Insurance Company Broker Caught Cooking the Books

Today’s post comes from respected colleague Jon Gelman from Jon Gelman, LLC – Attorney at Law in New Jersey. It is pretty common to hear about fraud when it comes to workers in workers’ compensation. But the fraud can also come from different cogs in the wheel of the workers’ compensation process, an issue that isn’t always covered as thoroughly unless it involves a lot of money, like this situation. This insurance company employee stole millions of dollars instead of buying insurance policies for “trucking, hauling, waste management, moving, and recycling businesses located in New Jersey and New York,” according to the post. So the insurance companies didn’t get their money, the businesses didn’t get their insurance policies, and this fraud violated the trust of the insurance broker itself. At the time of his original blog post, Mr. Gelman wrote that the prosecution anticipated the sentence would include jail.

NJ Attorney General Jeffrey S. Chiesa announced that an employee of a former Morris County insurance brokerage company pleaded guilty today to stealing several million dollars entrusted to her employer. These funds had been entrusted to the insurance brokerage for the purpose of purchasing insurance policies for small and medium-sized businesses in New Jersey and New York.

Kelly Roetto, 45, of Bedminster, pleaded guilty to an accusation charging her with second-degree theft by unlawful taking, second-degree issuing bad checks, and second-degree misconduct by a corporate official before Superior Court Judge Thomas V. Manahan in Morris County. 

Judge Manahan scheduled sentencing for Dec. 19.Under the plea agreement, the state will recommend that Roetto be sentenced to nine years in state prison. In addition, Roetto will be ordered to pay restitution and will agree to never again obtain an insurance license in the State of New Jersey.

This defendant used her position of trust within this insurance brokerage firm to divert millions of dollars

“This defendant used her position of trust within this insurance brokerage firm to divert millions of dollars,” Attorney General Chiesa said. “My office will continue to work with the insurance industry to root out corrupt insurance brokers.”

“This crime attacked the integrity of our insurance system by Continue reading »


Depositions: When the truth is “I don’t know”

I Don't Know“Tell the truth” is some good advice we’ve all heard and hopefully listened to once in a while. However, when it comes to having your deposition taken, this advice can take on a slightly different meaning. Our experienced attorneys guide hundreds of clients through depositions each year, so we often see this challenge.

It is human nature to seek answers to our questions. But sometimes in our quest for satisfaction, we have a hard time resisting the urge to make a leap or two, or start to speculate, or make assumptions about potential solutions. This is particularly true when we are faced with a formal line of questions such as those asked in a deposition. We feel guilty and lacking somehow if we don’t know the answer to a question, or we can’t remember a name or date or what happened between the blow to the head and waking up in the hospital. … It gives us a good feeling inside and relieves a little pressure to at least try to put the puzzle pieces together for the person asking the question. We’re nervous, and it just goes against our helpful natures to simply say “I don’t know.”

Sometimes, though, this very human trait can lead to problems for a case. At some point in the midst of these leaps in logic and speculation on answers to questions, our answer can transform into something that is no longer the truth. While speculating or thinking out loud isn’t lying, when you get down to it, it isn’t really telling the truth either. Sometimes the absolute, 100% honest-to-goodness truth is simply, “I don’t know” or “I don’t remember,” and that is a perfectly okay answer to give. When your words have the power to potentially damage your case, it is important to choose them wisely, and remember you do not need to give in to the pressure of making assumptions or jumping to conclusions to come up with a satisfactory answer. Just tell the truth.


Reflections On Apple’s Factory Working Conditions

Today’s post comes from guest author Ryan Benharris from Deborah G. Kohl Law Offices in Massachusetts. The post is commentary about a blog post that firm owner Rod Rehm wrote last year, but I find it very timely. Sometimes it seems like the march to outsource is overwhelming. With that outsourcing comes increased profits for companies and “better” jobs for workers, but sometimes the cost is also really high.

There have been recent news stories about unsafe working conditions that caused building collapses or fires in garment and poultry processing factories. One of the more recent fires was made even the more tragic when almost all of the exits were locked. Even with these dangerous working conditions, it seems like there’s a story a month about more jobs moving overseas, whether in technology or manufacturing.

