Denver Worker's Compensation Info: work injuries

Showing posts with label work injuries. Show all posts

Wednesday, October 19, 2016

Rate drop of Recordable Workplace Injuries

Asst Sec of Labor Encouraged by BLS Report on Occ Injuries & Illnesses in 2015

Washington, DC – Occupational injury and illness data recently released by the Bureau of Labor Statistics showed a significant drop in the rate of recordable workplace injuries and illnesses in 2015, continuing a pattern of decline that, apart from 2012, has occurred annually for the last 13 years.
Private industry employers reported about 2.9 million nonfatal workplace injuries and illnesses in 2015, representing a decline of about 48,000 from 2014, despite an increase in total hours worked. The rate of cases recorded was 3.0 cases per 100 full-time workers – down from 3.2 in 2014. The rate is the lowest recorded since at least 2002, when OSHA recordkeeping requirements were modified.
Assistant Secretary of Labor for Occupational Safety and Health issued the following statement:
“We are encouraged to see the significant decline in worker injury and illness rates. This is the result of the relentless efforts of employers, unions, worker advocates, occupational safety and health professionals, and federal and state government agencies ensuring that worker safety and health remains a top priority every day.”
“Despite the decline, approximately 2.9 million private sector workers suffered nonfatal injuries and illnesses last year. That is still far too many. At OSHA, we will continue to do all that we can to continue driving the rate down.”
Click here to view: BLS Report on Occupational Injuries and Illnesses in 2015 (PDF)
Source: OSHA

Original Source

Contact Neil O'Toole and John Sbarbaro

at the Law Office of O'Toole & Sbarbaro, P.C.

Phone: 303-595-4777

Located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

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Monday, September 23, 2013

Automated Adjudication = Automatic Waste

By ReduceYourWorkersComp 09/19/2013 09:30:00

I look at all of my bills. Not just during work for business matters, but my personal bills as well. I do not catch many errors. In fact I think I have only caught maybe a handful of issues my entire life. These weren’t big issues, sometimes they were just duplicate charges, service fees that were supposed to be waived, or deposits on hotels that were supposed to be waived because I rescheduled within the allotted time frame without penalty.

Of course I know of people that just pay their bills online automatically every month. They don’t review the itemized statements, nor do they even read the automated email notifications saying their bills were due and automatically paid per their own permission. For obvious reasons this drives me crazy. Humans sometimes fail. Systems sometimes fail. Mistakes happen. No matter how insignificant the duty may be, these risks of errors are always out there every day. Not just in billing matters, but in everything. My coffee order gets prepared incorrectly. My salad came with the dressing on the salad instead of on the side. Don’t even get me started about other issues involving flights being “on-time,” The point is to err is human, and last time I checked we were all human at least to some degree, especially in this industry.

Claims Industry Working To Become More Efficient

The latest craze is the argument over automated adjudication of minor claims and of lifetime claims that have steadied out as far as invasive treatment goes. Adjusters are busy, and insurers/TPAs are trying to do more with less. They want to become more efficient. They want to spend less and less time on what they deem to be “trivial” claims and spend more time on the more important claims that carry a higher exposure.

This makes sense. Adjusters should be spending more and more time focusing on the matters that are more important than Jim Worker who cut his finger and had to go to the doctor for a few stitches. Minor medical-only claims constitute a lot of the pending file counts on certain levels of adjusters, and those adjusters are also the ones that are just starting out in the claims world. This is where they should be learning the process, and how important it is to review every bill for relatedness.

But to introduce automatic claim handling by a computer worries me. I worry about leakage all the time, because wasting money is one of my many pet-peeves. The marketers of automated claim technology say that they protect against error, because of the data that has to be input into the system for a person. Date timeframes need to be in place. Body injury codes are input so the injury body part can be correctly identified. CPT codes and billing coding is also entered into the system to prevent certain treatments from being automatically paid. Maximum bill amount parameters can be placed so any big bill they may come in would be flagged and not paid so the adjuster can review and authorize the payment.

