Police and law enforcement officers

THE POST-TRAUMATIC STRESS DISORDER PRESUMPTION FOR SAFETY AND LAW ENFORCEMENT PERSONNEL: WHAT YOU NEED TO KNOW

Recently, SB 542 was passed for which a legal presumption of injury is applicable for Post-Traumatic Stress Disorder for certain Firefighters and Peace Officers.

The presumption will become effective as of 1/1/2020, and will only remain in effect until 1/1/25.

This article will discuss Post-Traumatic Stress Disorder, the Presumption, and How It will be applied.

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Image of nerves in the body's nervous system

PERIPHERAL NEUROPATHIES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Many work injuries give rise to Peripheral Neuropathies. Peripheral Neuropathy, for all intents and purposes, means damage to the nerves. Nerve Damage can come from many sources. Familiar Neuropathic Injuries include Carpal Tunnel Syndrome and Herniated Disks in the Spine which compress upon nerves.

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Suicidal thoughts and their effect on workers compensation claims

SUICIDE, SUICIDAL THOUGHTS AND WORKERS’ COMPENSATION: WHAT YOU NEED KNOW

Suicide and Suicidal Thoughts among Injured Workers are serious concerns. The Workers’ Compensation Community, Employers, Insurance Companies, Attorneys, Medical Providers. Attorneys and Judges are aware that Injured Workers can suffer to the point at which these events can occur

The Workers’ Compensation Community understands that Suicide and Suicidal Thoughts need to be addressed either through medical treatment and/or compensation. Both Suicide and Suicidal Thoughts can have an impact on an Injured Worker’s workers’ compensation claim.

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whole person impairment calculations

Interpreters and Workers’ Compensation: Injured Workers with Language Barriers, the Need for an Interpreter, and Workers’ Compensation: What You Need to Know

Usted Habla Ingles?”

California has an ethnically diverse workforce. It employs a large number of immigrants who are from all over the world. In California, you can find employees from Asia, the Middle East, Africa, Central and South America, and Europe. As a result of these participants in the workforce, there is a large number of workers for whom English is not their first language. There are some workers who cannot communicate in English.

After a work injury, an Injured Worker is required to communicate to a number of individuals with respect to their claim. These individuals, for whom communication is necessary, include the Employer, the Insurance Company, and the Medical Provider. Additionally, If the claim becomes litigated, the Injured Worker must interact with Lawyers and Workers’ Compensation Judges.

Per the Department of Industrial Relations, “[a]n injured employee is entitled to the services of a qualified interpreter in specified settings if he or she does not proficiently speak or understand the English language.” Thus, proficiency with English is of import.’

Why is an Interpreter Important?

In California Workers’ Compensation Law, statements made by Injured Workers are very important. The correctly provided information can assist with the acceptance of the claim being industrial. It also can assist with respect to entitlement to compensation.

Incorrectly provided information, likewise, can be devastating. Incorrectly provided information can be the basis for the denial of a claim, the denial of benefits, and possibly criminal prosecution for workers’ compensation fraud. Making a false statement to obtain workers’ compensation benefits can be the basis for criminal prosecution.

In sum, if an Injured Worker believes that they do not understand everything that is being asked in English, they should request an interpreter. Further, if they believe that they cannot properly communicate their answers, they should also get an interpreter.

Are You Proficient in English?

Proficiency essentially includes three elements: the ability to speak, the ability to understand, and the ability to communicate. So, if one lacks the ability to speak, understand or communicate adequately in English, they should consider themselves “not proficient” in English. Therefore, they should request an interpreter.

Proficiency in English has another element to it as far as the need for an interpreter. There is caselaw that suggests that being considered proficient in English does not require the ability to read and write in English. Therefore, if the Injured Worker is only able to only speak English proficiently, an interpreter is not necessary. Again, caselaw suggests that there is no requirement that they not be able to read and write English. See Stambuk v. Workers’ Comp. Appeals Bd. (Sanchez), 77 Cal. Comp. Cases 675, 2012 Cal. Wrk. Comp. LEXIS 82 (Cal. App. 4th Dist. June 14, 2012)

How Do I Request an interpreter?

