All posts by Paul J. McAndrew, Jr.

Broken Trust – Breaking The “Grand Bargain” Of Workers’ Compensation

Today’s post comes from guest author Catherine Stanton, from Pasternack Tilker Ziegler Walsh Stanton & Romano.

More than 100 years ago, Workers’ Compensation was established as a “grand bargain” between workers and employers. The state legislature enacted laws where injured workers gave up their right to sue if they were hurt on the job as a result of their employers’ negligence in exchange for a no fault system of medical and wage loss benefits. 

Included in this bargain was the right of the injured worker to obtain financial compensation for a permanent injury to an extremity, such as arms, legs, hands, feet, fingers and toes. Unfortunately, this “grand bargain” – at least as it pertains to injured workers – has been under attack for the last 10 years in New York under the guise of rising costs to employers.

During the New York State budget negotiations, the Business Council created a false narrative that injured workers’ benefits for extremity injuries were archaic and didn’t account for modern medicine. They claimed that benefits paid were creating a crisis in New York and forcing businesses to flee the state. As a result of their lobbying, the New York State Legislature directed the Workers’ Compensation Board in April 2017 to create a task force consisting of labor, medical providers, and insurance groups to issue proposed revisions that account for advances in modern medicine that enhance healing and result in better outcomes. What we have subsequently found out is that the Workers’ Compensation Board, without direction or authority, has been secretly working for the last couple of years to not only revise the current guidelines, but to scrap them altogether. These provisions would essentially eliminate most schedule loss of use extremity benefits to injured workers. As an attempt to not fuel the fire, they released their proposed revisions at 11:00 p.m. on the Friday of Labor Day weekend.

The Workers’ Compensation Board has been heavily criticized for their Anti Injured Worker Proposals by a number of labor unions, NYCOSH, physician groups, Workers’ Compensation practitioners, and injured workers themselves. As a result of the outrage, the New York State Assembly’s Committee on Labor held hearings at which a number of people from the taskforce testified. When representatives from the Board were asked why there were secret meetings years before the Legislature directed them to review the issue, their weak response was that “they” couldn’t understand some of the large discrepancies between the findings of the treating doctors and the insurance doctors. However, that argument holds little weight because the scenario they cited was the exception rather than the norm. They also pointed out that they relied heavily on the New York State Orthopedic Group for input.  Yet, when the Chair of the task force, Dr. Jeffrey Lozman, an orthopedist, and Dr. John M. Olsewsky, President of the NYS Society of Orthopedic Surgeons, testified, it became clear that their recommendations were largely disregarded in a way that would negatively impact injured workers.

It is clear that the New York State Workers’ Compensation Board is pushing the Business Council’s agenda. What is unclear is why the Board seems to be taking sides when their mission statement is to “protect the rights of employees and employers by ensuring the proper delivery of benefits to those who are injured or ill, and by promoting compliance with the law.”

Injured workers don’t have the means to fight, and but there are still steps you can take to defeat these harmful proposals. There is a 45-day comment period set to expire on October 23, 2017. You can contact your state legislator and the New York State Workers’ Compensation Board to voice your opposition. For additional information please go to:  www.nyworkerscompensationalliance.org/protectinjuredworkers

Workers’ Compensation was set up to help you if you are ever injured on the job. These benefits are your right. They are your protection. Just because you might not need the benefits now, doesn’t mean you or a loved one won’t need them down the road. Only by working together can we fight to make sure that these benefits as we know them remain in place. While a single voice might not make a difference, a loud collective voice stands a better chance. Go to the link and voice your disapproval. Have your family and friends do the same.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

Defense Base Act Coverage for U.S. Government Contractors Working in Puerto Rico

Today’s post comes from guest author Kit Case, from Causey Wright.

