San Antonio Legal Advice

The American Insurance Association and the Coalition for Medicare Secondary Payer reform both announced their support for the Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2012, introduced last week by Representatives Dave Reichart (R-Wa.) and Mike Thompson (D-Ca.).

The legislation is aimed at resolving the delays in the review of workers’ compensation set-asides for Medicare.

A Medicare Set-Aside Arrangement (MSA) is an account that is created when a workers’ compensation case is settled to protect Medicare from paying for expenses that are related to the worker’s injuries. Therefore, if a worker has to receive surgery, the MSA would be used to pay for it, rather than Medicare benefits.

“(The Centers for Medicare and Medicaid Services) takes too long to review proposed set-asides, fails to provide appropriate and consistent standards for determining amounts to be set aside, and provides no avenue to appeal CMS determinations,” Douglas Holmes, the coordinator of the Coalition for Medicare Secondary Payer Reform, said in a press release. “The process results in injured workers not receiving funds, additional costs for states and workers’ compensation payers, and additional liability for employers, insurance carriers, and attorneys. A legislative solution to this problem is needed.”

The coalition, which includes representatives for injured workers and insurance carriers, has been pushing for reform of this system for some time, and the Government Accountability Office released a report in March that included recommendations for improving these processes.

“In case after case, we hear of delays in approval, uncertainty of the amount to be reimbursed by injured workers, and changes in amounts to be set-aside after settlements have already been approved,” J.R. Boyd, the president of the Workers Injury Law and Advocacy Group, said in a press release.

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A new study examining the safety of young workers in the United States has yielded startling findings, says Massachusetts personal injury attorney Mark E. Salomone . According to statistics that appeared in HealthDay News, researchers from the Colorado School of Public Health found that approximately 20,000 teen job-related injuries occurred in 2010, including 88 teen deaths due to workplace injuries at privately owned companies. Most businesses with three or more employees carry Worker’s Compensation coverage, which applies to young employees as well as adults.
Teen worker injuries and fatalities can be the due to a number of factors, including dangerous work environments, defective work equipment or poor training. Teenager job injuries have many causes, from construction site accidents and company car accidents to repetitive stress carpal tunnel pain and restaurant worker kitchen burns .
The study found that, out of all the types of work young people are hired to do, farming is the most hazardous. “From a fatality standpoint, farm work is the most dangerous occupation for kids,” said study author Carol Runyan in an University of Colorado news release. “In farm work, youths are working around heavy equipment, digging and cutting with sharp implements. There are deaths almost every year from young people suffocating in grain bins.”
Massachusetts personal injury attorney Mark E. Salomone understands that young workers are typically more vulnerable than adults, across all industries, and that it is vital for teen employees and their families to explore not only Workers’ Compensation rights but other damages they may be able to recover. “Even if your family receives the maximum amount of teen Workers’ compensation benefits,” says Salomone, “it may not be enough to cover all the expenses incurred as a result of your child’s injury. A third party-such as a manufacturer, contractor or someone else whose actions may have been careless-could also be liable for a young worker’s injuries.”
Child labor laws exist across the nation, though in some companies they are not fully implemented or may go unheeded altogether. “We don’t tend to think of child labor as a major issue in the U.S., but we should,” says Runyan. “Laws governing the employment of youth ages 14 to 17 in this country are often very lenient and, in the case of family farms, virtually non-existent.”

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