Friday, April 26, 2013

OSHA issues final rule to protect workers using cranes and derricks in demolition and underground construction

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=NEWS_RELEASES&p_id=23952


WASHINGTON – The Occupational Safety and Health Administration today issued a final rule that applies the requirements of the August 2010 cranes and derricks in construction standard to demolition work and underground construction. Application of this rule will protect workers from hazards associated with hoisting equipment used during construction activities.
"It is important that construction workers in these sectors receive the same safety protections as other construction workers," said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels. "Extending this rule to demolition and underground construction work will help save lives and prevent injuries."
This final rule applies the same crane rules to underground construction and demolition that are already being used by other construction sectors, and streamlines OSHA's standards by eliminating the separate cranes and derricks standard currently used for underground and demolition work. The rule also corrects errors made to the underground construction and demolition standards in the 2010 rulemaking.
The final rule becomes effective May 23, 2013.
Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA's role is to ensure these conditions for America's working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit http://www.osha.gov.
###

U.S. Labor Department news releases are accessible on the Internet at www.dol.gov. The information in this release will be made available in alternative format upon request (large print, Braille, audiotape or disc) from the Central Office for Assistive Services and Technology. Please specify which news release when placing your request. Call 202-693-7828 or TTY 202-693-7755.

Monday, April 22, 2013

We are what we import | Bermuda Weekender

We are what we import | Bermuda Weekender

Florida Court Denies Petition To Transfer Structured Settlement Payment Rights


Click to ask the author from Fox Rothschild LLP a question

United States: Florida Court Denies Petition To Transfer Structured Settlement Payment Rights

15 April 2013
Article by W. Mason 
Like every other state, Florida law requires court approval of the transfer of the right to receive structured settlement payments. Typically, the approval process arises where a person entitled to a stream of payments wishes to transfer the right to receive those payments to a purchaser for a lump sum payment. In order to effectuate the transfer, the purchaser files a petition for approval of the transfer with the court. Typically, where the court finds that the purchaser has complied with certain stringent statutory notice requirements and the seller has otherwise established that the transfer is in his or her best interest, petitions for transfer are approved.
In a recent case, a Florida court denied approval of a structured settlement transfer where it was found that approval of the transfer would contravene the provisions of a Federal statute. In re Robotham, 2013 WL 127134. In Robotham, the seller, Derrick Robotham, was receiving periodic monthly payments as a result of a workers’ compensation claim he filed pursuant to the Longshore and Harbor Worker’s Compensation Act (“LHWCA”), 33 USCS § 916. The LHWCA is a Federal statute that essentially requires certain employers to pay worker’s compensation payment to longshore and harbor workers who are injured or contract diseases.  The LHWCA states:
No assignment, release, or commutation of compensation or benefits due or payable under this chapter, except as provided by this chapter, shall be valid, and such compensation and benefits shall be exempt from all claims of creditors and from levy, execution, and attachment or other remedy for recovery or collection of a debt, which exemption may not be waived.33 USC § 916. In the Fifth Judicial Circuit in and for Sumter County, Florida, Judge Michelle Morely noted that the Florida Structured Settlement Act conditions the approval of the transfer on compliance with applicable law. See Fla. Stat. 626.99296(3)(a)(1)(“The transfer complies with this section and does not contravene other applicable law”). Judge Morley found that approval of this particular transfer would contravene the LHWCA. Therefore, the petition was denied.
While typical structured settlement transfers will not implicate any conflict with Federal law, it is worth noting that the Florida Structured Settlement Act prevents approval of a transfer where a relevant Federal statute or other applicable law prevents assignment. As such, structured settlement purchasers and their attorneys should approach transactions that involve payment streams which result from a situation other than a typical personal injury settlement with additional scrutiny.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

