Opioid Abuse and the NJ Workers' Compensation Act

The implementation of the recently enacted NJ law concerning substance abuse disorders was the subject of an insightful panel discussion today at the annual meeting of the NJ Workers' Compensation Section.

(Left to right) Jag Desai, MD, Nancy J. Johnson, Esq., Jon L. Gelman, Esq,
Christopher P. Gargano, Esq., Mark B. Zirulnik, Esq., Hon Joanne Downey, Member of the NJ General Assembly
Photo Credit: Margaret Sherlock

The reviewed the implications of the newly enacted NJ law, A3, PL2017, c28, that was enacted on February 15, 2017, and become effective 90 days later. That Act requires health insurance coverage for the treatment of substance abuse disorders. It places certain restrictions on the prescription of opioid and certain other drugs. The law mandates abuse educational programs.

It became obvious during the roundtable program that opioid abuse over the last two or three decades has become an epidemic in nature and the impact to injured workers, employers, and the workers' compensation system has increased enormously.

While the Workers' Compensation Act was not embraced expressly in the text of the legislation, Assemblywoman Downey spoke of her continuing concern and commitment to review the issue further. Ms. Downey told the audience that she would continue to address substance abuse in the workplace going forward and more specifically treatment issues and integration into the NJ workers' compensation system.

Reference Material

The Ethics of Pain Management

The Workers’ Compensation Bench/Bar Conference

May 19, 2017

Round Table Discussion Bibliography

Statutes

P.L.2017, c.28 (Passed) 2017-02-15 S3 Requires health insurance coverage for treatment of substance use disorders; places certain restrictions on the prescription of opioid and certain other drugs; concerns continuing education related thereto.

New Jersey State Sources

Summary: http://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=S3

Text: http://www.njleg.state.nj.us/2016/Bills/S0500/3_I1.HTM
Text:http://www.njleg.state.nj.us/2016/Bills/S0500/3_R1.HTM

Text: http://www.njleg.state.nj.us/2016/Bills/AL17/28_.HTM

Roll Call: http://www.njleg.state.nj.us/bills/BillView.asp

Articles

Rousmaniere, Peter, “We’re beating back Opioids-Now What?, WorkCompCentral (2015) https://www.workcompcentral.com/special-report/special-report/id/2

Paduda, Joseph, “Prescription Drug Management in Workers Compensation,” Workers Compensation Issue 2016 Issues Report, CompPharma (2016)

https://www.ncci.com/Articles/Documents/II_IR2016-Paduda.pdf

Opioid Addiction, 2016 Facts and Figures, American Society of Addiction Medicine

http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

The Opioid Epidemic” By the Numbers, US CDC, June 2016

https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf

Lembke, Anna MD, “Why Doctors Prescribe Opioids to Known Opioid Abusers,” N Engl J Med 2012; 367:1580-1581, October 15, 2012 | DOI 10.1056/NEJMp1208498

http://www.nejm.org/

Alghnam S, Castillo R, “Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey,” Injury Prevention 2017;23:87-92.

http://injuryprevention.bmj.com/content/23/2/87

Stahl, Arthur, IAIABC Policy Guide on Reducing Opioid Abuse Offers Blueprint for Effective Reform, (September 8, 2013) https://www.lexisnexis.com/legalnewsroom/idoctor-health/b/recent-cases-news-trends-developments/archive/2013/09/08/iaiabc-policy-guide-on-reducing-opioid-abuse-offers-blueprint-for-effective-reform.aspx?Redirected=true

Blogs

Domer, Thomas, “Opioid Abuse in Workers’ Compensation,” Wisconsin Workers Compensation Experts Blog, June 17, 2016

https://wisworkcompexperts.com/2013/06/17/opioid-use-in-idoctor-health/

Geaney, John, “What impact will New Jersey’s opioid prescription bill have on workers’ comp?,” NJ Workers’ Compensation Blog, March 9, 2017

http://www.nwcdn.com/state-news/what-impact-will-new-jersey-s-new-opioid-prescription-bill-have-on-workers-comp-nwcdn-new-jersey-mem?A=WebApp&CCID=25405&Page=172&Items=1

Gelman, Jon L., “Doctors, Patients and Opioid Abuse,” Workers’ Compensation Blog, October 24, 2012

http://workerscompensation.blogspot.com/search?q=doctors%2C+patients+and+opioid+abuse

