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.

 

 

 

YOUNGER WORKERS AND WORK INJURIES:  YOUTHFUL WORKERS, SPECIAL CONCERNS FOR YOUNGER WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

“When I was young, it seemed that life was so wonderful”

Supertramp

Does Age matter?  Yes.  Younger Workers get injured at different rates than Older Workers.  A recent study brought light onto the issue of Age as a factor with respect to Work Injuries.

Younger Workers make up a significant number of the workforce.  Adolescents and Young Adults represent approximately 13% of the U.S. workforce. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

As a result of this, like all workers, they sustain work-related injuries. Per a study, it was estimated that “3.2 million nonfatal injuries to young workers were treated in hospital emergency departments, with the highest rates among workers aged 18–19 years. Data from 2018 indicate that the leisure and hospitality industry [i.e. food service such as McDonalds hotels, and amusement parks] contributed the highest percentage of injuries to workers aged 15–17 years requiring at least 1 day away from work.” Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

This article will discuss the rates of injury for Younger Workers, the implications for Younger Workers who sustain work injuries, the special concerns a Workers’ Compensation Attorney has with respect to these claims, and how the Workers’ Compensation Systems addresses Younger Workers’ Permanent Disability.

What Was the Study?

The study  that was done looked into nonfatal occupational injuries of Younger Workers within the United States during the years 2012 to 2018.  Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Does Age Make a Difference?

Yes. It was found that Younger Workers, aged 15-24, experienced a higher rate of job-related injury versus Adult Workers, aged 25-44.  Supra.

Are There Any Interesting Facts Concerning the Injury Rates?

AGE RANGE WITH HIGHEST RATE OF INJURY: The highest injury rate (404 per 10,000 FTE) occurred among workers aged 18–19 years.

MALE VERSUS FEMALE: Within each of the four age categories, the rate of injury was 1.4 to 1.5 times higher among males than among females.

YOUNGER VERSUS MIDDLE AGED WORKERS:  Annual rates of injuries among young workers aged 15–24 years were 1.2–2.3 times higher than those for workers aged 25–44 years. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Do Young People Get Hurt?

Younger Workers can get injured in a variety of ways.  One of the reasons why Younger Workers get injured is that they are often learning on the job. This makes them more susceptible to injuries.

For example,

“Contact with objects and equipment was the leading cause of occupational ED-treated injuries among all age groups examined, with rates of injuries ranging from 64 per 10,000 FTE among workers aged 25–44 years to 182 per 10,000 FTE among workers aged 18–19 years.” Supra.

“Lacerations and punctures were the most common type of ED-treated injuries reported among workers aged <25 years, with injury rates ranging from 66 to 99 per 10,000 FTE, “ Supra.

To the contrary, it should be noted that

“strains and sprains were most common among workers aged 25–44 years (injury rate of 47 per 10,000 FTE).” Supra.

Why are Work Injuries to Younger Workers a Concern?

One of the big concerns with respect to Younger Workers in California is the issue of lifetime medical care.   Young Workers, to some extent, are more able to recover from injuries versus Older Workers.

Some injuries that have long term implications.   There are injuries which can cause arthritis.   Arthritis can take decades to become a problem for the worker. Therefore, Younger Worker may need medical care decades after the injury happened.  Many Young Workers do not understand or appreciate this fact.   This is an issue of discussion concerning settlement of their case.

How Does the California Workers’ Compensation System View Younger Workers’ Permanent Disability?

Younger Workers’ Permanent Disability is not viewed as significant as older workers’ permanent disability.  For the same injury, a Younger Worker will receive less money than an Older Worker.

How is a Younger Worker’s Age Factored into Permanent Disability?

In the SCHEDULE FOR RATING PERMANENT DISABILITIES UNDER THE PROVISIONS OF THE LABOR CODE OF THE STATE OF CALIFORNIA (2005) , there is a provision for adjusting with respect to the Injured Worker’s age.

One of the steps in the permanent disability rating formula is to make an age adjustment.  Using a Table, a Younger Worker’s Permanent Disability is lowered via the rating adjustment.   See Schedule at P. 1-9.

In sum, the Schedule has a specific table that is used in a permanent disability rating formula to lower the disability rating. The disability rating being lowered translates into less money for the Injured Worker.

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.

 

INDOOR SWIMMING POOLS, WATER PARKS AND WORK-RELATED ASTHMA: POOL WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

In California, there are many individuals who work at Water-Related Facilities.   With respect to this article, the Water-Related Facilities to be discussed are swimming pools, water parks, and hydrotherapy spas.

These facilities have been implicated as a source of either “new asthma” or an “aggravation of a pre-existing asthma condition.”   An “asthma-related injury” caused by work at such a facility would give rise to a workers’ compensation claim.   Such a claim would allow the Injured Worker to obtain monetary compensation in the form of both temporary and permanent disability, medical care, and vocational rehabilitation benefits, if indicated.

