Health Care and Black Lung

One of the most serious diseases that exists has been dreaded primarily by coal miners, and by those exposed to mining industries. Coal workers' pneumoconiosis (CWP), also known as black lung disease or black lung, is caused by long exposure to coal dust. It is common in coal miners and others who work with coal.

It is similar to both silicosis from inhaling silica dust, and to the long-term effects of tobacco smoking. Inhaled coal dust progressively builds up in the lungs and is unable to be removed by the body; this leads to inflammation, fibrosis, and in worse cases, necrosis.

Like all occupational diseases, black lung is man-made and can be prevented, according to the United Mine Workers. In fact, the U.S. Congress ordered black lung to be eradicated from the coal industry in 1969. Today, it is estimated that 1500 former coal miners each year die an agonizing death in often isolated rural communities, away from the spotlight of publicity. More details about the legislation to help miners with this disease can be found at this site:

According to the American Lung Association (ALA), there is no known treatment for pneumoconiosis, but doctors treat the symptoms and complications of the disease. People who work in jobs where they are exposed to coal dust get pneumoconiosis. This includes working in a coal mine or loading coal for storage, working in a graphite mine or mill, and manufacturing carbon electrodes and carbon black. Carbon electrodes are used in some large furnaces, and carbon black is used in tires and other rubber goods, as well as many other products.

People who inhale coal dust may not have any symptoms for many years, according to the ALA. Over time, however, as the coal dust has settled deep in the lung, it eventually causes the lung to harden. As the lung hardens, breathing becomes more difficult and gets worse over time. Possible complications of pneumoconiosis include:

         Cor pulmonale (failure of the right side of the heart)
         Lung cancer
         Pulmonary tuberculosis
         Respiratory failure

Pneumoconiosis (Black Lung) is not treatable or curable. How severe each person's disease becomes is the result of the conditions of his or her work during exposure to coal dust. More details can be located at this website:

According to the US Department of Labor, the Division of Coal Mine Workers' Compensation, or Federal Black Lung Program, administers claims filed under the Black Lung Benefits Act. The Act provides compensation to coal miners who are totally disabled by pneumoconiosis arising out of coal mine employment, and to survivors of coal miners whose deaths are attributable to the disease. The Act also provides eligible miners with medical coverage for the treatment of lung diseases related to pneumoconiosis.

The Division of Coal Mine Workers' Compensation has published a notice of proposed rulemaking (NPRM) to address several issues that have arisen in administering and adjudicating claims under the Black Lung Benefits Act. The proposed regulations would:

         Require parties to disclose medical information about the miner developed in connection with a benefits claim.

         Clarify a liable coal mine operator�s obligation to pay benefits during post-award modification proceedings.

         Clarify that a supplemental report from an examining physician is a continuation of the physician�s earlier report for purposes of the evidence-limiting rules.

The NPRM was published in the Federal Register on April 29, 2015. The public may submit comments on the proposed rule online at the instructions on that web site) or by the other methods set forth in the NPRM. More material about this is located at this site: and at this website:

According to the National Institutes for Health (NIH), your risk of getting coal worker's pneumoconiosis depends on how long you have been around coal dust. Most people with this disease are older than 50. Smoking does not increase your risk of developing this disease, but it may have an additional harmful effect on the lungs. If coal worker's pneumoconiosis occurs with rheumatoid arthritis, it is called Caplan syndrome.

The doctor will do a physical exam and listen to your lungs with a stethoscope. A chest x-ray or chest CT scan will be performed. You may also need lung function tests.  Wear a protective mask when working around coal, graphite, or man-made carbon. Companies should enforce the maximum permitted dust levels. Avoid smoking. You should avoid further exposure to the dust. Details can be sourced at this website:

Although the overall percentage of Americans are not typically affected with this disease, there are many who are. Follow the recommendations of your health care provider. There are also financial resources available to assist you if you have developed the disease and are permanently disabled as a result. Be careful if you are in this industry.

Until next time.

Health Care and Spring Water

Earlier this Summer, companies that bottle spring water were forced to recall millions of plastic bottles of water filled with water collected at a natural spring. According to ABC News, Niagara Bottling said that one of its spring sources has a "positive indication" of E. coli, which the company said indicates that the water may be contaminated with human or animal wastes.