Treatise

Gelman, Jon L., “Medical—Medical and surgical treatment,” 38 N.J. Prac., Workers’ Compensation Law § 12.5 (3 ed.), 2017, Thomson Reuters www.westlaw.com

NJSBA: The Ethics of Pain Management: The Workers’ Compensation Bench/Bar Conference

Friday May 19, 2017 11:15AM - 1:30PM - Borgata, Atlantic City , NJ

The Ethics of Pain Management: The Workers’ Compensation Bench/Bar Conference WORKERS COMPENSATION TRACK A round table discussion of the ethical complications of opioid prescriptions in workers’ compensation matters from the medical and legal perspective.   State of the Division: Hon. Russell Wojtenko, Jr., Chief Judge Division of Workers Compensation Moderator/Speaker: Katherine Hellander Geist, Esq. Capehart Scatchard, Mt. Laurel Speakers:  Jag Desai, M.D., Interventional Pain Medicine Specialist Metropolitan Pain Consultants, Lyndhurst Christopher P. Gargano, Esq. The Bianchi Law Group, LLC, West Caldwell Jon L. Gelman, Esq. Jon L. Gelman, Attorney at Law, Wayne Mark B. Zirulnik, Esq. Zirulnik, Sherlock & DeMille, East Hanover    NJ CLE: 2.7 general credits NY CLE: (Transitional & Non-transitional) 2.5 professional practice credits PA CLE: 2.0 substantive credits pending ($8.00 check payable to NJICLE)  Click Here for More Information/Registration

Choosing a Mesothelioma Lawyer

Choosing a Mesothelioma Lawyer

Picking a mesothelioma legal advisor is an exceptionally individual choice. The perfect legal advisor is not just outfitted with assets and experience important to get you the pay you merit additionally is receptive to your requirements, sympathetic to your one of a kind therapeutic circumstance, and completely put resources into your family's future. 

Under the steady gaze of joining forces with a legal counselor, it's essential to make inquiries to help you decide whether he or she is sufficiently experienced to take your case. These may include.

Know Your Options 

More than one road of pay exists for mesothelioma growth patients and their families. Contingent upon your circumstance, you may document an individual harm or wrongful demise claim and additionally present a claim against an asbestos insolvency trust. Regardless of what way you at last pick, Weitz and Luxenberg legal advisors are focused on making the procedure basic and tranquil to give you more opportunity to concentrate on your wellbeing and your friends and family. 

Demonstrated Track Record

Harms related with mesothelioma tumor can incorporate torment and enduring, loss of wage, and expensive medicines not secured by your medical coverage � making it considerably more imperative to procure a lawyer who can offer a high possibility of success.* 

Weitz and Luxenberg has three many years of involvement in this sort of law and a demonstrated reputation of winning asbestos claims and vast settlements. Late trial decisions incorporate.

Mesothelioma Law Know the Risk Factors

Mesothelioma Law Know the Risk Factors

Albeit a few materials can precipitate this malady, mesothelioma is principally ascribed to presentation to asbestos as detailed by the Agency for Toxic Substances and Disease Registry of the CDC. Moreover, Asbestos has been arranged by the US Environmental Protection Agency (EPA) as a human cancer-causing agent. 

As indicated by the CDC (Center for Disease Control and Prevention), introduction to asbestos expands the danger of creating dangerous Mesothelioma. The inertness time frame for the malady is accounted for to associate with 20 to 40 years. So introduction to asbestos can go unnoticed for a considerable length of time. Consequently, mesothelioma cases are analyzed years after the main introduction to asbestos happens. In a review led by the CDC's National Institute for Occupational Safety and Health (NOSH), yearly various reason for death records were dissected for the period from 1999 to 2005.

Who ought to be concerned? 

Asbestos is foreign made into the United States and was even mined in the nation amid the twentieth century. In the US, the utilization of asbestos topped in 1973 when it added up to 803,000 metric tons before declining to 1,700 metric tons in 2007. Mechanical laborers utilized in settings, for example, assembling, development and shipbuilding preceding 1980 are the ones who are at most hazard, as government security control was not set up at the that time. Presentation keeps on happening today in view of the pulverization of structures in which asbestos was utilized amid development. 