But Mr. Benharris prompts us to consider the cost of these cheap goods. It also seems that the big-picture of all costs — human, transportation, and manufacturing — for making a product are starting to be considered. Mr. Rod Rehm recently wrote in a blog post, “Good News for American Workers” about manufacturers taking a second look at the United States to produce or assemble products. And I hope that China’s Lenovo company opening an assembly plant in North Carolina is the start of a trend that leads to both foreign and United States companies recognizing the value that can be gained through decreased transportation costs and the goodwill that can be gained by operating with higher safety standards by locating manufacturing and assembly jobs in the United States.

Our colleague Rod Rehm shared a great post about Apple’s inhumane factory working conditions in China the other day. It gave us pause because we use Apple products in our business all the time. Whether it’s an iPhone to keep in touch with the office 24/7 or an iPad to help win our clients’ cases in the courtroom, these tools have become an integral part of our lives and the lives of hundreds of millions of people across the world. We hope that through advocacy companies like Apple will improve their working conditions and increase standards of living across the globe.

We also hope that as Apple moves to provide better working conditions for all of its workers and subcontractors, it can repatriate many of its jobs cost effectively. In the video linked in Rod’s post, Jon Stewart points out that right now Apple saves about 20% on the cost of production by outsourcing to China. We, as fans of Apple’s products, would be willing to split the difference with them and pay 10% more for their excellent products if they’d absorb the other 10% and treat their workers humanely.

Here’s Rod’s original post (reprinted with permission):

When Henry Ford invented the Model T, he revolutionized manufacturing and in the process created tons of high-paying jobs for ordinary people. His wealth was shared. When Steve Jobs and Apple invented the iPhone, Continue reading »


The Vanishing Concept of a Job

Today’s post comes from respected colleague Jon Gelman from Jon Gelman, LLC – Attorney at Law in New Jersey. The idea of a steady job has evolved into instability for the worker, Mr. Gelman writes. This instability also means that because of the way temporary workers are employed, employers have no financial motivation to keep workers as safe as possible. And when a worker gets hurt, the transitory nature of a job translates to the hurt worker being more likely to be forced pay for their own injury or “the public at large” having to foot the bill. While the whole blog post is important for workers to consider, it’s also important for “the public at large” to consider, since workers’ injuries can end up affecting our pocketbooks while the businesses are able to collect their profits and put degrees of separation between them and the injured worker.

While reviewing some historical cases today, I realized that what is missing from the workplace is the concept of “a job.” America’s economy has dramatically changed, and so have jobs that were once available its workforce.

Even clearer is the fact that the concept of a job has disappeared. The idea of getting up in the morning and going regularly to a job has even vanished. The evolution changed slowly with the young generation claiming that a job cycle transformed from a lifetime position to one lasting two years. Then the next stage in the evolution occurred, where the employee became a transient worker and daily the job changed and no stable employer really exists.

This evolution has eroded the underlining framework of a functional workers’ compensation program and the delivery of benefits. The injured worker becomes lost to the system, and a safe and secure workplace becomes an illusion. Lost in the complexity is the adequate reporting of accidents and occupational disease, and the ability to accurately follow the evolution of latent diseases and medical conditions.

“A new trend in the U.S. labor market is reshaping how management and workers think about employment, while at the same time reshaping the field of occupational safety and health. More and more workers are being employed through “contingent work” relationships. Day laborers hired on a street corner for construction or farming work, warehouse laborers hired through staffing agencies, and hotel housekeepers supplied by temp firms are common examples, because their employment is contingent upon short term fluctuations in demand for workers. Their shared experience is one of little job security, low wages, minimal opportunities for advancement, and, all too often, hazardous working conditions. When hazards lead to work-related injuries, the contingent nature of the employment relationship can exacerbate the negative consequences for the injured worker and society. The worker might quickly find herself out of a job and, depending on the severity of the injury, the prospects of new employment might be slim. Employer-based health insurance is a rarity for contingent workers, so the costs of treating injuries are typically shifted to the worker or the public at large. Because employers who hire workers on a contingent basis do not directly pay for workers’ compensation and health insurance, they are likely to be insulated from premium adjustments based on the cost of workers’ injuries. As a result, employers of contingent labor may escape the financial incentives that are a main driver of business decisions to eliminate hazards for other workers.”

