KNEE AND HIP INJURIES, OSTEOARTHRITIS, AND WORKERS’ COMPENSATION: PHYSICAL ACTIVITIES AS RISK FACTORS FOR WORK INJURIES: WHAT YOU NEED TO KNOW

There is no requirement that the causes of a work injury has to be 100 percent industrial.

There are some medical conditions that can have a work-related component to them.  In other words, they are only partially caused by job duties.   Osteoarthritis (OA) can be that type of industrial injury.  OA is a common form of arthritis that can impact a variety of parts of the body.  The parts of the body OA can impact includes the knees.

This article will discuss OA , who Treats OA,  and how OA can be work-related.

What is Osteoarthritis?

Per the CDC, “Osteoarthritis (OA) is the most common form of arthritis. Some people call it degenerative joint disease or “wear and tear” arthritis. It occurs most frequently in the hands, hips, and knees.”

“With OA, the cartilage within a joint begins to break down and the underlying bone begins to change. These changes usually develop slowly and get worse over time. OA can cause pain, stiffness, and swelling. In some cases,  it also causes reduced function and disability; some people are no longer able to do daily tasks or work.”

Note:  The term degenerative joint disease is a term that is frequently used.   It is commonly abbreviated to DJD.

What Are the Symptoms of OA?

Symptoms of OA can include pain or aching, stiffness, decreased range of motion, and swelling. CDC.

Who Treats OA, and What Treatments are Available?

OA is an interesting medical condition in that there are two medical specialties that can address the condition.   The two types of doctors are Orthopedists and Rheumatologists.

Orthopedists focus on the bones and the joints.   They can prescribe medications and perform operations.

Rheumatologists focus on internal medicine matters.  They can prescribe medications and prescribe non-surgical treatments.

How Is OA Work-Related?

OA is work-related with respect to some activities.   According to one study,  A synthesis of 69 studies from 23 countries yielded strong and moderate evidence for lifting, cumulative physical loads, full‐body vibration, and kneeling/squatting/bending as increasing the risks of developing osteoarthritis (OA) in men and women.”  Strong and moderate evidence existed for no increased risk of OA related to sitting, standing and walking (hip and knee OA), lifting and carrying (knee OA), climbing ladders (knee OA), [and] driving (knee OA.)” Men and Women’s Occupational Activities and the Risk of Developing Osteoarthritis of the Knee, Hip, or Hands: A Systemic Review and Recommendations for Further Research, Monique A.M. Gignac Emma Irvin Kim Cullen Dwayne Van Eerd Dorcas E Beaton Quenby Mahood Chris McLeod Catherine L. Backman 14 February 2019, https://doi.org/10.1002/acr.23855

Note: thus, there are activities that can increase the risk of OA and other activities which are not a causative risk factor.  Thus, an analysis of one’s work activities is important when considering to file a claim.

What is the Legal Theory for Industrial Causation?

An Injured Worker must prove that their work activities contributed to the development of the disease. South Coast Framing, Inc. v. Workers’ Comp. Appeals Bd. (2015) 61 Cal.4th 291 [188 Cal.Rptr.3d 46, 349 P.3d 141].)

What is the Analysis?

The fact that one engages in certain injurious activities does not guarantee a valid claim.  A medical opinion is required. Such a medical opinion should include a medical examination, testing, review of medical records, review of one’s past medical history, and an analysis of the physical activities the worker engaged in at work. .

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.

HIGH-HEELED SHOES AND MUSCULOSKELETAL INJURIES AT WORK: CLOTHING APPAREL CAUSING ORTHOPEDIC INJURIES: WHAT YOU NEED TO KNOW

On the Job, Workers can get injured as a result of their attire. High-Heeled Shoes have long been considered as a possible source of work place injuries.  Injuries from High-Heeled Shoes can occur in a variety of ways and impact a multitude of parts of the body.

This article will discuss High-Heeled Shoes, the theories of industrial causation of High-Heeled Shoe related injuries, and injuries caused by High-Heeled Shoes.

What Are High Heeled Shoes?

High-Heeled Shoes are footwear in which the heel is farther off of the ground in comparison with the toe. They are considered aesthetically appealing and are commonly worn in professional settings.   As a result, many women wear them in the workplace. The alternative type of shoe is called a “flat.”

What Types of Medical Conditions Can High Heeled Shoes Cause?

