Author Archives: Matthew Funk

Take Someone to the Doctor with You

Today’s post comes from Jon Rehm of 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.

Prior results do not guarantee outcomes.
Attorney Advertising.

“Mental-Mental” Worker’s Comp Claims Following Connecticut School Shooting Injuries

Connecticut’s workers compensation law does not currently cover mental injuries which do not stem from a physical injury.

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

Following the Connecticut school shootings, unions representing police and firefighters and school employees have held discussions about laws to expand situations under which worker’s comp benefits would be available for mental health issues. Connecticut worker’s compensation law does not provide for “Mental-Mental” claims, which are claims for psychological disabilities that do not stem from an original physical injury. Police officers, firefighters, and school officials do not meet the requirements of Connecticut’s Statute for psychological counseling or time lost benefits in the event they are unable to work because of psychological disability in the wake of the shootings.

Since the mid-1970s Wisconsin has recognized non-traumatic mental injury (“Mental-Mental”) in worker’s compensation. Before 1974, compensable mental injuries were limited to post-traumatic injuries, mental disorders occurring after and due to a physical accident. The statute then defined injury as “mental or physical harm to an employee caused by accident.”

The Wisconsin Supreme Court set a new “Extraordinary Stress” standard for compensability, indicating if the mental injury resulted from situation of greater dimensions than the day to day stress, which all employees must experience, benefits and medical expenses could be paid. Continue reading →

Prior results do not guarantee outcomes.
Attorney Advertising.

Private Investigators in Workers’ Compensation

Corporations sometimes hire private investigators to verify that your claim is not fraud

Today’s post comes from guest author Leonard Jernigan of North Carolina.

As a workers’ compensation attorney I find it interesting that many people in the public question the disability status of injured workers. Let’s assume for the moment that you have sustained an injury on the job and you’ve been out of work for 5 months after back surgery. When you are unable to return to work quickly, the insurance industry has a lot of tools at its disposal to verify your disability status. They can pour over your medical records, pre- and post-injury, looking for any piece of evidence to deny your claim. They can send your file to lawyers who review medical records and recorded statements to potentially attack your credibility and honesty. They can hire a nurse to attend your appointments and speak with the physician and the staff, as well as obtain information directly from you. They can do background searches on you to see if you have a criminal or civil record. Obviously they will check to see if you ever filed a workers’ compensation claim before. They will also do social media and Internet searches on you and your family members (Facebook, Twitter, LinkedIn, etc.). They also can hire private investigators to follow you and your family around and take video recordings of your activities. With all these resources at the disposal of the insurance company, it’s hard to believe that many cases of employee fraud slip through the system.

A private investigator pretended to be a potential buyer and spent an hour or more going through the house.

We have one client recently who was followed by several private detectives for more than a year. They not only followed him around, but also followed his wife and son, who have no workers’ compensation claim. Another client had to sell his house because of his disability. A private investigator pretended to be a potential buyer and spent an hour or more going through the house. Does the concept of “Big Brother” come to mind? Are you concerned about invasion of privacy, particularly for family members, friends, and others who may be seen in such videos? We always tell our clients such activity may occur so don’t be alarmed by it, but that isn’t too comforting to people who are struggling through health issues, who have depression and anxiety problems, and who are sensitive to privacy concerns.

It would be interesting if the roles were reversed and employers who underpay premiums by misclassifying the status of their employees, who fail to purchase insurance required to protect their workers, and who don’t follow proper safety regulations that cause injury, were followed this closely by employees or regulators who administer the workers’ compensation program. I have no doubt that these employers and insurance representatives would be outraged.

Prior results do not guarantee outcomes.
Attorney Advertising.

Workplace Violence and Sandy Hook Elementary School

Today’s post comes from guest author Kristina Brown Thompson from The Jernigan Law Firm.

In light of the horrific elementary school shootings in Newtown, Connecticut last week it may be time to re-evaluate workplace violence, which seems to be increasing at an alarming rate. Technically, workplace violence is any act where an employee is abused, threatened, intimidated, or assaulted in the workplace. It can include threats, harassment, and verbal abuse, as well as physical attacks by someone with an assault rifle.

Two million American workers are victims of workplace violence every year. What’s worse is that workplace violence is one of the leading causes of job-related deaths in the United States. Last year, for example, one in every five fatal work injuries was attributed not to accidents but to workplace violence, and some employees are at an increased risk for harm. For example, employees who work with the public or who handle money are more at risk (i.e. bank tellers, pizza delivery drivers, or social workers). According to the 2011 Census of Fatal Occupational Injuries by the U.S. Dept. of Labor, robbers were found to be the assailants in almost a third of homicide/workplace violence cases involving men, whereas female workers were more likely to be attacked by a relative (i.e. former spouse or partner) while at work.

