Law Offices of Edward J. Singer APLC

Home » Blog » Workers Comp

WORKPLACE VIOLENCE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on November 2, 2020 by Edward Singer

Workplace Violence is a serious concern in California. Some of the most infamous workplace violence episodes have occurred in California. This includes the San Ysidro McDonalds shootings, the Piper Tech shootings, and the San Bernardino terrorist shootings.

Not all workplace violence involves fatalities. There are many workplace violence events of a non-fatal variety. These violence acts are significant in the workers’ compensation area because workers who are either injured in the incident or suffer emotional injury as a result of witnessing the events. These effected workers are entitled to seek medical treatment and disability benefits through the workers’ compensation system.

There was a recent study of interest which provides insight to workers with respect to these incidents.

This article will discuss non-fatal workplace violence, how it interacts with the workers’ compensation system and the rights that an Injured Worker has relating to those incidents.

What Were the Non-Fatal Workplace Violence Studied?

In a recent study, non-fatal violence in the workplace was investigated. In the study, the ^“types of crime included rape/sexual assault (including attempted rape, sexual attack with serious/minor assault, sexual assault without injury, unwanted sexual contact without force, and verbal threat of rape/sexual assault); robbery (including attempted robbery); aggravated assault (attack or attempted attack with a weapon, regardless of whether or not an injury occurred, and attack without a weapon when serious injury resulted, and including aggravated assault with injury, attempted aggravated assault with weapon, and threatened assault with weapon); simple assault (attack without a weapon resulting in no or minor injury, and including simple assault with injury and assault without weapon without injury); and verbal threat of assault.” Siegel, M. Johnson, CY, Lawson CC, Ridenour M Hartley D. Nonfatal Violent Workplace Crime Characteristics and Rates by Occupation- United States, 2007-2015. MMWR Morb Mortal Wkly Rep 2020;69: 324-328.

What Are the Frequency Rates of the Different Forms of Violence?

The most frequently reported type of crime was threat of assault (44%), followed by simple assault (37%), aggravated assault (13%), rape/sexual assault (3%), and robbery (3%). Siegel, M. Johnson, CY, Lawson CC, Ridenour M Hartley D. Nonfatal Violent Workplace Crime Characteristics and Rates by Occupation- United States, 2007-2015. MMWR Morb Mortal Wkly Rep 2020;69: 324-328.

Note: workplace violence does not necessary translate into matters of physical harm to workers. Threats of assault can cause psychological injury or give rise to physiological stress responses such as a heart attack. Likewise, witnessing these various events might give rise to such problems as well.

Are the Violence Rates Different Between Occupations?

Yes. In the study, “[d]uring 2007–2010, occupations with the highest rates of violent workplace crimes were Protective services (e.g., first responders) (101 crimes per 1,000 workers); Community and social services (19); Healthcare practitioners and technicians (17), Healthcare support occupations (17); Education, training, and library occupations (eight); and Transportation and material moving occupations (seven.)” Siegel, M. Johnson, CY, Lawson CC, Ridenour M Hartley D. Nonfatal Violent Workplace Crime Characteristics and Rates by Occupation- United States, 2007-2015. MMWR Morb Mortal Wkly Rep 2020; 69:324-328.

Note: It is interesting to note which areas of the workforce in which the acts occur. It appears that the key factor is the significant contact that workers have with the public.

Are All Workplace Violence Episodes a Valid Work Injury?

No. There are several issues that can come up. First, there is the initial aggressor rule. Second, if the alleged criminal has a relationship to the victim, there may be some issue of controversy as to whether it was a workplace event versus an event that happened at the workplace. Legal analysis would be recommended in those circumstances.

Is there a Difference Physical Injuries versus Psychological Injuries?

Yes. Psychological Injuries have thresholds that must be met in order to prevail.