There are High Heeled Shoe injuries which relate to those wearing them.  With these type of shoes,  there are issues concerning falls, issues concerning the impact on the prolonged use on the foot, and issues concerning the biomechanics of gait on other parts of the body.  Thus, physical injuries from shoes can range from toe to head.  Specific conditions caused by the footwear usage include hallux valgus and osteoarthritis.  Barnish MS, Barnish J High-heeled shoes and musculoskeletal injuries: a narrative systematic review BMJ Open 2016;6:e010053. doi: 10.1136/bmjopen-2015-010053

Many pathologies are associated with wearing high heel shoes mainly in the lower extremity including blisters, callosities, heel spur, bunions (hallux valgus) in the feet which is mainly due to the altered ankle joint axis and altered arch angle, pain in the calf muscle, knee and hip joint. Younus SM, Ali T, Memon WA, Qazi A, Ismail F. High heel shoes; outcome of wearing in young generation: a cross sectional study. Professional Med J 2014;21(4): 798-803.

Also,  similarly the spine is also adversely affected resulting in back pain which is mainly due to exaggerated spinal flexion. Younus SM, Ali T, Memon WA, Qazi A, Ismail F. High heel shoes; outcome of wearing in young generation: a cross sectional study. Professional Med J 2014;21(4): 798-803.

There has been study concerning women wearing high heel shoes in department store in which hallux valgus deformity was found more common in those workers than those who wore flat shoes. Soemarko DS, Rahmasari F, Kamal AF, Cahayadi SD. Hallux valgus among sales promotion women wearing high heels in a department store. Journal of Orthopaedic Surgery. January 2019. doi:10.1177/2309499019828456  It was noted that “The long duration of work with wearing high heels puts more pressure on the metatarsal, which increases the risk of HV” Supra.

What is the Legal Theory That Makes High Heel Injuries Industrial?

The legal theory behind most High Heel injury claims is that workers’ compensation is a “no-fault” system. Thus, a person’s decision to wear high heels at work is not necessarily of import.  The issue is more that the high heels were in fact worn and work and it was the wearing at work which was the cause of the physical condition.  Thus, the work activities which wearing the shoes is of import. See US Airways vs. WCAB (2002) 67 C.C.C. 1243 (writ denied.) Applicant was found to have left foot injury due to continuous trauma of having to wear high heels on the job. Applicant had a medical-legal opinion that supported it.

Secondary High Heel Injuries? Bystander Injuries?

Besides injuries to the workers wearing high heels, This can include being injured as a result of a first party fall, being stepped on by a high heel shoe, and being assaulted by a pair of high heels. Barnish MS, Barnish J High-heeled shoes and musculoskeletal injuries: a narrative systematic review BMJ Open 2016;6:e010053. doi: 10.1136/bmjopen-2015-010053

What Would be the Controversies in Such Injuries?

In matters involving High Heels, case analysis will focus on the usage of the shoes in the workplace.   If a cumulative trauma injury is alleged, an analysis will be done as to the nature and extent of the shoe usage in the workplace.   Likewise, there will be an inquiry as to the nature and extent of the usage of the shoes outside of work.

What Is I am Having Problems?

It is recommended that you seek medical attention.  An opinion indicating that the usage of the shoes in the workplace is a causative factor towards one’s musculoskeletal disorder, then a workers’ compensation clam should be considered.

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.

 

 

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

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.

 

NURSES IN THE WORKPLACE SUFFERING FROM STRESS: BULLYING IN THE WORKPLACE, PSYCHIATRIC INJURY AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Nursing is one of the most difficult and demanding professions in the world. It is also one of the most important.  Nurses confront life and death situations on a daily basis.

Nurses work with Doctors who are some of the brightest and most difficult individuals on the planet.  These Doctors have demanding schedules and responsibilities which impact on their ability to work with others.

Nurses work with other Nurses who are confronted with the same stressors and responsibilities.  At times, they can be in conflict with each other.

Nurses also work with patients who may have emotional issues that are either pre-existing or are relating to their medical problem at issue.   Also, they may have anger issues relating to their perceived mistreatment at the facility. Nurses also work with patient’s family members who are emotionally involved with the patient’s well- being. They too may be upset at their perceived mistreatment of their beloved family member.

Nurses finally work with medical institutions which have rules and regulations that they need to be in compliance with concerning their operations.

With respect to these numerous interactions, some of these interactions have been viewed as unacceptable and have been labeled as “bullying.”

