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OPERATING ROOM PERSONNEL AND ORTHOPEDIC WORK INJURIES: MEDICAL PROFESSIONALS SUFFERING MUSCULOSKELETAL DISORDERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 15, 2020 by Edward Singer

There is some irony to the fact that Operating Room Personnel, who help repair and treat patients with workers’ compensation injuries, are at risk of work injuries in doing so. Operating Room Personnel perform vital services in our society’s medical delivery system. Their hard work is appreciated by all. The Operating Room, however, is a difficult place to work.

This article will discuss Operating Room Personnel, the mechanisms of injury that occur as a result of the Operating Room, and the various musculoskeletal injuries that Operating Room Personnel are at risk for sustaining.

Who Are Operating Room Personnel?

Operating Room Personnel include Surgeons, Nurses, Scrub Nurses and Surgical Technicians.

What are the Mechanisms of Injury for Operating Room Personnel?

There are a variety of mechanisms of injury for Operating Room Personnel. These mechanisms include manipulation, standing and static stress.

What is Manipulation?

“Manual activities are another risk factor for work-related physical activity among operating room personnel. Manual activities mean the manual movement and transfer of surgical instruments and devices that require special attention. Pulling, pushing or lifting surgical instruments, heavy and specialized surgical equipment and patient displacement are the most common manual activities of operating room personnel.” J Multidiscip Healthc. 2020; 13: 735–741. Published online 2020 Jul 31. doi: 10.2147/JMDH.S259245 PMCID: PMC7402850 PMID: 32801736 A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel Reza Tavakkol, Ashkan Karimi, Soheil Hassanipour, Ali Gharahzadeh, and Reza Fayzi.

Some of the problems with respect to manipulation is that some of these activities may not be performed in an ergonomic fashion. Supra.

One study found the abnormal posture with respect to nurses. The study noted that “in most cases nurses were at high risk level and needed urgent and prompt change in their working posture.” Health Promot Perspect. 2016; 6(1): 17–22. Published online 2016 Mar 31. doi: 10.15171/hpp.2016.03 PMCID: PMC4847110 PMID: 27123432 Working posture and its predictors in hospital operating room nurses Farahnaz Abdollahzade,Fariba Mohammadi,Iman Dianat, Elnaz Asghari,Mohammad Asghari-Jafarabadi, and Zahra Sokhanvar.

What is “Standing?”

“[T]the team members are in a standing position throughout the surgery.25,26 Standing up for a long time is one of the most important risk factors for musculoskeletal disorders.27 Andersen et al found that prolonged standing may increase back pain and leg pain J Multidiscip Healthc. 2020; 13: 735–741. Published online 2020 Jul 31. doi: 10.2147/JMDH.S259245 PMCID: PMC7402850 PMID: 32801736 A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel Reza Tavakkol, Ashkan Karimi, Soheil Hassanipour, Ali Gharahzadeh, and Reza Fayzi.

What Is “Static Stress?”

“Static stress is one of the risk factors that cause musculoskeletal disorders in operating room personnel. Static stress includes activities such as prolonged standing and constant physical posture during surgery and holding equipment such as retractors during surgery.” J Multidiscip Healthc. 2020; 13: 735–741. Published online 2020 Jul 31. doi: 10.2147/JMDH.S259245 PMCID: PMC7402850 PMID: 32801736 A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel Reza Tavakkol, Ashkan Karimi, Soheil Hassanipour, Ali Gharahzadeh, and Reza Fayzi.

What Body Parts that Can Be Injured by Operating Room Work?

Practically every orthopedic body part is susceptible for injury in the Operating Room. “Operating room personnel are most affected by musculoskeletal pain (58–90%) due to difficult working conditions.20 Musculoskeletal disorders can occur in different parts of the body. The most common areas of involvement include the neck, shoulder, elbows, wrists, and hands, upper and lower back, hip and thighs, knees, ankles, and feet. Among the musculoskeletal disorders, low back pain has the highest prevalence.” Supra.

What If I Need Legal Advice?

If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.

Guide to the State Compensation Insurance Fund (SCIF)

Posted on September 8, 2020 by Edward Singer

One of California’s largest providers of Workers’ Compensation Coverage is the State Compensation Insurance Fund. The State Compensation Insurance Fund is known as the “State Fund” or “SCIF.”