Click here to read “At the Company’s Mercy: Protecting Contingent Workers from Unsafe Working Conditions”


Intoxication, Work, And Workers’ Compensation Don’t Mix

Today’s post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm in Iowa. For Nebraska, I would note that the law is slightly different, but similar, in this sort of a situation regarding workers’ compensation and intoxication.

Most of us know that, for both professional reasons and in the interest of safety, remaining sober while on the job is essential. However, it is important to also recognize that workers who are intoxicated at the time that they sustain a work injury stand a far lower chance of ever collecting workers’ compensation.

If the blood test shows the presence of alcohol or drugs, odds that the employee will be able to collect workers’ compensation are much lower.

This is because of the intoxication defense: if an employer can prove that intoxication was the cause of the workers’ injury, then they employer is not required to provide workers’ comp for that injury.

Now, there are some notable Continue reading »


Can I Collect Unemployment if I Have a Workers’ Compensation Case?

Injured workers are often forced to navigate the tricky waters of unemployment when they have a workers’ compensation claim. Not understanding how the two sets of laws interact can lead injured workers to trouble in unemployment and workers’ compensation for people who can ill afford the trouble. Here are some answers that Nebraska workers applying for unemployment after a work injury would want to know.

  1. When can you receive both workers’ compensation benefits and unemployment at the same time?

    Nebraska law allows you to collect workers’ compensation benefits and unemployment benefits at the same time only if your rate of weekly work comp benefit is worth less than your weekly unemployment. In that case, you collect your full workers’ compensation benefit, and unemployment pays the difference between your comp check and the unemployment benefits check. The advantage to the worker in this scenario is that the workers’ compensation is not subject to tax, while the unemployment benefits are taxable.

    Unemployment and workers’ compensation benefits rates are set under different formulas. You might fall into this category if you were injured shortly after starting a lower-paying job but had previously earned higher wages for a length of time at your previous job.

    However, if you do receive workers’ compensation benefits that are higher than your unemployment benefits, you cannot collect unemployment benefits.

  2. Won’t I “hurt” my workers’ compensation case if I have received unemployment benefits?

    There used to be some truth to concerns of unemployment benefits reducing the amount an employer has to pay on a workers’ compensation case. However, those concerns have temporarily been eliminated by the recent case of Hernandez v. JBS, found at this link: http://www.supremecourt.ne.gov/sites/supremecourt.ne.gov/files/coa/opinions/a12-435.pdf. In Hernandez, the Nebraska Court of Appeals overruled a Nebraska Workers’ Compensation Court judge who reduced the temporary total disability (TTD) pay awarded to a worker, who was fired by JBS, by the amount he received in unemployment.

    I believe the Nebraska Court of Appeals used sound reasoning to make their ruling in Hernandez.  However, the Nebraska Supreme Court has the ability to overturn the Nebraska Court of Appeals. Also, the Nebraska Legislature has the ability to rewrite Nebraska workers’ compensation and/or unemployment laws to overturn Hernandez.

    I would expect efforts to overturn Hernandez will be made in the courts and Legislature. My guess is the argument for overturning Hernandez will be that injured workers are receiving a “windfall” by receiving workers’ compensation on top of unemployment.

    This argument is nonsense. First of all, if a worker receives work comp benefits and unemployment, judges with the Nebraska Department of Labor and the Nebraska Workers’ Compensation Court have likely both found that the employee was not at fault for being terminated. Second, if a worker who cannot work because of a work injury is forced to apply for unemployment because he or she isn’t receiving workers’ compensation, there is a good chance that the employer either concocted a reason to fire the employee or forced the injured worker to do a job that she or he was unable to do.


Have A Happy And Safe Memorial Day

We would like to take time this Memorial Day to remember the men and women who died while serving in the United States Armed Forces, and to thank all of our men and women in uniform for their service. 

