THE EMPLOYEE’S DISABILITY QUESTIONNAIRE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Injured Workers, in their Workers’ Compensation Claim, may be evaluated by a Qualified Medical Evaluator (QME) or an Agreed Medical Evaluator (AME.)

With respect to these Evaluations, Injured Workers are required to fill out a variety of forms.     The DWC-AD Form 100 is one of those forms. It is the “Employee’s Disability Questionnaire.”

This article will discuss the “Employee’s Disability Questionnaire,” the questions that are asked, and how an Injured Workers’ case can be impacted  the form.

Why is the DWC-AD 100 A Disability Evaluation Unit (DEU) Form?   

QME reports or AME reports are sent to the Disability Evaluation Unit (DEU) are often sent to the DEU for a rating.  Ratings determine Injured Workers’ Permanent Disability Percentages.

The form’s questions assist the DEU with information that impacts the rating formula.

What Is the Form’s Purpose?

The form is intended to “aid the doctor in determining your permanent impairment or disability.”

Who Gives the Injured Worker the Form?

Generally, the form may be sent to the Injured Worker in advance of the QME or AME evaluation.   Sometimes, the evaluator’s offices will provide it to the worker.

What Happens to the Form?  

The evaluator includes the form as part of their report.  Insurance Companies, Attorneys and Injured Workers will receive it.  For Unrepresented Injured Workers, the report, with the form,  will be sent to the DEU for a rating.

What Questions Are Asked?

General identification information are requested which include providing your name, your social security number, your mailing address, your date of birth, and your date of injury.

You will also be asked your Employer’s Name, and the nature of Employer’s Business.  You will be asked for the insurance company’s claim number(s.)

There are questions about the evaluation. You will also be asked how the Evaluator was selected.  This can be by panel, agreement or sometimes at the request of a Workers’ Compensation Judge.   They will ask evaluation details including the name of the doctor and the date of the examination.

Your will be asked about your job duties at the time of injury.

You will be asked about the disability caused by your injury. Note:  Since this is form is attached to the QME report, it is your one opportunity to write down your unedited and unfiltered complaints. Judges, Insurance Companies, and Attorneys will be able to view your form and compare them to the QME’s reporting.

You will be asked about how the injury affects your work. Note: again, this is your one opportunity to write down to tell everyone involved your unedited and unfiltered opinion.

You will be asked as to whether you had a disability as a result of another injury or illness, If so, they ask you when and to describe it.

Why Are These Answers Important?

Your questionnaire’ answers assist the DEU with generating a Permanent Disability Rating.  The for helps the DEU specifically with two issues: Occupational Group Number and Apportionment.

The Occupational Group Number can change a disability rating.  It can cause it so go up, go down or remain the same.

The DEU will use the form to address apportionment.  The questions provides information for  the Disability Evaluation Unit so that they may make an annotation concerning apportionment.   Apportionment determines how much of the disability relates to the injury.  DEU ratings will often contain notes on apportionment.

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.

COVID-19 WORKERS’ COMPENSATION CASES AND PERMANENT DISABILITY: WHAT YOU NEED TO KNOW

A Stanford University Study reported on the residual complications from COVID-19. This study is important to Injured Workers who have filed COVID-19 related claims.

This article will address the study and what it means for Injured Workers.

What Was the Study About?

The study looked at COVID-19 patients, most of them who had been hospitalized, who reported symptoms and signs months after they became ill.  Stanford Press Release.

What Did the Study Find?

The study reported 84 different symptoms and signs from the patients. “Among the most common lingering symptoms were shortness of breath, fatigue, and sleep disorders.   In all, 84 different symptoms and clinical signs were reported, including loss of taste, and smell, cognitive disorders such as loss of memory and difficulty concentrating, depression, anxiety, chest pain and fevers.” Stanford.

Also, these persistant symptoms were found present in about 70 percent of those patients coming out of moderate to serious COVID-19. Stanford.

What Does This Mean for Injured Workers?

