THE CONTROLLED SUBSTANCE UTILIZATION REVIEW AND EVALUATION SYSTEM (CURES) AND WORKERS’ COMPENSATION: INJURED WORKERS, PRESCRIPTION DRUGS AND WORK INJURY TREATMENT: WHAT YOU NEED TO KNOW

Frequently, Injured Workers’ Medical Reports have the word “CURES” contained within it. This article will discuss what “CURES” means and the significance it is with respect to an Injured Workers’ claim and their access to treatment.

What is CURES?

The Controlled Substance Utilization Review and Evaluation System (CURES) “is a database of Schedule II, III and IV controlled substance prescriptions dispensed in California serving the public health, regulatory oversight agencies, and law enforcement. CURES 2.0 is committed to the reduction of prescription drug abuse and diversion without affecting legitimate medical practice or patient care.” Office of Attorney General, State of California.

What are Controlled Substances?

Per the United States Drug Enforcement Agency (DEA), “Drugs, substances, and certain chemicals used to make drugs are classified into five (5) distinct categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or dependency potential.” For an alphabetical list of controlled substances, here is the link: https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf

What Are Schedule II Drugs? 

Per the DEA, “Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are: Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin.”[emphasis added]

What Are Schedule III Drugs? 

Per the DEA, “Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are: Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone.” [emphasis added]

What Are Schedule IV Drugs? 

Per the DEA, “Schedule IV drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are: Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol.” [emphasis added]

Who Has Access To CURES? 

According to the State of California, “CURES 2.0 is limited to licensed prescribers and licensed pharmacists strictly for patients in their direct care; and regulatory board staff and law enforcement personnel for official oversight or investigatory purposes.” Office of Attorney General, State of California.

What Does This Mean to Injured Workers? 

During your treatment for your industrial injury, your doctors may prescribe controlled substances that are subject to the CURES laws. This means that your prescriptions will be monitored with respect to drug abuse and diversion. Drug abuse applies to misuse by the individual patient. Diversion applies if the drugs prescribed are being distributed by the patient to other individuals. In sum, if your doctor is complying with CURES, your prescriptions, that are controlled substances with the reporting requirements, are being monitored.

Further, your medical provider may search CURES to see what medications you are taking. This allows them to make appropriate prescriptions in compliance with the mandate concerning drug substance abuse and drug diversion. They may document that they have done a CURES search within their medical reporting. Also, this search may alert your medical provider with respect to the need to address possible issues of addiction or substance abuse with respect to your course of treatment.

Is There Any Privacy Concerning CURES? 

Yes. Per the State of California “The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and confidentiality and disclosure provisions of California law cover the information contained in CURES 2.0.” Office of Attorney General, State of California.

What Information Is Contained In CURES?

Per the State of California, “California Health & Safety Code Section 11165(d) requires dispensing pharmacies, clinics, or other dispensers of Schedule II through IV controlled substances to provide specified dispensing information to the Department of Justice on a weekly basis.” Office of Attorney General, State of California.

For Injured Workers who are receiving scheduled medication, if it is a particular scheduled drug, it will be submitted to the CURES database.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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 worker’s compensation cases for 28 years.

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WORKERS’ COMPENSATION LAWYERS, THE CALIFORNIA LAWYERS ASSOCIATION AND WORKERS’ COMPENSATION: ATTORNEYS REPRESENTING INJURED WORKERS: WHAT YOU NEED TO KNOW

The California Workers’ Compensation System is very complicated. Frequent changes in the law and current events require Attorneys practicing in workers’ compensation to stay up to date. In order to stay up to date, Workers’ Compensation Lawyers participate in educational programs. Therefore, Associations that provide educational programs and address issues such as the standards for Lawyers practicing within the field is of import. Injured Workers are best served when their lawyers are active members of such Associations.

In California, the California Lawyers Association (CLA) provides support to the Workers’ Compensation community to enhance the quality of the practitioners within the field. CLA has a Workers’ Compensation Section which supports the workers’ compensation community. The CLA Workers’ Compensation Section is essentially a spin-off from the State Bar Section on Workers’ Compensation. The CLA produces programs at the quality level of the State Bar.