These are all well and good. In fact, it looks great! If this system works according to plan, then how could anything ever be paid in error? On paper, these automated systems appear to be the next greatest thing since the computer so adjusters can do more and become more proactive at their desks. So what could the problem possibly be with implementing an automated adjudication process?

I can tell you one problem right now—it would only be as good as the person inputting the information. Like I said above—to err is human.

Automated Adjudication on Lifetime Claims = Large Medical Leakage

Let’s say automated adjudication is used for lifetime claims. After all, you have accepted the left knee as being compensable for life. You owe it, and you owe treatment on it, depending on your jurisdiction. But for ease of an example, we will just say you owe it no matter what. So it makes sense to just automate the medical bill payment on it, right?

No it does not. And I will tell you why: What if the doctor this person treats with just has their left knee as the primary diagnosis? This injured worker treats with their primary care doc. In the doctor’s system, they have the injured worker down as the left knee being most important and primary diagnosis. But if he comes in for a non-work related back strain, I doubt the primary diagnosis will change. The CPT code would probably just be for an office visit, so the system has no idea that the person treated for their back because it just sees the diagnosis code, and the CPT code. Nobody is there to view the medical report, so this bill gets paid. Along with bills for the flu, arm pain, lab results, medication of various types for various elements, and so on. Now you have paid the medical bills for who knows what, for who knows how many years. That is a leakage emergency!!

When will this be corrected? Who is in charge of making sure the treatment is for the compensable knee? The answer is probably nobody. Plus this can happen on a number of claims. Add all of that up, and now you have a substantial number of medical leakage. One that should have never occurred in the first place if you had a real person reviewing medical notes that go with the bill before they paid it.

I saw a fantastic statistic from Acrometis in an article on their website entitled “How much is your auto-adjudication costing you?” (http://www.acrometis.com/strength/0123.htm) In this article, Acrometis states that “…auto-approving all submissions under $250 results in overpaying $8,000,000 if you only look at submissions that were returned but not resubmitted. Applying the same approach to all the submissions analyzed results in overpayment of more than $133,000,000.”

Now I could stand a bill here and there being paid in error. But you have to look at the total from a macroeconomic view. Look at the entire scope of a carrier/TPA, not just on the one claim itself.

Auto Accepting Bills May Accept Large and Unrelated Medical Services

Lastly and yet another great point in that article shows that auto-accepting some bills may loop you into also accepting much larger and potentially unrelated medical services. This could include costly prescriptions, DME bills, unwarranted exploratory surgical procedures, and so on. This would depend on your jurisdiction, but the end result is the nightmare that every adjuster has, which is being forced to accept treatment on an unrelated non-compensable body part due to adjuster error. This is going to land the adjuster in some hot water, and probable disciplinary action I would hope. This type of error is inexcusable!

All of these errors do not need to happen, and should not happen at all. They should not happen because adjusting claims should be done by a real person, not some automated service. Before we jump on the ship of automatic adjudicating, we had better take a step back and look at the consequences of error, both from a human standpoint and from a systems standpoint.

Original Source

The Law Office of O'Toole & Sbarbaro, P.C. can help you with your workers' compensation or Social Security disability case.

http://www.otoole-sbarbaro.com

Phone: 303-595-4777

We are located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

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Friday, September 20, 2013

New Zealand Employer Fined Following Worker Injury -

By ReduceYourWorkersComp 09/18/2013 08:30:00
Companies that fail to enforce workplace safety measures oftentimes end up paying for it in more ways than one. Along with some negative PR, the financial penalties can be substantial. In a recent New Zealand case, a worker who was seriously injured in a grain silo accident in October of 2012 was recently awarded $26,000 in emotional harm reparations and his employer, NZ Starch Ltd of Onehunga, fined $35,000. The company had already paid nearly $20,000 to the victim.

