WORK HARDENING AND WORKERS’ COMPENSATION: THERAPY FOR INJURED WORKERS: WHAT YOU NEED TO KNOW

Workers’ Compensation Medical Treatment is special. Unlike Traditional Medicine, Industrial Medical Treatment has unique goals. Treatment for industrial injuries is of statutory construct. In other words, the Government has made special rules and regulations with respect to Injured Workers’ treatment.

California Workers’ Compensation Law, pursuant to Labor Code Section 4600(a), has the overall goal of industrial medical treatment to provide what is “reasonably required to cure or relieve the injured worker from the effects of the worker’s injury, ” This goal is further refined by statute and regulations.

Within this construct, there are other goals with respect to Injured Workers’ medical treatment. One of the most important goals of Industrial Medicine is to get the Injured Worker “back to work.”

The term “Back to Work” has many meanings. “Back to Work” can mean getting the Injured Worker back to the job they had when they got injured. “Back to Work” can mean that the Injured Worker can mean that there is a return to a modified position. “Back to Work” can mean that the Injured Worker is returned to an alternative position. “Back to Work” can mean that the Injured Worker is returned to a state upon which they are able to participate in a vocational rehabilitation program. In sum, “Back to Work” means returning an Individual back to the open labor market.

Work Hardening is a form of therapy that can assist with “Back to Work” issues.

This article will discuss the nature of “Work Hardening,” why Insurance Companies should encourage this treatment, and why Injured Workers should participate in such program programs.

What is Work Hardening?

Work Hardening is a form of “Occupational Therapy.”

“Work Hardening is an interdisciplinary, individualized, job specific program of activity with the goal of return to work. Work Hardening programs use real or simulated work tasks and progressively graded conditioning exercises that are based on the individual’s measured tolerances. Work hardening provides a transition between acute care and successful return to work and is designed to improve the biomechanical, neuromuscular, cardiovascular and psychosocial functioning of the worker.” Washington State Department of of Labor and Industries.

What Are the Goals of Work Hardening?

The Goals of Work Hardening include Improvement of Vocational Feasibility, Improvement of Employability, and Decrease in Vocational Handicap. Work Hardening: Occupational Therapy in Industrial Rehabilitation Leonard N. Matheson; Linda Dempster Ogden; Kris Violette; Karen Schultz American Journal of Occupational Therapy, May 1985, Vol. 39, 314-321. https://doi.org/10.5014/ajot.39.5.314

What Happens in a Work Hardening Program?

Work Hardening Programs work on the Injured Worker’s strength and endurance, they set goals, and they work on simulation of work tasks. Throughout the process, their progress is monitored to see if there is improvement.

Who Benefits from Work Hardening Programs?

“Experience shows that the clients who experience the greatest benefit from work hardening programs are those who are seriously deconditioned after an impairment caused by an injury or disease. In addition, people who have major discrepancies between their symptoms and objective findings and individuals whose impairment is limited to the dominant upper extremity substantially benefit from work hardening. “ Work Hardening: Occupational Therapy in Industrial Rehabilitation Leonard N. Matheson; Linda Dempster Ogden; Kris Violette; Karen Schultz American Journal of Occupational Therapy, May 1985, Vol. 39, 314-321. https://doi.org/10.5014/ajot.39.5.314

In sum, this observation means that individuals who have been off of work for a significant period of time benefit from work hardening. Deconditioning can occur when an individual has been off of work for a while. Also, there may be deconditioning from a severe injury which causes an immediate incapacity to perform physical activities. Delays and denials of medical treatment can further contribute to deconditioning.

Further, individuals with major discrepancies between symptoms and objective findings may have anxiety and emotional issues with respect to engaging in physical activities. Work Hardening can provide confidence to these workers with respect to their abilities to exert themselves without the fear of re-injury.

How Does an Injured Worker Get in a Work Hardening Program?

All medical treatment in the California Workers’ Compensation System requires that a Treating Physician issue a Request For Authorization(RFA) for a “work hardening” program. An RFA request is subject to Utilization Review (UR) If UR denies authorization, the denial can be appealed for an Independent Medical Review.

What Have Independent Medical ReviewI Decisions Said Concerning “Work Hardening”?

There is common language which is used repeatedly within IMR Decisions with respect to the authorization of such treatment.