Per the CLA, “[t]he purpose of the Workers’ Compensation Section of the California Lawyers Association is to serve our members, workers’ compensation practitioners, and the people of California by promoting an efficient and just compensation delivery system.”

Is The CLA Workers’ Compensation Section Exclusive for Applicant’s Attorneys? 

No. the Section is open to all participants in the workers’ compensation field. Therefore, both Applicant’s Attorneys and Defense Attorneys participated.

If an Attorney is a Member of the CLA Workers’ Compensation, Is That Important?

Yes and No. Any Lawyer can pay to be a member of the Workers’ Compensation Section. Therefore, being a member does not mean anything. Being an active member, however, is important. An active member, in my opinion, is one who regularly attends or participates in the various Educational Program provided.

Should an Injured Worker Value an Attorney Who Is a Member of CLA? 

Absolutely. As an active member, I have had the opportunity to attend countless seminars that CLA has provided. These seminars are well attended by both Applicant’s Attorneys and Defense Attorneys. The attorneys who I have seen attend these seminars are quite competent individuals. Further, the materials presented to them keep them apprised as to workers’ compensation law in general as well as recent case law and legislation that impacts the workers’ compensation system. Further, these seminars include many outstanding speakers and presenters in the industry. In sum, active participants in the Workers’ Compensation Section of CLA, are up to date on various workers’ compensation issues.

Further, participation in these programs allows Applicant’s Attorneys and Defense Attorneys to interact and debate ongoing issues within workers’ compensation. It is an opportunity to understand the positions that will be taken by the “other” side.

What are the Activities of the CLA’s Workers’ Compensation Section? 

The Workers’ Compensation Section of CLA is involved in the following activities: Publishing newsletters to keep members informed of new developments; establishing committees through which members may actively participate; presenting educational seminars on timely topics throughout the year; originating legislation which, upon approval, is made a part of our legislative program; recommending positions on pending legislation on behalf of the California Lawyers Association, and commenting on administrative regulations and rules of court.

What is the CLA Workers’ Compensation Section’s Purpose?

They ”are dedicated to serving our members, workers’ compensation practitioners, and the people of California by promoting an efficient and just compensation delivery system.”

Per the CLA website “[t]he purpose of the Workers’ Compensation Section of the California Lawyers Association is to serve our members, workers’ compensation practitioners, and the people of California by promoting an efficient and just compensation delivery system. The section, through standing committees, seeks to promote better legal practice, education and legislation affecting workers’ compensation. We review proposed state legislation and regulatory rules, and make recommendations to the authors. Our goal is to achieve the following constitutional mandate: Constitutional Basis of Laws

The Workers’ Compensations Act, codified in the Labor Code, with other related laws, has its jurisdictional basis in the California Constitution, Article XIV, sec. 4, which provides in part as follows:

The Legislature is hereby expressly vested with plenary power, unlimited by any provision of this Constitution, to create, and enforce a complete system of workers’ compensation…to compensate…workers for injury or disability, and…for death…irrespective of the fault of any party…to the end that the administration of such legislation shall accomplish substantial justice in all cases expeditiously, inexpensively, and without encumbrance of any character…””

What Type of Educational Programs Does CLA Provide in the Workers’ Compensation Section?

The Workers’ Compensation Section provides a wide variety of programs. There are seasonal programs which cover a large variety of topics. There are Rating Seminars which deal with rating issues. There are Specialization Seminars which assist attorneys in preparation of the specialization examination. Also, they also have Webinars on a large variety of topics as well.

What Other Services Does the CLA Provide? 

Per CLA, the “California Lawyers Association Workers’ Compensation Executive Committee, subcommittee on Technology and Social Media, offers access to our section members to listen to oral arguments made in Workers’ Compensation cases at various Districts of the California Court of Appeals.”

What Types of Committees Does the Workers’ Compensation Section Have? What Types of Things Do they Do?

