Workers Comp – Payday Loans VMR Wed, 23 Nov 2022 15:17:19 +0000 en-US hourly 1 Workers Comp – Payday Loans VMR 32 32 New Jersey is the most expensive state for comp Wed, 23 Nov 2022 15:17:19 +0000

New Jersey retained its spot as the most expensive state to purchase workers’ compensation coverage in the latest biennial rate rankings by the Oregon Department of Consumer and Business Services.

And while the top half of the list included perennials such as California, New York and Hawaii, Wyoming joined the top 10 after an average cost increase of more than 29% this year.

Average premiums of $2.44 per $100 of payroll in New Jersey were 192% of the study median, or $1.27 per $100 of payroll in Pennsylvania. New Jersey topped the last study, in 2020, with average costs of $2.52.

Hawaii, which ranked fifth in 2020, moved up to second place this year, with average premiums of $2.27. California fell from fourth place in 2020 to third this year, with average costs of $2.26. New York fell two places to fourth, with average costs of $2.15. Louisiana, which ranked eighth in 2020, rounded out the top five this year, with average costs of $2.13.

Wyoming was ranked the seventh most expensive state this year with average premiums of $1.86. In 2020, it ranked 26th, with average costs of $1.44.

The DCBS said the national median index rate of $1.27 per $100 of payroll was the lowest value since it began making national rate comparisons in 1986. During in the first year of the study, the national median index rate was $3.18, and by 1994 it had increased. at $4.35.

WorkCompCentral is a sister publication to Business Insurance. More stories here.

Changes to workers’ compensation rates affecting Florida, New Jersey and Oregon Tue, 15 Nov 2022 06:00:33 +0000 “Year after year, Floridians see a decline …]]>
compensation rates. This is fantastic news because small businesses in Florida are the backbone of our economy and paying less for workers’ compensation coverage is helping business owners combat the effects of rising inflation,” Florida Chief Financial Officer Jimmy Patronis said in a statement. (Credit:” width=”620″ height=”372″/> “Year after year, Floridians see a decline in workers’ compensation rates. This is fantastic news because small businesses in Florida are the backbone of our economy and paying less for workers’ compensation coverage is helping business owners combat the effects of rising inflation,” Florida Chief Financial Officer Jimmy Patronis said in a statement. (Credit:

Florida, New Jersey and Oregon have all made recent announcements regarding workers’ compensation rates for 2023. Below is a general summary of each state’s announcement.


For the sixth consecutive year, the Florida Office of Insurance Regulation (FLOIR) has approved lower workers’ compensation premium rates. Florida Insurance Commissioner David Altmaier signed a order on November 7, 2022, approving the 8.4% cut proposed by the National Council for Compensation Insurance (NCCI).

“Year after year, Floridians see a decline in workers’ compensation rates. This is fantastic news because small businesses in Florida are the backbone of our economy and paying less for workers’ compensation coverage is helping business owners combat the effects of rising inflation,” Florida Chief Financial Officer Jimmy Patronis said in a statement. “I’m always proud to support the Florida small business community as we work to keep Florida the best place to live, work and run a business.”

New Jersey

Two changes to workers’ compensation in New Jersey will go into effect on January 1, 2023. First, the state’s Compensation Assessment and Inspection Office announced a 6.1% drop of the premium rate. New Jersey Insurance Commissioner Marlene Caride revised the Bureau’s proposed 4.7% drop after reviewing financial and statistical information that included some of the economic impact of COVID-19.

New Jersey also announced an increase in the maximum and minimum weekly benefits available to workers’ compensation claimants. For all occupational injuries, except for beneficiaries of permanent partial disability, weekly benefits will increase from $284 minimum, $1,065 maximum to a minimum of $293 and a maximum of $1,099. For recipients of permanent partial disability, the range of maximum weekly benefits would increase from $284 to $1,065 to $293 to $1,099, depending on the duration of the disability.


Workers’ compensation rates in Oregon, on the other hand, will not change. The current rate of 9.8% will remain in effect in 2023. The additional contribution of 0.1% for self-insured and public self-insured groups and 0.5% for private self-insured, for respective totals of 9.9 and 10 .3%, will also remain the same for 2023. The workers’ compensation fund valuation will also remain stable at 2.2 cents per hour worked.