The IMR Decisions state as justification that “[t]here is a known etiology to the chronic pain syndrome or specific clinical condition which includes physical injury or disease. Other appropriate medical and/or invasive care has been attempted and proved to be inadequate to restore functional status. The patient has appropriate rehabilitation potential (i.e., he or she is judged to be able to substantially benefit from the program). The patient is not responding to less costly interventions including quality physical therapy programs; The patient has at least some behavioral or psychosocial issues affecting their recovery. For workers without behaviorally related issues and merely a physical gap between the current capabilities and future job requirements, work conditioning/work hardening programs are usually both more appropriate and cost effective.
The patient has substantial gaps between current physical capabilities and actual or projected occupational demands. There are no known contraindications to the treatment program, e.g., certain unstable medical conditions, primary substance abuse disorder or cognitive limitation which would prevent appropriate learning. The patient is committed to recovery.” 85 Cal. Comp. Cases 451 CM19-0133693, 85 Cal. Comp. Cases 446 CM19-0130002; 84 Cal. Comp. Cases 470, CM19-0021422 [emphasis added]

In sum, IMR Decisions provide several hurdles before such a program will be authorized. Therefore, it is important that the Injured Worker participate in traditional physical therapy programs prior to attempting to get authorization for a Work Hardening Program.

Why Should an Injured Worker Participate in “Work Hardening”?

There are many reasons why an Injured Worker should participate in a Work Hardening Program. First, the Work Hardening Programs can assist the Injured Person back to workplace. Second, Work Hardening Programs have been found to cut down on absenteeism post return to work. Schonstein E, Kenny DT, Keating JL, Koes BW. Work conditioning, work hardening and functional restoration for workers with back and neck pain. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD001822. DOI: 10.1002/14651858.CD001822. Third, the participation in a Work Hardening Program with failed results may be considered as credible evidence of inability to compete in the open labor market. Fourth, failure to participate in a Work Hardening Program may be viewed negatively as to the Injured Worker’s intentions and abilities.

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.

CALIFORNIA FIREFIGHTERS AND WORKERS’ COMPENSATION: FIRE FIGHTERS, WORK INJURIES AND THE MOST RECENT RAND STUDY: WHAT YOU NEED TO KNOW

California Firefighters are tasked with some of the most difficult jobs.   California is perhaps the Forest Fire Capitol of the United States or even the World!  Firefighters provide a vital services in ensuring that we live in safety.

In performing their duties, Firefighters get hurt and have industrial claims.   California Firefighters’ work injuries have been studied by the Rand Corporation and they have prepared a recent report. The study is entitled The Frequency and Economic Impact of Musculoskeletal Disorders for California Firefighters: Trends and Outcomes of the Past Decade, Dworsky, Seabury, and Broten.

This article will address the most recent Rand Corporation Study and what it means to Firefighter and their careers with respect to their work injuries.

What Is the Rand Corporation? What Did It Study?

Rand Corporation is commonly known as a “think tank.”   According to Rand, it “was established over 70 years ago to strengthen public policy through research and analysis. Over seven decades, our research teams have answered the difficult questions and generated actionable insights by combining the very best analytical tools and methods with a distinct, interdisciplinary approach.”  They are frequently used by government, such as the State of California to do research.   The term “public policy” implies that their results can impact laws and proposed legislation.   For our purposes, their conclusions may become the impetus for new changes in workers’ compensation law.

The Rand Corporation Study, with respect to California Firefighters was done with “[t]he purpose of this report was to provide new information to policymakers about the frequency, nature, and consequences of firefighter injuries in California, with a particular focus on MSDs.”  In other words, the State of California may use the data to change workers’ compensation law with respect to Firefighters, or Fire Departments may change their risk management approaches to attempt to reduce claims.

What Did the Rand Study Find?

Highest Rate of Injuries

The Rand Study found that “firefighters are significantly more likely to be injured than workers in other occupations.”

Highest Rate of Musculoskeletal Disorders (MSDs)

The Rand Study found that “ a larger share of those injuries are MSDs.”

Specifically, we found that nearly half (47 percent) of firefighter injuries are MSDs, compared to 38 percent for police officers, 42 percent for other public-sector workers, 37 percent in our private-sector comparison group with similar job requirements to firefighters, and 42 percent for other private-sector workers.