The Workers’ Compensation Section has an Executive Committee, an Educational Committee, a Practice and Ethics Committee, a Legislation Committee, an Awards and Recognition Committee, Publications Committee, Membership Committee, Technology/Website/Social Media, a Community Outreach Committee, and an Unpublished Cases Committee.

These committees work on many different things such as improving the level of professionalism and competence for all individuals who practice before the Workers’ Compensation Appeal Board. They do so by providing quality and affordable education, public outreach, and assist with legislation.

How Does the CLA Workers’ Compensation Section Provide Assistance to the Workers’ Compensation Community? 

Per the CLA, the Section “seeks to promote better legal practice, education and legislation affecting workers’ compensation. We review proposed state legislation and regulatory rules, and make recommendations to the authors. Our goal is to achieve the following constitutional mandate: Constitutional Basis of Laws: The Workers’ Compensations Act, codified in the Labor Code, with other related laws, has its jurisdictional basis in the California Constitution, Article XIV, sec. 4, which provides in part as follows: The Legislature is hereby expressly vested with plenary power, unlimited by any provision of this Constitution, to create, and enforce a complete system of workers’ compensation…to compensate…workers for injury or disability, and…for death…irrespective of the fault of any party…to the end that the administration of such legislation shall accomplish substantial justice in all cases expeditiously, inexpensively, and without encumbrance of any character…”

What Do Members of CLA Workers’ Compensation Section Get? 

As a member, they are provide a newsletter, and provide access and discounts to Workers’ Compensation Section Programs and Publications. In addition, Members are allowed to participate in the Section and the Committee activities.

What If I Need Advice?

If you would like a free consultation regarding your workers’ compensation claim, 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 28 years. Contact us today for more information.

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PROSTATE CANCER AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Prostate Cancer is a medical condition for which there may be an element of industrial causation. Since Prostate Cancer, in certain circumstances, may be industrially related, an Injured Worker could make a workers’ compensation claim for their Prostate Cancer. If the Workers’ Compensation Claim was accepted, the Injured Worker would cover the full range of benefits from disability payments, medical care to death benefits.

This article will discuss Prostate Cancer, Prostate Cancer Treatment, Permanent Disability as a result of Prostate Cancer, Industrial Causation of Prostate Cancer, Labor Code Statutes relating to Prostate Cancer, and Caselaw relating to decisions involving Prostate Cancer.

What is Prostate Cancer? What are the Signs of Prostate Cancer? 

Prostate Cancer is a disease in the Prostate Gland. It occurs when cells in the prostate grows abnormally and uncontrollably. It is a slow growing cancer which may cause symptoms with respect to both urine flow and sexual function. Additionally, there may be more generalized symptoms such as pain in the low back or pelvis area, weakness or numbness in the legs or feet, dizziness, or fatigue. Sources: National Cancer Institute and American Cancer Society.

How is Prostate Cancer Diagnosed? 

Per the American Cancer Society, there are many tests that are used to both diagnose and stage prostate cancer. Basically, an individual will go through a series of testing in order to assist in diagnosis. Urology is the field of medicine that address Prostate Cancer. Doctors who specialize in Urology are Urologists.

Tests include

  • Prostate-Specific Antigen (PSA) [Blood Test]
  • Digital Rectal Examination (DRE) [Physical Examination Test]
  • Prostate Biopsy [Surgical Procedure] Tissues are removed from the Prostate. A Pathologist makes a determination as to whether the tissue is negative for cancer, suspicious for cancer, or positive for cancer. Note: negative results does not mean that the individual should not be concerned about cancer. Further monitoring should be conducted.

Imaging Studies: X-Rays, Magnetic Resonance Imaging (MRI), Ultrasound (Transrectal ultrasound (TRUS), Radiology, Bone Scan, Computed Tomography (CT), Lymph Node Biopsy,

 

What are the Non-Industrial Risk Factors of Prostate Cancer?

There are a number of risk factors for prostate cancer. These risk factors include family history of prostate cancer, inherited genetic mutations, conditions such as prostatitis, inflammation of the prostate, and benign prostatic hyperplasia or BPH, a noncancerous enlargement of the prostate gland, diet high in red meats and high-fat dairy and low in fruits and vegetables, obesity, Age: approximately 60 percent of cases are diagnosed in men older than 65, Race and ethnicity (note: African-American men and Caribbean men of African ancestry are more likely to be diagnosed with prostate cancer.)

