Tuesday, February 16, 2010, 09:15 AM - Political developmentsIt's always interesting to see what's going on in workers' comp in other states. I often follow comp developments in other states through e-mails from the Workers' Comp Executive and through news bits on Workcompcentral.com
In Colorado there's a move to limit video surveillance of injured workers. Last week Colorado lawmakers approved (on a 6-5 House of Representatives committee vote) a bill to make it more difficult for insurers to do surveillance.
The bill would allow insurers to start surveillance at any time, but the worker would have the right to ask for a hearing on why they were being watched. An insurer who could not justify a basis for the surveillance could be fined $1,000 a day. Further, the judge could bar use of the videos in any trial or settlement negotiations.
The Colorado legislature heard testimony from many workers about abuses of surveillance films.
The bill is opposed by Colorado's attorney general's office, which sees video surveillance as an important fraud fighting tool.
Here's a link to a Denver website with more information about the issue:
http://www.9news.com/news/local/article ... ;catid=346
I have no reliable line on Colorado politics, but I suspect the bill will not pass the full Colorado legislature. Apparently several legislators voted in favor simply to move the matter forward.
What does intrigue is the concept of putting some judicial limits on surveillance activity. The bill does not require pre-authorization of surveillance, so it's not like insurers need to get a "warrant".
The Colorado bill (the exact language of which I haven't seen) appears to be aimed at surveillance "fishing expeditions".
It would seem that it's not rocket science to create a mechanism to give a workers' compensation judge some authority to strike a balance between harrassing surveillance and surveillance based on legitimate tips or concerns raised by doctors, for example.
Here's a link to a blog post I did several years ago, "Hold that Camera":
http://www.workerscompzone.com/index.ph ... 125-202439
Sunday, February 14, 2010, 02:25 PM - Medical treatment under WCFriday 4:30.
It could have been any Friday. On this occasion it was an irate spouse on the voicemail. Something has to be done.
The spouse noted that pain meds prescribed for the worker were being denied at the pharmacy. The worker has been on a long list of medications for years after multiple surgeries failed to provide pain relief or improve functionality.
Those meds included opioid drugs which could have severe withdrawal effects. Those effects can include extreme anxiety, diarrhea, fever, nausea, tremors and sweating. The workers' meds also included anti-depressants which are not to be abruptly ceased.
Whether the worker should or could be detoxed from some of the multiple meds was a moot point on a late Friday afternoon.
The caller didn't reference it, but the over the counter cost to fill those multiple meds was probably over $1,000. That's money that family did not have.
The worker's anxious voice could be heard in the background as the spouse demanded immediate action.
It was too late for the worker to reach the doctor's office.
The caller left no details as to why the meds were being denied.
There may have been some dosage adjustments, but there was little change in what had been prescribed for some time. The treating pain management specialist (on the carrier's MPN list) had always compliant in filing reports that documented quite explicitly the symptoms and the various medications prescribed. The case had been settled some years ago, and future medical was not in dispute.
Did the carrier have a pharmacy administrator as an intermediary between the adjuster and the pharmacy? Perhaps the intermediary could not reach the adjuster?
Perhaps the adjuster was not paying the pharmacy bill, so the pharmacy
(at a major supermarket chain) was not willing to refill the meds until the bill was cleared? The supermarket pharmacy was unlikely to fill these on a lien.
As the attorney listened to the 4:30 voicemail, he recalled that when he'd last seen this file several months ago it was apparent that the carrier was not sending copies of all treatment progress reports. The attorney recalled no recent UR delay or UR denial notices. Perhaps the adjuster had sent the medication request out to UR but not sent out UR notices?
Or as the spouse claimed in the voicemail, did the adjuster "deny" the medications without any UR basis?
The attorney's staff tried to reach the adjuster by phone and fax. No response. At the end of the day it wasn't clear whether the worker would wind up in the emergency room, whether the worker would use
his Medicare card (through Social Security Disability) to pay for the medications (shifting liability onto Medicare), or whether the worker would undergo a hellish weekend.
