ring-leader in a significant, long-term, serious crime that used the homeless as fodder for exploiting the Medicare and Medi-Cal programs," prosecutors wrote in a sentencing memo filed with the court. Mitts admitted that he received more than $1 million in kickbacks from three hospitals that took in the illegally referred patients from Skid Row.
From 2004 until October 2007, Mitts operated the Assessment Center, a facility on East Seventh Street in downtown Los Angeles that was also known as 7th Street Christian Day Center. "Mitts employed individuals he called ‘stringers’ to recruit homeless people with promises of small payments," according to the sentencing memorandum. "The Assessment Center was not a medical clinic, but a site that defendant used for the purpose of recruiting homeless Medicare and Medi-Cal beneficiaries for referral to three hospitals -- City of Angels Hospital, Los Angeles Metropolitan Medical Center, and Tustin Hospital and Medical Center. Defendant and others working for him would recruit homeless beneficiaries for in-patient hospital admissions whether or not such hospitalizations were medically necessary."
In relation to the tax evasion count, Mitts admits in the plea agreement that he failed to report more than $479,000 in income in 2005 and more than $620,000 in income in 2006. By failing to report this income, the Internal Revenue Service suffered losses of $349,857.
Mitts pleaded guilty in 2008 to conspiracy to commit health care fraud, money laundering and tax evasion. Mitts’ sentencing was delayed a number of times as he provided assistance to the government’s investigation that has led to 11 defendants being charged and convicted.
Mitts is the latest in a series of defendant to be sentenced in relation to the Skid Row investigation. For example, Robert Bourseau, one of the owners of City of Angels, was sentenced to 37 months in prison, and Dante Nicholson, the director of marketing at City of Angels, who also cooperated with the government in its investigation, was sentenced to one year in prison. Late last year, a doctor who admitted homeless patients to the Tustin Hospital and Medical Center after they had been driven from Skid Row was sentenced to one year in federal prison ...
The Skid Row "capping" -- or illegal referral -- scheme was discovered in the fall of 2006 after local authorities observed some patients discharged from a local hospital being "dumped" on Skid Row. The patients subsequently reported that they had been paid to go to the hospital.
Mitts "was a ring-leader in a significant, long-term, serious crime that used the homeless as fodder for exploiting the Medicare and Medi-Cal programs," prosecutors wrote in a sentencing memo filed with the court. Mitts admitted that he received more than $1 million in kickbacks from three hospitals that took in the illegally referred patients from Skid Row.
From 2004 until October 2007, Mitts operated the Assessment Center, a facility on East Seventh Street in downtown Los Angeles that was also known as 7th Street Christian Day Center. "Mitts employed individuals he called ‘stringers’ to recruit homeless people with promises of small payments," according to the sentencing memorandum. "The Assessment Center was not a medical clinic, but a site that defendant used for the purpose of recruiting homeless Medicare and Medi-Cal beneficiaries for referral to three hospitals -- City of Angels Hospital, Los Angeles Metropolitan Medical Center, and Tustin Hospital and Medical Center. Defendant and others working for him would recruit homeless beneficiaries for in-patient hospital admissions whether or not such hospitalizations were medically necessary."
In relation to the tax evasion count, Mitts admits in the plea agreement that he failed to report more than $479,000 in income in 2005 and more than $620,000 in income in 2006. By failing to report this income, the Internal Revenue Service suffered losses of $349,857.
Mitts pleaded guilty in 2008 to conspiracy to commit health care fraud, money laundering and tax evasion. Mitts’ sentencing was delayed a number of times as he provided assistance to the government’s investigation that has led to 11 defendants being charged and convicted.
Mitts is the latest in a series of defendant to be sentenced in relation to the Skid Row investigation. For example, Robert Bourseau, one of the owners of City of Angels, was sentenced to 37 months in prison, and Dante Nicholson, the director of marketing at City of Angels, who also cooperated with the government in its investigation, was sentenced to one year in prison. Late last year, a doctor who admitted homeless patients to the Tustin Hospital and Medical Center after they had been driven from Skid Row was sentenced to one year in federal prison ...
