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What You Need To Know About Amputations & Workers’ Compensation

Posted on July 20, 2021 by Edward Singer

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

Posted on July 19, 2021 by Edward Singer

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?

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

Posted on July 13, 2021 by Edward Singer

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?

What You Need To Know About The Employee’s Disability Questionnaire & Workers’ Compensation

Posted on July 12, 2021 by Edward Singer

Injured Workers, in their Workers’ Compensation Claim, may be evaluated by a Qualified Medical Evaluator (QME) or an Agreed Medical Evaluator (AME.)

With respect to these Evaluations, Injured Workers are required to fill out a variety of forms. The DWC-AD Form 100 is one of those forms. It is the “Employee’s Disability Questionnaire.”

This article will discuss the “Employee’s Disability Questionnaire,” the questions that are asked, and how an Injured Workers’ case can be impacted the form.

Why is the DWC-AD 100 A Disability Evaluation Unit (DEU) Form?

QME reports or AME reports are sent to the Disability Evaluation Unit (DEU) are often sent to the DEU for a rating. Ratings determine Injured Workers’ Permanent Disability Percentages.

The form’s questions assist the DEU with information that impacts the rating formula.

What Is the Form’s Purpose?

The form is intended to “aid the doctor in determining your permanent impairment or disability.”

Who Gives the Injured Worker the Form?

Generally, the form may be sent to the Injured Worker in advance of the QME or AME evaluation. Sometimes, the evaluator’s offices will provide it to the worker.

What Happens to the Form?

The evaluator includes the form as part of their report. Insurance Companies, Attorneys and Injured Workers will receive it. For Unrepresented Injured Workers, the report, with the form, will be sent to the DEU for a rating.

What Questions Are Asked?

General identification information are requested which include providing your name, your social security number, your mailing address, your date of birth, and your date of injury.

You will also be asked your Employer’s Name, and the nature of Employer’s Business. You will be asked for the insurance company’s claim number(s.)

There are questions about the evaluation. You will also be asked how the Evaluator was selected. This can be by panel, agreement or sometimes at the request of a Workers’ Compensation Judge. They will ask evaluation details including the name of the doctor and the date of the examination.

Your will be asked about your job duties at the time of injury.

You will be asked about the disability caused by your injury. Note: Since this is form is attached to the QME report, it is your one opportunity to write down your unedited and unfiltered complaints. Judges, Insurance Companies, and Attorneys will be able to view your form and compare them to the QME’s reporting.

You will be asked about how the injury affects your work. Note: again, this is your one opportunity to write down to tell everyone involved your unedited and unfiltered opinion.

You will be asked as to whether you had a disability as a result of another injury or illness, If so, they ask you when and to describe it.

Why Are These Answers Important?

Your questionnaire’ answers assist the DEU with generating a Permanent Disability Rating. The for helps the DEU specifically with two issues: Occupational Group Number and Apportionment.

The Occupational Group Number can change a disability rating. It can cause it so go up, go down or remain the same.

The DEU will use the form to address apportionment. The questions provides information for the Disability Evaluation Unit so that they may make an annotation concerning apportionment. Apportionment determines how much of the disability relates to the injury. DEU ratings will often contain notes on apportionment.

What If I Need Advice?

HEALTH CARE WORKERS, SOCIAL SERVICES WORKERS, AND CALIFORNIA WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on June 23, 2021 by Edward Singer

Work injuries are often studied based upon sector and occupation. Studies can impact how workers are trained and treated. Health Care Workers and Social Assistance Workers were recently studied in the article “Occupational Injuries in California Health Care and Social Assistance Industry” 2009 to 2018.” Kerri Wizner, Fraser W. Gaspar, Adriane Biggio, Steve Wiesner 06 June 2021 https: //doi.org/10.1002/hsr2.306

The study addressed a large variety of health care occupations including nurse, aides, assistances, service staff, administrative staff, and technicians. The study looked at the different healthcare facilities including hospitals, residential care sites, and social services providers.