Spine and Knee Injures Are More Common Than Upper Extremity Injuries

The Study found that there were “differences in the nature and cause of firefighter injuries. Compared to other occupations, injuries to firefighters are less likely to involve the upper extremities and significantly more likely to involve lower extremities or the trunk. Strains are the modal cause of injury for firefighters.”

Burn Injuries Are More Significant Than Other Occupations

The Rand Study found that “burns are significantly more common among firefighters than other workers but still represent a small share of injuries (6 percent) in comparison to MSDs.”

Cumulative Trauma vs. Specific Dates of Injury

The Rand Study found that “a lower share of firefighter injuries were reported as being due to cumulative trauma than workers in other occupations.”

Psychiatric Injuries for Firefighters

The Rand Study shows that the dated indicated that “firefighters and police have similar rates of psychiatric comorbidities. However, perhaps surprisingly, incidence rates of psychological injuries—including PTSD—for public safety workers are substantially lower than rates observed among other public-sector workers or comparable private-sector workers.”

Note: as noted in the study, Firefighters may carry with them a stigma concerning mental health issues.   Firefighters with mental health concerns may seek treatment privately rather than file a work injury claim.

Is There Any Good News for Firefighters with respect to the Study?

There was some good news in the Rand Study for Firefighters. The economic consequences of musculoskeletal disorders was less serve than for other similar occupations.   It was noted the Fire Departments appear to do better than other employers, including other public sector employers, at retaining Injured Workers.   Also, SB 863, a recent law change, provided for higher ratings for MSD injuries for Firefighters.  Finally, there was no evidence found that treatment caps for chiropractic, occupational therapy, or physical medicine treatments did not substantially impact most Firefighters.

What is there to Make of the Rand Study?

In light of the findings, it would appear that there would be no effort to try to increase additional indemnity to Firefighters.   Further,  it would appear that there would be no effort to change treatment protocol as well.  Perhaps, injury rate reduction would be explored.   In sum, risk management for the departments may try to take steps to reduce injuries.  Any reduction may be difficult to achieve due to the job’s physical demands.

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.

YOUNGER WORKERS AND WORK INJURIES:  YOUTHFUL WORKERS, SPECIAL CONCERNS FOR YOUNGER WORKERS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

“When I was young, it seemed that life was so wonderful”

Supertramp

Does Age matter?  Yes.  Younger Workers get injured at different rates than Older Workers.  A recent study brought light onto the issue of Age as a factor with respect to Work Injuries.

Younger Workers make up a significant number of the workforce.  Adolescents and Young Adults represent approximately 13% of the U.S. workforce. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

As a result of this, like all workers, they sustain work-related injuries. Per a study, it was estimated that “3.2 million nonfatal injuries to young workers were treated in hospital emergency departments, with the highest rates among workers aged 18–19 years. Data from 2018 indicate that the leisure and hospitality industry [i.e. food service such as McDonalds hotels, and amusement parks] contributed the highest percentage of injuries to workers aged 15–17 years requiring at least 1 day away from work.” Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

This article will discuss the rates of injury for Younger Workers, the implications for Younger Workers who sustain work injuries, the special concerns a Workers’ Compensation Attorney has with respect to these claims, and how the Workers’ Compensation Systems addresses Younger Workers’ Permanent Disability.

What Was the Study?

The study  that was done looked into nonfatal occupational injuries of Younger Workers within the United States during the years 2012 to 2018.  Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Does Age Make a Difference?

Yes. It was found that Younger Workers, aged 15-24, experienced a higher rate of job-related injury versus Adult Workers, aged 25-44.  Supra.

Are There Any Interesting Facts Concerning the Injury Rates?

AGE RANGE WITH HIGHEST RATE OF INJURY: The highest injury rate (404 per 10,000 FTE) occurred among workers aged 18–19 years.

MALE VERSUS FEMALE: Within each of the four age categories, the rate of injury was 1.4 to 1.5 times higher among males than among females.

YOUNGER VERSUS MIDDLE AGED WORKERS:  Annual rates of injuries among young workers aged 15–24 years were 1.2–2.3 times higher than those for workers aged 25–44 years. Guerin RJ, Reichard AA, Derk S, Hendricks KJ, Menger-Ogle LM, Okun AH. Nonfatal Occupational Injuries to Younger Workers — United States, 2012–2018. MMWR Morb Mortal Wkly Rep 2020;69:1204–1209. DOI: https://dx.doi.org/10.15585/mmwr.mm6935a3external icon.

