HEALTHCARE WORKERS, COVID-19’S MENTAL HEALTH IMPACT, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

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.

WORKERS’ WITH PRE-EXISTING MENTAL HEALTH ISSUES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Many Workers, prior to starting employment, have diagnosed medical illnesses.  There are a variety of forms of mental illness.

A study looked into mentally ill individuals in the workplace.  This study discusses how work impacts the mentally ill. This information is important with respect to workers’ compensation stress claims.

This article will discuss mental illness, forms of mental illness, work’s impact on mentally ill individuals, and what it means in the context of workers’ compensation stress claims.

What Is Mental Illness?

 Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. Psychiatry.org. “ Mental illness is common. In a given year: nearly one in five (19 percent) U.S. adults experience some form of mental illness one in 24 (4.1 percent) has a serious mental illness, one in 12 (8.5 percent) has a diagnosable substance use disorder.” Psychiatry.org

There is a variety of mental illnesses.  These include anxiety disorder, Attention-deficit/hyperactivity disorder, autism, bipolar disorder, clinical depression, dementia, obsessive compulsive disorder, post-traumatic stress disorder, schizophrenia,

What Is California Psychiatry Injury Causation Standard?

Labor Code Section 3208.3 provides the causation standard.  The causation burden per (b)(1) is that “In order to establish that a psychiatric injury is compensable, 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”  This means greater than 50 percent.

There is a lower standard in certain circumstances.  Per (b)(2), “… 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 cause is at least 35 to 40 percent.

 Does Working Impact Mental Illness?

The study found that “Individuals with mental illness who are employed, compared to those who are unemployed, reported slightly higher levels of overall life satisfaction and psychophysiological health”. Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

How Does The Study Relate to Work Injuries?

Mentally ill individuals may have improved health and satisfaction when they are working.  Therefore, this improvement in their mental state should be factored into work injury causation analysis.   Also, it may have value with respect to permanent disability apportionment.

What Was in the Study’s Reporting?

The study reported that “, the mechanism underlying the relationship between having an occupation and life satisfaction implies that having an occupation enhances individuals’ perception of their own physical and psychological health, which in turn might increase their satisfaction with life” Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

What Is the Impact of Unemployment on Mental Illness?

The study noted that “[u]nemployment can lead to, among other things, diminished social status, financial debt, reduced self-esteem, and feelings of guilt. Most importantly, unemployment is significantly associated with psychiatric problems and approximately 37% higher risk of suicide (Milner, Page & Lamontagne, 2014).” Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

Note: This finding is important.  Mental health treatment and assessment of impairment during a pre-employment period is exacerbated by unemployment.  Thus, with no unemployment In combination with work, a Mentally Ill individual’s mental state may be significantly elevated prior to confronting work stress.

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 PAIN, ENJOYMENT AND GENERAL ACTIVITY SCALE (PEG) AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

The California Workers’ Compensation System employs various scales and tests to assist with Injured Workers’ evaluation and treatment.  One of these tests is the Pain, Enjoyment and General Activity Scale (PEG.)

This article will discuss the PEG Scale and how it can be used within the workers’ compensation system.

Why Are Scales Used in General?

Scales can be used for many reasons.   Scales are generally self-reporting. Thus, all that is needed to administer one is a pen, a clipboard, and the questionnaire. Thus, they are a cheap, quick and easy way to extract information from Injured Workers. Scales can show that an injured Worker is credible.  They can show that an Injured Worker is malingering or exaggerating. Scales can show a cry for help.

One way a scale can be used Is by comparing them to prior scales.  When compared, it can show a patient’s assessment of medical improvement or lack thereof.

Scales are employed by medical examiners, treaters and utilization review evaluators to assess the Injured Workers’ disability status, permanent disability, and whether forms of treatment are indicated and should be approved.

In an article discussing PEG, it was noted that “[t]he competing demands of primary care, in which visits are short and pain is only one of several problems warranting attention, make efficiency of assessment a paramount concern.  A balance must be found between feasibility and key characteristics such as reliability, validity, and responsiveness.”  Krebs EE, Lorenz KA, Bair MJ, et al. Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. J Gen Intern Med. 2009;24(6):733-738. doi:10.1007/s11606-009-0981-1

What Is PEG Scale’s Complete Name?  How Does It Relate to Workers’ Compensation?

The PEG Scale’s full name is the Pain, Enjoyment of Life and General Activity Scale.

California Workers’ Compensation Law employs the AMA Guides to assess permanent impairment.  In the assessment of permanent impairment, Pain is a factor that is considered.  Also, Activities of Daily Living is also a factor.

In sum, the scale overlaps some of these issues.

What Does the PEG Scale Consist Of?

The PEG Scale consists of three questions that are rated from 0 to 10.

What is the Pain Scale’s First Question?

The first question is “what number best describes your pain on average in the past week?”

How is the First Scale Question Answered?

The question is answered in a 0 to 10 scale. 0 being “no pain” to 10 being “pain as bad as you can imagine.”

What is the Second Question of the Pain Scale?

The second question is “what number best describes how, during the past week, pain has interfered with your enjoyment of life?”