We also know that today is a national holiday and the symbolic beginning of summer, so we hope that everyone is enjoying their time off and being safe. For your information, below is a list of grilling safety tips adopted from a guide published by the U.S. Consumer Product Safety Commission:

Gas Grill Safety Tips

  1. Check the tubes that lead into the burner for any blockage from insects, spiders, or food grease. Use a pipe cleaner or wire to clear blockage and push it through to the main part of the burner.
  2. Check grill hoses for cracking, brittleness, holes, and leaks. Make sure there are no sharp bends in the hose or tubing.
  3. Move gas hoses as far away as possible from hot surfaces and dripping hot grease. If you can’t move the hoses, install a heat shield to protect them.
  4. Replace scratched or nicked connectors, which can eventually leak gas.
  5. Check for gas leaks, following the manufacturer’s instructions, if you smell gas or when you reconnect the grill to the liquid petroleum (LP) gas container. If you detect a leak, immediately turn off the gas and don’t attempt to light the grill until the leak is fixed.
  6. Keep lighted cigarettes, matches, or open flames away from a leaking grill.
  7. Never use a grill indoors. Use the grill at least 10 feet away from your house or any building. Do not use the grill in a garage, breezeway, carport, porch, or under a surface that can catch fire.
  8. Do not attempt to repair the tank valve or the appliance yourself. See an LP gas dealer or a qualified appliance repair person.
  9. Always follow the manufacturer’s instructions that accompany the grill.
  10. Store LP containers upright, and never near a grill or indoors or in a hot car or car trunk.
  11. Do not store or use gasoline or other flammable liquids near the grill.

Charcoal Grill Safety Tips

Charcoal produces carbon monoxide (CO) when it is burned. CO is a colorless, odorless gas that can accumulate to toxic levels in closed environments. Each year about 30 people die and 100 are injured as a result of CO fumes from charcoal grills and hibachis used inside.

To reduce these CO poisonings:

  1. Never burn charcoal inside of homes, vehicles, tents, or campers. Charcoal should never be used indoors, even if ventilation is provided.
  2. Since charcoal produces CO fumes until the charcoal is completely extinguished, do not store the grill indoors with freshly used coals.


New Trend – Penalties For Not Participating In Your Employer’s Wellness Program

Today’s post comes from guest author Tom Domer from The Domer Law Firm in Wisconsin. Employer wellness plans are very popular, and Mr. Domer brings up the dark side of such offerings. His thought-provoking questions about how wellness programs may interact with worker’s compensation claims are useful points to consider.

A new study by AON Hewitt indicates more employers will be using penalties to prompt participation in an employee wellness program. Many employers use incentives for participation in wellness and health management programs such as Health Risk Questionnaires, biometric screenings, and smoking cessation programs. Those incentives include health insurance premium increases and other penalties, and potential reward such as premium discounts, gift or cash cards. All these penalties and rewards are aimed at an effort to prompt employees to participate in wellness initiatives.

The connection to worker’s compensation for these wellness programs is interesting. For example, biometric screenings could be used against employees who may later file worker’s compensation claims for occupational exposures. Additionally, such pre-existing conditions that are revealed in the screening programs may prove an additional barrier to employees receiving worker’s compensation benefits for a later claimed injury or occupational disease.


Diesel Fumes and Lung Cancer

Diesel Fumes Cause Lung Cancer

Today’s post comes from guest author Leonard Jernigan from The Jernigan Law Firm in North Carolina. There are so many cancers that people are diagnosed with that have unknown causes. So if there is an awareness that a substance increases risk for cancer, I think it’s important to try to minimize exposure to that substance. And although it’s not realistic to avoid these substances altogether, the trucking industry in particular has made an effort to use more efficient, clean-burning engines. I think it’s important to be aware of the situation and encourage more research and use of technology for both health and environmental reasons.

Lung cancer is the leading cause of death for men and women in the United States. It’s greater than breast and colon cancer in women and greater than prostate, colon, pancreatic and liver cancer in men. If diagnosed early there is a 70-80% survival rate for 5 years, and a low-dose CT scan of the chest can detect 60-70% of lung cancers at an early stage. Unfortunately, there has been no significant progress in the treatment of lung cancer in 40 years and between 10,000–20,000 occupational lung cancer deaths occur each year in the United States.