This article will discuss the nature of Water-Related Facilities, conditions which make these facilities susceptible to “water-related asthma injuries”, and the types of workers at such facilities that are at risk.

What Has Science Found Concerning Water-Related Facilities and Asthma?

“Clinicians need to be aware of the potential adverse effect that indoor swimming pools and water parks may have on both causing the onset of new asthma and aggravating pre-existing asthma. Attention to swimming pools and water parks as potential triggers for asthma may, for selected patients, be an important factor in asthma management.

The American College of Chest Physicians has developed a consensus statement for the diagnosis and management of work-related asthma that clinicians can refer to when evaluating adult patients with asthma35 . Weisel CP, Richardson SD, Nemery B, et al. Childhood asthma and environmental exposures at swimming pools: state of the science and research recommendations. Environ Health Perspect. 2009;117(4):500-507. doi:10.1289/ehp.11513

What Types of Workers are Susceptible to these Injuries?

Lifeguards and Pool Maintenance Workers have been implicated to be at risk for these injuries.

What Is Asthma?

Per the Centers for Disease Control, “Asthma is a disease that affects your lungs…Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs.”

“Occupational asthma occurs when someone who never had asthma develops it because he or she is exposed to something at work. This can happen if you develop an allergy to something at work such as mold or if you are exposed to irritants such as wood dust or chemicals at work over and over at lower levels or all at once at higher levels.” Supra.

What is It About Pools that Can Bring on Asthma?

The term commonly used with respect to Occupational Asthma, in this setting, is Disinfection By Products (DBPs.)

“[T]traditional chemical disinfection processes result in the formation of disinfection by-products (DBPs) (Aggazzotti and Predieri 1986; Aggazzotti et al. 1998; Beech et al. 1980; Chu and Nieuwenhuijsen 2002; Fantuzzi et al. 2001; Glauner et al. 2005; Judd and Jeffrey 1995; Kim et al. 2002; Li and Blatchley 2007; Weil et al. 1980; Weisel and Shepard 1994; Zwiener et al. 2007). The specific types and levels of DBPs formed depend on numerous factors, including the type and amount of disinfectant used, characteristics of the swimming pool and pool water, and swimmer hygiene (Zwiener et al. 2007).” Weisel CP, Richardson SD, Nemery B, et al. Childhood asthma and environmental exposures at swimming pools: state of the science and research recommendations. Environ Health Perspect. 2009;117(4):500-507. doi:10.1289/ehp.11513

One study reported that it was “nitrogrogen trichloride is a cause of occupational asthma. This should be considered when choosing chlorine-based disinfectants that are likely to come into contact with a nitrogen source. It should also be considered in anyone developing occupational asthma working at a swimming pool and is also a likely cause of asthma in those who swim in these pools.  To prevent further cases, much more attention should be paid to the quality of air in indoor swimming buildings, as well as t the care of the chlorine content of the water. Occupational asthma caused by chloramines in indoor swimming-pool air.  K.M. Thickett, J.S. McCoach, J.M. Gerber, S. Sadhra, P.S. Burge, European Respiratory Journal 2002 19:827-832, DOR: 10.1183/09031936.02.00232802

Does the Worker Need to Go In the Water Be at Risk for Injury?

No. Workers who do not go into pools are at risk as well.  Working at the swimming pool, but not going in the pool, may be a sufficient exposure. As noted above, it is an issue of air quality within the facilities that is a concern.

I Work at a Pool Facility and Am Having Lung Problems, What Should I Do?

It is recommended you seek medical attention, If you receive a diagnosis of asthma, you would consider filing a workers’ compensation claim.  It is recommended you consult with an attorney as well.

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.

 

STONE FABRICATION WORKERS AND LUNG PROBLEMS: INJURED WORKERS WITH SILICOSIS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Stone Fabrication Workers are at risk for occupational lung problems.  These problems stem from exposure to silica dust.  It is noted in the article that “[o]ver the past few decades, great attention has been paid to the emergence of silicosis cases that are associated with occupational exposure to silica dust generated by the manufacturing, finishing, and installation of AS kitchen and bathroom countertop products, both in fabrication shops and during in-home assembly procedures.” Artificial Stone Associated Silicosis: A Systematic Review, Leso,  Int. J. Environ. Res. Public Health 201916(4), 568; https://doi.org/10.3390/ijerph16040568

Rose C, Heinzerling A, Patel K, et al. Severe Silicosis in Engineered Stone Fabrication Workers-

In California, Stone Fabrication Work is very popular.  Many Homes, Office Buildings, Commercial Buildings, and Apartments have beautiful countertops that are made out of silica-based engineered products.   To produce and install these countertop products, there are many skilled workers who are exposed to this harmful respirable crystalline silica.   This exposure can cause serious damage to the lungs.  This damage, caused by an industrial exposure, gives right to the Injured Worker claiming their benefits and medical care under Workers’ Compensation.

