John Larkin sustained injuries while employed as a police officer by the City of Marysville. The WCJ determined that Larkin’s earnings to be $1,008.47 per week and that he was not entitled to the maximum indemnity levels available under Labor Code 4458.2.
Labor Code section 4458.2 provides workers’ compensation benefits to certain peace officers injured in the line of duty. The terms of the statute apply to any "active peace officer of any department as described in Section 3362 [who] suffers injury or death while in the performance of his or her duties as a peace officer." (§ 4458.2.) The statute likewise provides benefits to those injured while performing services as part of a so-called posse comitatus - a group of citizens convened by law enforcement authorities for certain limited law enforcement purposes, in accordance with section 3366 - and to certain reserve peace officers as described in section 3362.5. (§ 4458.2.)
Larkin argued in his petition for reconsideration that the plain language of the statutes entitled regularly sworn, salaried peace officers to maximum indemnity levels. The Board disagreed, finding the WCJ’s reasoning persuasive and denying Larkin’s petition. In affirming the Board’s order, the Court of Appeal interpreted section 4458.2 to avoid what it deemed an "absurd result." It concluded that the policy considerations underlying section 4458.2 and section 3362 reflected a legislative interest in encouraging volunteer service to support police and fire agencies.
The California Supreme Court granted review to determine whether the benefits provided under section 4458.2 extend to both volunteer peace officers and to regularly sworn, salaried officers. It affirmed the Court of Appeal in the case of Larkin v WCAB.
In light of the text of sections 4458.2 and 3362, their place in the structure of the statutory scheme, and the Workers’ Compensation Appeals Board’s interpretation of the statute, the Supreme Court concluded that section 4458.2 does not extend maximum indemnity levels to regularly sworn, salaried officers. This conclusion is bolstered by a review of the legislative history governing the relevant statutory provisions. The Court of Appeal’s judgment was affirmed ...
Labor Code section 4458.2 provides workers’ compensation benefits to certain peace officers injured in the line of duty. The terms of the statute apply to any "active peace officer of any department as described in Section 3362 [who] suffers injury or death while in the performance of his or her duties as a peace officer." (§ 4458.2.) The statute likewise provides benefits to those injured while performing services as part of a so-called posse comitatus - a group of citizens convened by law enforcement authorities for certain limited law enforcement purposes, in accordance with section 3366 - and to certain reserve peace officers as described in section 3362.5. (§ 4458.2.)
Larkin argued in his petition for reconsideration that the plain language of the statutes entitled regularly sworn, salaried peace officers to maximum indemnity levels. The Board disagreed, finding the WCJ’s reasoning persuasive and denying Larkin’s petition. In affirming the Board’s order, the Court of Appeal interpreted section 4458.2 to avoid what it deemed an "absurd result." It concluded that the policy considerations underlying section 4458.2 and section 3362 reflected a legislative interest in encouraging volunteer service to support police and fire agencies.
The California Supreme Court granted review to determine whether the benefits provided under section 4458.2 extend to both volunteer peace officers and to regularly sworn, salaried officers. It affirmed the Court of Appeal in the case of Larkin v WCAB.
In light of the text of sections 4458.2 and 3362, their place in the structure of the statutory scheme, and the Workers’ Compensation Appeals Board’s interpretation of the statute, the Supreme Court concluded that section 4458.2 does not extend maximum indemnity levels to regularly sworn, salaried officers. This conclusion is bolstered by a review of the legislative history governing the relevant statutory provisions. The Court of Appeal’s judgment was affirmed ...
The FDA has approved BioDelivery Sciences International Inc abuse resistant opioid treatment for chronic pain. The story in Reuters Health says that Belbuca is an opioid film patch and aims to treat patients with chronic pain who need round-the-clock treatment and for whom current alternatives do not suffice.The patch is expected to be commercially available in the United States by the first quarter ending March in seven dosages.
Belbuca is placed on the inner lining of the cheek, leading to faster delivery of analgesic drug buprenorphine directly into the blood stream. Buprenorphine has a lower abuse potential than most opioid medications. The Belbuca treatment can also prevent misuse through snorting or injecting as the film patch is difficult to crush or liquefy. Since most of the drug is absorbed through the cheek and with little going through the digestive tract, Belbuca could potentially lead to lower constipation, a common side effect that most oral drugs are known to cause.
Given the lower possibilities of misuse as seen with buprenorphine, physicians can write a six-month prescription as opposed to writing one on a strict monthly basis. The abuse of opioids, a class of drugs that include heroin and prescription painkillers, has long been a concern in the United States. An overdose of prescription painkillers can produce euphoric highs and even disrupt parts of the brain that control breathing.
The approval comes a little more than a month after the FDA staff flagged dosage concerns over Collegium Pharmaceutical Inc's opioid drug, Xtampza, and Purdue Pharma's fast-acting oxycodone painkiller ...
Belbuca is placed on the inner lining of the cheek, leading to faster delivery of analgesic drug buprenorphine directly into the blood stream. Buprenorphine has a lower abuse potential than most opioid medications. The Belbuca treatment can also prevent misuse through snorting or injecting as the film patch is difficult to crush or liquefy. Since most of the drug is absorbed through the cheek and with little going through the digestive tract, Belbuca could potentially lead to lower constipation, a common side effect that most oral drugs are known to cause.
Given the lower possibilities of misuse as seen with buprenorphine, physicians can write a six-month prescription as opposed to writing one on a strict monthly basis. The abuse of opioids, a class of drugs that include heroin and prescription painkillers, has long been a concern in the United States. An overdose of prescription painkillers can produce euphoric highs and even disrupt parts of the brain that control breathing.
The approval comes a little more than a month after the FDA staff flagged dosage concerns over Collegium Pharmaceutical Inc's opioid drug, Xtampza, and Purdue Pharma's fast-acting oxycodone painkiller ...
Estela Chanchavac filed a Continuous Trauma Claim against LB Industries Inc., and its two industrial carriers, Sentry Insurance and Twin City Fire Insurance Company. There was no election against either carrier, both remained active defendant participants in the case. Thus it was the view of the WCJ that "It should be noted at the outset that the employer is no longer a party to this action. Its carriers have entered their appearances in this case, so the employer is effectively dismissed as a party. cf. L.C. section 3757".
One of the carriers, Twin City, had already obtained a chiropractic PQME with the applicant. Sentry sought to obtain its own PQME in orthopedics. Applicant objected contending that jointly, the two carriers can only obtain one PQME. The WCJ ruled that Sentry Select had been properly assigned a QME panel in orthopedics, and that applicant and Sentry should utilize the doctor remaining after the striking process to resolve any disputes between them. Applicant petitioned for Reconsideration and/or Removal which was denied by the WCAB in the case of Chanchavac v LB Industries.
The Petitions were dismissed without considering the merits. However, the WCJ noted that most of the exhibits introduced by applicant which relate to the selection procedure show that Sentry was entirely shut out from that process.
Applicant argued that permitting each defendant to obtain its own QME evaluations will result in "dueling reports" that will complicate the proceedings. In response the WCJ said "That is certainly true, which is why the legislature provided a simple expedient to avoid the problem. As noted in the Opinion, applicant could simply have elected against Twin City, thereby stopping Sentry from conducting any discovery at all. Cf. Kelm v Koret of California (1981) 46 CCC 113."
As noted in that decision, the election process under L.C. section 5500.5 is specifically designed "for the purpose of ameliorating the procedural morass which has faced the board in multiple defendant cases", and to "avoid the confusion and delay inevitable where multiple defendants are involved."
The WCJ went on to note that "Although this option was presented to applicant on the morning of trial, she steadfastly refused to avail herself of it. She has instead insisted that Sentry remain an active party defendant in this case, while simultaneously attempting to prevent it from acting. The undersigned believes she cannot have it both ways. If she does not wish to designate one carrier with whom she wishes to litigate, she must litigate with all of them, all of whom must in turn be permitted to defend their own interests as they see fit. There is simply no basis or precedent for designating one carrier as some sort of "lead carrier" which other carriers must follow, or the carrier in which all other carriers are in "privity" and therefore bound by its decisions and actions." ...
One of the carriers, Twin City, had already obtained a chiropractic PQME with the applicant. Sentry sought to obtain its own PQME in orthopedics. Applicant objected contending that jointly, the two carriers can only obtain one PQME. The WCJ ruled that Sentry Select had been properly assigned a QME panel in orthopedics, and that applicant and Sentry should utilize the doctor remaining after the striking process to resolve any disputes between them. Applicant petitioned for Reconsideration and/or Removal which was denied by the WCAB in the case of Chanchavac v LB Industries.