Please note: Research has also shown that a healthy lifestyle, including a well-balanced diet and maintaining a healthy weight, may reduce prostate cancer risk.

What are the Industrial Risk Factors for Prostate Cancer? Are There Other Factors? 

Prostate Cancer can be work-related in two fashions. First, there is a scientific basis for showing that there is a causative factor in certain occupations or occupational exposures with respect to the development of Prostate Cancer. Second, there is a legal basis for showing a causative factor. A legal basis is a statutory presumption. For certain law enforcement officers and safety officers, they are afforded a “Cancer Presumption.” If they fit within the elements of the “Cancer Presumption,” they can be legally found to have industrial cancer without having to prove it on a scientific basis. Their Departments, however, are afforded the opportunity to “rebut the presumption.”

How Is Prostate Cancer Work-Related?

Prostate Cancer can be work-related in a variety of manners. Prostate Cancer can be work-related with respect to certain:

  • Worksite Exposures: Certain Pesticides, Chromium
  • Occupations: Administrative and Management Positions, Firefighting and Law Enforcement, Pilots, and Agriculture
  • Work Activities: Shift Work
  • Statutory: Labor Code Presumption for Cancer 3212.1

See Cancer Med. 2018 Apr; 7(4): 1468–1478, Published online 2018 Mar 1. doi: 10.1002/cam4.1358 Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC)

Jeavana Sritharan, Jill MacLeod,  Shelley Harris, Donald C. Cole, Anne Harris, Michael Tjepkema, Paul A. Peters, and Paul A. Demers; and J Cancer Prev. 2019 Jun; 24(2): 91–111.

Published online 2019 Jun 30. doi: 10.15430/JCP.2019.24.2.91, Occupational Risk Factors for Prostate Cancer: A Meta-analysisSrmena Krstev and Anders Knutsson

What is the Statutory Basis for Supporting Industrial Prostate Cancer?

Labor Code Section 3212.1 provides for a “General” Cancer Presumption. This Presumption applies to certain Safety and Law Enforcement Officers. This Presumption has been used to specifically make claims for “Prostate Cancer.” It provides as follows:

“(a) This section applies to all of the following:

(1) Active firefighting members, whether volunteers, partly paid, or fully paid, of all of the following fire departments:

(A) A fire department of a city, county, city and county, district, or other public or municipal corporation or political subdivision.

(B) A fire department of the University of California and the California State University.

(C) The Department of Forestry and Fire Protection.

(D) A county forestry or firefighting department or unit.

(2) Active firefighting members of a fire department that serves a United States Department of Defense installation and who are certified by the Department of Defense as meeting its standards for firefighters.

(3) Active firefighting members of a fire department that serves a National Aeronautics and Space Administration installation and who adhere to training standards established in accordance with Article 4 (commencing with Section 13155 ) of Chapter 1 of Part 2 of Division 12 of the Health and Safety Code.

(4) Peace officers, as defined in Section 830.1, subdivision (a) of Section 830.2 , and subdivisions (a) and (b) of Section 830.37, of the Penal Code , who are primarily engaged in active law enforcement activities.

(5)(A) Fire and rescue services coordinators who work for the Office of Emergency Services.

(B) For purposes of this paragraph, “fire and rescue services coordinators” means coordinators with any of the following job classifications:  coordinator, senior coordinator, or chief coordinator.

(b) The term “injury,” as used in this division, includes cancer, including leukemia, that develops or manifests itself during a period in which any member described in subdivision (a) is in the service of the department or unit, if the member demonstrates that he or she was exposed, while in the service of the department or unit, to a known carcinogen as defined by the International Agency for Research on Cancer, or as defined by the director.

(c) The compensation that is awarded for cancer shall include full hospital, surgical, medical treatment, disability indemnity, and death benefits, as provided by this division.