“In these uncertain times, stability is important for programs that benefit employers and workers,” Andrew Stolfi, director of Oregon’s Department of Consumer and Business Services and insurance commissioner, said in a statement. “Maintaining good benefits for workers, while reducing costs for employers, is positive for everyone.


Workers’ compensation report examines effects of long COVID | 2022-11-11 Fri, 11 Nov 2022 05:00:00 +0000

Boca Raton, FL – A new report from the National Board of Compensation Insurance shows that about a quarter of workers’ compensation claims involving COVID-19 were for patients who developed long COVID.

For the report, researchers analyzed NCCI data on workers’ compensation claims from March 2020 to June 2021 and medical services provided last March. Researchers have identified nearly 7,700 claims related to COVID-19, with payouts of more than $120 million. Of those claims, 24% were for patients who developed long COVID, or when symptoms of the disease – including fatigue, shortness of breath, “brain fog”, heart palpitations, headaches, anxiety and depression – last three months or more. Additionally, among hospitalized patients, 47% developed long COVID, compared to 20% of non-hospitalized patients.

Other key findings:

  • Cardiovascular and pulmonary symptoms were most common in patients who developed long COVID.
  • In terms of demographics, women and healthcare workers have most often experienced long COVID. Nearly a third of long-term workers’ compensation claims from COVID were for people between the ages of 51 and 60.
  • The average cost for a hospitalized worker with long COVID was about $216,000, more than five times higher than the average cost for non-hospitalized workers.

The study is based on an NCCI report published in October 2021 titled COVID-19 and The New Reality – Prolonged COVID.

Grinberg: DIR considering new EAMS regulations | Workers Compensation News Tue, 08 Nov 2022 08:06:37 +0000

By Gregory Grinberg

Tuesday, November 8, 2022 | 0

I bring to your attention today a topic so exciting, so thrilling, so prone to making your hair stand on end, that I almost thought it was appropriate to get a note on this blog post. before publishing it.

Gregory Grinberg

It’s not about cool ninja krav maga fights at the workers’ compensation appeal board. This is not about a worker who said he was injured after being bitten by a radioactive spider, but was later photographed fighting crime while technically on TD. This is the new EAMS regulation proposed by the WCAB.

Search your souls, dear readers: isn’t this the most exciting news of all time?

Some of the changes are relatively minor: insurance companies will receive UANs, as will claims administrators and attorneys. The proposed regulations codify electronic or digital signatures as well as scanned handwritten signatures and eliminate Section 10205.6, which allowed parties to designate their preferred method of service, which is appropriate because accepting service by email does not is no longer optional (see 8 CCR Section 10625(b)(2).)

The big takeaway for immediate action is that since some insurance companies are separate entities from claims administrators already registered with EAMS, they should do so quickly once the new regulations are approved and put into effect. work. The way to do this is to contact the Central Registration Unit via email at and provide the name, address, phone number, and email address of the insurance company.

So, dear readers, follow me as we take another step into the future and move from paper to all things electronic.

Gregory Grinberg is a managing partner of the SF Bay South office of Gale, Sutow & Associates and a certified specialist in workers’ compensation law. This post is reprinted with permission from Grinberg’s WCDefenseCA blog.

Travelers launches mental health app for injured workers | Workers Compensation News Fri, 04 Nov 2022 07:01:53 +0000

Friday, November 4, 2022 | 0

The Travelers Cos. Inc. announced Thursday the launch of Wysa for Return to Work, an app designed to promote the mental health of injured employees and facilitate more holistic recovery.

According to the company’s workers’ compensation claims data, more than 40% of employees who missed days of work due to injury experienced a psychosocial barrier to recovery.

The app helps users “learn mental resilience skills that can help overcome these obstacles. The app responds to what users communicate through a secure, anonymous, SMS-like platform, and offers strategies that include cognitive-behavioral techniques, guided meditation, and breathing exercises,” Travelers said.

The app was created in partnership with Wysa Ltd., a provider of mental health support tools incorporating artificial intelligence.

The new app is available to injured employees who indicate one or more psychosocial barriers to their recovery during conversations with a nurse or a Travelers claims professional. Early pilot results show that injured employees using Wysa for return to work reduced the number of missed workdays by around a third, compared to those not using the app.

Business Insurance is a sister publication of WorkCompCentral. More stories are here.