October 15, 2018

NOTICE TO EMPLOYERS, INSURANCE CARRIERS, SELF-INSURED EMPLOYERS UNDER THE LONGSHORE AND HARBOR WORKERS’ COMPENSATION ACT, AND OTHER INTERESTED PERSONS

SUBJECT: Defense Base Act Coverage for U.S. Government Contractors Working in Puerto Rico

In the aftermath of the devastation caused by Hurricanes Irma and Maria in Puerto Rico in September of 2017, various agencies of the United States have utilized the services of private contractors to provide humanitarian and other assistance as part of the global relief effort there. The Defense Base Act (DBA) requires private contractors performing work under a U.S. government contract to purchase DBA insurance to cover their employees working in Puerto Rico.

The DBA, an extension of the Longshore and Harbor Workers’ Compensation Act, applies to injuries incurred by workers in Puerto Rico working under a contract with the U.S. government, see Section 1, 42 U.S.C. § 1651(a)(1-6).

Federal agency contracting personnel should include contract provisions requiring private contractors to secure DBA insurance from a carrier authorized by the U.S. Department of Labor.  Because the DBA applies to all employees of government contractors, DBA insurance must be in place before workers are deployed to Puerto Rico or work is performed in Puerto Rico.  The DBA applies to U.S. workers, local workers, and foreign national workers.

When DBA insurance is properly secured, the DBA provides the exclusive remedy for these workers who sustain an injury, an illness, or are killed. The DBA is administered by the United States Department of Labor, Office of Workers’ Compensation Programs (OWCP), Division of Longshore and Harbor Workers’ Compensation (DLHWC).  OWCP/DLHWC authorizes insurance carriers to write DBA policies and employers to self-insure for DBA. See a list of those insurance carriers which are currently authorized to write DBA coverage.

If an employee covered by the DBA sustains a work-related injury, it must be reported to OWCP/DLHWC.  The DBA carrier should also be contacted immediately.  An employee may submit a claim for injuries arising from employment under a U.S. government contract in Puerto Rico to OWCP/DLHWC.  The case will then be assigned based on where the claimant resides.

For more information Visit the USDOL Defenst Base Act  and Division of Longshore and Harbor Workers’ Compensation Defense Base Act pages.

Photo by The National Guard on Foter.com / CC BY

Injured Volunteer Firefighters And Ambulance Workers May Be Eligible For Benefits

Today’s post comes from guest author Anthony Pizza, from Pasternack Tilker Ziegler Walsh Stanton & Romano.

New York workers are generally covered by the Workers’ Compensation Law, but there are special laws which cover volunteer first responders – firefighters and ambulance workers.

Closely aligned with the Workers’ Compensation Law are the Volunteer Firefighter Benefits Law (VFBL) and the Volunteer Ambulance Workers Benefit Law (VAWBL). As their titles suggest, these two laws protect people who volunteer in the potentially hazardous duties of fighting fires, responding to motor vehicle accidents and tending to those injured in a variety of circumstances. While not all firefighters and ambulance workers are unpaid, many areas outside the five boroughs of New York City and other smaller cities maintain volunteer forces to provide these indispensable services. Given the inherent danger involved, volunteers often suffer injury when “on duty”.

In the event of an injury, both laws provide wage replacement benefits and medical coverage. Also, there is a “built in” presumption of an earning capacity for volunteers; therefore, even if a volunteer is not otherwise employed, she or he may be entitled to benefits. In addition to physical injury, the laws cover such events as exposure to noxious fumes, smoke or chemicals and post-traumatic stress disorder. 

The list of what entails an “injury in the line of firematic or ambulance worker duty” is extensive. These events include maintaining vehicles and participation in certain department-sanctioned events. We take pride in representing those who volunteer their efforts in the service of others, especially when those efforts can be fraught with danger.

In order to best insure that your rights are protected, be sure to contact our office for a no-cost consultation. And thank you for volunteering!

Who Is Your Doctor?: Choice of Doctor Under Worker’s Compensation

Today’s post comes from guest author Sam Liverseed, from The Domer Law Firm.