The company said it didn't receive any reports of illness or injury. E. coli microbes can cause diarrhea, cramps, nausea, headaches, or other symptoms, the company said, and may pose a greater risk for infants, young children, some of the elderly and people with severely compromised immune systems. More information about this healthcare issue can be found at this website:

The recalled water was sold under the brand names of Acadia, Acme, Big Y, Best Yet, 7-11, Niagara, Nature's Place, Pricerite, Superchill, Morning Fresh, Shaws, Shoprite, Western Beef Blue and Wegmans. ACME Markets, which operates supermarkets in Delaware, Maryland, New Jersey and Pennsylvania, was among the supermarket chains announcing involvement in the recall. Among others were Shaws grocery stores in Maine, Massachusetts, New Hampshire, Rhode Island and Vermont; and Wegmans in Maryland, Massachusetts, New Jersey, New York, Pennsylvania and Virginia.

According to Mother Jones, while many spring water brands started out selling water from a single source, a large portion now draw from multiple springs, even though they don't often tout that fact. The original springs are insufficient in part because demand has grown to the point where the quantity of water available from these natural springs isn't enough. For others, the springs have been over pumped, or the groundwater levels dropped and caused them to dry up.

There are a few rules that bottled-water brands have to follow, however. In order to be called "spring water," according to the EPA, a product has to be either "collected at the point where water flows naturally to the earth's surface or from a borehole that taps into the underground source." Unlike the term "spring water," other terms like "glacier water" or "mountain water" aren't regulated and "may not indicate that the water is necessarily from a pristine area," according to the EPA. 

But, despite spending over $11 billion per year on bottled water, most Americans don't know much about the origins of these beverages. More info can be found at this site:

According to the Livestrong Foundation, bottled water is increasingly common, with Americans drinking more than 2 billion gallons of it each year. With the large variety of different types of water on the market, it can be confusing to know the difference between one and the other. Spring water and purified water come from two different sources, and in many cases, are as safe as tap water for drinking, although personal preference often determines they type of water chosen.

Spring water is also sometimes called artesian water, ground water or well water. Spring water may be accessed by a well, and it can be treated or not. In all cases, spring water is collected when it flows or arrives to the surface. Natural springs can form along the sides of hills and in valleys, and some people consider the natural filtration process of spring water to make for better tasting water that is richer in minerals.

Springs for spring water can form where there is any rock, with limestone being a common case in much of the United States. The soft texture of limestone makes it easy for the water to well through. Springs form when an underground aquifer is filled sufficiently high that the excess seeps through to the surface. While water from springs are often clear because they are filtered through rock, the mineral composition of the soil will affect the color.

As well, spring water can be safe to drink without any treatment, however, the quality of the water is not guaranteed. Bottled spring water is required to be tested and filtered for any sediment to meet EPA standards. More material about spring water can be found at this site:

Spring water is the subject of many popular misconceptions. Many of those misconceptions are promoted through less than accurate advertising pitches. For example, many people believe that spring water is actually �pure� water. On the contrary, spring waters contain many of the same impurities found in drilled wells or even tap water. In fact, since springs feed rivers, there�s lots of spring water right in your own tap water! On average, the purity of spring water is roughly comparable to that of tap water. Some have lower TDS levels and some are much higher.

But is spring water �100% pure� as many spring water companies advertise? As it turns out, the �100% pure� refers not to the absence of impurities in the water, but to the source of the water itself. That is, 100% of the water in the bottle came from an underground source (i.e. a spring), rather than from a surface water. These cleverly worded phrases may be legally permissible, but many people find them to be misleading, to say the least.  Even more frightening is the fact that most people actually believe them.

Another adjective which frequently pops up in spring water advertising is �natural�. While this term may conjure up images of a pristine wilderness setting, the fact is that �natural� can mean just about anything. This vague term could actually apply to your local tap water since the closest river to your home or office is most certainly a �natural� source. It may be natural, but how many people who would go down to the river and scoop themselves a refreshing glass of �pure and natural� river water!

Spring water advertising is all about images � images of the mountains, streams and wildlife. What really happens to get that bottle of water to you is actually quite different from those images. Many, if not most, spring waters are not bottled at their source. Instead, the water is pumped into large tanker trucks for transportation to a bottling facility at a different location.

