What You Need To Know About Back Surgery, Return To Work, & Workers’ Compensation

Workers’ Compensation Medical Studies have been done on many topics.   Studies have reported on surgeries performed within the workers’ compensation environment.  Some studies have looked examined spinal surgeries.

Study results impact Injured Workers.  Studies results can create insurance Company expectations concerning surgery success and recovery times.   Insurance Company expectations from these studies can be imposed upon treating doctors concerning temporary and permanent disability.

This article will discuss back surgery, a study concerning back surgery, the back surgery study’s results. and what the study means for injured workers.

What Is Back Surgery?

The Spine has three segments: cervical, thoracic, and lumbar.  The lumbar segment of the spine is usually referred to as back or low back.  Back surgeries are generally on the area referred to as the lumbar spine.   There are various types of surgeries.   There are surgeries to address lumbar spine disks and there are other procedures that address the stability of the spine.   Common surgeries are laminectomies, fusions and disc replacement.

Besides the problems being operated on, there is also issue of levels.   The lumbar spine has multiple levels.   Some surgeries operate on one level and others involve multiple levels.

There are a variety of reasons why a particular surgery may be indicated.  This article will be addressing one of the reasons. A surgery to address a herniated lumbar disk. Specifically, a surgery to address a disk at only one level.   This procedure is called a laminectomy.

Why Is Back Surgery a Significant Workers’ Compensation Issue?

Back Surgeries are expensive.T they cause periods of temporary disability and may result in findings of permanent disability.   Back Surgeries can have complications that can be costly such as treatment for post-operative infections.  Thus, Insurance Companies, in a risk management analysis, may wish to prevent surgery liability by either denying the treatment or settling the case.

What Were the Study’s Results?

The study addressed focused only on a single-level lumbar disk herniation surgery.

According to the study, “[p]atients receiving WC(workers; compensation) with shorter duration of radiculopathy before diskectomy had higher RTW(return to work) rates; fewer physical therapy, chiropractic, and psychotherapy sessions; and fewer postoperative diagnoses of psychological illnesses.”  Ren BO, O’Donnell JA, Anderson JT, Haas AR, Percy R, Woods ST, Ahn UM, Ahn NU. Time to Surgery Affects Return to Work Rates for Workers’ Compensation Patients With Single-Level Lumbar Disk Herniation. Orthopedics. 2021 Jan 1;44(1):e43-e49. doi: 10.3928/01477447-20201202-06. Epub 2020 Dec 7. PMID: 33284984.

The study found that “within 12 weeks of injury, post-diskectomy patients do reasonably well, with a 70.0% (95% CI, 65.9%–74.1%) rate of RTW.”

The study also found that “[o]n the other hand, if a patient waited more than 2 years to have surgery for radiculopathy, RTW(return to work) rates decreased as low as 31.3% (95% CI, 26.3%–36.3%).” Ren BO, O’Donnell JA, Anderson JT, Haas AR, Percy R, Woods ST, Ahn UM, Ahn NU. Time to Surgery Affects Return to Work Rates for Workers’ Compensation Patients With Single-Level Lumbar Disk Herniation. Orthopedics. 2021 Jan 1;44(1):e43-e49. doi: 10.3928/01477447-20201202-06. Epub 2020 Dec 7. PMID: 33284984.

Note: the study’s results are confounding to Insurance Companies.  The study suggests that acting promptly to approve a surgery can lead to more promising results.   The study implies that a long drawn out battle for a back surgery can result in a poor result.  Thus, acting quickly and spending a considerable amount of money for treatment leads to a better result in this circumstance.  Thus, these types of cases are a true test for Adjusters.

Was There Anything Else Interesting from the Study?

Irrespective of surgery, the factors of  legal representation, psychological co-morbidity and mean household income can negatively impact return to work. Ren BO, O’Donnell JA, Anderson JT, Haas AR, Percy R, Woods ST, Ahn UM, Ahn NU. Time to Surgery Affects Return to Work Rates for Workers’ Compensation Patients With Single-Level Lumbar Disk Herniation. Orthopedics. 2021 Jan 1;44(1):e43-e49. doi: 10.3928/01477447-20201202-06. Epub 2020 Dec 7. PMID: 33284984.

