Category Archives: Workers’ Compensation

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.

OSHA’s Top 10 Violations for 2018 revealed at National Safety Council Congress and Expo

Today’s post comes from our colleagues at WorkersCompensation.com

The Occupational Safety and Health Administration (OSHA) announced the preliminary Top 10 most frequently cited workplace safety violations for fiscal year 2018. Patrick Kapust, deputy director of OSHA’s Directorate of Enforcement Programs, presented the Top 10 on the Expo floor as part of the 2018 NSC Congress and Expo, the world’s largest annual gathering of safety professionals.

While the rankings for OSHA’s Top 10 most cited violations vary little from year to year, violation No. 10 on this year’s list, “Eye and Face Protection” (1926.102), was not on the 2017 list.

“Knowing how workers are hurt can go a long way toward keeping them safe,” said National Safety Council President and CEO Deborah A.P. Hersman. “The OSHA Top 10 list calls out areas that require increased vigilance to ensure everyone goes home safely each day.”

The Top 10 for FY 2018* are:

1. Fall Protection – General Requirements (1926.501)

7,270

2. Hazard Communication (1910.1200)

4,552

3. Scaffolding (1926.451)

3,336

4. Respiratory Protection (1910.134)

3,118

5. Lockout/Tagout (1910.147)

2,944

6. Ladders (1926.1053)

2,812

7. Powered Industrial Trucks (1910.178)

2,294

8. Fall Protection – Training Requirements (1926.503)

1,982

9. Machine Guarding (1910.212)

1,972

10. Eye and Face Protection (1926.102)

1,536

A more in-depth look at the Top 10 violations for 2018 will be published in the December edition of the Council’s Safety+Health magazine.

*Preliminary figures as of Oct. 1, 2018

About the National Safety Council
The National Safety Council (nsc.org) is a nonprofit organization whose mission is to eliminate preventable deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy. Founded in 1913 and chartered by Congress, NSC advances this mission by partnering with businesses, government agencies, elected officials and the public in areas where we can make the most impact.

Trump Policies Bad for Workers’ Compensation

Dr. Richard Victor

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

Dr. Richard Victor, an economist who founded the Workers’ Compensation Research Institute (WCRI) 35 years ago, just presented a paper at the WCRI National Conference in Boston.  He indicated that federal policies on immigration and health insurance promise to make worse the challenges the United States faces by an aging workforce and a widespread labor shortage. He noted that workers’ compensation claims could double and overall costs could expand by over 300% in the next dozen years, without any increase in benefits to workers.  External forces could bring far more cases into the system because of a number of forces, including an aging workforce, labor shortage, slowdown in immigration, and more shifting to workers’ compensation claims that should be paid by group health insurance. Dr. Victor projected current claims out a dozen years to 2030 indicating that claims should actually be down to about ¾ of today’s numbers, but external factors will more than overtake that favorable percentage. Labor shortages caused by baby boomers retiring will increase injury rates.  Research indicates that the older workforce will mean an increase in lost work days and more injuries and a real impact on labor shortage as more baby boomers retire. Dr. Victor indicated “These labor shortages, which will be longer and deeper than anything we have experienced, will lead to significant increase in workers’ compensation claims and longer durations of disability.” During a period of labor shortages, employers relax hiring standards and hire workers they would not have hired in a normal labor market, including workers who are less capable. The overall labor shortfall leads to more workers’ compensation claims.

The Immigration Factor:

Economists have seen immigration as a factor that mitigates against the impact of the labor shortage. The Trump Administration, changing federal immigration policy, will further tighten labor markets and prolong the duration of a labor shortage. Moreover, Trump’s “anti-immigration rhetoric” also discourages people to come to America.  In health care, Victor noted that one in six health care workers is foreign-born including 27% of physicians and surgeons, 15% of nurses, and 22% of home health aide, each of which effects the workers’ compensation system.