Medicare Set Asides – and You - Marinelink.com


Medicare Set Asides – and You

By Gary English, President of Marine Forensic & Investigation Group, LLC.
Thursday, April 18, 2013
File
Jones Act and LHWCA employers must protect Medicare’s interest or pay the price. It may be boring, but it is important. Read and heed.
Attention maritime entities that employ Jones Act Seamen covered by liability insurance, including self-insurance, or land based employees covered by no-fault insurance or any workers’ compensation act:  you MUST protect Medicare interests. These plans are also known as Non-Group Health Plans (NGHP).  Failure could mean a fine of $1,000.00 per day per claim or liable to reimburse Medicare for payments made to a claimant. This reimbursement could be pursued from the insurance company, the insured, or even counsel, possibly including defense counsel.
Medicaid Medicare SCHIP Extension Act of 2007 (MMSEA) §111 has added mandatory reporting requirements with respect to Medicare beneficiaries who receive a settlement, judgment, award or other payment from an entity. This includes Jones Act and Longshore and Harbor Workers’ Compensation Act (LHWCA) employers. Under this reporting scheme, these entities are designated as a Responsible Reporting Entity (RRE).
First of all, who can be considered an RRE is not so straight forward. It could be the employer or it could be liability insurer (including self-insurer), no fault insurer, or workman’s comp insurer. In short, it can be a real “spaghetti monster.” And, for any maritime attorney settling Jones Act and LHWCA 905(b) claims, this is a very important – and complicated – issue. In the end, all the analysis points to the conclusion that the employer will ultimately be held responsible. 
According to MMSEA §111, RREs have a responsibility to: 1.) determine whether a plaintiff/claimant is entitled to Medicare benefits on any basis; and 2.) upon settlement of a Medicare beneficiary’s claim, submit all information required by Centers for Medicare and Medicaid Services (CMS) with respect to the claimant to CMS. The actual RRE reporting is triggered by settlement, award, judgment or other payment to a Medicare beneficiary.  A Medicare beneficiary is a person age 65 or older, a person under 65 with certain disabilities, and a person of all ages with end-stage renal disease.  However, the analysis concerning the determination of a Medicare beneficiary is not as simple as it may seem. To satisfy these responsibilities, the RRE is required to input either a Medicare Health Insurance Claim Number (HICN) or the injured party’s Social Security Number (SSN), the first six characters of the Medicare beneficiary’s last name, his/her date of birth, and gender. Other relevant information may include the nature and extent of the injury or illness, facts about the incident giving rise to the injury or illness, information sufficient to assess the value of reimbursement, and information sufficient to assess the value of future care planning. RREs are ultimately responsible for complying with the reporting process including ensuring the accuracy of all reported information. While RREs may not contract away their obligation under this law, they may elect to use an agent for reporting purposes.  RREs must report settlements, judgments, awards, or other payments regardless of whether or not there is an admission or determination of liability.  Table 1 provides when reporting requirements become mandatory after a Total Payment Obligation to the Claimant (TPOC) threshold is meet for Liability Insurance, including self-insurance.
Table 2 provides when reporting requirements become mandatory after a TPOC threshold is meet for Workers’ Compensation. These reporting requirements will result not only in added infrastructure cost (personnel and systems) for RREs, but also in additional steps in legal claim resolution by mandating verification of CMS benefits throughout litigation until resolution.  To avoid lengthy delays, it is best to begin investigating a person’s Medicare beneficiary status as soon as a colorable Medicare beneficiary claim arises.
If the claimant/plaintiff was not a Medicare beneficiary at a time when the RRE assumed ongoing responsibility for future medical care, the RRE must continue to monitor the claimant’s/plaintiff’s Medicare status, because it may change over time. If the claimant/plaintiff becomes a Medicare beneficiary, the RRE must report when that individual becomes a Medicare beneficiary unless responsibility for ongoing medicals has terminated before the individual becomes a Medicare beneficiary. If reporting entity’s responsibility for future medical costs terminates before the claimant/plaintiff becomes a Medicare beneficiary, there is no reporting requirement. In cases involving more than one defendant, if more than one RRE has assumed responsibility for ongoing medicals, Medicare would be secondary to each such entity and, therefore, each such entity must report.
There is no safe harbor for an RRE, and the status of every claimant should be verified through the query process regardless of the claimant’s age or any other threshold.  It is critical to start the verification process at the onset of a new claim, or at the latest, when settlement appears to be a realistic near-term goal. The process takes time; so early submission is urged to capture any data that will be reported at settlement. Reported data is to be sent electronically from the RRE to the CMS Coordination of Benefits Contractor (COBC).  Each RRE must assign or name an Authorized Representative. This individual must have the legal authority to bind the organization to a contract in the terms of MMSEA §111 requirements and processing.  The Authorized Representative has ultimate accountability for the RRE’s compliance with the reporting requirements and, therefore, cannot be an agent of the RRE.
Additionally, each RRE must assign or name an Account Manager. Each RRE ID can have only one Account Manager. This is the individual who controls the administration of an RRE’s account and manages the overall reporting process. The Account Manager may be an RRE employee or agent. The Account Manager may choose to manage the entire account and data file exchange, or may invite other company employees or data processing agents to assist.
At the RRE’s discretion, the Account Manager may designate other individuals to register as users of the Coordinator of Benefits Secured Website (COBSW) associated with the RRE’s account, known as Account Designees.  Account Designees assist the Account Manager with the reporting process and may be RRE employees or agents.  There is no limit to the number of Account Designees associated with an RRE ID.  In short, if you enter into a settlement, judgment, award or make other payments to a seaman or land based employee you must protect Medicare’s interests.  Failure could result in a fine of $1,000 per day per claim or you may end up reimbursing Medicare for a claimant’s medicals years later.