NZ Starch had previously pleaded guilty to one charge (Section 6) under the Health and Safety in Employment Act 1992 and was sentenced at the Manukau District Court today. The victim was asked by his supervisor to sweep remaining grain from a silo before a new delivery. The silo contains a sweep auger which operates when gravity no longer forces the grain out of the silo, but which leaves a 10 centimetre residue of grain that has to be swept out by hand.

The victim knew he was supposed to turn off the auger before entering the silo, but had been shown by a supervisor how to slow the auger and sweep out the silo when it was operating at slow speed. This method was not authorised by NZ Starch.

Worker Suffered Major Injuries Following Fall

As an investigation discovered, the worker fell into the moving auger blades suffering a head injury, fractures to his right arm, right lower leg, right eye socket and jaw as well as broken tendons in one leg and extensive bruising. “The victim did not comply with company procedures, but the company had not isolated the hazard by installing an interlock which would have locked the silo access door while the auger was still active,” Chief Inspector Investigations for the Health and Safety group Keith Stewart said.

“This would have ensured workers could not override company instructions by slowing the auger and working in a dangerous environment,” Stewart added.

Original Source

The Law Office of O'Toole & Sbarbaro, P.C. can help you with your workers' compensation or Social Security disability case.

http://www.otoole-sbarbaro.com

Phone: 303-595-4777

We are located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

Disclaimer

Wednesday, September 11, 2013

The Deadly Symmetry In Work Comp. A Stick With Two Short Ends - The Law Office of O'Toole & Sbarbaro, P.C.

There is a decades old ongoing discussion in work comp: is it the employer or employee who benefits or loses? The answer: both.

Neither Employer of Employee Are “Winners” in Work Comp

Neither the employer (who, ultimately, pays for everything) nor the employee (who has substantial net wage loss in nearly every claim) can be said to “win”, no matter what the outcome. “Winning”, to most people, means emerging undamaged, but the net losses in comp sometimes remain unknown to the parties until years later.

The most perfidious feature of work comp laws is the “substantial evidence” rule, which permits a comp board ruling to be unreviewable on questions of fact and medical opinion if it is supported by “substantial evidence”, which, in fact, is defined as “a scintilla of evidence”, which is hardly substantial at all.

So what? Well, it means that a typical comp system can make inconsistent rulings on a large group of claims, but each will be based on “substantial evidence” even though the rulings in bulk are contradictory. Comp systems have noticed this since the beginning, and so have the lowliest ALJs, who quickly realize that they are shielded from review, except on questions of law, not fact. So, no matter who might win a particular claim, all can become the next victim of “substantial evidence”.

Case Law Decisions Lead to Predictable Outcomes Most of the Time

But “a scintilla of evidence” is not a rule which demands the best of any system. It leads to decisions which erode into predictable outcomes most of the time, warranted or not, punctuated by irrational outcomes for no apparent reasons. One NY comp case, in the 1980s, was so inexplicable that it made a list of outrageous decisions which was published in the Readers’ Digest.

The comp claim involved a high school teacher who was so “stressed” by work that he shot and killed the principal. And then went on to win a max rate “stress claim”. This was upheld by the highest court in NY based on “substantial evidence”. The principal’s widow, in turn, had no problem winning a death claim, also based on – “substantial evidence”.

Therefore, neither party got the “short end” since both “won”.

If the result of a claim is only measured by who got money or who did not, the real “winners” and “losers” can never be identified. In the above high school case, what was the true effect on workplace morale? Was it ever considered? What was the successor principal faced with in terms of maintaining discipline and integrity in the school system?

By ReduceYourWorkersComp 09/10/2013 09:30:00

And what did the attorneys representing workers do with that decision? For years it was routinely cited as authority for “all doubts are resolved in the worker’s favor”, although what doubt was in that claim is difficult to imagine.

The teacher later gave an interview to a newspaper, after his win in the highest court, complaining of the “stress” the litigation had subjected him to.