One area of concern is the relationship between diesel exhaust exposure and lung cancer. In June of 2012 the International Agency for Research on Cancer (IARC) classified diesel engine exhaust as carcinogenic to humans, and studies of underground miners support that statement and also indicate that others who are around diesel fumes may be at an increased risk. Toxic chemicals in diesel gas are nitrogen oxides, sulfur oxides, carbon monoxide, benzene, PAHS (polycyclic aromatic hydrocarbons), aldehydes and nitro-PAHS.

Railroad workers, miners, truck drivers, bus operators, longshoremen and others who have been heavily exposed to diesel fumes are obviously at greater risk than those with less exposures, but even minimal exposures may cause harm. In urban areas, like lower Manhattan, there is concern that diesel exposures may be a public health hazard and detection systems have been placed in areas to collect exposure data. As for workers who have experienced intense, short-term duration to diesel fumes, a chemical called 1-hydroxypyrene may be elevated in urine, but the test for this marker is not performed by most commercial laboratories. The Mount Sinai – Irving J. Selikoff Center for Occupational & Environmental Medicine is studying diesel exposure and may be a good resource for future information, as well as the National Clean Diesel Campaign: www.epa.gov/diesel.


Workers: Watch the Heat!

It has been a roller coaster of a May here on the Great Plains. Nebraska and Iowa have both been hit with weather extremes. For example, “Two days after Lincoln recorded a record low temperature and less than two weeks after the city saw significant snow, thermometers soared Tuesday.” And I saw on Facebook via Radio Iowa News, that “Sioux City reports 106 on Tuesday afternoon, beating the old record of 97, set in 2001.” Because the Journal Star says this is the earliest Lincoln’s ever hit 100 degrees (a new record), I will go out on a limb to say that we’re done with freezes for a while, which makes me think about the next season: summer and heat.

Did you know that heat issues can be covered by workers’ compensation? But prevention is preferred, so here are some links with lots of resources for those who work outside, no matter the weather, and also for those who play, garden, golf, exercise, and enjoy the outdoors. In addition, just like one’s body adjust somewhat to cold, the body also adjusts to heat, so a person who spends the summer in the air conditioning will have less tolerance for the heat than someone who spends all day outdoors. In addition, pay attention to prescription medicines, as some can cause sunburn or heat problems quicker than a person not taking that medication would experience them. The heat can also affect folks who may not be considered the traditional “outside” worker, as, for example, if one is unloading cargo from a truck to a warehouse in 100 degree heat, it can be much hotter than that in both the truck and warehouse.

One term that is mentioned on a regular basis in the media once the humidity kicks in is the “heat index,” which is defined as followed, according to http://www.weather.com/outlook/health/fitness/tools/heat: “The Heat Index is the temperature the body feels when heat and humidity are combined.” Of course this means that what it feels like isn’t the actual temperature, as it only felt like 95 when it was 100 recently because of a “dry heat.”

  • Welcome to OSHA’s Campaign to Prevent Heat Illness in Outdoor Workers
    There is a lot of information on here, and looking through some of it is a reminder that employers should expect and encourage workers to be safe when it comes to working in the heat. Employers should make an effort to encourage this safety focus by both talking about and acting on recommendations to help employees be safer and more productive.
  • Using the Heat Index: A Guide for Employers
    “Water. Rest. Shade. The work can’t get done without them.” This quote from the website is a very useful safety reminder. It looks like there are lots of opportunities through these links for conversations to occur between workers and employers about taking heat index into account when planning work.
  • NIOSH Workplace Safety and Health Topics: Heat Stress
    This site includes an overview; types of heat stress; recommendations for employers; recommendations for workers; and many other links that share resources and research about being in the heat.
  • Heat Safety Tool
    Although I’m generally easily amused, I am sincerely happy to say that there’s an app for that! Because so many people are connected with mobile technology, I am looking forward to downloading this app on my phone for the summer for personal use.
  • OSHA Quick Card
    Here’s a Quick Card resource from OSHA that folks can print out for reference points. And as neat as mobile apps are, from a practical perspective, paper does make a better fan.

So regardless of why you’re outside, enjoy, take care, and be safe!