The Petitions were dismissed without considering the merits. However, the WCJ noted that most of the exhibits introduced by applicant which relate to the selection procedure show that Sentry was entirely shut out from that process.
Applicant argued that permitting each defendant to obtain its own QME evaluations will result in "dueling reports" that will complicate the proceedings. In response the WCJ said "That is certainly true, which is why the legislature provided a simple expedient to avoid the problem. As noted in the Opinion, applicant could simply have elected against Twin City, thereby stopping Sentry from conducting any discovery at all. Cf. Kelm v Koret of California (1981) 46 CCC 113."
As noted in that decision, the election process under L.C. section 5500.5 is specifically designed "for the purpose of ameliorating the procedural morass which has faced the board in multiple defendant cases", and to "avoid the confusion and delay inevitable where multiple defendants are involved."
The WCJ went on to note that "Although this option was presented to applicant on the morning of trial, she steadfastly refused to avail herself of it. She has instead insisted that Sentry remain an active party defendant in this case, while simultaneously attempting to prevent it from acting. The undersigned believes she cannot have it both ways. If she does not wish to designate one carrier with whom she wishes to litigate, she must litigate with all of them, all of whom must in turn be permitted to defend their own interests as they see fit. There is simply no basis or precedent for designating one carrier as some sort of "lead carrier" which other carriers must follow, or the carrier in which all other carriers are in "privity" and therefore bound by its decisions and actions." ...
California Labor Commissioner Julie A. Su, the Department of Industrial Relations, the California Commission on the Status of Women and Girls and other community sponsors including Asian Americans Advancing Justice - Los Angeles hosted the Workplace Justice Summit to focus on enforcing workplace protections. The summit at Loyola Law School brought together government leaders, workers’ rights advocates, employer organizations, prosecutors and law enforcement to increase collaboration in efforts to fight wage theft and other workplace abuses.
"This year is the 20th anniversary of the freedom of the heroic Thai garment workers who were trafficked into the U.S. and forced to work behind barbed wire and under armed guard in El Monte," said Labor Commissioner Su. "The purpose of the Summit is to honor our commitment to those workers and increase our effectiveness to ensure the horror of El Monte is never repeated." Su honored the Thai garment workers at a special reception the preceding evening.
The Labor Commissioner has had a record-breaking four years in enforcing labor laws. Since 2012, hearing awards in Berman wage claims have been at a record high. Total wages and civil penalties assessed in citations have been more than $70 million a year each year from 2012 to 2014, compared to $25.4 million in 2010. Under Labor Commissioner Su, public works enforcement has also been at all-time highs of $25.2 million in 2012, $40.2 million in 2013 and $30.4 million in 2014, compared to less than $25 million every year in the decade prior.
The summit focused on strategies to fight workplace abuses, including wage theft, discrimination and the gender pay disparity, human trafficking, workplace violence and retaliation. District attorneys who have partnered with the Labor Commissioner’s Office provided training on how to prosecute wage theft cases.
"This summit will help make workplace justice a reality for even more California workers," said Christine Baker, Director of the Department of Industrial Relations (DIR). The Labor Commissioner’s Office, officially known as the Division of Labor Standards Enforcement (DLSE), is a division of DIR.
"Fair pay, economic justice and a level playing field for businesses require creative solutions and collaboration with advocates, workers, prosecutors and employers," said David M. Lanier, Secretary of the California Labor and Workforce Development Agency ...
"This year is the 20th anniversary of the freedom of the heroic Thai garment workers who were trafficked into the U.S. and forced to work behind barbed wire and under armed guard in El Monte," said Labor Commissioner Su. "The purpose of the Summit is to honor our commitment to those workers and increase our effectiveness to ensure the horror of El Monte is never repeated." Su honored the Thai garment workers at a special reception the preceding evening.
The Labor Commissioner has had a record-breaking four years in enforcing labor laws. Since 2012, hearing awards in Berman wage claims have been at a record high. Total wages and civil penalties assessed in citations have been more than $70 million a year each year from 2012 to 2014, compared to $25.4 million in 2010. Under Labor Commissioner Su, public works enforcement has also been at all-time highs of $25.2 million in 2012, $40.2 million in 2013 and $30.4 million in 2014, compared to less than $25 million every year in the decade prior.
The summit focused on strategies to fight workplace abuses, including wage theft, discrimination and the gender pay disparity, human trafficking, workplace violence and retaliation. District attorneys who have partnered with the Labor Commissioner’s Office provided training on how to prosecute wage theft cases.
"This summit will help make workplace justice a reality for even more California workers," said Christine Baker, Director of the Department of Industrial Relations (DIR). The Labor Commissioner’s Office, officially known as the Division of Labor Standards Enforcement (DLSE), is a division of DIR.
"Fair pay, economic justice and a level playing field for businesses require creative solutions and collaboration with advocates, workers, prosecutors and employers," said David M. Lanier, Secretary of the California Labor and Workforce Development Agency ...
In August, California amended workers’ comp benefit notice regulations that govern the DWC-1 claim form/Notice of Potential Eligibility (NOPE), posting notices and other notices that employers and claims administrators use to inform employees of their rights and obligations under state law.
The regulations address statutory changes enacted in 2012, and require additions to notices including Medical Provider Network (MPN) information that replaces the requirement for a separate MPN poster, new language on electronic service of notices, advice that medical services are subject to approval, a revised permanent disability description and new language on timely reporting.
The state made the regulations effective January 1, 2016 to allow claims operations and employers time to obtain and distribute revised notices, so they may continue to use current versions until the end of 2015, after which they should begin using updated materials. With the January 1 effective date less than 3 months away, the community must gear up quickly.
Private entities may publish the required workers’ comp posting notices and new hire pamphlets if they are approved by the state, and many insurers and employers rely on the California Workers’ Compensation Institute (CWCI) to produce these materials and keep them up to date. After the state amended the regulations in August, CWCI updated its new hire pamphlet and posting notice, obtained state approvals, translated them into Spanish and printed them along with the new DWC-1/NOPE, which as of January will consist of a 3-page NOPE attached to four copies of the claim form, printed on NCR paper to eliminate the need to photocopy. In addition to the changes adopted in August, CWCI added information to its pamphlet and posting notice on the state’s $120 million Return to Work Supplement Program to reflect regulations adopted in April, and updated its "Facts For Injured Workers" pamphlet, which many claims administrators use to provide information to injured workers early in the life of a claim, and to meet the notice requirement about fraudulent receipt of temporary disability and the notice requirement for victims of workplace crime.
CWCI now has the revised materials in stock and ready to ship. Claims operations or employers that wish to obtain revised notices so they can update their claim kits before the January 1 deadline, or who need more details, can visit www.cwci.org/store.html or call (510) 251-9470 ...
The regulations address statutory changes enacted in 2012, and require additions to notices including Medical Provider Network (MPN) information that replaces the requirement for a separate MPN poster, new language on electronic service of notices, advice that medical services are subject to approval, a revised permanent disability description and new language on timely reporting.
The state made the regulations effective January 1, 2016 to allow claims operations and employers time to obtain and distribute revised notices, so they may continue to use current versions until the end of 2015, after which they should begin using updated materials. With the January 1 effective date less than 3 months away, the community must gear up quickly.
Private entities may publish the required workers’ comp posting notices and new hire pamphlets if they are approved by the state, and many insurers and employers rely on the California Workers’ Compensation Institute (CWCI) to produce these materials and keep them up to date. After the state amended the regulations in August, CWCI updated its new hire pamphlet and posting notice, obtained state approvals, translated them into Spanish and printed them along with the new DWC-1/NOPE, which as of January will consist of a 3-page NOPE attached to four copies of the claim form, printed on NCR paper to eliminate the need to photocopy. In addition to the changes adopted in August, CWCI added information to its pamphlet and posting notice on the state’s $120 million Return to Work Supplement Program to reflect regulations adopted in April, and updated its "Facts For Injured Workers" pamphlet, which many claims administrators use to provide information to injured workers early in the life of a claim, and to meet the notice requirement about fraudulent receipt of temporary disability and the notice requirement for victims of workplace crime.
