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6-Year Old Shoots Teacher: Injured Workers in the News #73

It is reported that an Elementary School Teacher was deliberately shot by a six-year-old student in her classroom.  She is reportedly critically ill.  Dailymail.com

This article will discuss this fact pattern under the premise that the Teacher was a Public School Employee within the State of California.

Are There Limits to This Teacher’s Workers’ Compensation Benefits?

In California, Workers’ Compensation Benefits are limited.   With respect to total temporary disability benefits, absent some exception, the Teacher, given the fact pattern, would likely be eligible for only 104 weeks.  With respect to medical care, while Labor Code Section 4600 provides for treatment to cure or relieve from the effects of the injury, the Teacher’s medical care would be subject to Utilization Review.  This means that Requests For [Medical] Authorization are subject to approval.

Beyond Workers’ Compensation, Is There Anything That This Teacher Can Do To Get Benefits?

If the Teacher is going to be unable to return to work within 104 week, it would appear that the Teacher should investigate her retirement rights.  Retirement can come in different forms.  Retirement can be based upon years of employment or based upon a medical disability.  In California, there is the California State Teachers’ Retirement System.   This system provides retirement benefits to California public school educators from pre-kindergarten thought community college.

Given this fact pattern, the Teacher should consult with both CALSTRS as well as the Social Security Administration for 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 27 years. Contact us today for more information.

A MTA WORKER IS BOTH A HERO….AND AN INJURED WORKER: INJURED WORKER IN THE NEWS, #55

Mr. Anthony Wilson, an MTA Worker, is both a hero and an Injured Worker.   It was reported that “[l]ast week, Nelson was cleaning the Pelham Bay subway station in the Bronx when police allege 49-year-old Alexander Wright began to harass customers. Nelson stepped in to protect them, but the suspect quickly turned his rage toward Nelson, breaking his collarbone and nose.”  KESQ.COM

This fact pattern may involve many unique issues. This article will discuss two important issues that come up with these type of events;  the injury investigation and the Injured Worker’s high profile work injury celebrity status.

Why Would High Profile Claim Like This Be Investigated?

In California, any assault claim has the possibility of an insurance company defense of initial physical aggressor.  The initial physical aggressor rule could bar an Injured Worker’s claim.  Therefore, it is worthy of inquiry by the insurance company.  In other words, there will be an investigation as to whether the Injured Worker made the first physical contact.

Labor Code Section 5402, allows insurance companies 90 days to investigate claims.  “If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division.”  Thus, the Insurance Company will got out and get witness statements and see if the incident was caught on tape before accepting the claim.

Why Is The Injured Worker’s Celebrity Status A Problem?

An Injured Worker who becomes a celebrity as a result of their injury creates a problem.

When an Injured Worker is in a high profile worker’ compensation case, they may be on television or interviewed for news articles. These television reports or interviews may reveal information concerning the Injured Worker’s injuries and their physical activity level.   Additionally, in interviews, Injured Workers may try to make a positive and uplifting impression rather than be accurate concerning their complaints.  This information can be used to impeach the Injured Worker.  Also, it could be sent to examining or evaluating physicians.

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 27 years. Contact us today for more information.

ANGRY CUSTOMER + MACHETE + A DICK’S SPORTING GOODS STORE MANAGER = WORK INJURY: INJURED WORKER IN THE NEWS, #53

A Dick’s Sporting Goods Store had quite an incident.   A Customer, angry over the fact that he could not purchase a gun, reportedly took out a machete and slashed the Store Manager and 2 others.  The Store Manager is reported to have serious injuries to his torso, arms, and head.  It is reported that the Manager suffered severed tendons in the arms. TimesofIsrael.com

Does Workers’ Compensation Treat All Injured Body Parts Treated Equally?

No.  In California Workers’ Compensation, each body part is addressed separately.   Each body part, not including psych injuries, is to be assessed under the American Medical Association Guidelines 5th Edition.   A Whole Person Impairment is assigned to each body part.   This impairment is translated into a rating percentage.  The Worker’s Occupation is also used to adjust the rating percentage.  Per the Rating Schedule, After the rating is adjusted for diminished future earning capacity, it is then modified to take into account the requirements of the specific occupation that the employee was engaged in when injured.   SCHEDULE FOR RATING PERMANENT DISABILITIES 2005.  The adjustment is based upon who value the body part is to the occupation.  In other words, a job that requires lifting will get added value for a back.  With the Manager, their torso, arms, and head will be assigned distinct values.  With a Manager, the head may be rated higher both on a cosmetic level and on a cognitive level versus the torso and arms.  Should a psychiatric injury be pled, that rating percentage would go upwards as a Manager’s job requires a significant mental capacity.