How Do Young People Get Hurt?

Younger Workers can get injured in a variety of ways.  One of the reasons why Younger Workers get injured is that they are often learning on the job. This makes them more susceptible to injuries.

For example,

“Contact with objects and equipment was the leading cause of occupational ED-treated injuries among all age groups examined, with rates of injuries ranging from 64 per 10,000 FTE among workers aged 25–44 years to 182 per 10,000 FTE among workers aged 18–19 years.” Supra.

“Lacerations and punctures were the most common type of ED-treated injuries reported among workers aged <25 years, with injury rates ranging from 66 to 99 per 10,000 FTE, “ Supra.

To the contrary, it should be noted that

“strains and sprains were most common among workers aged 25–44 years (injury rate of 47 per 10,000 FTE).” Supra.

Why are Work Injuries to Younger Workers a Concern?

One of the big concerns with respect to Younger Workers in California is the issue of lifetime medical care.   Young Workers, to some extent, are more able to recover from injuries versus Older Workers.

Some injuries that have long term implications.   There are injuries which can cause arthritis.   Arthritis can take decades to become a problem for the worker. Therefore, Younger Worker may need medical care decades after the injury happened.  Many Young Workers do not understand or appreciate this fact.   This is an issue of discussion concerning settlement of their case.

How Does the California Workers’ Compensation System View Younger Workers’ Permanent Disability?

Younger Workers’ Permanent Disability is not viewed as significant as older workers’ permanent disability.  For the same injury, a Younger Worker will receive less money than an Older Worker.

How is a Younger Worker’s Age Factored into Permanent Disability?

In the SCHEDULE FOR RATING PERMANENT DISABILITIES UNDER THE PROVISIONS OF THE LABOR CODE OF THE STATE OF CALIFORNIA (2005) , there is a provision for adjusting with respect to the Injured Worker’s age.

One of the steps in the permanent disability rating formula is to make an age adjustment.  Using a Table, a Younger Worker’s Permanent Disability is lowered via the rating adjustment.   See Schedule at P. 1-9.

In sum, the Schedule has a specific table that is used in a permanent disability rating formula to lower the disability rating. The disability rating being lowered translates into less money for the Injured Worker.

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.

 

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

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.

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.

“WET-WORK” EXPOSURE AND SKIN-RELATED INJURIES: DERMATITIS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

 Some occupations require workers to perform tasks involving liquids.  Some occupations involve workers immersing their hands in liquids throughout the day.   This exposure to liquid is referred to in literature and in occupational studies as “Wet Work.”

“Wet Work” Exposure encompasses activities of frequent contact with liquids. This “Wet Work” Exposure can lead to the development of Skin Disorders.   Since these activities are work-related, the Injured Worker suffering from “wet work” skin disorder can make a workers’ compensation claim.  A workers’ compensation claim may entitle the Injured Worker to obtain monetary disability benefits, medical treatment, and vocational retraining.

Occupational Skin Disorders constitute a large portion of work injuries.  They rank only second to musculoskeletal disorders.  They represent greater than 45 percent of occupational illnesses. Wet-work Exposure: A Main Risk Factor for Occupational Hand Dermatitis  Ali Behroozy1 Tessa G. Keegel https://doi.org/10.1016/j.shaw.2014.08.001  Contact Dermatitis makes up 80 percent of all occupational skin disorders. Supra.

This article will discuss “Wet-Work,” industrial “Wet Work” Skin Disorders, Occupations that are at risk for “Wet Work” Skin Disorders , and Permanent Disability as a result of such “Wet Work” Skin Disorders.

What Is Wet Work?

Wet Work becomes a problem with respect to Worker’s skin when there is significant frequency and duration of activities that involve liquids.  Researchers have defined the criteria as to how much frequency and duration constitutes “Wet Work.” Wet-Work has been “defined as activities where workers have to immerse their hands in liquids for >2 hours per shift, or wear waterproof (occlusive) gloves for a corresponding amount of time, or wash their hands >20 times per shift.” Supra.

How Is Wet Work Harmful to Workers?

Long or repeated exposure to water, along with the simultaneous effects of washing and cleaning agents, disenfectants, solvents, alkalis, and acids can damage the barrier properties of stratum corneum and underlying skin layers (living epidermis). Working with gloves also can cause injury as well to the skin.  Supra.