The Labor Code Section 3208.3 provides lower burdens for violent acts. It is noted in the section that “in the case of employees whose injuries resulted from being a victim of a violent act or from direct exposure to a significant violent act, the employee shall be required to demonstrate by a preponderance of the evidence that actual events of employment were a substantial cause of the injury.” Further, ““substantial cause” means at least 35 to 40 percent of the causation from all sources combined.”

Further, there are other sections that may assist on a psychiatric claim. They, however, require a factual analysis. Therefore, they may be relevant but will not be discussed within this article.

Additionally, for certain safety and law enforcement officers, there is a post-traumatic stress disorder presumption. Click here for an article discussing it.

Are There Any Other Sources of Benefits?

Yes. The State of California has a Victims of Crime Program which can also provide benefits in some circumstances. Click here for an article discussing it.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

STRESS AND INJURED WORKERS: INJURED WORKERS WITH DIFFICULTIES POST WORK-INJURY AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on October 19, 2020 by Edward Singer

This article is to discuss injured Workers’ stressors and a recent study on the matter. Prior to reviewing the study, I took it upon myself to list the stressors based upon my 28 years of representing Injured workers. The following is my assessment of stressors for Injured Workers while they are pursuing their claims are as follows:

Dealing with medical facilities and doctors
Being out of work
Dealing with your employer
Dealing with insurance
Dealing with attorneys
Dealing with litigation
Dealing with the Workers’ Compensation Appeals Board

Wow! Injured Workers have a lot of stressors!

As I indicated, a study was recently done which sheds some additional light on the stressors of injured workers. Is my assessments correct? Are there other items of concern?

Are Injured Workers Stressed Out?

Yes. The study found that the “[t]he prevalence of psychological distress among workers’ compensation claimants is high.” Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

What Did the Study Find as Being Stressors?

Severe psychological distress, being off work, worse general health and requiring support during claim were most strongly associated with greater odds of service use. Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

Are Injured Workers more stressed out than other People?

Yes. According to the Study, it was found. Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

What Were the Factors that the Study Found as Stressful?

The study found “being off work, poor general health, low work ability, financial stress, stressful interactions with healthcare providers and having diagnosed mental health conditions had the strongest associations with presence of psychological distress Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

One additional item that came out of the study that caught me by surprise that Injured Workers with prior psychological issues are susceptible to increased stress.

Can an Injured Worker Claim This Stress as Part of Their Claim?

With changes in the law, psychiatric injury claims are limited. Further, stress resulting from litigation is mostly considered as non-industrial. In certain limited facts, stress may be claimed. It is a factual inquiry.

Is There Case Law Re: Stress from Litigation?

Yes. The Courts have found that a psychiatry injury caused as a result of the litigation process is not work-related. Rodriguez v. Workers’ Comp. Appeals Bd. (1994) 21 Cal.App.4th 1747 [27 Cal.Rptr.2d 93]. There are some limited exceptions. See Patrick v. Marina City Club, 2010 Cal. Wrk. Comp. P.D. LEXIS 19 (carrier misconduct as the basis for stress)

What Should An Injured Worker Do?

Injured Workers should approach matter on multiple levels. One level is to seek medical attention and/or counseling for one’s stress. Another level is to address the situations that are causing the stress. This can include changing doctors, getting an attorney, addressing the employment situation is a substantial way and perhaps opening up to a friend or family member to get this stress off their chest. Also, if you are unrepresented, contacting the Information and Assistance Officer at the local WCAB may be helpful. Also, your company may may have an Employee Assistance Program which can help as well.

In sum, if an Injured Worker is having stress, there is help and solutions out there. Don’t try to go it alone.

What if I Need Advice?

What You Should Know About Therapy for Injured Workers

Posted on October 15, 2020 by Edward Singer

Workers’ Compensation Medical Treatment is special. Unlike Traditional Medicine, Industrial Medical Treatment has unique goals. Treatment for industrial injuries is of statutory construct. In other words, the Government has made special rules and regulations with respect to Injured Workers’ treatment.