CWCI now has the revised materials in stock and ready to ship. Claims operations or employers that wish to obtain revised notices so they can update their claim kits before the January 1 deadline, or who need more details, can visit www.cwci.org/store.html or call (510) 251-9470 ...
Insurance Commissioner Dave Jones announced that Department of Insurance actuaries found Aetna Life Insurance Company's most recent small group health insurance rate increase excessive and unreasonable. Aetna is increasing rates for small businesses and their employees by an annual average of 27.4 percent. This increase will impact small businesses that renew their policies in the fourth quarter of 2015 -affecting over 40,000 employees.
"Small businesses are the lifeblood of California's economy," said Commissioner Jones. "Small businesses simply cannot afford unwarranted and unreasonable increases in health insurance costs nor can their employees."
Department of Insurance actuaries reviewed Aetna's rate filing and found that the average 27.4 percent increase was not based on Aetna's most recent claims experience but was based on an unreasonable and excessive pricing trend and other unreasonable assumptions. Commissioner Jones advised Aetna of the department's finding that the rate increase was unjustified. Aetna decided to impose the rate increase despite the finding that the rate increase is excessive and unreasonable, costing small businesses a projected $5.5 million in excessive rates.
Unlike 35 other states, California does not have the legal authority to reject excessive health insurance rate increases. A recent national study found that those states with the authority to regulate health insurance rates had lower rate increases as compared to states like California which do not have the authority to regulate health insurance rates ...
"Small businesses are the lifeblood of California's economy," said Commissioner Jones. "Small businesses simply cannot afford unwarranted and unreasonable increases in health insurance costs nor can their employees."
Department of Insurance actuaries reviewed Aetna's rate filing and found that the average 27.4 percent increase was not based on Aetna's most recent claims experience but was based on an unreasonable and excessive pricing trend and other unreasonable assumptions. Commissioner Jones advised Aetna of the department's finding that the rate increase was unjustified. Aetna decided to impose the rate increase despite the finding that the rate increase is excessive and unreasonable, costing small businesses a projected $5.5 million in excessive rates.
Unlike 35 other states, California does not have the legal authority to reject excessive health insurance rate increases. A recent national study found that those states with the authority to regulate health insurance rates had lower rate increases as compared to states like California which do not have the authority to regulate health insurance rates ...
Division of Workers’ Compensation Chief Judge Richard Newman and Executive Medical Director Rupali Das are leaving the division for new endeavors: Judge Newman will join the Workers’ Compensation Appeals Board (WCAB) and Dr. Das will retire from state service.
Chief Judge Newman will leave DWC at the end of November to assume the position of Secretary and Deputy Commissioner of the WCAB as of December 2. The current Secretary, Rick Dietrich, retires effective December 30. Judge Newman has had a long career in workers’ compensation. Prior to beginning his tenure as chief judge in September 2011, he worked for the Division as an attorney, judge and presiding judge. As chief judge, Newman had the responsibility of overseeing the Division’s 24 district offices, including the hiring and supervision of judges and judicial staff and involvement in facility and personnel issues.
During his tenure, Judge Newman re-instituted yearly statewide judge and I and A training and regular PJ training. He worked to promote uniform district office procedures and forms, participated in a major revision of the Policy and Procedure Manual, helped in the creation of the new online QME panel process. He assisted the Division in the implementation of SB 863, including development of the lien fee payment process and revision of the lien filing regulations. He also helped bring in Court Call to enable the option of telephonic conferencing by attorneys, and he worked to equalize the workload among district offices through the use of video lien trials and conferences. He is currently overseeing the creation of updated and simplified EAMS manuals for judges, secretaries and hearing officers. Judge Thomas Clarke will assume the position of acting chief judge.
After dedicating her career to improving the health of Californians, Dr. Rupali Das will be retiring from state service in January 2016. Since her appointment as DWC Executive Medical Director in 2012, Dr. Das has been an influential and innovative member of the DIR executive team and played a key role in implementing SB 863, Governor Brown’s groundbreaking workers’ compensation reform legislation, including Independent Medical Review, Independent Bill Review, and an updated physician fee schedule.
Dr. Das advocated for appropriate evidence-based practices, transparency, and metrics to guide and improve policy and prioritize quality of care. She was a strong proponent of the importance of prevention in all policies. Dr. Das worked closely with her team to strengthen the evidence-based framework of DWC’s Medical Treatment Utilization Schedule and introduce updated guidelines for the treatment of chronic pain in workers. She collaborated with other state agencies to address the nationwide epidemic of prescription drug overdose and death and propose guidelines for prescribing opioids for injured workers. She worked to educate medical audiences about workers’ compensation and enhance the quality of Qualified Medical Evaluators.
Dr. Das joined state service in 1993. Prior to joining DWC, she served at Cal/EPA and the California Department of Public Health. Following retirement, she will be joining Zenith Insurance Company as its Senior Vice President and California Medical Director.
Immediately following Dr. Das’ retirement, Associate Medical Director Dr. Raymond Meister will assume interim responsibilities while DWC conducts an active search for an Executive Medical Director ...
Chief Judge Newman will leave DWC at the end of November to assume the position of Secretary and Deputy Commissioner of the WCAB as of December 2. The current Secretary, Rick Dietrich, retires effective December 30. Judge Newman has had a long career in workers’ compensation. Prior to beginning his tenure as chief judge in September 2011, he worked for the Division as an attorney, judge and presiding judge. As chief judge, Newman had the responsibility of overseeing the Division’s 24 district offices, including the hiring and supervision of judges and judicial staff and involvement in facility and personnel issues.
During his tenure, Judge Newman re-instituted yearly statewide judge and I and A training and regular PJ training. He worked to promote uniform district office procedures and forms, participated in a major revision of the Policy and Procedure Manual, helped in the creation of the new online QME panel process. He assisted the Division in the implementation of SB 863, including development of the lien fee payment process and revision of the lien filing regulations. He also helped bring in Court Call to enable the option of telephonic conferencing by attorneys, and he worked to equalize the workload among district offices through the use of video lien trials and conferences. He is currently overseeing the creation of updated and simplified EAMS manuals for judges, secretaries and hearing officers. Judge Thomas Clarke will assume the position of acting chief judge.
After dedicating her career to improving the health of Californians, Dr. Rupali Das will be retiring from state service in January 2016. Since her appointment as DWC Executive Medical Director in 2012, Dr. Das has been an influential and innovative member of the DIR executive team and played a key role in implementing SB 863, Governor Brown’s groundbreaking workers’ compensation reform legislation, including Independent Medical Review, Independent Bill Review, and an updated physician fee schedule.
Dr. Das advocated for appropriate evidence-based practices, transparency, and metrics to guide and improve policy and prioritize quality of care. She was a strong proponent of the importance of prevention in all policies. Dr. Das worked closely with her team to strengthen the evidence-based framework of DWC’s Medical Treatment Utilization Schedule and introduce updated guidelines for the treatment of chronic pain in workers. She collaborated with other state agencies to address the nationwide epidemic of prescription drug overdose and death and propose guidelines for prescribing opioids for injured workers. She worked to educate medical audiences about workers’ compensation and enhance the quality of Qualified Medical Evaluators.
Dr. Das joined state service in 1993. Prior to joining DWC, she served at Cal/EPA and the California Department of Public Health. Following retirement, she will be joining Zenith Insurance Company as its Senior Vice President and California Medical Director.
Immediately following Dr. Das’ retirement, Associate Medical Director Dr. Raymond Meister will assume interim responsibilities while DWC conducts an active search for an Executive Medical Director ...
Total knee replacement can usually relieve pain and improve function, but a nonsurgical regimen can also be effective in some people without posing the complication risks that can plague people who choose surgery, according to a new study reviewed in Reuters Health. The test found that while 85 percent of patients who underwent surgery showed clinically-significant improvement after one year, so did 67 percent assigned to a combination of supervised exercise, use of insoles, pain medication, education and dietary advice.
There's little debate that knee replacement helps many people, and the new test of 100 patients - the first randomized controlled trial ever done on the technique - confirms it. Surgery patients didn't show just some improvement. They registered far less pain and disability than those assigned to the non-surgery group.
Yet the study was needed because as many as 1 percent of surgery patients die within 90 days of their operation and about 1 in 5 have residual pain at least six months after the procedure, said Dr. Jeffrey Katz of Harvard Medical School in Cambridge, Massachusetts, in an accompanying editorial in the New England Journal of Medicine. "Until now, we have lacked rigorously controlled comparisons between total knee replacement and its alternatives."
