- project management
- data analytics
- deployment of technology
- process design
Thursday, March 11, 2021
The Business of Law
Tuesday, March 9, 2021
Injuries can Affect the Whole Family
Sunday, March 7, 2021
Who is the Employer?
"any person who receives remuneration from an employer for the performance of any work or service while engaged in any employment under any appointment or contract for hire or apprenticeship, express or implied, oral or written, whether lawfully or unlawfully employed, and includes, but is not limited to, aliens and minors." Section 440.02(15)(a).
- Was the worker an employee?
- If the worker was an employee, who is the employer?
- If the injury was caused by some other person, is that person a co-employee?
"may not be the basis for determining whether an engaged individual is an employee or an independent contractor or whether an entity is the joint employer of an engaged individual"
"if such actions were taken during a public health emergency declared pursuant to s. 381.00315 or a state of emergency declared pursuant to s. 252.36:" (Senate), or
"if taken during a public health emergency or other state of emergency declared by the Governor under s. 252.36." (House).
"a civil cause of action brought under s. 440.10, s. 440.192, s. 440.38, s. 440.381, s. 448.103, s. 448.110, s. 448.25, chapter 532, or s. 717.115, or in a civil cause of action, as provided for under general law"
(a) Providing financial assistance to engaged individuals who are unable to work because of health or safety concerns; (Senate)(a) Providing financial assistance to previously engaged individuals who are unable to work because of health and safety concerns. (House; the distinction being "engaged" versus "previously engaged").(b) Directly providing benefits related to the health and safety of engaged individuals, including, but not limited to, medical or cleaning supplies, personal protective equipment, health checkups, or medical testing; 36 (Senate).(b) Directly providing benefits that are related to the health and safety of engaged individuals, including medical or cleaning supplies, personal protective equipment, health checks, or medical testing. (House; the distinctions being broader language in the Senate "but not limited to," and verbiage: Senate - "related to," House - "that are related to").(c) Providing training or information related to the health or safety of engaged individuals or the public; or (Senate and House identical).(d) Taking any action intended to protect public health and safety, including, but not limited to, actions required or suggested by federal, state, or local law. (Senate)(d) Taking any action, including action required or suggested by any federal, state, or local law, ordinance, order, or directive that is intended to protect public health and safety. (House -very similar language, though expressed slightly differently.
https://www.myfloridahouse.gov/https://www.flsenate.gov/
Thursday, March 4, 2021
Statutory Interpretation Illustration
Tuesday, March 2, 2021
The New Florida Rules of General Practice
Sunday, February 28, 2021
Pertinence in Discovery
Interactive testimony under oath (a "deposition" - Rule 60Q6.114(2)(a))A party is asked to send documents or things to another party (a "request to produce" - Rule 60Q6.114(2)).A non-party is asked to send documents to a party (a "subpoena" - Rule 60Q6.114(2)).
"it is unfortunate that both claimants and E/Cs (employer/carriers) use preprogrammed in computers requests to produce."
"these generic requests to produce, by both sides, lead to unnecessary litigation and judicial intervention, time consuming and leading to the resolution of the important issues in the case."
Thursday, February 25, 2021
Collections Efforts for Medical Care
"Gulf Coast demanded that Kottler pay her medical bills, but in Florida an 'employee is not liable for payment for medical treatment or services provided,' Fla. Stat. § 440.13(13)(g), and '[a] health care provider may not collect or receive a fee from an injured employee,' id. § 440.13(13)(a). Instead, '[s]uch providers have recourse against the employer or carrier for payment for [medical] services rendered . . . .' Id."
"The healthcare provider or health care facility providing services pursuant to this section shall be paid for the services solely by the employer or its insurance carrier, except for payments from third parties who have been determined to be liable for such payment."
"Subject to the provisions of paragraph (2)(d), the employee is not liable for payment for treatment or services provided pursuant to this section."
"Any consumer in Florida unfamiliar with its worker’s compensation laws who received the letter Kottler received would be misled to think that she was obligated to remit payment for medical bills that were owed by her employer."
“'actually employ[] or implement[] . . . procedures to avoid errors,' and then ensure those procedures were 'reasonably adapted to avoid the specific error at issue.'”
"is appropriate when there exists no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law. Fed. R. Civ. P. 56(a)."