Health Insurance

A shortage of people with adequate health insurance is also a problem for workers’ compensation. Health insurance deductibles have risen from the hundreds to many thousands of dollars, and this new reality causes more workers to go without or delay getting medical care for an injury or illness. When they can no longer ignore their condition, many claim it as a work-related condition and seek workers’ compensation (he cited a Rand Research study indicating workers with high deductible or co-insurance plan postponed care in over one-third of cases of the most common kind of workers’ compensation claims – soft tissue injuries.” As the number of workers who lose their insurance grows (since the Trump Administration and Congress ended subsidies and other aspects of the Affordable Care Act) case shifting form health insurance to workers’ compensation could have a major effect, ballooning workers’ compensation claims by as much as 35% in the next dozen years.

Victor’s conclusion: “You end up with a 300% increase in workers’ compensation costs without increasing benefits to injured workers.”

 

Q&A With Senior Partner Matt Funk: Mandatory Arbitration, Sexual Harassment Legislation, Scaffolding & More

Senior Partner Matt Funk

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

Matt Funk is the president of the New York State Trial Lawyers Association and is a senior partner at Pasternack Tilker Ziegler Walsh Stanton & Romano. The New York Law Journal recently asked Funk to share his opinions on the U.S. Supreme Court’s recent decision on employment contracts and new laws on sexual harassment and scaffold protection.

Q: Do you think the Supreme Court’s recent decision that employment agreements that ban class actions do not violate federal labor laws will have an impact on workers?

A: The Supreme Court decision is a blatant misinterpretation of labor rights that will ultimately harm workers across the country. Individual workers typically lack the resources to take on major corporations by themselves. Through class-action lawsuits, workers can join together to hold negligent employers and bad actors accountable.

By allowing employers to strip this fundamental right away from workers, the Supreme Court is forcing victims to take reported violations to paid third-party arbitrators, usually from an arbitration firm chosen by the employer, which creates a strong potential for bias. It removes the dispute-resolution mechanism from an independent court, and places it into the hands of decision-makers in the pockets of the accused party, making it difficult to hold employers responsible for misconduct and labor violations.

Q: When did mandatory arbitration clauses really become so entrenched in the agreements and contracts that consumers regularly encounter?

A: Mandatory arbitration clauses have their roots in the Federal Arbitration Act, a law passed in 1925 that granted businesses the ability to resolve disputes outside of the courtroom through third-party arbitrators. The law was designed for business-to-business transactions but over the past 30 to 40 years, the courts have made it easier for corporations to include these clauses in contracts where the individual consumer or employee has no real power to change the contract terms. Eventually, these clauses became par for the course, often cloaked in legalese unrecognizable to the untrained eye.

Consumers often overlook these clauses, unaware of how their rights are being limited until it’s too late to avoid them or take action. The only way to level the playing field, and make sure corporations take consumer safety seriously, is to ban mandatory arbitration clauses in employment and consumer contracts.

Q: What is the association’s reaction to recent sexual harassment legislation passed and signed into law in New York City?

A: The legislation is a major step in the right direction, at a critical moment in the fight for gender equality. Over the past year, women across the country have shared their experiences in the workplace, demonstrating how institutions have reinforced sexism to physically harm and intimidate women, discourage their ambitions, prevent career advancement, and create hostile workplaces.

The City Council recognized that it was imperative to do more than just listen—they needed to act and do something to change the status quo. The legislation will help ensure that all managers and employees are properly trained and educated, creating a foundation for institutional reform that reverberates across businesses and organizations of all stripes in New York City.

Q: I know the association has taken a position on the Scaffold Safety Law in New York. What are the concerns?

A: It’s no secret that construction work is one of the most dangerous jobs in New York. In 2016 alone, 71 construction workers in New York State died in on-the-job incidents, the highest total we’ve seen since 2002. The Scaffold Safety Law is a much-needed source of justice and accountability that is essential to protecting workers and making safety paramount.

Given the risks involved, it’s up to owners and general contractors who have ultimate control over the work site to create a secure working environment, by following safety guidelines and providing proper equipment. When owners and general contractors ignore basic rules and fail to provide adequate gear, they put workers at risk and create tragedies out of sheer negligence and disregard for their employees’ lives.