The Complex Landscape Surrounding High-Impact Drugs and Worker Compensation Tue, 01 Nov 2022 11:40:36 +0000
Although high costs and other challenges remain a concern, specialty medications, including biologics and biosimilars, should be continually evaluated for potential benefits for injured workers, as they may provide relief than traditional therapies. can not. (Credit: Kenishhirotie/

When we talk about addressing pharmacy issues in workers’ compensation programs, opioid concerns are often at the top of the agenda, and while opioid management remains a high priority, it is not isn’t the only pharmacy trend we need to watch closely.

High-impact categories such as topicals, compound kits, combination packs, and specialty drugs represent proportionately low usage, however, they can be associated with exponentially higher costs. In order to effectively manage clinically relevant utilization and savings within these classes, it is important to recognize the trends associated with each of these cost drivers.

In recent years, the industry has seen the use of topical medications, which are applied to the skin or mucous membranes, increase. These drugs are now a leader in expenditure and a growing source of concern in the field of workers’ compensation. The category appears to be the next horizon that billers and dispensers, especially dispensing physicians, will look to as a money-making opportunity and stands out as an ongoing trend.

Topicals are being prescribed in workers’ prescriptions with increasing frequency – ranking third among major therapeutic classes with 12.4% of total drug cost and 5.7% of total prescriptions. Within this class, some cost factors stand out, such as private label topical analgesics (PLTA), which are associated with limited clinical efficacy and exorbitant prices that often rule them out as a first-line treatment option. favorable line. Examples include Velma, Lidopro and New Terocin.

Also, under the category of topical and dermatological medications are topical prescription medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as Voltaren Gel and Pennsaid, as well as some topical anesthetics such as ZTLido and Lidoderm, and these contain specific and limited foods and foods. Drug Administration (FDA) approval for use to be considered with appropriate venue and therapy.

Conversely, PLTAs are not FDA approved and are not evaluated for compliance with applicable regulations and policies for safe and effective use. These products are also not recommended as first-line treatment.

Additionally, they rarely offer greater clinical benefit over comparable, more cost-effective over-the-counter (OTC) alternatives and often contain the same ingredients. Creating further challenges, most of these products are marketed directly to physicians’ offices for distribution, creating paper bills and out-of-network issues regarding cost management and circumvention of security and clinical controls.

Although topical medications may have several benefits and be a viable option for some patients, they require careful monitoring. In many cases, their lack of demonstrated superiority, efficacy, and price impact supports the case for consideration of therapeutic ingredient equivalents, which produce lower costs and/or clinically effective results. .

The high price of combo packs

We also see high priced compound kits and combo packs where the individual components are available separately or in different formulations at a much lower cost. Compound kits contain two or more premeasured drug ingredients that must be combined immediately prior to use based on a prescription and are sold together as a single product, usually under a National Drug Code (NDC). Combination packs consist of several commercially available products that are conveniently packaged together for sale with a common therapeutic purpose.

An example that illustrates the extreme price markup for products in a combo pack involves an OTC topical gel combined with alcohol wipes packaged as a single product. When distributed separately, they have an average wholesale price (AWP) of around $15 combined. However, as a combo pack product co-packaged under an NDC, the price of these same products now represents an AWP of approximately $3,400.

Fortunately, we are seeing downward trends in the combo pack category, in part due to the implementation of various programs and checks used to address them specifically. Unfortunately, the inflated cost associated with these products, which average around $2,100 per prescription, speaks to the importance of a continued focus on this area and the impacts it can have.

Similar to some of the other categories discussed, the specialty drug category, which includes drugs that are typically used to treat complex chronic conditions, and represents a major area of ​​pharmaceutical development with significant costs.

Specialty drugs

There is no universal specialty drug list that easily identifies this group of relatively low-volume and expensive drugs. Most entities establish their own definition of what should be included in the category, which typically includes a combination of criteria involving drugs used to treat rare complex conditions, considerations for special storage and handling requirements, cost and various clinical applications of use, such as administration difficulties, patient compliance, specific testing and monitoring requirements, and patient safety and immunogenicity issues.

Given this, the specialty category includes a broader definition of products that fall under this set of criteria, as well as biologics and biosimilars defined by the FDA to include vaccines, viruses, therapeutic serums, toxins, blood or its derivatives, allergenic and other products. . In workers’ compensation, for example, the specialty category often represents injectables used to manage inflammatory conditions or various types of joint pain.