(As published in the April 2013 edition of Marine News - www.marinelink.com)

Saturday, March 23, 2013

John George Brown (American artist, 1831-1913)   The Longshoreman's Noon


AWESOME HOUSES MADE FROM SHIPPING CONTAINERS






LONGSHORE SAFETY VIDEO - OSHA






Maritime Training: Container Lashing Training Videos



LASHING ABOARD MAERSK

DE-LASHING CONTAINERS

LASHING CONTAINERS


TRAINSTAINER WORKED BY SCOTTY B ON THE OAKLAND PIERS


Excellent video showing the perspective of a Transtainer Operator.  This one is from the Port of Oakland.


I COVER THE WATERFRONT - SONG VERSIONS

JOHN LEE HOOKER


BILLIE HOLIDAY

LOUIS ARMSTRONG


I COVER THE WATERFRONT - MOVIE


Max Miller's best-seller forms the basis of this romantic melodrama about cynical, hard-drinking reporter Joe Miller (Ben Lyon), who exploits his romance with Julie Kirk (Claudette Colbert) to hand in a sensational story to his newspaper. Julie's father Eli (Ernest Torrence) is a decrepit sea-captain who smuggles in illegal Chinese on the West Coast. For years, Joe has been promising his newspaper editor a major scoop on Chinese smuggling operations, and he finally delivers when Joe catches Eli red-handed. But his torrid affair with Julie confuses matters. Originally Joe's plan was to get to Eli through Julie, but now he is in love with her, and he is not sure what to do.


Saturday, March 9, 2013

PASSENGER RAIL STATION - HAMLET, NORTH CAROLINA


ALJ KANE (CINCINNATI) FINDS CLAIMANT IN DBA CASE PERM TOTAL WHERE JOBS LOCATED BY EMPLOYER WERE 75 MILES FROM RURAL HOME

READ FULL DECISION - NEWTON vs SEII


Long Beach Post - After 7 Hours of Public Comment, Controversial SCIG Rail Yard Approved

Long Beach Post - After 7 Hours of Public Comment, Controversial SCIG Rail Yard Approved


NJ.com NY/NJ port employers and longshoremen reach tentative deal



By Steve Strunsky/The Star-Ledger 
on March 07, 2013 at 7:51 PM

A tentative six-year deal has been reached between local shipping companies and the union representing 4,500 longshoremen at the Port of New York and New Jersey, the two sides announced today.

The deal between the New York Shipping Association and a dozen union locals belonging to the International Longshoremen’s Association addresses regional issues not specified in a related master contract agreement reached last month between the longshoremen’s union and a nationwide port employers’ group.
The protracted, sometimes contentious talks over the master contract between the ILA’s international leadership and the United States Maritime Association, or USMX, included threats of a potentially crippling East Coast port strike by 15,000 longshoremen at more than a dozen ports from Maine to Texas.
A tentative deal on the master contract was reached on Feb.1, after two contract extensions brokered by the Federal Mediation and Conciliation Service that allowed the passing two scheduled strike deadlines.

But local agreements still must be struck between employer groups from individual ports and the ILA locals whose members work those docks.

"I understand that not all the ports have reached agreements," said Joe Curto, president of the New York Shipping Association, and a member of the USMX negotiating team.

ILA and USMX negotiators are scheduled to meet in Florida next week to finalize some outstanding issues under the tentative master-contract agreement. Only then — if local deals are settled — can union leaders present a master contract and related local deals to rank-and-file longshoremen for ratification.
Unlike during prior negotiations, however, there is no longer a strike deadline looming.

"Both sides, I believe, are working in good faith without a hard deadline to settle all the issues," Curto said.

Despite the lingering uncertainties, today’s agreement was hailed as a significant achievement. The Port of New York and New Jersey is the largest port involved in the master talks both in terms of cargo volume and the number of longshoremen employed there.

"We are happy to announce that NYSA and the ILA have successfully concluded local contract negotiations on a six-year deal and have produced a settlement that both sides agree will protect ILA members into the future and will allow NYSA-member shippers and carriers to remain competitive in the marketplace," the ILA and NYSA said in a joint statement, which followed four days of intense negotiations.
The local talks had centered on reforms to work rules that employers believed had hurt the competitiveness of the port, which were resisted by a union whose ranks have been decimated over the decades by containerization and other technological advances.

Curto declined to specify what local issues were agreed upon. The ILA did not respond to requests for comment.