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 27 years. Contact us today for more information.

 

MCDONALD’S WORKER PEPPERED IN POSSIBLE ROBBERY ATTEMPT: INJURED WORKER IN THE NEWS, #51

A McDonald’s Worker was pepper sprayed in what was believed to be an attempted robbery.   The employee’s injuries were reported to be minor. They were not taken to the hospital.  nypost.com

This article will discuss the issues with respect to this incident.

If the Worker Wanted to Pursue a Claim of Emotional Injury, Does the Fact It Appeared to Be Attempted Robbery Matter?

No.  From the facts, there were actual events of employment that occurred, the worker being pepper sprayed.  Thus, there would be a basis for the Injured Worker to pursue a psychiatric claim if they wished to pursue such a case. The fact that a robbery was suspected would not matter.

At the Time of the Incident, Is There Anything the Injured Worker Should Do?

In this matter, while the injuries were minor, it would be advisable that the Injured Worker to attend at least one medical evaluation to be treated and to document their complaints. Additionally, the evaluation should be a physical examination so that blood pressure readings and other physical findings can be documented.  Failure to document complaints can cast doubt as to disability if later claimed.

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 27 years. Contact us today for more information.

 

 

MTA CLEANER SUSTAINS INJURIES IN AN UNPROVOKED ATTACK: INJURED WORKER IN THE NEWS # 48

It is reported that a New York City MTA Worker was slugged in the face.  She worked as a cleaner. It is also reported that she worked for a company contracted with the MTA.    Nypost.com

This article will discuss “unprovoked attacks.”

Are There Any Special Benefits For Individuals Who Sustain Work-Related “Unprovoked Attacks”?

Possibly.  In California, a number of companies and government agencies provide benefits beyond workers’ compensation for unprovoked attacks.  In other words, some employers, when there is an unprovoked attack, will pay the injured worker funds that exceed traditional workers’ compensation benefits.

The companies who have this benefit are likely to do so are government agencies.  Unprovoked Attack Benefits are usually are delineated in a Union Contract or the Memorandum of Understanding.

If an Injured Worker sustains an injury caused by an unprovoked attack, they may want to make an inquiry as to whether they are eligible.  The Human Resources Department should be able to provide the worker the answer to their eligibility.  Again, these benefits are not too common.  They usually involve occupations that have extensive contact with the public or individuals who are incarcerated. 

An example of these benefits come from the Los Angeles version of the MTA.   Some employees are provided the benefit per the contract as follows: “SECTION 2. PAYMENT FOR TIME LOST (a) It is further agreed that if the Operator is physically injured as a result of such robbery, or as a result of an unprovoked attack by another person, such injury resulting in a loss of time, he/she shall be paid 100% of the time lost during the first seven (7) days of disability and 80% of the time lost thereafter. If Workers’ Compensation Benefits are provided during this period, the basis of payment will be as shown above less the Workers’ Compensation Benefits. Operators sustaining injury shall be paid for all time lost as the result of an unprovoked attack when medical verification is provided. Payment will be limited to a maximum of one (1) year after the date of any one incident. (b) An Operator required to wear prescription glasses as a condition to his/her license to drive, whose prescription glasses are lost or damaged as a result of robbery or unprovoked attack, will be compensated up to a maximum of four (4) days’ pay for time lost until the glasses are repaired or replaced. (c) In the event an Operator loses time due to the loss of his/her regulation watch in a robbery or unprovoked attack, he/she will be compensated for the remainder of his/her assignment that day.”

Given the Present Fact Pattern, What Should This Worker Do?

With the reported facts, the Applicant worked for a company that was contracted with the MTA. Thus, it is more likely that her employer may not provide her for such a benefit. Again, she should check with her Human Resources Department to ascertain whether she is entitled to this additional benefit.

Are There Disputes Concerning Unprovoked Attacks? What Happens?

Yes. Over my years of representation, Employers can dispute an unprovoked attack claim.  If this happens, there is likely a dispute resolution process that occurs.  This would be addressed via the Union Contract or Memorandum of Understanding.  Whether there was an unprovoked attack is not something that the Workers’ Compensation Appeals Board would adjudicate.

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 27 years. Contact us today for more information.

 

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