California Workers’ Compensation Law, pursuant to Labor Code Section 4600(a), has the overall goal of industrial medical treatment to provide what is “reasonably required to cure or relieve the injured worker from the effects of the worker’s injury, ” This goal is further refined by statute and regulations.

Within this construct, there are other goals with respect to Injured Workers’ medical treatment. One of the most important goals of Industrial Medicine is to get the Injured Worker “back to work.”

The term “Back to Work” has many meanings. “Back to Work” can mean getting the Injured Worker back to the job they had when they got injured. “Back to Work” can mean that the Injured Worker can mean that there is a return to a modified position. “Back to Work” can mean that the Injured Worker is returned to an alternative position. “Back to Work” can mean that the Injured Worker is returned to a state upon which they are able to participate in a vocational rehabilitation program. In sum, “Back to Work” means returning an Individual back to the open labor market.

Work Hardening is a form of therapy that can assist with “Back to Work” issues.

This article will discuss the nature of “Work Hardening,” why Insurance Companies should encourage this treatment, and why Injured Workers should participate in such program programs.

What is Work Hardening?

Work Hardening is a form of “Occupational Therapy.”

“Work Hardening is an interdisciplinary, individualized, job specific program of activity with the goal of return to work. Work Hardening programs use real or simulated work tasks and progressively graded conditioning exercises that are based on the individual’s measured tolerances. Work hardening provides a transition between acute care and successful return to work and is designed to improve the biomechanical, neuromuscular, cardiovascular and psychosocial functioning of the worker.” Washington State Department of of Labor and Industries.

What Are the Goals of Work Hardening?

The Goals of Work Hardening include Improvement of Vocational Feasibility, Improvement of Employability, and Decrease in Vocational Handicap. Work Hardening: Occupational Therapy in Industrial Rehabilitation Leonard N. Matheson; Linda Dempster Ogden; Kris Violette; Karen Schultz American Journal of Occupational Therapy, May 1985, Vol. 39, 314-321. https://doi.org/10.5014/ajot.39.5.314

What Happens in a Work Hardening Program?

Work Hardening Programs work on the Injured Worker’s strength and endurance, they set goals, and they work on simulation of work tasks. Throughout the process, their progress is monitored to see if there is improvement.

Who Benefits from Work Hardening Programs?

“Experience shows that the clients who experience the greatest benefit from work hardening programs are those who are seriously deconditioned after an impairment caused by an injury or disease. In addition, people who have major discrepancies between their symptoms and objective findings and individuals whose impairment is limited to the dominant upper extremity substantially benefit from work hardening. “ Work Hardening: Occupational Therapy in Industrial Rehabilitation Leonard N. Matheson; Linda Dempster Ogden; Kris Violette; Karen Schultz American Journal of Occupational Therapy, May 1985, Vol. 39, 314-321. https://doi.org/10.5014/ajot.39.5.314

In sum, this observation means that individuals who have been off of work for a significant period of time benefit from work hardening. Deconditioning can occur when an individual has been off of work for a while. Also, there may be deconditioning from a severe injury which causes an immediate incapacity to perform physical activities. Delays and denials of medical treatment can further contribute to deconditioning.

Further, individuals with major discrepancies between symptoms and objective findings may have anxiety and emotional issues with respect to engaging in physical activities. Work Hardening can provide confidence to these workers with respect to their abilities to exert themselves without the fear of re-injury.

How Does an Injured Worker Get in a Work Hardening Program?

All medical treatment in the California Workers’ Compensation System requires that a Treating Physician issue a Request For Authorization(RFA) for a “work hardening” program. An RFA request is subject to Utilization Review (UR) If UR denies authorization, the denial can be appealed for an Independent Medical Review.

What Have Independent Medical ReviewI Decisions Said Concerning “Work Hardening”?

There is common language which is used repeatedly within IMR Decisions with respect to the authorization of such treatment.