Additionally, for workers’ compensation, specialty drugs can be particularly challenging because they are prescribed to treat conditions that may be directly or even indirectly related to workplace injuries or illnesses. Different distribution channels also pose additional challenges, with around half of these drugs being dispensed through doctors’ surgeries, clinics and hospitals, as opposed to traditional pharmacies. Additionally, many of these products are billed using J codes.

Even though many of these drugs are prescribed to manage complex, often chronic conditions, there are some notable medical conditions that are trending in the workers’ compensation space. The top five medical conditions account for over 60% of all specialty drug costs and usage. The majority are used as blood clotting treatment and preventative medications, including medications that prevent and treat deep vein thrombosis and pulmonary embolism like Eliquis or Xarelto. Other categories of disease states among the top five were determined by drugs used to treat HIV or AIDS, primarily antiviral drugs, which are currently used for post-exposure prophylaxis following a needle stick injury of needle. Cancer drugs, autoimmune disorders and migraine medications, including new therapeutic class injectables – such as Ajovy, Emgality and Aimovig – round out the top five conditions.

Although high costs and other challenges remain a concern, specialty medications, including biologics and biosimilars, should be continually evaluated for potential benefits for injured workers, as they may provide relief than traditional therapies. can’t, which could result in a better quality of life as well as fewer hospital admissions, emergency room visits, and lab tests. However, in other cases, less expensive but equally effective alternative therapies might offer a better choice.

Targeted solutions for pharmaceutical challenges

When it comes to addressing these high-impact pharmaceutical challenges, the best approach is to deploy targeted clinical solutions that leverage three strategies to optimize pharmacy programs.

First, identifying these difficult, high-impact pharmaceutical categories is critical, as they are not easily identifiable in the data. Additionally, a pharmacy program should include options for proactive solutions for post-dispensing review, plan changes, medication list control or formulary management, as well as medication decision support. prior authorization of medicines which includes both clinical and regulatory aspects that strengthen utilization management and billing controls.

Second, follow the evidence. Apply clinical controls that target these categories and scenarios for interventions to promote more cost-effective first-line alternatives through timely clinical review and recommendations, drug utilization evaluations, and formal usage review. Integrate these categories into predictive and demonstrative risk modeling to establish clinical solutions that address patient safety, align with evidence-based treatment recommendations, and apply various treatment guidelines such as the Official Guidelines on the disability (ODG). Follow up by supporting ongoing clinician engagement, monitoring, education and coordination.

Finally, use reporting and data analysis tools to continually improve customer collaboration through training, support, and partnership review to address areas of opportunity.

Nikki Wilson, Pharm.D./MBA, is Senior Director of Clinical Pharmacy Services at Mitchell, an Enlyte company. As a licensed pharmacist, Wilson has over 13 years of comprehensive industry experience through leadership roles overseeing home prescription delivery programs, clinical pharmacy operations and benefits management. social and product development.

The opinions expressed here are those of the author.


Springfield Workers Compensation – Nomad Lawyer 007 Sat, 29 Oct 2022 05:33:20 +0000

Workers Compensation Springfield: If you own or work for a small business in Springfield, Illinois, you must provide workers’ compensation insurance. This law covers employers with five or fewer employees.

In this article, we will discuss what Springfield employers should do to ensure their employees receive injury compensation benefits. You will also learn how to get perks and how much it will cost.

Work-related injuries can happen in any workplace

Work-related injuries are common in many industries and can disrupt a business. These types of accidents result in significant medical costs and loss of work time. They can also lead to problems with worker morale and legal action. If you or someone in your business has been injured, it’s important to understand your legal options.

Many work-related injuries occur as a result of repetitive motions. Workers who perform a repetitive motion such as heavy lifting or carrying objects may be subject to back, shoulder or neck strain. Fortunately, there are ways to prevent strain by using proper lifting techniques. However, some injuries cannot be avoided and can lead to long-term disabilities.

Another common type of injury is falling objects or structures. This could result in a head or knee injury. Other injuries can occur due to faulty equipment. If you work in a construction environment, you need to make sure your equipment is safe and well maintained to avoid accidents.