So who wins every comp claim? Everyone but the employer and employee.

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

The post The Deadly Symmetry In Work Comp. A Stick With Two Short Ends appeared first on Reduce Your Workers Compensation Insurance Coverage Costs with Timely Information for Employers | Work Comp Roundup.

Original Source

The Law Office of O'Toole & Sbarbaro, P.C. can help you with your workers' compensation or Social Security disability case.

http://www.otoole-sbarbaro.com

Phone: 303-595-4777

We are located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

Disclaimer

Tuesday, September 10, 2013

Horror Story: What Happens When Modified Duty is Not Provided -Law Office of O'Toole & Sbarbaro, P.C. Worker's Comp Blog

By ReduceYourWorkersComp

A recent case in San Diego shows what happens when the adjuster and the employer do not provide Modified Duty. On August 8, 2013 San Diego District Attorney Bonnie Dumanis announced the guilty pleas of a daughter – father conspiracy to commit workers’ compensation fraud, grand theft and perjury.

Yolandi Kohrumel, age 35, and her father Anton Buitendag, age 65, were sentenced to one year in jail and 180 days in jail, respectively, by the San Diego Superior Court Judge Duane Moring. Restitution in the full amount the insurer, AIG, had been defrauded, of $1,558,653, was also ordered.

Worker Claimed Multiple Complications From Injury

Ms. Kohrumel started work as a store manager for a national office supply company in 2002. After 3 months on the job, Ms. Kohrumel claimed a box fell on her toe and broke her toe. In November, 2002, Ms. Kohrumel had surgery on her toe. Following the toe surgery, she was given crutches. Ms. Kohrumel claimed she could not use the crutches, and was provided a wheelchair. The news articles do not address why the third party administrator (TPA) adjuster agreed to a wheelchair instead of having a physical therapist assist the Ms. Kohrumel to learn how to properly use the crutches correctly. The news article also does not address why the claimant was provided a wheelchair instead of a knee walker for her injured toe.

Once Ms. Kohrumel had the wheelchair, she alleged she developed carpal tunnel syndrome from using the wheelchair. The news articles do not address whether or not the TPA adjuster had an Independent Medical Examination (IME) done to confirm the carpal tunnel syndrome claim. [In California IME doctors are called Agreed Medical Evaluators (AME) or if appointed by the Division of Workers’ Compensation, Qualified Medical Evaluators (QME)]. She was provided an electric wheelchair.

The news articles do not explain why neither the TPA adjuster nor the employer arranged for Ms. Kohrumel to work modified duty. Modified duty for a store manager should have been a no brainer, whether the employee was on crutches, using a knee walker, a standard wheel chair or an electric wheelchair.

Ms. Kohrumel then alleged she developed hypersensitivity to her feet, along with regional pain syndrome, depression and anxiety. The news articles also do not mention any AMEs or QMEs for the alleged hypersensitivity, regional pain syndrome, depression and anxiety. In defense of the TPA adjuster, all of Ms. Kohrumel’s doctors believed her subjective claims, or elected not to dispute them. Still, an AME or QME could have assisted the adjuster to dispute these additional claims.

Injured Worker Was Receiving 25 Prescriptions From Various Doctors

By 2004, Ms. Kohrumel, who represented herself, was receiving 25 prescriptions from her various doctors. She alleged she was unable to care for herself and needed 24 hour a day assistance, seven days a week. With the doctors stating Ms. Kohrumel was permanently disabled, the TPA adjuster agreed for Ms. Kohrumel’s husband to provide her the around the clock care. Her husband provided the care until his death in September, 2011. Following her husband’s death, Ms. Kohrumel requested her father, Mr. Buitendag, provide her the around the clock care, to which the adjuster agreed.