(d) The cancer so developing or manifesting itself in these cases shall be presumed to arise out of and in the course of the employment.  This presumption is disputable and may be controverted by evidence that the primary site of the cancer has been established and that the carcinogen to which the member has demonstrated exposure is not reasonably linked to the disabling cancer.  Unless so controverted, the appeals board is bound to find in accordance with the presumption.  This presumption shall be extended to a member following termination of service for a period of three calendar months for each full year of the requisite service, but not to exceed 120 months in any circumstance, commencing with the last date actually worked in the specified capacity.

(e) The amendments to this section enacted during the 1999 portion of the 1999-2000 Regular Session shall be applied to claims for benefits filed or pending on or after January 1, 1997, including, but not limited to, claims for benefits filed on or after that date that have previously been denied, or that are being appealed following denial.

(f) This section shall be known, and may be cited, as the William Dallas Jones Cancer Presumption Act of 2010.”

Is There Caselaw concerning Prostate Cancer?

Yes. There has been some significant litigation with respect to Prostate Cancer. Most of it has related around the “Cancer Presumption” and the issues related to it. Issue of interest in presumption litigation can include the burden of proof, the potential rebuttal of the presumption and the statute of limitations. See the following cases County of Fresno vs. WCAB (2019) 84 C.C.C. 996 (writ denied) (Issue: whether claim barred by Statute of Limitations); County of Orange vs. WCAB (2005) 70 C.C.C. 1499 (Prostate Cancer found industrial. Defendant failed to rebut presumption.) Faust vs. City of San Diego (2003) 68 C.C.C. 1822 (Panel Decision) (Issue: the procedure concerning both establishing presumption and rebutting the presumption. In summary, in a case where an applicant has invoked the presumption of section 3212.1, the applicant has the initial burden of showing (1) that he or she was employed in an included capacity; (2) that he or she has been exposed to a known carcinogen during the employment; and (3) that he or she has developed or manifested cancer. When the applicant has made this showing, the burden shifts to the defendant to rebut the presumption by evidence that: (1) the primary site of the cancer has been identified; and (2) that the carcinogen is not reasonably linked to the disabling cancer.)

What is Permanent Disability Impairment for Prostate Cancer?

Permanent Disability Impairment for Prostate Cancer is multi-factorial. Prostate Cancer directly impacts two Activities of Daily Living (ADLs), urination and sexual function. The AMA Guides for Permanent Impairment, 5th Edition, has a Table 7-8 which addresses the Criteria for Rating Permanent Impairment Due to Prostate and Seminal Vesicle Disease discusses Prostate Cancer. It provides that “[f]or Prostate and seminal vesicle ablation; occurs almost exclusively with extirpative surgery for prostate cancer; combine impairment estimates

for prostate and seminal vesicle loss with impairment for sexual dysfunction or urinary incontinence if present (see the Combined Values Chart, p. 604.)”

In sum, Permanent Disability Impairment from Prostate Cancer can be complex due to the nature and extent of both the condition and the treatment that has been provided.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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 worker’s compensation cases for 28 years.

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KAISER PERMANENTE (KAISER) AND WORKERS’ COMPENSATION: INJURED WORKERS, MANAGED CARE, TREATMENT FOR INJURIES, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

In California Workers’ Compensation, an Injured Worker’s treatment for their industrial injuries is limited. Insurance Companies limit the treatment by the employment of Managed Provider Networks (MPNs) which dictate the providers that an Injured Worker can use. Kaiser Permanente is a medical provider in the State of California which provides both treatments for Injured Workers as well as provides Managed Care in the form of Health Insurance.

Many Employees in California rely upon Kaiser Permanente to provide their general health coverage. Some of these Employees have been Kaiser members for decades. Some of these Employees, in the event of an industrial injury, prefer to treat with Kaiser. They are comfortable with the facilities, they know that they providers have all of their medical records, and they have some faith that they will be fair and respectfully in treated by them in them with respect to their industrial injury.

This article will discuss Kaiser Permanente and its Occupational Medical Program called Kaiser On-The-Job. 

What is Kaiser Permanente (Kaiser)? 