Is There Anything an Injured Worker Should Do?

Injured Workers with spinal problems should get appropriate medical care at the onset of injury. In the case of severe back pain and in cases with radiculopathy, they should seek out an orthopedic surgeon to have their condition assessed.

Per the study, if surgery is truly indicated, surgery it suggests that it be done promptly. Each individual’s medical condition and recovery, however, is different. Thus, the treatment course should be done on an individual basis and not per a study.

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.

HOME HEALTHCARE WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Home Healthcare is an important field in California.  Many individuals require in-home services for a variety of medical conditions.  Home Healthcare Workers (HHCW) can be employed in a variety of ways including through the State.

This article will discuss Home Healthcare Workers, their tasks, and the occupational risks of HHCWs.

What Are Home Healthcare Workers? 

Per the United States Department of Labor, “[h]ome healthcare workers provide hands-on long-term care and personal assistance to clients with disabilities or other chronic conditions. These workers, who may be home health aides, personal/home care aides, companions, nursing assistants or home health nurses, are employed in patients’ homes and in community-based services such as group homes.”

What Tasks Do They Perform?

“Depending on their training and job duties, they help patients with activities of daily living such as meals, bathing, dressing and housekeeping, and may perform clinical tasks such as medication administration, wound care, blood pressure readings and range of motion exercises.”  USDL

What are The Home Healthcare Hazards?

Home Healthcare Workers are subject to a large variety of hazards.  They include bloodborne and biological pathogens, latex sensitivities, ergonomic hazards, violence, hostile animals, dangerous conditions and unhygienic conditions.

How Do These Problems Occur?

Bloodborne and Biological Pathogens: This can include saliva, urine and feces.  These can occur while performing injections or changing bags such as urostomy bags.

Latex Sensitivity: This can arise out of the use of gloves. Glove use can result in contact dermatitis.

Ergonomic Hazards:  This can arise from working at a patient’s home which is not set up in an ergonomic fashion.  For example, lifting may be required in an awkward position.

Violence: This most commonly arises in patients that suffer from dementia.  They have the capacity to act out in a violent fashion.  This can include being bitten, kicked, pinched, punched, scratched, or shoved.

Hostile Animals: This most commonly relates to aggressive family pets who may bite or jump on workers.  Additionally, they can be tripping hazards as well.

Dangerous Conditions: These conditions can arise from physical defects on the premises as well as exposures to drug residues, infectious agents and cleaning chemicals..

Unhygienic Conditions: Unlike hospitals, home settings may not have proper disposal of biological waste. This can result in transmission of pathogens.

Travel: Home Healthcare Worker may service more than one patient in a day.  Thus, there duties may include travel from one location to another

Environmental Hazards: This can include second-hand smoke, exposure to asbestos, exposure to lead paint and exposure to allergens such as dust and mold.

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.

 

COMMON WORK INJURIES AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

The Workers’ Compensation System is a Risk Management System.  It is designed to payout benefits for work-related injuries.   Therefore, it is very important for the industry to identify what types of injuries and occupations have high risk of injury.

The US Government has a Bureau of Labor Statistics which identify both common injuries and what occupations are at risk for injury.  On 11/4/20, statistics were issued for the year 2019.

This article will discuss common work-related injuries, occupations which have high rates of incidence for work injuries and other information.

What are Common Worker Related Injuries?

In the Manufacturing Field, the Injuries Rates were:  Sprains, Strains, or Tears (28.0 percent), Soreness or Pain (14.5 percent), and Cuts, Lacerations, or Punctures (13.3 percent)

What Occupations Have Higher Rates of Injury?

In order of incidences, per the BLS report, the occupations with the highest rate of injuries are listed from highest to lowest:

Nurses Assistants

Heavy and Tractor-Trailer Truck Drivers

Laborers and freight, Stock and Material Movers, Hand

Light Truck Drivers

Construction Laborers

Maintenance and Repair Workers, General

Stockers and Order Fillers

Janitors and Cleaners, except Maids and Housekeeping Cleaners

Registered Nurses

Retail Salespersons

Is There Other Interesting Data? 