The IMR Decisions state as justification that “[t]here is a known etiology to the chronic pain syndrome or specific clinical condition which includes physical injury or disease. Other appropriate medical and/or invasive care has been attempted and proved to be inadequate to restore functional status. The patient has appropriate rehabilitation potential (i.e., he or she is judged to be able to substantially benefit from the program). The patient is not responding to less costly interventions including quality physical therapy programs; The patient has at least some behavioral or psychosocial issues affecting their recovery. For workers without behaviorally related issues and merely a physical gap between the current capabilities and future job requirements, work conditioning/work hardening programs are usually both more appropriate and cost effective.
The patient has substantial gaps between current physical capabilities and actual or projected occupational demands. There are no known contraindications to the treatment program, e.g., certain unstable medical conditions, primary substance abuse disorder or cognitive limitation which would prevent appropriate learning. The patient is committed to recovery.” 85 Cal. Comp. Cases 451 CM19-0133693, 85 Cal. Comp. Cases 446 CM19-0130002; 84 Cal. Comp. Cases 470, CM19-0021422 [emphasis added]

In sum, IMR Decisions provide several hurdles before such a program will be authorized. Therefore, it is important that the Injured Worker participate in traditional physical therapy programs prior to attempting to get authorization for a Work Hardening Program.

Why Should an Injured Worker Participate in “Work Hardening”?

There are many reasons why an Injured Worker should participate in a Work Hardening Program. First, the Work Hardening Programs can assist the Injured Person back to workplace. Second, Work Hardening Programs have been found to cut down on absenteeism post return to work. Schonstein E, Kenny DT, Keating JL, Koes BW. Work conditioning, work hardening and functional restoration for workers with back and neck pain. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD001822. DOI: 10.1002/14651858.CD001822. Third, the participation in a Work Hardening Program with failed results may be considered as credible evidence of inability to compete in the open labor market. Fourth, failure to participate in a Work Hardening Program may be viewed negatively as to the Injured Worker’s intentions and abilities.

What if I Need Advice?

BODY ARMOR, WORK INJURIES AND LAW ENFORCEMENT: POLICE OFFICERS, SHERIFFS AND INJURIES DUE TO EQUIPMENT: WHAT YOU NEED TO KNOW

Posted on October 11, 2020 by Edward Singer

Law Enforcement Officers are required to carry various items as part of their job duties. Equipment, such as Duty Belts, have been recognized as being damaging to the lumbar spine. Due to that fact, the State of California has enacted a Back Injury Presumption for with respect to Law Enforcement Officers who wear duty belts.

Besides Duty Belts, there is other Law Enforcement equipment that has become implicated as to causing physical injury. One of these items is Body Armor. Body Armor has become popular for Law Enforcement to wear to protect them. Body Armor, however, can be physically restrictive. This restrictiveness can be a source of musculoskeletal injury. It should be noted that this Body Armor can be life saving for officers. Police Officers: Surviving a real life-threatening incident while wearing body armor Xiong, Houawa 2014 May URI: https://scholarworks.csustan.edu/handle/011235813/703 (in thesis data, all 24 officers studied survived life-threatening incidents and were able to to return to full duty after the incidents.)

This article will discuss Law Enforcement Officers’ use of Body Armor, the problems with respect to such equipment, and whether it has been found to cause physical problems.

What Is Body Armor?

There are different types of body armor. There is body amor that is designed for military use. Also, there is a different body armor that is designed with respect to Law Enforcement. This different body armor is called Light Armor. The armors of the light variety care called Individual Light Armor Vests or ILAVs.

Are There Any Studies Concerning Light Armor Vests?

Yes. A recent study compared ILVAs versus Normal Station Wear.

What are the Problems with Light Body Armor?

