Why CNAs and Home Health Aides Should Care about the Fight over a Federal Regulation

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

A U.S. District Court in Washington, D.C., recently struck down a federal regulation that would mandate that home health aides are paid the minimum wage and paid overtime under the federal Fair Labor Standards Act (FLSA). Though the decision will likely be appealed, this decision is still a bad decision for the men and women who do the hardest jobs in health care – home health aides and certified nursing assistants.

Why home health aides aren’t covered by federal wage laws

Home health aides were exempted from the FLSA 40 years ago in order to make caring for the elderly less expensive. However, companion care has become a big and very profitable business. An index of publically traded home-health-care stocks has consistently outperformed the stock market as a whole for the last 13 years. This profitably is due in part to the minimum wage and overtime exemptions for home health aides.

How the home health exception affects other jobs in the medical field

The federal government estimates that nearly 1 million are employed as home health aides, while private sources estimate that number as 2 million. Home health is also a fast-growing field of employment. Home health aides essentially have the same job duties as certified nursing assistants (CNAs). CNAs are generally covered by minimum wage and overtime laws, but workers with the same skills and same duties are exempt from those laws if they are working as home health aides. CNA wages are pushed down by home health aide wages, which are exempt from federal wage laws.

Why pay is about more than wages

A recent study of CNAs showed that nearly 60 percent of CNAs report injuries during a 12-month period. The injury rate is similar for home health aides. The study also showed that higher-paid CNAs were injured less frequently than lower-paid CNAs. The study indicated that organizational factors really drove injury rates among CNAs. In other words, in settings where CNAs are truly valued, paid fairly and trained, the injury rates are lower. But if CNAs are treated as low-wage, high-turnover cogs in a machine, then injury rates are higher. Low pay for CNAs and home health aides isn’t just an issue for employees. Low pay for home health aides and CNAs has been linked to poor patient care.

While the Obama administration has been criticized for being too aggressive in enforcing the FLSA, the U.S. Department of Labor announced that they will delay enforcement of the home health aide regulation until July 2015. This assumes courts will let the Department of Labor actually enforce the regulation. Anyone concerned about this issue should contact their members of Congress to support legislation that ends the home health aide exception. People should also contact their state legislators to support legislation that would ensure that home health aides are covered by state wage and hour laws.

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Facebook Postings Hurt Workers’ Compensation Claims

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

While Facebook is extremely popular and used by over a billion people every day, no Facebook posting has ever helped an injured worker in a workers’ compensation claim. On the contrary, use of a Facebook page poses real dangers for injured workers pursuing workers’ compensation benefits.

Since Facebook is a public site, anything posted can be used by respondent insurance companies in claims denial. Even the most benign postings (birthday parties, family gatherings, etc.) can pose problems. For example, a grandparent lifting a 30 pound grandchild when doctors have imposed a 10 pound lifting limit could damage a claim. Additionally, nothing prevents an Administrative Law Judge from looking at a Facebook page.  Even innocent posts may be subject to misinterpretation. A picture of the worker riding a motorcycle or fishing taken prior to the injury but posted afterward could place the seed of doubt in an ALJ’s mind that the worker is not as limited as he claims. The best advice is to be extremely careful about what is posted because “friends” are not the only one who can access your Facebook page.

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Deadliest Jobs in the U.S.

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

According to the Bureau of Labor Statistics, lumberjacks, fishermen and pilots have the highest risk of death while working. Data collected in 2013 showed that for every 100,000 loggers over 80 were killed on the job; for every 100,000 fishermen over 60 were killed on the job; for every 100,000 pilots and flight engineers over 40 were killed on the job.

The rest of the top ten most dangers jobs (in order from greatest to least number of deaths on the job) are:

  1. extraction workers,
  2. roofers,
  3. refuse and recyclable material collectors,
  4. mining machine operators,
  5. driver/sales workers and truck drivers,
  6. farmers/ranchers, and
  7. electrical power-line installers and repairers.