Yes.

Elderly Workers:  “Private industry workers age 65 years or over had a median of 16 days away from work due to injuries and illnesses in 2019, compared to 8 days for all private industry workers.”

Male vs. Female Workers:  Men had higher injury rates that Women in 2019.

What Does This Data Mean to Workers?

Employers and Risk Management, knowing this data, will act upon these matter.   For example, Carriers may pay close attention to elderly injured workers due to the fact that they have extended periods of disability.  There may be some incentive to offer them modified work.  Further, for occupations that have high work injury rates, safety classes and other measures may be implemented to address lifting techniques and other techniques to prevent risk.

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.

NURSES: DOES YOUR WORKING SHIFT MATTER?  MUSCULOSKELETAL INJURIES, SHIFT CHOICE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Nurses are at risk for work-related musculoskeletal injuries (WMSD.)  A study addressed whether a Nurse’s Work Shift impacted WMSDs.

This article will discuss Nursing, Nursing Shifts, and how particular Shift Work may impact industrial injuries.

What Are Nursing Duties? What Makes Nurse at Risk for Injury?

Nursing Duties are physically demanding.  Patient care can require individuals to work in awkward positions and deal with individuals whose weight can shift at any moment.

“WMSDs(work-related musculoskeletal disorders) in nurses are mainly caused by shifting patients (which includes helping patients turn over or get in and out of bed), routine treatments in nursing, poorly designed work environments, and remaining active for prolonged periods of time.4 The physiological loads created by these nursing activities are all risk factors of WMSDs in nurses.” Chang WP, Peng YX. Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis. J Occup Health. 2021 Jan;63(1):e12208. doi: 10.1002/1348-9585.12208. PMID: 33682989; PMCID: PMC7938703.

Likewise, “cllinical nurses must deal with daily routine work in busy wards, patient care and treatment, and correspondence for various matters. Their jobs are time‐consuming, complicated, and full of stress, and they are often on tight schedules, all of which are associated with WMSDs.” Supra.

What Musculoskeletal Body Parts Do Nurses Injure?

Nurses are susceptible to injury for every body part imaginable.   This includes the neck, shoulders and back.

Nurses are prone to WMSDs in the lower back, shoulders, neck, back wrists, knees, and ankles. Supra.

What are Shifts?

Hospitals and other medical facilities provide 24 hours a day service for 7 days a week.  Thus, the facilities have various work shifts.  Some facilities may have 8-hour shifts, some 10-hour shifts, and others 12-hour shifts.    

What Shifts are There?

Within an 8-hour format, there is generally a morning shift, an evening shift, and an overnight shift.

How Do Nurses’ Shifts Vary?

Nurses can have regular fixed shifts.   Also, there are Nurses who have rotating or irregular shifts.

What was the Study About?

The study focused on Nurses who worked rotating and irregular shifts. The theory of the study was that “working rotating and irregular shifts, which causes the physiological burden of disrupted circadian rhythms in the body, may also exacerbate muscle tension and pain.” Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis. J Occup Health. 2021 Jan;63(1):e12208. doi: 10.1002/1348-9585.12208. PMID: 33682989; PMCID: PMC7938703.

What Were the Results?

The study “indicated that RS (rotating shifts) + IS (irregular shifts) nurses are more likely to experience back pain associated with WMSD than are FDS (fixed day shift) nurses.”  Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis. J Occup Health. 2021 Jan;63(1):e12208. doi: 10.1002/1348-9585.12208. PMID: 33682989; PMCID: PMC7938703.

In sum, Nurses working irregular shift are more likely to experience musculoskeletal disorders.

As a Lawyer, Are There Any Reasons That May Cause the Higher Rate?

In my opinion, irregular shifts can include irregular routines.  Nurses who have regular shifts may have better understanding of their shift’s physical requirements.   Also, they may be more familiar with their surroundings.   Thus, they are able to take better precaution to prevent injury.

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.

What You Need To Know About Healthcare Workers, Covid-19’s Mental Health Impact, And Workers’ Compensation

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.

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