Workers’ Compensation is required for employers with less than 5 employees in Springfield

If you are an employer in Springfield, you must have workers’ compensation insurance. This insurance is a no-fault benefit that pays compensation after an accident at work or occupational disease. It covers medical care, vocational rehabilitation and other benefits for injured workers and their families. It is mandatory for all employers, even those with less than 5 employees, and represents a cost of doing business.

Although you can avoid having to purchase workers’ compensation insurance by choosing a self-insured plan, the Division of Labor and Industries (ODI) requires employers to obtain this coverage if they have fewer than five employees. . However, companies with more than two corporate officers must take out work accident insurance.

Obtaining Benefits

Obtaining workers’ compensation benefits can be a complicated process. A qualified Springfield workers compensation attorney can guide you through the process. Workers’ compensation benefits cover most work-related illnesses and injuries, as well as some additional expenses. However, the employer is responsible for providing a safe work environment and meeting certain health standards. Failure to comply with these standards may result in damages from the employer.

First, you must notify your employer in writing of your injury. Generally, you must report the injury within 45 days. This ensures a paper trail and will help you file an application if you are eligible. Additionally, you should seek medical attention for any injury you have. The doctor should document your injury and provide you with a note that you can submit to your employer.


Regardless of the size of your business, you should have workers’ compensation insurance. This type of insurance will cover most of the costs you incur as a result of a work-related injury or illness. Additionally, you may be reimbursed for any additional expenses you incur as a result of the injury. Having this type of insurance is important because it can protect you and your business from potential lawsuits from injured employees.

The cost of workers’ compensation coverage depends on many factors, including your industry, payroll, and work-related risk factors. Your workplace’s claims history will also play a role in determining the cost of your policy. Some states offer discounts to employers with a strong safety record.

Source: Gettyimages

get a lawyer

If you’ve been injured on the job, you should ask a workers’ compensation lawyer to help you navigate the system. A lawyer knows how to present evidence to support your case and can advise you on how to negotiate a fair settlement offer. Without legal assistance, you may be forced to accept a lower settlement offer.

Workplace injuries can be devastating and traumatic, but the law may provide compensation for medical expenses and lost wages. An experienced and proven lawyer can help you get the compensation you need to recover from your work-related injuries.

FAQ: Springfield Workers Compensation

Who is covered by workers’ compensation?

Workers’ compensation covers a wide range of employees, including full-time, part-time, and temporary workers. It also covers certain contractors and volunteers in certain cases. Generally, any worker who is injured or becomes ill in the line of duty is covered by workers’ compensation.

How long does it take to get a workers compensation check in Illinois?

There is no definitive answer to this question because every worker’s compensation case is different. However, most settlements are usually finalized within a few months.

What is the salary for paid workers in Illinois?

Workers’ Compensation in Illinois is an insurance system that pays benefits to employees who are injured or sick as a result of their work. Benefits may include medical expenses, income replacement and death benefits. Workers’ compensation is usually paid by employers, but in some cases it may be paid by workers’ compensation insurance companies.

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Iowa State University settles with ex-custodian alleging retaliation and discrimination Wed, 26 Oct 2022 22:14:22 +0000

Curtiss Hall (left) and the Campanile (right) on the campus of Iowa State University in Ames on Friday, July 31, 2015. (/The Gazette)

The state board has settled a lawsuit with a former Iowa State University custodian who said she was not told she could take time off for her migraines , retaliated for the time she took to remedy it, and was discriminated against because of her skin color.

During her employment, Dominique Jackman “was treated disrespectfully by other employees when they repeatedly made comments about minorities such as ‘black people weren’t there when they were growing up and now they are everywhere,” according to a July 2020 lawsuit former ISU employee Jackman filed a lawsuit against the state of Iowa and three of its employees.

“In late 2018, Jackman complained to her then-supervisor … about these comments,” according to the lawsuit. “Jackman is not aware of any investigation that has been conducted as a result of his complaint. Jackman stopped eating in the break room with those employees because of those comments.

Jackman also accused the state of Iowa and its supervisors of failing to inform her of her rights to family leave; disregarding his disability; discriminate against and retaliate against her for this disability; defame it; and intentionally inflicting emotional distress.

“The acts and omissions of the defendants were outrageous and intentionally designed to discredit and humiliate Jackman, damage his reputation, and cause him severe mental anguish and emotional distress,” according to his lawsuit. “The conduct of the defendants was willful, gratuitous and malicious and was in knowing and reckless disregard of Jackman’s rights.”

