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Job Choice, Spinal Pain & Workers’ Compensation

Posted on October 20, 2021 by Edward Singer

Your job choice may impact you having spinal pain. Neck and Back pain may have a relationship to your job satisfaction. A recent study suggests that workers’ spinal pain may have some connection to whether the workers like their job. Skillgate E, Isacson Hjortzberg M, Strömwall P, Hallqvist J, Onell C, Holm LW, Bohman T. Non-Preferred Work and the Incidence of Spinal Pain and Psychological Distress—A Prospective Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(19):10051. https://doi.org/10.3390/ijerph181910051

This article will discuss the possible relationship between spinal pain and job satisfaction.

How Did the Study View Job Satisfaction?

A non-preferred work is, here, defined as reporting working in a non-preferred profession and/or non-preferred workplace. Skillgate E, Isacson Hjortzberg M, Strömwall P, Hallqvist J, Onell C, Holm LW, Bohman T. Non-Preferred Work and the Incidence of Spinal Pain and Psychological Distress—A Prospective Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(19):10051. https://doi.org/10.3390/ijerph181910051

This study essentially looked at those who liked their job and those who didn’t.

Is There Other Research Results Concerning Pain Intensity and Job Satisfaction?

Yes. There have been studies suggesting a positive association with job satisfaction and pain. It was reported that “people who did not like their workplace experienced higher pain intensity compared to those who did like their job.” The study did not address any causal relationship, however. Supra.

What was the Current Study’s Conclusions?

“Non-preferred work seems to be associated with a higher incidence of developing spinal pain, psychological distress and spinal pain with concurrent psychological distress, especially if the possibility to change job is low. “ Supra.

In sum, workers stuck with an unhappy job are more likely to have spinal pain versus those who have job satisfaction.

What Does This Mean?

This study, to some degree, supports the nature and extent of an Injured Workers’ pain. Injured Workers, who have jobs with little satisfaction, may legitimately suffer more spinal pain than those who have job satisfaction. Therefore, there is perhaps a valid argument to make that these Injured Workers should have their pain assessments discounted.

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. Contact us today for more information.

FIREFIGHTER INJURY FREQUENCY AND WORKER’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 27, 2021 by Edward Singer

In California, the State, Counties, Municipalities, and Cities employ Firefighters. Firefighting, like other safety positions, are dangerous occupations which have significant risk of injury. Firefighters are expected to and are willing to put themselves in harm’s way to save lives. Due to their injury rates, data concerning Firefighter Work Injuries have been studied as to the nature of their work injuries and their injury rates. A recent RAND study provides some insight into the challenges that Firefighters face.

What Are Firefighters’ Work Injury Rates Compared to Others?

Compared to other occupations, Firefighters have high injury rates. Their rate is slightly less Police Officers. Between 2005-1017, the rates were 200 per 1000 workers for Firefighters. This rate is compared to 35 to 50 injuries per 1000 for all workers. Dworsky M, Seabury SA, Broten N. The Frequency and Economic Impact of Musculoskeletal Disorders for California Firefighters: Trends and Outcomes over the Past Decade. Rand Health Q. 2021;9(2):4. Published 2021 Aug 16.

What Are the Most Significant Injuries That Firefighters Sustain?

Of all types of injuries, 47 percent of all Firefighter injuries were musculoskeletal in nature. Supra.

What Body Parts Do Firefighters Injure?

Compare to other occupations, Firefighters sustain more trunk, ie spine, and lower extremity injuries versus upper extremity injuries than other occupations. Supra.

What Are the Causes of Injury for Firefighters?

Strains are the most common cause of injury for Firefighters. Also, burn injuries are more common for firefighters. They represent 6 percent of their injuries. Supra.

Do Firefighters Seek Psychiatric Treatment for Musculoskeletal Disorder Injuries?

It was found that there was no difference between psychiatric issues for firefighter versus workers in similar occupations. Supra.

The caveat to this issue is whether Firefighters use their own health insurance to address psychiatric issues rather than workers’ compensation. Further, there is also the stigma problem. Firefighters may not want it known to Management and co-workers that they have mental health issues.

What If I Need Legal Advice?

WCITN #3: Even Superheroes Get Hurt: What You Need to Know

Posted on July 21, 2021 by Edward Singer

Holy Cow Batwoman! Pow, Kabam! Ouch!

Ruby Rose, who played Batwoman, on the CW Television Show reported that she sustained two injuries while working on the program.

While wearing a latex Batwoman Mask, she developed an allergic reaction. She also had an accident on the set which required back surgery. foxnew.com

Can An Allergic Reaction Be An Industrial Injury?

Yes. Allergic reactions can be work-related injuries. If so, the Injured Worker will receive medical treatment paid for by the insurance company as well as monetary compensation.

