Category Archives: Workers’ Compensation

“Reform” Warning – Governor Cuomo’s Proposed Budget Reduces Workers’ Compensation Benefits

Recently Governor Cuomo delivered his State of the State address for 2016. I heard the live telecast and noticed that many of the proposals in the budget are positive and beneficial to working class people, including allocating an additional $2.1 billion in school funding; rebuilding the infrastructure to improve roads and mass transportation; increasing the minimum wage to $15 per hour; and bolstering public safety. In reviewing the actual budget proposal itself, however, there appears to be amendments to the Workers’ Compensation system that will not benefit injured workers and their families.

In order to understand the so-called “reforms” on workers, you need the historical perspective. Prior to the enacting of state Workers’ Compensation statutes, simply put, workers were allowed to sue their employers for negligence. In the early 20th century, spurred on by social reformers and the tragedy of the Triangle Shirtwaist Factory Fire that killed almost 150 women and girls, laws were enacted to protect workers. Known as the “great compromise,” workers gave up the right to sue their employers in exchange for timely payment of medical and indemnity benefits. For much of that century, Workers’ Compensation laws were expansive and assisted injured workers in getting treatment so they could eventually return to work or receive ongoing benefits in the event they could not.

Today most states have seen changes where the concept of medical treatment and wage replacement for injured workers is being substantially eroded. This agenda to reduce benefits to the injured worker has been part of a nationwide effort starting more than 20 years ago by the Business Council (aka the Insurance Industry). Their agenda was put into effect almost nine years ago here in New York when workers gave up many benefits under the guise of “reform.” These included a reduction in the amount of wage replacement injured workers receive and a limitation on medical treatment in exchange for increasing the weekly benefits more in line with the state average.

Now the Business Council is back to further chip away at injured worker benefits. It has put together a wish list in hopes of further reducing medical benefits and monetary benefits to injured workers who should be able to rely on their treating doctors to determine the best course of treatment. However, one of their proposals is that treatment would be determined by a “panel” for the first 90 days of treatment. This panel, of course, would not include a doctor of the injured workers’ choice, but would be determined by the insurance company for the employer.

Additionally, the Council is proposing a cap on benefits based upon a fixed timeframe as opposed to when injured workers finish their treatment and/or surgical procedures. These measures are being proposed strictly based upon the cost savings realized by the insurance industry and have nothing to do with compensating injured workers or ensuring them of the best treatment available for their particular injury. What this will do, in essence, is shift the cost of medical treatment and wage replacement to other sources such as federal programs and state programs that are paid for by the tax payer instead of the employer’s insurance company. This will ensure continued growth in profits for the insurance industry at the expense of injured workers and their families.

Governor Cuomo’s budget proposal contains some of the Business Council’s “wish list,” but thankfully not everything – at least not yet. Please contact the Governor, your State Senator or Assembly Person and tell them that our rights and benefits should never be negotiated away. Workers are the backbone of this country. They have built this nation and rebuilt New York. We must ensure they are taken care of when they get hurt.

 

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.

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Action Needed To Ensure Sick 9/11 First Responders Receive Benefits

Animal Control Officer Diane DiGiacomo

A couple weeks ago, the Workers’ Compensation community was stunned over the outcome of the case of Animal Control Officer Diane DiGiacomo who developed cancer from exposure to toxins in the air after 9/11. Diane’s job was to search for and rescue pets near Ground Zero when many of the buildings surrounding the area were either evacuated or abandoned for weeks after the terrorist attack. 

Diane had filed a Workers’ Compensation claim after being diagnosed with breast cancer that had metastasized to her brain. The judge ruled that she was not entitled to New York State Workers’ Compensation benefits because she had not filed a timely claim. At the time of the ruling, Diane was bedridden and weighed a mere 60 pounds. Tragically, four days after the decision, she died as a result of her cancer. While my firm did not represent her, Diane’s tragic story touched many of us in the industry, whether as advocates for the injured worker or as defense counsel. What makes this case particularly sad is that the judge noted it was clear from the medical evidence that the cancer developed at least in part due to her exposure to the toxins in the air. Unfortunately, Diane was not entitled to Workers’ Compensation benefits because the deadline to register had passed.   