A common dilemma faced by many injured workers: where to seek treatment following a work injury. Some employers force injured workers to a designated medical provider and many times the injured worker continues treatment with that provider. Workers often assume they cannot switch or see their own physician (which is not correct). Treatment at the employer-designated provider continues until the injured worker is sent back to work, even if the injured worker has not fully healed, which can lead to further injury or employment consequences.

Workers can receive treatment from their own doctor following a work injury.  An injured worker in Wisconsin has a right to two “choices” of treating practitioners. What constitutes a “choice” is defined in Wisconsin Statute §102.41(2)(a) and includes any physician, chiropractor, psychologist, dentist, physician assistant, advanced practice nurse practitioner, or podiatrist. The important aspect of physician choice is that referrals from one doctor to another do not exhaust a choice.    

We frequently receive calls from injured workers who believe that a referral from their primary care doctor to an orthopedic doctor is the second choice. But that is not how the law works.  Only if the injured worker leaves the referral chain do they use their “second choice.” 

A referral from a primary care physician to an orthopedic doctor is a single choice. If the orthopedic doctor refers to a pain management physician, again, it is a single choice. The injured worker has now seen three doctors (Primary Care, Orthopedic, Pain Management), but is still within the same “choice.”  Doctors within the same practice count as a single choice. 

Injured workers need to be aware of their options. Insurance companies may designate a referral to an Orthopedic doctor as the “second opinion” and therefore, the second choice, when really this is still only a single choice. This crucial distinction affords the injured worker the opportunity to receive quality care. 

What happens in an emergency? The employer may arrange for emergency treatment after which the injured worker can choose their own doctor without using a choice. This common-sense provision allows employers to direct emergency care without sacrificing the worker’s choice of quality care in the future. 

The best advice for injured workers is to always obtain a referral from a treating doctor to any other doctor or specialist.  In Wisconsin, the injured worker – not the employer or the worker’s compensation insurance company – controls treatment.

Somebody get me a doctor: Nebraska rules against P.A reports in workers’ compensation

Somebody get me a shot! (Sorry no appropriate Diamond Dave images to go with this post)

Today’s post comes from guest author Jon Rehm, from Rehm, Bennett & Moore.

The Nebraska Supreme Court held recently that a written reports from a Physician’s Assistant or P.A. are inadmissible into evidence under the Rule 10 of the Nebraska Workers’ Compensation Act.

The decision resolves what amounted to a “circuit split” among the seven judges of the Nebraka Workers’ Compensation Court as to whether P.A. reports were admissible into evidence.

The decision didn’t come as a shock to me or any of the other lawyers at this firm. The decision shouldn’t impact how we or any other lawyers develop evidence in Nebraska workers’ compensation cases.

But I believe the decision harms workers in rural areas whose only access to medical care is often a P.A. The decision also harms workers without health insurance whose only treatment for a work injury might be treating with a P.A. at an urgent care clinic. If an employer denies compensability, the only medical evidence that employee may have would be a report from a P.A.

Most lawyers “fix” P.A. reports by having the supervising doctor sign the report. I’ve had P.As take offense at that request. I’ve also had defense lawyers attack medical opinions on hearsay grounds by getting a medical doctor to admit that the P.A. is the one with first-hand knowledge about the injured worker.

Lawyers are stuck with two options if a P.A report is the sole source of expert opinion from a treating provider: 1) Call the P.A. live as a witness in the same manner as in a civil trial or 2) retain an examiner.

Neither of those is a great option. The best fix would be for the Legislature or the Nebraska Workers’ Compensation Court to amend Rule 10 to allow P.A reports into evidence.

Time Off or Time-Loss?

Today’s post comes from guest author Jane Dale, from Causey Wright.

Our clients often come to us with issues relating to their employment that are not directly related to their work injury or workers’ compensation claim. Given how entwined a work injury can be with employment-related issues, it can be helpful to have a general understanding of both legal areas.

