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

Posted on March 8, 2021 by Edward Singer

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, 5^th 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.

What You Need To Know About The Cage-aid Questionnaire And Workers’ Compensation

Posted on March 3, 2021 by Edward Singer

Workers’ Compensation Medical Treatment can employ various questionnaires to assess an Injured Workers’ need for treatment. One of these questionnaires is called CAGE-AID.

This article will discuss the purpose of the CAGE-AID questionnaire, how it is used in an industrial treatment setting, and how it may impact an injured worker’s treatment.

What is the CAGE-AID Questionnaire?

The CAGE-Aid questionnaire is a substance abuse screening tool. Substance abuse applies to alcohol, legal drugs and street drugs.

Why is Substance Abuse a Problem with Workers’ Compensation Treatment?

Substance abuse is a multi-factorial problem in workers’ compensation. There are workers who, prior to their injury, have histories of either substance or alcohol abuse. Further, there are workers, as a result of their injuries, begin to abuse drugs or alcohol. This abuse can either be with prescription drugs, alcohol, or street drugs. Finally, there are injured workers who, not as a result of their work injuries, engage in substance abuse.

Why is The Questionnaire Called CAGE?

The abbreviation refers to some of the terms within the questions. The terms are cut, annoyed, guilty and eye opener.

What are the Questions Asked?

There are four questions. They are:

Have you ever felt that you ought to cut down on your drinking or drug use?

Have people annoyed your by criticizing your drinking or drug use?

Have you ever felt bad or guilty about your drinking or drug use?

Have you ever had a drink or used drugs first thing in the morning to steady your nerves or get rid of a hangover (eye opener)?

How is it Scored?

It is scored one for yes and zero for no.

How is The Score Interpreted?

If one or more responses is yes, then it is regarded as a positive screening test. Thus, possible substance abuse is something that the medical provider should explore with the partient.

How Should Injured Workers Answer the Questions?

These questions may impact medical treatment decisions. Medical providers need accurate information in order to provide appropriate treatment. Substance abuse, when combined with prescription drugs, can lead to harmful and deadly drug interactions. Therefore, it is important to be honest when answering the questions.

Additionally, if an injured worker has a substance abuse problem that is preventing their recovery from a work injury, it is possible that the workers’ compensation medical system may provide some assistance with respect to substance abuse treatment. This, however, would be subject to the limitations within Labor Code Section 4600.

What If I Need Advice?

What You Need To Know About Workers’ With Pre-existing Mental Health Issues And Workers’ Compensation

Posted on February 26, 2021 by Edward Singer

Many Workers, prior to starting employment, have diagnosed medical illnesses. There are a variety of forms of mental illness.

A study looked into mentally ill individuals in the workplace. This study discusses how work impacts the mentally ill. This information is important with respect to workers’ compensation stress claims.

This article will discuss mental illness, forms of mental illness, work’s impact on mentally ill individuals, and what it means in the context of workers’ compensation stress claims.

What Is Mental Illness?

Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. Psychiatry.org. “ Mental illness is common. In a given year: nearly one in five (19 percent) U.S. adults experience some form of mental illness one in 24 (4.1 percent) has a serious mental illness, one in 12 (8.5 percent) has a diagnosable substance use disorder.” Psychiatry.org

There is a variety of mental illnesses. These include anxiety disorder, Attention-deficit/hyperactivity disorder, autism, bipolar disorder, clinical depression, dementia, obsessive compulsive disorder, post-traumatic stress disorder, schizophrenia,

What Is California Psychiatry Injury Causation Standard?

Labor Code Section 3208.3 provides the causation standard. The causation burden per (b)(1) is that “In order to establish that a psychiatric injury is compensable, 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” This means greater than 50 percent.

There is a lower standard in certain circumstances. Per (b)(2), “… 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 cause is at least 35 to 40 percent.

Does Working Impact Mental Illness?

The study found that “Individuals with mental illness who are employed, compared to those who are unemployed, reported slightly higher levels of overall life satisfaction and psychophysiological health”. Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

How Does The Study Relate to Work Injuries?

Mentally ill individuals may have improved health and satisfaction when they are working. Therefore, this improvement in their mental state should be factored into work injury causation analysis. Also, it may have value with respect to permanent disability apportionment.

What Was in the Study’s Reporting?