"People need to understand and respect that knee replacement is not without complication. Knee replacement is a big surgical procedure and there are risks associated with it," Dr. Andrew Pollak, chairman of orthopedics at the University of Maryland School of Medicine in Baltimore, told Reuters Health. The study "really emphasizes what we suspected all along - total knee replacement works. It will be obvious to many of us who take care of patients. But for patients with significant symptoms and evidence of arthritis, total knee replacement is a very effective way of improving quality of life," said Pollak, who was not associated with the research. "Therapy alone has a role. It does help certain patients. It can certainly prolong the time to when knee replacement is necessary."
More than 670,000 total knee replacements are done in the U.S. each year at a cost of $36.1 billion ...
There's little debate that knee replacement helps many people, and the new test of 100 patients - the first randomized controlled trial ever done on the technique - confirms it. Surgery patients didn't show just some improvement. They registered far less pain and disability than those assigned to the non-surgery group.
Yet the study was needed because as many as 1 percent of surgery patients die within 90 days of their operation and about 1 in 5 have residual pain at least six months after the procedure, said Dr. Jeffrey Katz of Harvard Medical School in Cambridge, Massachusetts, in an accompanying editorial in the New England Journal of Medicine. "Until now, we have lacked rigorously controlled comparisons between total knee replacement and its alternatives."
"People need to understand and respect that knee replacement is not without complication. Knee replacement is a big surgical procedure and there are risks associated with it," Dr. Andrew Pollak, chairman of orthopedics at the University of Maryland School of Medicine in Baltimore, told Reuters Health. The study "really emphasizes what we suspected all along - total knee replacement works. It will be obvious to many of us who take care of patients. But for patients with significant symptoms and evidence of arthritis, total knee replacement is a very effective way of improving quality of life," said Pollak, who was not associated with the research. "Therapy alone has a role. It does help certain patients. It can certainly prolong the time to when knee replacement is necessary."
More than 670,000 total knee replacements are done in the U.S. each year at a cost of $36.1 billion ...
A story published on NPR says that ten ranking Democrats on key Senate and House committees are urging the Labor Department to respond to a "pattern of detrimental changes in state workers' compensation laws" that have reduced protections and benefits for injured workers over the past decade.
In a letter to Labor Secretary Thomas Perez, the lawmakers cited an investigation by NPR and ProPublica, which found that 33 states have cut workers' comp benefits, made it more difficult to qualify or given employers more control over medical care decisions. The letter also referred to NPR/ProPublica stories last week that detailed an emerging trend that permits employers to dump out of state-regulated workers' comp programs, write their own injury plans and limit benefits on their own. "State workers' compensation laws are no longer providing adequate levels of support and compensation for workers injured on the job," the lawmakers wrote. "The race to the bottom now appears to be nearly bottomless..."
The letter is signed by Bernie Sanders, the Democratic presidential hopeful and ranking minority member of the Senate Budget Committee, Patty Murray, D-Washington, the ranking member of the Senate Labor Committee, Bobby Scott, D-Virginia, the ranking member of the House Workforce Committee, and seven other senior Democrats on House and Senate Budget, Finance, Employment, Workforce, Ways and Means, and Social Security Committees.
The agency said it would review the letter and work "with stakeholders to find real solutions" but did not commit to any specific action. An NPR/ProPublica request to speak with Secretary Perez was declined.
Until budget cuts in 2004, the Labor Department tracked changes in state workers' comp laws and failures to meet 19 minimum and essential standards for benefits established by a 1972 Commission convened by President Richard Nixon.
Rep. Scott says the benefits cutbacks make federal action necessary, even though workers' comp is legislated and managed by states. "If these workers aren't getting benefits under workers' comp a lot of them end up getting benefits under Social Security Disability or Medicaid [and] food stamps because they're not working," said Rep Scott. "And so there is a strong federal interest in making sure that the workers' comp programs pay appropriate benefits."
A 2007 study by J. Paul Leigh, a health economist at the University of California, Davis, estimated that workplace injuries not covered by workers' comp cost government programs about $30 billion a year.
Federal intervention may also come as the result of the "opt out" movement in Texas and Oklahoma, in which employers shun heavily-regulated workers' comp and are permitted to write and administer their own largely-unregulated workplace injury plans. South Carolina and Tennessee are considering opt-out laws now and proponents are aiming for a dozen states by the end of the decade ...
In a letter to Labor Secretary Thomas Perez, the lawmakers cited an investigation by NPR and ProPublica, which found that 33 states have cut workers' comp benefits, made it more difficult to qualify or given employers more control over medical care decisions. The letter also referred to NPR/ProPublica stories last week that detailed an emerging trend that permits employers to dump out of state-regulated workers' comp programs, write their own injury plans and limit benefits on their own. "State workers' compensation laws are no longer providing adequate levels of support and compensation for workers injured on the job," the lawmakers wrote. "The race to the bottom now appears to be nearly bottomless..."
The letter is signed by Bernie Sanders, the Democratic presidential hopeful and ranking minority member of the Senate Budget Committee, Patty Murray, D-Washington, the ranking member of the Senate Labor Committee, Bobby Scott, D-Virginia, the ranking member of the House Workforce Committee, and seven other senior Democrats on House and Senate Budget, Finance, Employment, Workforce, Ways and Means, and Social Security Committees.
The agency said it would review the letter and work "with stakeholders to find real solutions" but did not commit to any specific action. An NPR/ProPublica request to speak with Secretary Perez was declined.
Until budget cuts in 2004, the Labor Department tracked changes in state workers' comp laws and failures to meet 19 minimum and essential standards for benefits established by a 1972 Commission convened by President Richard Nixon.
Rep. Scott says the benefits cutbacks make federal action necessary, even though workers' comp is legislated and managed by states. "If these workers aren't getting benefits under workers' comp a lot of them end up getting benefits under Social Security Disability or Medicaid [and] food stamps because they're not working," said Rep Scott. "And so there is a strong federal interest in making sure that the workers' comp programs pay appropriate benefits."
A 2007 study by J. Paul Leigh, a health economist at the University of California, Davis, estimated that workplace injuries not covered by workers' comp cost government programs about $30 billion a year.
Federal intervention may also come as the result of the "opt out" movement in Texas and Oklahoma, in which employers shun heavily-regulated workers' comp and are permitted to write and administer their own largely-unregulated workplace injury plans. South Carolina and Tennessee are considering opt-out laws now and proponents are aiming for a dozen states by the end of the decade ...
A recent study indicates that more than two-thirds of people who have been prescribed antidepressants are likely not suffering from depression at all. Sixty-nine percent of those taking SSRIs (selective serotonin reuptake inhibitors) such as Prozac, do not display the classic symptoms of major depressive disorder, which is commonly known as clinical depression, according to a report published in the Journal of Clinical Psychiatry.
SSRIs are also prescribed for other mental disorders, including generalized anxiety disorder, social phobia, obsessive compulsive disorder, and panic disorder, but the researchers found that 38 percent of those taking the drugs did not meet the criteria for these conditions either.
Commonly considered to have fewer side effects than other antidepressants, SSRIs are the most prescribed class of drugs for treating depression and other psychiatric disorders.
The authors of the study say that many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.
Between 1988 and 2008, the use of antidepressants increased almost 400 percent, with 11 percent of Americans now taking these drugs regularly. This statistic is certainly not reflected in this histories given to PTPs in typical workers' compensation cases. One might question why workers' compensation claimants differ, or why PTPs and QMEs do not challenge histories that routinely defy existing epidemiological data.
The official U.S. guidelines for diagnosing clinical depression are when a "person has five or more depressive symptoms over a two week period, most of the day, nearly every day." Symptoms of clinical depression range from a depressed mood to thoughts of suicide. They might also include a lack of interest in normal activities, changes in weight or appetite, insomnia or too much sleep, restlessness, fatigue, guilty feelings and problems with concentration or decision-making.
Although SSRIs are considered to be safer than other antidepressants, they are not without potentially serious side effects. Studies have shown that the use of antidepressants involves an "increased risk of suicidal behaviour and thoughts in children and adolescents, particularly in the early stages of treatment." The use of Prozac and Seroxat actually doubles the risk of suicidal behavior among young people. Studies have also indicated an increased risk of children being born with autism when their mothers take SSRIs during pregnancy.