Tuesday, February 23, 2021
Preposterous or Incoherent
An intriguing decision was rendered by the New Jersey Superior Court Appellate Decision in October 2020: Anesthesia Associates v. Weinstein Supply, A-5033-18T4 and A-5718-18T4. The case consolidates for appeal two decisions of New Jersey workers' compensation judges regarding jurisdiction over medical billing disputes. It is intriguing for its analysis of jurisdiction, its reliance upon secondary authority, and for its defense of workers' compensation judges.
A side element of intrigue in many workers' compensation opinions is the volume of abbreviation engaged by the court; this is a great example. Essentially, the Court said:
the WCA is interpreted as regards the jurisdiction over AAM and SJC MPCs. There is involvement of the PABWC, as well as the PDOLI in one case and WCBNY in the other. Each MPC was instigated by an MPAP under the WCA.
In each of the two cases, an individual injured elsewhere (Pennsylvania and New York) received a minimal volume of medical service in New Jersey. The New Jersey medical providers (Anesthesia Associates - AAM and Surgicare of Jersey City - SJC) received reimbursement through those other jurisdictions: PDOLI (Pennsylvania Department of Labor and Industry) and WCBNY (Workers' Compensation Board of New York). Dissatisfied with the reimbursement, each filed a Medical Provider Claim (MPC) under the New Jersey Workers' Compensation Act (WCA) by submitting a Medical Provider Application for Payment (MPAP).
In neither instance had the injured worker invoked the jurisdiction of the New Jersey Division of Workers' Compensation by filing a claim. However, the medical providers contended that the Division nonetheless had subject matter jurisdiction independent of such a worker-filed claim. These medical providers essentially argued that the Medical Provider Claim is a "separate cause of action," which is "rooted in breach of contract" and subject to the jurisdiction of New Jersey's Division.
In the Anesthesia Associates claim, the Court noted that payment had been made pursuant to the Pennsylvania fee schedule, and the provider was seeking greater reimbursement in New Jersey. Notably, states continue to engage various methods for constraining medical costs, the court noted that "New Jersey bases payment on the 'usual and customary charges'" rather than a fixed fee schedule. Thus, it is practical to conclude that these providers envisioned greater reimbursement under New Jersey law.
A worthy discussion point as regards the Medical Provider Application for Payment (MPAP) forms is language pre-printed upon them. These forms state that:
"the Employee sustained an injury by an accident arising out of and in the course of his/her employment with Respondent, [that was] compensable under [the WCA]."Thus, the allegations include contention by the party seeking relief that there is, or could be, a New Jersey workers' compensation claim as regards that particular worker. One might wonder whether the filing of such a form in the absence of a worker-filed claim, or at least the opportunity for one, would amount to a misrepresentation of fact?
The jurisdictional issue in these two cases was one of "connection between New Jersey and the injured employee(s)." Clearly, the medical care providers had ties to, were located in, New Jersey. However, that was not the critical question. Rather than relying upon analysis of the New Jersey law, the Court instead turned to a secondary authority known in the workers' compensation community: Larsons. It explained that this author's "proper jurisdictional analysis" had been adopted by the New Jersey Supreme Court in 2003. Rather than rely upon the Court, this opinion quotes the secondary authority, which is curious. The Court concluded that the trial judges had properly engaged that six-element test in their conclusions that New Jersey lacked jurisdiction.
In the second claim, the medical provider alleged that, absent jurisdiction in New Jersey, it was "left without any forum to recover." Reaching back literally to the birth of our nation (the Constitution was ratified in June 1788), Surgicare asserted that Marbury v. Madison, 5 U.S. 137 (1803) compelled New Jersey to find jurisdiction to cure this alleged absence of any forum. That analysis does contain many references to jurisdiction but is most famous for its holding regarding judicial review and the role of the U.S. Supreme Court.
The New Jersey Court was unpersuaded by Marbury, however. It noted that New Jersey's declining jurisdiction did not leave Surgicenter without recourse entirely, but merely relegated it to the forum offered by the state of New York. Despite Surgicenter being dissatisfied by the outcome of proceeding in New York, that is application of the New York reimbursement constraints, the sound conclusion was that New York indeed offered a forum.
The Superior Court Appellate Decision affirmed both trial judge's declining of jurisdiction regarding these reimbursement disputes.
The Superior Court also noted that the disappointed medical providers' appellate statements were less than complimentary of the trial judges in these cases. One described the trial judge's decision as "an 'extraordinarily brazen, unsupportable misuse of authority.'" The other described the "decision in its case [w]as 'incoherent,' and 'preposterous.'"