Remember, those �pristine� springs are being visited many times each day by large diesel tanker trucks � not exactly a �pristine� image. Health regulations dictate that the water in those tanker trucks be either chlorinated or ozonated at all times to protect against bacterial contamination. Additional info about this topic is found at this site:

At the end of the day, much of what is consumed in the bottled water industry comes down to personal preference and taste. Is spring water better than tap water? Maybe, or maybe not. That is for you to decide, and how much you are willing to spend on your next drink of cold, clear water on the go. If you�re like most Americans, you prefer convenience over cost.

Until next time.

Medicare and Medicaid celebrate 50 years this week

July 30 is the 50th anniversary of Medicare and Medicaid, which serves 1 out of every 3 Americans. Insurance Commissioner Mike Kreidler will join the celebration by speaking at the Northwest regional event, held on July 30 from 10:30 a.m. to 12 p.m. at the Greenwood Senior Center in Seattle. The event is being hosted by the Centers for Medicare & Medicaid Services (CMS) Region X Office.

Commissioner Kreidler will join a panel of experts to discuss how Medicare and Medicaid have changed society and the ways in which we can work together to strengthen and improve health care for future generations in Washington state.

You�re invited to attend the celebration; register here.

CMS is observing the 50th anniversary by reflecting on the impact of these two programs and raising awareness about the services they provide to Americans.

Contract forges stronger bond with Washington�s Indian tribes for health care

Commissioner Mike Kreidler and representatives of the American Indian Health Commission signed a landmark contract July 21 that is designed to improve health care for Washington state Indian tribes.

From left: Vicki Lowe, John Hamje, Leslie Wosnig, Carolyn Smith,
Commissioner Kreidler, Todd Dixon

The contract will fund and support training for tribal staff and members regarding their Medicare insurance options.

The support comes through the Statewide Health Insurance Benefits Advisors program, better known as SHIBA. Kreidler�s office manages the program in Washington. Funding is split by the state and federal governments.

�I�m proud of the strong working relationship we have with the American Indian Health Commission and Washington tribes,� Kreidler said at the contract signing. �This will help us better understand and respect the rights and interests of tribal members.�

Signing the contract on behalf of the tribes was Leslie Wosnig of the Suquamish Tribe. She is also secretary of the American Indian Health Commission. Vicki Lowe, grant manager for the Jamestown S�Klallam Tribe, also attended the event.

SHIBA provides free and unbiased information about health care access and coverage in Washington. The contract with the American Indian Health Commission will support several activities, including helping tribal elders understand their Medicare options and get assistance with prescription drug plans.

The program serves more than 100,000 state residents annually through volunteer advisers.

�This is an unprecedented partnership. Now we�ll be working even more closely together to make quality health care more accessible to tribal members throughout the state,� Kreidler said. �Our goal is to reduce disparities in health care. Our mission is to help all who live in Washington.�

OIC hiring Deputy Commissioner for Company Supervision

The OIC is looking for a Deputy Insurance Commissioner for our Company Supervision Division. This rewarding position manages a wide variety of situations and influences the course of insurance affairs, at the state, national, and international levels through contacts with the regulatory community and through colleagues in the agency. This position works together with the other members of the Executive Management Team to set strategic direction of the agency; establish legislative goals; ensure fiscal responsibility; and, create an inclusive, performance based culture. This is a civil service exempt position.

The Deputy for the Company Supervision Division is an executive leader who manages a division of approximately 57 employees at two locations. This position is the highest authority within OIC with designated responsibility to direct the regulatory program and internal operations of the Company Supervision Division.

This position is responsible for the financial and market examination and supervision of all Washington organized insuring entities and all other insuring entities licensed to do business in this state. The position�s mission is to protect insurance consumers, the public generally, and the state�s economy by ensuring the safety and soundness of insuring entities, and to ensure that they comply with applicable law. This position has broad statutory discretion and specific statutory authority involving the registration/licensing, operation, supervision, receivership, liquidation, and merger of insuring entities.

Duties of this position include:
  • Regulating and supervising all insuring entities organized in Washington to assure financial stability and compliance with consumer facing market activity regulations.
  • Licensing, regulating, and supervising all insuring entities organized in other states or non-U.S. jurisdictions that do business in Washington to assure financial stability and compliance with consumer facing market activity regulations.
  • Supervising programs designed to ensure protection of insurance consumers from the failure of insurers doing business in this state and from insurer deviation from legally required market practices. These programs include the management of financially troubled or insolvent insurers and the coordination with insurer guaranty associations.
  • Exercising broad statutory discretion over laws and regulations regarding registration or licensing, operation, liquidation, merger or acquisition of insurers, and insurer activity in the Washington marketplace.
Find more information about this job and other openings at

Health Care and UV Safety

The sun can be brutal to your skin, especially during the warmer months of the year. Additionally, protection against its rays is often neglected by most people. According to the US Department of Health and Human Services (HHS), the need to protect your skin from the sun has become very clear over the years, supported by several studies linking overexposure to the sun with skin cancer.