Considering the risks, these drugs should never be casually prescribed. However, in this climate of increased reliance on pills to solve every problem, over-prescription of medications is rampant, particularly in the U.S ...
SSRIs are also prescribed for other mental disorders, including generalized anxiety disorder, social phobia, obsessive compulsive disorder, and panic disorder, but the researchers found that 38 percent of those taking the drugs did not meet the criteria for these conditions either.
Commonly considered to have fewer side effects than other antidepressants, SSRIs are the most prescribed class of drugs for treating depression and other psychiatric disorders.
The authors of the study say that many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.
Between 1988 and 2008, the use of antidepressants increased almost 400 percent, with 11 percent of Americans now taking these drugs regularly. This statistic is certainly not reflected in this histories given to PTPs in typical workers' compensation cases. One might question why workers' compensation claimants differ, or why PTPs and QMEs do not challenge histories that routinely defy existing epidemiological data.
The official U.S. guidelines for diagnosing clinical depression are when a "person has five or more depressive symptoms over a two week period, most of the day, nearly every day." Symptoms of clinical depression range from a depressed mood to thoughts of suicide. They might also include a lack of interest in normal activities, changes in weight or appetite, insomnia or too much sleep, restlessness, fatigue, guilty feelings and problems with concentration or decision-making.
Although SSRIs are considered to be safer than other antidepressants, they are not without potentially serious side effects. Studies have shown that the use of antidepressants involves an "increased risk of suicidal behaviour and thoughts in children and adolescents, particularly in the early stages of treatment." The use of Prozac and Seroxat actually doubles the risk of suicidal behavior among young people. Studies have also indicated an increased risk of children being born with autism when their mothers take SSRIs during pregnancy.
Considering the risks, these drugs should never be casually prescribed. However, in this climate of increased reliance on pills to solve every problem, over-prescription of medications is rampant, particularly in the U.S ...
Virglio Duarte worked for The Vons Companies, Inc. as a baker since 1990. He suffered a work-related injury in 2009 that restricted his ability to use his left arm. Vons rescheduled Duarte for 12 weeks to a shift at which he had access to a "baker’s helper," who did the lifting, pushing and pulling that the baker usually does.
Vons generally offers up to 12 weeks of what it calls modified duty to employees who have a workers’ compensation injury. If the employee continues to have work restrictions after 12 weeks, he or she is taken off this modified duty and put on temporary disability - in this case involuntarily. Vons investigated another position for Duarte that turned out to be unavailable. After a lengthy leave of absence, Vons terminated Duarte.
Duarte contends in his civil suit against Vons that he was not accommodated properly, Vons failed to engage in a good faith interactive process, and he was harassed because of his disability. Duarte brought claims under FEHA, as well as other causes of action. Vons moved for summary judgment arguing there was no triable issue of fact. The trial court granted a summary judgment in favor of Vons, and the Court of Appeal affirmed in the unpublished case of Duarte v. The Vons Companies, Inc.
For a plaintiff to prevail on claims for disability discrimination and failure to provide a reasonable accommodation, he or she must show that he or she was able to perform the essential functions of the position from which he or she was terminated with or without a reasonable accommodation. The FEHA does not require an employer to shift a disabled employee’s essential duty to other employees. The statute does not require other employees to work harder or longer. Slowing production or assigning an injured worker lighter loads is not required by law. Also, that another employee is required to do an employee’s duties suggests that the duties are essential.
Although an employee cannot be expected to identify and request all possible accommodations during the interactive process, "the employee should be able to identify specific, available reasonable accommodations through the litigation process, and particularly by the time the parties have conducted discovery and reached the summary stage." .) If the employee cannot identify such a reasonable accommodation after discovery in litigation, he or she has suffered no remediable injury from any violation.
The only accommodations Duarte proposed was to have a helper do all the lifting, pulling, pushing, and reaching and pouring of heavy material and allowing Duarte to use a scooper instead of pouring. The proposed accommodation was not reasonable as a matter of law. With regard to Duarte’s claims that Vons did not fulfill its duty to engage in the interactive process, Duarte’s failure to identify a reasonable accommodation that was available at the time the interactive process should have occurred, dooms his claim ...
Vons generally offers up to 12 weeks of what it calls modified duty to employees who have a workers’ compensation injury. If the employee continues to have work restrictions after 12 weeks, he or she is taken off this modified duty and put on temporary disability - in this case involuntarily. Vons investigated another position for Duarte that turned out to be unavailable. After a lengthy leave of absence, Vons terminated Duarte.
Duarte contends in his civil suit against Vons that he was not accommodated properly, Vons failed to engage in a good faith interactive process, and he was harassed because of his disability. Duarte brought claims under FEHA, as well as other causes of action. Vons moved for summary judgment arguing there was no triable issue of fact. The trial court granted a summary judgment in favor of Vons, and the Court of Appeal affirmed in the unpublished case of Duarte v. The Vons Companies, Inc.
For a plaintiff to prevail on claims for disability discrimination and failure to provide a reasonable accommodation, he or she must show that he or she was able to perform the essential functions of the position from which he or she was terminated with or without a reasonable accommodation. The FEHA does not require an employer to shift a disabled employee’s essential duty to other employees. The statute does not require other employees to work harder or longer. Slowing production or assigning an injured worker lighter loads is not required by law. Also, that another employee is required to do an employee’s duties suggests that the duties are essential.
Although an employee cannot be expected to identify and request all possible accommodations during the interactive process, "the employee should be able to identify specific, available reasonable accommodations through the litigation process, and particularly by the time the parties have conducted discovery and reached the summary stage." .) If the employee cannot identify such a reasonable accommodation after discovery in litigation, he or she has suffered no remediable injury from any violation.
The only accommodations Duarte proposed was to have a helper do all the lifting, pulling, pushing, and reaching and pouring of heavy material and allowing Duarte to use a scooper instead of pouring. The proposed accommodation was not reasonable as a matter of law. With regard to Duarte’s claims that Vons did not fulfill its duty to engage in the interactive process, Duarte’s failure to identify a reasonable accommodation that was available at the time the interactive process should have occurred, dooms his claim ...
The judge overseeing a class action lawsuit against FedEx Ground over its classification of certain drivers as independent contractors instead of employees has approved the company’s June-announced $228 million settlement with 2,300 California-based FedEx drivers.
The settlement will resolve the legal battle that’s now stretched a decade, as the original complaint in the case was brought against the LTL giant in 2005. Truck operators for the company claimed their designation as contractors, and not company employees, kept them from being eligible for certain state-required employee benefits like overtime pay and rest breaks.
The settlement covers just the 2,300 drivers that worked at the company in California between 2000 and 2007. Other similar cases in other states will proceed separately, said company spokesperson Perry Colosimo.
The settlement came following an August 2014 ruling against FedEx in the case. The federal 9th Circuit Court of Appeals’ Aug. 27, 2014-issued ruling said the drivers bringing the suit should have been classified as employees.
This July, the U.S. 7th Circuit Court of Appeals made a similar in ruling against FedEx involving drivers in Kansas. The federal appeals upheld the Kansas Supreme Court’s 2014 ruling that said 500 drivers based in the Sunflower State were improperly classified as contractors instead of employees. Both the 7th Circuit and 9th Circuit appellate courts would be the last stops before the Supreme Court ...
The settlement will resolve the legal battle that’s now stretched a decade, as the original complaint in the case was brought against the LTL giant in 2005. Truck operators for the company claimed their designation as contractors, and not company employees, kept them from being eligible for certain state-required employee benefits like overtime pay and rest breaks.
The settlement covers just the 2,300 drivers that worked at the company in California between 2000 and 2007. Other similar cases in other states will proceed separately, said company spokesperson Perry Colosimo.
The settlement came following an August 2014 ruling against FedEx in the case. The federal 9th Circuit Court of Appeals’ Aug. 27, 2014-issued ruling said the drivers bringing the suit should have been classified as employees.
This July, the U.S. 7th Circuit Court of Appeals made a similar in ruling against FedEx involving drivers in Kansas. The federal appeals upheld the Kansas Supreme Court’s 2014 ruling that said 500 drivers based in the Sunflower State were improperly classified as contractors instead of employees. Both the 7th Circuit and 9th Circuit appellate courts would be the last stops before the Supreme Court ...
A federal jury in Los Angeles convicted the former owner and the former operator of a durable medical equipment supply company of health care fraud charges in connection with a $1.5 million Medicare fraud scheme.
