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Find out in this article how the new workers’ compensation guidelines going into effect in 2012 will impact New York injured workers.

Workers’ compensation laws benefit both employers and employees. Not only does workers’ comp help ensure that individuals who are injured on the job receive the compensation they deserve, it also establishes predictable liability limits for employers.Workers’ compensation benefits may help workers through a temporary time of need when they suffer from a condition that will eventually heal.

However, workers’ comp also provides special monetary benefits to those employees who are permanently impaired by workplace injuries.These awards are given not for the actual injury sustained, but rather for residual permanent physical and functional impairments.

Guidelines for determining permanent impairment level are an essential ingredient in the workers’ comp framework. In any given case, an injured worker’s New York workers’ compensation attorney, medical professionals, and the state Workers’ Compensation Board may all look to the guidelines to set expectations as to amount of compensation.

Now, after a decade and a half under the former Medical Impairment Guidelines, New York is moving to a new set of workers’ comp impairment rules in 2012. Schedule Awards for Impairments Unchanged, but Significant Updates in Evaluating Non-schedule Conditions There are two types of awards under the New York Impairment Guidelines, schedule awards and non-schedule awards.

Schedule awards are for permanent impairment of extremities, loss of vision, loss of hearing or facial disfigurement. Written “schedules” in the Impairment Guidelines establish very specific, technical rules for determining loss of use levels.

Loss of use is measured as a percentage, and often the specificity contained in the guidelines makes a workers’ comp case involving a schedule injury less contentious as to award amount. Effective January 1, a new set of rules known as the 2012 New York State Guidelines for Determining Permanent Impairment and Loss of Wage Earning Capacity will go into effect.

These new guidelines were developed by the New York State Workers’ Compensation Board to replace their aging 1996 counterparts. The section devoted to schedule loss of use awards is unchanged under the new guidelines.

However, the non-schedule permanent disability portions of the guidelines have received significant updates based primarily on the recommendations of the Insurance Department’s Workers’ Compensation Reform Task Force and Advisory Committee. Non-schedule awards are for permanent impairments that are not specifically covered by a schedule.

Conditions of the lungs, heart, skin, brain and spine are among those that commonly fall in the non-schedule category. Even though there are schedules for impairments of the extremities, some such impairments are not amenable to a schedule award, for instance, progressive and severe painful conditions of major joints; these impairments are also categorized as non-schedule awards.

The revamped non-schedule sections of the guidelines establish new standards for medical professionals charged with evaluating impairment and physical function — they clarify the determination of loss of wage earning capacity by adopting a new analysis scheme. Among other improvements, a comprehensive functional assessment component to determine functional ability loss is included, covering dynamic work-related functions (like lifting, carrying and pushing), general tolerances (walking, sitting and standing) and specific tolerances (such as climbing, stooping and kneeling).

The Effect of New York’s New Workers’ Comp Rules on Injured Workers Workers’ compensation law can be complicated, especially in cases involving rare or particularly severe medical conditions. It is often difficult to judge just how much compensation an injured worker needs given their physical limitations.

Different doctors may have different opinions about levels of impairment, and injured workers who do not strenuously assert their rights to workers’ compensation authorities can end up without the monetary benefits they need. It is the hope that the new 2012 Guidelines will eliminate some of the ambiguity in making impairment and compensation level determinations.

By clarifying the process and solidifying rating metrics, they should improve both the speed and consistency of workers’ comp classifications. They are expected to be highly utilized by lawyers, claims professionals and others involved in the workers’ comp process.

If you have been injured on the job or are suffering from a work-related illness, you should get in touch with an experienced New York workers’ compensation attorney as soon as possible. Legal representation can mean higher awards and a smoother, easier process for you. In addition, even though the 2012 Guidelines are eventually expected to help streamline the process, it is especially important to seek out qualified legal help in their first months of use as workers’ comp authorities familiarize themselves with the ins and outs of the new standards.

Contact a workers’ comp attorney today to help ensure you receive the full amount you deserve for your injury claim.

A reform of workers’ compensation prescription drug benefits being aggressively lobbied by just about every business group in the state passed the Senate Banking and Insurance Committee on Thursday morning. But not before some heated rhetoric and testy back-and-forths that call into question the bill’s future.

Lambasting doctors that upcharge insurers as much as 600 percent for drugs after they unbundle and repackage them, Sen. Alan Hays, R-Umatilla, introduced SB 668 to cap drug dispensers’ markup at $4.18.