The Court addressed these comments and accusations. It found those statements to be "pejorative attacks on the judges" and "to be totally unwarranted and disrespectful." The Court noted that
"the judges of the court of compensation, like other judges, are dedicated public servants who strive each day to properly assess the cases before them after giving due regard to the facts and the applicable law."
Litigants in all forums, regardless of the law being argued, might be well advised to remember that.
Sunday, February 21, 2021
Vaccination Tribulation
For whatever reason, there are a fair number of people who have little interest in a vaccine for SARS-CoV-2/COVID-19. I have spoken to some who are ambivalent and others who are fearful. I heard from one who is beyond those, expressing downright opposition to vaccination, and not just personally. That individual feels that vaccines should be avoided societally. These conversations have reminded me that "people are different," as Florida Georgia Line reminded with their 2019 release.
There are interesting observations about vaccines, their efficacy, and herd immunity in the recent post Vaccinations Implications (2021). That post also discusses the perceptions of some in the medical community regarding the SARS-CoV-2 vaccine. Suffice it to say that there is not 100% acceptance even among that population. Significant numbers of medical professionals have either declined the vaccination or are delaying their own inoculation for the time being. What do we lay-people conclude from their reticence or delay?
May we assume that everyone recognizes the benefits of vaccination? No, we may not. May we assume that everyone concedes that there are at least some benefit to vaccination? No, we may not. May we assume that on any topic in America today we can find both ardent proponents and violent opposition? Well, that seems reasonably likely lately. I had one person express surprise at my openness to vaccines, and was asked "don't you remember Thalidomide?" That seems a bit over-the-top. Perhaps there are some topics upon which we might unanimously agree as a society, but I am not sure what the topics would be.
It is not just an American conflict, this vaccine. The British Broadcasting Corporation (BBC) reports that in Australia there are protests about the vaccine even before its distribution has begun. Pfizer's vaccine is set for immediate delivery, and the "Oxford" vaccine (AstraZeneca) is expected to be delivered within weeks. Protest participants chanted privacy-referenced slogans such as "my body, my choice." Their reticence is curious, as the Australian plan provides free inoculation, but is said to be entirely voluntary. One strives to understand how such a plan violates anyone's personal freedom or privacy.
So, there are some folks who are unwilling to accept the vaccine, at this time.
But, there are various reports of others who are very eager to obtain an injection (or two). In Polk County Florida, the winner of "Paramedic of the Year" was arrested for stealing the vaccine. That story makes references to "falsified" documents, and others who may have been aware of, or involved in, the diversion of vaccines. CBS News reports that a Fire Captain in Polk County was also arrested in that investigation.
CNN reported recently about a vehicle theft at the "Strawberry Festival Grounds in Plant City (Florida)." There were vials of the vaccine in the car (which was reportedly left unattended and running; side note, not a wise maneuver). The reports are not clear regarding whether the intended target was a vaccine or merely the car. KTLA reported the vaccine was worth approximately $10,000.
Remember when people lied about their age for such mundane and banal reasons as obtaining alcohol?
"Everyone knows that life isn't fair. Saying it's not fair suggests that you think life is supposed to be fair, which makes you look immature and naïve."
Florida sometimes makes international news. This "grannies" story has. It has been featured in India, the United Kingdom, and Canada. Some outlets quoted claims that this disguise scheme was the same as having "stolen a vaccine."
Thus, we find ourselves in an intriguing dichotomy. A great many people who are entitled to the vaccine are not taking the opportunity for whatever reason. A fair few others who are not entitled to the vaccine are striving through imagination, obfuscation, and even criminality to obtain it. Seemingly, some stand on the deck of the Titanic denying and others are dressing as old ladies to sneak into the lifeboats. It is an interesting time, this utopia in which we live.
Where would you come down? If you are eligible, will you line up? If the random chance arises, as it reportedly did in early January for two in Washington, would you take the shot? Suddenly, the eligibility in Miami changed yesterday with the announcement of availability for those 55 years old (instead of 65), if the person suffers from one of thirteen medical diagnoses (with a note from your doctor). If you had such a condition, would you jump at this new chance?
If through some happenstance you have the opportunity, how will you react? These are interesting times. Many are pent-up, frustrated, and scared. But, taking a COVID-19 vaccine at this time necessarily means one of your neighbors may go without. How are we equipped for this moral dilemma? Can we individually, collectively, and societally do what is "fair?" Or, will each of us act in our own best interest? As the song reminds us, "People are Different," maybe we just have to accept that in our new, utopian, even brave world? Things simply become curiouser and curiouser.