Fox News reports that the NFL and more than 4,500 former players want to resolve concussion-related lawsuits with a $765 million settlement that would fund medical exams, concussion-related compensation and medical research. The plaintiffs include at least 10 members of the Pro Football Hall of Fame, including former Dallas Cowboys running back Tony Dorsett. They also include Super Bowl-winning quarterback Jim McMahon and the family of Pro Bowl linebacker Junior Seau, who committed suicide last year.
Many former players with neurological conditions believe their problems stem from on-field concussions. The lawsuits accused the league of hiding known risks of concussions for decades to return players to games and protect its image. The NFL has denied any wrongdoing and has insisted that safety has always been a top priority. Many have also filed workers' compensation claims in California, even if they only played one game here.
Senior U.S. District Judge Anita Brody in Philadelphia announced the proposed settlement Thursday after months of court-ordered mediation. She still must approve it at a later date. The settlement likely means the NFL won't have to disclose internal files about what it knew, when, about concussion-linked brain problems. Lawyers had been eager to learn, for instance, about the workings of the league's Mild Traumatic Brain Injury Committee, which was led for more than a decade by a rheumatologist.
In court arguments in April, NFL lawyer Paul Clement asked Brody to dismiss the lawsuits and send them to arbitration under terms of the players' contract. He said that individual teams bear the chief responsibility for health and safety under the collective bargaining agreement, along with the players' union and the players themselves.
Players lawyer David Frederick accused the league of concealing studies linking concussions to neurological problems for decades. Brody had initially planned to rule in July, but then delayed her ruling and ordered the two sides to meet to decide which plaintiffs, if any, had the right to sue. She also issued a gag order, so it has been unclear in recent weeks whether any progress was being made. The lawyers were due to report back to her Tuesday, but Brody instead announced in court files Thursday that the case had settled.
In recent years, a string of former NFL players and other concussed athletes have been diagnosed after their deaths with chronic traumatic encephalopathy, or CTE. Those ex-players included Seau and lead plaintiff Ray Easterling, who filed the first suit in Philadelphia in August 2011 but later committed suicide.About one-third of the league's 12,000 former players have joined the litigation since 2011. They include a few hundred "gap" players, who played during years when there was no labor contract in place, and were therefore considered likely to win the right to sue.
The timing of the settlement allowed the NFL to drop the issue from the national conversation before the start of the new season. All 32 clubs were scheduled to play their final exhibition games Thursday night, in preparation for the start of the regular season next week. The first real game is next Thursday, with the reigning Super Bowl champion Baltimore Ravens playing at the Denver Broncos ...
Many former players with neurological conditions believe their problems stem from on-field concussions. The lawsuits accused the league of hiding known risks of concussions for decades to return players to games and protect its image. The NFL has denied any wrongdoing and has insisted that safety has always been a top priority. Many have also filed workers' compensation claims in California, even if they only played one game here.
Senior U.S. District Judge Anita Brody in Philadelphia announced the proposed settlement Thursday after months of court-ordered mediation. She still must approve it at a later date. The settlement likely means the NFL won't have to disclose internal files about what it knew, when, about concussion-linked brain problems. Lawyers had been eager to learn, for instance, about the workings of the league's Mild Traumatic Brain Injury Committee, which was led for more than a decade by a rheumatologist.
In court arguments in April, NFL lawyer Paul Clement asked Brody to dismiss the lawsuits and send them to arbitration under terms of the players' contract. He said that individual teams bear the chief responsibility for health and safety under the collective bargaining agreement, along with the players' union and the players themselves.
Players lawyer David Frederick accused the league of concealing studies linking concussions to neurological problems for decades. Brody had initially planned to rule in July, but then delayed her ruling and ordered the two sides to meet to decide which plaintiffs, if any, had the right to sue. She also issued a gag order, so it has been unclear in recent weeks whether any progress was being made. The lawyers were due to report back to her Tuesday, but Brody instead announced in court files Thursday that the case had settled.