Ventures to Take in Case Of Asbestos-Exposure Related Mesothelioma 

In the wake of thinking about a few research discoveries, introduction to asbestos has been singled out as the primary driver of Mesothelioma much of the time. This presentation influences people in an unexpected way. A few elements are included, including fixation, recurrence and term of introduction and additionally the shape, size and compound cosmetics of the strands that decide your odds of contracting Mesothelioma. 

It is normal to feel worried about Mesothelioma on the off chance that you have encountered ceaseless presentation to asbestos. Specialists suggest that such individuals ought to get general CT outputs or trunk x-beams. They should likewise get lung work tests as these tests can identify issues brought about by asbestos strands. In the event that any issues are distinguished, you ought to get an expert Mesothelioma conclusion. In the shocking occasion of being determined to have Mesothelioma, you have the justification for documenting a claim.

What Are Law Firm Fees

What Are Law Firm Fees

Law workplaces may have differing charges and furthermore particular portion decisions. Regardless, an achieved and disapproving of law office fathoms that losses of asbestos-related afflictions more than likely have enough cash related weight in dealing with their illness, and can't hold up under the cost of ahead of time costs for legal depiction. In this way, many firms wear down what's known as a probability charge start, inferring that they simply get paid when you get paid. 

If the law office doesn't win your case, they don't get compensation either by and large. The inspiring news, regardless, is that a firm should be adequately sure for your circumstance to take it on, which implies there is a not too bad shot that if your case is snatched, it will be productive. 

Law office charges are rates expelled from your total settlement or choice total, and again, the rate aggregate will change dependent upon the firm. Guarantee you perceive how the costs and rates work with the firm already so that there will be no perplexity later on. 

If a law office doesn't give a probability charge introduce, there is a better than average shot that they don't have the budgetary resources for adequately show your case. Attorneys without the resources for manage your case when in doubt can't give you the best depiction.

Extra Tips to Remember

• When scanning for a law office, you shouldn't restricted your pursuit down to your nearby group as it were. Quite possibly's your case might be recorded out of state. 
• An accomplished mesothelioma attorney ought to have no issues traveling to your city to meet with you, given that they are out of state. 
• In spite of the fact that the law office ought to have the capacity to give you a normal assume that you may get, giving a correct sum is inconceivable. Any firm that promises you a correct sum ought to be viewed as conniving.

CMS Prohibited From Collecting for Unrelated Conditions

A Federal Court in California has prohibited the Center for Medicare and Medicaid Services (CMS) from seeking reimbursement of conditional payments when the medical codes for the conditions are unrelated or not related even if the primary code was for a work-related medical condition. The court made the following ruling in a motion for partial summary judgment in a declaratory judgment action.

"The Court shall issue a judicial declaration that: (1) One “item or service,” as used in the Medicare Secondary Payer statute, 42 U.S.C. § 1395y(b)(2)(B)(ii), does not as a matter of law equate to any medical items, devices, supplies, or services that appear under in a single line-item charge on a payment summary form issued by CMS. Rather, a statutory “item or service” simply refers to one indivisible medical item, device, medical supply, or service, regardless of how it is billed; (2) Whether a particular line-item charge on a payment summary form contains more than one indivisible item, device, medical supply, or service is a factual question that must be resolved on a case-by-case basis; (3) If a single line-item charge on a payment summary form contains multiple diagnosis codes—some of which relate to a medical condition covered by the insurance policy administered by CIGA and some of which do not—the presence of one covered code does not ipso facto make CIGA responsible for reimbursing the full amount of the charge; and (4) In the event that a single line-item charge on a payment summary form contains one indivisible item, device, medical supply, or service that is covered by the workers' compensation policy CIGA is administering, and one indivisible item, device, medical supply, or service that is not so covered, CIGA does not have a responsibility to make payment for the uncovered item, device, medical supply, or service just because it was billed under the same single line-item charge as the covered item, device, medical supply, or service."

***

"For the reasons discussed above, the Court shall enter (1) an order vacating and setting aside the disputed portions of three reimbursement demands at issue in this lawsuit and (2) a judicial declaration that CMS's interpretation of the MSP is unlawful with respect to reimbursement of conditional payments. The Court declines to issue further declaratory relief or an injunction at this time. 

California Insurance Guarantee Association v Price,  Case No 2:15-cv-01113-ODW (FFMx), 2017 WL 1737717 (05/03/2017)