At some point, if these symptoms remain persistent, the Treating Doctors, Qualified Medical Evaluators, and Agreed Medical Evaluators will need to make a determination that these symptoms should be considered as permanent impairment. An assignment as permanent impairment allows an Injured Worker to collect permanent disability benefits.  The medical providers, in order to do so, may need to do make these determinations ahead of additional studies that may come in the future.

Further, due to the myriad of symptomology, a variety of specialties may be necessaryt to address these impairments.  These specialties may include internal medicine doctors, neurologists, psychiatrists and psychologists.

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.

VISUAL ANALOG PAIN SCALE (VAPS) AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

In the Workers’ Compensation System, Doctors and Medical Evaluators ask Injured Workers to fill out various scales and questionnaires. One of these scales is the Visual Analog Pain Scale (VAPS.)

Scales and questionnaires can impact an Injured Worker’s ability to get treatment and disability payments. Therefore, Injured Worker should understand how to answer them properly.

This article will discuss the Visual Analog Pain Scale(VAPS), how the VAPS is administered, how VAPS is to be answered, how VAPS is graded, and how VAPS can be used within the workers’ compensation setting.

What is VAPS? What Is it Designed to Measure?

The Visual Analog Pain Scale is “a unidimensional measure of pain intensity, which is utilized in diverse adult populations.”  Measure of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP) Gillian A. Hawker, Samra Mian, Tetyana Kendzerska Melissa French 07 November 2011 https: //doi.org/10.1002/acr.20543

The VAPS is intended to explore the issue of pain.

What Does VAPS Look Like?

The VAP Scale can be set up either horizontally or vertically. Supra.

This is an example of a scale:    0 “no pain”   |————————————————–| 100 “worst imaginable pain.”

How Many Questions Are There in VAPS?

One. It is the simple answering of one’s pain level.  This is done by marking a spot on the spectrum to describe the pain. Supra.  The spot can be measured and assigned a number.  See below.  Some scales allow for the patient to assign a number.

How is the Score Interpreted?

“A higher score indicates greater pain intensity. Based on the distribution of pain VAS scores in post surgical patients (knee replacement, hysterectomy, or laparoscopic myomectomy) who described there postoperative pain intensity as none, mild, moderate, or severe, the following cut points on the pain VAS have been recommended: no pain (0-4mm), mild pain (5-44mm), moderate pain (45-74 mm) , and severe pain (75-100 mm) ” Supra.

Why Are These Terms important?

In workers’ compensation, the evaluators look at pain. Pain is often characterized by the terms of slight, moderate or severe.

The definitions for slight, moderate and severe are different in the field of industrial medicine. California used to use them to assign permanent disability.  In order to do so, they defined the terms.  The 1997 Permanent Disability Rating Schedule defined the terms as follows: “Pain is not always disabling. It becomes disabling when its degree affects function. Regulations define four degrees of subjective pain – minimal, slight, moderate and severe. By definition, minimal (mild) pain is not disabling because it causes no handicap in the activity precipitating the pain. However, slight, moderate and severe pain reflect increasingly greater degrees of handicap on work activity, and are ratable factors of disability.” P.1-7.  While these terms are no longer used for permanent disability purposes, they are frequently documented in medical reports.

Pain’s nature and extent, in certain circumstances, can be a factor in assessing whole person impairment. Whole person impairment is then translated into permanent disability.

How Can Testing Impact Injured Workers’ Claims?

Testing creates credibility issues.  When an Injured Worker provides a 100 score, it means either that they are in severe pain, they are exaggerating, or that they are making a cry for help.  In cases with minor injuries, high scores will impact the credibility of the pain reporting.

Also, an injured Worker may wish to ask how the question should be answered. Pain level when medicated or pain level during a certain period of time, i.e. this moment or this week, are legitimate questions.

What Is the Problem with this VAP Scale?

Pain assessments can be confounded with respect to an individual’s “pain reference.”