In order to be able to obtain Workers’ Compensation benefits for exposure after the 9/11 attacks, those who participated in the rescue, recovery, and clean up operations had to file a TWC-12 registration form prior to the current deadline of September 11, 2014. You did not have to actually be sick to file this form, but it preserved your rights if you worked in the area to file a claim later if you were found to be sick. It should be noted that the deadline has been extended twice because many of the illnesses such as cancer are slow starting and do not manifest themselves until many years after final exposure to toxins. The New York State Legislature has not extended this deadline again, at least as of this date.  

Officer DiGiacomo did not file her claim until sometime after September 11, 2014, because she was not actually diagnosed with cancer until after this date. According to the New York State Workers’ Compensation Board website, as of September 11, 2011, there were close to 49,000 WTC- 12 forms filed; however, hundreds or even thousands more may have been at the site doing rescue, recovery, and clean up and have not registered precisely because they were not sick as of the deadline or they didn’t know they had 9/11-related medical conditions. Perhaps it was based on their lack of understanding of the law or the opinion of some that they did not want to register because they somehow felt they would be taking benefits away from those who were already ill. Whatever the reason, it is imperative that the deadline once again be extended so that those who are currently ill, or become ill, have the full protection of the law.  

A bill introduced in the New York State Assembly by Assemblyman Peter J. Abbate, Jr., and co-sponsored by Assemblyman Phillip Goldfeder to extend the deadline to September 11, 2017, is still sitting in Committee. While Officer DiGiacomo did not live long enough to see the deadline extended, it is not too late to compensate her son and the rest of her family. Let’s make sure that those who helped get our city back on its feet are not forgotten.

 

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.

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Call “Reform” What It Is: Death By A Thousand Cuts For Workers’ Rights

This week I attended the 20th anniversary of the Workers’ Injury Law and Advocacy Group (WILG) in Chicago. I am a proud past president of this group – the only national Workers’ Compensation bar association dedicated to representing injured workers.  

As an attorney who has represented injured workers for more than 25 years, I have seen their rights and benefits shrink under the guise of “reform”. After the tragic Triangle Shirtwaist Factory fire in 1911, which killed almost 150 women and girls, workplace safety and Workers’ Compensation laws were enacted. For the next half century or so, many protections and safeguards were implemented. However, many of these reforms were not sufficient, and in 1972, the National Commission on State Workmen’s Compensation Laws, appointed by then-President Nixon, issued a report noting that state Workers’ Compensation laws were neither adequate nor equitable. This led to a decade when most states significantly improved their laws. 

Unfortunately, there has once more been a steady decline in benefits to injured workers, again under the guise of reform. One major argument is that many workers are faking their injuries or they just want to take time off from work. There was even a recent ad campaign in which a young girl was crying because her father was going to jail for faking an injury. Workers’ Compensation fraud does exist, but the high cost of insurance fraud is not as a result of workers committing fraud.

A colleague of mine compiled a list of the top 10 Workers’ Compensation fraud cases in 2014 in which he noted that the top 10 claims of fraud cost taxpayers well more than $75 million dollars with $450,000 of the total amount resulting from a worker committing insurance fraud. That leaves $74.8 million as a result of non-employee fraud, including overbilling and misclassification of workers. We are told that insurance costs are too high; yet, according to the National Council on Compensation Insurance (NCCI) in 2014, estimates show that private Workers’ Compensation carriers will have pulled in $39.3 billion in written premiums, the highest since they began keeping data in 1990. More premiums result in higher net profits. Despite this, many states have implemented changes in their Workers’ Compensation systems aimed at reducing costs to the employer. The end results, however, is that fewer benefits are given to the injured worker and more profits go to the insurance companies.

