Friday, April 4, 2008, 11:56 AM - Political developmentsGreeting from Sherman Oaks. I'm here in L.A. attending meetings of the California State Bar's workers' compensation subcommittee.
Next week I'll be doing a recap of the Top 10 developments in California workers' comp in the first quarter of 2008.
But catching my eye today was a study on the consequences of the general healthcare crisis. The study, entitled "Dying for Coverage" is by Families USA.
The ranks of the uninsured for health coverage in California continues to swell. We've got individuals-and families-who are ticking health time bombs.
Some of them die due to inattention to their health.
Here's the report:
http://www.familiesusa.org/assets/pdfs/ ... fornia.pdf
Surely we can do better than this system.
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Wednesday, April 2, 2008, 10:35 PM - Political developmentsSome of the nation's premier safety net programs are looking quite creaky.
That would be Social Security Disability and SSI (known as "Title II" and "Title XVI" respectively). These are the Federal programs for disabled workers (SSD) and other disabled individuals (SSI).
Processing backlogs have grown to intolerable levels. Moving a case from the application through several levels of denials to an actual hearing with a judge may now take a year or more.
This is partly due to inadequate funding of the claims resolution process by the Bush Administration. A shaky economy doesn't help, either. And in California the 104 week temporary disabiity limit may be an incentive for many workers to apply for SSD or SSI benefits as their TD benefits are cut off.
I haven't seen studies yet, but it's quite likely that the 104 week rule is a mechanism shifting costs from the workers' comp private sector (insurers and self-insureds) to the public sector (i.e. Uncle Sam and its
Social Security trust funds, which are projected to run out of money in the future).
But there's even another angle worth noting. Private disability insurers
(such as LTD carriers Unuum, Metlife etc) are clogging up the system
with claims that shouldn't be there.
SSD and SSI require a finding that the individual has been unable to engage in substantial gainful activity (i.e.work) for a period of 12 months or more in a row. Under Social Security rules, the individual must be unable to do all work, not merely unable to do their former
job. That's different-a more stringent definition- than under LTD plans, which generally define disability as inability to do past work or other work for which the person is suited.
But LTD carriers require claimants to pursue SSD claims, hoping that the worker will qualify, thus entitling the LTD carrier to an offset. Many of these claims are unlikely to meet Social Security's dissability threshold. And the volume of claims is clogging the system, penalizing worthy claimants.
It's an issue that should be of concern to the California workers' comp community. Too often the comp community wears blinders when it comes to following these collateral issues. But these sorts of issues have real consequences for claimants.
The New York Times has an interesting piece on this issue-by Mary Williams Walsh- which you can find here:
http://www.nytimes.com/2008/04/01/busin ... nted=print
Monday, March 31, 2008, 09:17 PM - Political developmentsIt was 1974.
I was in law school, living in a ramshackle country house on a corner of a hog farm. The place was about 20 miles from both Chapel Hill (where I was at UNC Law) and Durham (home of Duke's Blue Devils). Surrounded by corn fields and a secluded pond good for little but water moccasins and brave skinnydippers, my abode was in "the sticks". The kind of a place where a guy can pee off the front porch.
I'd do my classes at UNC, grab a North Carolina barbecue, and then head over to the Duke law school library to study before heading out to the hog farm.
Once in a while something would come along to break my routine. Cesar Chavez was one of those things.
Chavez spoke at Duke.
I can remember him vividly. A small man, burning with intensity. He seemed world weary, yet determined. Chavez told the story of his 1965 long march from Delano to Sacramento. His 1969 fast. The efforts to ban el cortito, the short handled hoe. Boycotts of table grapes and lettuce. The ongoing struggle with the growers. His visits at colleges and salons of power across the country to whip up public support for the boycotts.
Important as those things were, it was clear that there was more. Chavez was speaking for people who had no voice, no money, and no prospects for either. It was a struggle that would be ongoing, he said.
I remember that he spoke calmly, and without rancor or bitterness.
It would be a long struggle, he said. There would be some lost battles, and many sacrifices.
I realized he was talking not just about farm workers, but rights of all workers.
I went back to my cold, dilapidated hog-farm house that night. Ran up the creaky stairs to turn on the electric blanket. and then down to the porch. Wasn't in the mood to read that deadly dull contracts law course outline.
Sat in a rocking chair on that big front porch. The skies were clear, the stars brilliant.
And as I sat there, I knew I'd seen-and heard-a bright shining star,,,,,,something that would stay with me all my life.
"Si, se puede".
You can find the text of Chavez' 1984 address to the Commonwealth Club of California by clicking here:
http://www.americanrhetoric.com/speeche ... ddress.htm
Wednesday, March 26, 2008, 11:02 PM - Political developmentsMajor healthcare reform this year in California looks dead as a doornail.
Last year's special session failed to produce an airtight deal, and the budget debacle and recession are setting the stage for an ugly legislative session.
But-to its credit-the Schwarzenegger administration appears ready to get tough with healthcare insurers who try to rescind the policies of sick
Blue Shield has filed an appeal in Hailey vs California Physicians Service, requesting the California Supreme Court take the case. The Court of Appeals had upheld some limits on healthcare recissions. The Hailey decision can be seen here:
http://www.courtinfo.ca.gov/opinions/do ... 035579.PDF
Now the California Department of Managed Care has decided to file an "amicus" brief ("friend of the court" brief) urging the California Supreme Court NOT take up the Hailey case on appeal. If the Supreme Court refuses to review Hailey, Hailey is "the law". Meanwhile, the administration is meeting with insurers to encourage development of new policies on recissions.
Recently there have been high-profile jury verdicts in some cases against insurers who tried to rescind coverage from sick people. Legislative hearings are on the horizon.
Check out today's piece by John Howard and Anthony York in the Capitol Weekly:
http://www.capitolweekly.net/article.ph ... 67binwg6z4
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Monday, March 24, 2008, 11:43 PM - Political developmentsIs graveyard shift work a health risk? Are night shift workers more susceptible to accidents and illness?
As many as 15 million Americans-15% of the work force-work hours other than the day shift. There's some evidence-though controversial-that night shift work makes accidents more likely. The World Health Organization has noted that graveyard shift work may be a risk factor for cancer. The CDC has published research onnight shift work and various maladies..
Stanford and UCSF sleep and neurology researchers are looking into the issue. Who knows? If the epidemiology results are right, perhaps there will be industrial cases making the connection. Something else for those underwriters to worry about?
Doctors-of all people-understand the problem. Any doctor who has taken night call or served marathon shifts as an intern can identify with the problems of the sleep-deprived brain. It's hell to play with our body's circadian rhythms.
Check out a good piece in the San Francisco Chronicle, "Night Shift" by Erin Allday:
http://www.sfgate.com/cgi-bin/article.c ... =printable
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