This article will discuss fabricators, how they are exposed to harmful silica, what lung diseases can be caused or aggravated by silica, and how workers’ compensation can assist Fabricators who suffer from industrial exposure to silica.

What is Silicosis?

Silicosis is a progressive, irreversible, and incurable fibrotic pulmonary disease that is caused by the inhalation of respirable crystalline silica (RCS) dust. Artificial Stone Associated Silicosis: A Systematic Review, Leso,  Int. J. Environ. Res. Public Health 201916(4), 568; https://doi.org/10.3390/ijerph16040568

How Do Workers Get Exposed to Silica? Why Is Important?

The exposure occurs when the “[a]Artificial stone is formed of finely crushed rocks that are mixed with a polymeric resin. Its silica content is approximately 90%, a much higher percentage than the silica content of natural marble (3%) or granite stones (30%) [18]. Through the cutting and grinding of AS slabs with high-energy, powerful devices may result in high levels of exposure to RCS dusts, although little information is currently available regarding concentrations in these specific workplace settings/tasks IIt should be noted that the Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health have identified exposure to silica as a “health hazard to workers involved in manufacturing, finishing and installing natural and manufactured stone countertop products, both in fabrication shops and during in-home finishing/installation” Artificial Stone Associated Silicosis: A Systematic Review, Leso,  Int. J. Environ. Res. Public Health 2019, 16(4), 568; https://doi.org/10.3390/ijerph16040568

Work-related injuries require industrial exposure.  With respect to silica exposure cases, it is important that Injured Worker prove the nature and extent of their exposure.

The nature and extent analysis looks to the “lifetime cumulative exposure, total amount of inhaled RCS, and individual susceptibility Artificial Stone Associated Silicosis: A Systematic Review, Leso,  Int. J. Environ. Res. Public Health 2019, 16(4), 568; https://doi.org/10.3390/ijerph16040568

In sum, how long did the Injured Worker do this type of work? How much inhalation was there?  Was Personal Protective Equipment (PPE) used?  If so, what types of PPE did the Injured Worker use?  Were there any other safety precautions taken beyond the use of PPE?

What Happens When Silica is Inhaled?

“Mechanistically, when respirable silica particles are inhaled, they can reach the lower respiratory tract and the gaseous exchange zones where, after having been phagocytosed by alveolar macrophages, they can persist and then trigger an inflammatory process that is characterized by the production of reactive oxygen species (ROS). The inflammation that is generated by ROS damages the pulmonary parenchyma and the subsequent repair/regeneration process leads to fibrogenesis and carcinogenesis” Artificial Stone Associated Silicosis: A Systematic Review, Leso,  Int. J. Environ. Res. Public Health 2019, 16(4), 568; https://doi.org/10.3390/ijerph16040568

What Medical Conditions Can Come from Silica Exposure?

Silica Exposure has been linked to a variety of medical conditions. “Silicosis is an incurable occupational lung disease caused by inhaling particles of respirable crystalline silica. These particles trigger inflammation and fibrosis in the lungs, leading to progressive, irreversible, and potentially disabling disease. Silica exposure is also associated with increased risk for lung infection (notably, tuberculosis), lung cancer, emphysema, autoimmune diseases, and kidney disease.” Rose C, Heinzerlin A, Patel K, et al. Severe Silicosis in Engineered Stone Fabrication Workers-California, Colorado, Texas and Washington 2017-2019, MMWR Morb Mortal Wkly Rep 2019;68:813-818. [emphasis added]

What Should an Injured Worker Do?

If an Injured Worker who works with silica based products and suffers from the various medical conditions indicated above, they should strongly consider pursuing a workers’ compensation claim.

Why Should an Injured Worker a Workers’ Compensation Claim?

With respect to a Silica Exposure case, an Injured Worker may be entitled to workers’ compensation benefits.   This includes temporary disability benefits, permanent disability benefits, vocational rehabilitation benefits, and death benefits, if indicated.  Also, lifetime medical care will be provided.  Further, there are some special Labor Code Sections that may apply in these cases. Labor Code Section 4656 provides for additional temporary disability periods for chronic lung diseases beyond those for ordinary claims.

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.

THE STATE COMPENSATION INSURANCE FUND (SCIF) AND WORKERS’ COMPENSATION: INJURED WORKERS, THE STATE FUND, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

One of the largest providers of Workers’ Compensation Coverage in California is the State Compensation Insurance Fund.  The State Compensation Insurance Fund is commonly known as the “State Fund” or “SCIF.”

