CMS to Rely on New Life Tables for Workers Compensation Set Aside Agreements

The Centers for Disease Control (CDC) has recently published its 2006 United States Life Tables. Effective July 19, 2010, the Centers for Medicare & Medicaid Services (CMS) will begin referencing the CDC's Table 1: Life table for the total population: United States, 2006, for WCMSA life expectancy calculations. This means that for any newly submitted WCMSA proposal received by CMS' Coordination of Benefits Contractor (COBC), or where any WCMSA case is reopened on or after July 19, 2010, CMS will apply the CDC's 2006 Table 1 for life expectancy calculations.


In 2006, the overall expectation of life at birth was 77.7 years, representing an increase of 0.3 years from life expectancy in 2005. From 2005 to 2006, life expectancy at birth increased for all groups considered. It increased for males (from 74.9 to 75.1) and females (from 79.9 to 80.2), the white (from 77.9 to 78.2) and black populations (from 72.8 to 73.2), black males (from 69.3 to 69.7) and females (from 76.1 to 76.5), and white males (from 75.4 to 75.7) and females (from 80.4 to 80.6).


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Temporary Benefits Due During Period of Unrelated Medical Condition

An asthma flare up, that delayed surgery for a compensable back injury, was not a reason to halt the payment of workers' compensation temporary disability payment. The Court held:

"....when treatment for the original work related injury is delayed due to unrelated
conditions, the claimant was entitled to continued disability benefits during the entire period."

"The compensation judge correctly ordered continued temporary disability benefits from November 9, 2006 through February 17, 2007, "the period of time when [Schock] was unable to proceed with an authorized anterior fusion at C5-6 and C7 because of asthma flare-ups unrelated to the work accident." Schock did not refuse treatment, there is no evidence that she was able to return to work or that she was at maximum medical improvement during the brief delay in her neck surgery. Her  asthma condition was temporary and beyond her or her doctor's control."

Shock v Morristown Memorial Hospital/Atlantic Health Systems, Docket No, A-1658-09T2, (NJ Ap. 2010), Decided July 2, 2010

To read more about temporary disability and workers' compensation click here.

Click here for more information on how Jon L Gelman can assist you in a claim for workers' Compensation claim benefits. You may e-mail Jon  Gelman or call 1-973-696-7900.