The Scaffold Safety Law offers workers and their families a way to hold negligent owners and general contractors accountable. In instances where workers are seriously injured or killed as a result of unsafe working conditions, their families are forced to take on the costs of lost wages, medical bills and other impacts that are not adequately covered by workers’ compensation, not to mention the physical and emotional pain that results. The Scaffold Safety Law can help mitigate the financial stresses and devastation facing victims and their families, while delivering them justice. At the same time, it insists that owners and contractors follow safety guidelines and promote worker safety so workers can return home to their families at the end of a hard day’s work.

Q: You’re nearing the end of your term as NYSTLA president. What achievements are you most proud of?

A: Over the last year, I’m particularly proud of NYSTLA’s leadership in expanding and strengthening the legal rights of everyday New Yorkers. Working with a broad network of affected residents and families, advocates, and legislators, NYSTLA has been able to achieve legislative and regulatory victories that deliver justice and practical, meaningful results.

In January, Lavern’s Law was enacted, establishing legal rights for patients harmed by negligent failure to diagnose cancer or a malignant tumor by changing the statute of limitations to reflect the date of discovery. And in 2017, legislation was passed that expands access to SUM auto insurance, promoting better insurance coverage for drivers. Elsewhere on the road, we successfully fought for the implementation of a regulatory framework for ride-share services that is the best in the nation when it comes to protecting consumers, including proper insurance coverage. Not to be forgotten, we also reinforced victims’ legal rights through a bill that allows lawsuits to proceed in the same county where the violation occurred. And, finally, as a workers’ compensation attorney, I am particularly proud of our success working with the labor movement to beat back harmful changes that were proposed that would have gutted the workers’ compensation system.

At the same time, NYSTLA has continued to help young lawyers develop professionally and gain the knowledge they need to make a significant impact through a continuing legal education program that has repeatedly been voted the best in the state.

We believe in leading by example, and our efforts this year serve as a reminder of how the legal community can make a difference on behalf of the public interest.

Recovering From Injurty – “Is Heroism the Standard?” Redux

Judge David B. Torrey

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

My friend and colleague, Professor and Judge David Torrey, with whom I serve on the Board of the College of Workers’ Compensation Lawyers, recently posted this blog in response to an insurance industry speaker’s exhortation that injured workers should “ get off their asses” and get better. Here’s his moving response:

Many in the workers’ compensation community complain that seriously injured workers can develop a disability lifestyle, become dependent on drugs, and unreasonably extend their disabilities. Instead of falling into such a lifestyle, these critics argue, disabled workers should show “resilience.” This rhetoric, which I have written about before on this blog, has its genesis in progressive medical/rehabilitation thinking, Muscular Christianity (I think), and, realistically, employer/insurer cost considerations.

The complaint is legitimate, and one with which I have some sympathy. I also believe that some legitimately injured workers do indeed unreasonably extend their disabilities — if only waiting for a generous lump sum settlement. Many readers will know of the sharp critique of this type advanced by Dr. Nortin Hadler in his many books.

On the other hand, the “duty-of-resilience” critique can go too far, and is often articulated in overly simplistic terms. At my agency’s conference in Hershey, Pennsylvania (June 7-8), an articulate industry speaker, addressing an audience about medical marijuana, posited forcefully that the “choice between opioids and medical marijuana [for chronic pain patients] is a false choice….” What workers need to do, instead, is show some resilience and “get off their asses!” After all, a friend of his, who is partially paraplegic, has shown resilience and will often go hiking with him. If she can do it, so can others!

I believe the speaker knew his audience and thus took some pleasure in feeding these lions of the community some red meat, and indeed they rewarded this coarse declaration with a leonine roar of applause.

Yet, his panel partner, Dr. Michael Wolk, thereupon gently reminded the industry speaker — and the audience — that not all people respond to pain and other impairments the same way; indeed, he posited that science has shown that one’s genetic make-up can affect the ability to be resilient.

Dr. Wolk (my God, an astonishing speaker) might also have remarked, as have other physicians at our Pennsylvania conferences, that heroism is not appropriately considered the recovery standard in the first place. Commentators like the industry speaker, talking about resilience, often invoke exceptional individuals, like Christopher Reeve, but most of us realize that not everyone is Superman.