In recent years, a string of former NFL players and other concussed athletes have been diagnosed after their deaths with chronic traumatic encephalopathy, or CTE. Those ex-players included Seau and lead plaintiff Ray Easterling, who filed the first suit in Philadelphia in August 2011 but later committed suicide.About one-third of the league's 12,000 former players have joined the litigation since 2011. They include a few hundred "gap" players, who played during years when there was no labor contract in place, and were therefore considered likely to win the right to sue.
The timing of the settlement allowed the NFL to drop the issue from the national conversation before the start of the new season. All 32 clubs were scheduled to play their final exhibition games Thursday night, in preparation for the start of the regular season next week. The first real game is next Thursday, with the reigning Super Bowl champion Baltimore Ravens playing at the Denver Broncos ...
Previous NCCI studies of Temporary Total Disability (TTD) indemnity benefits duration showed an increase in nationwide average duration following the onset of the Great Recession in 2007.
As this updated, post-recession research shows, Accident Year (AY) 2009 was the nationwide peak at 143 days, and average duration has since declined to 140 days in AY 2012. Average durations have risen or fallen in step with the national unemployment rate. Countrywide estimates in this study are based on data for 46 jurisdictions - all jurisdictions except ND, OH, WA, WV, and WY - and include large deductible and self-insured claims, where reported to NCCI.
Countrywide, the Contracting and Manufacturing industry groups had the steepest declines in average duration from AY 2009 to AY 2011, following substantial increases between AY 2006 and AY 2009. Recent duration trends in the other industry groups were either slight declines or modest increases.
The median of the average durations in states with seven-day waiting periods is about 20 days longer than in states with three-day waiting periods. Within most industry groups, average durations for women are longer than average durations for men. However, men have higher shares of claims than women in the longer-duration industry groups, so that when viewed overall, men's average duration is longer than women's.
Duration increased for all age groups between AY 2005 and AY 2009, with most age groups reflecting the countrywide duration increase of 10%. Duration for the youngest age group-workers under age 30 or less - stands out as about 30% lower than countrywide ...
As this updated, post-recession research shows, Accident Year (AY) 2009 was the nationwide peak at 143 days, and average duration has since declined to 140 days in AY 2012. Average durations have risen or fallen in step with the national unemployment rate. Countrywide estimates in this study are based on data for 46 jurisdictions - all jurisdictions except ND, OH, WA, WV, and WY - and include large deductible and self-insured claims, where reported to NCCI.
Countrywide, the Contracting and Manufacturing industry groups had the steepest declines in average duration from AY 2009 to AY 2011, following substantial increases between AY 2006 and AY 2009. Recent duration trends in the other industry groups were either slight declines or modest increases.
The median of the average durations in states with seven-day waiting periods is about 20 days longer than in states with three-day waiting periods. Within most industry groups, average durations for women are longer than average durations for men. However, men have higher shares of claims than women in the longer-duration industry groups, so that when viewed overall, men's average duration is longer than women's.
Duration increased for all age groups between AY 2005 and AY 2009, with most age groups reflecting the countrywide duration increase of 10%. Duration for the youngest age group-workers under age 30 or less - stands out as about 30% lower than countrywide ...
A West Hollywood doctor pleaded guilty to a federal drug trafficking charge for writing hundreds of prescriptions for various controlled substances after a federal order revoked his authority to prescribe drugs. James William Eisenberg, 72, who resides in the Venice district of Los Angeles, pleaded guilty to one count distribution of hydrocodone, a drug best known by the brand names Vicodin and Norco.Eisenberg wrote the prescriptions while he worked out of several medical offices in West Hollywood, including a Santa Monica Boulevard storefront he called Pacific Support Services. Eisenberg also issued "medical marijuana" recommendations from these West Hollywood locations. He has been prohibited from issuing such recommendations and from practicing medicine at medical marijuana clinics as a condition of his release on bail.