Many workers must understand what SCIF is and how it operates. The reason is that many injured workers’ claims are being adjusted through the Fund.

This article will discuss the State Compensation Insurance Fund and how Injured Workers should approach their claims if the Fund handles them.

What are the State Fund’s Goals?

The State Fund aims “to become California’s workers’ compensation carrier of choice.” Their purpose “is to provide fairly priced workers’ compensation insurance, help make workplaces safe, and restore injured workers.”

What are the Origins of the State Compensation Insurance Fund?

The State Fund was established in 1914. It was created within the California State Constitution.

ARTICLE XIV Labor Relations, Section 4, includes “the establishment and management of a state compensation insurance fund.”

This was part of the Constitutional Mandate to provide a “complete system of workers’ compensation [which] includes adequate provisions for the comfort, health and safety and general welfare of any workers and those dependent upon them for support to the extent of relieving from the consequences of any injury or death incurred or sustained by workers in the course of their employment, irrespective of the fault of any party; also full provision for securing safety in places of employment; full provision for such medical, surgical, hospital and other remedial treatment as is requisite to cure and relieve from the effects of such injury.”

In sum, the State of California has a vested interest in the success and stability of the State Compensation Insurance Fund as a provider of workers’ compensation insurance. This is interest-based upon a constitutional mandate.

What is the State Compensation Insurance Fund?

Per their website, the “State Fund is California’s leading provider of workers’ compensation insurance. Not for profit and funded solely by premiums and investment income, we’ve supported California’s entrepreneurial spirit and played a vital role in the state’s economy for over 100 years. By innovating in areas such as workplace safety and injured worker care, we’re committed to serving California for the next 100 as well.”

State Fund offers diverse and comprehensive products and services that provide a strong and stable option for employers and injured employees with fast, reliable claims service and medical and indemnity benefits. State Fund’s accident prevention services—provided to policyholders at no additional cost—ultimately help save businesses money.

With approximately 110,000 policyholders, more than $918 million in premiums, and nearly $21 billion in assets, Californians rely on the security and certainty offered by the State Fund to the state’s employers, particularly the small businesses and new ventures that are key to California’s economic recovery.

For many Employers, the State Fund is the carrier of “last resort.” This is where they must get their workers’ compensation insurance.

The Fund has two parts. There is a State Fund Policy and State Fund Contracts. The State Fund Policy is the section that handles private employers. The State Fund Contracts is the section that adjusts various government agencies that contract with the State Fund to administer their claims.

What are the Core Values of the State Compensation Insurance Fund? Why Should You Be Aware of It?

Per the SCIF Website, the Core Values are “Respect Everyone. Create an environment where all people and perspectives are valued, and teams work together to serve the diverse needs of California businesses. Be Innovative. Seek solutions and consider new approaches to serve our customers and help improve California’s workers’ compensation system. Do What’s Right. Approach every situation with a passion to help, a desire to learn, and a commitment to integrity—because doing the right thing isn’t always simple, easy, or clear. Show We Care. Listen to understand and invest the time and resources needed to help California employers and injured workers.”

These are important to know. If you feel your adjuster is not following the “Core Values,” they should be reminded. Most of the time, however, I have found that the SCIF adjusters act very professionally. Experienced SCIF adjusters are well-trained.

How Do You Rate the State Fund as a Carrier?

These comments are from my own experience.

The State Fund has tremendous resources. They have lots of assets and money. They are an innovator within workers’ compensation and have taken steps to claims management ahead of their time. They were paperless well in advance of others in the industry.

Their claims management approach tends to rely on their adjusters. Their adjusters can be perfect and well-trained. They handle the case management as opposed to counsel. Their counsel tends to be more appearance-oriented rather than directing the case management of the claim.

Overall, I think they do an excellent job of adjusting their claims.

The State Fund has been known to have an excellent training program for their attorneys. Also, they have a reputation as having outstanding appellate attorneys. There are many reported cases involving the State Fund.

Have You Had Any Personal Experience With the State Fund?

Besides handling claims against them, I have had two claims and awards with SCIF as the carrier. They have been decent in my requests for treatment off of my award. I am relatively satisfied with their handling.