What was apparent was that on a Friday afternoon, before a long holiday weekend, one worker's family was in crisis.
It was a puzzle. A very unpleasant puzzle.
It's a puzzle many of us often see. Even if it's not a Friday afternoon it can be a very unpleasant puzzle.
Thursday, February 11, 2010, 09:18 AM - Political developmentsOne danger for workers is that a dispirited labor movement could decide to take a breather during the next election cycle.
Union activists staffed phone banks and walked door to door for Democratic candidates during recent election cycles. The rank and file union household vote went Democratic.
It hasn't always been that way. Remember the Reagan Democrats?
In Massachussetts some of those Democrats drifted to Scott Brown. With his direct manner and his pick up truck, it's not hard to see why that happened.
Sure, there are Tea Partiers who come out of an old strand in American politics, a strand that is anti-Federalist:
http://www.realclearpolitics.com/articl ... 00260.html
But most union households are not tea partiers. However, they are folks looking for progress on issues that matter to them: jobs, health care, and workplace issues.
So the strategic political mistakes and hubris of this administration have increasingly dispirited some unionists, documented in this Politico piece by James Hohmann:
This could be a challenge even in "blue" California. Those of us who want to see worker rights stay in the forefront will need to make the case. A dispirited union base could spell disaster for California Democrats come November.
Update: in my last post I noted that an independent expenditure group has been formed to aid Jerry Brown's campaign, the "Level the Playing Field 2010" committee. Today's there's word another committee is being formed to ensure a well funded effort, "California Working Families 2010":
http://www.capitolweekly.net/article.ph ... xslr5i5n50
Looks like Democrats in California will not make the Martha Coakley mistake, taking things for granted.
Wednesday, February 10, 2010, 08:30 AMIt's Wednesday, hump day.
Worker interests continue to get short shrift in Washington. While the President and Congress wrangle on a jobs bill to attack unemployment, the President's appointment to the National Labor Relations Board appears to be doomed.
THe nomination of Craig Becker to the NLRB failed yesterday on a 52 to 33 vote, with 60 votes being required to move the nomination. That's the effect of the Scott Brown election, although it must be noted that several Democrats (including the endangered Blanche Lincoln of Arkansas and Cornhusker Ben Nelson) voted against Becker anyway.
For years unions have had the NLRB stacked against them. The Board is important in that it determines the direction of labor law, including union election disputes.
Here's more on the issue from a piece in Politico:
Meanwhile, also of interest is a piece in the San Francisco Chronicle noting that Democratic interests and unions are planning a $20 million independent expenditure against Meg Whitman. The effort will be called "Level the Playing Field 2010".
This comes amid growing concern that Whitman is prepared to buy the governorship. The fear is that she could dominate the airwaves, swamping Jerry Brown in the process. With her huge financial advantage, Whitman might be able to avoid direct meeting with voters and the press.
But Democrats appear determined that eMeg will not get a free ride:
http://www.sfgate.com/cgi-bin/article.c ... 1BV2AH.DTL
Monday, February 8, 2010, 09:50 PM - Political developmentsIt can't have been a good weekend for Insurance Commissioner Poizner.
The Super Bowl airwaves were full of Meg Whitman ads. Whitman refuses to debate Poizner at the Republican convention, but she has no problem getting up on TV.
Far behind in polling, Poizner has unleashed almost no media presence with his own cash pile of $17.7 million (that reflects the $19 million he's given his own campaign).
It looks like contributors aren't flocking to his cause. Today the Secretary of State web site reveals that Poizner has received just one contribution of $5,000 so far in 2010:
http://www.sacbee.com/static/weblogs/ca ... ner-h.html
For a candidate headed into a major battle, that's beyond weak. It's emblematic of a failing campaign.
How can this guy compete if he doesn't have a fundraising operation and if he doesn't spend some of his own cash to generate some public enthusiasm?
What is the Commish waiting for?