Photos: The 1945 SS Greenhill Park explosion

Photos: The 1945 SS Greenhill Park explosion

Philly.com: Deal to expand Wilmington port is dead


Philly.com:  Deal to expand Wilmington port is dead

http://www.presstelegram.com/news/ci_22751459/port-long-beach-seeks-form-maritime-business-cluster

http://www.presstelegram.com/news/ci_22751459/port-long-beach-seeks-form-maritime-business-cluster


Saturday, February 23, 2013

CITING CREDIBILITY, ALJ STANSELL-GAMM (WASHINGTON) DENIES CLAIM FOR SECTION 48(a) DISCRIMINATION

THOMAS vs. GENERAL SHIP REPAIR

 
                                      Girls by the Waterfront (on verso: Burlesque) , 1946 

Excerpt

Regarding the conflicting testimony in this case, Mr. Thomas was not a credible witness since his testimony was confusing and at times evasive.  In contrast,  three witnesses credibly testified about Mr. Thomas’ refusal to wear the fire retardant life jacket.  The record contains no credible evidence that Mr. Thomas’ discharge was motivated by retaliation for his workers’ compensation claim.  The temporal proximity between his return to work from workers’ compensation leave and his termination is explained by the other employee’s request for the return of his life jacket which in turn caused Mr. Rappold to discuss the situation when  Mr.
Thomas  returned to work on July 1, 2012.  Further, Mr. Thomas has not demonstrated any discriminatory action because several General Ship employees have  gone out on workers’ compensation leave and not been terminated upon their return to work.  And, Mr. Thomas is not the first General Ship employee to be terminated for insubordination or violation of company rules.    Finally, Mr. Thomas’ termination was warranted because  his obstinacy about the fire
retardant life jacket made it impossible for General Ship to continue to employ him.

Tuesday, February 19, 2013

New port cranes begin to shoulder load at Seagirt

New port cranes begin to shoulder load at Seagirt


New port cranes begin to shoulder load at Seagirt

Public-private partnership expands terminal and prepares Baltimore for the larger ships of the future

Monday, February 11, 2013

Courthouse News Service: American Stevedoring Says Union Let Mobs Run Docks

Courthouse News Service




     MANHATTAN (CN) - Mafia-corrupted union bosses threatened to put a stevedore company's boss "in a box" if he didn't cede control of docks to the Longshoremen's union, American Stevedoring claims in court. American Stevedoring, which used to run Brooklyn's Red Hook Marine Terminal, sued the International Longshoremen's Association, and others, in a federal RICO complaint.

     The union defendants include the AFL-CIO, the NYSA-ILA Pension Fund, the Police Port and Guards Union, the NYSA-PPGU and six individuals, including three top officers of the International Longshoremen.
     Defendants include Michael Farino, a principal of MTC Transportation, and Joseph Pollio, vice president of ILA Local 1814.  The stevedore company claims that the defendants let a syndicate known as the "Waterfront Group" extort, harass, defraud and embezzle in Red Hook.      
American Stevedoring claims it refused to bow to mob pressure and worked with law enforcement.
     The Waterfront Group responded with "crippling" financial harm to the stevedore company, which forced it to close up shop in 2011, according to the complaint.
     "Many members of the Waterfront Group and/or those organized crime figures associated with it have been indicted and/or convicted of crimes with some of their illegal activities," the complaint states. "In addition, there have been multiple investigations of members of the Waterfront Group and efforts by the federal government to eliminate organized crime's influence over the Waterfront; however, the actions taken against the organization thus far have been ineffective. That ends today."
     The 49-page complaint - with 255 pages of attachments - details the history of union-related racketeering prosecutions in federal courts, recently leading to the conviction of longshoreman officer Michael Coppola in 2012.
     In 2010, another ILA officer, Albert Cernades, was indicted in an alleged conspiracy to extort "Christmas tributes" from rank-and-file members to pay to organized crime members, according to the complaint.
     In its complaint, American Stevedoring cites dozens of other examples of corruption cases in New York City courts.
     The stevedores claim that Harold Daggett, the president of the AFL-CIO, is the "captain" of the Waterfront Group.
     "Defendant Daggett told American's president, Sabato Catucci ('Sabato'), that he wanted to see Sabato thrown out of the port sector, as he regarded Sabato to be a 'troublemaker' who 'did not know how to give the ILA what it wanted,'" the complaint states.
     In August 2011, Daggett started putting pressure on American to leave the docks in favor of a more corruptible Red Hook Container Terminal (RHCT), the stevedores claim.
     Sabato, who describes himself as a World War II veteran and self-made businessman, claims that Daggett told two people to threaten to put him "in a box" if he did not agree to stop operating on the terminals.
     Those people are defendants Louis Pernice, AFL-CIO vice president, and Farrino, the MTC principal, according to the complaint.
     One month after alleged threat, American claims, ILA and PPGU members threatened to strike to coerce it into signing a succession agreement.
     "On September 26, 2011, American, faced with the illegal Port-wide strike that threatened to render American insolvent, signed the succession agreement (which Daggett precipitated) and the next day (September 27th), RHCT, LLC took over American's operation at the terminals," the complaint states. (Parentheses in complaint.)
     American Stevedoring demands $100 million in punitive damages for RICO violations, and interference with business relations.
     It is represented by Michael Hiller, with Weiss & Hiller.

