Today’s post comes from guest author Jon Rehm from Rehm, Bennett & Moore.
Having a work injury is incredibly stressful. Sometimes when a worker is under stress, they won’t understand what a treating doctor is telling them, which leads to frustration and anger on the part of the worker directed toward the doctor. In turn, the worker’s attitude will lead many doctors to not cooperate in a worker’s case. This is especially true if the insurance company has a nurse case manager working on the claim.
One solution for an injured worker is to bring a trusted friend or family member to the doctor with them to medical appointments. I see at least two advantages to bringing in someone else:
1) another person would be able to help you describe symptoms and how the injury happened and
2) the other person can help you understand what the doctor is telling you.
But not every friend or family member is the right choice to go to an appointment with you. You should choose someone who is level headed so that they do not get into an argument with the doctor. You should remember that the doctor is taking down a record of your visit and that that written record will likely be looked at by the judge deciding your workers’ compensation case, should your case go to trial. If you or a friend or family member gets into an argument with a doctor, it will likely hurt your case.
Injured workers who are non-English speakers can present more challenges to effective medical treatment. Not only is there a language barrier but there is often a cultural barrier as well. The language barrier is often used to the advantage of the employer and insurer, because they will often provide interpreters to the doctor. Non-English speakers should try to bring along a fluent interpreter in their language. A bad interpreter can almost be as bad as no interpreter. However, the same rules about temperament and judgment apply for those who go to doctors with non-English speakers. Sometimes doctors get frustrated with language and cultural barriers of non-English speaking injured workers. Employers and insurers know this and use this to their advantage.
Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.
The Zadroga 9/11 Victims Claim Fund has started to make payments to victims of the World Trade Center attack. First Responders andthose who lived or worked in the immediate geographical site near “ground zero” may be entitled to the payment of benenfits for illness and injuries that they suffer as a result of the terrorist attack.
Those eligible include, individuals present at a 9/11 crash site at the time of or in the immediate aftermath, who suffer physical harm as a result of the crashes or debris removal. Also the personal representatives of individuals who were present at a 9/11 crash site, who died as a result of the crashes or debris removal, are eligible to file claims.
Today’s post comes from guest author Charlie Domer from The Domer Law Firm.
In many workers’ compensation cases, Medicare pays medical treatment expenses for an injured worker that may otherwise be the responsibility of the workers’ compensation insurance carrier. In the past decade, workers’ compensation practitioners have become well-versed in dealing with Medicare issues and establishing Medicare Set Asides—effectively deals between the federal government (Medicare) and the work comp insurance company to cover future work-related medical care for the injured worker.
However, Medicare does not cover all types of medical treatment expenses. Thus, certain types of medical treatment cannot be considered part of a Medicare Savings Account (MSA), but those expenses could still be the responsibility of the insurance carrier. One of those non-Medicare-covered expenses are TENS units for chronic law back pain. On August 1, 2012, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum regarding Transcutaneous Electrical Nerve Stimulation (TENS) units for chronic low back pain. The new CMS policy indicated that chronic low back pain (CLBP) is “an episode of low back pain that has persisted for three months or longer; and is not a manifestation of a clearly defined and generally recognizable primary disease entity.” CMS indicated that for all workers’ compensation cases settled after June 8, 2012, use of TENS units for chronic low back pain will no longer Continue reading »
Today’s post comes from guest author Kristina Brown Thompson from The Jernigan Law Firm.
Over the past decade, North Carolina has witnessed an ongoing decrease in the number of workplace fatalities. This past year (2012) there was a total of thirty-five reported workplace fatalities. In 2004, for example, there were 90 workplace fatalities. According to the Department of Labor, the Occupational Safety and Health Division has been working with the state’s most hazardous industries to prevent deaths on the job. However, North Carolina continues to have one of the highest unemployment rates in the country at 9.2 % (December 2012) and with fewer jobs there are obviously fewer chances of an accidental death on the job.
According to the National Council for Occupational Safety the number of fatalities may be artificially low. In a report published in April of 2012 entitled “North Carolina Workers: Dying for a Job,” the National Council for Occupational Safety alleges that the N.C. Department of Labor’s “report of occupational fatalities greatly understates the true extent of the problem.” (http://www.coshnetwork.org/north-carolina-workers-dying-job). The report further states that the listed fatalities “include only those cases that the state OSHA program investigated” and that their internal analysis found that about thirty additional deaths occurred in 2011. The National Council for Occupational Safety then recommended stricter deterrents to promote safe work environments, imposition of more penalties as permitted under the current statutes, as well as a special emphasis program to protect Hispanic workers.
Let’s hope that on the job fatalities continue to drop in 2013, but beyond “hope” the best way to insure a continued decrease is to make all employees and employers aware of potential life threatening dangers and then enforce compliance with safety standards.
Workers have flooded North Dakota to work in the booming oil industry.
Today’s post comes from guest author Jay Causey from Causey Law Firm.
A recent article in the New York Times (An Oil Boom Takes a Toll on Health Care, January 28, 2013) recounted the growing burden on North Dakota hospitals because of on-the-job injuries to workers who have flooded that state to work in the booming oil industry. Apparently North Dakota hospitals are swimming in debt from unpaid bills because, as the article by John Eligon states, “many of the new patients are transient men without health insurance or a permanent address in the area.”
