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Disability vs Workers Comp Insurance: What’s Covered?

You encounter many dangers on the construction site that could result in an injury. You can’t do your job when you’re injured, but you still have bills to pay, so workers comp insurance and disability insurance offer coverage to keep you afloat. These two insurance options have a similar end goal, which is to provide compensation when you are unable to work due to injury or illness, but they vary in the details. Read more

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Seeking Workers Comp for First Responders

As a nation, we may often feel divided from one another (politically, culturally, and socially), but in moments of tragedy we stand united. December 14th will forever after be, in these United States, a day of national mourning. On that day in 2012, 20-year-old Adam Lanza walked into Sandy Hook Elementary in Newtown, Connecticut and opened fire, resulting in the deaths of 20 children and six staff members.

It has been almost a year and a half since then, and the shooting has sparked a debate over the right to bear arms. While the left and the right are in grid-lock over the issue (and with no end in sight), the Connecticut General Assembly has proposed legislation that most Americans will support.

The new bill is being referred to as S.B. 56, and offers workers comp for first responders who witness traumatic events and now suffer from Post-Traumatic Stress Disorder. Typically, we picture PTSD being triggered by loud noises or crowded spaces, but for the first responders at Sandy Hook, a TV show or a child’s laughter can bring them to tears as they relive the horrifying experience. According to current Connecticut workers comp law, mental health claims are not covered if they do not have a corresponding physical injury.

S.B. 56 would create workers comp benefits for first responders with PTSD after, “visually witnessing the immediate aftermath of such death or maiming, of one or more human beings.” According to the Connecticut General Assembly. Immediate aftermath being defined as within six hours of a scene being secured by law enforcement officers. While the legislation is widely supported, there are currently a few detractors.

The primary opposition to the bill comes from municipal employers who are worried that the bill would dramatically increase their workers comp costs. They believe the bill is too vague and that any on-duty (or off-duty) first responder would just have to go to the scene several hours after it had been secured and they would get full workers comp benefits.

Lori Pelletier, executive secretary-treasurer of Connecticut AFL-CIO stated, “Workers who have experienced PTSD as a result of work are no different than workers who have torn ACLs as a result of work, except that the injury is to the whole body, inside and out.” First responders deserve fair treatment under the law because when things go badly, they are the first people on the scene, and despite horrific circumstances (like Sandyhook) they do their duty, and do it as quickly as possible. They should expect the same from their elected officials.

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NY Labor Law 240 Costs Contractors Billions

NY Labor Law 240 has been infamous for its radical costs in the circles of contractors and insurance providers. The law, in the eyes of contractors, requires that, “a construction contractor or developer who holds the construction insurance policy for a job be solely responsible for any injuries suffered by workers on that project.” Opponents of NY Labor Law 240 and New York state legislators are currently fighting over whether the law does more harm than good.

According to a study conducted by the Cornell University Department of Policy Analysis and Management and SUNY’s Nelson A. Rockefeller Institute of Government the bill has resulted in 667 more construction incidents per year and has resulted in nearly $3 billion a year in unnecessary costs. While $3 billion represents a considerable sum (and must also put quite a lot of strain on the construction and real estate industries) the more concerning figure is that over 500 construction workers are injured in scaffolding accidents.

Paul Fernandes, the chief of staff of the Building and Construction Trades Council of Greater NY, believes that this study will disappear just like many similar reports in the past. He claims that it is, “Yet another in the long line of anti-worker research that purports to advocate for worker safety by weakening business’ responsibility for workplace safety and health.” This may be true but the bill and the financial and human repercussions seem to bring about a discussion on whether or not the chicken or the egg came first.

The existing bill costs the contractors a lot of money because of all the workers comp claims and, due to those high number of claims, insurance providers have either stopped offering coverage for scaffolding accidents or have driven their costs way up. The supply of insurance companies that offer the plan has become very small while the demand has only escalated which has led to extremely expensive insurance plans. With no bill in place the cost of insurance would go down as more insurance providers began to offer the policy again and offered some competition. The removal of the law could also leave employees at fault for mistakes that result in injury which could lead to some very trying circumstances for construction workers and builders. However, without the law in place the construction industry could save almost $3 billion which may result in more jobs or higher salaries and end up spurring more economic growth. It will be interesting to see which side the legislators end up joining forces with.