Mr. Buitendag felt his services for caring for his daughter were worth $500 per day, or over $182,000 per year. The TPA adjuster refused to pay the father because he was a foreigner, without a work visa. At this point, Ms. Kohrumel was represented by an attorney and started litigating the issue before the California Workers’ Compensation Appeals Board.

Ms. Kohrumel decided her residence, a two bedroom apartment, was not large enough for her wheelchair to navigate properly. The TPA adjuster hired a moving company to relocate Ms. Kohrumel and her father. The moving company was advised they would have to do everything as Ms. Kohrumel was wheel-chair bound.

Fraud Uncovered Cost Total of $1,500,000

The movers saw Ms. Kohrumel get out of her wheelchair for extended periods, to lift and move heavy boxes in her garage. She was able to move about without any limitations. The movers reported this to the TPA adjuster, who had the movers videotape Ms. Kohrumel as she stood for two hours picking up, moving and sorting through the boxes in her garage.

Investigators for the District Attorney’s Office served a search warrant on Ms. Kohrumel’s garage and found more than 20 boxes of unused prescription medications. The following day, Ms. Kohrumel agreed to enter guilty pleas on 8 felony counts, including grand theft, perjury, false documents and insurance fraud. Mr. Buitendag pleaded guilty to 3 felonies including attempted grand theft. The judge in addition to the jail time ordered Ms. Kohrumel to repay the $1,558,653 she had stolen from the insurance company.

Ms. Kohrumel was obviously a person who had no qualms about ripping off the workers’ compensation insurer and was apparently a fairly good con-man, as she fooled various doctors. However, if the employer and the adjuster had arranged for modified duty both before and after her toe surgery, would she be in jail today and would the insurer be out $1.5 million? There is no way to know for sure, but we know from experience that the sooner an injured employee is provided modified duty, the faster the claim will come to a conclusion, and the opportunity for symptom magnification is greatly diminished.

Original Source

Contact the Law Office of O'Toole & Sbarbaro, P.C. today if you have a workers' compensation or a Social Security disability case.

http://www.otoole-sbarbaro.com

Phone: 303-595-4777

We are located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

Disclaimer

Monday, September 9, 2013

Commission Keeps Claimant's Counsel and Recording Devices out of Employer's Medical Evaluations

September 5, 2013

by Merrilee Harrell

A recent decision of the Alaska Workers’ Compensation Appeals Commission concluded that claimant’s counsel may not attend and record an employer’s independent medical evaluation (EME) unless the examining physician consents. InASRC Energy Services, Inc. v. Kollman, AWCAC Decision No. 186 (August 21, 2013), the Commission reversed an interlocutory decision of the Alaska Workers’ Compensation Board that injured worker Jeffrey Kollman may record an EME and have a witness present despite the objection of the employer’s physicians. Kollman v. ASRC Energy Services, Inc., AWCB Decision No. 13-0076 (June 27, 2013). The Board had relied onLangfeldt-Haaland v. Saupe Enterprises, 768 P.2d 1144 (Alaska 1989), which held that a civil litigant had a right to record a court-ordered Rule 35 medical evaluation and have his attorney present during the evaluation. On appeal, the Commission noted that Civil Rule 35 is significantly different from AS 23.30.095(e) of the Alaska Workers’ Compensation Act. AS 23.30.095(e) states that “The employee shall... submit to an examination by a physician or surgeon of the employer’s choice...” which, the Commission noted, leaves the choice of EME physician exclusively with the employer. A Rule 35 medical evaluation, in contrast, may be ordered by a judge “only on motion for good cause shown and upon notice... to all parties and shall specify the time, place, manner, conditions, and scope of the examination and the person or persons by whom it is to be made.”