The harmful ultraviolet rays from both the sun and indoor tanning �sunlamps� can cause many other complications besides skin cancer - such as eye problems, a weakened immune system, age spots, wrinkles, and leathery skin. UV rays are their strongest from 10 am to 4 pm Seek shade during those times to ensure the least amount of harmful UV radiation exposure.

When applying sunscreen be sure to reapply to all exposed skin at least 20 minutes before going outside. Reapply sunscreen every two hours, even on cloudy days, and after swimming or sweating, according to the HHS. A significant amount of info can be found at this website:

As well, according to the University of Washington, UV or ultraviolet lamps are used in biological safety cabinets, light boxes, and cross linkers in many university laboratories and in some patient care rooms. One of the problems in working with UV radiation is that the symptoms of overexposure are not immediately felt so that persons exposed do not realize the hazard until after the damage is done.

The health effects of exposure to UV light are familiar to anyone who has had a sunburn. However, the UV light levels around some UV equipment greatly exceeds the levels found in nature. Acute (short-term) effects include redness or ulceration of the skin. At high levels of exposure, these burns can be serious. For chronic exposures, there is also a cumulative risk of harm. This risk depends upon the amount of exposure during your lifetime. The long-term risk for large cumulative exposure includes premature aging of the skin and even skin cancer.

The eyes are also susceptible to UV damage. Like the skin, the covering of the eye or the cornea, is epithelial tissue, too. The danger to the eye is enhanced by the fact that light can enter from all angles around the eye and not only in the direction you are looking. The lens can also be damaged, but since the cornea acts as a filter, the chances are reduced, according to the University of Washington.

This should not lessen the concern over lens damage however, because cataracts are the direct result of lens damage. Burns to the eyes are usually more painful and serious than a burn to the skin. Make sure your eye protection is appropriate for this work. More info on this type of UV exposure can be found at this site:

According to the Centers for Disease Control (CDC) protection from ultraviolet (UV) radiation is important all year round, not just during the summer or at the beach. UV rays from the sun can reach you on cloudy and hazy days, as well as bright and sunny days. UV rays also reflect off of surfaces like water, cement, sand, and snow. More details about UV protection can be found at this site:

People who get a lot of exposure to ultraviolet (UV) rays are at greater risk for skin cancer. Sunlight is the main source of UV rays, but you don�t have to avoid the sun completely, according to the American Cancer Society. And it would be unwise to stay inside if it would keep you from being active, because physical activity is important for good health. But getting too much sun can be harmful. There are some steps you can take to limit your exposure to UV rays.

Some people think about sun protection only when they spend a day at the lake, beach, or pool. But sun exposure adds up day after day, and it happens every time you are in the sun. Simply staying in the shade is one of the best ways to limit your UV exposure. If you are going to be in the sun, �Slip! Slop! Slap! and Wrap� is a catchphrase that can help you remember some of the key steps you can take to protect yourself from UV rays:

         Slip on a shirt.
         Slop on sunscreen.
         Slap on a hat.
         Wrap on sunglasses to protect the eyes and skin around them.

Children need special attention. They tend to spend more time outdoors, can burn more easily, and may not be aware of the dangers. Parents and other caregivers should protect children from excess sun exposure by using the steps above. It�s important, particularly in sunnier parts of the world, to cover your children as fully as is reasonable. You should develop the habit of using sunscreen on exposed skin for yourself and your children whenever you go outdoors and may be exposed to large amounts of sunlight.

Children need to be taught about the dangers of too much sun exposure as they become more independent. If you or your child burns easily, be extra careful to cover up, limit exposure, and apply sunscreen. Many more details about UV safety can also be located at this site:

According to the American Academy of Opthalmology, growths on the eye, such as pterygium, can show up in your teens or twenties, especially in surfers, skiers, fishermen, farmers, or anyone who spends long hours under the mid-day sun or in the UV-intense conditions found near rivers, oceans, and mountains. Diseases like cataract and eye cancers can take many years to develop, but each time you are out in the sun without protection you could be adding damage that adds to your risks for these serious disorders.