If you need an interpreter, you should request one through the insurance Company. You should contact the adjuster and request that one be provided.

Who Pays for the Interpreter?

If the interpreter is indicated in accordance with the Labor Code, it is the Insurance Company that pays for the interpreter.

Do I get an Interpreter When I see my Attorney?

In most circumstances, you are not entitled to an Interpreter to meet your attorney. An interpreter will only be provided if there is a deposition or court proceeding. Otherwise, you will have to rely on the attorney’s staff to provide someone to interpret. Otherwise, you can bring a family member or friend to assist with interpreting matters.

What Is the Authority in the Labor Code for the Right to have an interpreter?

Labor Code 4600 provides the authority for interpreters.

Labor Code Section 4600(f) provides “[w]hen at the request of the employer, the employer’s insurer, the administrative director, the appeals board, or a workers’ compensation administrative law judge, an employee submits to examination by a physician and the employee does not proficiently speak or understand the English language, he or she shall be entitled to the services of a qualified interpreter in accordance with conditions and a fee schedule prescribed by the administrative director. These services shall be provided by the employer. For purposes of this section, “qualified interpreter” means a language interpreter certified, or deemed certified, pursuant to Article 8 (commencing with Section 11435.05) of Chapter 4.5 of Part 1 of Division 3 of Title 2 of, or Section 68566 of, the Government Code.

(g) If the injured employee cannot effectively communicate with his or her treating physician because he or she cannot proficiently speak or understand the English language, the injured employee is entitled to the services of a qualified interpreter during medical treatment appointments. To be a qualified interpreter for purposes of medical treatment appointments, an interpreter is not required to meet the requirements of subdivision (f), but shall meet any requirements established by rule by the administrative director that are substantially similar to the requirements set forth in Section 1367.04 of the Health and Safety Code. The administrative director shall adopt a fee schedule for qualified interpreter fees in accordance with this section. Upon request of the injured employee, the employer or insurance carrier shall pay for interpreter services. An employer shall not be required to pay for the services of an interpreter who is not certified or is provisionally certified by the person conducting the medical treatment or examination unless either the employer consents in advance to the selection of the individual who provides the interpreting service or the injured worker requires interpreting service in a language other than the languages designated pursuant to Section 11435.40 of the Government Code.

Are There Common Languages in California That Require Interpreters?

In California, languages considered as common include Spanish, Tagalog, Arabic, Cantonese, Japanese, Korean, Portuguese, and Vietnamese.

Are there Special Rules for Certain Languages?

Due to the concern with respect to availability of interpreters for rare foreign languages in California

Yes. For medical treatment appointments or medical legal exam, an interpreter may be provisionally certified (A) if the claims administrator has given prior written consent to the interpreter who provides the services, or (B) the injured worker requires interpreter services in a language other than Spanish, Tagalog, Arabic, Cantonese, Japanese, Korean, Portuguese, and Vietnamese, in which case the physician may use a provisionally certified interpreter if that fact is noted in the record of the medical evaluation.

When Are interpreter Services to be Provided?

Per the Department of Industrial Relations,Interpreter services must be provided at a deposition, at an appeals board hearing, at a medical-legal examination, and at a medical treatment appointment.”

Are there Concerns about Finding an interpreter?

Yes. There are challenges with respect to Interpreters. Some Injured Workers speak certain dialects of languages or speak a unique language. There are times when dialects become an issue. For example, there has been a number of occasions I am aware of in which Spanish-Speaking injured Workers require an interpreter who is skilled with respect to the dialect spoken in a particular region from Mexico. There have been times in which depositions and hearings have been continued in order to obtain an appropriate interpreter.

Further, for some exotic languages such as Amharic, interpreters are in demand and there may be difficulty finding one available.

Are there Different Types of Interpreters?

Yes. There are different types of interpreters. Some of special qualifications. There are interpreters that are certified. There is also provisional certification.

Certification means that that the individual has a Certification Commission for Healthcare Interpreters. These individuals are listed on certified, which means listed on the State Personnel Board webpage or the California Courts webpage.

