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.

HEALTHCARE WORKERS, VIOLENT PATIENTS AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Healthcare Systems have a high incidence of workplace violence.   Healthcare Workers experience five times the amount of violence in comparison to the average worker in the United States.

Violent acts can cause work injuries both of a physical and mental nature.  Healthcare Workers, in these circumstances, may seek medical treatment and compensation via Workers’ Compensation.

This article will discuss the nature of the term “violence”, a worker’ compensation law addressing violent acts, the nature of violent encounters, and the rates of violence.

What Is Violence?

Violence can mean different things. There is physical violence, i.e. a patient striking a nurse,  and there is verbal violence, i.e. a patient threatening a nurse’s life.

Research has a more expansive definition. ” In the most basic of explanations, violence may present in the form of verbal threats, aggressive language, or escalate to physical assault.”

Verbal harassment includes racial slurs, attacking appearance or perceived sexual orientation, cursing, yelling at, or berating another person.”

Sexual harassment includes unwelcome sexual advances, insulting gestures, and verbal or physical conduct of a sexual nature.”

Verbal threats include statements of intent to cause harm, and threatening body language or gestures.”

Physical violence includes spitting, biting, pulling hair, and any other type of unwanted physical contact intending to cause harm.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Comment:  The definition of violence used by researchers is quite expansive nature. .Hharassment  such attacks on  race, gender or sexual orientation have been included.

How Does Workers’ Compensation Laws Address Violence?

California Workers’ Compensation Law addresses both the physical and verbal aspects of violence.  Workers’ compensation claims can be filed for injuries that are physical in nature.  Thus, if a nurse was assaulted and hurt their back, they can get treatment and compensation for the claim.  Further, a nurse was subjected to racial harassment, they would be able to pursue a psychological or stress injury.  Sometimes, violence can lead to both physical and mental injuries.  A claim can include both types of injuries.

Are There Any Special Laws Concerning Violent Acts?

Yes. The threshold for psychiatric claims of injury is lowered if there is a claim of violence.  Labor Code Section 3208.3 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.” Substantial is defined as 35 to 40 percent.

How Significant Is It Within the Health Care Industry?

“In 2016, health care workers made up 69% of all reported workplace violent injuries, according to the Bureau of Labor and Statistics.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

In sum, an overwhelming amount of workplace violence occurs within the healthcare profession.

Are There Different Violence Rates Among Occupation?

Yes. Violence rates can vary based upon occupation and sex.

Paramedics

They are subject to the highest amount of verbal violence

Nurses/Physicians

They are subject to the highest amount of verbal threats

Nurses

They have the highest rate of violence threats by visitors.

Female Nurses

They are at far greater risk of being a victim of violence versus their counterpart.

Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Who Commits the Violence in Healthcare Settings? 

Males, 35 years and younger, have been found to be the highest offenders of violence against healthcare professionals.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

It has been found that 9 factors can be indicators of violence at the time of admissions. These include a “diagnosis of psychosis or bipolar disorder, history of psychiatric disorder, male gender, age younger than 35 years, below-average intelligence, no history of employment, homelessness, and agitated behavior.” .” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

What Are the Causes of Violence in the Health Care?

The Healthcare system, but its very nature, has elements that can contribute to violence.  These include “[[l]ong waiting times, lack of security, lack of adequate staff, and patient areas being open to the public.” .” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Are There Other Factors that Can Impact Violence in Health Care?

“There are many factors thought to increase the risk of violence among ED workers, including an increased number of patients and visitors using alcohol and drugs, psychiatric disorders, dementia, the presence of weapons, stressful environment, overcrowding, prolonged waiting times, and flow of violence from the community into the ED.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

Is There Anything Special About Emergency Departments?

Emergency Departments have a number of factors that can contribute to violence they can include “an increased number of patients and visitors using alcohol and drugs, psychiatric disorders, dementia, the presence of weapons, stressful environment, overcrowding, prolonged waiting times, and flow of violence from the community into the ED.” Pitts E, Schaller DJ. Violent Patients. 2021 Jul 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30725966.

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 27 years. Contact us today for more information.

NURSES: DOES YOUR WORKING SHIFT MATTER?  MUSCULOSKELETAL INJURIES, SHIFT CHOICE AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Nurses are at risk for work-related musculoskeletal injuries (WMSD.)  A study addressed whether a Nurse’s Work Shift impacted WMSDs.