This point was vividly made two years ago in the memoir, A Body Undone: Living on After Great Pain (NYU Press 2016). The author, Christina Crosby, a professor at Wesleyan University, was rendered quadriplegic in a cycling accident, and has been left with chronic pain as well. She recounts in her memoir what life is like with such a catastrophic injury, shows that she indeed has great resilience — but leaves the heroism narrative behind. She makes clear that her circumstances, like education; a life of reflection and discipline; and the unflagging love and support of her family, make her ability to bounce back possible. Most of us know that not every injury victim will have these advantages. (My complete review of Professor Crosby’s book is posted at the research website www.davetorrey.info.)

Is all this not common sense? We have known for a century, after all, that young men respond differently to their traumatic wartime exposures. Some show a grim resilience; some are troubled for life, but are able to continue on; some are broken. In the modern day, most of us would not address such veterans with the admonition that they get off their asses. Injured workers deserve the same respect.

 

Improper Body Mechanics While Lifting Far From Only Cause Of Nursing Injuries

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

A commenter on our firm’s Facebook page stated the use of proper body mechanics will prevent nurses from getting injured. There is some truth to that statement, but there are many ways, probably not limited to this list, that nurses can get injured that aren’t related to lifting at all. Here a few I’ve encountered recently:

  1. Inadequate staffing – There is a strong correlation between staffing levels and nursing injuries. Nurses, especially CNAs, may be forced to lift or move patients on their own because of inadequate staffing or lack of equipment. Nurses may also be forced to prevent patients from suddenly falling. Use of proper lifting techniques may not be possible in such situations.
  2. Patient attacks – Studies show patient attacks on nurses are on upswing. I see a lot of this in nurses that work in mental or behavioral health.  Even they aren’t nurses, many direct care workers and human services technicians who work in mental and behavioral health are vulnerable to patient or client attack. It’s hard to argue a patient attack is the fault of the nurse
  3. Slips and falls – Slip and falls are a common type of work injury. I represented a nurse working at a dialysis clinic who injured their back when they slipped in pool of urine.
  4. Environmental and chemical exposures – In rural areas, many nursing or medical facilities are in older buildings that are vulnerable to mold and other environmental exposure. If you work in a sick building, it’s hard to argue that’s your fault.

Even if you use proper technique, repetitive heavy lifting can still cause strain and can be disabling in some instances. Nursing personnel are particularly vulnerable to these types of injuries.

I want to make one thing crystal clear: whether a nurse or any other employee is injured because of improper lifting technique THOSE INJURIES ARE STILL COVERED BY WORKERS COMPENSATION! (most of the time) In exchange for no-fault compensation, employees give up the right to sue their employer for negligence. While this might not seem like a grand bargain to a worker who was hurt to no fault of their own, that compromise is the cornerstone of workers compensation.

While the idea of no-fault compensation for work injuries is a winner in a court of law, the idea is more controversial in the court of public opinion as expressed on social media. There is an idea out there that filing a workers’ compensation claim is “milking the system” and that you certainly shouldn’t file a claim if you are at-fault for the injury. Statements that nursing injuries can be avoided, if nurses just use proper lifting techniques is consistent with that line of thinking.

A lot of hostility to those who bring work injury claims and their attorneys stems from concepts like “personal responsibility.” But when a nurse is hurt on the job because of understaffing, slipping on urine on the floor or a toxic building, the employee isn’t fully able to hold their employer responsible for the full extent of their harms even if the employer is fully responsible for the harm.

There is also the assumption that workers compensation claims are fraudulent. But would it be fair to assume that all nursing homes defraud Medicare and Medicaid just because one chain of homes in Florida defrauded the government $1 billion? No, it wouldn’t and the same is true for workers’ compensation claims. Ultimately entitlement to workers’ compensation benefits is determined in court where employees are subject to medical examination from doctors picked by insurance companies. Injured workers are also subject to written and oral questioning from insurance company lawyers. Employees usually have formidable barriers to win compensation in a disputed workers’ compensation case, so the idea that fraudulent claims run rampant is absurd.