HEALTHCARE WORKERS, VIOLENT PATIENTS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Healthcare Systems have a high incidence of workplace violence.   Healthcare Workers experience five times the amount of violence in comparison to the average worker in the United States.

Violent acts can cause work injuries both of a physical and mental nature.  Healthcare Workers, in these circumstances, may seek medical treatment and compensation via Workers’ Compensation.

This article will discuss the nature of the term “violence”, a worker’ compensation law addressing violent acts, the nature of violent encounters, and the rates of violence.

What Is Violence?

Violence can mean different things. There is physical violence, i.e. a patient striking a nurse,  and there is verbal violence, i.e. a patient threatening a nurse’s life.

Research has a more expansive definition. ” In the most basic of explanations, violence may present in the form of verbal threats, aggressive language, or escalate to physical assault.”

Verbal harassment includes racial slurs, attacking appearance or perceived sexual orientation, cursing, yelling at, or berating another person.”

Sexual harassment includes unwelcome sexual advances, insulting gestures, and verbal or physical conduct of a sexual nature.”

Verbal threats include statements of intent to cause harm, and threatening body language or gestures.”

Physical violence includes spitting, biting, pulling hair, and any other type of unwanted physical contact intending to cause harm.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Comment:  The definition of violence used by researchers is quite expansive nature. .Hharassment  such attacks on  race, gender or sexual orientation have been included.

How Does Workers’ Compensation Laws Address Violence?

California Workers’ Compensation Law addresses both the physical and verbal aspects of violence.  Workers’ compensation claims can be filed for injuries that are physical in nature.  Thus, if a nurse was assaulted and hurt their back, they can get treatment and compensation for the claim.  Further, a nurse was subjected to racial harassment, they would be able to pursue a psychological or stress injury.  Sometimes, violence can lead to both physical and mental injuries.  A claim can include both types of injuries.

Are There Any Special Laws Concerning Violent Acts?

Yes. The threshold for psychiatric claims of injury is lowered if there is a claim of violence.  Labor Code Section 3208.3 provides 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.” Substantial is defined as 35 to 40 percent.

How Significant Is It Within the Health Care Industry?

“In 2016, health care workers made up 69% of all reported workplace violent injuries, according to the Bureau of Labor and Statistics.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

In sum, an overwhelming amount of workplace violence occurs within the healthcare profession.

Are There Different Violence Rates Among Occupation?

Yes. Violence rates can vary based upon occupation and sex.

Paramedics

They are subject to the highest amount of verbal violence

Nurses/Physicians

They are subject to the highest amount of verbal threats

Nurses

They have the highest rate of violence threats by visitors.

Female Nurses

They are at far greater risk of being a victim of violence versus their counterpart.

Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Who Commits the Violence in Healthcare Settings? 

Males, 35 years and younger, have been found to be the highest offenders of violence against healthcare professionals.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

It has been found that 9 factors can be indicators of violence at the time of admissions. These include a “diagnosis of psychosis or bipolar disorder, history of psychiatric disorder, male gender, age younger than 35 years, below-average intelligence, no history of employment, homelessness, and agitated behavior.” .” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

What Are the Causes of Violence in the Health Care?

The Healthcare system, but its very nature, has elements that can contribute to violence.  These include “[[l]ong waiting times, lack of security, lack of adequate staff, and patient areas being open to the public.” .” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Are There Other Factors that Can Impact Violence in Health Care?

“There are many factors thought to increase the risk of violence among ED workers, including an increased number of patients and visitors using alcohol and drugs, psychiatric disorders, dementia, the presence of weapons, stressful environment, overcrowding, prolonged waiting times, and flow of violence from the community into the ED.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Is There Anything Special About Emergency Departments?

Emergency Departments have a number of factors that can contribute to violence they can include “an increased number of patients and visitors using alcohol and drugs, psychiatric disorders, dementia, the presence of weapons, stressful environment, overcrowding, prolonged waiting times, and flow of violence from the community into the ED.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

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.

WORKERS’ COMPENSATION IN THE NEWS, EPISODE #2, A RESTAURANT COOKING UP STRESS: WHAT YOU NEED TO KNOW

A Restaurant closed for a “day of kindness” after enduring customers’ abuse. Nypost.com  Restaurant Employee stress is real.  Some of the story’s restaurant’s employees were reduced to tears from customers swearing, threatening, arguing, and yelling.

The story illustrated multiple stressors that restaurant employees experience.  Customer abuse was the highlight.  There were management problems as well. The Employer noted that they “.. have had to make adjustments due to the increase in business volume, size of kitchen, product availability and staffing availability.”

Can Work Stress Be the Basis for a Workers’ Compensation Claim?

Yes. Work stress can be a source of psychiatric injury claim.   it can be the source of other stress related conditions.

Do The Restaurant Employees From the Story Have a Claim?

In California, the predominant cause of a psychiatric claim of injury arise from actual events of employment.  Further, good-faith personnel action which is substantial (35-40%) can defeat a claim.

In the story, the stressors did not come from employer discipline or write-ups.  Rather it came from Customers and Management organizational issues.  Thus, it can be argued that 100 percent of the work stressors do not fall within the personnel action defense.