“Nurse Bullying” has been subject o was subject to a study which found interesting results.  This article will discuss the nature of nurse bullying, how nurse bullying should be analyzed within a workers’ compensation setting, and what a nurse should do if they are subjected to stress.

Even If I am not a Nurse, Why Should I Be Concerned about Nurse Bullying?

“Workplace bullying has also been acknowledged as a threat to patient outcomes and the delivery of quality of patient care, as well as the erosion of personal health and professional wellbeing [91314]. Excellence in patient care flourishes in an environment built on open communication and respectful professional relationships. An environment that condones bullying perpetrates destruction of professional communication.”  Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

What Is Bullying in the Nursing Profession?

Individuals studying bullying characterized the situation as on in which there is a power imbalance.   These interactions can have serious effects on the organization. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

Who Was Responsible for the Bullying?

In the study, there are many types of bullying offenders, including patients, caregivers, doctors, and nurses. Of these, bullying most frequently occurs among nurses and is particularly committed by a colleague rather than by a manager. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

Note: for workers’ compensation purposes, the employment position of the offender is very important

Bullying has also been defined in other studies.

“Bullying goes by many names: workplace aggression, indirection aggression, social or relational aggression, horizontal (lateral) violence, and workplace violence. It has become so popularized in the press; bullying is often, mistakenly, used as an overarching concept. There is a tendency to use many of these terms interchangeably [8]. Bullying is different from horizontal violence in that a real or perceived power differential between the instigator and recipient must be present [15]. Some of the most recent literature suggests that all of these behaviors exist on a conceptual continuum of workplace victimization [3].” Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

Is Bullying the Same as Job Stress?

Those researching this have distinguished it from ordinary job stress.  It is something different from the day to day social stresses or poor management.

What Types of Bullying are Going on?

Bullying has been described in situations where the nurse is new to the area,  in situations where the nurse witnesses mistreatment of others, in situations in which they are singled out for public censure or humiliation, in situation in which there are constantly being interrupted, situations in which they are not in the social clique and they are subject to juvenile-like behavior, situations in which they feel they are being punished with disciplinary  action or threats,   Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

What are the Consequences of Bullying?

Nurses being subjected to bullying is a societal concern.  If this bullying impacts patient medical treatment, it must be addressed in those terms in addition to the health concerns of the Nurse effected.

It is reported that “[n]urses bullied at the workplace may complain of mental symptoms, such as depression, anxiety, and fear, as well as physical symptoms, such as fatigue, headaches, and palpitations. They are also more susceptible to burnout and turnover intention and have lower levels of organizational commitment and nursing productivity. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

If a Nurse Is Having Medical Problems as a Result of Bullying, What Should They Do?

First, seek medical attention to treat your medical problems.  Second, seek assistance through your company’s Employee Assistance Program if one is available. Third, make a consultation with a lawyer as to whether there is some legal action that can be pursued.

There are two areas of law which should be explored.  Workers’ Compensation and Employment Law are two areas which should be analyzed with respect to the bullying.

If a Workers’ Compensation Claim is pursued, the Nurse can claim monetary compensation in the form of temporary disability benefits, permanent disability benefits, medical care, and vocational rehabilitation benefits.

What Are the Legal Barriers for Workers’ Compensation Psychiatric Claims?

With all psychiatric claims of work injury, a detailed factual analysis must be made.  With respect to bullying, there are issues of length of employment and whether the events causing the stress where personnel actions.  Bullying claims are viewed in the same light as all other psychiatric claims.

Labor Code Section 3208.3 provides the threshold requirements for psychiatric claims.

In general, an employee shall demonstrate by a preponderance of the evidence that actual events of employment were predominant as to all causes combined of the psychiatric injury.

Also, in general, there is also a six-month employment requirement.

Also, “[n]o compensation under this division shall be paid by an employer for a psychiatric injury if the injury was substantially caused by a lawful, nondiscriminatory, good faith personnel action.”

Note: Bullying can involve different players.   Some of them supervisors. Supervisors’ actions can be viewed as personnel action. Therefore, there may be “good faith personnel action” defenses that insurance Companies can be raise to defeat such a claim. Therefore, there is no guarantee that bullying cases will be accepted as a valid work injury claim.

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.

