COVID-19, HEALTHCARE WORKERS, AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

A recent Occupational COVID-19, Study addressed Coronavirus Work Injury Claims for Health Care Workers.  The study was done in Germany.  Nienhaus A. COVID-19 among Health Workers in Germany-An Update. Int J Environ Res Public Health. 2021 Aug 31;18(17):9185. doi: 10.3390/ijerph18179185. PMID: 34501773; PMCID: PMC8431697.

Healthcare Workers, being on the front line of medical care, are at significant risk for industrial COVID-19 infection injuries.  Infection rates appear to be different for each particular Healthcare Occupation.   Infection risk differs from support staff workers to nurses to doctors.  Likewise, the Healthcare Worker’s workplace can impact the infection risk. Facility types, i.e. hospital, nursing home, etc, can play a role in infection rates.

This article will discuss the study which addresses Healthcare Workers and their industrial COVID-19 infection rates.

What Health Care Facilities Are Impacted?

The study showed that “most claims concern inpatient and outpatient nursing (39.5%) or clinics (37.6%).” Supra.

In contrast, medical practices are not subject to as many claims.  It was reported that “As few as 3.2% of the claims concern medical practices.” Supra.

In other words, it appears that facilities which address extended patient care have greater rates than mere evaluations or examinations.

What Was the Claims Acceptance Rate for Occupational Injury?

 It was reported that “.. 77.5% of all claims were assessed, and in 81.4% of these, the OD(Occupational Disease) was confirmed.” Supra.

Thus, it appears in Germany that there is wide acceptance of industrial claims of injury for COVID-19.

How Are Healthcare Workers Impacted?

Nursing is the profession most impact with 68.8% of the cases. Supra.

Hospitals had the highest claims rates with 41.3 claims per 1000 full time workers. Supra.

What Was Treatment Severity?

It was reported seventy-seven workers died (0.09%) and three hundred and seventy-five (0.4%) were hospitalized. Supra.

The majority of workers got treatment clinics (52.3%) and inpatient and outpatient care facilities (28.0%)  Supra.

What Percent Claims Considered as Industrial?

 A total of 65,693 (77.5%) claims were assessed, and for 81.4% of these claims, the Occupational Disease was confirmed. Supra.

Where Was the Highest Frequency of Claims?

The Occupational Disease rate per 1000 full time workers highest in clinics, followed by inpatient and outpatient care (28.9 and 20.8). Supra.

Where Were the Highest Claims Rates?

The Occupational Disease rate per 1000 full time workers was highest in clinics, followed by inpatient and outpatient care (28.9 and 20.8). Supra.

The hospital breakdown was  per 100,000 full time workers highest for clinics (25.4), followed by inpatient and outpatient care (10.5) and medical practices (8.7). 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.

UPPER EXTREMITY WORKERS’ COMPENSATION SURGERIES: WHAT YOU NEED TO KNOW

Studies about workers’ compensation as always of interest to Injured Workers.   A lot of these studies tell us how and why insurance companies, employers and doctors act in particular ways.   A study addressing upper extremity surgeries provides us such insight. The study compared the results of industrial versus non-industrial upper extremity surgeries.

This article will discuss, upper extremity surgeries, issues relating to upper extremity surgeries, and the results of the study.

What Are Upper Extremity Surgeries?

 With respect to upper extremities, there are a variety of surgeries that are done on an industrial basis.  Upper extremity surgeries can range from shoulders to finger tips. Parts operated on can include areas such as the shoulders, biceps, elbows, forearms, wrists, and fingers.

For shoulders and elbows, there operations can include fracture surgeries, total shoulder replacements, shoulder arthroscopies, rotator cuff repairs, tennis elbow, golfer’s elbow, and elbow arthroscopy.

For the wrist, operations can include fracture surgeries, carpal tunnel releases, wrist arthroscopies, wrist joint replacements and wrist fusions.

How Are Workers’ Compensation Upper Extremity Surgeries Different Than Non-Industrial Upper Extremity Surgeries?

Approval:  Unlike Health Insurance Company approval for surgeries, Workers’ Compensation surgeries are subject to utilization review and independent medical review. Thus, there are guidelines and algorithms that must be met in order for surgeries to get authorized.  This can lead to delays in getting approval.

Medical Providers:  For many Injured Workers, they are constrained to using hand surgeons and upper extremity surgeons within the workers’ compensation insurance medical provider networks. Thus, the quality of the surgeon is subject to the insurance company’s dedication to having good providers.

Total Temporary Disability Benefits: For Injured Workers, they receive benefits is they remain symptomatic. Therefore, it is necessary that the voice all of their problems.

Permanent Disability Benefits: For Injured Workers, they need to be critical of the results of the surgery and be able to describe them.  Therefore, the result is viewed with this mindset.

What Was the Study’s Conclusion?

 The study “found that patients receiving WC[workers’ compensation] had worse postsurgical results after upper extremity surgery and demonstrated less pre- vs postoperative improvement than uncompensated patients regardless of which outcomes were measured. However, this effect was not uniform among different types of outcomes. Functional measures, such as AOM or grip strength, were least likely to demonstrate a significant difference between compensated and uncompensated patients. The same was true in studies that measured pre- vs postoperative improvement rather than only assess patient postoperatively.” Fujihara Y, Shauver MJ, Lark ME, Zhong L, Chung KC. The Effect of Workers’ Compensation on Outcome Measurement Methods after Upper Extremity Surgery: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2017;139(4):923-933. doi:10.1097/PRS.0000000000003154. It was noted that this analysis was aware that compensated patients can result in artificial reduction of the therapeutic effect which may lead to incorrect conclusions. Supra.

The study noted that “.. the effect of WC on surgical outcome is not solely an issue of malingering Americans. Compensation systems that do not incentivise feigning impairment, also observe worse outcomes associated with WC. Rather, this may indicate that increased impairment among workers receiving WC may be a result of psychological effects on patients caused by a sense of victimization or injustice .” Fujihara Y, Shauver MJ, Lark ME, Zhong L, Chung KC. The Effect of Workers’ Compensation on Outcome Measurement Methods after Upper Extremity Surgery: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2017;139(4):923-933. doi:10.1097/PRS.0000000000003154

In sum, it would appear that Injured Workers have poorer post-operative results.   There are factors of income, malingering, psychological effects of victimhood and injustice may be the factors lead to a poorer workers’ compensation result.

Knowing these Results, How Will an Injured Worker Be Treated?

 Insurance Companies, knowing the surgery result may be poor, may want to avoid providing for it.  This can be done in two ways: one, settling the case before surgery, two, contesting the need for the surgery.

Doctors take pride in their work.  Doctors like to have good results.  Therefore, doctors may not thrilled with Injured Workers because there will be some level of dissatisfaction and representations that the surgical result was not optimal.

Employers, like Insurance Companies, may not be happy with surgeries with poor results.  For them, they are faced with a costlier claim as well as possible issues with respect to return to work.   Return to work issues would involve either qualified Injured worker status or the need to provide alternative or modified work.

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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