“When I learned about the facts of this situation, I said ‘There ought to be a law against that,’” said Hays. “This bill will stop [doctors] from ripping off the system by charging extremely inflated fees for medication.”

The bill seeks to close the so-called drug repackaging loophole, which allows physicians to charge increased reimbursement rates for medication bought wholesale, repackaged for patients and then given a heftier price tag. Those markups costs employers as much as $62 million annually, and are a major contributor to this year’s 8.9 percent increase in workers’ compensation premiums, according to industry estimates.

The bill passed the Senate Banking and Insurance committee with a 7-4 vote, with dissenting lawmakers arguing that the bill injects government into an issue that should be handled by the free market. Senators Mike Fasano, R-New Port Richey, Gwen Margolis, D-Coconut Grove, Joe Negron, R-Stuart  and Eleanor Sobel, D-Hollywood, voted against the bill.”Is the carrier forced to send the patient, the workers comp patient, to any particular doctor?” Fasano asked in a testy exchange with Hays. “If we know that there are doctors, as you say, ripping off the system, why would the carriers be allowing the patients to go see them?”

Hays was blunt and terse in his response: “I really have no idea the origin or the purpose of the question.”

Dr. Gary Kellman, one of two doctors to speak out against the bill at the hearing, said his office in Plantation could not continue to dispense drugs to patients if the price was capped, due to the costs involved.

“This very idea that doctors are gouging the system is unbelievably offensive to me,” he said, adding that insurers let their workers’ compensation patients get drugs directly from doctors (rather than from a pharmacy) because those workers get better faster.

More than a dozen business groups have expressed support for closing the loophole.

Back in 2010, the bill passed both houses, but was vetoed by Gov. Charlie Crist. The bill moves next to the Health Regulation Committee in the Senate. Its companion in the House, HB 511 (which has some 22 co-sponsors), cleared its first committee last month, and is on its way to a vote in the Health and Human Service Committee.

By Kate Hinds | 01/19/2012 – 5:15 pm

Read more: http://www.upi.com/Business_News/Security-Industry/2012/01/19/KAPL-workers-push-for-union/UPI-72481326990321/#ixzz1jwn8FxRC

Submitted by NORML on Jan 13, 2012

An Arkansas Court of Appeals decided to deny a workers compensation award to an employee because they say his marijuana use contributed to the explosion that burned him.

Greg Prock was working for Bull Shoals Landing Marina when he and a coworker were asked to remove the tops of two empty oil barrels. He had been told on a previous occasion to use an air chisel to open oil barrels to avoid creating sparks that could ignite the oil, according to the Marina’s co-owner. In this case, Mr. Prock used an acetylene torch to take the barrel top off, something that he routinely did according to co-workers, without instance. But this time, a spark ignited the oil in the barrel, creating a fireball that set both men on fire.

The men were drug tested after the accident, something that is routine in most workplace accidents all over the nation. Both men tested positive for marijuana. One of the Marina’s owners testified in court that Mr. Prock exhibited what he called “suspicious behavior the morning of the accident, and Mr. Prock testified in court that he did smoke marijuana three to four times a week after work, but never before. He also testified in court that he had not had any marijuana two full weeks before the accident because he was trying to pass a drug test for a potential new employer.

An administrative law judge ruled that the accident was caused by Mr. Prock attempting to finish a task quickly, and ruled he was credible when he said he did not smoke marijuana that morning. The Arkansas Workers’ Compensation Commission reversed that ruling, saying that Mr. Prock’s credibility was in question because there were other inconsistencies in his testimony, as well as testimony about his behavior that morning from his boss and his co-worker that was also burned in the accident.

Yesterday, an appellate court upheld that workers compensation commission decision, adding that Arkansas law presumes that illegal substances caused a workplace accident when evidence of drug use is found. They said the burden of proof was not upon the employer in this situation to prove that Prock was impaired prior to the explosion that resulted in his injuries, but rather the burden was on the employee to prove that it wasn’t caused by the drug use, when drug use is found evident.

Out of the nine judges on the appellate court three of them disagreed with the opinion. One of those judges said that since he had used the torch in the past to open barrels, that proved that his use of marijuana may not have directly caused the accident. Judge Raymond Abramson noted that Mr. Prock method of opening barrels that way was dangerous, but said there was no direct causal link between the drug use and the explosion, and that Mr. Prock should be awarded full benefits.

External Links:

http://www.businessinsurance.com/article/20120111/NEWS08/120119962?tags=|68|75|305|340|304|92