Kaiser is a Managed Care Institution. Kaiser provides Health Care Plans for Employers, Individuals, and for Medicare Recipients. Also, Kaiser provides Occupational Care for work injuries. Kaiser Permanente is frequently listed as a Medical Care Provider for many Managed Provider Network Plans or MPNs

What Occupational Services Does Kaiser Provide?

Kaiser has a Department called Kaiser On-The-Job. This Department provides medical treatment for workers’ compensation injuries. In addition, the Department provides for Medical Evaluations, Screening and Monitoring, Drug and Alcohol Testing, and Immunizations.

  • The Medical Evaluations provided can include Preplacement and Post-Offer Examinations, Fitness for Duty and Return to Work Examinations, and Department of Transportation and Department of Motor Vehicle Examinations.
  • The Screening and Monitoring services provided include Respiratory Clearance, Asbestos Evaluations, Lead Surveillance, Hazardous Waste Worker Evaluations, Firefighter Examinations, and Hearing Conservation.
  • The Drug and Alcohol Testing provided can include Urine Specimen Collection and Breath Alcohol Testing.
  • The Immunization Services provided include immunization for Hepatitis A & B, Tetanus, Diphtheria, and Pertussis.

Per Kaiser, “On-the-Job” provides: specialized care for work-related injuries, skilled physicians who are board certified or board eligible in occupational medicine or a related specialty, urgent and after-hours care available 24 hours a day, every day at many locations, coordinated clinical services, including physical therapy, radiology, specialty care, and pharmacy, and onsite staff who works with you, your employees, and any medical or insurance providers.”

They note that “Many of [their] dedicated occupational health centers are located on Kaiser Permanente hospital campuses, so it’s easy for ..employees to take care of their health needs in one trip.”

Further, the Kaiser promotes “On The Job” as “Cost savings — Employees in [their] care get back to work faster and at a lower cost; Available to all …employees — All of your employees [at a company for which Kaiser is a provider], not just … Kaiser Permanente members can access [their] occupational health services; Support for [the employer] throughout the process — [they will] get timely reports on employee work status, and we’ll work closely with you to coordinate … employees’ appropriate return to work. One-stop convenience — Nearly all of [Kaiser “On The Job”] centers are located in or near clinical facilities, offering convenient access to specialists, pharmacy, X-ray, physical therapy, and more; Advanced health information technology — Caregivers have real-time access to the electronic medical records of Kaiser Permanente members, helping them make quick, well-informed decisions that improve outcomes; and Culturally responsive care — Members receive care that respects their diverse.”

Why Do Insurance Companies Employ Kaiser in Their Managed Provider Networks?

Insurance Companies utilize Kaiser for many reasons. First, Kaiser is a Managed Care Facility. As a result, Kaiser has been able to promote itself as a “cost-saving” provider. They refer to various studies as proof of that assertion.

Note: As an advocate for Injured Workers, the term “cost savings” concerns me. Cost savings can be achieved by various means which are to the detriment of an Injured Worker. This can include the denial of treatment, the premature return of the employee back to their usual and customary occupation, the issuance of medical reports which do not support an award of permanent disability, the failure of the doctors to refer the injured worker out to address all work-related conditions, and the failure to award the he need for future medical care.

Kaiser asserts that they achieve this goal by following “state-mandated fee schedules, relying on an outcomes-based strategy to manage claims costs. Elements of this approach include: Integrated care — [their] occupational health physicians, nurses, care coordinators, and therapists are connected to the same electronic health record system. Real-time access to medical records means they can make well-informed decisions faster for better outcomes and higher patient satisfaction. Convenient locations — Many Kaiser Permanente On-the-Job facilities are located at or near [their] medical offices and hospitals. This means employees — even those who aren’t Kaiser Permanente members — can get the care they need quickly, so they can return to health and to work as soon as appropriate. Coordinated case management — Kaiser Permanente On-the-Job keeps employers informed with regular work status reports, and works with them to help ensure employees return to work appropriately.”

In the study they cite that they have be able to reduce costs per claim, medical costs per claim, average pharmacy costs per claim, fewer claims involving litigation, lowering medical costs for low back injuries per claim and lower costs for shoulder and upper arm injuries per claim.