One issue that comes up quite frequently is whether an Employer can require our clients to use up their vacation, sick-leave, and/or PTO for time missed from work when the reason they are missing work is a work-related injury. The short answer is yes. At present, there is no law that prevents an Employer from forcing injured workers to use up their vacation or PTO while they are unable to work due to their injury. However, it could be unlawful for an Employer to create “special rules” that apply to only one employee or only to employees with L&I claims. If they do so, it is possible they are violating other laws that prohibit discrimination of disabled persons and/or retaliation against employees who have filed L&I claims. Regardless, even if such a policy exists, the Employer cannot prevent injured workers from obtaining monetary workers’ compensation benefits if they would otherwise be entitled to it. If an injured worker is entitled to time-loss or loss of earning power benefits, then it does not matter that they are also receiving PTO or vacation benefits.

Another issue that we may see more of given the recent passage (and soon to be enacted) laws relating to Paid Sick Leave are questions about whether injured workers can earn paid sick leave if they are not working full time or full duty. Depending on what type of employee an injured worker is (salaried or hourly), they may have the right to earn paid sick leave for each hour worked. An Employer should not be able to deny accrual of paid sick leave simply because an injured worker is unable to work full-time or full-duty. Additionally, an Employer cannot prevent an injured worker from using their paid sick leave while the injured worker is receiving benefits under their claim so long as the basis for using it would otherwise be appropriate.

Ultimately, these are difficult questions to answer. The specific circumstances of each case needs to be evaluated to arrive at an answer and may require the advice of both an attorney who focuses on workers’ compensation as well as one who focuses on employment law. If you have questions, please feel free to contact me to start the discussion.

Photo by bunkosquad on Foter.com / CC BY-NC-ND

U.S. Department of Labor

Today’s post was shared by US Dept. of Labor and comes from www.dol.gov

WASHINGTON, DC – The U.S. Department of Labor today announced the launch of the New and Small Business Assistance and the Compliance Assistance Toolkits webpages. These new online tools assist American small businesses and workers with simple, straightforward resources that provide critical Wage and Hour Division (WHD) information, as well as links to other resources.

The webpages were established in response to feedback received from new and small business stakeholders voicing their need for a centralized location to secure the tools and information they need to comply with federal labor laws. These new webpages provide the most relevant publications and answer the questions most frequently asked by new and small business owners. These tools, in conjunction with worker.gov and employer.gov, ensure greater understanding of federal requirements and provide tools to help employers find resources offered by other regulatory agencies.

“The Wage and Hour Division has long understood that the majority of employers want to do the right thing and comply with the law, but they need to know how,” said the Wage and Hour Division’s Acting Administrator Bryan Jarrett. “These new webpages demonstrate our ongoing commitment to proactively help employers comply with the law and provide them the tools they need to understand their responsibilities. We encourage all employers to visit these new webpages and reach out to us for assistance at any time.”

In…

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U.S. Department of Labor

Today’s post was shared by US Dept. of Labor and comes from www.dol.gov

DES PLAINES, ILThe U.S. Department of Labor has reached a settlement with Omnicare of Northern Illinois that requires the company to pay $300,000 in back pay and interest to 132 pharmacy technicians of Asian heritage to remedy pay discrimination violations identified at its Des Plaines, Illinois, facility.

The settlement follows a routine compliance evaluation by the Department’s Office of Federal Contract Compliance Programs (OFCCP), where investigators found that, as of April 1, 2013, Omnicare of Northern Illinois paid Asian employees in pharmacy technician positions less than similarly situated employees.

"Employers should review their compensation processes to ensure that their employees do not suffer from discriminatory practices," said Carmen Navarro, Acting Regional Director, Office of Federal Contract Compliance Programs in Chicago. "This settlement demonstrates the U.S. Department of Labor’s commitment to combating pay discrimination and holding companies with federal contracts accountable if they fail to ensure equal employment opportunity."

Omnicare of Northern Illinois also agreed to review employee compensation practices and make adjustments as necessary. Other non-monetary forms of relief contained in the settlement include compensation monitoring and Equal Employment Opportunity training for employees.

In addition to Executive Order 11246, OFCCP enforces Section 503 of the Rehabilitation Act of 1973 and the Vietnam Era Veterans’…

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