The article will discuss the study’s data, conclusions and impact on Health Care Workers.

What Was the Study’s Purpose?

The study looked at injury prevention workforce health, and injury-related cost savings. Supra.

Thus, a typical risk management agenda was addressed. In short, questions such as “what facilities have problems with work injuries?”, “what occupations have problems with work injuries?”, and “what type of work activities cause work injuries?” are addressed.

What Are the Injury Rates of Import in the Health Care and Services Fields?

Sex: Women sustain the majority of work injuries. The data showed that “the majority of injuries were sustained by women (78.1%), with three-quarters of cases affecting individuals aged 32 to 53 years.” Supra. Note: This may relate to two factors. A greater amount of women working in the field. Also, women may have greater physical challenges of dealing with large or immobile patients. As noted in the study, lifting was found to be a significant source of injury.

Facilities: The injury rates differed in each industry subgroups. Hospitals had the highest number of claims with Ambulatory Care, second, Nursing Care, third. The Social Assistance Group had the least claims. Supra. Note: Hospitals are often less specialized that nursing care facilities. Thus, there are more tasks and more activities performed in a non-ergonomic fashion in a hospital. Likewise, there may be far more activity. Thus, the data is logical.

Occupation: Health care and social assistance settings each have a different proportion of job types, given the variety of health services offered. … Across all settings within California, nurses had the highest proportion of injuries (22.1%), followed by aides/assistants (20.4%), services staff (13.2%), administrative staff (11.0%), and technicians (10.3%). The highest proportion of injury occurred in nursing jobs in hospitals (32.2% vs 3.2%-20.6%), aides/assistants in nursing/residential care sites (40.2% vs 12.1%-16.7%), and social services in social assistance settings (40.6% vs 3.2%-8.0%).” Supra. Note: This finding is not surprising as the largest percentage of injuries are reported within the most physically challenged positions.

Types of Injuries: There was an analysis of the types of Injuries reported. The study reported “[s]trains and tears (defined by the State of California as an injury of the muscle or the musculotendinous unit¹³), were the most common injury, representing 34.4% of all claims, followed by contusions (11.0%), sprains (injury to ligaments) (10.0%), other specific injuries (9.6%), and puncture wounds (7.7%). These injury types were similar across the industry sub-groups apart from ambulatory care, which had a higher proportion of puncture wounds than other settings (14.1% vs 3.4%-5.9%, respectively).” Note: Most of the injuries were of a musculoskeletal nature. The other concern in the healthcare setting is puncture wounds which can be caused by sharps and needles.

Activities Causing Injury: There was an analysis concerning what activities caused the work injuries. The study found “[a]cross all settings, lifting injuries (10.8%) and strains NOC (9.1%) were the most common causes of injury, followed by miscellaneous NOC causes (6.6%), repetitive motion (6.0%), and injury due to being struck accidentally or on purpose by a fellow worker, patient, or other person (5.9%).”

Parts of the Body Injured: There are an analysis concerning which body parts were most frequently injury. Per the study, ”[t]he low back was the most frequently injured body part, representing 13.6% of all claims; followed by multiple body parts (12.8%), finger(s) (9.1%), shoulder(s) (6.8%), and knee(s) (6.1%). Nursing/residential care settings reported the highest proportion of both lifting injuries (15.8% vs 8.9%-9.9%) and low back injuries (16.9% vs 10.0%-13.1%) as compared to the other settings.” [emphasis added] Note: Most body parts injured are within the musculoskeletal systems.

Ambulatory care:

The rates for ambulatory care employee injuries were found to be increasing. Supra. Note: Ambulatory care relates to outpatient centers. Many hospital patients are moved to rehabilitation centers to begin the rehabilitation process. These settings can require patients to begin performing physical activities in a weakened state. Thus, there are significant injury risks for assisting workers.

What May Result from This Study?

The main findings were the high rates of injury in both the hospital setting as well as for ambulatory care employees. Extra safety and training measures may likely be implemented to lower the injury rates with the setting and within the employee class.

What If I Need Advice?