In order to legally prescribe controlled substances such as hydrocodone, physicians must be registered with the United States Attorney General and have a valid DEA registration number. On December 14, 2011, a DEA administrative judge determined that Eisenberg acted as a "drug dealer" and suspended his registration number. The DEA issued an order permanently revoking Eisenberg’s registration on July 24, 2012. The orders issued by the administrative judge were based on findings that Eisenberg, who at the time was working out of a "medical marijuana" club in Arizona, "lacked a legitimate medical purpose and acted outside of the usual course of professional practice" when he wrote prescriptions for oxycodone (the generic form of a drug often best known as the brand-name OxyContin) and Xanax in exchange for $150 cash payments. The DEA judge also found that Eisenberg wrote "medical marijuana" recommendations to undercover officers posing as patients, and that Eisenberg prescribed OxyContin to one of the undercover agents "before [Eisenberg] had even performed a physical examination."
DEA investigators later learned that Eisenberg continued to prescribe controlled substances, including hydrocodone, in violation of the DEA’s orders. A review of a California Department of Justice database that can be used to track prescriptions showed that, following the suspension of Eisenberg’s registration number, patients filled more than 1,700 of his prescriptions for controlled substances, including more than 1,200 prescriptions for hydrocodone. As charged in the indictment, Eisenberg wrote one of those prescriptions on December 27, 2011, less than two weeks after his registration number was suspended.
DEA investigators executed a federal search warrant on one of Eisenberg’s West Hollywood offices on February 19, 2013. The affidavit in support of the search warrant outlines evidence, including surveillance and undercover operations, that Eisenberg continued to write prescriptions for controlled substances in violation of the DEA’s revocation order. The evidence included an operation in which an undercover agent, posing as a patient, obtained a prescription from Eisenberg for hydrocodone and alprazolam (the generic form of a drug best known as Xanax).
As a result of his guilty plea, Eisenberg faces a statutory maximum sentence of 10 years in federal prison when he is sentenced by United States District Judge Michael W. Fitzgerald on December 9, 2013 ...
In order to legally prescribe controlled substances such as hydrocodone, physicians must be registered with the United States Attorney General and have a valid DEA registration number. On December 14, 2011, a DEA administrative judge determined that Eisenberg acted as a "drug dealer" and suspended his registration number. The DEA issued an order permanently revoking Eisenberg’s registration on July 24, 2012. The orders issued by the administrative judge were based on findings that Eisenberg, who at the time was working out of a "medical marijuana" club in Arizona, "lacked a legitimate medical purpose and acted outside of the usual course of professional practice" when he wrote prescriptions for oxycodone (the generic form of a drug often best known as the brand-name OxyContin) and Xanax in exchange for $150 cash payments. The DEA judge also found that Eisenberg wrote "medical marijuana" recommendations to undercover officers posing as patients, and that Eisenberg prescribed OxyContin to one of the undercover agents "before [Eisenberg] had even performed a physical examination."
DEA investigators later learned that Eisenberg continued to prescribe controlled substances, including hydrocodone, in violation of the DEA’s orders. A review of a California Department of Justice database that can be used to track prescriptions showed that, following the suspension of Eisenberg’s registration number, patients filled more than 1,700 of his prescriptions for controlled substances, including more than 1,200 prescriptions for hydrocodone. As charged in the indictment, Eisenberg wrote one of those prescriptions on December 27, 2011, less than two weeks after his registration number was suspended.
DEA investigators executed a federal search warrant on one of Eisenberg’s West Hollywood offices on February 19, 2013. The affidavit in support of the search warrant outlines evidence, including surveillance and undercover operations, that Eisenberg continued to write prescriptions for controlled substances in violation of the DEA’s revocation order. The evidence included an operation in which an undercover agent, posing as a patient, obtained a prescription from Eisenberg for hydrocodone and alprazolam (the generic form of a drug best known as Xanax).