Allergic Contact Dermatitis (ACD) is an inflammation of the skin caused by an immunologic reaction triggered by dermal contact to a skin allergen. For ACD to occur, a worker must be first sensitized to the allergen. Subsequent exposures of the skin to the allergenic agent may elicit an immunologic reaction resulting in inflammation of the skin. The reaction is not confined to the site of contact and may result in systemic responses. ACD may be caused by industrial compounds (i.e. metals, epoxy and acrylic resins, rubber additives, chemical intermediates), agrochemicals (i.e. pesticides and fertilizers), and commercial chemicals.

A common allergic reaction is latex allergies. Per the CDC, Latex Gloves have proved effective in preventing transmission of many infectious diseases. But for some workers, exposures to latex may result in allergic reactions. Reports of such reactions have increased in recent years–especially among Health Care Workers.

Can An Accident at Work Be An Industrial Injury?

Yes. Workers’ Compensation is “no fault.” Thus, if Ruby Rose had hurt her back by an accidental trip, she would still be able to have a valid claim. The claim would have paid for her back surgery, paid her compensation for her time off of work as well as provided her additional benefits.

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 over 27 years. Contact us today for more information.

What You Need To Know About Amputations & Workers’ Compensation

Posted on July 20, 2021 by Edward Singer

Amputations can be a life-changing event for a Worker. Workers may lose their ability to perform their job as well as perform activities of daily living.

The Workers’ Compensation Community is concerned about amputation cases as they involve extensive medical costs and missed time from work.

This article will discuss amputations, special laws concerning amputations, and interesting data derived from a recent study.

What Is an Amputation?

The Workers’ Compensation Appeals Board defined amputation. In Cruz vs. Mercedes Benz, 72 C.C.C. 1281 (Panel Decision), the WCAB indicated “ Defining amputation as the severance or removal of a limb, part of a limb, or other body appendage comports with the ordinary meaning, and includes the range of potentially compensable scenarios, including both traumatic loss of a body part in an industrial injury and surgical removal during treatment. This definition conforms to our understanding of the common meaning of the term “amputation,” which encompasses external projecting body parts, not internal parts, even if they include bone. It is also consistent with the definitions in the International Dictionary of Medicine and Biology, Dorland’s Illustrated Medical Dictionary, and Stedman’s Medical Dictionary. To the extent that some definitions refer to organs, appear to encompass all body parts, or include an equivocal “etc.,” we reject them or interpret them in a manner consistent with our understanding of the term “amputation.”

Thus, surgery on a lumbar disc was found not to constitute an amputation.

Why Is an Amputation Important in California Workers’ Compensation?

An amputation in a workers’ compensation case triggers entitlement to additional periods of total temporary disability. 240 weeks is allowed in the case of amputations. Labor Code Section 4656. In these cases, there is no requirement that the temporary disability period be connected to the amputation. Jon Van Ness, Applicant v. Barbara Herzstein, 2007 Cal. Wrk. Comp. P.D. LEXIS 239 (Panel Decision)

How Do Amputations Occur on an Industrial Basis?

Occupationally related amputations can occur for many reasons. The accident itself can be the source of the amputation, i.e. a skill saw cutting off a finger. They can result of a crush injury which necessitates an amputation. They can be the result of post-surgical infection. They can be the result of an industrially related disease process such as diabetes.

Interesting Amputation Facts Are:

Males vs. Females

Men sustain most of the work-related amputations. (84.8%) Gomez NG, Gaspar FW, Thiese MS, Merryweather AS. Trends in incidence and correlation between medical costs and lost workdays for work-related amputations in the State of California from 2007 to 2018. Health Sci Rep. 2021 Jul 1;4(3):e319. doi: 10.1002/hsr2.319. PMID: 34250271; PMCID: PMC8247939.

Full-Time vs. Part-Time Employees

Full-Time Employees were more likely to sustain amputation versus Part-Time Workers. (71.7%.) Supra.

Most Amputated Parts

Most claims consisted of partial-hand amputations (82.0%). Most of those were partial-hand amputations, 66.7% were fingers without the loss of the thumb. Following partial-hand amputations, partial-foot amputations were the next most common claim at 5.9%. Supra.

Type of Business

Manufacturing is the industry with the highest number of claims (24.1%.) Supra.

What Should an Injured Worker Take from This Study?

The study noted that “[a]mputations represent high medical costs and number of lost workdays.” Gomez NG, Gaspar FW, Thiese MS, Merryweather AS. Trends in incidence and correlation between medical costs and lost workdays for work-related amputations in the State of California from 2007 to 2018. Health Sci Rep. 2021 Jul 1;4(3):e319. doi: 10.1002/hsr2.319. PMID: 34250271; PMCID: PMC8247939.

Due to the increased medical expense and missed time from work, Insurance Companies will make efforts to control the costs. They may do so by employing a Defense Counsel as well as a Nurse Case Manager.