In New York, one of the reform measures increased the amount of money per week to injured workers but limited the amount of weeks they can receive these benefits with the idea that they will return to work once their benefits run out. Additionally, limitations have been placed on the amount and types of treatment that injured workers may receive. Again, this is with the notion that once treatment ends, injured workers miraculously are healed and will not need additional treatment. In reality, those injured who can’t return to work receive benefits from other sources from state and federal governments at the taxpayer’s expense.  This is what is known as cost shifting, as those really responsible to pay for benefits – the insurance companies who collect the premiums from the employers – have no further liability. The reformers of 100 years ago would be appalled at what is happening to injured workers and their families today. It is time that those who are generating profits at the expense of injured workers do what is fair and just – provide prompt medical care and wage replacement to injured workers for as long as they are unable to work.

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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.

 

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Creative Legal Argument Leads To An Award of Lifetime Diability Benefits

Good lawyering requires both creativity and a deep knowledge of the law. Last week I obtained a ruling of Permanent Total Disability for a client. The ruling entitles her to much-deserved lifetime weekly compensation benefits. This is especially important because in 2007 the Workers Compensation Law was changed to put limits on the time period for which you can receive benefits. There is now a 10-year limit on benefit duration unless you had a 100% Medicial Disability or a 100% Loss of Wage Earning Capacity (ability to work and earn money).

My client is a 55 year-old woman with a severe back condition. All of the doctors she consulted with conculded that she has a 60% medical disability. Most attorneys would have accepted that rating as is, entitling her to just 350 weeks of compensation benefits. But that would have been the wrong outcome.

Because of my client’s educational level and work experience, I knew that she was entitled to more. She only has a high school education and does not know how to use a computer. My client has never worked in any other position other than house cleaning.

All of the doctors who testified conceded that my client’s injury prevented her from doing her job – the work of a house cleaner. In fact, they all conceded that she could not do any type of physical labor. I then took my client’s testimony and established her lack of transferrable skills, focusing on her education and work experience. In essence I showed that there was no other work that she could successfully perform.

The judge agreed with my argument — my client has only a 60% Medical Disability, but has a 100% loss of her Wage Earning Capacity. The judge awarded my client Total Disability benefits, which allowed an award of a lifetime of benefits, not just a 10-year benefit period. This was a huge, and much-deserved, victory for my client.

When representing clients it is important to know your client and to know their background. This is how we practice. We strive to obtain the best outcome for out clients by knowing them, knowing the law and knowing how to obtain the maximum benefits for them.

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Understanding The Legionnaires’ Disease Outbreak

Most of us have heard the frightening statistics regarding the recent outbreak of Legionnaires’ disease in the Bronx.  As of this date, 12 people have died and more than 120 additional cases have been reported.   But what exactly is this mysterious malady affecting so many at one time and what are its causes?  

Legionnaires’ disease is a common name for a type of pneumonia caused by breathing in water mist containing the bacteria. It was named after a 1976 outbreak in Philadelphia during an American Legion convention that killed more than 30 people and sickened almost 200 more. Most of us rarely hear about this disease unless it is part of a large outbreak, but according to the Centers for Disease Control, anywhere from 8,000-18,000 people are hospitalized each year in the U.S. as a result of Legionnaires’.  The current outbreak in the Bronx seems to point to the building’s cooling towers that are used as part of their air conditioning, ventilation, and heating systems, but the bacteria can be found in almost any warm water system or device that disperses water including humidifiers, spas and whirlpools, and dental water lines. The disease is not contagious and can only be caused by breathing in the bacteria- laden vapor. 

The New York Committee for Occupational Safety and Health (NYCOSH) has put out a fact sheet for workers and unions. Workers performing routine maintenance on or in cooling towers and other water systems may need to wear respiratory protection. The Occupational Safety and Health Administration (OSHA) requires the employer to determine hazards and provide training programs if the use of a protective device is required. Additionally, there are recommendations regarding assessment of work sites for potential Legionnaires’ disease. Cooling towers should be regularly maintained and cleaned with the use of chlorine and unused water lines should be frequently flushed.

