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.

 

NURSES IN THE WORKPLACE SUFFERING FROM STRESS: BULLYING IN THE WORKPLACE, PSYCHIATRIC INJURY AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Nursing is one of the most difficult and demanding professions in the world. It is also one of the most important.  Nurses confront life and death situations on a daily basis.

Nurses work with Doctors who are some of the brightest and most difficult individuals on the planet.  These Doctors have demanding schedules and responsibilities which impact on their ability to work with others.

Nurses work with other Nurses who are confronted with the same stressors and responsibilities.  At times, they can be in conflict with each other.

Nurses also work with patients who may have emotional issues that are either pre-existing or are relating to their medical problem at issue.   Also, they may have anger issues relating to their perceived mistreatment at the facility. Nurses also work with patient’s family members who are emotionally involved with the patient’s well- being. They too may be upset at their perceived mistreatment of their beloved family member.

Nurses finally work with medical institutions which have rules and regulations that they need to be in compliance with concerning their operations.

With respect to these numerous interactions, some of these interactions have been viewed as unacceptable and have been labeled as “bullying.”

“Nurse Bullying” has been subject o was subject to a study which found interesting results.  This article will discuss the nature of nurse bullying, how nurse bullying should be analyzed within a workers’ compensation setting, and what a nurse should do if they are subjected to stress.

Even If I am not a Nurse, Why Should I Be Concerned about Nurse Bullying?

“Workplace bullying has also been acknowledged as a threat to patient outcomes and the delivery of quality of patient care, as well as the erosion of personal health and professional wellbeing [91314]. Excellence in patient care flourishes in an environment built on open communication and respectful professional relationships. An environment that condones bullying perpetrates destruction of professional communication.”  Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

What Is Bullying in the Nursing Profession?

Individuals studying bullying characterized the situation as on in which there is a power imbalance.   These interactions can have serious effects on the organization. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

Who Was Responsible for the Bullying?

In the study, there are many types of bullying offenders, including patients, caregivers, doctors, and nurses. Of these, bullying most frequently occurs among nurses and is particularly committed by a colleague rather than by a manager. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

Note: for workers’ compensation purposes, the employment position of the offender is very important

Bullying has also been defined in other studies.

“Bullying goes by many names: workplace aggression, indirection aggression, social or relational aggression, horizontal (lateral) violence, and workplace violence. It has become so popularized in the press; bullying is often, mistakenly, used as an overarching concept. There is a tendency to use many of these terms interchangeably [8]. Bullying is different from horizontal violence in that a real or perceived power differential between the instigator and recipient must be present [15]. Some of the most recent literature suggests that all of these behaviors exist on a conceptual continuum of workplace victimization [3].” Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

Is Bullying the Same as Job Stress?

Those researching this have distinguished it from ordinary job stress.  It is something different from the day to day social stresses or poor management.

What Types of Bullying are Going on?

Bullying has been described in situations where the nurse is new to the area,  in situations where the nurse witnesses mistreatment of others, in situations in which they are singled out for public censure or humiliation, in situation in which there are constantly being interrupted, situations in which they are not in the social clique and they are subject to juvenile-like behavior, situations in which they feel they are being punished with disciplinary  action or threats,   Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

What are the Consequences of Bullying?

Nurses being subjected to bullying is a societal concern.  If this bullying impacts patient medical treatment, it must be addressed in those terms in addition to the health concerns of the Nurse effected.

It is reported that “[n]urses bullied at the workplace may complain of mental symptoms, such as depression, anxiety, and fear, as well as physical symptoms, such as fatigue, headaches, and palpitations. They are also more susceptible to burnout and turnover intention and have lower levels of organizational commitment and nursing productivity. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

If a Nurse Is Having Medical Problems as a Result of Bullying, What Should They Do?

First, seek medical attention to treat your medical problems.  Second, seek assistance through your company’s Employee Assistance Program if one is available. Third, make a consultation with a lawyer as to whether there is some legal action that can be pursued.

There are two areas of law which should be explored.  Workers’ Compensation and Employment Law are two areas which should be analyzed with respect to the bullying.

If a Workers’ Compensation Claim is pursued, the Nurse can claim monetary compensation in the form of temporary disability benefits, permanent disability benefits, medical care, and vocational rehabilitation benefits.

What Are the Legal Barriers for Workers’ Compensation Psychiatric Claims?

With all psychiatric claims of work injury, a detailed factual analysis must be made.  With respect to bullying, there are issues of length of employment and whether the events causing the stress where personnel actions.  Bullying claims are viewed in the same light as all other psychiatric claims.