Amalya Cherniavsky, 41, and her husband, Vladislav Tcherniavsky, 46, of Long Beach, California, were both convicted of one count of conspiracy to commit health care fraud and five counts of health care fraud. Sentencing is scheduled for Dec. 14, 2015, before U.S. District Judge Terry J. Hatter Jr. of the Central District of California, who presided over the trial.
The evidence at trial demonstrated that Cherniavsky owned JC Medical Supply (JC Medical), a purported durable medical equipment (DME) supply company, and that she co-operated the company with her husband, Tcherniavsky. According to the trial evidence, the defendants paid illegal kickbacks to patient recruiters in exchange for patient referrals. The evidence further showed that the defendants paid kickbacks to physicians for fraudulent prescriptions - primarily for expensive, medically unnecessary power wheelchairs - which the defendants then used to support fraudulent bills to Medicare.
According to the evidence presented at trial, between 2006 and 2013, the defendants submitted $1,520,727 in fraudulent claims to Medicare and received $783,756 in reimbursement for those claims.
The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Central District of California. The case was investigated by the FBI, HHS-OIG’s Los Angeles Regional Office and the California Department of Justice. The case is being prosecuted by Trial Attorneys Blanca Quintero and Kevin R. Gingras of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 2,300 defendants who have collectively billed the Medicare program for more than $7 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Eileen M. Decker of the Central District of California, Special Agent in Charge Chris Schrank of the U.S. Department of Health and Human Services-Office of the Inspector General’s (HHS-OIG) Los Angeles Region, Assistant Director in Charge David Bowdich of the FBI’s Los Angeles Division and Special Agent in Charge David Jett of the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse made the announcement ...
Amalya Cherniavsky, 41, and her husband, Vladislav Tcherniavsky, 46, of Long Beach, California, were both convicted of one count of conspiracy to commit health care fraud and five counts of health care fraud. Sentencing is scheduled for Dec. 14, 2015, before U.S. District Judge Terry J. Hatter Jr. of the Central District of California, who presided over the trial.
The evidence at trial demonstrated that Cherniavsky owned JC Medical Supply (JC Medical), a purported durable medical equipment (DME) supply company, and that she co-operated the company with her husband, Tcherniavsky. According to the trial evidence, the defendants paid illegal kickbacks to patient recruiters in exchange for patient referrals. The evidence further showed that the defendants paid kickbacks to physicians for fraudulent prescriptions - primarily for expensive, medically unnecessary power wheelchairs - which the defendants then used to support fraudulent bills to Medicare.
According to the evidence presented at trial, between 2006 and 2013, the defendants submitted $1,520,727 in fraudulent claims to Medicare and received $783,756 in reimbursement for those claims.
The case was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Central District of California. The case was investigated by the FBI, HHS-OIG’s Los Angeles Regional Office and the California Department of Justice. The case is being prosecuted by Trial Attorneys Blanca Quintero and Kevin R. Gingras of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 2,300 defendants who have collectively billed the Medicare program for more than $7 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Eileen M. Decker of the Central District of California, Special Agent in Charge Chris Schrank of the U.S. Department of Health and Human Services-Office of the Inspector General’s (HHS-OIG) Los Angeles Region, Assistant Director in Charge David Bowdich of the FBI’s Los Angeles Division and Special Agent in Charge David Jett of the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse made the announcement ...
The Division of Workers’ Compensation (DWC) will be updating the clinical topic medical treatment guidelines of the Medical Treatment Utilization Schedule (MTUS) set forth in section 9792.23 et seq. The DWC begins this process by posting two new additional guidelines, the proposed Occupational Interstitial Lung Disease Guideline and Occupational/Work Related Asthma Guideline, to its online forum. Members of the public may review and comment on the proposals until October 26, 2015.
"The MTUS updates help to ensure that medical treatment in the California workers’ compensation system is based on the newest and best evidence," said DIR Director Christine Baker. DWC is a division of DIR.
Once the online forums have been completed for each specific clinical topic, the DWC will combine all of the proposed regulatory updates and additions to section 9792.23 et seq. into one rulemaking package.
"The MTUS chapters on Occupational Interstitial Lung Disease and Occupational Asthma provide an important framework for evidence-based treatment of workers with potentially debilitating diseases," added DWC Executive Medical Director Dr. Rupali Das. "We are actively updating all our medical treatment guidelines to incorporate the current scientific and medical knowledge for many other work-related conditions."
The proposed guidelines incorporate by reference the June 6, 2015 version of the American College of Occupational and Environmental Medicine’s "Occupational Interstitial Lung Disease Guideline" and "Occupational/Work Related Asthma Guideline" which the DWC has adopted with permission from the publisher.
The MTUS Occupational/Work Related Asthma Guideline and the MTUS Occupational Interstitial Lung Disease Guideline are set forth in proposed new regulatory sections 9792.23.10 and 9792.23.11 respectively of Title 8 of the California Code of Regulations and can be found in DWC’s website ...
"The MTUS updates help to ensure that medical treatment in the California workers’ compensation system is based on the newest and best evidence," said DIR Director Christine Baker. DWC is a division of DIR.
Once the online forums have been completed for each specific clinical topic, the DWC will combine all of the proposed regulatory updates and additions to section 9792.23 et seq. into one rulemaking package.
"The MTUS chapters on Occupational Interstitial Lung Disease and Occupational Asthma provide an important framework for evidence-based treatment of workers with potentially debilitating diseases," added DWC Executive Medical Director Dr. Rupali Das. "We are actively updating all our medical treatment guidelines to incorporate the current scientific and medical knowledge for many other work-related conditions."
The proposed guidelines incorporate by reference the June 6, 2015 version of the American College of Occupational and Environmental Medicine’s "Occupational Interstitial Lung Disease Guideline" and "Occupational/Work Related Asthma Guideline" which the DWC has adopted with permission from the publisher.
The MTUS Occupational/Work Related Asthma Guideline and the MTUS Occupational Interstitial Lung Disease Guideline are set forth in proposed new regulatory sections 9792.23.10 and 9792.23.11 respectively of Title 8 of the California Code of Regulations and can be found in DWC’s website ...
Doctors in Australia have carried out a pioneering procedure to treat chronic pain, fitting a permanent spinal cord implant which can record signals from the nervous system and adjust the strength of impulses sent to affected areas.The procedure is claimed to be a breakthrough for treatment of chronic pain and could help patients to avoid pain-killers.
Joe Grewal, the first human to be fitted with a permanent implant, said he has suffered chronic back pain for more than 30 years and now "feels amazing". The 60-year-old said his pain level had dropped from eight of ten before the treatment to "two or three" immediately afterwards. The device, developed by Saluda Medical, was fitted at the Royal North Shore Hospital in Sydney on Tuesday.The implant was inserted within the spinal canal, about five millimetres from the spinal cord. From there, the implant sends an electrical current through the nerves to provide relief in the area of the body that is experiencing pain.
Dr Charles Brooker, the specialist who fitted the implant, said it was a "big advance" because the device could record signals emerging from the nervous system. "Spinal cord stimulators [send] signals into the spinal cord and so the person with pain feels tingling in the pain area and that confuses the brain and they don't feel the pain, they just feel a pleasant tingling sensation," Dr Brooker told ABC News.
The Evoke closed loop neuromodulation control system is designed to automatically adjust stimulation levels for maximum symptom relief irrespective of patient movement. A major drawback of conventional spinal cord stimulation products is that the electrodes placed along the spine move relative to the location of the nerves of the spinal cord. As they move, the level of stimulation of the nerves changes. Simple activities like coughing, sitting down or moving the head can cause changes in the nerve signals of up to 10 times, often causing unpleasant sensations, ranging from uncomfortable tingling to severe shocks. The new machine can adjust itself to produce whatever set level the patient wants, and that's a big advance because previously, whenever people moved or their heart was pulsating, various things would make the electrical signal waver up and down quite significantly.
Saluda chief executive John Parker said his implant, which will initially cost about $30,000, had the capacity to reach a market 10 times the size of the current one and had the potential to help patients with other nerve conditions, including Parkinson's disease and overactive bladder syndrome. Parker was formerly an executive director at Cochlear, a global biotechnology company based in Australia that designs, manufactures and supplies the Nucleus cochlear implant, the Hybrid electro-acoustic implant and the Baha bone conduction implant that has restored the sense of hearing. Cochlear was named Australia's most innovative company in 2002 and 2003, and one of the world's most innovative companies by Forbes in 2011 ...