Transportation accidents, falling, being struck by an object or equipment, and homicides are the most likely cause of fatalities. In the homicide category, cab drivers have the greatest risk, primarily because they are not properly trained to handle assaults.

Original post in the 1/28/215 Washington Post by Max Ehrenfreund

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Avoid the Pitfalls of Auto-Pay Agreements

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

Many of my clients tell me, with fear in their voice, that they have one or more bills set to automatically pull from their bank accounts, but they have no money in the bank to cover the payment and will face overdraft charges if the payment pulls from their account.  Typically, these are car payments, as many auto loan lenders offer lower rates if the purchaser agrees to set up automatic payments.  Some businesses, like your local gym, may require auto-pay agreements. It seems like a good idea, when one is working.

Add an injury or disability into the mix, though, and it can become your worst nightmare.  Even under the best circumstances, an injured worker that is receiving their time loss compensation benefits – often 60 – 65% of pre-injury wages, or a much smaller percentage if they were a high wage earner and have hit the ceiling of compensation rates – will most certainly not be getting paid on the same schedule as their payroll department was using.  Juggling bills is hard enough with decreased income levels, but the forfeiture of control over the ebb and flow of funds in your bank account can put you in financial peril after an injury.

If you find yourself in the scenario I have described, try contacting your lender or service provider to inquire about making changes to the agreement you signed – or terminating the agreement, if needed – to at least make the drafts from your account occur on a better schedule but, preferably, to take back control of the payments.  You should maintain the ability to make payments to creditors on your own schedule when funds are available.  The auto-draft agreements are a contractual agreement, though, and you may need legal assistance to alter them.  In my experience, though, lenders are usually able to work with their clients to maintain the integrity of their loans.  In the long run, repayment is their goal and facilitating your ability to manage your payments is in their best interest, too.

Photo credit: 401(K) 2013 / Foter / CC BY-SA

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The workers’ compensation system is broken — and it’s driving people into poverty

Today’s post comes to us from the Washington Post via our colleague Jon Gelman.

There’s a good news/bad news situation for occupational injuries in the United States: Fewer people are getting hurt on the job. But those who do are getting less help.

That’s according to a couple of important new reports out Wednesday on how the system for cleaning up workplace accidents is broken — both because of the changing circumstances of the people who are getting injured, and the disintegration of programs that are supposed to pay for them.

The first comes from the Department of Labor, which aims to tie the 3 million workplace injuries reported per year — the number is actually much higher, because many workers fear raising the issue with their employers — into the ongoing national conversation about inequality. In an overview of research on the topic, the agency finds that low-wage workers (especially Latinos) have disproportionately high injury rates, and that injuries can slice 15 percent off a person’s earnings over 10 years after the accident.

“Income inequality is a very active conversation led by the White House,” David Michaels, director of the Occupational Health and Safety Administration, said in an interview. “Injuries are knocking many families out of the middle class, and block many low-wage workers from getting out of poverty. So we think it’s an important component of this conversation.”

There are two main components to the financial implications of a workplace injury. The first is the legal…

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Measuring Our Progress Since The Triangle Shirtwaist Factory Fire

As an attorney who practices in the field of Workers’ Compensation, there are some events that are seminal in the history of workplace safety. One of those events was the Triangle Shirtwaist Factory fire, which occurred on March 25, 2011. The Triangle Shirtwaist Factory was one of the largest factories in New York and employed 500 mostly Italian and Jewish immigrant women between the ages of 13 and 23.

These women worked long hours for low wages in this cramped sweatshop at sewing machines to produce women’s blouses, known in those days as shirtwaists. In order to protect themselves from their claim of thefts by the workers, the factory owners would lock the doors to one of the stairways leading to the street. While the union movement in New York was very strong and some of the workers had joined the International Ladies’ Garment Workers’ Union, the factory itself was a non-union shop; many believed the owners would lock their doors to keep organizers out. Whatever the reason, locking those doors had devastating effects.