How is the Second Question Answered?

The question is answered in a 0 to 10 scale. 0 being “does not interfere” to 10 being “completely interferes.”

What is the Third Question on the Pain Scale?

The third question is “what number best describes how, during the past week, pain has interfered with your general activity?”

How is the Third Question Answered?

The question is answered in a 0 to 10 scale. 0 being “does not interfere” to 10, “completely interferes.”

How is the PEG Scale Scored?

The scale is scored by adding up all three numbers and dividing by 3.

What Is the PEG Scale Specifically Used For?

“This scale can be administered in person at a clinic or hospital, answered via phone interview or personally completed at home. It is a flexible scale that can be used for many scenarios. For example, the PEG scale is often used to determine if a medication is effective; using it for this purpose helps determine an individual’s level of functioning while taking medication(s). Individuals who show a stable level of functioning, with no other factors that suggest a dosage adjustment, a medication taper or a medication change is needed, would then continue on their medication regime.”  Painscale.com

Is There Any Advice to An Injured Worker?

Yes. These scales will be used possibly for two purposes: first, to evaluate your credibility, and  second, to evaluate your improvement with respect to prescription medications and treatment.

Thus, it is best to make your best efforts to accurately answer them.

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.

 

ARE INJURED WORKERS SATISIFIED WITH THEIR INDUSTRIAL MEDICAL TREATMENT?  QUALITY WORK-RELATED MEDICAL CARE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

“I Can’t Get No, Satisfaction”

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California Industrial Medical Treatment is controlled by the Labor Code. Thus, it differs from both traditional Private Medical Care as well as Government Programs such as Medicare and Medicaid.

Industrial medical care is part of a risk management system designed to provide cost-cutting elements with respect to providing the service.

Researches have looked into Injured Workers’ satisfaction with respect to their treatment.

This article will discuss Injured Worker’s satisfaction with their medical treatment.

What is Industrial Medical Care?

In California, Industrial Medical Treatment is guided by the Labor Code.   The Labor Code contains various treatment limitations.

Medical Control is one limitation. Insurance Company Managed Provider Networks limit the doctors that Injured Workers can choose.

Medical treatment is limited by utilization review of medical treatment requests.  These utilization reviews can deny treatment that does not follow the set algorithms and schedules.

What Is Private Medical Care?

Private Medical Care can come from a variety of sources. There is cash payment in where there is a direct provider patient relationship.  There are personal insurance policies for which the individual purchases the policy directly from the medical insurance company.  Finally, there is employer provided health insurance policies.

What is Medicare?

Per the SSA, “Medicare is [the U.S]… health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those with disabilities and those who have permanent kidney failure.

The program helps with the cost of health care, but it does not cover all medical expenses.”

What Is Medicaid?

Per Medicaid.gov, Medicaid programs [are] designed to provide health coverage for low-income people. This program is separate from Medicaid.

Can Injured Workers have Multiple Insurance Coverages?

Yes. Injured Workers can have multiple coverages at the same time.   It is possible that an Injured Worker can have private coverage, medicare and workers’ compensation at the same time.  For Injured Workers with low income and are on social security disability, they may have medicare, medicaid, and workers’ compensation at the same time.

What was the Study’s Overall Finding? Were There Other Findings?

The study found that “that Workers’ Compensation status is independently associated with dissatisfaction with health care compared with other primary payer groups.” Compton J, Glass N, Fowler T. The Effect of Workers’ Compensation Status on the Patient Experience. JB JS Open Access. 2019;4(2):e0003. Published 2019 Jun 11. doi:10.2106/JBJS.OA.19.00003

The study, however, had other findings of interest as well.

Workers’ Compensation treatment rated lower than Private Insurance and Medicaid.   It did, however, rate at about the same level of satisfaction as Medicare. Compton J, Glass N, Fowler T. The Effect of Workers’ Compensation Status on the Patient Experience. JB JS Open Access. 2019;4(2):e0003. Published 2019 Jun 11. doi:10.2106/JBJS.OA.19.00003.

With respect to mental health issues, workers’ compensation treatment, satisfaction was rated lower than private insurance.   It was however comparable to both Medicare and Medicaid patients. Compton J, Glass N, Fowler T. The Effect of Workers’ Compensation Status on the Patient Experience. JB JS Open Access. 2019;4(2):e0003. Published 2019 Jun 11. doi:10.2106/JBJS.OA.19.00003.

There was one area in which there was some higher level of satisfaction with respect  to industrial medical treatment.   This was when the treatment included surgical authorization.  Patients with Workers’ Compensation who were scheduled for a surgical procedure were more likely to be satisfied with their care.  Patients with surgical authorization have higher levels of satisfaction.  Compton J, Glass N, Fowler T. The Effect of Workers’ Compensation Status on the Patient Experience. JB JS Open Access. 2019;4(2):e0003. Published 2019 Jun 11. doi:10.2106/JBJS.OA.19.00003

What Can Be Done to Improve Care Injured Workers’ Satisfaction?