Joe Grewal, the first human to be fitted with a permanent implant, said he has suffered chronic back pain for more than 30 years and now "feels amazing". The 60-year-old said his pain level had dropped from eight of ten before the treatment to "two or three" immediately afterwards. The device, developed by Saluda Medical, was fitted at the Royal North Shore Hospital in Sydney on Tuesday.The implant was inserted within the spinal canal, about five millimetres from the spinal cord. From there, the implant sends an electrical current through the nerves to provide relief in the area of the body that is experiencing pain.
Dr Charles Brooker, the specialist who fitted the implant, said it was a "big advance" because the device could record signals emerging from the nervous system. "Spinal cord stimulators [send] signals into the spinal cord and so the person with pain feels tingling in the pain area and that confuses the brain and they don't feel the pain, they just feel a pleasant tingling sensation," Dr Brooker told ABC News.
The Evoke closed loop neuromodulation control system is designed to automatically adjust stimulation levels for maximum symptom relief irrespective of patient movement. A major drawback of conventional spinal cord stimulation products is that the electrodes placed along the spine move relative to the location of the nerves of the spinal cord. As they move, the level of stimulation of the nerves changes. Simple activities like coughing, sitting down or moving the head can cause changes in the nerve signals of up to 10 times, often causing unpleasant sensations, ranging from uncomfortable tingling to severe shocks. The new machine can adjust itself to produce whatever set level the patient wants, and that's a big advance because previously, whenever people moved or their heart was pulsating, various things would make the electrical signal waver up and down quite significantly.
Saluda chief executive John Parker said his implant, which will initially cost about $30,000, had the capacity to reach a market 10 times the size of the current one and had the potential to help patients with other nerve conditions, including Parkinson's disease and overactive bladder syndrome. Parker was formerly an executive director at Cochlear, a global biotechnology company based in Australia that designs, manufactures and supplies the Nucleus cochlear implant, the Hybrid electro-acoustic implant and the Baha bone conduction implant that has restored the sense of hearing. Cochlear was named Australia's most innovative company in 2002 and 2003, and one of the world's most innovative companies by Forbes in 2011 ...
Cal/OSHA cited two Northern California construction businesses more than $300,000 for exposing workers to cave-in hazards at a residential construction site in Piedmont. The companies violated Cal/OSHA’s order to stop work until the imminent hazard was abated.
Cal/OSHA cited San Mateo-based general contractor EMI Design and Construction Inc. for 10 workplace safety violations, including two willful and three serious in nature with total proposed penalties of $164,465. Salt Light Investments Inc., a construction project management company in Berkeley, was cited for three workplace safety violations including two willful in nature, with proposed penalties of $140,375.
The violations were discovered during an April 20 investigation at the residential construction site. Cal/OSHA investigators found 11-foot unshored walls and issued a stop-work order that same day to address the unsafe excavation. Three weeks later, Cal/OSHA learned that the employers ordered workers back to the site, despite failing to correct the imminent hazards.
Both EMI Design and Construction Inc. and Salt Light Investments Inc. were issued willful violations for failing to shore up an excavation up to 11 feet and for a lack of a design for proper shoring as required. EMI was also cited three serious violations for an unguarded floor opening, an unguarded wall opening and unguarded exposed rebar ends.
A similar hazard caused a fatal accident at a Milpitas construction site in January 2012. In that case, a construction employer ordered a worker back to an excavation site with unshored 12-foot walls three days after a stop-work order had been issued because of the hazard. The walls caved in, killing the worker. Cal/OSHA launched a criminal investigation, leading to two years’ jail time for both the construction company owner and the project manager.
A serious violation is cited when there is a realistic possibility that death or serious harm could result from the actual hazardous condition. A willful violation is cited when the employer is aware of the law and violates it, or when the employer is aware of the hazardous condition and does not take reasonable steps to address it ...
Cal/OSHA cited San Mateo-based general contractor EMI Design and Construction Inc. for 10 workplace safety violations, including two willful and three serious in nature with total proposed penalties of $164,465. Salt Light Investments Inc., a construction project management company in Berkeley, was cited for three workplace safety violations including two willful in nature, with proposed penalties of $140,375.
The violations were discovered during an April 20 investigation at the residential construction site. Cal/OSHA investigators found 11-foot unshored walls and issued a stop-work order that same day to address the unsafe excavation. Three weeks later, Cal/OSHA learned that the employers ordered workers back to the site, despite failing to correct the imminent hazards.
Both EMI Design and Construction Inc. and Salt Light Investments Inc. were issued willful violations for failing to shore up an excavation up to 11 feet and for a lack of a design for proper shoring as required. EMI was also cited three serious violations for an unguarded floor opening, an unguarded wall opening and unguarded exposed rebar ends.
A similar hazard caused a fatal accident at a Milpitas construction site in January 2012. In that case, a construction employer ordered a worker back to an excavation site with unshored 12-foot walls three days after a stop-work order had been issued because of the hazard. The walls caved in, killing the worker. Cal/OSHA launched a criminal investigation, leading to two years’ jail time for both the construction company owner and the project manager.
A serious violation is cited when there is a realistic possibility that death or serious harm could result from the actual hazardous condition. A willful violation is cited when the employer is aware of the law and violates it, or when the employer is aware of the hazardous condition and does not take reasonable steps to address it ...
The Monterey Herald reports that about 30 people who say workers’ compensation law SB 863 has created a complicated and convoluted system expressed their frustrations in a protest outside the Workers’ Compensation offices in Salinas on Wednesday. "It is driving them down," said Dr. David Torrez, spokesman for the protesters. "There are increases in depression, anxiety, suicide, divorce and fractured families."
SB 863 is considered one of Gov. Jerry Brown’s landmark reforms. The bill took effect in 2013 and made wide-ranging changes to the state’s workers’ compensation system, including increased benefits to injured workers and cost-saving efficiencies, says a report by the Department of Industrial Relations and its Division of Workers’ Compensation.
Torrez said workers he sees are dissatisfied with the effects of SB 863 and "the draconian methods that various workers’ compensation insurance carriers are using to deny them some very basic medical rights and benefits."
Gilbert Stein, a lawyer who specializes in workers’ compensation, told the crowd they were protesting in the wrong place. He said they should be protesting the law with their legislators.
Torrez is a chronic-pain specialist and marched with the other protesters. He said he was speaking for and showing his support of injured farmworkers from the Monterey, Santa Cruz and San Benito county areas. Torrez, who is an assistant professor at Stanford School of Medicine, says there have been complaints of major delays in the access, treatment, medication and follow-up of patients. Torrez said the processes keep the patient from getting needed treatment, therapy or medicines.
And it is getting more difficult to find doctors who accept workers’ compensation patients because, he said, of the amount of paperwork involved. "It has become punitive," said Torrez. "The very people these laws were enacted to benefit and protect" are being hurt by them ...
SB 863 is considered one of Gov. Jerry Brown’s landmark reforms. The bill took effect in 2013 and made wide-ranging changes to the state’s workers’ compensation system, including increased benefits to injured workers and cost-saving efficiencies, says a report by the Department of Industrial Relations and its Division of Workers’ Compensation.
Torrez said workers he sees are dissatisfied with the effects of SB 863 and "the draconian methods that various workers’ compensation insurance carriers are using to deny them some very basic medical rights and benefits."
Gilbert Stein, a lawyer who specializes in workers’ compensation, told the crowd they were protesting in the wrong place. He said they should be protesting the law with their legislators.
Torrez is a chronic-pain specialist and marched with the other protesters. He said he was speaking for and showing his support of injured farmworkers from the Monterey, Santa Cruz and San Benito county areas. Torrez, who is an assistant professor at Stanford School of Medicine, says there have been complaints of major delays in the access, treatment, medication and follow-up of patients. Torrez said the processes keep the patient from getting needed treatment, therapy or medicines.
And it is getting more difficult to find doctors who accept workers’ compensation patients because, he said, of the amount of paperwork involved. "It has become punitive," said Torrez. "The very people these laws were enacted to benefit and protect" are being hurt by them ...
During a recent webinar - Recognizing and Combatting Medical Fraud, Waste and Abuse in Property and Casualty - Verisk Analytics outlined the ways medical fraud is perpetrated and ways it can be identified and controlled. According to the company, it is estimated that $234 billion goes to medical fraud, waste and abuse in the healthcare system annually - that’s $28.5 million an hour.