Preventing workplace violence is a challenging task and OSHA advises employers to create a Workplace Violence Prevention Program. Creating a safe perimeter for employees is crucial. Likewise, having an emergency protocol in place should reduce the number of fatalities in an attack, and that’s exactly what happened at the Sandy Hook Elementary School in Connecticut when the school’s protocol saved the lives of many children.

Prior results do not guarantee outcomes.
Attorney Advertising.

Can Cell Phones Cause Cancer (On The Job)?

An Italian court ruled that excessive mobile phone use can cause cancer.

Today’s post comes to us from Thomas Domer of Wisconsin. New York’s standard for an occupational disease claim is very similar to Wisconsin’s in that an occupational disease must be caused by a recognizable link to the employee’s occupation. The harmful condition (cancer here) must have been caused by some aspect of the employment to be compensable.

An Italian court ruled that excessive mobile phone use can cause cancer. Italy’s Supreme Court upheld a ruling linking a business executive’s brain tumor and excessive mobile phone use. While much of the scientific opinion generally suggests there is not enough evidence to declare such a link, those studies were co-financed by the same companies that produce mobile telephones. The evidence in the Italian case was based on studies conducted between 2005 and 2009 by a group led by Dr. Lennart Hardell, cancer specialist at the University Hospital in Orebro in Sweden. The Italian court, relying on this research, noted this was independent research unlike other research financed by mobile telephone companies. The business executive Innocenzo Marcolini developed a tumor in the left side of his head after using his mobile telephone for 5 to 6 hours a day for a dozen years. He usually held the phone in his left hand while taking notes with his right hand. He developed a “neurinoma” which affected his cranial nerve, and sought worker’s compensation from the Italian Worker’s Compensation Authority. The initial application was rejected because of a lack of proof but a court in Brescia later ruled there was a causal link between the use of mobile and cordless telephones and tumors.

Wisconsin provides benefits for an employee’s death or disability due to a cancerous condition if causally related to work exposure to carcinogens. There are numerous potential cancer causing agents in the workplace, but none so far have been linked to cell phone use. The causation standard is straightforward in Wisconsin. If the patient suffers from a condition caused by an “appreciable period of workplace exposure” the physicians are asked whether that exposure was either the sole cause of the condition or at least a material, contributory, causative factor in the condition’s onset or progression. This Italian court case suggests a further inquiry into the subject may be appropriate.

Prior results do not guarantee outcomes.
Attorney Advertising.

The Costs and Complications of The Other Disease on Workers’ Compensation Claims

Source: NCCI

Today’s guest post comes to us from Jon Gelman of New Jersey.

Employers and their insurance companies are responsible for the treatment of all medical conditions that arise from an industrial accident or exposure. A recent study published by NCCI concludes that costs are soaring as medical conditions become more complicated by other conditions known as comorbidity diagnoses. These conditions are frequently: obesity, hypertension, drug abuse, chronic pulmonary conditions and diabetes.

“While the average medical cost for a workers compensation claim is approximately $6,000, the medical cost of an individual claim can be a few hundred dollars or millions of dollars. In 2010, an NCCI study found that claims with an obesity comorbidity diagnosis incurred significantly higher medical costs than comparable claims without such a comorbidity diagnosis. Relative to that study, this study expands the number of comorbidities examined and provides additional information on both the types of claimants receiving comorbidity diagnoses and the types of providers submitting comorbidity diagnoses.”

KEY FINDINGS

The share of workers compensation claims with a comorbidity diagnosis nearly tripled from Accident Year1 2000 to Accident Year 2009, growing from a share of 2.4% to 6.6%Claims with a comorbidity diagnosis have about twice the medical costs of otherwise comparable claims
Comorbidity diagnoses for hypertension are the most prevalent of those investigated
The initial comorbidity diagnosis tends to occur early in the life of a claim
Hospital and physician visits account for a majority of visits resulting in a recorded comorbidity diagnosis
Only a small portion of visits result in the recording of a comorbidity diagnosis

View complete report: Comorbidities in Workers Compensation

Prior results do not guarantee outcomes.
Attorney Advertising.

Workers' Law Watch

Published by Pasternack Tilker Ziegler Walsh Stanton & Romano LLP

Published by:

Author Archives: Matthew Funk

Take Someone to the Doctor with You

“Mental-Mental” Worker’s Comp Claims Following Connecticut School Shooting Injuries

Private Investigators in Workers’ Compensation

Workplace Violence and Sandy Hook Elementary School

Can Cell Phones Cause Cancer (On The Job)?

The Costs and Complications of The Other Disease on Workers’ Compensation Claims