As a result of his guilty plea, Eisenberg faces a statutory maximum sentence of 10 years in federal prison when he is sentenced by United States District Judge Michael W. Fitzgerald on December 9, 2013 ...
The Division of Workers’ Compensation has posted a 15-day notice of modification to the electronic document filing and lien filing fee rules to the DWC website. Members of the public are invited to present written comments regarding the proposed modifications to dwcrules@dir.ca.gov until 5 p.m. on September 11.
The proposed modifications include:revisions to the definitions of the terms "cost," "party," and "section 4903(b) lien" Revisions also add a new section that sets forth when lien filing or activation fee refunds will automatically take place and provides a procedure for requesting lien fee refunds. This new provision states that lien filing and or lien activation fees will automatically be refunded when (1) a payment was not processed due to a system error; (2) the fee was previously paid or the lien is not available for activation; (3) an improper amount is paid; or (4) a lien filing fee is properly paid, but due to a procedural defect in the filing of the lien, the filing is not effective and the filer was not able to re-file and cure the defect with 15 days. Iif the automatic refund is not issued, the Lien Filing Fee Refund Request form must be submitted with any required documentary proof. A refund will only be provided upon a showing of good cause. The bases for good cause are stated.
Finally there are new revisions to the EAMS reference guide and instructional manual and the JET File Business Rules and Technical Specifications.
The notice, text of the regulations, and forms can be found on the proposed regulations page ...
The proposed modifications include:revisions to the definitions of the terms "cost," "party," and "section 4903(b) lien" Revisions also add a new section that sets forth when lien filing or activation fee refunds will automatically take place and provides a procedure for requesting lien fee refunds. This new provision states that lien filing and or lien activation fees will automatically be refunded when (1) a payment was not processed due to a system error; (2) the fee was previously paid or the lien is not available for activation; (3) an improper amount is paid; or (4) a lien filing fee is properly paid, but due to a procedural defect in the filing of the lien, the filing is not effective and the filer was not able to re-file and cure the defect with 15 days. Iif the automatic refund is not issued, the Lien Filing Fee Refund Request form must be submitted with any required documentary proof. A refund will only be provided upon a showing of good cause. The bases for good cause are stated.
Finally there are new revisions to the EAMS reference guide and instructional manual and the JET File Business Rules and Technical Specifications.
The notice, text of the regulations, and forms can be found on the proposed regulations page ...
The Division of Workers’ Compensation issued a notice of public hearing for the Predesignation of Personal Physicians and Reporting Duties of the Primary Treating Physician Rulemaking regulations. The public hearing on the proposed regulations has been scheduled for 10 a.m., October 7, in the auditorium of the San Francisco State Office Building at 455 Golden Gate Ave., San Francisco, CA 94102-3688. Members of the public may also submit written comment on the regulations until 5 p.m. that day.
The regulations implement provisions of Senate Bill (SB) 863 that limit the number of chiropractic visits an injured worker may have unless a specific exception applies. The regulations also revise the method for an employee to designate a personal physician. The changes include:
1) The optional form for an employee to use to predesignate a personal physician to provide them with medical treatment in case of a work related injury or illness is being revised to state that an employee may predesignate a personal physician if, in addition to the other required preconditions, the employee has health care coverage for nonoccupational injuries or illnesses on the date of injury.
2)The form is also being amended to provide space for the employer to provide the name of the insurer that covers them for nonoccupational injuries or illness.
3) The optional form for an employee to use to predesignate a personal chiropractor or personal acupuncturist form is being amended to advise the employee that for dates of injury on or after January 1, 2004, a chiropractor cannot be a treating physician after the employee has received 24 chiropractic visits unless the employer has authorized additional visits in writing. The form will also advise the injured worker that the term "chiropractic visit" means any chiropractic office visit, regardless of whether the services performed involve chiropractic manipulation or are limited to evaluation and management.
