JANITORS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

A large part of the labor market is the occupation of Professional Cleaners.  They are also referred to as Commercial Janitors.  The Janitorial Occupation is susceptible for a variety of work injuries and occupational illnesses. Janitorial work presents unique risks for work injuries for those within the field.

This article will discuss Janitors, Janitorial Tasks, Industrial injuries and Occupational Illnesses that are prevalent within the Occupation, and the barriers that Janitors have with respect to filing claims.

What are Janitors?

Janitors perform a variety of maintenance tasks a variety of facilities. They use a multitude of tools and chemicals to perform their jobs.  They can engage in a large variety of repetitive physical tasks, ie. sweeping or mopping.

Janitors can work at institutions such as schools, hospitals, parks, and prisons.

Janitors can work in commercial buildings such as shopping malls, and they can work in residential properties.

What Are Janitor’s Risks of Industrial Injury?

Each type of facility can present unique risks of work injury for Janitors.

For example, hospitals and medical facilities can have significant amounts of potentially infectious biological material present.  Schools can have issues relating to mold exposure.

Further, the physical activities of being a Janitor may cause work injury.

What Types of Injuries Do Janitors Sustain?

There are a variety of work-related orthopedic injuries. These injuries relate, in part, due to the fact that “Janitorial work is repetitive and requires bending, twisting, and other motions that can lead to or exacerbate musculoskeletal disorders, such as arthritis” Using Behavioral Risk Factor Surveillance System Data as an Occupational Health Profile Washington State Janitors, 2011 to 2017 Anderson, Naomi J. MPH; Marcum, Jennifer L. DrPH Journal of Occupational and Environmental Medicine: September 2019 – Volume 61 – Issue 9 – p 747-753 doi: 10.1097/JOM.0000000000001652

Also, Janitors may sustain respiratory injuries relating to the cleaning chemicals that they use.  Further, they may sustain dermatological injuries due to wet work.

What Are the Injury Rates for Janitors?

In a Washington State Study, it was noted that “[t]he prevalence of self-reported work-related injuries in the past year was higher than that of all others …. Analyses of WC data indicate that work-related injury risk may be higher for the industry group containing Janitors than other industries2 overall and in several injury types, with women at particularly high risk.” Using Behavioral Risk Factor Surveillance System Data as an Occupational Health Profile Washington State Janitors, 2011 to 2017 Anderson, Naomi J. MPH; Marcum, Jennifer L. DrPH

Journal of Occupational and Environmental Medicine: September 2019 – Volume 61 – Issue 9 – p 747-753 doi: 10.1097/JOM.0000000000001652

Thus, the workers’ compensation industry both has a concern over janitorial injuries as well as an understanding that work injuries are common.  Thus, Risk Management handling Janitorial claims will work hard to manage these claims.  This can be done with respect to reporting requirements.  It can also be done with respect to return to work issues which can include modified work.

Do Janitors Have Emotional Issues?

Yes. Janitors, in the study, reported “being diagnosed with a depressive disorder ..significantly higher and has been reported previously.    Using Behavioral Risk Factor Surveillance System Data as an Occupational Health Profile Washington State Janitors, 2011 to 2017 Anderson, Naomi J. MPH; Marcum, Jennifer L. DrPH Journal of Occupational and Environmental Medicine: September 2019 – Volume 61 – Issue 9 – p 747-753 doi: 10.1097/JOM.0000000000001652

While this finding did not address work-relatedness, it is possible that the depressive disorder may be in party work-related in nature and give rise to a workers’ compensation claim.

Can Shift Work Impact Janitors?

Yes. Shiftwork has been connected to various medical conditions.

Shiftwork can cause issues of inadequate sleep.  Inadequate sleep can lead to other health issues.

Do Janitors Have Barriers in Filing Workers’ Compensation Claims?

Yes. There is some concern as to whether all janitor work injury claims are filed.  As noted in the study, “[l]ow-wage, immigrant, and/or Hispanic worker populations, including many Janitors, may also not be aware of the WC system (or how to navigate the system, if they lack internet access) or of their right to seek medical care for an occupational injury or illness. Janitors may also face barriers to reporting an injury to their employer, such as fear of consequences.    Using Behavioral Risk Factor Surveillance System Data as an Occupational Health Profile Washington State Janitors, 2011 to 2017 Anderson, Naomi J. MPH; Marcum, Jennifer L. DrPH Journal of Occupational and Environmental Medicine: September 2019 – Volume 61 – Issue 9 – p 747-753 doi: 10.1097/JOM.0000000000001652

If a Janitor is concerned about their employment situation if they claim a work injury, it is important for them to seek legal counsel to discuss their concerns to make a determination as to whether they should file the 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.

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.

