Category Archives: healthcare

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 & Rehm, 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 & Rehm, 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 , , , .

Why CNAs and Home Health Aides Should Care about the Fight over a Federal Regulation

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090429-A-0868C-005A U.S. District Court in Washington, D.C., recently struck down a federal regulation that would mandate that home health aides are paid the minimum wage and paid overtime under the federal Fair Labor Standards Act (FLSA). Though the decision will likely be appealed, this decision is still a bad decision for the men and women who do the hardest jobs in health care – home health aides and certified nursing assistants.

Why home health aides aren’t covered by federal wage laws

Home health aides were exempted from the FLSA 40 years ago in order to make caring for the elderly less expensive. However, companion care has become a big and very profitable business. An index of publically traded home-health-care stocks has consistently outperformed the stock market as a whole for the last 13 years. This profitably is due in part to the minimum wage and overtime exemptions for home health aides.

How the home health exception affects other jobs in the medical field

The federal government estimates that nearly 1 million are employed as home health aides, while private sources estimate that number as 2 million. Home health is also a fast-growing field of employment. Home health aides essentially have the same job duties as certified nursing assistants (CNAs). CNAs are generally covered by minimum wage and overtime laws, but workers with the same skills and same duties are exempt from those laws if they are working as home health aides. CNA wages are pushed down by home health aide wages, which are exempt from federal wage laws.

Why pay is about more than wages

A recent study of CNAs showed that nearly 60 percent of CNAs report injuries during a 12-month period. The injury rate is similar for home health aides. The study also showed that higher-paid CNAs were injured less frequently than lower-paid CNAs. The study indicated that organizational factors really drove injury rates among CNAs. In other words, in settings where CNAs are truly valued, paid fairly and trained, the injury rates are lower. But if CNAs are treated as low-wage, high-turnover cogs in a machine, then injury rates are higher. Low pay for CNAs and home health aides isn’t just an issue for employees. Low pay for home health aides and CNAs has been linked to poor patient care.

While the Obama administration has been criticized for being too aggressive in enforcing the FLSA, the U.S. Department of Labor announced that they will delay enforcement of the home health aide regulation until July 2015. This assumes courts will let the Department of Labor actually enforce the regulation. Anyone concerned about this issue should contact their members of Congress to support legislation that ends the home health aide exception. People should also contact their state legislators to support legislation that would ensure that home health aides are covered by state wage and hour laws.

The offices of Rehm, Bennett, Moore & Rehm, 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 employment law, Health, healthcare, 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 & Rehm, 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 , , , .

Deadline for ACA Sign Up Is Monday

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Monday, March 31, is the deadline to enroll for coverage this year through the Affordable Care Act’s process. There’s a lot of information out there, and it can be extremely overwhelming. For procrastinators, here are some good places to start, hopefully help to beat the deadline, and most importantly, enroll in insurance coverage.

A starting place is healthcare.gov. 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. Note that the one-page guide recommends applying either online or by phone, as a paper application won’t be processed quick enough to meet Monday’s deadline.

Here’s an example of how the ACA affects people in one industry that the firm works with through the website www.truckerlawyers.com. The Smiths, who are strong advocates for drivers, recently had both a blog post and a podcast about options for truckers, so follow the links to explore those resources. This information also generally applies to those who aren’t truckers, too.

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.

An editorial in the Kansas City Star recently argued a number of points about the wisdom of having insurance coverage. 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.”

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 & Rehm, 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, healthcare, trucker and tagged , , , , .