The State of Iowa has denied these charges and allegations – asking a court to dismiss them for several reasons, including that Jackman changed his story and that any wrongdoing by ISU employees was not “outrageous , intentional or reckless, in law”.

“None of the conduct that plaintiff alleges against any of the individually named defendants is sufficiently outrageous to sustain a claim (intentional infliction of emotional distress),” according to the state’s motion to dismiss. “His allegations that the ISU defendant failed to provide FMLA documents, failed to accommodate his migraines, or failed to respond to racist comments from co-workers do not rise to the level of outrage required. to support an IIED claim in Iowa.”

The settlement reached by the two parties last week pays Jackman and his lawyers a total of $50,000 – including $6,087 for lost earnings, $25,000 for non-wage damages like emotional distress and $18,913 for attorney’s fees.

“Jackman acknowledges that such payments infringe litigation and such payments should not be construed as the State of Iowa or any of the Released Parties conceding the reasonableness of attorneys’ fees or expenses, and should not be construed as an admission of liability or wrongdoing by the State of Iowa or any of the released parties,” according to the settlement.

Jackman, 38, whose employment with Iowa State ended on April 5, 2019, also agreed as part of the agreement not to seek future employment with ISU.

The ISU regulations are among four staff regulations the board has signed so far this fiscal year, which began July 1. tort claims, 13 pending faculty or staff grievances or disciplinary cases, and 136 pending workers’ compensation claims.

The University of Iowa had 14 pending lawsuits, 20 pending internal discrimination complaints and 603 workers’ compensation claims as of June.

UI Health Care had 24 pending lawsuits, and Northern Iowa University had two pending lawsuits and 65 pending workers’ compensation claims.

Jackman, according to her lawsuit, began working at Iowa State as a full-time caretaker in October 2017. While an ISU employee, she sometimes suffered from debilitating migraines that left her bedridden. and nauseous.

Although she said she told a supervisor that her absences from work were due to migraines, Jackman said she did not always call immediately “due to the debilitating effect of migraines,” according to her lawsuit.

The state of Iowa issued her lack of work warnings, but Jackman in her lawsuit said no one told her about the family and medical leave law or that she had a “serious medical condition who might qualify her for benefits or leave eligibility.

In late 2018, Jackman said she complained to a supervisor about racially disrespectful behavior and abuse that occurred throughout her employment, but she was unaware that the State of Iowa had been investigated.

Shortly thereafter, in January 2019, Iowa State hired a new custodial supervisor — who had been Jackman’s supervisor in a previous job with Green Hills Retirement Community, according to the lawsuit.

Jackman accused the supervisor of creating a “hostile work environment” at his former job, prompting him to quit, according to the lawsuit. But the supervisor told Iowa State Human Resources that Jackman had been terminated, prompting HR to inform Jackman that she “is being investigated for falsifying her job application.” employment for the ISU,” according to the lawsuit.

When an Iowa State program coordinator on April 4, 2019, asked Jackson to sign a waiver for Green Hills, Jackman said she asked why and received no explanation, according to the trial. Jackman refused to sign and was fired the following day.

She quickly applied for unemployment benefits, and the state of Iowa appealed her decision — although the Employment Appeals Board ultimately upheld her benefits, according to the lawsuit.

Fighting the claims, the State of Iowa argued that they should be dismissed because, among other reasons, Jackman changed his story, the ISU and its agents are immune, and even though a court found that the supervisor was not immune, she acted “in good faith. ”

“The ISU has an interest in employing honest and trustworthy candidates, and therefore strictly prohibits the falsification of employment documents,” according to the state’s motion to dismiss, arguing that the supervisor in question “had a vested interest in in good faith to raise concerns with Human Resources about potential violations of respondent ISU policies.

Vanessa Miller covers higher education for The Gazette.

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OC workers’ compensation lawyer gets four years in prison for fraud | KFI AM 640 Sat, 22 Oct 2022 22:00:00 +0000

SANTA ANA (CNS) – An Orange County workers’ compensation plaintiff was sentenced to four years in state prison and ordered to pay more than $700,000 in restitution to seventeen insurance for participating in two separate insurance fraud referral programs.