In sum, liquid exposure essentially compromises the dermis. This can lead to irritation of the skin. This irritation can continue to fester if the acts of performing “Wet Work” continued.   This continued irritation can lead to skin diseases and disorders.

Also, implicated within “Wet Work” is not only the use of the liquids.   The frequently drying off the hands is also part of the harmful process to the skin.

What Skin Conditions Can Arise from “Wet Work?”

There are a variety of Skin Conditions that can arise from “Wet Work.” They include Acneiform Dermatitis, Allergic Contact Dermatitis, Cumulative Irritant Dermatitis, Eczema, Frictional Dermatitis, Hyperkeratotic Hand Dermatitis, Irritant Contact Dermatitis, Maceration, Pustular Dermatitis, and Traumatic Irritant Contact Dermatitis.

Contact Dermatitis, the AMA Guide for Rating Permanent Impairment, 5th Edition, describes the condition as an “inflammatory skin reaction induced by exposure to an external agent and is the most frequent cause of occupational skin disease.”  It notes that the two common types of contact dermatitis is irritant which is 80 percent of the cases.   This represents direct tissue damage.  The Allergic Contact Dermatitis involves delayed cellular hypersensitivity.

There are many substances that can irritate with respect to being an allergen agent  Per the AMA Guides, it is noted that “[m]any cutaneous allergens, such as chromates, nickel salts, epoxy resins, and preservatives, are also primary irritants. Allergy can be induced or maintained by chemicals in concentrations insufficient to irritate nonallergic skin. Allergen

cross-sensitivity is an important phenomenon in which an individual who is allergic to one chemical (eg, urushiol in poison ivy or poison oak) also will react to structurally related chemicals (eg, in Japanese lacquer, mango, and cashew nutshell oil).”

What Occupations Engage in Wet Work?

There are many occupations that involve “Wet Work.” This includes agriculture, beautician services, catering, construction, dish washing, domestic workers, engine serving, flower arranging, food preparation and processing, hairdressing, healthcare workers, household cleaning, leather work, machine tool operation, manufacturing, metal machining, metal plating, metal treatment, metal work, nursing, painting,  and printing.

Do “Wet Work” Injuries Translate Into Permanent Disability?

Yes.

The AMA Guides for Rating Permanent Impairment, 5th Edition, notes that the “[a]ccurate diagnosis is the key to proper management of contact dermatitis. If the specific agent(s) can be identified … and successfully avoided, full recovery usually is anticipated; but if contact continues, the dermatitis may become chronic and disabling, and it may prevent the individual from performing some activities of daily living.” AMA Guides at P. 177. [emphasis added]

 The concept of “Wet Work” injuries resulting permanent disability is longstanding within California Workers’ Compensation Law.  Prior to the adoption of the AMA Guides to determine impairment, the 1997 Schedule for Rating Permanent Disabilities Under the Provisions of the Labor Code Section of the State of California, 1997, provided for a permanent disability relating to “wet work.”  At the time, permanent disability was rated by actual or prophylactic work restrictions.  In the Schedule, under the Skin Condition Section, 6.2, there was work restriction “Precluding Wet Work.”  It was defined as a restriction that “contemplate[d] [that] the individual must avoid more than incidental contact with water, and/or other liquids provide for a 25% standard disability.  Page 2-6.  Note: This illustrates that Workers’ Compensation Law recognized the value the ability of an Individual to be able to perform “wet work” activities in the open labor market.

Under the current law, the AMA Guides apply. Under the current Rating Schedule, the AMA Guides for Rating Permanent impairment, 5th Edition, on P. 178, has a table that can be used to address a skin impairment caused by “wet work.”  There is a table which is entitled the “Criteria for Rating Permanent Impairment Due to Skin Disorders,” Table 8-2, which is one table that can apply to assigning whole person impairment to “wet work” skin injuries.

Under the AMA Guides, Table 8-2, the table requires the evaluating physician will look at three items of import.  First, the presence of skin disorder signs and symptoms, second, the effect that the skin disorder has on the performance of activities of daily living, and third, the need for treatment in terms of nature, extent and duration.

In sum, permanent disability, for these skin conditions, will be assessed on an individual basis.   Generally speaking, a Physician who specialized in Dermatology should be making the assessment.

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. Click Here.

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