Additionally, as you sleep, your eyes enjoy continuous lubrication. During sleep the eyes also clear out irritants such as dust, allergens or smoke that may have accumulated during the day. Some research suggests that light sensitive cells in the eye are important in your ability to regulate wake-sleep cycles.

This may be more critical as you age, when more people have problems with insomnia. While it's important that you protect your eyes from overexposure to UV light, your eyes also need minimal exposure to natural light every day to help maintain normal sleep-wake cycles. More information on this topic can be found at this website:

July, which is UV Safety Month, and August are a great time to spread the message about sun, fun, and UV safety to the community. Be careful.

Until next time. 

Did you know adjusters need an insurance license?

Many consumers are not aware that insurance adjusters are required to have a license.

First, what�s an adjuster? Most people who have had an auto accident or a homeowner�s claim have worked with an adjuster, the person who investigates or reports claims to the insurer. There are three primary types of adjusters:
  • Crop adjusters work on claims under crop insurance.
  • Independent adjusters represent the insurer and work for the insurer. They interact with consumers who file claims with the company.
  • Public adjusters represent the insured. Consumers can hire a public adjuster to represent them to their insurance company. 
Adjusters can get a resident license, meaning that Washington is their state of residence, or they can have a nonresident license, meaning they reside in another state and conduct business in Washington.

Why is important that an adjuster have a license?
Just like an insurance agent or broker has, there are rules of conduct that adjusters must follow. If they don�t, our office can take action against them via a fine and/or taking action against their license. Before you work with an adjuster, regardless of the type of license he or she has, take a moment to look them up in the OIC�s licensing database. You can see the status of the license, agencies the adjuster may represent, and investigations into and disciplinary action taken against the adjuster.

If you have a bad experience with an adjuster, you can file a complaint through our website.

Aetna To Buy Humana for $37B

Less than 24 hours after it was announced that Centene was buying Health Net, Aetna announced the purchase of Humana.  I wonder how much longer Cigna can hold off Anthem.

Let the consolidations continue!

Insurer Aetna to buy Humana in $37B deal


July 1 Small Employers Face Penalties for Helping Employees Pay Health Premiums/Costs

Beginning Wednesday, July 1st, employers who help employees pay for individual health insurance premiums or assist with healthcare costs outside of small group health coverage could face hundreds of dollars in IRS fines per day.  

Prior to the passage of the Affordable Care Act, with its mandate that all Americans purchase insurance and requirement for businesses to offer employees insurance plans, many small companies provided coverage by directly reimbursing medical costs or for the cost of private insurance plans. Businesses do it because that�s a less complicated process than dealing with an official health insurance plan, but continuing to do so after July 1 could cost them hundreds of dollars in fines each day.

The penalties will only affect businesses with less than 50 employees. Those with more than 50 employees are already required to offer a health insurance plan

Fox News Article


Use extreme caution this Fourth of July

This year's Fourth of July festivities in Washington are complicated by the statewide drought we are experiencing. As a result, many local and state government officials are asking Washington citizens to forego fireworks, even where they are legal. 

Many municipalities in Washington have banned the use of fireworks. Washington State Patrol has a list of fireworks laws in Washington cities. They also have a list of public fireworks displays in Washington

Insurance policies generally cover fires that are accidental in origin. We recommend you talk to your insurance agent or broker about your coverage in the event of a fire or injury on your property.

If guests are injured by a personal display of fireworks, the homeowner policy may include medical coverage and personal liability coverage. 

Find more information about your insurance on our website.

Health Net Acquired by Centene | Adios Health Net

Announced this morning that Centene (a Medicaid provider out of St. Louis I've never heard of) has agreed to buy Health Net for stock and cash worth just over $6 billion.  

Let the unraveling continue.   

The deal comes amid a frenzy of merger talks in the health-insurance industry.
St. Louis-based Centene, a Medicaid-focused health insurer, expects the deal to boost its presence in California and other western states, while allowing for $150 million a year in synergies in the second year after closing

Centene to buy Health Net


New Medicare cards are coming starting in April

The Centers for Medicare & Medicaid Services (CMS) will start mailing redesigned Medicare cards to beneficiaries in Washington state aft...