Labor Code Section 3208.3 provides the threshold requirements for psychiatric claims.

In general, 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.

Also, in general, there is also a six-month employment requirement.

Also, “[n]o compensation under this division shall be paid by an employer for a psychiatric injury if the injury was substantially caused by a lawful, nondiscriminatory, good faith personnel action.”

Note: Bullying can involve different players.   Some of them supervisors. Supervisors’ actions can be viewed as personnel action. Therefore, there may be “good faith personnel action” defenses that insurance Companies can be raise to defeat such a claim. Therefore, there is no guarantee that bullying cases will be accepted as a valid work injury 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.

 

STRESS AND INJURED WORKERS: INJURED WORKERS WITH DIFFICULTIES POST WORK-INJURY AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

This article is to discuss injured Workers’ stressors and a recent study on the matter. Prior to reviewing the study, I took it upon myself to list the stressors based upon my 28 years of representing Injured workers. The following is my assessment of stressors for Injured Workers while they are pursuing their claims are as follows:

Dealing with medical facilities and doctors
Being out of work
Dealing with your employer
Dealing with insurance
Dealing with attorneys
Dealing with litigation
Dealing with the Workers’ Compensation Appeals Board

Wow! Injured Workers have a lot of stressors!

As I indicated, a study was recently done which sheds some additional light on the stressors of injured workers. Is my assessments correct? Are there other items of concern?

Are Injured Workers Stressed Out?

Yes. The study found that the “[t]he prevalence of psychological distress among workers’ compensation claimants is high.” Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

What Did the Study Find as Being Stressors?

Severe psychological distress, being off work, worse general health and requiring support during claim were most strongly associated with greater odds of service use. Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

Are Injured Workers more stressed out than other People?

Yes. According to the Study, it was found. Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

What Were the Factors that the Study Found as Stressful?

The study found “being off work, poor general health, low work ability, financial stress, stressful interactions with healthcare providers and having diagnosed mental health conditions had the strongest associations with presence of psychological distress Collie, A., Sheehan, L., Lane, T.J. et al. Psychological Distress in Workers’ Compensation Claimants: Prevalence, Predictors and Mental Health Service Use. J Occup Rehabil 30, 194–202 (2020). https://doi.org/10.1007/s10926-019-09862-1

One additional item that came out of the study that caught me by surprise that Injured Workers with prior psychological issues are susceptible to increased stress.

Can an Injured Worker Claim This Stress as Part of Their Claim?

With changes in the law, psychiatric injury claims are limited. Further, stress resulting from litigation is mostly considered as non-industrial. In certain limited facts, stress may be claimed. It is a factual inquiry.

Is There Case Law Re: Stress from Litigation?

Yes. The Courts have found that a psychiatry injury caused as a result of the litigation process is not work-related. Rodriguez v. Workers’ Comp. Appeals Bd. (1994) 21 Cal.App.4th 1747 [27 Cal.Rptr.2d 93]. There are some limited exceptions. See Patrick v. Marina City Club, 2010 Cal. Wrk. Comp. P.D. LEXIS 19 (carrier misconduct as the basis for stress)

What Should An Injured Worker Do?

Injured Workers should approach matter on multiple levels. One level is to seek medical attention and/or counseling for one’s stress. Another level is to address the situations that are causing the stress. This can include changing doctors, getting an attorney, addressing the employment situation is a substantial way and perhaps opening up to a friend or family member to get this stress off their chest. Also, if you are unrepresented, contacting the Information and Assistance Officer at the local WCAB may be helpful. Also, your company may may have an Employee Assistance Program which can help as well.

In sum, if an Injured Worker is having stress, there is help and solutions out there. Don’t try to go it alone.

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.

HOSPICE WORKERS AND WORKERS’ COMPENSATION: STRESSFUL WORK ENVIRONMENTS AND PSYCHOLOGICAL WORK INJURIES: WHAT YOU NEED TO KNOW

Some Occupational or Work Environments that have unusual forms of stress.   Hospices and Hospice-related duties is one.  In a society with an increasing aging population, Hospice Workers perform the vital function of addressing the needs of terminally ill patients.  Working in such facilities or performing such duties can have an emotional impact on the worker.

There has been a number of articles which have discussed the emotional concerns of these workers.

There are multiple issues that relate to why Hospice Workers experience stress.

This article will discuss the nature of Hospice Work, why such employment is stressful, and what a Hospice Worker can do in the event that the work-related stress becomes disabling.

What is a Hospice? 

