Category Archives: health insurance

Repeal of ACA Would Undercut Doctor Choice in Workers’ Compensation Claims

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aca repealThe repeal of the Affordable Care Act (President Barack Obama’s health care law) is a real possibility in the Trump administration. It will be difficult to know how a repeal would affect workers’ compensation without having an idea about what alternative plan, if any, would replace the Affordable Care Act. But it seems certain that if Americans lose health insurance, they will have less control over their own medical care if they are hurt at work.

In 2011, Vermont passed a single-payer health care plan. In a blog post I wrote for Jon Gelman’s blog, I observed that if all employees had their own doctors, it would be next to impossible for employers to route injured workers to occupational-medicine clinics. A blogger for Lynch Ryan made a similar observation. Doctor choice is critical, because some employers go so far as to unlawfully conspire with claims adjusters and doctors to undermine the value of an employee’s workers’ compensation claim. A single-payer system decouples health insurance from employment, which makes employers less influential in the system

The ACA is not a single-payer system, but millions of Americans gained health insurance through public Medicaid programs in states that chose to expand Medicaid after the Supreme Court struck down the mandated Medicaid expansion in 2012. This coverage was decoupled from employment. Insurance obtained through an exchange is also not tied to individual employers either. People who lacked health insurance tended to not have doctors, which meant that they had no choice but to see whomever their employer wanted them to for a work injury.

The workers most vulnerable to injury are often the workers least likely to have health insurance. Younger people are more likely not to have health insurance. As Milwaukee lawyer Charlie Domer pointed out in a blog post last fall, younger workers are more likely to get hurt on the job. New employees are often unable to enroll in company health insurance plans right away. Last fall, I wrote a post about how employees within the first few months of their employment are more likely to get hurt on the job.

A silver lining to the gray cloud of a prospective ACA repeal is that even if an employee loses health insurance, Nebraska workers’ compensation court Rules 49 and 50 still allow an injured worker to choose a doctor who treated them before – presumably when that worker had health insurance. Unfortunately, Nebraska did not expand Medicaid, so there would be a smaller proportion of Nebraskans of who gained health insurance under the ACA than in states, like Iowa, where Medicaid was expanded.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Affordable Care Act, Employment, health insurance, healthcare and tagged , , , .

Workers’ Compensation Basics: Understanding Medical Care and Treatment

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Doctor_examines_patientThis blog post is the next in the series that examines the basics of workers’ compensation.

The first, and perhaps most important, workers’ compensation benefit is the medical benefit. This is a workers’ compensation benefit that includes payment of all treatment for a work injury. The treatment can be as small as stitches from a cut finger all the way to complex spine surgery. Regardless, the treatment and medical care should be covered 100 percent by the employer or workers’ compensation insurance company. There is neither co-payment nor deductible due for the treatment for the work injury. This medical coverage for work injuries can potentially last for life, depending on the injury and circumstances.

Not only is all treatment, like surgery, covered for work injuries, but so are other methods of rehabilitation: like physical therapy and medication. In other words, there should not be any co-payments for physical therapy, prescription medication, or other medical devices. Further, the mileage traveling to and from the treatment (or even to the pharmacy) should be reimbursed. This year that rate is 57.5 cents per mile.

These tips below are important to ensure that all of your medical bills and prescriptions for your work injury continue to be properly paid in full.

When you go to your doctor for treatment, make sure to inform your medical provider that you are seeing them for a work-related injury or illness, and ask them to send the bills to your employer. Also, make sure to thoroughly explain to your medical provider how you were injured or how you became ill. Give details about how the accident or work activities injured you or made you sick. Finally, inform the medical provider everything about your injury or illness: where you hurt, how the pain feels, your ability to function at home and work, etc. If your doctor wants you to avoid certain activities in order to promote healing, be sure to get a written copy of those restrictions from your doctor.

Look for information about choosing a physician (physician choice) to treat a work injury in an upcoming blog post in the workers’ compensation basics series.

Read the previous blog posts in the series by clicking on these links:

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Cancer, Doctor, health insurance, healthcare, mental health, prescription drugs, Workers' Comp Basics, Workers' Compensation and tagged , , , .

ACA Sign-up Deadline Set for Sunday

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healthcaregov.pngSunday, Feb. 15, is the 2015 deadline to enroll for health insurance coverage through the Affordable Care Act’s process. The information that’s out there can be pretty overwhelming, and sometimes websites don’t work, especially when enrollment is time sensitive, as it now is. For procrastinators, here are some good places to start, hopefully help to beat the deadline, and most importantly, enroll in insurance coverage.

A good starting place is the healthcare.gov website. Be sure to use the .gov, as other places (.com, .net, etc.) aren’t actually the insurance exchange and at worst, can be scams. From there, if things get confusing, as insurance often does, another option is to call 800-318-2596 for help, according to healthcare.gov. Or, by clicking on “Find local help” and providing a zip code, there are more direct ways to get ahold of someone and ask questions.

The site itself answers such questions as what kind of coverage a person qualifies for when the marketplace application is filled out. Unfortunately, Nebraska is one of the states that has chosen to not expand Medicaid, so clicking on the link about what Medicaid expansion means will help explain how this affect people. However, many folks are qualifying for subsidies, which are automatically applied to specific plans, often the silver level, and help people afford more comprehensive coverage, with the subsidies based on income.

Why should a person go to the effort? Because there are actually financial and societal benefits to having health insurance, especially if something happens and a person has medical needs. That being said, the ACA coverage is not meant to take the place of employer-sponsored coverage for sick workers.