The study reported that “, the mechanism underlying the relationship between having an occupation and life satisfaction implies that having an occupation enhances individuals’ perception of their own physical and psychological health, which in turn might increase their satisfaction with life” Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

What Is the Impact of Unemployment on Mental Illness?

The study noted that “[u]nemployment can lead to, among other things, diminished social status, financial debt, reduced self-esteem, and feelings of guilt. Most importantly, unemployment is significantly associated with psychiatric problems and approximately 37% higher risk of suicide (Milner, Page & Lamontagne, 2014).” Granjard A, Mihailovic M, Amato C, et al. Occupation and life satisfaction among individuals with mental illness: the mediation role of self-reported psychophysiological health. PeerJ. 2021;9:e10829. Published 2021 Jan 29. doi:10.7717/peerj.10829.

Note: This finding is important. Mental health treatment and assessment of impairment during a pre-employment period is exacerbated by unemployment. Thus, with no unemployment In combination with work, a Mentally Ill individual’s mental state may be significantly elevated prior to confronting work stress.

What If I Need Advice?

REMOTE WORKERS’ COMPENSATION TRIALS VS. IN PERSON TESTIMONY: THE WORKERS’ COMPENSATION APPEALS BOARD SIGNIFICANT PANEL DECISION: A WORKERS’ COMPENSATION ATTORNEY’S VIEW: WHAT YOU NEED TO KNOW

Posted on February 17, 2021 by Edward Singer

In WCAB vs. Chevron (2021), the Workers’ Compensation Appeals Board issued a Significant Panel Decision on with respect to how California Workers’ Compensation Appeals Board have trials done remotely. Currently, the WCAB uses a “zoom” like product called Lifesize to conduct their trials.

What Was the Chevron Case issue?

In Chevron, in person testimony was taken. After the change to remote testimony, there was additional witness testimony. The Workers’ Compensation Judge on the matter did not want to proceed. The issue was essentially whether all testimony be taken in the same manner. Thus, there was the argument that the matter be delayed until “in person” testimony could take place.

The Applicant wished the matter to proceed with remote testimony rather than wait.

What Was the Ruling?

In the particular case, the WCAB ordered the trial to proceed with remote testimony.

The WCAB, ruled that “each case must be resolved according to its own particular circumstances, and it would therefore be inappropriate to institute a blanket rule that it is per se unreasonable to continue a case to allow for in-person testimony.”

“However, in consideration of Executive Order N-63-20, the purposes of the workers’ compensation system, and current conditions, the default position should be that trials proceed remotely, in the absence of some clear reason why the facts of a specific case require a continuance. Moreover, as the party seeking the continuance, the burden should be on defendant in this case to demonstrate why a continuance is required.” [emphasis added]

What Facts Would Required for “In Person” Testimony?

At trials, Judges have the opportunity to view Injured Workers when they are not testifying. They see them sitting and observing the trial, and they see them walking up to take the stand to testify, and they see them during break time. Additionally, they are able to view the Injured Worker’s posture during testimony. Thus, it is possible to view whether someone is exhibiting pain behavior.

Based upon my 29 year Trial Attorney experience, an Applicant’s live testimony is important when there is an allegation of marked or profound disability. Thus, if an Injured Worker has a severe limp, a Judge would be able to observe it if there was live testimony. This observation is not possible with remote testimony.

Thus, matters in which observation of the Applicant is of import would be the cases upon which a party may wish to have “in person” testimony.

What If I Need Advice?

CALIFORNIA VIRUS-21? COVID-19, CALIFORNIA HOMEGROWN VIRUS MUTATION, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on January 26, 2021 by Edward Singer

Is There Something New with Respect to COVID-19?

Yes. There is a new strain of Coronavirus which is a B1429 strain. This may be unique to California.

“Health officials are still determining if the new variant shares is more contagious than the regular strain” NY Post, “We’re concerned that it [B1429] attaches to the human cell a little more than the natural virus the one we’ve been dealing with. That might make it more contagious, we aren’t sure yet, we’re looking at it,” said Mark Ghaly, California Health and Human Services Secretary. Supra.

Is This Important for Workers?

For Workers’ Compensation purposes, the information about the new strain is important. It may provide some explanation as to the severity of a COVID-19 infection. Further, this new strain may be used to determine industrial causation. For example, if co-workers have the same strain of COVID-19, this information may assist in finding industrial causation.

What If I Need Advice?