 

 

 

 

EVEN TREATERS GET INJURED AT WORK: OCCUPATIONAL AND PHYSICAL THERAPISTS SUSTAINING INDUSTRIAL INJURIES:  MEDICAL PROVIDERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Occupational and Physical Therapists play a large role in helping Injured Workers recover from their industrial injuries.  In doing so, however, Occupational and Physical Therapists may be placing themselves at risk for sustaining a work injury. More specifically, both Occupational and Physical Therapist’s work activities can place them at risk for sustaining musculoskeletal disorders. These musculoskeletal disorders can include back problems, shoulder problems, and wrist problems.

The article will discuss Occupational and Physical Therapists, what activities they perform on the job that may be injurious to them, and the rates of injuries that occur for Occupational and Physical Therapists.

What is an Occupational Therapist (OT)?

Per the American Occupational Therapy Association, “occupational therapists …help people… participate in the things they want and need to do through the therapeutic use of everyday activities (occupations.)”

OT Programs can include “an individualized evaluation, during which the client/family and occupational therapist determine the person’s goals, [a] customized intervention to improve the person’s ability to perform daily activities and reach the goals, and an outcomes evaluation to ensure that the goals are being met and/or make changes to the intervention plan.”

What is a Physical Therapist (PT)?

Per the American Physical Therapy Association, “[p]hysical therapists are movement experts who improve quality of life through prescribed exercise, hands-on care, and patient education.”

“Physical therapists examine each person and then develops a treatment plan to improve their ability to move, reduce or manage pain, restore function, and prevent disability.”

What is the Difference Between an Occupational and Physical Therapists?

The Occupational Therapist focuses on the patient’s ability to perform work-related functions.  The Physical Therapist focuses on physical activities in general.

What Are The Work Activities That Are Injurious to OTs and PTs?

Transfers/Lifts and manual therapy have been found to be associated with musculoskeletal disorders. “Darragh AR, Campo M, King P. Work-related activities associated with injury in occupational and physical therapists. Work. 2012;42(3):373-84. doi: 10.3233/WOR-2012-1430. PMID: 22523031; PMCID: PMC3839086.  These activities have been found to impact the lumbar spine.  Supra.

Patient handling activities include (transfers, repositioning and patient lifting. Supra.

Manual therapy includes soft tissue work, joint mobilization, and orthopedic techniques. Supra.

Manual Therapy was found also found as a risk factor consistent risk factor for both injuries as well as gradual onset of WSMDs. Supra.  In workers’ compensation terms, this would be considered as a cumulative trauma injury.

With Respect to Musculoskeletal Disorders? Is There Any Difference Between OTs and PTs?

No. “Occupational (OTs) and physical therapists (PTs) have substantial and similar rates of work-related injury (WRI), musculoskeletal pain and musculoskeletal disorders (WMSD)” Darragh AR, Campo M, King P. Work-related activities associated with injury in occupational and physical therapists. Work. 2012;42(3):373-84. doi: 10.3233/WOR-2012-1430. PMID: 22523031; PMCID: PMC3839086.

“Darragh et al. reported an annual WRI incidence rate among OTs and PTs of 16.5 and 16.9 per 100 full-time workers, respectively.” Darragh AR, Campo M, King P. Work-related activities associated with injury in occupational and physical therapists. Work. 2012;42(3):373-84. doi: 10.3233/WOR-2012-1430. PMID: 22523031; PMCID: PMC3839086.

What Are Injury Rates for Activities?  What Do Therapists Think Are the Causes of Their Injuries?

“Manual therapy and transfers/lifts accounted for more than half of all injuries (54.0%), across all practice areas.” Supra.  “Manual therapy was the greatest proportion of injuries to the wrist and hand (69.1%).” Supra.  “Transfer and lifting activities were associated with 26.6% of injuries Over half of these injuries were to the low back (53.0%), followed by the shoulder (19.7%) and the head/neck (18.2%).” Supra.   “Other activities associated with injury included environmental and equipment interactions (10.9%), multiple activities (6.5%) and patient falls (5.7%)”

What Do Therapists Think of How They Get Hurt?

Therapists opine that force, awkward posture, repetitive motion, sustained posture, and fatigue were factors contributing to those type of injuries.  Supra.

For wrist and hand injuries, therapists opine that repetitive motion (experienced during joint mobilizations and range of motion activities), force (experienced during range of motion, soft tissue work, and joint mobilizations), awkward posture and sustained posture were factors contributing to those type of injuries. Supra.

For transfer and lifting activities, opined that “these injuries occurred both gradually because of repeated performance of transfers over time and more suddenly when a patient behaved in an unexpected way (grabbed the therapist, stumbled, or moved in an unexpected direction.) The majority of therapist identified force (72.7%;48/66), including overexertion and lifting, and awkward posture (54.5%; 36/66) as the primary contributing factors to their transfer injuries.” Supra.

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.

 

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