This author believes that the following items may improve the level of satisfaction of industrial medical care.   First, expanded Managed Provider Networks with more doctors to choose from.  Second, improvement of the utilization review process to allow for greater authorization of treatment.

As noted above, Injured Workers are happy when there are results that occur as part of the treatment.  This is shown in their level of satisfaction with respect to surgical authorization.

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.

RADIOGRAPHIC WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Radiology Workers have safety challenges when they perform their duties. They are exposed to a variety of things that make them susceptible to work injuries.

In event they get injured while performing their duties, they would be entitled to file a workers’ compensation claim to collect benefits and receive medical care.

This article will discuss the Radiology Worker Occupation, Industrial Exposures that place them at risk of industrial injury and the mechanisms of injury.

What Are Radiographic Workers?

Radiographic Workers are medical professions. They handle medical imaging of the human body.  There are many different technologies that are used to perform such imaging.  Imaging studies that that Radiologists can perform Computed Tomography Scan (CT), Magnetic Resonance Imaging (MRI), Nuclear Medicine Imaging (This includes Positron-Emission Tomography (PET)), Ultrasound, and X-Ray.

Some of these imaging studies require the patients to have dyes injected into their bodies to allow for enhanced imaging.

Radiographic Workers can work in both the public and private sections. They can work in hospitals, prisons and other medical facilities.

What Types of Medical Conditions Can Radiology Workers Be Exposed to at Work?

Radiology Workers can sustain industrial injuries to practically all body parts and systems.  Radiology Workers are at risk of infectious disease in the workplace. Radiology Workers are at risk of musculoskeletal disorders in the workplace. Occupational Health and Radiation Safety of Radiography Workers Hasna Albander

What is an Infectious Exposure? Are There Different Forms?

Infectious exposure is an exposure that is transmitted from one source into a host.  The term host refers to the infected person. Thus, the Radiology Worker becomes the host of the infectious disease. Essentially, these occupational exposures enter the worker’s body and causes illness.

How Many Forms of Infectious Exposures Are There?

There are six forms of Infectious exposure.  They are Direct Transmission, Indirect Transmission via Fluids, Indirect Transmission by vectors, Indirect transmission by Vehicles ,Indirect Transmission via Vehicles, Indirect Transmission via Airborne Media, and Indirect Transmission via Droplets. Occupational Health and Radiation Safety of Radiography Workers Hasna Albander

What Is Direct Transmission?

Direct Transmission is when the infectious agent is transmitted by direct contact of the infectious agent from one individual to a susceptible host (worker. CDC)  For example, direct transmission can be skin to skin contact.

What Is Indirect Transmission via Fluids?

Indirect Transmission by Fluids. An example of indirect transmission by fluid is urine.

What is Indirect Transmission via Vectors?

Indirect Transmission by Vectors. The term vector essentially refers to insect bites. Examples of transfer by vector would be bites from mosquitos, fleas and ticks.

What is Indirect Transmission via Vehicles?

Indirect Transmission by Vehicles is essentially when an object carries the infection. Examples of vehicles include a number of items such as food, water, biologic products (blood), and fomites (inanimate objects such as handkerchiefs, bedding, or surgical scalpels). CDC.

What is Indirect Transmission by Airborne Media?

Indirect Transmission by Airborne Media is when the agents are suspended in the air.  An example of this agents includes dust and droplets that contain microorganisms or spores.  CDC

What is indirect Transmission by Droplets?

Indirect Transmission by Droplets is when there is a liquid transmission. Eye, Nose or Mouth fluids are examples of this transmission. Thus, sneezing, coughing and tearing are forms of droplet transmission.

What Types of Illnesses Can Arise from Transmission?

Per the CDC, “[w]orkers in the healthcare industry are also at risk for influenza as well as airborne (such as tuberculosis “[TB]) and percutaneously transmitted (such as HIV) infection from patients” Su CP, de Perio MA, Cummings KJ, McCague AB, Luckhaupt SE, Sweeney MH. Case Investigations of Infectious Diseases Occurring in Workplaces, United States, 2006-2015. Emerg Infect Dis. 2019;25(3):397-405. doi:10.3201/eid2503.180708

What Are Examples of Cumulative Trauma Musculoskeletal Exposures of Radiology Workers?

There are a variety of ways that repetitive trauma musculoskeletal injuries are described in literature. This includes recurrence motion injury, repeated strain and cumulative trauma disorder. Occupational Health and Radiation Safety of Radiography Workers, Hasna Albander

Cumulative Trauma injuries can be specific to the imaging that the worker performs.  For example, “[c]omputerized technologists are more likely to experience spinal stress and RSI from intensive keyboard work. Intense keyboard work. RSI keyboard affects CTD ‘s hands and grips. Like tendinitis, carpal and ganglion syndrome. Occupational Health and Radiation Safety of Radiography Workers, Hasna Albander

Sonographers are also at risk for cumulative trauma injuries due to equipment design, low posture, constant transducer pressure, difficult movements, unsatisfactory breaks, and overall stress. Occupational Health and Radiation Safety of Radiography Workers, Hasna Albander

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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