Hospices are health care facilities which provide care to those who are facing the end of their life.   They provide services to ensure that the patients’ physical, emotional, and spiritual needs are met during this period.

These facilities can involve multiple disciplines, can be face-paced, and can involve transitioning caseloads.

What Are The Difficulties When Working at a Hospice?

There are a number of difficulties with Hospices.  There is the difficulties of dealing with the emotional support needed for both families and the patients who are facing death. There is the difficulties with heavy caseload.  There is the administrative, agency and institution,  requirements in these facilities which can be a source of stress.

24-7 Care

“The hospice system provides 24-7 support and includes rapid response teams who cover nights and weekends. Even though other hospice workers have taken over providing care to that patient, the feeling of caring doesn’t stop.” Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Graveyard and Rotating Shifts have been known to cause medical problems irrespective of the fact that it involves Hospice Work.

Heavy Caseload

“Caseloads are widely different by role due to the nature of the work, with social workers and chaplains carrying larger numbers of patients than nurses and aides. Despite these differences, many of the challenges reported were remarkably similar. Workload is intense; often there is not time for lunch (unless while driving) or even to use the bathroom. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Stress from heavy caseload should not be considered as a “good faith personnel action.”

Different Roles

“Different roles reported different challenges. Many of the hospice worker roles are salaried, officially paid and expect to work 40 h per week, but often ending up putting in additional hours without additional compensation. Managers are also salaried but have less expectation of “only” working 40 h. On the other hand, aides are paid overtime when they work more than 8 h, but are discouraged from doing so. These differences led to different pressures.”. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Some of these Role Issues may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.

Communication

“Communication problems may also contribute to the chaotic nature of many workdays. Interdisciplinary teams, by definition, means different roles, responsibilities, and vocabularies, all caring for the same patients, usually in separate visits or calls. Such complexity can result in unanticipated communication problems as indicated by the following nurse’s example: Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Some of these communication difficulties may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.

What are the Consequences of The Difficulties of Working in a  Hospice Environment?

The consequences of such employment is Occupational Burnout as well as Secondary Traumatic Stress.

What is Occupational Burnout? 

“Job (occupational) burnout is defined as a prolonged response to job stressors, encompassing exhaustion, cynicism, and inefficacy (Maslach, Schaufeli, & Leiter, 2001); however, a more recent definition includes exhaustion and disengagement (Demerouti, Bakker, Vardakou, & Kantas, 2003; Demerouti, Mostert, & Bakker, 2010). Exhaustion, in this sense, refers to being drained of physical, cognitive and emotional energy as a result of exposure to job demands, while disengagement is interpreted as distancing oneself from work and possessing a negative attitude toward work-related objects and tasks. Job burnout is associated with depletion of energy and personal resources, which makes it an important factor in the process of health impairment (Basińska & Gruszczyńska, 2017). Burnout can cause the individual to be susceptible to other negative consequences of experienced stress, including posttraumatic stress disorder (PTSD) or secondary traumatic stress.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnoutPsychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What is Secondary Traumatic Stress?

Secondary Traumatic Stress “is characterized primarily by symptoms of intrusion (returning thoughts, dreams related to trauma), avoidance (an effort to get rid of emotions, thoughts associated with traumatic event) and hyperarousal (increased vigilance, anxiety, and impatience; Bride, Robinson, Yegidis, & Figley, 2004 Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnoutPsychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What is Compassion Fatigue?

In one article, it noted that “It is important to mention that the consequence of secondary exposure to trauma at work is also called compassion fatigue (Figley, 2002), which indicates that STS bears some similarity to burnout syndrome, especially to emotional exhaustion. According to Figley (1995) STS appears as a complex state of dysfunction and exhaustion in which emotional distress and suffering experienced by trauma victims is taken on by the helpers.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnoutPsychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What are the Problems for Hospice Workers?

From the studies, as noted above, it would appear that the stress is two-fold.   There is the stress from performing the job and there is the stress from dealing with the administration of the facilities.   Thus, both the work, and the work-setting can be injurious to the worker on an emotional level.

If a Hospice Worker is Having Emotional Problems, What Should They Do? What Are the Concerns?

First, they should seek medical assistance.   This can include utilizing an Employee Assistance Program if one is available. A workers’ compensation claim may be considered.   Before doing so, an analysis should be done with respect to whether the worker will meet the threshold requirements for proving up a claim.   Consultation with an attorney is recommended.   Some of the threshold issues may involve the length of employment, outside stressors, and whether there has been good faith non-discriminatory personnel action.

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.

 

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