The Commission also noted that Langfeldt-Haaland was a 3-2 decision that explicitly limited its holding to Civil Rule 35 medical evaluations. The majority had argued the importance of allowing counsel to “observe shortcomings and improprieties during the examination which could be the subject of inquiries on cross-examination at trial; and ... [to] object to questions posed to the plaintiff during the examination that concern privileged information.” The dissenting judges pointed out that “adopting such a rule could have a chilling effect on otherwise reputable physicians performing medical examinations.” The Commission found the dissent’s position more persuasive, and also took into account a survey of SIME physicians that showed a significant percentage of the physicians surveyed would decline to perform evaluations if they were required to allow the evaluation to be witnessed and recorded. Requiring EME evaluations to be witnessed and recorded would thus have a chilling effect on the employer’s choice of physician if the employer’s choice was limited by such a requirement.

The commission emphasized that the plain language of AS 23.30.095(e) gives the employer the exclusive choice of EME physician, noting that the statute “does not say that the choice of an EME physician is exclusively the employer’s, provided that the employer chooses a physician who would allow witnessing and recording of the EME.” The commission concluded that such a restriction would interfere with the employer’s choice of physician as contemplated by AS 23.30.095(e). Kollman has appealed the Commission’s ruling to the Alaska Supreme Court.

Original Source

Original Source

Contact the Law Office of O'Toole & Sbarbaro, P.C. today if you have a workers' compensation or a Social Security disability case.

http://www.otoole-sbarbaro.com

Phone: 303-595-4777

We are located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

Disclaimer

Friday, September 6, 2013

Employers: Know Your Work Comp Claims – Or Else! - Law Office of O'Toole & Sbarbaro, P.C. Worker's Comp Blog

By ReduceYourWorkersComp 09/05/2013 09:30:00

In comp claims, there is no substitute for knowledge of the facts. Not just the underlying facts about the injury, but the facts about how the claim is being handled.

Last week, an employer who was experiencing a rash of dubious comp injury reports had received no information from the comp board or the carrier on how the claims were being handled. The employer was also required by federal law to monitor employee injury reports and make sure that the employees could safely operate heavy vehicles. The employer, therefore, wanted to review the claim folders before the comp board, which, in NY, it has the right to do.

Employer Needs To Be Proactive To Obtain Information

But the employer did not have the board file numbers for the claims. A phone call to the carrier elicited no cooperation whatsoever. “Why do you want to know the claim numbers? Sorry, we don’t have them.” (Two of the claims were over a year old and had been to hearings.)

The employer was pleased to discover that the files could be located without the WCB number and without the carrier’s assistance or approval. The employer, however, was disturbed at the carrier’s attitude. Why shouldn’t an employer have access to the facts?

In NY, employers, until recently, were automatically notified of hearings and the the results. To be sure, that is only a bare minimum but it is a lot better than nothing. But if we go back even farther we come to a time when the carrier did not even attend hearings – just the employer. And the law has not changed since then. The employer has been gradually removed from the claim process until it has far less access to information than any other party in the process.

Employer Has Right To Full Access Of Claim Information

An employer has every right to full access to the information in a claim folder and does not need anyone’s permission to get it. But what should it do if its carrier doesn’t see things that way?

Obstructions on the information highway are like obstructions on a vehicular freeway. Don’t try to go over them or through them – and don’t put on the brakes and sit in the middle of the traffic. Instead, slow down and cautiously drive around them.

A carrier who tells an employer, “Why do you want to know?”, is inviting short pithy replies. A perfectly acceptable response might be, “Because I’m the only one paying for all this”, even if it fails to arouse sympathy. A better one is, “Because the law makes me, not you, primarily responsible for poor claim performance and harm to my workers”.

Raw information is so valuable that it is worth nearly any effort to obtain it. The employer should also be aware there are many laws that require the information that the employer needs. Comp claim information is needed for proper handling of unemployment claims, discrimination claims, private disability claims, tax matters, ERISA, ADA, FMLA, as well as a host of other laws. So an employer who is asked, “Why do you want to know”, is speaking with someone who is unaware of the comp law since its very beginnings, not to mention all the other laws passed since then.