As an Employer, I have had claims filed against me. They have done a decent job handling the claim. I did run into a problem with one adjuster on an issue. It was not easy to resolve the issue. Further, the State Fund offers several educational programs for Employers, which I attended and found helpful. Overall, I am satisfied with their insurance.

As an Injured Worker, Should I Be Concerned that the State Fund is the Insurance Company?

No. You should not be concerned. You should be vigilant concerning your rights and pay attention to the documentation you receive. On occasion, they will make a mistake. Other carriers do so as well. Unlike other carriers, however, because of their status, they need to be “the standard” for quality claims handling.

What If I Need Legal Advice?

If you want a free consultation concerning any workers’ compensation case, don’t hesitate to contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.

THE SERIOUS CONSEQUENCE OF WORK INJURIES: INJURED WORKERS, SUICIDE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Posted on September 6, 2020 by Edward Singer

After an industrial injury, Injured Workers are faced with a number of life obstacles. They have their body which has broken down in some shape or form and is in need of repair and healing. A claims process has arisen in which the Injured Worker’s Employee/Employer relationship has changed. They have taken on a new relationship with a workers’ compensation insurances company which is both trying to assist with the process and trying to manage the risk by taking steps to minimize the claim. They have a new relationship with doctors who, while they have a relationship with them, they are also beholden to the employer and insurance company. Finally, their family relationship may have changed. They may no longer be providing the economic contribution to the family. They may no longer be able to help perform chores in the house. They may need to be dependent upon others in the house for assistance. They may be spending more time in the house with other family members leading to more conflict.

These stressors can lead to serious consequences. This article will discuss a recent study from South Korea of import, which discusses the risk of suicide in individuals who have suffered occupational injuries.

What Factors Did the Study Look at?

The study looked at a variety of factors: loss of income, return to work, the nature and extent of the disability, pensions, and family disruption. Lee H, Kim I, Kim M, et al

Increased risk of suicide after occupational injury in Korea Occupational and Environmental Medicine Published Online First: 13 August 2020. doi: 10.1136/oemed-2020-106687

What Was Were the Conclusions?

Industrially Injured Workers are statistically at a higher risk of injury when compared to others that are economically active.

The study found that “Injured workers showed higher mortality from suicide for both men (SMR=2.22, 95% CI 2.14 to 2.31) and women (SMR=2.11, 95% CI 1.81 to 2.45) compared with the economically active population in Korea.” Lee H, Kim I, Kim M, et al Increased risk of suicide after occupational injury in Korea Occupational and Environmental Medicine Published Online First: 13 August 2020. doi: 10.1136/oemed-2020-106687

One interesting note, which is of import, was the more severely disabled workers had a lower suicide risk. Supra. One reason hypothesized as the fact that they have received a disability pension. This notion of disability pension, when translated into a United States analysis and within the State of California could imply a Social Security Disability Award, a Government Employee Disability Pension, such as CALPERS, LACERA, KCERA, CALSTRS or LACERS, or a Disability Pension from a Private Disability Plan. Further, on Workers’ Compensation Case of a high percentage, such as 100 percent, the disability payments are substantial.

What Do We Need to Learn from the Study?

Most importantly, it is those who have injuries that cause the loss of employment, but which do not cause permanent disability, that we should be concerned with. In essence, individuals who lose their job and does not get substantial financial assistance are at a greater risk for suicide. Increased risk of suicide after occupational injury in Korea Occupational and Environmental Medicine Published Online First: 13 August 2020. doi: 10.1136/oemed-2020-106687

What Should We Do?

For those Injured Workers it is important that efforts be made to get them treated promptly and get them returned to the workforce. Both expediting treatment and the prompt provision of the Job Voucher would certainly assist in these cases. Further, there should be awareness to identify these individuals and get them psychological counseling through the workers’ compensation system or through an Employee Assistance Program. Also, those Injured Workers may benefit from retaining Legal Counsel to assist them. They may need assistance in the handling of their workers’ compensation claim as well as potential claims related to disability discrimination.

