Reading Room

Joint replacement claims are becoming more frequent in workers’ compensation, and proving compensability remains challenging.

Joint replacement claims are becoming more frequent in workers’ compensation and proving compensability remains challenging. As the aging working population has expanded so has been the need for workers’ compensation to pay for the cost of replacing aging joints.

As the US flu vaccination program rolls out, the numbers are also growing for those who have reported adverse consequences from the H1N1 vaccine.

The 2009 influenza pandemic has created a new framework of acts and regulations to respond to the World Health Organization’s (WHO) phase 6 pandemic alert. Governmentally imposed employment disruptions resulting from regulatory work disruptions to prevent the spread of disease maybe massive.

While workers’ compensation was envisioned as a summary and remedial social insurance program, the challenges facing the workers’ compensation system to deliver benefits as promised may be seriously burdened.

An employee who is laid off may also collect workers’ compensation benefits. Because the economy is doing poorly that doesn’t necessarily mean that an injured or disabled worker is excluded from other benefits.

The present economic downturn has been compared to the Great Depression of the 1930s or the recession of the 1980s.

A licensed practical nurse who suffered from preexisting pulmonary disability was permitted to recover benefits against her employer when a co-employee sprayed perfume at work. The NJ Appellate Division ruled that a licensed practical nurse was allowed to seek benefits when exposed to an employee's perfume even though the injured worker came to the employment with severe pre-existing obstructive lung disease.

In a landmark decision of immense national significance, the US Sixth Circuit Court of Appeals ruled that a RICO claim brought by injured workers against their employer, insurance carrier and employer medical expert could proceed. Several injured workers brought the Federal Racketeer Influenced and Corrupt Organizations Act (RICO) against their employer, Crawford & Company and [cut-off treatment doctor] Dr. Saul Margules.

Delay has always been a problem when injured workers need medical treatment.  Traditionally, insurance companies, especially in hard economic times, have sought to hold onto their money and not distribute benefits.

The escalating financial crisis of Lehman Brothers [stock down 94% Jan-Sept 2008], may have a major impact on workers’ compensation throughout the US. Over this weekend, the financial guru's scheduled meetings in an effort to avoid a complete crash of Lehman Brothers. In the meantime, the waves of this potential economic meltdown are sending hurricane-type surges throughout the US workers’ compensation system.
 

The NJ Star-Ledger newspaper conducted an eight-month survey involving hundreds of thousands of workers compensation claims pending before the New Jersey Division of Workers Compensation. The Star Ledger series ran for three days and exposed huge difficulties in the NJ workers' compensation system.