FWK PARTNER JOHN KAWCZYNSKI, ESQ.: Supreme Court Rejects "Anything That Floats" Test to Determine Vessel Status

Supreme Court Rejects "Anything That Floats" Test to Determine Vessel Status
 
02/10/2013 11:35:15 PM EST

Supreme Court Rejects "Anything That Floats" Test to Determine Vessel Status

 
By John E. Kawczynski Field Womack & Kawczynski, LLC. South Amboy, New Jersey 

In Lozman v. City of Riviera Beach, Florida, 2013 U.S. LEXIS 907, 568 U.S. ____, 184 L. Ed. 2d 604 (Jan 15, 2013), the U.S. Supreme Court was asked to determine whether the City of Riviera Beach, Florida, properly claimed admiralty jurisdiction as part of its efforts to evict a floating home owned by Lozman from a city-owned marina. The specific question before the Court was whether the floating home was a “vessel” so that admiralty jurisdiction existed. 

Although not expressly overturning its earlier decision in Stewart v. Dutra Constr. Co., 543 U.S. 481, 160 L. Ed. 2d 932, 125 S. Ct. 1118, 39 BRBS 5(CRT) (2005), the Supreme Court has attempted to define the outer li, rmits of its prior interpretation of 1 U.S.C.S. § 3 which defines a “vessel” as “every description of watercraft or other artificial contrivance used, or capable of being used, as a means of transportation on water.”
In attempting to fashion a test to distinguish between those things that are potentially capable of being used as a means of transportation, the Court attempted to distinguish between those floating objects that are practically capable of being used for transportation as compared to those that are merely theoretically capable of being used for transportation. Applying this test to the facts of this case, the Court held that Lozman’s floating home was not practically capable of transportation because it was generally unseaworthy (e.g., it had no rudder, it had an unraked hull, it did not generate its own power, its rooms looked like “ordinary nonmaritime living quarters”, and it had French doors and “ordinary windows” ). Other factors included the fact that the floating home was not self-propelled. 2013 U.S. LEXIS at *11-*13, 184 L. Ed. 2d at 611-612.

In an effort to articulate a test to apply the Court offered, “Consequently, in our view a structure does not fall within the scope of this statutory phrase unless a reasonable observer, looking to the home’s physical characteristics and activities, would consider it designed to a practical degree for carrying people or things over water.” . 2013 U.S. LEXIS at *11, 184 L. Ed. 2d at 611. 

With the Court’s holding, we now appear to have come full circle and are left with a fact-specific analysis as to whether a floating object is a “vessel.” Now, however, the Court has added a new, and perhaps final, factor to consider – the “reasonable observer.” Thus, many floating objects that were previously thought to be vessels under Dutra may once again find that they are not “vessels” because they fail to meet the new “reasonable observer” test. Thus, rather than clarifying the outer limits of Dutra, the court simply added more confusion to this area of law. 

© Copyright 2013 John E. Kawczynski. All rights reserved. Reprinted by permission. This article will appear in an upcoming issue of Benefits Review Board Service—Longshore Reporter (LexisNexis).

Friday, February 8, 2013

JUDGE AVERY (COVINGTON) FINDS CLAIMANT IS NOT ENTITLED TO PPD AWARD WHERE HE WAS ALREADY PERMANENTLY TOTALLY DISABLED BEFORE ACCIDENT


 
Excerpt

While, for reasons previously discussed, I do not find Claimant’s obtaining employment
with Employer to be a bar to his recovery, I find what is a bar to his ultimately receiving
compensation is the fact he was totally disabled for the job he was performing at the time he
tripped and fell.  As Employer/Carrier argue, Claimant’s economic disability is no greater now
than it was before the November 25, 2008 accident, even if his back conditioned is worsened and
he has a neck injury.  Claimant was not medically qualified to perform the heavy work which he
sought and secured from Employer at the time of the accident, and he still is not according to the
present restrictions assigned to him.  In other words, for the job of sand blaster, Claimant was
totally disabled before and after the November 25, 2008 accident; and therefore, he has sustained
no loss of wage earning capacity as a result of the most recent accident.   Thus, Claimant has
failed to make a prima facie case of total disability.  To find Claimant, who was already totally
disabled for the job he was performing, more disabled because of his most recent fall is
redundant.

Clary vs. BAE Systems Southeast



 

"I COVER THE WATERFRONT" RADIO DRAMA FROM 1955


"Brother's Keeper" starring Larry Thor as a waterfront reporter aired august 29, 1955 from CBS radio. Stories from the files of a newspaper man's memory based upon the best selling book "I Cover the Waterfront" by Max Miller. This version includes parts 1 and 2.

