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.

HOSPICE WORKERS AND WORKERS’ COMPENSATION: STRESSFUL WORK ENVIRONMENTS AND PSYCHOLOGICAL WORK INJURIES: WHAT YOU NEED TO KNOW

Some Occupational or Work Environments that have unusual forms of stress.   Hospices and Hospice-related duties is one.  In a society with an increasing aging population, Hospice Workers perform the vital function of addressing the needs of terminally ill patients.  Working in such facilities or performing such duties can have an emotional impact on the worker.

There has been a number of articles which have discussed the emotional concerns of these workers.

There are multiple issues that relate to why Hospice Workers experience stress.

This article will discuss the nature of Hospice Work, why such employment is stressful, and what a Hospice Worker can do in the event that the work-related stress becomes disabling.

What is a Hospice? 

Hospices are health care facilities which provide care to those who are facing the end of their life.   They provide services to ensure that the patients’ physical, emotional, and spiritual needs are met during this period.

These facilities can involve multiple disciplines, can be face-paced, and can involve transitioning caseloads.

What Are The Difficulties When Working at a Hospice?

There are a number of difficulties with Hospices.  There is the difficulties of dealing with the emotional support needed for both families and the patients who are facing death. There is the difficulties with heavy caseload.  There is the administrative, agency and institution,  requirements in these facilities which can be a source of stress.

24-7 Care

“The hospice system provides 24-7 support and includes rapid response teams who cover nights and weekends. Even though other hospice workers have taken over providing care to that patient, the feeling of caring doesn’t stop.” Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Graveyard and Rotating Shifts have been known to cause medical problems irrespective of the fact that it involves Hospice Work.

Heavy Caseload

“Caseloads are widely different by role due to the nature of the work, with social workers and chaplains carrying larger numbers of patients than nurses and aides. Despite these differences, many of the challenges reported were remarkably similar. Workload is intense; often there is not time for lunch (unless while driving) or even to use the bathroom. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Stress from heavy caseload should not be considered as a “good faith personnel action.”

Different Roles

“Different roles reported different challenges. Many of the hospice worker roles are salaried, officially paid and expect to work 40 h per week, but often ending up putting in additional hours without additional compensation. Managers are also salaried but have less expectation of “only” working 40 h. On the other hand, aides are paid overtime when they work more than 8 h, but are discouraged from doing so. These differences led to different pressures.”. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Some of these Role Issues may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.

Communication

“Communication problems may also contribute to the chaotic nature of many workdays. Interdisciplinary teams, by definition, means different roles, responsibilities, and vocabularies, all caring for the same patients, usually in separate visits or calls. Such complexity can result in unanticipated communication problems as indicated by the following nurse’s example: Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto,  Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.

Note: Some of these communication difficulties may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.

What are the Consequences of The Difficulties of Working in a  Hospice Environment?

The consequences of such employment is Occupational Burnout as well as Secondary Traumatic Stress.

What is Occupational Burnout? 

“Job (occupational) burnout is defined as a prolonged response to job stressors, encompassing exhaustion, cynicism, and inefficacy (Maslach, Schaufeli, & Leiter, 2001); however, a more recent definition includes exhaustion and disengagement (Demerouti, Bakker, Vardakou, & Kantas, 2003; Demerouti, Mostert, & Bakker, 2010). Exhaustion, in this sense, refers to being drained of physical, cognitive and emotional energy as a result of exposure to job demands, while disengagement is interpreted as distancing oneself from work and possessing a negative attitude toward work-related objects and tasks. Job burnout is associated with depletion of energy and personal resources, which makes it an important factor in the process of health impairment (Basińska & Gruszczyńska, 2017). Burnout can cause the individual to be susceptible to other negative consequences of experienced stress, including posttraumatic stress disorder (PTSD) or secondary traumatic stress.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnoutPsychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What is Secondary Traumatic Stress?

Secondary Traumatic Stress “is characterized primarily by symptoms of intrusion (returning thoughts, dreams related to trauma), avoidance (an effort to get rid of emotions, thoughts associated with traumatic event) and hyperarousal (increased vigilance, anxiety, and impatience; Bride, Robinson, Yegidis, & Figley, 2004 Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnoutPsychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What is Compassion Fatigue?

In one article, it noted that “It is important to mention that the consequence of secondary exposure to trauma at work is also called compassion fatigue (Figley, 2002), which indicates that STS bears some similarity to burnout syndrome, especially to emotional exhaustion. According to Figley (1995) STS appears as a complex state of dysfunction and exhaustion in which emotional distress and suffering experienced by trauma victims is taken on by the helpers.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnoutPsychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421

What are the Problems for Hospice Workers?

From the studies, as noted above, it would appear that the stress is two-fold.   There is the stress from performing the job and there is the stress from dealing with the administration of the facilities.   Thus, both the work, and the work-setting can be injurious to the worker on an emotional level.

If a Hospice Worker is Having Emotional Problems, What Should They Do? What Are the Concerns?

First, they should seek medical assistance.   This can include utilizing an Employee Assistance Program if one is available. A workers’ compensation claim may be considered.   Before doing so, an analysis should be done with respect to whether the worker will meet the threshold requirements for proving up a claim.   Consultation with an attorney is recommended.   Some of the threshold issues may involve the length of employment, outside stressors, and whether there has been good faith non-discriminatory personnel action.

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.

 

Domestic Terrorism and Workers’ Compensation: What You Need to Know

There have been a number of incidents in both California and the United States which can arguably be called acts of “Domestic Terrorism.”   In recent years, there have been incidents in Gilroy, California, San Bernardino, California, and Poway, California which could arguably be labeled as “Domestic Terrorism.”   Essentially, these acts have impacted Northern, Central, and Southern California.

Frequently, these terrorist acts occur in areas or locations at which workers are present.   These workers are at risk of sustaining work-related injuries. This article will discuss various Labor Code Sections which may be applicable in the event of “Domestic Terrorism.”

Recently, there was the enactment of Labor Code Section 4600.05. This specific Labor Code Section addresses acts of “Domestic Terrorism.” There are other relevant Labor Code Sections as well. Continue reading

I have a Psychiatric Workers’ Compensation Claim and have been provided a GAF (Global Assessment of Function) Score, What Does It Mean?: What You Need to Know

California Workers’ Compensation Law has special rules to assign Permanent Disability to Injured Workers who have sustained Psychiatric Injuries.

In order to obtain a Psychiatric Permanent Disability Percentage, an Injured Worker must obtain a permanent disability rating. A rating is obtained via an evaluation of the injured worker by a mental health practitioner. Generally, in California Workers’ Compensation Law, Psychiatrists or Psychologists are the medical providers who evaluate Injured Workers for Psychiatric Injuries. Treating Psychiatrists and Psychologists are also allowed to make this evaluation.

With respect to a Psychiatric Permanent Disability, the evaluators will make the assessment as to whether (a) there is a permanent disability; and (b) the amount of it.

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