For many workers, it is important that they understand what is SCIF and how it operates.  The reason being is that many Injured Worker’s claims are being adjusted through the fund.

This article will discuss the State Compensation Insurance Fund and how Injured Workers should approach their claims if they are being handled by the Fund.

What are the State Fund’s Goals?

The State Fund’s goal is “to become California’s workers’ compensation carrier of choice.” Their purpose “is to provide fairly priced workers’ compensation insurance, help make workplaces safe, and restore injured workers.”

What are the Origins of the State Compensation Insurance Fund?

The State Fund was established in 1914.  It was created within the California State Constitution.

ARTICLE XIV Labor Relations, Section 4, includes “the establishment and management of a state compensation insurance fund.”

This was part of the Constitutional Mandate to provide a “complete system of workers’ compensation [which] includes adequate provisions for the comfort, health and safety and general welfare of any and all workers and those dependent upon them for support to the extent of relieving from the consequences of any injury or death incurred or sustained by workers in the course of their employment, irrespective of the fault of any party; also full provision for securing safety in places of employment; full provision for such medical, surgical, hospital and other remedial treatment  as is requisite to cure and relieve from the effects of such injury.”

In sum, the State of California has a vested interest in the success and stability of the State Compensation Insurance Fund as a provider of workers’ compensation insurance.  This is interest based upon a constitutional mandate.

What is the State Compensation insurance Fund?

Per their website, the “State Fund is California’s leading provider of workers’ compensation insurance. Not for profit and funded solely by premiums and investment income, we’ve supported California’s entrepreneurial spirit and played a vital role in the state’s economy for more than 100 years. By innovating in areas such as workplace safety and injured worker care, we’re committed to serving California for the next 100 as well.”

State Fund offers diverse and comprehensive products and services that provide a strong and stable option for employers and injured employees with fast, reliable claims service and medical and indemnity benefits. State Fund’s accident prevention services—provided to policyholders at no additional cost—ultimately help save businesses money.

With approximately 110,000 policyholders, more than $918 million in premiums, and nearly $21 billion in assets, Californians rely on the security and certainty offered by State Fund to the state’s employers, particularly the small businesses and new ventures that are key to California’s economic recovery.

For many Employers, the State Fund is the carrier of “last resort.”  This is the place where they have to get their workers’ compensation insurance.

The Fund has two parts. There is State Fund Policy and State Fund Contracts.   The State Fund Policy is the section which handles private employers.   The State Fund Contracts is the section which adjusts various government agencies which contract with the State Fund to administer their claims.

What are the Core Values of the State Compensation Insurance Fund? Why Should You Be Aware of It?

Per the SCIF Website, the Core Values are “Respect Everyone. Create an environment where all people and perspectives are valued and teams work together to serve the diverse needs of California businesses. Be Innovative. Seek out solutions and consider new approaches to serve our customers and help improve California’s workers’ compensation system. Do What’s Right. Approach every situation with a passion to help, a desire to learn and a commitment to integrity—because doing the right thing isn’t always simple, easy, or clear. Show We Care. Listen to understand and invest the time and resources needed to help California employers and injured workers.”

These are important to know.   If you feel that your adjuster is not following the “Core Values,” they should be reminded of that them.  Most of the times, however, I have found that the SCIF adjusters act is a very professional manner.  Experienced SCIF adjusters are well trained.

How Do You Rate the State Fund as a Carrier?

These comments are from my own personal experience.

The State Fund has tremendous resources. They have lots of assets and monies. They are an innovator within workers’ compensation and have taken steps to claims managements that were ahead of their time.  They were paperless well in advance of others in the industry.

Their claims management approach tends to rely on their adjusters.   Their adjusters can be very good and well trained.  They handle the case management as opposed to counsel.  Their counsel tend to be more appearance oriented rather than directing the case management of the claim.

Overall, I think they do a good job in adjusting their claims.

The State Fund has been known to have an excellent training program for their attorneys. Also, they have a reputation as having very good appellate attorneys.   There are many reported cases involving the State Fund.

Have You Had Any Personal Experience With the State Fund?

Besides handling claims against them, I have had two claims and awards with SCIF as the carrier.   They have been decent in my requests for treatment off of my award.  I am relatively satisfied with their handling.

As an Employer, I have had claims filed against me.   They have done a decent job handling the claim.   I did run into a problem one adjuster on an issue.   It was not easy resolving the issue.   Further, the State Fund offers a number of educational programs for Employers which I attended and found helpful.   Overall, I am satisfied with their insurance.

As an Injured Worker, Should I Be Concerned that the State Fund is the Insurance Company?

No. You should not be concerned.  You should be vigilant concerning your rights and pay attention to the documentation you received.   On occasion, they will make a mistake. Other carriers do so as well.  Unlike other carriers, however, because of their status, they need to be “the standard” as to quality claims handling.

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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