This article will discuss Nursing, Nursing Shifts, and how particular Shift Work may impact industrial injuries.

What Are Nursing Duties? What Makes Nurse at Risk for Injury?

Nursing Duties are physically demanding.  Patient care can require individuals to work in awkward positions and deal with individuals whose weight can shift at any moment.

“WMSDs(work-related musculoskeletal disorders) in nurses are mainly caused by shifting patients (which includes helping patients turn over or get in and out of bed), routine treatments in nursing, poorly designed work environments, and remaining active for prolonged periods of time.4 The physiological loads created by these nursing activities are all risk factors of WMSDs in nurses.” Chang WP, Peng YX. Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis. J Occup Health. 2021 Jan;63(1):e12208. doi: 10.1002/1348-9585.12208. PMID: 33682989; PMCID: PMC7938703.

Likewise, “cllinical nurses must deal with daily routine work in busy wards, patient care and treatment, and correspondence for various matters. Their jobs are time‐consuming, complicated, and full of stress, and they are often on tight schedules, all of which are associated with WMSDs.” Supra.

What Musculoskeletal Body Parts Do Nurses Injure?

Nurses are susceptible to injury for every body part imaginable.   This includes the neck, shoulders and back.

Nurses are prone to WMSDs in the lower back, shoulders, neck, back wrists, knees, and ankles. Supra.

What are Shifts?

Hospitals and other medical facilities provide 24 hours a day service for 7 days a week.  Thus, the facilities have various work shifts.  Some facilities may have 8-hour shifts, some 10-hour shifts, and others 12-hour shifts.    

What Shifts are There?

Within an 8-hour format, there is generally a morning shift, an evening shift, and an overnight shift.

How Do Nurses’ Shifts Vary?

Nurses can have regular fixed shifts.   Also, there are Nurses who have rotating or irregular shifts.

What was the Study About?

The study focused on Nurses who worked rotating and irregular shifts. The theory of the study was that “working rotating and irregular shifts, which causes the physiological burden of disrupted circadian rhythms in the body, may also exacerbate muscle tension and pain.” Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis. J Occup Health. 2021 Jan;63(1):e12208. doi: 10.1002/1348-9585.12208. PMID: 33682989; PMCID: PMC7938703.

What Were the Results?

The study “indicated that RS (rotating shifts) + IS (irregular shifts) nurses are more likely to experience back pain associated with WMSD than are FDS (fixed day shift) nurses.”  Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis. J Occup Health. 2021 Jan;63(1):e12208. doi: 10.1002/1348-9585.12208. PMID: 33682989; PMCID: PMC7938703.

In sum, Nurses working irregular shift are more likely to experience musculoskeletal disorders.

As a Lawyer, Are There Any Reasons That May Cause the Higher Rate?

In my opinion, irregular shifts can include irregular routines.  Nurses who have regular shifts may have better understanding of their shift’s physical requirements.   Also, they may be more familiar with their surroundings.   Thus, they are able to take better precaution to prevent injury.

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.

NURSES IN THE WORKPLACE SUFFERING FROM STRESS: BULLYING IN THE WORKPLACE, PSYCHIATRIC INJURY AND WORKERS’ COMPENSATION: WHAT YOU NEED TO KNOW

Nursing is one of the most difficult and demanding professions in the world. It is also one of the most important.  Nurses confront life and death situations on a daily basis.

Nurses work with Doctors who are some of the brightest and most difficult individuals on the planet.  These Doctors have demanding schedules and responsibilities which impact on their ability to work with others.

Nurses work with other Nurses who are confronted with the same stressors and responsibilities.  At times, they can be in conflict with each other.

Nurses also work with patients who may have emotional issues that are either pre-existing or are relating to their medical problem at issue.   Also, they may have anger issues relating to their perceived mistreatment at the facility. Nurses also work with patient’s family members who are emotionally involved with the patient’s well- being. They too may be upset at their perceived mistreatment of their beloved family member.

Nurses finally work with medical institutions which have rules and regulations that they need to be in compliance with concerning their operations.

With respect to these numerous interactions, some of these interactions have been viewed as unacceptable and have been labeled as “bullying.”

“Nurse Bullying” has been subject o was subject to a study which found interesting results.  This article will discuss the nature of nurse bullying, how nurse bullying should be analyzed within a workers’ compensation setting, and what a nurse should do if they are subjected to stress.