Some individuals have never experienced severe pain in their life.  For women who have experienced childbirth and for those who have passed a kidney stone, their pain references, however, can be in the severe range.  Thus, an individual’s past medical conditions is important to review as a reference.

It is quite conceivable that they have experienced pain in the 90s up to 100.   Some individuals also have strong pain tolerances.  A 70 to them would be a 95 to others Thus, these individual’s reporting may only be relevant when compared to other  assigned scores provided on different dates of evaluation or treatment.

How Should an Injured Worker Answer the VAPS?

An Injured Worker should make their best effort to accurately describe their pain.

If there is any confusion concerning how to answer or mark the scale, you should clarify with the evaluator. For instance, you could be a 50 on medications and a 70 without.  Thus, it is important that the doctor or evaluator understand your reason for assigning a particular level of pain.

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 28 years. Contact us today for more information.

THE QUEBEC BACK PAIN DISABILITY SCALE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

For both workers’ compensation treatment and evaluation, Injured Workers are frequently asked to fill out surveys concerning their medical conditions. The Quebec Back Pain Disability Scale (QBPDS) is one of those surveys.

This article will discuss how and why such scales are used within the workers’ compensation system, what is the Quebec Back Pain disability Scale, what questions are asked within the scale, how the scale is scored? and what it can mean to a workers’ compensation claim.

What is the QBPDS?

This questionnaire is one that addresses back pain.  It inquires as to the daily activities that impacted by Back Pain.

Why are Surveys and Scales Used?

Surveys and Scales which ask the Injured Worker to self-report on their conditions are helpful to both treating doctors and evaluators.  First, they are a cheap quick method of getting some insight into the Injured Worker’s complaints.  Second, they can give the doctor or evaluator a sense of how serious the worker perceives their injury.  Third, they can give some insight as to whether someone is exaggerating with respect to the complaints. Fourth, if the same scale is administered over time, it can reveal some insight as to the course of the injured Worker’s condition.  Repeated testing may show whether the Injured Worker sees their pain improving, staying the same, or getting worse.

What are the QBPDS Questions Asked?

There are twenty questions asked within the inventory. The questions are about getting out of bed, sleeping through the night, turning over in bed, riding in a car, standing up for 20-30 minutes, sitting in a chair for several hours, climbing one slight of stairs, walking a few blocks, walking several kilometers, reaching up to high shelves, throwing a ball, running one block, taking food out of the refrigerator, making your bed, putting socks or pantyhose on, bending over to clean the bathtub, moving a chair, pulling or pushing heavy doors, carrying two bags or groceries, and lifting and carrying a heavy suit case.

Note: The questions are interesting in that they include activities that an individual may rarely or never participate in.  For example, there are some people who do not throw balls or handle suit cases.

How Are the Responses Scored?

There are five responses that can be made. They are not difficult at all, minimally difficult, somewhat difficult, fairly difficult, very difficult, and unable to do.  They are scored from 0-5.

Note: The responses address ability to perform activities as opposed to the individual’s pain experience.

What Do the Scores Mean?

A higher score represents a greater level of perceived functional disability.  A lower score represents a lower level of perceived functional disability.

Is The QBPDS Helpful for Treating Evaluators and Physicians With Respect to Permanent Disability Assignment?

In California Workers’ Compensation Law, Activities of Daily Living are a basis for making impairment assessments.  Impairment assessments render a Whole Person Impairment which then translates into a Permanent Disability Percentage. The QBPDS can be helpful to an evaluator on their assessment.  The Activities of Daily Living based upon the AMA Guides 5th Edition are Self-care: urinating, defecating, brushing teeth, personal hygiene combing hair, bathing, dressing oneself, and eating,  Communication:  writing, typing, seeing, hearing, and speaking, Physical activity:  standing, sitting, reclining, walking, and climbing stairs, Sensory Function: hearing, seeing, tactile feeling, tasting, smelling, Nonspecialized Hand Activities: grasping, lifting, tactile discrimination,  Travel: riding, driving, flying, Sexual Function: orgasm, ejaculation, lubrication, erection, and Sleep: restful and nocturnal sleep pattern.

