The compensation judge denied)petitioner’s motion for temporary disability and medical benefits regarding a rotator cuff tear in his right shoulder and problems with his left knee. where the compensable injuries he sustained in his work—related accident had to do with his left shoulder, neck and lower back assessing the conflicting medical testimony the compensation judge found that the new problems were not causally related to the work—related, and that conservative treatment, rather than surgery, was recommended for petitioner’s lower-hack problems. Young v. CBI Services (App. Div. 2003
The compensation judge aptly found that the concededly palliative treatment recommended by petitioners examining physiatrist — to alleviate the back pan caused by defects in the seat of the school bus she drove —were reasonably necessary to relieve the effects of her injury. Van Dunk v. West Milford Board of Education
CMS: MEDICARE SECONDAY PAYER OPEN FORUM
Special Open Door Forum - October 20th: Medicare as Secondary Payer
CMS has become aware of a growing number of questions and issues surrounding "Medicare as Secondary Payer" policy. A significant portion of the concerns CMS has heard relate to payment for medical care when a Workers' Compensation case is involved. For that reason, this topic will be discussed in a special "Medicare as Secondary Payer" Open Door forum.
After some opening remarks on the topic, CMS subject matter experts will answer your questions and respond to your comments using this live national teleconference format.
In the spirit of Administrator Tom Scully's Open Door Initiative, we are proud to pilot this forum on Monday, October 20th at 3:00 to 4:00 PM ET. We hope to meet your expectations in addressing your concerns in this area, and we look forward to your input!
For those attending by phone, the call-in number is 1-800-837-1935 and the conference ID is 3017366. For those attending in person, the meeting will be held in Room 305A of the Humphrey Building in Washington, DC.
CMS: AIA DRAFT MEDICARE SECONDAY PAYER LEGISLATIVE PROPOSAL QUESTIONED
The AIA hosted a meeting in Washington DC on October 9, 2003 to discuss its proposed legislation now in its 15th draft. The ABA, WILG and AFL-CIO were invited to participate in the discussion which lasted the entire day. Significant concern has been rasied over the legislation and its inpact on the automobile and products liability litigation. The draft proposal shifts responsibility to the State agencies concerning the review of some Medicare Secondary Payer issues. Additional concern has been generated as to whather this will result in a national workers' compensation system and the expansion of a major vendor industry involving vendors of set-aside agreements which will ultimately delay and burden the workers' compensation process even further.
ASBESTOS LIABILITY SURGES
Asbestos Wave Surges; Crest Still to Come
The U.S. property/casualty industry—principally commercial insurers, and to a lesser extent, professional reinsurers—remains significantly underfunded by nearly 40 percent with regard to reserves for ultimate, undiscounted asbestos and environmental liabilities, according to a special report released by A.M. Best Co.
With incurred-to-date losses of $45 billion (asbestos) and $31 billion (environmental), A.M. Best's estimates of unfunded asbestos and environmental liabilities as of year-end 2002 are $20 billion and $25 billion, respectively, for a total of $45 billion, down from $53 billion at year-end 2001.
While a number of insurer groups have significantly raised their asbestos reserve levels in recent years, many more reportedly have yet to fully fund their obligations. In addition, environmental survival ratios are weakening as reserves continue to be paid down without further strengthening.
U.S. asbestos losses have surged dramatically in recent years, with incurred losses more than doubling to more than $4 billion in 2001 from the previous three-year annual average of $1.7 billion. Further underlining the industry's move to bolster its reserves for such losses, an additional $8 billion in asbestos losses were incurred during 2002, while Hartford Insurance Group alone posted a $2.6 billion addition to asbestos reserves during the first quarter of 2003. A.M. Best fully expects additional, sizable asbestos charges to be taken during the remainder of 2003.