 

EXERTIONAL HEAT SYNDROME: HEATED WORK ENVIRONMENTS, WORK INJURIES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Heat Exertion can produce serious injuries in the workplace. The medical condition is commonly known as Exertional Heat Illness (ESI.) Heat Illnesses are multi-causal. Human’s body temperatures can be elevated by a number of factors. First, there is the heat and humidity in the environment. Second, there is the clothing and equipment being used by the worker. Third, there is the nature, extent and the duration of the activities.

This article is focused towards the Heat Exertion as opposed to the Heat Exposure. Note: Heat Exertional Illness is a huge concern for military. Thus, this matter has been studied within that context. Heat Exertion is a concern for all military personnel. Even Military Working Dogs have been studied. Predicting military working dog core temperature during exertional heat strain: Validation of a Canine Thermal Model Catherine O’Brien William J.Tharion Anthony J.Karis Heather M.Sullivan https://doi.org/10.1016/j.jtherbio.2020.102603Get rights and content

In the civilian setting, there are also various occupations that involve serious issues that can bring rise to heat exertional illness.

This article will discuss Heat Exertion Illness, risk factors involved with HEI, the nature and extent of injuries arising from heat exertion, and how it can be addressed within a workers’ compensation setting.

What Is Exertional Heat Illness (EHI)?

Exertional Heat illnesses (EHI) is essentially a variety of medical conditions that may occur during physical exertion that is performed in hot and humid environments. This can be the case when there is performance of strenuous physical activities for extended durations in hot environments.

In the civilian workforce, HEI may impact occupations such as Agriculture, Construction Workers, Police Officers, and Refinery Workers.

For instance, with respect to Wildland Fire Fighters, a study noted the nature and extent of the clothing and equipment that they carry. The study noted that “WLFFs wear standard fire equipment: Nomex long-sleeve shirt and pants, mid-calf leather logger boots, a 100% cotton short-sleeve undershirt, leather gloves, hard hat, and a 12 to 20 kg pack containing food, water, safety gear, and work tools.” High Work Output Combined With High Ambient Temperatures Caused Heat Exhaustion in a Wildland Firefighter Despite High Fluid Intake John S.Cuddy MS Brent C. Ruby PhD https://doi.org/10.1016/j.wem.2011.01.008

Why is EHI a Serious Concern?

Due to the fact that EHI can cause a variety of medical conditions, there is also a wide range of medical problems that EHI can cause.

Mild forms of EHI can include heat cramps. Severe forms of EHI can include heat stroke. Severe EHI can lead to multiorgan damage and death. Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

Does Body Temperature Play a Role?

Yes. Body Core Temperature plays a role in the severity of the injury. Temperatures less than 40 degrees Celsius (104 degrees Farenheit) percent are associated with milder symptoms and temperatures greater than 40 degrees Celsius brought on more serious symptoms which provided central nervous system symptoms such as dizziness, confusion, and loss of consciousness. Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

What are the Main Risk Factors in EHI?

There are a variety of risk factors that can impact EHI. The main risk factors in the study were gender, physical fitness, obesity, previous history of heat illness, motivation, hot environmental conditions, and service unit. Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

“[T]these risk factors into three groups—host (individual physiologically limiting), environmental and organizational (training organization) factors. Supra.

Are There Risk Factors of Interest?

Yes.

Females were more likely to experience EHI than males.

High Body Mass Index (BMI) individuals are more likely to experience EHI.

Lower Physical Fitness individuals are more likely to experience EHI.

Over Motivated Individuals are more likely to experience EHI. One reason being is that they may not pace themselves.

A prior history of heat illness makes individuals more susceptible to heat stroke or severe heat illness.

Hot conditions such as summer seasons and in hot weather conditions make individuals at greater risk of EHI.

Some Units, task dependent and equipment dependent groups, can have increased risk of EHI versus other units. . Alele FO, Malau-Aduli BS, Malau-Aduli AEO, J Crowe M. Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies. Int J Environ Res Public Health. 2020 Sep 25;17(19):E7037. doi: 10.3390/ijerph17197037. PMID: 32993024.

If a Worker is Suffering from a Heat-Related Illness, What Should They Do?

If the Injured Worker was exposed to excessive heat in the workforce, they can consider filing a workers’ compensation claim. This would allow them to claim medical care, monetary benefits in the form of temporary and permanent disability benefits. Also, vocational rehabilitation benefits may be indicated. If a fatality situation, a death claim for the dependents may be indicated.

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.

9.3Edward Jay Singer
Edward Jay SingerReviewsout of 22 reviews