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SUN EXPOSURE AND WORKERS’ COMPENSATION: WORK INJURIES FROM OCCUPATIONAL SUN EXPOSURE: WHAT YOU NEED TO KNOW

Posted on August 20, 2020 by Edward Singer

Many Workers spend significant periods of time working outdoors. This outdoor exposure during working hours can be a cause of Occupational Skin Disease. If a cause of one’s Skin Disease is partially caused by work-related exposure, the Injured Worker is then able to make a claim for workers’ compensation claim and may be entitled to monetary compensation, temporary disability and permanent disability benefits, medical care, vocational rehabilitation benefits and death benefits.

“Currently, it is estimated that one in five Americans will develop skin cancer during their lifetime, the majority diagnosed with nonmelanoma skin cancer (NMSC), which includes basal cell (BCC) and squamous cell (SCC) carcinomas.” Skin cancer as an occupational disease: the effect of ultraviolet and other forms of radiation Claudia C. Ramirez, MD, Daniel G. Federman, MD, and Robert S. Kirsner, MD

This article will discuss the nature of Sun Exposure Skin Diseases, What Occupations Are at Risk for Occupational Skin Disease, Statutes that Relate to Skin Disorders, and Case law discussing Skin Conditions.

What are Sun-Related Skin Diseases?

Sun Exposure can lead to various skin conditions. These include cancerous, pre-cancerous, and non-cancerous conditions. These can include photoaging -solar lentigo, wrinkles and loose or irregular skin. Pre-Cancerous Skin conditions include Actinic Keratosis. Cancerous Conditions include Basal Cell Carcinoma, Squamous Cell Carcinoma and Malignant Melanoma.

What Occupations are at Risk for Occupational Skin Disease?

Occupations at risk for Occupational Skin Disease include the following jobs: cabin attendants, construction workers, farmers, landscapers, physical education teachers, pilots, police officers, postal workers, roofers, telephone line workers, waterman, and welders.

What is Exposure? Are There Different Exposures?

“The damaging effects of ultraviolet radiation accumulate over the years. In general, the risk of developing skin cancer increases with the amount of time spent under the sun and the intensity of radiation. The intensity of radiation varies according to the season of the year, time of day, geographic location (latitude), elevation above sea level, reflection from surfaces (e.g., white sand or concrete, water, snow), stratospheric ozone, clouds, and air pollution.

Recent studies have focused on the effects of intermittent (short-term, occasional) sun exposure in comparison to chronic (long-term) exposure. It appears that the type of exposure may influence the type of cancer that develops. For example, intermittent solar exposure may be an important factor leading to the onset of basal cell carcinoma of the skin. …

In contrast, the relationship between squamous cell carcinoma and solar UVR appears to be quite different. For squamous cell tumours, high levels of chronic occupational sunlight exposure, especially in the 10 years prior to diagnosis, results in an elevated risk for this cancer in the highest exposure group.” https://www.ccohs.ca/oshanswers/diseases/skin_cancer.html

Besides Typical Sun Exposure, Are There Other Suspected Causes of Occupational Skin Disease?

Yes. Irradiation, Nonionizing Microwave Frequencies, Cosmic Radiation, and Ionized Radiation are also suspected causes of Occupational Skin Disease.

“Although sun exposure is thought to be a common etiologic factor, some studies have suggested alternative explanations, such as irradiation from the welding arc in welders, nonionizing microwave frequency radiation from radar use in police officers, and cosmic radiation in pilots and cabin attendants. Disturbances in circadian rhythm have also been suggested as having a role in the increased risk of skin cancer in pilots and cabin attendants and should be elucidated in future studies. Occupations in which there is an increased exposure to ionizing radiation, such as radiation technicians and radiologists, showed an increased risk for melanoma and NMSC. Surprisingly, there is a paucity of publications regarding skin cancer incidence amongst lifeguards, ski instructors, professional cyclists, and other professionals who spend time outside as part of their jobs. Ample evidence exists, however, that amongst selected occupations skin cancer is an important occupational disease.” Skin cancer as an occupational disease: the effect of ultraviolet and other forms of radiation Claudia C. Ramirez, MD, Daniel G. Federman, MD, and Robert S. Kirsner, MD

Are There Any Labor Code Sections which Support Claims of Occupational Skin Disease?

Yes. With respect to the present issue of Sun-Related Occupational Skin Disease, there is the Cancer presumption which applies to both certain Law Enforcement and Safety Officers. This is Labor Code Section 3212.1. For an article discussing the Cancer Presumption, click here.