Are Stressed Out Employees Eligible for Time off From Work?

Work stress can cause employees to go out sick. Mental Health Practitioners may take stressed out employee off of work.  This may entitle the Injured Worker to obtain benefits during their time off.   It should be noted that in the story, the workers, technically, never received a day off.  Instead, they spent the day cleaning the restaurant.

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.

STRESSED OUT WORKERS: SOCIAL MEDIA, UNSYMPATHETIC CUSTOMERS, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

A TikTok trend, is stressing out Starbucks Baristas.  The NyPost reports that customers who are TikTok fans are essentially harassing workers with outlandish orders.  One famous order is from an Edward.  Edward’s drink is a double blended drink containing 13 ingredients. nypost.   Unless a commensurate tip is provided for time consuming orders, it is  understandable why these customized drinks can be a source of Barrista stress, anxiety and upset.  Further, too many of these orders simultaneously ordered could place a real grind on the fulfillment of regular orders.

Customer stress can a valid basis for a Workers’ Compensation “Stress” or “Psyche” claim. Should the stress from being inundated by these ridiculous time consuming orders give rise to an emotional disorder, a Barrista could consider filing a workers’ compensation claim to seek medical attention and benefits.

Are There Any Requirements to File Such a Claim?

Before filing a workers’ compensation claim, it is important for an Injured Worker to have some understanding as to whether they will prevail.

The “Six-Month” Rule

Given a claim relating to excessive order, an employee must have six months of employment that need not be continuous.  If you have issues as to whether you worked six months, an attorney consultation is indicated.

“Predominant Cause”

The employee must provide by a preponderance of the evidence that the injury was caused by work.  There is a defense of good faith personnel action.   If there are various sources of work stress such as write-ups or discipline, an attorney consultation is 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.

 

What You Need To Know About Healthcare Workers, Covid-19’s Mental Health Impact, And Workers’ Compensation

Many California Healthcare Workers are in the frontline of treating COVID-19 treatment.  Treating pandemic patients can take an emotional toll on healthcare professionals.

A recent study looked into this psychological impact of COVID-19 on frontline healthcare workers. Healthcare workers who suffer emotional symptoms as a result of their work may need to seek medical attention.  If this is the circumstance, these emotional symptoms may give rise to a work injury claim.   As a result, a workers’ compensation case may be claimed.

This article will look into COVID-19’s emotional impact on frontline health care workers and how they can address this issue.

What are the General Mental Health Challenges of Healthcare Workers?

Irrespective of COVID-19, Healthcare Workers are at risk for emotional injuries, burnout is a common emotional problem. “Burnout in healthcare workers is widely understood as having three separate dimensions.”  It can include feelings of emotional exhaustion, cynicism, and reduced personal achievement. (Freudenberger, 1974; Selamu et al., 2019). Deng D, Naslund JA. Psychological Impact of COVID-19 Pandemic on Frontline Health Workers in Low- and Middle-Income Countries. Harv Public Health Rev (Camb). 2020;28:https://harvardpublichealthreview.org/wp-content/uploads/2020/10/Deng-and-Naslund-2020-28.pdf.

Studies have demonstrated prevalence of burnout to be as high as 70% for physicians and 50% for nurses in some high-income countries (Aiken, 2002; Lamothe et al., 2014). Supra.

How Can a Public Health Crises Impact the HealthCare Workers Emotionally?

 “Public health crises such as infectious disease outbreaks, in the form of either epidemic or pandemic, can often bring about high levels of acute and chronic stress in both the victims and frontline health workers. Posttraumatic stress disorder (PTSD) is defined by Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-5) as a constellation of emotional and behavioral changes in response to traumatic events. Individuals with PTSD often experience recurrent flashbacks, nightmares, and uncontrollable anxiety.” Deng D, Naslund JA. Psychological Impact of COVID-19 Pandemic on Frontline Health Workers in Low- and Middle-Income Countries. Harv Public Health Rev (Camb). 2020;28:https://harvardpublichealthreview.org/wp-content/uploads/2020/10/Deng-and-Naslund-2020-28.pdf.

Has the COVID-19 Pandemic Impacted Healthcare Workers Emotionally?

Several emotional conditions have been connected to COVID-19. Studies have found increase level of PTSD and Depressive Symptoms, Anxiety, and Insomnia among healthcare workers. Supra.

Are There Risk Factors with Respect to Healthcare Workers’ Emotional Reactions?

Yes.

Direct Contact With COVID-19 Patients: Healthcare Workers in direct contact with COVID 19 patients were found to have higher prevalence of emotional symptoms.

Work Experience: Workers with fewer years of work experience were found to be at risk of emotional symptoms.

Sex:  Female workers had a higher prevalence of affective symptoms than male counterparts.

Occupation: Nurses were found to have more emotional issues versus other medical staff. Supra.

What Can a Health Worker Do If They Are Having Emotional Systems?

First, they should seek medical attention. This can be done via Health Insurance, an Employee Assistance Program or Workers’ Compensation.   It is recommended that a Healthcare Worker consult with an attorney prior to deciding which route to initially take.

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.

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