Provision Certification means that provisionally certified, which means deemed qualified to perform interpreter services when a certified interpreter cannot be present, either: (A) by agreement of the parties, or (B) based on a finding by the workers’ compensation administrative law judge conducting a hearing that the interpreter is qualified to interpret at the hearing, or by the arbitrator conducting the arbitration that the interpreter is qualified to interpret at the arbitration. The finding of the judge or arbitrator and the basis for the finding must be set forth in the record of proceedings.

How Do You Find a Certified interpreter?

California Courts webpage. Certified interpreters for the purposes of medical treatment appointments and medical legal exams are listed in the registry for Certification Commission for Healthcare Interpreters (CCHI) or National Board of Certification for Medical Interpreters (National Board).

What if I Need Advice?

If you would like a free consultation regarding your workers’ compensation claim, or if you feel you have medical mismanagement claims, please contact the Law Offices of Edward J. Singer, A Professional Law Corporation. They have been helping people in Central and Southern California deal with their workers’ compensation cases for 26 years. Contact us today for more information.

COLD-RELATED CONDITIONS AND WORKERS’ COMPENSATION: INJURED WORKERS, EXPOSURE TO COLD IN THE WORKPLACE, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

“Baby, it’s Cold Outside!”

Many Injured Workers who are exposed to Cold on the job. Cold Exposure can be a source of work injuries. Cold Exposure can take many forms. Cold Exposure can be the result of outdoor work as well as indoor work. Cold Exposure can be the result of cold weather.

Cold Exposure can be the result of working in a refrigerated work environment. Cold Exposure can be the result of working in an environment for which there is an air conditioning system. Work Environments that have poor insulation or lack of a heating system for workers also expose workers to cold.

Work-Related Cold Exposure Injuries can entitle workers to obtain medical treatment for these medical conditions and obtain workers’ compensation benefits.

This article will discuss Cold Exposure and Cold-Related Medical Conditions. Further, case law concerning cold-related injuries will be discussed.

 

How Cold is Cold?

A Cold Environment is one that is near-freezing temperatures. This is considered “Extreme Cold.” A Cold Environment causes the body to work harder to maintain its temperature. Both Cold and Wind Chill can impact the degree of coldness.

Extreme Cold can drive down the skin and the internal temperature of the body. This is what is known as the core temperature. Extreme Cold can cause the body to shift blood flow from the extremities and outer skin of the core. When this occurs, it can lead to serious health problems, tissue damage, and death.

According to the American Conference of Governmental Industrial Hygienists (ACGIH®) Threshold Limit Values (TLV®), workers should be protected from exposure to cold so that the deep core temperature does not fall below 96.8°F (36°C) and to prevent frostbite to body extremities [ACGIH 2019]. DHH(NIOSH) Publication Number 2019-113

 

Are there Risk Factors When Dealing with Cold Exposure?

Yes. There are some risk factors that make for a greater chance of injury when exposed to cold. These risk factors include wetness, dampness, being improperly dressed as well as exhaustion.

These risk factors can also include workers who have pre-existing health conditions such as hypertension, hypothyroidism, and diabetes. Also, a worker with poor physical conditioning is also at risk.

 

What Types of Occupations are at Risk for Cold Exposure?

There are a variety of workers who are at risk for cold-exposure related injuries. These occupations include Snow Cleanup Crews, Sanitation Workers, Police Officers, and Emergency Response Personnel such as Firefighters and Emergency Medical Technicians.

Further, other occupations include an individual who works in refrigerated areas or manufacturing facilities that require cold temperatures. Additionally, Long Haul Truck Drivers are at risk for cold exposure.

 

Was are Cold-Related Medical Conditions?

Cold-Related Medical Conditions include Chiliblains, Trenchfoot aka Immersion Foot, Frostbite, and Hypothermia.

Besides Cold-Related conditions, Cold Exposure can also have an impact on other medical conditions. Cold-related conditions aggravate a Worker’s pre-existing musculoskeletal injuries and vascular disorders.

 

What is Chiliblains?

“Chilblains are the painful inflammation of small blood vessels in the skin that occur in response to repeated exposure to cold but nonfreezing temperatures. Small blood vessels in the skin may become permanently damaged by cold temperatures, resulting in redness and itching during additional exposures.