On that fateful day in March, a fire broke out that was fueled by thousands of pounds of fabric. Many were able to escape to the roof and then to adjoining buildings. Unfortunately for those on the ninth floor, there was very little means of escape. The elevator proved inadequate as it was only able to accommodate 12 people at a time, and the operator was only able to make four trips before it broke down totally. Bodies of many of the workers were found at the bottom of locked stairwells or in the elevator shaft when they tried to escape. The fire escape was flimsy and when it became overloaded with panicked women, it broke and sent dozens to their death. Those trapped in the factory by the fire were left with the agonizing choice of jumping to their deaths or being burned alive. Many chose to jump. Bystanders recounted stories of seeing victims kiss each other or hold hands as they jumped two and three at a time; they described the horrific thud as bodies landed on the stone streets below. When the final tally was taken, 146 people had perished. The catastrophe sent shockwaves throughout New York City and the immigrant communities of Manhattan’s Lower East Side, where families struggled to recognize the charred remains of their loved ones in makeshift morgues.

On March 24, 1911, the New York Court of Appeals declared the state’s compulsory Workers’ Compensation law unconstitutional. The next day, 146 people were dead from that Triangle Shirtwaist fire. With no Workers’ Compensation system in place, family members and dependents had to turn to the courts in an attempt to force Triangle to compensate the injured and the families of the deceased. A civil suit brought by 23 victims’ families against the owners netted a whopping $75 in damages per victim! New Yorkers were appalled and angry at the greed and negligence of the owners and managers.

The Triangle Shirtwaist Factory Fire was a preventable tragedy caused by unsafe work conditions and was a catalyst for change. New York finally adopted a Workers’ Compensation law in 1913. This law was intended to protect workers from unsafe working conditions and afford them with wage replacement benefits and medical treatment in exchange for giving up their right to sue. Unfortunately, we see an erosion of many of these benefits under the guise of reform, while insurance companies have made record profits. This month, while we acknowledge this grim anniversary, we need to make sure that these women’s deaths were not in vain. Let us never forget the reason Workers’ Compensation laws were enacted, and let’s be sure the system is not watered down to the point that injured workers and their families go back to getting $75 for a preventable death.

 

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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“Cost-Shifting” Exposed: How Injured Worker Medical Care Decisions Are Made (And Who Pays)

Medical coverage is a topic on everyone’s mind. Obamacare, while controversial, has started a real dialogue in this country regarding health care. Regardless of whether you are in favor of the current law, most Americans want affordable health care for themselves and their families.

Many employers pay for a substantial amount of their workers’ premiums as a benefit to them, and take this into consideration when making salary decisions due to the high cost, thereby leaving workers to pay for all or some of their medical coverage. Sometimes insurers pay for benefits that are not their responsibility because the proper entity refuses to pay. This is known as cost shifting. As a practitioner in the field of Workers’ Compensation, this idea of cost shifting has become an all too common occurrence.

By way of background, as a result of social reform, most states enacted some form of Workers’ Compensation legislation in the early 20th Century. In exchange for timely payment of medical and indemnity benefits, workers gave up the right to sue their employers. In 2007 in New York, there was a series of further reforms that led to compromise between labor groups, the insurance industry and the Business Counsel. There was an increase in the amount of weekly benefits to injured workers to conform with the State average weekly wage (now a maximum of approximately $800 per week) in exchange for a limit on the amount of weeks an injured worker is entitled to receive these benefits.  Additionally, medical treatment guidelines have been introduced with the premise that they would streamline costs and get injured workers faster and more effective medical care. These guidelines are based upon the principles of Evidence Based Medicine (EBM), which is the use of clinical trials and data to determine whether a specific treatment should be recommended for a specific diagnosis.  It is sometimes referred to as “cookbook” treatment.

In New York, the Court of Appeals recently ruled by a 4-3 margin that any treatment not specifically included and pre-authorized is presumptively unnecessary. In other words, if a treatment requested is not within the medical treatment guidelines, it is denied. This takes the decision making out of the hands of the treating physician who is really in the best position to determine what treatment would be most beneficial for patients. In order to overcome this presumption, the doctor now must engage in what has been seen in most cases as an exercise in futility to request a variance to overcome this presumption.