Is There Case Law Concerning Sun Exposure?

Yes. A sample of sun-related cases include issues such as: Defendant claiming non-industrial sun exposure as the source of nasal cancer. See County Sanitation District No. 2 vs. WCAB (2004) 69 C.C.C. 1463; Defendant disputing CT injury date in which there was a claim of multiple CT injury dates. Injury was claimed as skin cancer caused by sun exposure. City of Vista vs WCAB (2017) 83 C.C.C. 95; also see City of Corona vs. WCAB (1997) 62 C.C.C. 1693. In the matter, “Applicant was treated by Shira Young, M.D., and was evaluated by James Lineback, M.D. Dr. Young felt that there was a probability that sunlight played a role in the development of Applicant’s skin cancer. Dr. Lineback opined that it was reasonably probable that the skin lesions were directly related to sunlight exposure.”

Are There Anything a Worker Should Do?

In my years of representing Injured Workers, one of the most tragic cases I ever had was a melanoma case. While the melanoma initially appeared in a location on the body which was not exposed to the sun, the cancer turned out to be fatal. Despite seeking advanced medical treatment, the worker died shortly after he opened his claim.

Early detection of the disease is of import. If you do so, there is a chance for a successful recovery.

For all those who work in the sun or with skin issues, you should check your skin on a regular basis and seek medical attention. Per the Centers for Disease Control, “[a] change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that doesn’t heal, or a change in a mole. Not all skin cancers look the same.

For melanoma specifically, a simple way to remember the warning signs is to remember the A-B-C-D-Es of melanoma—“A” stands for asymmetrical. Does the mole or spot have an irregular shape with two parts that look very different? “B” stands for border. Is the border irregular or jagged? “C” is for color. Is the color uneven? “D” is for diameter. Is the mole or spot larger than the size of a pea? “E” is for evolving. Has the mole or spot changed during the past few weeks or months?”

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POST TRAUMATIC STRESS DISORDER (PTSD), OCCUPATIONAL CAUSES, & EMPLOYER ASSESSMENT AND REACTION: WORKERS’ COMPENSATION AND PTSD: WHAT YOU NEED TO KNOW

Posted on August 5, 2020 by Edward Singer

Post-Traumatic Stress Disorder is a Psychiatric Diagnosis that Injured Workers can receive as a result of exposure to workplace stress. In the California Workers’ Compensation System, both Insurance Companies and Employers are well aware of the serious consequences with PTSD injuries. This includes the fact, Workers’ Compensation Laws include several Labor Code Sections that support Injured Workers making PTSD claims.

This article will discuss PTSD, workplace causes of PTSD, risk management approaches to PTSD, and Labor Code Sections that impact to PTSD claims.

What is PTSD?

“Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened, even when they are not in danger.” – National Institute of Mental Health

The Specific and Cumulative Nature of Stressors?

Workplace stressors causing PTSD vary temporally. They can occur in a specific manner such as a robbery. They can occur in a cumulative fashion such an Employee being continually bullied in the workplace.

What Are the Causes of PTSD in the Workplace?

Workplace causes of PTSD can be broken into two categories. There is Workplace Stress and Traumatic Stressful Events.

What Workplace Stress can give rise to PTSD?

Workplaces stressors that can give rise to PTSD include supervisor relations, group morale and cohesion, administrative procedures, workload, shift duties, resources and internal personal conflict Post-traumatic stress disorder in occupational settings: anticipating and managing the risk Alexander C. McFarlane, Richard A. Bryant Occupational Medicine, Volume 57, Issue 6, September 2007, Pages 404–410, https://doi.org/10.1093/occmed/kqm070

What Traumatic Stressful events can give rise to work-related PTSD?

Traumatic stressful events that can occur in the workplace include mass disasters, serious accidents, threats or death and injury, deaths of colleagues, witnessing deaths, suffering and injury and assault. Post-traumatic stress disorder in occupational settings: anticipating and managing the risk Post-traumatic stress disorder in occupational settings: anticipating and managing the risk Alexander C. McFarlane, Richard A. Bryant Occupational Medicine, Volume 57, Issue 6, September 2007, Pages 404–410, https://doi.org/10.1093/occmed/kqm070

Why are Insurance Companies and Employers concerned about PTSD cases?