Don’t get mad. Be patient, ask others to assist – and get the information

Original Source

Contact the Law Office of O'Toole & Sbarbaro, P.C. today if you have a workers' compensation or a Social Security disability case.

http://www.otoole-sbarbaro.com

Phone: 303-595-4777

We are located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

Disclaimer

Thursday, September 5, 2013

How Mediation Saves Workers Compensation Dollars - Law Office of O'Toole & Sbarbaro, P.C. Worker's Comp Blog

By ReduceYourWorkersComp 09/03/2013 10:40:00

Mediation of Workers Compensation claims is commonplace in some states and mandatory in a couple (e.g., South Carolina as of 5/15/2013). Elsewhere, such as in California, claims professionals and attorneys are just starting to catch on to the benefits of mediation.

Multiple Appearances With Judge Can Accomplish Little

Budget cutbacks and increasing caseloads mean less time for cases to be heard by a workers compensation judge. The result is multiple appearances which accomplish little. This costs the employer money for the defense attorney’s fees and consequential costs from the inability to get a ruling. For the injured worker’s attorney who typically will receive a fixed percentage contingent fee, each appearance without resolution decreases the attorney’s hourly rate of compensation. The injured worker shares the employer’s frustration with the inability to get a ruling, with consequent stress and depression. Sometimes this frustration causes the injured worker to seek new counsel with instructions to “be more aggressive.”

In contrast, mediation is as fast and efficient as the parties want it to be. Mediations can be scheduled for a time and place of the parties’ convenience. As much time as is necessary can be allocated for the mediation. The issues to be resolved can be as narrow as definition of the industrial injury or as broad as conclusion of all indemnity, medical and penalty claims.

Mediation Facilitates Communication and Settlement

Mediation focuses the parties’ attention. This contrasts with a court appearance where an attorney may be juggling appearances in multiple courtrooms.

Mediation can result in settlement when the parties are unable to negotiate a settlement on their own. The presence of the neutral can facilitate communication. Typically, parties will be together for some of the mediation and sometimes in separate sessions. Separate sessions, known as caucuses, allow the mediator to exercise subtle diplomacy. Settlement can result even when the parties or attorneys are hostile.

The mediation may be the only opportunity the injured worker gets to tell the story of the injury and treatment. For many injured workers, relating the narrative allows them to put it in the past and move on, a good result for all concerned.

Author: Teddy Snyder is a mediator of workers compensation claims throughout California. An attorney of 36 years experience, Ms. Snyder has concentrated her practice on settlements. She is a frequent speaker and author for bar and claims groups on the topics of settlement and Medicare Secondary Payer Act compliance. LEXIS-NEXIS has designated her a Notable Person in Workers Compensation. Ms. Snyder can be reached at TSnyder@WCMediator.com or through www.WCMediator.com.

Original Source

Contact the Law Office of O'Toole & Sbarbaro, P.C. today if you have a workers' compensation or a Social Security disability case.

http://www.otoole-sbarbaro.com

Phone: 303-595-4777

We are located in the Denver Metro area.

226 West 12th Avenue Denver, Colorado 80204

Disclaimer

Wednesday, September 4, 2013

Critics Say It's Time NY Ends 1885 Scaffold Law - Law Office of O'Toole & Sbarbaro, P.C. Worker's Comp Blog

ALBANY, N.Y. August 31, 2013 (AP)

By MICHAEL GORMLEY Associated Press

Years before skyscrapers, when New York City's tallest building was still the 281-foot spire of Wall Street's historic Trinity Church, state lawmakers passed the Scaffold Law, which made property owners and contractors liable for most "gravity-related" injuries to workers on construction sites.

As the years went by, and the buildings and dangers climbed ever higher, the 1885 law stayed on the books and allowed injured workers to collect big court verdicts for medical bills, pain and suffering. And it remained long after other states abandoned similar laws in favor of less costly federal workers' compensation insurance.