IRAQ WAR CONTRACTOR FINED FOR LATE REPORTS OF 30 DEATHS

Iraq War Contractor Fined for Late Reports of 30 Deaths

   by T. Christian Miller ProPublica,   Feb. 7, 2013, 7 a.m.
The U.S. Department of Labor has fined a private security contractor $75,000 for failing to file timely reports on the deaths of workers in Iraq as required by law. The Sandi Group, based in Washington D.C., delayed telling the Labor department that 30 of its employees had been killed while working for the company between 2003 and 2005, according to the department.
The Sandi Group, a privately held company known for employing large numbers of Iraqis as security guards, did not return requests for comment. Since 2005 the company has won U.S. government contracts worth at least $80.9 million, according to a federal contracting database.
The fine, believed to be the largest ever levied against a single company for failing to report war zone casualties in a timely manner, is part of an enforcement crackdown that began after a ProPublica series highlighted problems with a government program designed to provide health benefits to civilian contractors working in Iraq and Afghanistan. "Timely reporting of work-related injuries, illnesses and fatalities are vitally important to protect the interests of injured workers and their families," Gary A. Steinberg, acting director of the Department of Labor office which negotiated the settlement amount with the company, said in a prepared statement.
The Labor Department is responsible for administering an obscure government program called the Defense Base Act. The act requires that contractors working overseas for the U.S. government take out specialized insurance, similar to workers compensation, to provide medical treatment for injuries sustained on the job, or to pay death benefits in the event of work-related fatalities.
The ProPublica series found the system in shambles. Insurance companies routinely delayed payments and medical treatment to injured American workers, while charging taxpayers hundreds of millions of dollars for the policies. The Labor Department failed to bring enforcement actions against companies that flouted the law, even when federal administrative judges urged the agency to act. Foreign workers, such as Iraqi and Afghan translators who helped U.S. troops, frequently at risk to their own lives, often received no benefits at all.
After the series ran, the department began publishing information on contractor deaths and injuries and posted report cards showing how quickly insurance companies reported casualties. They also vowed more aggressive enforcement.
Injured workers, however, say that problems remain. Marcie Hascall Clark has battled for years to receive medical treatment and lost wage payments for her husband, who was injured in Iraq. She says she hasn't seen any improvement in a process she contends still moves too slowly. "The [Labor Department] is worse than ever," said Clark, who runs a website for injured contractors.
As of December, 3,258 civilian contract workers had been killed or died in Iraq, and another 90,000 had reported injuries.

Thursday, February 7, 2013

Kennedy grills Texas Instruments president

Kennedy grills Texas Instruments president


Kennedy grills Texas Instruments president

Photos

Joseph Kennedy III
Taunton Gazette Photo | Mike Gay

Congressmen Joseph Kennedy III speaks at the Taunton Area Chamber of Commerce's annual meeting on Monday at the Holiday Inn in Taunton.



By Christopher Nichols
Posted Feb 06, 2013 @ 11:03 PM

Congressman Joseph Kennedy, III, questioned Texas Instruments President and CEO Richard Templeton on the company’s efforts to help provide compensation to former nuclear workers in the area diagnosed with cancer.
In the 1950s and 1960s, workers at the Metals and Controls plant in Attleboro, which later became a part of Texas Instruments, worked hands-on with nuclear materials, and many have since been diagnosed with various types of cancer.
Kennedy cited a talk he had with a Rehoboth man who was diagnosed with kidney cancer in 1992. Kennedy said the man knew of more than 180 of his former colleagues that have been diagnosed with some form of cancer.
“I tell those stories not to cast blame,” Kennedy said at the House Committee on Science, Space and Technology hearing on Wednesday. “The human cost of this country’s nuclear development in the 50’s and 60’s is not unique to Texas Instruments or to Attleboro. But I do believe that your company, along with the federal government, has a responsibility to the men and women we put in harm’s way.”
In 2001, the government established the Energy Employees Occupational Illness Compensation (EEOIC) program to provide compensation and pay medical bills for former employees.
Since then, the government has paid 301 claims related to Metals and Controls Corporation, totaling over $27 million, according to the Department of Labor.
Nationally, EEOIC has paid out over $9 billion in claims.
On Wednesday, Kennedy said many former employees still are not aware of their potential eligibility for benefits and more needs to be done to reach out to them.
“The money is there. The program is there. The need, tragically, is there. The communication is not. And we need to fix that,” Kennedy said.
When questioned, Templeton agreed with the need to improve outreach about EEOIC’s existence.
“I think you described the actions we need to take,” Templeton said. “We need to stay in contact between the appropriate government agencies and your office. We’ve been very active with the departments to make sure any information we could help with was available, and we need to continue that, take a look if there’s more that could be done. We should be doing it with you.”
Former workers who believe they may be eligible for benefits can visit the EEOIC’s website at www.dol.gov/owcp/energy, or call 1-866-888-3322.
Read more: http://www.tauntongazette.com/news/x206923381/Kennedy-grills-Texas-Instruments-president#ixzz2KDifd5Nh

Tuesday, February 5, 2013

Detecting deception: How to handle a malingering patient - amednews.com

Detecting deception: How to handle a malingering patient - amednews.com




[Illustration by Jon Krause / www.jonkrause.com]

Detecting deception: How to handle a malingering patient

Some medical experts say the number of patients who exaggerate illnesses seems to be rising. Doctors can help identify such behavior.