And the problem is growing rapidly. In 2000, fraud accounted for 10 percent of Property and Casualty spend. In 2015, fraud accounts for 30 percent. Medical fraud costs an estimated $30 to $50 billion annually. In worker’s compensation, $5 billion annually is attributed to fraud with 30 percent of that attributed to prescription fraud and abuse.
Not surprising, personal injury protection (PIP) fraud totals $6.8 billion annually. One in four PIP claims in New York have a fraud component, while one in three in Florida do. The Florida Office of Insurance Regulation reported no-fault fraud and abuse cost the state’s consumers and insurers about $658 million in 2011.
The Verisk solutions manager outlined the following examples of fraud, waste and abuse: Misidentified procedures; Cost shifting; Drug seeking; Identity theft - patient or provider; High times - when a provider bills for more hours than are in a day; Template billing - everyone seen is billed for the same procedures and diagnoses; Specialty procedure and diagnoses codes mismatch; Upcoding; Evaluation and maintenance codes by PTs and MTs; Boiler plate billing; Accelerated treatment path - Evaluation and maintenance, MRI then surgery; Modifier abuse - code 59 is commonly used indicating more work so extra charges.
Insurance Research Council data released earlier this year found that claims with possible fraud and/or buildup were more likely to include chiropractic treatment, physical therapy, alternative medicine and pain clinics.
With the changes to the U.S. healthcare system over the past few years, there is evidence of a trend towards cost shifting from group healthcare to the Property and Casualty industry. Doctors are trying to make up for lost revenue by charging more in workers’ compensation and auto cases ...
And the problem is growing rapidly. In 2000, fraud accounted for 10 percent of Property and Casualty spend. In 2015, fraud accounts for 30 percent. Medical fraud costs an estimated $30 to $50 billion annually. In worker’s compensation, $5 billion annually is attributed to fraud with 30 percent of that attributed to prescription fraud and abuse.
Not surprising, personal injury protection (PIP) fraud totals $6.8 billion annually. One in four PIP claims in New York have a fraud component, while one in three in Florida do. The Florida Office of Insurance Regulation reported no-fault fraud and abuse cost the state’s consumers and insurers about $658 million in 2011.
The Verisk solutions manager outlined the following examples of fraud, waste and abuse: Misidentified procedures; Cost shifting; Drug seeking; Identity theft - patient or provider; High times - when a provider bills for more hours than are in a day; Template billing - everyone seen is billed for the same procedures and diagnoses; Specialty procedure and diagnoses codes mismatch; Upcoding; Evaluation and maintenance codes by PTs and MTs; Boiler plate billing; Accelerated treatment path - Evaluation and maintenance, MRI then surgery; Modifier abuse - code 59 is commonly used indicating more work so extra charges.
Insurance Research Council data released earlier this year found that claims with possible fraud and/or buildup were more likely to include chiropractic treatment, physical therapy, alternative medicine and pain clinics.
With the changes to the U.S. healthcare system over the past few years, there is evidence of a trend towards cost shifting from group healthcare to the Property and Casualty industry. Doctors are trying to make up for lost revenue by charging more in workers’ compensation and auto cases ...
High rates of inappropriate opioid use, physician drug dispensing and the increased utilization and cost of pharmaceuticals in the California workers’ compensation system have been well documented by public policy research. These issues are now associated with another emerging cost driver -- drug testing.
Prior CWCI research on the topic, published in May 2012, documented the viral-like growth in the volume of drug testing in the system that began a decade ago. This new CWCI study builds on that initial research, using more recent and detailed data. Utilization of quantitative drug tests between 2007 and 2014 increased by 2,431 percent. Quantification of opiates remains the leading test by volume, followed by quantification of substances (PCP/Cocaine/Ethanol) that would be illicit or problematic in conjunction with the use of prescribed medications. Among the injured workers who were drug tested, the average number of tests per employee per date of service more than tripled driving the average amount paid per date of service up from $96 in 2007 to $307 in 2014 - a 220 percent increase.
There is evidence of a migration to physician in-office/non-laboratory drug testing. In 2008, 74 percent of Urine Drug Tests (UDT) services were provided by just four laboratories, but during the ensuing four years the mix of providers shifted, with the big laboratories accounting for a declining share of the market while the number of non-laboratory providers billing for these services increased. Between 2008 and the end of 2014, the total number of UDT providers receiving workers’ compensation reimbursements more than doubled from 428 to 876.
Absent an accepted empirical, evidence-based protocol on the appropriate level and scope of testing, it is difficult to reconcile the noted increases in the volume and variety of drug testing with clinical appropriateness and favorable outcomes for the injured worker. There is likely a dearth of empirical evidence showing improved clinical outcomes when UDT is used for patient adherence ...
Prior CWCI research on the topic, published in May 2012, documented the viral-like growth in the volume of drug testing in the system that began a decade ago. This new CWCI study builds on that initial research, using more recent and detailed data. Utilization of quantitative drug tests between 2007 and 2014 increased by 2,431 percent. Quantification of opiates remains the leading test by volume, followed by quantification of substances (PCP/Cocaine/Ethanol) that would be illicit or problematic in conjunction with the use of prescribed medications. Among the injured workers who were drug tested, the average number of tests per employee per date of service more than tripled driving the average amount paid per date of service up from $96 in 2007 to $307 in 2014 - a 220 percent increase.
There is evidence of a migration to physician in-office/non-laboratory drug testing. In 2008, 74 percent of Urine Drug Tests (UDT) services were provided by just four laboratories, but during the ensuing four years the mix of providers shifted, with the big laboratories accounting for a declining share of the market while the number of non-laboratory providers billing for these services increased. Between 2008 and the end of 2014, the total number of UDT providers receiving workers’ compensation reimbursements more than doubled from 428 to 876.
Absent an accepted empirical, evidence-based protocol on the appropriate level and scope of testing, it is difficult to reconcile the noted increases in the volume and variety of drug testing with clinical appropriateness and favorable outcomes for the injured worker. There is likely a dearth of empirical evidence showing improved clinical outcomes when UDT is used for patient adherence ...
A former private security officer was sentenced to jail for five felony counts of workers’ compensation fraud stemming from an "accident" in 2009. Howard William Neel, 59, of Oroville, was sentenced to one year in the Butte County Jail as a condition of three years of probationary supervision. During that time Neel will also be required to complete a theft awareness and financial management program and to pay restitution to the workers’ compensation program.
According to the Butte County District Attorney’s Office, Neel was working as a private security officer for a local security company in December 2009 when another driver slightly backed into his Crown Victoria at a gas station. Neel claimed extensive back, neck and leg pain. He was treated at Enloe Medical Center and was taken off work.
In subsequent medical appointments, Neel told doctors the impact to his vehicle at the gas station had been so severe that his vehicle was "spun around", knocking him down. But investigators obtained surveillance tape from the gas station and found the collision to be minor. The video showed Neel walking normally after the crash, but he started limping when the other party involved saw him. When that individual left, Neel started walking normally again.
Neel was seen by several doctors and repeatedly denied any back, neck or leg injuries prior to the December 2009 event. However, investigators found Neel suffered the same type of back injury while lifting boxes 10 years prior, which was also treated under the worker’s compensation system.
Additionally, Neel used a cane when he went to doctors’ offices, but undercover surveillance tapes showed him without any cane while working around his house or with his horses ...
According to the Butte County District Attorney’s Office, Neel was working as a private security officer for a local security company in December 2009 when another driver slightly backed into his Crown Victoria at a gas station. Neel claimed extensive back, neck and leg pain. He was treated at Enloe Medical Center and was taken off work.
In subsequent medical appointments, Neel told doctors the impact to his vehicle at the gas station had been so severe that his vehicle was "spun around", knocking him down. But investigators obtained surveillance tape from the gas station and found the collision to be minor. The video showed Neel walking normally after the crash, but he started limping when the other party involved saw him. When that individual left, Neel started walking normally again.
Neel was seen by several doctors and repeatedly denied any back, neck or leg injuries prior to the December 2009 event. However, investigators found Neel suffered the same type of back injury while lifting boxes 10 years prior, which was also treated under the worker’s compensation system.
Additionally, Neel used a cane when he went to doctors’ offices, but undercover surveillance tapes showed him without any cane while working around his house or with his horses ...