4) Once the employee has received 24 chiropractic visits, if the employee still requires medical treatment, the employee will have to select a new physician who cannot be a chiropractor. This prohibition shall not apply to the provision of postsurgical physical medicine prescribed by the surgeon or physician designated by the surgeon pursuant to the postsurgical component of the Division of Workers’ Compensation’s Medical Treatment Utilization Schedule.
The regulations concerning the reporting duties of primary and secondary treating physicians are being revised to include essentially the same information.
The notice, text of the regulations, and forms can be found on the proposed regulations page ...
The regulations implement provisions of Senate Bill (SB) 863 that limit the number of chiropractic visits an injured worker may have unless a specific exception applies. The regulations also revise the method for an employee to designate a personal physician. The changes include:
1) The optional form for an employee to use to predesignate a personal physician to provide them with medical treatment in case of a work related injury or illness is being revised to state that an employee may predesignate a personal physician if, in addition to the other required preconditions, the employee has health care coverage for nonoccupational injuries or illnesses on the date of injury.
2)The form is also being amended to provide space for the employer to provide the name of the insurer that covers them for nonoccupational injuries or illness.
3) The optional form for an employee to use to predesignate a personal chiropractor or personal acupuncturist form is being amended to advise the employee that for dates of injury on or after January 1, 2004, a chiropractor cannot be a treating physician after the employee has received 24 chiropractic visits unless the employer has authorized additional visits in writing. The form will also advise the injured worker that the term "chiropractic visit" means any chiropractic office visit, regardless of whether the services performed involve chiropractic manipulation or are limited to evaluation and management.
4) Once the employee has received 24 chiropractic visits, if the employee still requires medical treatment, the employee will have to select a new physician who cannot be a chiropractor. This prohibition shall not apply to the provision of postsurgical physical medicine prescribed by the surgeon or physician designated by the surgeon pursuant to the postsurgical component of the Division of Workers’ Compensation’s Medical Treatment Utilization Schedule.
The regulations concerning the reporting duties of primary and secondary treating physicians are being revised to include essentially the same information.
The notice, text of the regulations, and forms can be found on the proposed regulations page ...
The California Department of Insurance announced that it will hold a public hearing on September 30, 2013 to consider the WCIRB’s January 1, 2014 Regulatory Filing, which was submitted on August 9, 2013. In the Regulatory Filing, the WCIRB proposes a number of changes to the California Insurance Commissioner’s regulations contained in the California Workers’ Compensation Uniform Statistical Reporting Plan - 1995, the California Workers’ Compensation Experience Rating Plan - 1995, and the Miscellaneous Regulations for the Recording and Reporting of Data - 1995. The Regulatory Filing hearing will be held: September 30, 2013 at 10:00 AM California Department of Insurance San Diego Room 300 Capitol Mall, Second Floor in Sacramento.
The Workers’ Compensation Insurance Rating Bureau of California, the nonprofit group that advises the state on rates and regulations, on Aug. 9 proposed that the state change a classification system, use collective bargaining agreements to validate an employee’s hourly wage rate and amend other arcane items.
But, the Sacramento Business Journal reports that the hearing of more general interest will be a second public hearing related to the Rating Bureau’s 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 workers’ 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. California’s workers’ comp insurers use the recommendations from the commissioner and the Rating Bureau as a benchmark, but they’re free to set their own rates ...
The Workers’ Compensation Insurance Rating Bureau of California, the nonprofit group that advises the state on rates and regulations, on Aug. 9 proposed that the state change a classification system, use collective bargaining agreements to validate an employee’s hourly wage rate and amend other arcane items.
But, the Sacramento Business Journal reports that the hearing of more general interest will be a second public hearing related to the Rating Bureau’s 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 workers’ 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. California’s workers’ comp insurers use the recommendations from the commissioner and the Rating Bureau as a benchmark, but they’re free to set their own rates ...