“Wearing body armour has also been found to compromise trunk posture (Phillips et al., 2016) and reduce range of motion in multiple planes (Lenton et al., 2016). Axial trunk rotation has been shown to be reduced by up to 12° when wearing military-styled body armour (Lenton et al., 2016). A generalized increase in trunk and hip forward flexion during tasks has also been associated with wearing body armour (Lenton et al., 2016; Phillips et al., 2015). The effects of both a forward trunk posture and any compromise in trunk or shoulder mobility may further affect an officer’s ability to compensate for any balance compromise and put them at greater risk of falls and subsequent injury (Dempsey et al., 2013).” The effects of body armour on mobility and postural control of police officers Ben Schram Robin Orr Ben Hinton Geoff Norris Rodney Pope https://doi.org/10.1016/j.jbmt.2020.03.001

What Were The Findings of the Study?

The study found “[s]ignificant differences were found between ILAV or N conditions in various components of the FMS, including right Straight Leg Raise, left shoulder mobility, and both right and left quad rotary stability. No significant differences were found in any of the balance measures between these conditions.” Supra.

The conclusions made were that the “ILAVs can significantly affect police officer mobility and therefore may contribute to injury risk and decreased ability to complete occupational tasks, though this should be weighed against protective benefits. ILAVs should therefore be carefully selected to minimise injury risk without detracting from occupational performance.” Supra. [emphasis added]

Are There Any Issues of Controversy with Respect to Body Armor?

Yes. One matter that can become an issue with respect Body Armor is the fact that there are multiple types of body armor which have different styles. There was a study that compared different ILAV and found that there were differences in the comfort and performance. The perceived effects and comfort of various body armour systems on police officers while performing occupational tasks B. Schram1* , B. Hinton2 , R. Orr , R. Pope and G. Norris Schram et al. Annals of Occupational and Environmental Medicine (2018) 30:15 https://doi.org/10.1186/s40557-018-0228-x.

In sum, there are different brands that may have different impacts on the officers wearing them.

What Does Caselaw Say with Respect to Body Armor?

A search review was done with respect to this article. As the writing of this article, there have been no reported cases concerning injury related to the use of body armor. This caselaw search does not reveal as to whether such claims have been made and have been accepted as legitimate injury claims. Rather, the search indicates that there has been no controversy to the point that there has been any noteworthy or reported litigation involving body armor.

What Is the Future?

Many Law Enforcement Departments have received grants and funds to provide body armor to their departments. As a result, there will be more increased use of body armor. This increased use may likely cause musculoskeletal problems which may give rise to a physical injury. This type of physical injury would be the basis for filing a workers’ compensation claim.

What if I Need Advice?

CAR WASH WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on October 9, 2020 by Edward Singer

Car Wash Workers have many unique issues with respect to workers’ compensation. Car Wash Workers perform varied tasks which place them at risk for injury. Car Wash Workers are exposed to chemicals and liquids which may place them at risk for injury.

This article will discuss Car Wash Workers and the job tasks that place them at risk for industrial injury.

What Makes Car Wash Workers at Risk for Injury?

“The car wash industry, however, has salient features that predispose to important occupational health risks, namely, the use of hazardous chemicals (ie, hydrofluoric acid), the requirement of repetitive use of extremities, [and] close contact with moving machinery,” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What are the Common Job Tasks Do Workers Perform at Car Washes?

In the study, most participants rotated among the few major tasks at the car wash, including drying cars (63%), brushing and soaping cars (56%), and vacuuming and cleaning cars (50%).
Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, DrPH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Complaints Can Car Wash Workers Have?