As has been mentioned before in this blog, folks having health insurance coverage benefits more than just the individual.

“You’ll be pulling your weight. Americans pick up the costs of caring for uninsured patients in the form of higher insurance premiums, higher taxes and more expensive care,” according to an editorial around this time last year in the Kansas City Star newspaper.

In addition to the benefits of having health insurance, there is a greater penalty for not enrolling this year than there was last year, according to healthcare.gov. “If you don’t have health coverage during 2015, you may have to pay a penalty. The fee in 2015 is higher than it was for 2014 – 2 percent of your income or $325 per adult/$162.50 per child, whichever is more.”

Just as it’s important for employers to have workers’ compensation insurance coverage, individuals – and their families – should have health insurance to try to plan for the unknown.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Affordable Care Act, health insurance, healthcare and tagged , , , .

How Safe Is Healthcare for Workers?

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injured nurseThe article that today’s blog post is based upon is an in-depth look at how one state’s OSHA office interacts with a sector of the healthcare community: hospitals. Like Iowa, but unlike Nebraska, Oregon is one of 27 states or U.S. territories that has an OSHA office at the state level.

The “Lund Report: Unlocking Oregon’s Healthcare System” article talks extensively about nuances within ways that OSHA offices, whether state or federal, can measure the safety of healthcare providers like hospitals and nursing homes.

As evidenced in previous blog posts about senior-care workers and lifting injuries, I have continuing concerns for the safety of healthcare workers.

According to the in-depth article, “A Lund Report review suggests that in Oregon, regulators are de-emphasizing attention to hospital employee safety, despite national data showing that healthcare workers are injured in the U.S. each year at rates similar to farmers and hunters. Most Oregon hospitals have not been inspected by the state Occupational Safety and Health Division in years. And when on-the-job hazards are detected, Oregon’s OSHA office levies the lowest average penalties in the country.”

Should workers get lost as the patients are the focus of these healthcare institutions? Should regulation and inspections or fines by such groups as OSHA be the driving force toward workplace safety for healthcare employees?

It seems to me that healthcare administrators’ emphasis on profit is more important than proper concern for their employees – the nation’s caregivers. And if you or your family member is the healthcare worker who gets hurt on the job, this lack of focus on the worker is more than just a philosophical argument.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Disability, Health, health insurance, Uncategorized, Work Injury, Worker safety, Workers' Compensation and tagged , , , .

Shutdown Hurts Groups that Help Injured Workers

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I can imagine few feelings worse than being hurt on the job, being unable to work and not getting benefits, and/or not being able to seek treatment. I get calls from my clients in that predicament frequently, and it is probably the worst part of my job. 

But the shutdown has made this situation even worse for injured workers with denied claims. The shutdown has endangered funding to community action programs that can help injured workers at least get short-term help with rent, housing utilities and food.  

Please call your senator and representative and tell them to come to their senses and end this shutdown. Also, please consider donating to your local community action program, which you can find by doing an internet search.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Government, health insurance and tagged , , , .

The Problems with States Refusing Medicaid Expansion

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Medicaid expansion was a large part of the recent health care reform law under the Affordable Care Act. For reasons that seem to be solely based on politics, some state governors have made public their decision to reject the Medicaid expansion, and as a result, federal funding of the expansion.

Besides the obvious problems this rejection would cause for millions of uninsured Americans and the health care providers who treat these uninsured people, this rejection could have a negative effect on workers, especially injured workers, of these states.

Fellow workers’ compensation lawyer, friend and colleague Tom Domer of Wisconsin discussed the possible ramifications when an injured worker does not have access to health insurance. Mr. Domer discussed the following scenario that we see day in, and day out, in a previous blog post:

“The personal toll on the uninsured is devastating, especially for those dealing with work injuries.

As a worker’s compensation attorney, the following scenario plays out on a daily basis: A hard-working individual—who is lucky enough to have health insurance through the employer—is injured at work through no fault of his own. The injury is severe enough to not allow a return to work, or the employer simply terminates the employee (this insidious action happens far too often with far too little publicity). After termination, the injured worker is offered federal COBRA rights to continue paying the health insurance premiums at the full 100%, which of course, is near impossible when you are off work without income. Thus, the worker loses health insurance for himself and for his family.

On the flip side, the worker’s compensation insurance company is supposed to pay for reasonable medical treatment expenses related to the injury; however, the carrier usually hires an “independent” medical doctor to deny the worker’s compensation claim. The injured worker is then left out in the cold with an injury that requires medical treatment, but he has no ability to get that medical treatment without health insurance or workers’ compensation coverage. The worker then calls me and asks the emotionally-laden question: ‘What do I do?’”

Nebraska is one of the states that is “Leaning Toward Not Participating” in the Medicaid expansion, at least according to Gov. Dave Heineman’s public statements on the topic.

This can have a devastating effect on Nebraska workers who have suffered an injury.

As Mr. Domer further states:

“Access to health insurance alters this equation. If the worker had adequate access to health insurance, especially Medicaid, he could obtain the medical care that could allow a return to work, regardless of whether the worker’s compensation insurer accepted or denied the claim. Whether work-related or not, injured individuals should have the opportunity to get healthy in our country.”

So what can be done about this problem? Contact your government officials to encourage them to provide injured workers increased access by expanding Medicaid.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Government, Health, health insurance, insurance regulation and tagged , , .

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

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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.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in health insurance, Workers' Compensation and tagged .