What If I Need Advice?

CALIFORNIA BACK INJURIES AND TREATMENT GUIDELINES: EVIDENCE BASED MEDICINE (EBM) AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on July 9, 2021 by Edward Singer

California Workers’ Compensation has embraced Evidence Based Medicine (EBM) to dictate industrial medical care authorization.

Thus, when a EBM study is published, the Workers’ Compensation Community looks to its conclusions. The community looks to see the results are aligned with the Labor Code’s mandate to provide treatment to cure or relieve from the effects of an industrial injury.

Back Injury treatment was assessed in a recent EBM study. They looked to see if guidelines treatment achieved favorable results. The results of such a study can shape both insurance company and medical office policy.

This article will discuss the study which looked at California back injury treatment in light of EBM-related guidelines.

What Is Evidence Based Medicine?

Evidence Based Medicine “…integrates medical research with clinical expertise and patient values to support decision making based on the best available evidence.” Gaspar FW, Thiese MS, Wizner K, Hegmann K. Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system. PLoS One. 2021 Jun 17;16(6):e0253268. doi: 10.1371/journal.pone.0253268. PMID: 34138937; PMCID: PMC8211224.

In other words, an Injured Worker’s treatment is geared more towards past research and study results. The Injured Worker’s treating physician’s clinical impressions are viewed as secondary. Thus, EBM-like treatment is provided in an algorithmic or formulaic fashion.

What Was the Study’s Purpose?

“The aim of this study was to determine the influence of adherence to guideline recommendations on lost workdays for workers with acute LBP(low back pain) claims in California’s WC system.” Gaspar FW, Thiese MS, Wizner K, Hegmann K. Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system. PLoS One. 2021 Jun 17;16(6):e0253268. doi: 10.1371/journal.pone.0253268. PMID: 34138937; PMCID: PMC8211224.

In other words, treatment currently can be in a number of modality forms. Some are within guidelines, some treatment which is not recommended by guidelines and some others. During an accepted claim, Injured Workers’ treatment are usually authorized. Sometimes, authorized treatment can be ones that are outside of the guidelines.

What Is Guideline Treatment?

Guideline treatment is based upon the “American College of Occupational and Environmental Medicine (ACOEM)’s Low Back Disorders Practice Guideline was used as the source of guideline recommendations [16]. ACOEM’s treatment guidelines have been adopted in California’s Medical Treatment Utilization Schedule (MTUS), which determines what is reasonable and necessary medical care.” Gaspar FW, Thiese MS, Wizner K, Hegmann K. Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system. PLoS One. 2021 Jun 17;16(6):e0253268. doi: 10.1371/journal.pone.0253268. PMID: 34138937; PMCID: PMC8211224.

What Is the Criticism of the Study?

The study did not look at every back condition. The study limited itself to very specific back conditions. Thus, the results are very limited. The danger of such a study it will be interpreted to apply to back conditions that were not part of the study.

As noted in the study, “to focus on the treatment of uncomplicated LBP claims, claims were removed if they had an inpatient admission during the claim or a “red flag” diagnosis that may indicate treatment outside of guideline recommendations, such as fracture, cancer, infection, aortic aneurysm, and paralysis (S1 Table). Claims were excluded with stenosis diagnoses if they also had an accompanying surgical procedure (i.e., decompression, fusion, or adhesiolysis). Claims were also excluded if there had been a prior LBP claim to remove complicated clinical presentations due to LBP recurrences.” Gaspar FW, Thiese MS, Wizner K, Hegmann K. Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system. PLoS One. 2021 Jun 17;16(6):e0253268. doi: 10.1371/journal.pone.0253268. PMID: 34138937; PMCID: PMC8211224. [emphasis added]

Thus, the study should not be considered one that should be viewed in an expansive nature. It was limited as many back problems were not addressed. It only address uncomplicated back pain complaints.

What Did the Study Look at?

The workers were placed into categories concerning whether or not they received guideline treatment. Likewise, there were categories in which they received no guideline treatment or no treatment at all. Gaspar FW, Thiese MS, Wizner K, Hegmann K. Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system. PLoS One. 2021 Jun 17;16(6):e0253268. doi: 10.1371/journal.pone.0253268. PMID: 34138937; PMCID: PMC8211224.

What Were the Study’s Results?

The results of the study were that “[w]hen workers received guideline-recommended interventions, they typically returned to work in fewer days. The majority of workers received at least one non-recommended intervention, demonstrating the need for adherence to guideline recommendations. Fewer lost workdays and improved quality care are outcomes that strongly benefit injured workers.”

The other result of interest was that “workers who received either no intervention or other medical interventions experienced more favorable outcomes than those who received non-recommended interventions” This result suggests that alternative treatment or no treatment is better than non-recommended interventions.

What If I Need Advice?