In the study, “Car wash workers reported a high prevalence of health symptoms during the 12 months prior to the survey, including at least one site of musculoskeletal pain (80%); upper airway, eye, or skin irritation (71%); and at least one lower respiratory symptom (47%) (Table 2). Approximately one-half of all workers reported eye and throat irritation, back pain, neck or shoulder pain, hand pain, headaches, or nausea/stomach discomfort. The majority of workers reported multiple symptoms across the different symptoms groups. Thirty-eight (54%) participants reported two or more musculoskeletal symptoms in the past 12 months, and 37 (53%) reported two or more types of irritation (nose bleeds, throat irritation, eye irritation/burning, skin rash, or skin burn). Two workers had suffered fractures at work in the past 12 months, and one-quarter of the work force reported a laceration or abrasion of the skin. Three workers reported an episode of asthma or an asthma attack in the past 12 months.” Occupational Health of New York City Car Wash Workers Dickens, Brittany BA; Ruiz-Olivo, Laura BA; Palaguachi, Diego BA; Jimenez, David BA; Markowitz, Steven B. MD, Dr PH Author Information Journal of Occupational and Environmental Medicine: February 2019 – Volume 61 – Issue 2 – p e77-e79 doi: 10.1097/JOM.0000000000001520

What Type of Hand Movements Can Be a Source of Injury?

There are numerous tasks at Car Washes that can be a source of injury. These tasks involve Manual Handling, Awkward Hand Positions, Applying Pressure, and the use of Vibrating Tools.

Manual Handling includes “lifting, pulling, pushing, carrying and holding. Tasks that require these actions can include moving and transporting heavy equipment; everyday machines, such as vacuums; and loads, such as laundry.”

Awkward Hand Position includes “contorting hand posture to abnormal positions to clean hard-to-reach areas or slanted surfaces, such as windows. This would also include risks associated with using older or cheap spray bottles or equipment handles.”

Applying Pressure includes “pressing down or applying extra pressure to remove dirt or soil. Consider more powerful cleaning products or equipment if workers are using too much elbow grease to get the job done.”

The Use of Vibrating Equipment which includes “losing control and constant shaking. Machines that vibrate too much can cause hand fatigue, increasing the chances of workers losing control of the equipment.” . The importance of hand care in the car care industry Rich DiPaolo (2016)

Are There Chemical Exposures That Are Injurious to Car Wash Workers?

Yes. Chemicals used at Car Washes have been implicated in causing occupational illness.

“Exposure to hydrofluoric acid (HF) causes corrosive chemical burns and potentially fatal systemic toxicity. Car and truck wash cleaning products, rust removers, and aluminum brighteners often contain HF because it is efficient in breaking down roadway matter.” Reeb-Whitaker CK, Eckert CM, Anderson NJ, Bonauto DK. Occupational Hydrofluoric Acid Injury from Car and Truck Washing–Washington State, 2001-2013. MMWR Morb Mortal Wkly Rep. 2015;64(32):874-877. doi:10.15585/mmwr.mm6432a4

“Occupational exposure to HF-based wash solutions can result in chemical burns, disability, and death. HF’s potential to cause severe injury.” Supra.

Are Car Wash Employees At Risk for Skin Disorders?

Yes. Cash Wash Employees suffer skin-related due to working with liquids. This type of work is called “wet work.” Zani MLC, Lazzarini R, Silva-Junior JS. W arm-water immersion foot among car wash workers. Rev Bras Med Trab. 2017;15(3):217-221. Published 2017 Sep 1. doi:10.5327/Z1679443520170021

“Wet work is characterized by activities involving frequent immersion of the hands in water, frequent or intensive hand washing or frequent use of impermeable gloves. Workers exposed to wet work might develop hand eczema and contact dermatitis”

Car Washes provide for the risk of both hand skin disorders as well as foot skin disorders. Supra.

“Prolonged contact with water causes different forms of dermatitis, including hand eczema among workers exposed to wet work3. In turn, superficial mycoses are the conditions that most commonly affect the lower limbs. However, continuous and excessive contact with water might also cause a disorder known as immersion foot or trench foot. The latter is a dermatosis that results from prolonged exposure to physical agents such as dampness and cold, and was first described among soldiers in World War I (1914-1918). ”
Supra.

What if I Need Advice?