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

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

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

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

What Is Violence?

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

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

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

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

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

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

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

How Does Workers’ Compensation Laws Address Violence?

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

Are There Any Special Laws Concerning Violent Acts?

Yes. The threshold for psychiatric claims of injury is lowered if there is a claim of violence.  Labor Code Section 3208.3 provides that “ in the case of employees whose injuries resulted from being a victim of a violent act or from direct exposure to a significant violent act, the employee shall be required to demonstrate by a preponderance of the evidence that actual events of employment were a substantial cause of the injury.” Substantial is defined as 35 to 40 percent.

How Significant Is It Within the Health Care Industry?

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

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

Are There Different Violence Rates Among Occupation?

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

Paramedics

They are subject to the highest amount of verbal violence

Nurses/Physicians

They are subject to the highest amount of verbal threats

Nurses

They have the highest rate of violence threats by visitors.

Female Nurses

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

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

Who Commits the Violence in Healthcare Settings? 

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

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

What Are the Causes of Violence in the Health Care?

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

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

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

Is There Anything Special About Emergency Departments?

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

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for over 27 years. Contact us today for more information.

Workers’ Compensation In the News, Episode # 3: Even Super Heroes Get Hurt: What You Need to Know

Holy Cow Batwoman! Pow, Kabam! Ouch!

Ruby Rose, who played Batwoman, on the CW Television Show reported that she sustained two injuries while working on the program.

While wearing a latex Batwoman Mask, she developed an allergic reaction.  She also had an accident on the set which required back surgery. foxnew.com

Can An Allergic Reaction Be An Industrial Injury? 

Yes. Allergic reactions can be work-related injuries.  If so, the Injured Worker will receive medical treatment paid for by the insurance company as well as monetary compensation.

Allergic Contact Dermatitis (ACD) is an inflammation of the skin caused by an immunologic reaction triggered by dermal contact to a skin allergen. For ACD to occur, a worker must be first sensitized to the allergen. Subsequent exposures of the skin to the allergenic agent may elicit an immunologic reaction resulting in inflammation of the skin. The reaction is not confined to the site of contact and may result in systemic responses. ACD may be caused by industrial compounds (i.e. metals, epoxy and acrylic resins, rubber additives, chemical intermediates), agrochemicals (i.e. pesticides and fertilizers), and commercial chemicals.

A common allergic reaction is latex allergies. Per the CDC, Latex Gloves have proved effective in preventing transmission of many infectious diseases. But for some workers, exposures to latex may result in allergic reactions. Reports of such reactions have increased in recent years–especially among Health Care Workers.

Can An Accident at Work Be An Industrial Injury? 

Yes. Workers’ Compensation is “no fault.”  Thus,  if Ruby Rose had hurt her back by an accidental trip, she would still be able to have a valid claim.  The claim would have paid for her back surgery, paid her compensation for her time off of work as well as provided her additional benefits.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for over 27 years. Contact us today for more information.

AMPUTATIONS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Amputations can be a life-changing event for a Worker.  Workers may lose their ability to perform their job as well as perform activities of daily living.

The Workers’[ Compensation Community is concerned about amputation cases as they involve  extensive medical costs and missed time from work.

This article will discuss amputations, special laws concerning amputations, and interesting data derived from a recent study.

What Is an Amputation?

The Workers’ Compensation Appeals Board defined amputation.  In Cruz vs. Mercedes Benz, 72 C.C.C. 1281 (Panel Decision), the WCAB indicated “ Defining amputation as the severance or removal of a limb, part of a limb, or other body appendage comports with the ordinary meaning, and includes the range of potentially compensable scenarios, including both traumatic loss of a body part in an industrial injury and surgical removal during treatment. This definition conforms to our understanding of the common meaning of the term “amputation,” which encompasses external projecting body parts, not internal parts, even if they include bone. It is also consistent with the definitions in the International Dictionary of Medicine and Biology, Dorland’s Illustrated Medical Dictionary, and Stedman’s Medical Dictionary. To the extent that some definitions refer to organs, appear to encompass all body parts, or include an equivocal “etc.,” we reject them or interpret them in a manner consistent with our understanding of the term “amputation.”

Thus, surgery on a lumbar disc was found not to constitute an amputation.

Why Is an Amputation Important in California Workers’ Compensation?

An amputation in a workers’ compensation case triggers entitlement to additional periods of total temporary disability. 240 weeks is allowed in the case of amputations. Labor Code Section 4656.  In these cases, there is no requirement that the temporary disability period be connected to the amputation. Jon Van Ness, Applicant v. Barbara Herzstein, 2007 Cal. Wrk. Comp. P.D. LEXIS 239 (Panel Decision)

How Do Amputations Occur on an Industrial Basis?