Jon Woods, 61, of Cypress, was convicted in August of 37 counts of insurance fraud as well as an enhanced sentence for aggravated white-collar felony, the prosecutor’s office said Friday. of Orange County.

District Attorney Todd Spitzer said his office is “committed to ensuring a level playing field for business owners and insurance companies. By prosecuting bad actors and recovering fraudulently paid funds, we help business owners stay competitive and protect consumers from rising premiums.

Woods was one of 10 like-minded lawyers charged in June 2017 following a complex insurance fraud investigation. Charges have also been brought against Carlos Arguello, Fermin Iglesias and Edgar Gonzalez, as well as four chiropractors and several employees working for Arguello.

Arguello, his employees, and Iglesias all pleaded guilty in their cases in Orange County Superior Court. Arguello and Iglesias were also charged in federal court with violating federal laws relating to their program with medical providers, resulting in a four-year federal sentence for Arguello and a five-year federal prison sentence for Iglesias, according to Orange County District Attorney’s Office.

Prosecutors said that from 2011 to 2016, Woods paid Arguello for workers’ compensation clients purchased through Arguello’s lawyers’ marketing business, Centro Legal International, and later Tu Justicia Legal, as well as Centro de Abogados.

Primarily targeting Hispanic neighborhoods in the state, Arguello’s company distributed more than four million flyers a month to attract potential customers for Arguello’s program. The flyers contained various toll-free numbers that all rang to a call center in Tijuana, Mexico, where operators acted as a sales force, dispatching an “enrollment” representative from Arguello’s network to the company’s home. calling within 24-48 hours to sign legal documents to engage the law firm and begin the injury claim.

In addition to paying a monthly fee to obtain clients, Woods also sent subpoenas to companies controlled and operated by Arguello, for an amount equal to the number of clients he received from Arguello, have prosecutors said. These companies billed the worker’s employer’s workers’ compensation insurance policy for all subpoena services provided for Woods, as the law requires the cost of an injured worker proving his claim for workers’ compensation is paid by the employer’s workers. compensation insurance — including the cost of obtaining records through subpoenas ordered by the injured worker’s attorney.

Arguello’s program required that all clients purchased through Arguello’s marketing be sent to clinics chosen by his organization, prosecutors said. Like the lawyers participating in his program, a group of doctors or chiropractors were also paying Arguello for workers’ compensation patients, they added.

Woods was also convicted of participating in a second fraud scheme in which he returned additional subpoena work to USA Photocopy, a subpoena company owned by Edgar Gonzalez. Gonzalez paid various business expenses for Woods’ law firm as a bribe to receive subpoena work for the firm’s records, according to the prosecutor’s office.

The subpoena companies of Arguello and Gonzalez’s records had offshore offices in El Salvador, where employees reviewed subpoena records to identify more companies they can serve with more subpoenas in El Salvador. Woods name. These companies billed workers’ compensation insurance companies for each subpoena.

Senior Assistant District Attorney Noor Hasan of the Insurance Fraud Unit prosecuted the case.

Dollar General faces $1.6 million in OSHA fines | Workers Compensation News Thu, 20 Oct 2022 07:03:09 +0000

Thursday, October 20, 2022 | 0

Dollar General Corp. and Dolgencorp LLC, which owns more than 18,000 Dollar General discount stores in 47 states, face $1.6 million in new fines from the Occupational Safety and Health Administration after the agency claimed that the discount chain and its operator were “again ignoring federal workplace safety standards.” .”

OSHA said Monday the latest fines, stemming from inspections at four locations in Alabama, Florida and Georgia, bring the chain’s total fines since 2017 to $9.6 million.

In the latest round, inspectors cited stores for four willful violations and 10 repeat violations for failing to keep receiving and storage areas clean and orderly, and for stacking materials in an unsafe manner. These violations exposed workers to risks associated with slips, trips and being struck by objects.

OSHA citations also included those for exposing workers to fire and entrapment hazards by not keeping exit routes and electrical panels clear and unobstructed. Finally, the company received citations for failing to mount and label fire extinguishers and for having a locked exit door that required a key to open.

OSHA says it has conducted 182 inspections at Dollar General sites nationwide, where agency inspectors often find unsafe conditions that put workers’ safety at risk if they need to get out quickly in the event of an emergency. emergency.

Business Insurance is a sister publication of WorkCompCentral. More stories are here.