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Former Senator Ron Calderon Charged in Worker’s Comp Scandal

Those looking to avoid spending the next 396 years in federal prison should avoid the same career path as former California State Senator Ron Calderon. The congressman has been brought up on charges of mail fraud, wire fraud, money laundering, and bribery. He turned himself in to authorities on Monday February, 24th and confessed to his crimes.

The crimes centered on a piece of legislation, which Ron Calderon supported, that would be extremely beneficial to those who bribed the former senator. One such man is Michael Drobot, a former hospital owner, who paid Calderon’s son $30,000 to work 15 days during the summer for the past three years. While most college students and high school students feel like they make a steal when they make over $3k during the summer, the young Calderon was making almost 10x that. And, with college to pay for, it would definitely be a tempting offer, but someone in Ron Calderon’s position can’t exactly cry poverty.

Drobot pleaded guilty this past Friday, on charges of conspiracy and paying illegal kickbacks. While Calderon made approximately $100,000, the former hospital owner made close to $500 million in a worker’s compensation fraud scheme. Paying that sum of cash to Calderon now seems like a small investment compared to the amount that Drobot made.

According to LA Weekly, the scheme relied on “a loophole in state law called the ‘spinal pass-through.’ Under this loophole … Drobot billed insurers twice for the same equipment used in spinal surgeries at Pacific Hospital of Long Beach.” In an attempt to keep such an extravagant amount of capital flowing into his bank account, Drobot tried bribing politicians to keep the loophole open. Fortunately for bill comp insurers, the loophole was removed last year.

While Calderon faces almost 400 years in federal prison, Drobot may receive a reduced sentence due to a plea deal. He has testified that he gave Ron Calderon, “tens of thousands of dollars so he would support legislation that would allow hospitals to charge workers compensation carriers for the cost of medical tools.” Drobot will likely not receive a sentence that exceeds 10 years. As a bill comp insurer, please be on the lookout for any suspicious activity or malpractice, because you could ultimately stop another fraudulent worker’s comp scheme from stealing millions of dollars and influencing corrupt politicians.

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Worker’s Compensation Fraud Costs Ohio Man $55k

The holiday season typically brings about the happiest of feelings and an inspiring amount of generosity in most people. It is commonly known as the ‘Season of Giving,’ and one Ohio man probably ended up giving a little bit more than he intended at the end of last year. Todd Bittner of Hamilton County was found guilty this past December of two counts of worker’s compensation fraud, which will result in $55k moving from Mr. Bittner’s bank account and into the account of the Ohio Bureau of Worker’s Compensation (BWC).

The $55k will not be the only way Bittner will pay for insurance fraud. On top of the large premiums, he also faces four years of community control and 500 hours of community service. The sentence may seem extreme, but for a man who has continued to operate his construction firm since 2007, despite being approached on numerous occasions by the BWC for lapsed coverage, it appears these charges stem from years of negligence. In September of 2007, the BWC’s Employer Fraud Team (EFT) approached Bittner Construction about the construction firm’s lapsed coverage. Mr. Bittner explained to them that he was responsible for the firm’s worker’s comp duties, and that they would pay the premiums. However, he never paid the premiums, nor did he ever enter a payment plan that the EFT required him to do.

In July of 2013, Bittner was indicted for 12 fifth-degree felony counts of worker’s compensation fraud. He pleaded guilty to two of the 12 counts this past October as part of a plea deal. The other 10 counts were immediately dismissed.

Upon learning that Bittner had been found guilty, BWC Administrator/CEO Steve Buehrer stated, “Bittner Construction had lapsed coverage, and this wasn’t the first time. BWC attempted to work with Mr. Bittner, but he failed to pay the premiums or enter into a payment plan. The bottom line is that all employers need to pay for workers compensation coverage. We’re pleased that these overdue premiums will finally be collected.” Worker’s compensation insurance is required by law in the United States, and it is there to protect both employers and employees from litigation and injuries. By following the rules and not committing worker’s compensation fraud, employers can worry less about what unexpected legal fees they will have to pay in the future, and save themselves a lot of headache.