Note: as an advocate for Injured Workers, implied within these reduced costs are the denial of treatment, early return to work, the provision of less costly medications, the less advice by doctors to injured workers that they should get a lawyer, and possibly less sophisticated reporting and analysis of claims by treating doctors as to addressing all affected body parts. A more sophisticated analysis would allow for more permanent disability and medical care for the Injured Worker.

As a Representative of Injured Worker’s, How Do You Feel About Kaiser?

Kaiser can be both good and bad with respect to treatment for industrial injuries. Unlike other treatment arrangements, Kaiser employs a “gatekeeper” doctor to manage the treatment. This means that you are sent to an Occupational Medicine Doctor for your treatment. You are then reliant upon that doctor to refer you to various specialties such as an orthopedic surgeon or internal medicine doctor.

Kaiser does have nice facilities and has many diagnostic testing available at the facilities. Also, they have pharmacies at facilities as well. Therefore, there is a convenience factor for injured workers.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, 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 worker’s compensation cases.

Photo by Pop & Zebra on Unsplash

FRAGRANCES AND WORK-RELATED ASTHMA: WORK INJURIES CAUSED BY EXPOSURE TO PERFUME AND FRAGRANCES: WHAT YOU NEED TO KNOW

Workplaces contain many chemicals that can irritate a Worker’s Lungs.   These irritations can occur in two ways.   It can occur when a Worker with pre-existing conditions, such as asthma, is exposed to the chemicals.   Also, it can occur with Worker who has no pre-existing conditions.

Asthma is a significant illness within the United States Population. Per the Centers for Disease Control and Prevention, in 2018, 24,753,379 individuals suffered from the disease and 2,607,598 of them were from the State of California.   In addition, there are large amounts of the population that suffer from Childhood Asthma, 5,530,131, in the United States.   The large number of individuals with Asthma implies that there is a large number of the workforce has pre-existing Asthma.

This article will discuss Asthma, Fragrances, Perfumes, and Work-Related Asthma.

What Is Asthma? What Is Occupational Asthma or Work-Related Asthma?

Per the American Academy of Allergy, Asthma & Immunology, “Asthma is a chronic disease involving the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs. If you have asthma your airways are always inflamed. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness.”

Occupational Asthma “is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.”  Per the CDPH, “[a]sthma is work-related when it is caused or made worse by something at work. Symptoms can start right after an employee breathes in a substance, or hours after leaving work. Sometimes a person can suddenly develop work-related asthma from substances they have worked around for years.”

What are Fragrances?

The term “fragrances,” for the purposes of this article, refers to perfumes and products that contain “fragrances.” A “fragrance” is essentially a pleasant scent.  In essence, a perfume is a “fragrance” that is placed upon a person.   Besides perfumes, various commercial and household products are enhanced with “fragrances” so that they “smell” good.

Both perfumes and fragrances contain chemicals effect an individual’s respiratory system.  As a result of exposure to these perfumes or fragrancies, an individual may suffer from respiratory symptoms which can include wheezing, chest tightness, cough, shortness of breath, or difficulty breathing.

What About Air Fresheners?

There are problems with Air Fresheners.   Per CDHP, “Air fresheners and deodorizers come in many forms: plug-ins, sprays, liquids, and gels. These products mask bad odors rather than get rid of them. Air fresheners add chemicals to the air that can cause asthma and other health problems such as headaches and allergies.”

How Does an Industrial Onset of Asthma Arise?

Occupational or Work-Related Asthma can be from a single event of inhalation or inhalation of a substance over a prolonged period of time.

What Are Examples of Industrial Exposures?

Use of Air Fresheners: There was one report where the use of an air freshener triggered asthma symptoms required the Worker to go to the emergency room for a visit.  As a result, the Worker required treatment of oral steroids to control their asthma.

Scented Lotions: Scented lotion from one worker got on a co-worker’s jacket.  This exposure worsened the co-worker’s asthma symptoms and gave him hives.  He was required to go to the emergency room 6 times as a result of 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.

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