Even If I am not a Nurse, Why Should I Be Concerned about Nurse Bullying?

“Workplace bullying has also been acknowledged as a threat to patient outcomes and the delivery of quality of patient care, as well as the erosion of personal health and professional wellbeing [91314]. Excellence in patient care flourishes in an environment built on open communication and respectful professional relationships. An environment that condones bullying perpetrates destruction of professional communication.”  Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

What Is Bullying in the Nursing Profession?

Individuals studying bullying characterized the situation as on in which there is a power imbalance.   These interactions can have serious effects on the organization. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

Who Was Responsible for the Bullying?

In the study, there are many types of bullying offenders, including patients, caregivers, doctors, and nurses. Of these, bullying most frequently occurs among nurses and is particularly committed by a colleague rather than by a manager. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

Note: for workers’ compensation purposes, the employment position of the offender is very important

Bullying has also been defined in other studies.

“Bullying goes by many names: workplace aggression, indirection aggression, social or relational aggression, horizontal (lateral) violence, and workplace violence. It has become so popularized in the press; bullying is often, mistakenly, used as an overarching concept. There is a tendency to use many of these terms interchangeably [8]. Bullying is different from horizontal violence in that a real or perceived power differential between the instigator and recipient must be present [15]. Some of the most recent literature suggests that all of these behaviors exist on a conceptual continuum of workplace victimization [3].” Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

Is Bullying the Same as Job Stress?

Those researching this have distinguished it from ordinary job stress.  It is something different from the day to day social stresses or poor management.

What Types of Bullying are Going on?

Bullying has been described in situations where the nurse is new to the area,  in situations where the nurse witnesses mistreatment of others, in situations in which they are singled out for public censure or humiliation, in situation in which there are constantly being interrupted, situations in which they are not in the social clique and they are subject to juvenile-like behavior, situations in which they feel they are being punished with disciplinary  action or threats,   Gaffney DA, Demarco RF, Hofmeyer A, Vessey JA, Budin WC. Making things right: nurses’ experiences with workplace bullying-a grounded theory. Nurs Res Pract. 2012;2012:243210. doi:10.1155/2012/243210

What are the Consequences of Bullying?

Nurses being subjected to bullying is a societal concern.  If this bullying impacts patient medical treatment, it must be addressed in those terms in addition to the health concerns of the Nurse effected.

It is reported that “[n]urses bullied at the workplace may complain of mental symptoms, such as depression, anxiety, and fear, as well as physical symptoms, such as fatigue, headaches, and palpitations. They are also more susceptible to burnout and turnover intention and have lower levels of organizational commitment and nursing productivity. Yoo, S.Y.; Ahn, H.Y. Nurses’ Workplace Bullying Experiences, Responses, and Ways of Coping. Int. J. Environ. Res. Public Health 2020, 17, 7052.

If a Nurse Is Having Medical Problems as a Result of Bullying, What Should They Do?

First, seek medical attention to treat your medical problems.  Second, seek assistance through your company’s Employee Assistance Program if one is available. Third, make a consultation with a lawyer as to whether there is some legal action that can be pursued.

There are two areas of law which should be explored.  Workers’ Compensation and Employment Law are two areas which should be analyzed with respect to the bullying.

If a Workers’ Compensation Claim is pursued, the Nurse can claim monetary compensation in the form of temporary disability benefits, permanent disability benefits, medical care, and vocational rehabilitation benefits.

What Are the Legal Barriers for Workers’ Compensation Psychiatric Claims?

With all psychiatric claims of work injury, a detailed factual analysis must be made.  With respect to bullying, there are issues of length of employment and whether the events causing the stress where personnel actions.  Bullying claims are viewed in the same light as all other psychiatric claims.

Labor Code Section 3208.3 provides the threshold requirements for psychiatric claims.

In general, 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.

Also, in general, there is also a six-month employment requirement.

Also, “[n]o compensation under this division shall be paid by an employer for a psychiatric injury if the injury was substantially caused by a lawful, nondiscriminatory, good faith personnel action.”

Note: Bullying can involve different players.   Some of them supervisors. Supervisors’ actions can be viewed as personnel action. Therefore, there may be “good faith personnel action” defenses that insurance Companies can be raise to defeat such a claim. Therefore, there is no guarantee that bullying cases will be accepted as a valid work injury claim.

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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