In this recent Bronx outbreak, the New York City Health Commissioner issued an order to all owners of buildings with cooling towers to disinfect all of them within 14 days of receiving the order and keep records of the inspection and disinfection. Those workers with the task of cleaning and decontaminating the towers are advised to wear protective respirators as well as rubber gloves, goggles, and protective clothing. 

Every worker is entitled to a safe work place. According to NYCOSH, certain groups of workers are at increased risk of exposure to Legionnaires’ disease, including those who maintain, clean, decontaminate, or work in close proximity to water systems and system components such as cooling towers, evaporative condensers, humidifiers, potable water heaters and holding tanks and pipes that may contain stagnant warm water.

Workers should be aware of Legionnaires’ disease symptoms, which include fever, headache, joint aches, and fatigue, that can deteriorate into difficulty breathing, chills, chest pain, and gastrointestinal symptoms. As Legionnaires’ is a type of pneumonia, it can be diagnosed with a chest x-ray and lab tests to confirm the bacteria. While most in the Bronx outbreak who died had a compromised immune system, early treatment with antibiotics can lessen the symptoms and improve the changes of recovery. 

  

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.   

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We’re Having A Worldwide Heat Wave: How You Can Stay Safe

A few weeks ago, I read about a crisis occurring in Pakistan and India. In Pakistan, a week-long heatwave killed more than 1,200 people and in India, the heat killed close to 2,200. Tens of thousands more were treated at area hospitals for heatstroke. It appears that the combination of prolonged temperatures above 100 degrees combined with power outages had a devastating impact on people.

As I read the news while sitting in the comfort of my air conditioned home, I thought briefly about the fact that we are all so lucky that events such as this rarely happen in this country. We have the resources and the alternatives available if we lose power or if we don’t have air conditioning during a heat wave. The City regularly opens up cooling centers or keeps City pools open longer so that residents are able to combat some of the more severe heat of the day.  However, not all of us are lucky enough to work inside where it is cool or engage in work activity that is not strenuous. What about those who work outside, or do heavy labor without the benefit of air conditioning? How do they protect themselves from the extreme heat that may be a part of their everyday work?

I was surprised to find out that each year, hundreds of people die due to heat-related illnesses and thousands more become ill. Outdoor workers are particularly vulnerable to heat stress.  According to the U.S. Department of Labor Blog, thousands of employees become sick each year and many die from working in the heat. In 2012, there were 31 heat-related worker deaths and 4,120 heat-related worker illnesses. Labor-intensive activities in hot weather can raise body temperatures beyond the level that normally can be cooled by sweating. Heat illness initially may manifest as heat rash or heat cramps, but can quickly escalate to heat stroke if precautions aren’t taken.

I am always surprised when I see firefighters on days with extreme heat fighting fires or see construction workers, road workers, or landscapers outside in the day-time heat engaged in strenuous physical. I often wonder how they are able to work without collapsing. The answer is that many of these workers become used to the extreme heat and are acclimated to it. Heat illness disproportionately affects those who have are not used to working in such extreme temperatures, such as new or temporary workers.

The Occupational Safety and Health Administration has a campaign to prevent heat illness in outdoor workers. It recommends providing workers with water, rest, and shade, and for them to wear light colored clothing and a hat if possible. OSHA advises that new workers or workers returning from vacation should be exposed to the heat gradually so their bodies have a chance to adapt. However, even the best precautions sometimes cannot prevent heat-related illness.   According to WebMD, signs of heat exhaustion include fatigue, headaches, excessive sweating, extreme thirst, and hot skin. If you have signs of heat exhaustion, get out of the heat, rest, and drink plenty of water. Severe heat illness can result in heat stroke. Symptoms of heat stroke include convulsions, confusion, shortness of breath, decreased sweating, and rapid heart rate, and can be fatal, so please be aware and seek immediate medical attention if you have any of these symptoms.      

For those who work outside in the boiling heat, heat illness can be prevented. However it can also kill so please be careful and remember – water, rest, and shade. 

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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.   

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Workers Can’t Wait to Cash In?