The QBPDS does not explore self-care and sexual function. Therefore, it is not fully comprehensive to render an ADL assessment.

As an Injured Worker, What Should I Do When I Fill Out These Scales?

When fill out these scales, try to be accurate as possible. Sometimes, I personally roll my eyes when I see scales in which every answer is the highest.

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.

 

 

 

 

AGE, PHYSICAL DEMANDING JOBS AND MUSCULOSKELETAL DISORDERS: OLDER WORKERS AT RISK FOR WORK INJURIES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

The Labor Market in the United States is aging. As a result, Older Workers are performing a large variety of task within the Open Labor Market. Older Workers performing more tasks that make them at risk for work injuries. This is the case with respect to musculoskeletal injuries. Musculoskeletal injuries are commonly known as orthopedics injuries which include medical conditions with respect to the spine, the upper and the lower extremities. A study was done with respect and there were some findings made.

This article will discuss Older Workers, injury rates for Older Workers, and laws which impact Older Workers’ Workers’ Compensation Claims.

Does Age Matter When Looking at the Risk of Work Injuries?

Age alone is not the issue. The type of labor is what is of import. In the labor market, there are jobs with minimal physical demands. There are other jobs which involve greater physical demands. Thus, some Older Workers perform light duty jobs such as receptionists or greeters. Other Older Workers perform more arduous jobs such as warehouse worker or construction worker.

The study, of interest, focused on jobs with physical demands.

Old Age combined with greater physical demands were relevant with respect to work injuries. See P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

It was found when the occupational [physical] demands were greater there was an increase of risk of injury. Further, “[t]he relationship between age and claim-risk was strongest when occupational demands were highest.” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Is the Increase Risk Associated only with Musculoskeletal Injuries?

It was found that “Older age was associated with a higher risk of work injury claims for both musculoskeletal and non-musculoskeletal conditions,” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Is there a Difference Between Musculoskeletal vs. Non-Musculoskeletal Disorders?

Yes. “with a slightly stronger relationship observed for occupational physical demands and risk of musculoskeletal, compared with non-musculoskeletal, conditions.” P. M. Smith, J. Berecki-Gisolf, Age, occupational demands and the risk of serious work injury, Occupational Medicine, Volume 64, Issue 8, December 2014, Pages 571–576, https://doi.org/10.1093/occmed/kqu125

Are There any Laws or Rules in Workers’ Compensation that Assist Older Workers?

Yes. Age is factored as part of the Permanent Disability Rating Formula.
Per the Schedule for Rating Permanent Disabilities, California Workers’ Compensation Law provides for an age adjustment which provides for an increase in permanent disability for ages 42 and older. It also scales up with age and tops out at age 62. The age used in this assessment is the age on the date of injury. There is a table upon which you obtain the figures. It is on Pages 6-1-6-5. See SCHEDULE FOR RATING PERMANENT DISABILITIES UNDER THE PROVISIONS OF THE LABOR CODE OF THE STATE OF CALIFORNIA (2005)

Are There Any Rules that Do Not Assist Injured Workers?

Yes. There is a legal issue of apportionment. Apportionment is a tool allowed to reduce an Injured Workers’ Award.

Labor Code Section 4663, provides that “[a] physician shall make an apportionment determination by finding what approximate percentage of the permanent disability was caused by the direct result of injury arising out of and occurring in the course of employment and what approximate percentage of the permanent disability was caused by other factors both before and subsequent to the industrial injury, including prior industrial injuries. See Escobedo v. Marshalls, CNA Ins. Co., 70 Cal. Comp. Cases 604, 2005 Cal. Wrk. Comp. LEXIS 71 (W.C.A.B. April 19, 2005). In Escobedo, the board indicated that apportionment of permanent disability can be made based on the preexisting arthritis in applicant’s knees was found acceptable. Note: Older Employees are more likely to have pre-existing arthritic processes which could allow for apportionment to be found.

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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