Good News on Opioid Usage for a Change – it’s Down in California Workers’ Comp

Efforts to curb the use of opioids in California’s workers’ compensation system appear to be paying off.

New research from the California Workers’ Compensation Institute on prescription drugs used to treat injured workers shows that opioids now account for less than a quarter of all workers’ comp prescriptions in the state, down from nearly a third a decade ago.

Report: Number of Qualified Medical Evaluators in California Workers’ Comp Fell

The number of qualified medical evaluators resolve disputes over California workers’ compensation claim issues fell 20 percent between January 2012 and September 2017, according to a new California Workers’ Compensation Institute study.

However, the CWCI study shows that the impact on QME accessibility was partially offset by an increase in the median number of office locations per QME, which doubled over the same period.

Does workers’ comp cover on-the-job injury caused by spider nightmare?

Injuries to workers can occur in many ways, but few employers expect such injuries to come out of an employee's nightmare. When that happens, is the injury covered by workers' compensation? According to the Court of Appeals of Arkansas, the answer is no. But why?

In November 2015, Shawn Hansen was employed by the City of Siloam Springs, Ark., as a firefighter and an EMT. Hansen worked 24-hour shifts. During his shifts, he was required to stay on premises unless he was performing a work-related errand or activity. Because of the 24-hour scheduling scheme, the city provided sleeping arrangements and encouraged the employees to sleep during nighttime hours.

Workplace fatalities: 25 most dangerous jobs in America

It was not until 1970 that Congress, under President Richard Nixon, passed the Occupational Safety and Health Act. There were 14,000 workplace fatalities that year. As part of the act, the Occupational Safety and Health Administration, or OSHA, was established to set and enforce safety standards in the workplace. Since then, standards have improved and workplace fatalities have declined to less than 5,200 in 2016. Still, some jobs remain far more dangerous than others.

Today, the vast majority of working Americans are relatively safe in their work environment. Across all industries in both the public and private sectors, there were 3.6 deaths for every 100,000 full-time workers. For certain professionals, such as school teachers and administrators or writers and editors, mistakes almost never have physical ramifications, and workplace fatality rates hover just above zero.

California Division of Workers’ Comp Suspends 21 Medical Providers for Fraud

The California Division of Workers’ Compensation has suspended 21 more medical providers from participating in the state’s workers’ compensation system, bringing the total number of providers suspended this year to 115. The providers were suspended for fraud or other criminal actions.

The suspensions were made possible by the passage last year of Assembly Bill 1244, which requires the DWC administrative director to suspend any medical provider convicted of a crime involving fraud or abuse of the Medi-Cal or Medicare programs or the workers’ comp system, a patient, or related types of misconduct.

Father And Son in California Sentenced in $400K Workers’ Comp Scheme

From Insurance Journal
November 20, 2017

Jaime Rosario Del Real, 61, and son Israel Del Real, 37, have both pleaded guilty to four felony counts for their role in a $400,000 insurance fraud scheme denying workers’ compensation insurance and medical care for injured workers.

The father and son were sentenced to 250 days in jail, 10 years of felony probation and ordered to pay $382,951 in restitution. This case was prosecuted by the Monterey County District Attorney’s Office.

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