Occupationally related amputations can occur for many reasons.  The accident itself can be the source of the amputation, i.e. a skill saw cutting off a finger.  They can result of a crush injury which necessitates an amputation. They can be the result of post-surgical infection.  They can be the result of an industrially related disease process such as diabetes.

Interesting Amputation Facts Are:  

Males vs. Females

Men sustain most of the work-related amputations.  (84.8%) Gomez NG, Gaspar FW, Thiese MS, Merryweather AS. Trends in incidence and correlation between medical costs and lost workdays for work-related amputations in the State of California from 2007 to 2018. Health Sci Rep. 2021 Jul 1;4(3):e319. doi: 10.1002/hsr2.319. PMID: 34250271; PMCID: PMC8247939.

Full-Time vs. Part-Time Employees

Full-Time Employees were more likely to sustain amputation versus Part-Time Workers. (71.7%.) Supra.

Most Amputated Parts

Most claims consisted of partial-hand amputations (82.0%).  Most of those were partial-hand amputations, 66.7% were fingers without the loss of the thumb. Following partial-hand amputations, partial-foot amputations were the next most common claim  at 5.9%.  Supra.

Type of Business

Manufacturing is the industry with the highest number of claims (24.1%.) Supra.

What Should an Injured Worker Take from This Study?

The study noted that “[a]mputations represent high medical costs and number of lost workdays.” Gomez NG, Gaspar FW, Thiese MS, Merryweather AS. Trends in incidence and correlation between medical costs and lost workdays for work-related amputations in the State of California from 2007 to 2018. Health Sci Rep. 2021 Jul 1;4(3):e319. doi: 10.1002/hsr2.319. PMID: 34250271; PMCID: PMC8247939.

Due to the increased medical expense and missed time from work, Insurance Companies will make efforts to control the costs.  They may do so by employing a Defense Counsel as well as a Nurse Case Manager.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for over 27 years. Contact us today for more information.

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

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

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

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

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

Do The Restaurant Employees From the Story Have a Claim?

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

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

Are Stressed Out Employees Eligible for Time off From Work?

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

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for over 27 years. Contact us today for more information.

WORKERS’ COMPENSATION IN THE NEWS, EPISODE #1: BURGER MADNESS: WHAT YOU NEED TO KNOW

Many news articles involve work injuries.  A recent viral story about Burger King Employees quitting their jobs en masse is one of them.

Fox News reported that  “[e]mployees there said they’ve been working in a kitchen with no air conditioning for weeks, with the temperature reaching more than 90 degrees at one point, according to KLKN Channel 8.  One employee, former general manager Rachael Flores, was reportedly hospitalized for dehydration, according to KLKN Channel 8. “

This article will discuss how these facts involve a work-related injury and what legal issue, within workers’ compensation, that may apply.

What Is the Work Injury? 

From the facts, the high heat at the work location may have caused the work to suffer from dehydration.   This is suggestive of a heat-related illness/injury.

Heat Illnesses can include (1)  Heat Stroke which is the most serious form of heat illness. It requires immediate medical treatment. Symptoms include confusion, loss of consciousness, and seizures; (2)  Heat Exhaustion which is is a less serious form of heat illness. It can involve headaches, nausea, dizziness, irritability, thirst and heavy sweating. It can lead to heat stroke; (3)  Heat Cramps which is a mild form of heat illness. It is essentially muscle cramps and spasms. They can occur either when working or not; and (4) Heat Rash which is a skin irritation. It is also known as “prickly heat.”

How Does This Injury Become A Workers’ Compensation Claim?

The Burger King Employee who suffered from dehydration should file a workers’ compensation claim.  Workers’ Compensation Insurance should pay for this worker’s medical bills and receive all other workers’ compensation benefits.

Is There A Special Claim That May Apply In This Case?

Yes.  This claim has facts to suggest that the employer acted in a way that would be considered serious and willful misconduct.  The working conditions concerning the high heat may have been in violation of safety regulations.  Also, there may have been intentional acts delaying the repair of the air conditioning unit.

Per Labor Code Section 4553, “the amount of compensation [for the workers’ compensation claim] otherwise recoverable shall be increased one-half, together with costs and expenses not to exceed two hundred fifty dollars ($250), where the employee is injured by reason of the serious and willful misconduct of any of the following: (a) The employer, or his managing representative. (b) If the employer is a partnership, on the part of one of the partners or a managing representative or general superintendent thereof. (c) If the employer is a corporation, on the part of an executive, managing officer, or general superintendent thereof.”

What If I Need Advice?

 If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for over 27 years. Contact us today for more information.

9.3Edward Jay Singer
Edward Jay SingerReviewsout of 22 reviews