First, in the event of an obvious stressful event, i.e. a shooting in the workplace, Insurance Companies and Employers realize that the chances of having any legal defense to defeat such a claim is minimum. Therefore, their goal is to minimize the risk.

In other words, the most important goal for Employers and Insurance Companies is to minimize the expenses on the claim. Costs that can be minimized include medical treatment, temporary and permanent indemnity, future medical treatment, and vocational rehabilitation.

How is the Risk Managed in PTSD Cases?

It has been suggested that PTSD risk management should include screening, observation, and treatment. Post-traumatic stress disorder in occupational settings: anticipating and managing the risk Alexander C. McFarlane, Richard A. Bryant Occupational Medicine, Volume 57, Issue 6, September 2007, Pages 404–410, https://doi.org/10.1093/occmed/kqm070

What is Screening?

As part of Risk Management, there will be an attempt to screen Workers who may be at risk for PTSD. It is noted that “Screening for psychological disorders is an effective strategy in workers who are at significant risk because of their levels of trauma exposure. Such a strategy involves identifying individuals at risk and screening them in the immediate aftermath and again approximately 6 months later.” Post-traumatic stress disorder in occupational settings: anticipating and managing the risk Alexander C. McFarlane, Richard A. Bryant Occupational Medicine, Volume 57, Issue 6, September 2007, Pages 404–410, https://doi.org/10.1093/occmed/kqm070

Note: Screening presents problems. Are the individuals screening trained to do so? Will the Employees react negatively towards this screening? Is it better that such screening be done by a medical provider provided through a workers’ compensation claim by some other means such as an EAP program?

What is Observation?

Risk Management suggest that Managers observe Workers who are at risk for PTSD. They will be looking for things such as increased alcohol use, interpersonal and or family conflict, social withdrawal, depression, somatic distress and performance deterioration. Supra.

Note: Observation can be very problematic for Injured Workers. Having suffered through a psychiatric disturbance is certainly enough for one person. The notion that Management is tantamount to spying on the individual can add additional unnecessary paranoia and psychiatric symptomology to the already existing PTSD symptoms.

What is Treatment?

“The aim of effective treatment is to minimize these disabilities before they emerge.” Supra. Per Labor Code Section 4600, Injured Workers are entitled to treatment subject to a utilization review schedule and Independent Medical Review.

Note: Minimizing disabilities translates to lower costs on cases. Effective treatment reduces the need for temporary disability, permanent disability, need for future care and need for vocational rehabilitation services. In the Workers’ Compensation System, however, Insurance Companies are slow to act and often deny both treatment and claim.

Why Are Post-Trauma Factors Important in Managing Risk?

As much as what happened to cause the PTSD, events that happen post injury can shape the course an Injured Worker’s claim.

“In the aftermath of the event, a range of factors can modify the recovery or escalate distress such as social support and stress that emerge in the aftermath of the event such as continued exposure to the distress of the victims or critical legal investigations of the circumstances of the event where blame is involved.” Post-traumatic stress disorder in occupational settings: anticipating and managing the risk Alexander C. McFarlane, Richard A. Bryant Occupational Medicine, Volume 57, Issue 6, September 2007, Pages 404–410, https://doi.org/10.1093/occmed/kqm070

In sum, what happens in the workplace or elsewhere after the PTSD event can have a profound impact on the claim. Therefore, Risk Management principles dictate that Management should continue to view the workplace as an ongoing site of injury. Post Injury events can push individuals who were functioning over the edge and create profound disability.

What Labor Code Sections specifically address PTSD issues?

There are two Labor Code Sections that I view as specifically related to PTSD.

The first is the PTSD Presumption which applies to certain law enforcement and safety offices. This is Labor Code Section 3212.15. For more information concerning this Presumption, click here.

The second is the Labor Code Section which lowers the causative burden for stress claims which involve violent acts. Labor Code Section 3208.3(b)(2) which 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”.[emphasis added]

Note: This was included due to the fact that those events described have a significant possibility of resulting in PTSD. This section lowers the burden of causation from predominant cause (greater than 50 percent) to 35 to 40 percent for the Injured Worker.

What If I Need Legal Advice?