The New York Committee for Occupational Safety and Health (NYCOSH) reported that the New York State Workers’ Compensation Board received 202,643 variance requests in the first 10 months the guidelines were implemented. A quarter of the requests were rejected by the Board immediately. The rest can lead to protracted litigation. As a result, in many instances injured workers will now shift the cost to another party, such as their own private insurance, Medicare or even worse, pay for the treatment out of pocket. It is the path of least resistance. We all pay an additional price for medical costs borne by group health insurance carriers, Medicaid, and Medicare that should in fact be paid by Worker’s Compensation insurers. This cost shifting may increase Workers’ Compensation insurance profits, but it hurts both the employers’ and the employees’ bottom line. Injured workers don’t stop needing treatment just because their medical claim is denied. Someone has to pay for the cost of lost time and medical treatment. It is time that the proper party step up and take responsibility.

 

 

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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New Law Protects People From Deadly Carbon Monoxide

As an attorney who has practiced in the field of Workers’ Compensation for more than 25 years, I have represented thousands of injured workers, spouses, and families of workers killed on the job. Sadly, many of these deaths and injuries were preventable.

I recently read a blog published by an attorney friend of mine from North Carolina involving carbon monoxide poisoning. I thought it was extremely timely as on December 30, 2014, New York State Governor Cuomo signed into law new legislation that requires every restaurant and commercial building in the state to install carbon monoxide detectors by June 2015. This law, known as Steven Nelson’s Law, was named in honor of Mr. Nelson, a Long Island restaurant manager killed on the job as a result of carbon monoxide poisoning from a malfunctioning water heater flue pipe in the basement of the restaurant. Just this week, two men were found dead in Long Island at a Holbrook auto detailing shop from apparent carbon monoxide poisoning. Every household should have a carbon monoxide detector, just as every house should have a smoke detector. Under the existing New York State law, every one- or two-family home, condominium and cooperative, and each unit of a multiple dwelling constructed or sold after July 30, 2002, must have a working carbon monoxide detector. This law regarding residential dwellings was passed in 2010 and called Amanda’s Law after a young girl who died after sleeping at a friend’s house where there was a clogged boiler vent. Restaurants and other commercial buildings were excluded prior to Steven Nelson’s Law. But not only is it important to have a CO detector, it’s equally as important to be sure it is working properly. Test it on a regular basis, along with your smoke detector, and be sure to replace the batteries once a year.

The Centers for Disease Control and Prevention (CDC) estimate that at least 430 people die each year from unintentional carbon monoxide poisoning (www.cdc.gov/features/copoisoning/). Winter is the most dangerous time of the year for carbon monoxide poisoning because of improperly used generators and heavy snow drifts that can clog heating vents.

Carbon monoxide (CO) is a colorless, odorless, and tasteless gas that can severely damage the human body, and as noted above, in some cases can lead to death. Symptoms include headaches, dizziness, vomiting, confusion, weakness, blurred vision and nausea. Extreme symptoms include severely impaired mental state, coordination loss, loss of breath, increased heart rate, chest pain, and loss of consciousness. Anyone experiencing CO poisoning symptoms should be removed from the enclosed environment and taken to a medical professional. Call your local authorities to make a report.

Be aware of CO sources in your home. Any gas-burning appliance such as a furnace, boiler, gas stove, water heater, fireplace or gas-powered tool can be a CO source. Make sure these types of appliances are serviced regularly to lower the risk of CO poisoning. Don’t put a gas generator in the house, garage, or outside your house near a window. Generators have the capability of producing CO levels several hundred times those found in normal automobile exhaust. The CDC recommends that generators should be used at least 20 feet away from your house in a properly ventilated area.

It is unfortunate, but typical, that many laws are enacted as a result of a tragedy. Death or injury by carbon monoxide poisoning is completely preventable. A simple device can save your life.

 

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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