“Swamped by uninsured laborers flocking to dangerous jobs in the oil industry, the hospitals here in the North Dakota oil patch are sinking under skyrocketing debt, a flood of gruesome injuries and bloated business costs from the inflated economy.” – John Eligon, New York Times
Mr. Eligon goes on to discuss actions by the governor and state legislature to increase medical training and medical facilities in North Dakota, and to obtain increased Medicaid financing for the state’s rural hospitals. Not only are medical facilities groaning from the increase of gruesome injuries associated with highly dangerous work environments, Mr. Eligon recounts the health issues that arise from the cramped housing scenarios in the work camps that have sprung up near the oil fields. This includes a significant increase in the incidence of sexually transmitted diseases.
However, nowhere in Mr. Eligon’s article is there any mention of, or reference to, North Dakota’s workers compensation system which would seemingly provide the principal coverage for the injuries and conditions that are the subject of his article. Is the NYT oblivious to the fact of coverage for industrial injuries and conditions under each state’s workers compensation law? Or are workers injured in the new booming oil economy of North Dakota somehow being denied coverage under that state’s system, or being engineered out of coverage by the terms of their employment with the oil companies? It seems that a minimal inquiry, at least, on these points was owed by the NYT in its article.
Today’s post comes from guest author Roger Moore from Rehm, Bennett & Moore.
It used to be that the most to fear from an examination scheduled by an insurance company would be an unfair or incomplete assessment of the work injury. Now it seems insurance companies are using doctors to essentially cross-examine injured workers and delve deeply into irrelevant issues in an attempt to embarrass, harass and probe where they do not belong.
Do you have painful, frequent, or difficulty urinating?
Do you have painful breasts, periods or intercourse?
Have you suffered physical, sexual or emotional abuse?
Do you have erectile difficulty?
Do you get along with supervisors and other employees?
Do physical or mental problems run in your family?
Is anyone in your family disabled?
Did you smoke, drink or use illegal drugs in the past?
These are some of the more disturbing questions asked by a doctor of a patient in a pre-exam questionnaire sent directly from the doctor’s office to the injured worker. You might surmise that this was a case of some sort of reproductive injury associated with mental duress of some type by looking at the questions. In fact, this worker only alleged carpal tunnel syndrome! Most assuredly, embarrassing facts about this worker would just happen to show up in the defense doctor’s final report for the Court’s review at trial.
Any time anyone other than your lawyer sends you something to complete, you should be very careful about filling it out. It’s probably unethical for doctors to send these reports to injured workers who are represented, but we’re seeing more and more of these go out. They are becoming more and more intrusive; in fact, this questionnaire was 11 pages long. It’s my practice not to have clients complete any of these pre-exam questionnaires from doctors.
Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.
The fiscal reality is that workers’ compensation is in greater jeopardy than ever before as the debate in Washington is not about the deficit at all. The debate is about government spending which includes health care.
Overall health care devours 18 percent of the US economy and amounts to 25% of the Federal budget.
Medical treatment for injured workers continues to be delayed, denied and limited under current workers’ compensation programs. Medical costs continue to be shifted to other programs including employer based medical care systems and the Federal safety net of Medicare, Medicaid, Veterans Administration and Tricare.
While a trend continues to emerge to offer “Opt Out” and “Carve Out Programs,” they are not global enough to solve the critical budget deficit issues. The latest emerging trend is for employers to utilize ERISA based medical care plans to efficiently delivery medical care. In NJ a limited alternate dispute-resolution procedure between unions and employers has been introduced. See “NJ Care Outs –Another Evolutionary Step” authored by David DePaolo.
The US economy continues to be very weak. This in an ominous signal for the nation’s workers’ compensation program which is starved for premium dollars. Premiums are based upon Continue reading »
A recent fire at a Pakistani garment factory is reminiscent of the Triangle Shirtwaist factory fire
Today’s post comes from guest author Leonard Jernigan from The Jernigan Law Firm.
The fires in two clothing factories in Pakistan on August 12, 2012, where locked exit doors and lack of safety inspections helped fuel the flames of death for over 300 people, has similarity with the Triangle Shirtwaist Factory fire in New York (147 deaths) in March of 1911, and the chicken factory fire in Hamlet, N.C. (54 deaths) in 1991. Both sites had locked exit doors that trapped workers. Two brothers owned the Triangle factory and two brothers owned the factories in Pakistan. Garment workers jumped to their deaths in New York and workers in Pakistan were forced to jump out of upper-floor windows to try to escape the flames. It was reported that Punjab province safety inspections were abolished in 2003 to develop a more “business friendly environment,” and the Hamlet factory had never been inspected in 11 years of operation.
The latest news is that the factories that burned in Pakistan were allegedly inspected just weeks before the fires by Social Accountability International (SAI), a nonprofit monitoring group that gets much of its financing from corporations. Western companies (like Gap and Gucci), who make clothes in Pakistan and other countries where the labor is cheap, relied on SAI to give them some peace of mind about working conditions, but the total failure of SAI to do it the job is evident. Either it was sleep walking while doing inspections and just going through the motions, or it was just a front for major corporations.
In the United Sates, as we strive to downsize government in the years ahead, we need to keep in mind that government regulations concerning safety must be enforced. If not, safety everywhere will become an issue - on the highway, in the products we use and the food we eat – and we may similarly find ourselves, or a family member, trapped in a deadly situation, with no way out.
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