Symptoms of chilblains include redness, itching, possible blistering, inflammation, and possible ulceration in severe cases..” DHH(NIOSH) Publication Number 2019-113.

 

What is Trendfoot aka Immersion Foot?

“Trench foot is an injury of the feet after prolonged exposure to wet and cold-related conditions. Trench foot occurs because wet feet lose heat faster than dry feet. To prevent heat loss, the body constricts blood vessels in the feet, and then the skin tissue begins to die.

Symptoms of trench foot include reddening of the skin, numbness, leg cramps, swelling, tingling pain, blisters or ulcers, bleeding under the skin, and gangrene (e.g., foot turns purple, blue, or gray).” DHH(NIOSH) Publication Number 2019-113

This condition can occur at temperatures as high as 60°F

 

What is Frostbite?

“Frostbite is an injury caused by freezing of the skin and deeper tissues, resulting in the loss of feeling and color in the affected areas. Frostbite can permanently damage body tissues, and severe cases can lead to amputation.

Examples of risk factors for frostbite include contact with metal or water, dehydration, diabetes, smoking, alcohol abuse, sedating or judgment impairing medications, and prior history of frostbite. Symptoms of frostbite include numbness; tingling or stinging; aching; and bluish or pale, waxy skin.” DHH(NIOSH) Publication Number 2019-113.

 

What is Hypothermia?

Hypothermia is another cold-related illness. “[w]hen exposed to cold temperatures, the body loses heat faster than it can be produced. Prolonged exposure to cold causes internal body temperature to drop, resulting in a condition called hypothermia. Hypothermia affects brain function, making the victim unable to think clearly or move well (i.e., they may be unable to protect themselves from hazards, or experience slips, trips, and falls). This makes hypothermia particularly dangerous because a person may not recognize the symptoms and will be unable to make life-preserving decisions.

Symptoms of hypothermia can depend on how long a person has been exposed to cold temperatures and individual variability. Hypothermia Symptoms and First Aid Early symptoms include shivering, fatigue, loss of coordination, confusion, and/or disorientation. Late symptoms include no shivering, blue skin, dilated pupils, slowed pulse and breathing, and/or loss of consciousness. If hypothermia is suspected, medical assistance should be requested immediately (e.g., call 911).” DHH(NIOSH) Publication Number 2019-113.

Hypothermia occurs when the normal body temperature of 98.6 degrees drops to less than 95 degrees. It can occur even at cool temperatures above 40 degrees.

 

Has there been Caselaw concerning Cold Exposure?

Yes. There have been several cases of interest concerning Cold Exposure.

Nature and Extent of Cold Exposure: In a case involving a partial lower extremity amputation, the applicant claimed cold exposure as a causative element that caused the necessity for the amputation to be required. The Court of Appeal discussed the fact that there was an issue concerning the duration and degree of cold exposure.

In sum, the applicant and applicant’s medical evidence was not found to be convincing as to bring it to the level of substantial evidence on the issue. The applicant’s claim was not found to be industrial. Cigna vs. WCAB (1996) 61 Cal. Comp. Cases 1378.

The take away from the case is that evidence of nature, i.e. the temperature and elements exposed to, and the amount of time of the exposure are important facts that the Injured Worker should obtain in order to prove up their case.

Exposure to Cold Aggravating Pre-Existing Medical Conditions: In this case, applicant claimed that her exposure to cold air in her employment aggravated her underlying bronchial disease and caused chronic pulmonary disease. Applicant prevailed. Aetna vs. WCAB (1976) 41 C.C.C. 252.

 

Can Cold Injuries Be Prevented?

Yes. There are countless efforts that Employers and Workers can take to reduce the risk of cold-related illness and injury.

Prevention measures include planning, education, reducing cold exposure, allowance for breaks to be in heated environments, proper clothing and the allowance for changing out wet clothing. There are many additional measures that can be taken to prevent cold-related injury.

 

What If I Need Advice?

If you would like a free consultation regarding your workers’ compensation claim, or if you feel you have medical mismanagement claims, please contact the Law Offices of Edward J. Singer, A Professional Law Corporation.

They have been helping people in Central and Southern California deal with their workers’ compensation cases for 26 years. Contact us today for more information.

 

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