By ALICIA GALLEGOS, amednews staff. Posted Sept. 10, 2012.
Ronald Schouten, MD, knew immediately that something was strange about the patient who lurched oddly into his exam room and collapsed into a chair. The man, who complained of a head injury, appeared to understand Dr. Schouten’s words, but the patient’s voice was garbled and his mannerisms were overdramatic.
“His speech deficit didn’t make any sense,” said Dr. Schouten, an associate professor of psychiatry at Harvard Medical School and director of the Law & Psychiatry Service at Massachusetts General Hospital. “His hands were shaking violently, and he asked for water. Miraculously, he didn’t spill a drop.”
Dr. Schouten learned that the patient, who claimed to have fallen during work, was the subject of a theft investigation. The doctor soon decided the man was a malingerer.
Patients who malinger, or exaggerate illness, can be a problem for health professionals. Malingering is recognized as the intentional production of false or grossly exaggerated symptoms motivated by external gain.
A 2002 study in the Journal of Clinical and Experimental Neuropsychology examined about 10,000 neuropsychological assessments that involved patients who applied for or received compensation benefits or who were involved in injury litigation. Researchers found that 29% of personal injury and 30% of disability claim cases involved probable malingering and symptom exaggeration. Probable malingering was present in 8% of medical cases not related to litigation or compensation claims.
Patients learn the symptoms of nearly every disease online.
Of the 10,000 cases, 39% of mild head injury cases and 31% of chronic pain complaints resulted in probable malingering impressions.
In his 2007 book, Assessment of Malingered Neuropsychological Deficits, neuropsychologist Glenn J. Larrabee, PhD, said half of people involved in medical-legal claims exaggerate illnesses.
The problem is not limited to workers’ compensation and disability cases. Patients pretend to be sick or disabled to avoid work, stay out of legal trouble, obtain medication or receive special accommodations such as extra time on a collegiate exam.
Headlines in the past year illustrate how some patients fake illness for financial gain. For example, 10 New York railroad retirees were arrested in May for disability pension fraud. In 2012, women in Virginia, Arizona and California falsely claimed to have cancer and raised thousands of dollars in donations.
The bad economy is leading more people to pretend to be sick for money, said Donald Schroeder, MD, an Oregon-based orthopedic surgeon and past president of the Oregon Medical Assn. Consider that 55% of 500 fraud examiners said occupational fraud had risen, according to a 2009 survey by the Assn. of Certified Fraud Examiners. Intense financial pressure was listed as the largest contributing factor to the increase.
People “are losing their jobs and are desperate to find a way to support themselves,” said Dr. Schroeder, who conducts exams in personal injury and workers’ compensation cases. “They’ll file compensation claims, or they’ll go to court in personal [injury cases]. The problem is greater than ever.”

Difficulties in spotting malingerers

Physicians face myriad challenges in identifying malingering patients. One is time constraints of medical visits, said David Fleming, MD, chair of the American College of Physicians’ Ethics, Professionalism, and Human Rights Committee.
“We’re seeing so many patients [who] have chronic conditions, it’s difficult to pick up on the fact there may not be an objective reason to treat a particular patient,” he said. “We don’t really have the time to investigate. Oftentimes, it’s easier” just to treat them.
97% of nonhealth professionals can identify symptoms associated with major depressive disorders.
Lack of a long-term patient-physician relationship adds to the problem. If patients see many different physicians, that limits doctors getting to know and build trust with them, Dr. Fleming said.
Mental conditions that mirror the appearance of malingering can make spotting a fake troublesome, said Christopher Stewart-Patterson, MD, a fellow with the American College of Occupational and Environmental Medicine. Dr. Stewart-Patterson, who practices occupational medicine in Canada, co-wrote an article on malingering in the January/February issue ofAMA Guides Newsletter, which is published by the American Medical Association.
Munchausen syndrome, for example, is a disorder in which patients falsify or cause their own symptoms. The condition comes from a desire to be seen as injured or to receive sympathy.
“It’s imperative that mental health issues be ruled out as an explanation of the presentation before malingering is seriously considered,” Dr. Stewart-Patterson said.
Faking symptoms of common medical and psychiatric conditions is not difficult, according to Dr. Stewart-Patterson’s article inAMA Guides Newsletter. Ninety-seven percent of untrained people can correctly choose symptoms associated with major depressive disorder on subjective checklists, the article said. Sixty-three percent can identify at least five symptoms associated with a brain injury.
Patients easily can go online to learn the symptoms of nearly every disease, said Dr. Schouten. His book, Almost a Psychopath: Do I (or Does Someone I Know) Have a Problem with Manipulation and Lack of Empathy? details how doctors can detect manipulative behavior in patients.
63% of nonhealth professionals can identify at least 5 symptoms associated with a brain injury.
“With the Internet and the availability of all sorts of medical information, you could come up with a list of symptoms,” Dr. Schouten said. “Then, when the physician says, ‘Do you have this,’ [a patient] has every symptom under the sun.”
A key barrier to pinpointing malingering is a doctor’s desire to be supportive of patients, say medical experts.
Family doctors “trust their patients and rely on the histories they take to make a diagnosis,” Dr. Stewart-Patterson said. “[They] often see themselves as an advocate. If a patient is saying, ‘I can’t do this job,’ the tendency is to side with the patient.”