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

It’s not uncommon in the workers’ compensation arena that we hear allegations of malingering or workers being hurt on purpose to reap the monetary rewards of a work injury. Some employers refuse to settle a case as long as the worker is still employed by the company, fearing a large monetary settlement will encourage other workers to get injured.  The limited benefits of a workers’ compensation claim make these assertions ridiculous.  Specifically, no benefits are paid for the pain and suffering.  Additionally, the reality is that many states compensate a permanent injury for only a matter of weeks or years.  The worker and his or her family are left to deal with the ongoing effects of these injuries for the balance of their lifetime. 

The Insurance Journal listed the top 10 leading causes “of serious, nonfatal workplace injuries” from “2012 claims data for injuries lasting six or more days and ranked the injuries by total workers’ compensation costs,” according to a recent article.

Not surprisingly, horseplay or purposefully getting injured was not among them. In fact, the leading cause of workplace injuries is ironically enough – overexertion! Overexertion and other exertion-related injuries made up almost a third of all workplace injuries. So much for the theory of money-hungry workers playing around or purposefully getting injured. Falls comprise two of the top 10 leading causes of workplace injuries, making up a total of just over 24 percent of all injuries.  Being struck by or striking objects combined for around 15 percent. Motor vehicle accidents (5.3 percent) and repetitive movements (3.1 percent) round out the top 10 list. The full list is detailed below. In total, the 10 most common work injuries accounted for almost 84 percent of all injuries.     

  1. Overexertion 25.3 percent
  2. Falls on same level 15.4 percent
  3. Struck by object or equipment 8.9 percent
  4. Falls to lower level 8.6 percent
  5. Other exertions or bodily reactions 7.2 percent
  6. Roadway incidents 5.3 percent
  7. Slip or trip without fall 3.6 percent
  8. Caught in or by equipment or objects 3.5 percent
  9. Repetitive motions 3.1 percent
  10. Struck against object or equipment 2.9 percent

The Occupational Safety and Health Administration (OSHA) reports that workplace deaths have decreased from 38 per day in 1970 to 12 per day in 2012, according to the article. Additionally, OSHA reports occupational injury and illness rates have declined 67 percent since 1970, all while employment has almost doubled.

Despite these accomplishments, insurance companies and large employers continue to lobby state legislatures about the injustice and cost of workers’ compensation benefits. In reality, workers and their families continue to bear the real burdens of workplace injuries.

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OSHA Reports that Cost of Work-related Injuries are Shifting to Employees

Today’s post comes from guest author Leonard Jernigan, from The Jernigan Law Firm.

Many decades ago, OSHA created workplace safety standards to help employees avoid injuries from dangerous working conditions. Despite these standards, each year more than 3 million workers are seriously injured or killed while on the job. Because Workers’ Compensation fails to cover all the costs of injury, some low-wage workers (who have a disproportionate rate of injury and have more hazardous occupations than other workers) are slipping below the poverty line ($24,250 for a family of four), and the financial burden of work-related injuries is shifting from those who created the unsafe work environment to the families and workers who are injured. In 2012 alone work-related injuries and deaths cost $198 billion, according to the National Safety Council.

According to a recent report by OSHA, Workers’ Compensation only covers about 21% of lost wages and medical costs, so injured workers and their private insurance policies are then forced to cover on average 63% of the injured worker’s medical bills. Taxpayers are picking up the final 16% of work-related injury costs.

The solution to this inequality is for companies to create a workplace that prevents injuries and illnesses from occurring in the first place. OSHA believes that the reason for the majority of work-related injuries and fatalities is due to a combination of the misclassification of employees as independent contractors, the rising usage of temporary workers, and workers from different companies that are forced to work together at the same jobsite despite differences in training.  About 4,500 workers are killed on the job every year according to the Bureau of Labor Statistics. Three million serious occupational injuries and illnesses are reported annually and OSHA suspects that this figure is only a fraction of the unreported number of injuries and fatalities on the job.

Read more about the cost of failing to protect workers here: http://1.usa.gov/1zJOFCC

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