Today, New York's Scaffold Law, protected by the state's powerful labor unions and trial lawyers, is the only one of its kind in the nation. It requires another layer of general liability insurance for contractors, and hits taxpayers by adding hundreds of thousands, even millions of dollars, to the cost of every public project.

Some New York government agencies and contractors say the cost of the insurance, which can often be double that of other states, is hitting a crisis point that could soon suspend work on bridges, schools and the recovery from Superstorm Sandy.

"It increases the cost of doing business and decreases what we are capable of doing in New York state," said Carley Hill, of Union Concrete and Construction Corp. in West Seneca. "You are losing potential millions of dollars in jobs that could go to people."

For example, building groups estimate that the law's required liability insurance premiums will add an extra $200 million to $400 million to the state's $5 billion replacement of the Tappan Zee Bridge.

New York City's school system says the insurance cost it incurs from the law is enough to build two new schools every year, according to an internal document obtained by The Associated Press.

In western New York, the general liability insurance premium was $380,000 to cover rehabilitation on just 23 miles of the state Thruway.

That liability insurance existed in other states but was long ago replaced by federal workers' compensation insurance, which requires workers to give up their right to sue for liability and provides standard payments for medical bills and lost wages as a quick way to settle claims without assessing blame.

What makes New York unique is that the Scaffold Law gives workers on all construction sites the ability to sue property owners and contractors directly for liability, which can include compensation for punitive damages or pain and suffering.

That has spawned multimillion-dollar settlements against construction companies, which have, in turn, driven up the premiums to pay for the general liability insurance.

Former General Motors Co. worker Tim Swedenhjelm of East Concord credits the law with helping him walk again after a 1999 accident when scaffolding collapsed on him, breaking bones in his back, paralyzing his leg and stopping his heart for two minutes. A big court award he didn't want to divulge paid for more tests, four back surgeries and two knee surgeries.

"I would have been written off if it was just workers' compensation," he said.

But opponents of the law say taxpayers can no longer afford the cost of the required liability insurance, and public projects are reduced or lost at a time when New York's job growth is already trailing that of the nation. Some also complain that the general liability insurance required by the law has become difficult to obtain. "It is now fast becoming a crisis of availability," said Mike Elmendorf, CEO of the Associated General Contractors. "If you can't insure it, you can't build it."

Those were among the argument of business this year in the 2013 legislative session. Through a series of closed-door, unannounced negotiations, the perennial issue came perhaps closer than ever to substantial changes, according to players from both sides.

"For the first time, some of the trade unions are willing to sit down and have discussion," said Senate Deputy Majority Leader Thomas Libous.

Meanwhile, powerful Assembly Speaker Sheldon Silver has been accused of blocking repeal or changes because he works for a Manhattan law firm that handles such cases and paid him $450,000 last year.

"We don't think it's the right policy to undo these important protections," said Silver spokesman Michael Whyland.

Brian Sampson of the business group Unshackle Upstate called the law "the symbol that continues to tie us to the dark old days of Albany where a few well-connected people and some behind closed doors 'negotiations' controlled nearly all legislative decisions."

The Trial Lawyers Association alone has spread more than $2 million in campaign contributions since the 2010 elections to Democrats and Republicans in the Assembly and Senate as well as Gov. Andrew Cuomo, who would be a key to forcing changes it the law.

Mike McGuire of Construction and General Building Laborers Local 79 in New York City, who spent 16 years on high-rise construction sites, acknowledges the current system isn't perfect and there may be room for compromise.

"The big guys are pretty good, they don't nickel and dime," McGuire said. But some smaller "bottom-of-the-barrel" operators cut corners with little regard for their, often temporary, employees, he said.

"There are inequities in every law," McGuire said. "But if you get rid of it, the inequities are going to go 180 degrees. ... It will favor the contractors and you put people's lives in danger."

Original Source

Contact the Law Office of O'Toole & Sbarbaro, P.C. today if you have a workers' compensation or a Social Security disability case.

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