Signs a patient could be faking

But by ignoring potential malingering, doctors are contributing to the problem, said Dominic Carone, PhD, a neuropsychologist who conducts brain injury exams at the State University of New York Upstate Medical University in Syracuse. His book, Mild Traumatic Brain Injury: Symptom Validity Assessment and Malingering, discusses detection of malingering.
Countless dollars in tests, medications and treatments are wasted on dishonest patients, he said.
“Physicians don’t want to do harm, but if you don’t call malingering out or change the treatment plan, you’re harming other patients,” he said. “The system is being clogged up by people who don’t need to be going to therapies or diagnostic imaging that” doesn’t need to be done.
Keen observation is the first step to confirming suspicions of malingering.
For instance, Carone has seen patients walk in his building who appear to be in normal physical condition but act differently when they notice him watching.
He said doctors should ask themselves: How do patients act when they think no one is looking? Does the patient exam fit with the complaint? How does the medical history match up?
Another red flag is a patient who claims to have every possible symptom of a certain condition, even rare indications, Dr. Schouten said. Physicians should note whether a person’s demeanor corresponds with the medical problem, he said. For example, check to see if a person complaining of serious depression laughs and jokes with the doctor and other staff members.
“It’s very difficult to maintain a feigning of symptoms over a long period,” Dr. Schouten said. “They’re going to slip up.”
Documentation is key. Keeping detailed charts about a patient’s presentation and testing results leaves a necessary paper trail and helps other specialists who later examine the patient, medical experts said. Physicians should focus on the facts of a medical visit.
“When doctors interact with the legal system, they are constantly exposed to the legal system’s misdirected emphasis on opinions,” said the article in the AMA Guides Newsletter. “The issues of malingering and validity can be addressed purely based on fact, without any interference from opinions.”
Carone suggests telling patients up front that exams may not yield the results they expect.
“The patient needs to know you’re going to do an objective assessment, and you might be providing them some information that they don’t agree with at the end of the day,” he said. “Setting expectations early is really important, and that helps you pick up on when there’s an agenda present.”
Doctors should be cautious when confronting patients suspected of malingering, said C. Donald Williams, MD, a Washington state-based psychiatrist who has written several academic papers on the subject.
When doctors have “a question, they should not make an accusation, but rather act neutrally and professionally,” he said. “We’re not prosecuting attorneys. We’re professionals.”
Physicians have ethical obligations to report patients in some circumstances, said Dr. Fleming, of the ACP. If patients are using medication for criminal purposes or if fraud is suspected, doctors must tell authorities, he said.
In some cases, physicians must simply say no to patients, Dr. Schroeder said.
“We are taught to do the best for our patients and support them, but there are times when we can’t help people,” he said. Sometimes, “I’m the bad guy that has to drop that bomb, who says, ‘No further treatment will be beneficial.’ Sometimes, the patient needs to hear that.”

 ADDITIONAL INFORMATION: 

How to identify a malingerer

Patients who exaggerate illnesses often demonstrate signs of suspicious behavior. Physicians can detect such false conditions by observing how patients act.
Obtain and review past records. Physicians should check documents that relate to prior claims and medication history to determine if a patient’s background is being presented accurately. Refusal to release medical history suggests that the patient may be hiding information.
Check for consistency. Doctors should repeat questions to a patient to observe whether the patient’s statements remain congruent. Consistency of both presentation during the visit and over time should be evaluated.
Use tests and questionnaires. Established tests provide doctors with standardized data to measure if a patient’s result or response is unusual compared with most cases. Doctors interested in such testing tools can find a specialist to help in the evaluation if necessary.
Focus on facts. When interacting with legal or criminal claims, physicians might feel pressured to give opinions. Instead, they should concentrate on factual information from the patient’s visit such as test results.
Check past compliance. Physicians should review a patient’s prior adherence with medical treatment and cooperation to take tests. Lack of compliance could be a red flag.
Look at social history. Reviewing past occupational or social functioning can help doctors determine what’s behind a patient’s behavior. For example, a history of multiple lawsuits, legal difficulties or workplace conflict may suggest purposeful intent or malingering.
Source: “Malingering and Other Validity Considerations,” AMA Guides Newsletter, January/February

Copyright 2012 American Medical Association. All rights reserved.