Source: https://premiumreduction.blog/tag/employee-relations/page/2/
Timestamp: 2019-04-24 20:00:53+00:00

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The proposed FY 2018 budget includes $543 million with $130 million for “federal and state compliance assistance activities to enhance employer outreach and training.” The budget for fiscal year 2017, which ends Sept. 30, was $552.8 million. While adding money to compliance assistance, the proposed budget slashes funding for the standards and statistics programs. Enforcement remains intact and there are no new riders that would prohibit the agency from enforcing any standards or other parts of the law.
Meanwhile, the Mine Safety and Health Administration would see relatively small changes in funding for fiscal year 2018, but NIOSH might experience a sizable reduction in its budget, and the Chemical Safety Board still is scheduled for elimination.
Falls are the leading cause of death for construction workers, accounting for 367 of the 985 construction fatalities recorded in 2015. Two videos have been posted on the Stand-Down homepage and a series of infographics can be downloaded.
Omega Demolition Corp. was working on the demolition of an I-90 bridge when a falling beam injured several workers and killed one. An investigation found that the company overstressed the beam, resulting in the beam’s failure and $152,000 in fines was levied. A commission has been set up to review the findings and determine whether the fines and citations will stand and what additional measures the Illinois Tollway will take.
A federal appeals court has affirmed that Pan Am Railways, Inc. must pay $260,000 in punitive and compensatory damages and take corrective action on behalf of an employee who was subjected to retaliation for filing a Federal Railroad Safety Act whistleblower complaint. The court found the North Billerica-based commercial railroad retaliated against the employee, who works in a rail yard in Waterville, Maine, when it charged him with dishonesty in connection with his FRSA complaint. The employee had tried to report an injury.
Failure to abate safety hazards, including not using traffic control devices when employees were working near the road, not training workers on tree-trimming operations and safeguards, and not using a chipping machine in a safe manner led to a cease-operation order against Sunset Tree Service & Landscaping LLC. The company has a history of violations.
An Ohio-based employee of Michigan, Farmington Hills-based Autoneum North America suffered an amputation of his right hand, wrist and part of his forearm when his arm got caught in a shredding machine at the auto insulation manufacturer plant in Oregon, Ohio. The company faces $569,463 in proposed penalties for failure to equip the machine with adequate safety guards.
Canton-based Republic Steel, an automotive steel manufacturer, is facing $279,578 in proposed penalties after investigators found workers at its plant exposed to machine hazards and lead.
Sioux Falls-based Hultgren Construction L.L.C. faces two willful citations and a proposed penalty of $101,400 for failing to properly train and instruct employees, for exposing employees to struck-by and crushing hazards, and not performing an engineering survey prior to beginning demolition. The company was renovating a historic building in downtown Sioux Falls when the building collapsed, killing one of its employees.
American adults who have been impacted by change at work are more likely to report chronic work stress, less likely to trust their employer, and more likely to say they plan to leave the organization within the next year compared with those who haven’t been affected by organizational change, according to a recent survey by the American Psychological Association.
Although 78 percent of workers reported average or better levels of engagement, one in five employees reported low or very low levels. Workers who felt they were treated fairly by their employers were more than five times as likely to report high or very high levels of work engagement, compared with employees who didn’t feel treated fairly. Other important factors affecting engagement were employee involvement, growth and development opportunities, and health and safety efforts.
Although most employed adults (71 percent) felt that their organization treats them fairly, one in five said they did not trust their employer.
Trust and engagement play important roles in the workplace, accounting for more than half of the variance in employee well being.
Workers reported having more trust in their companies when the organization recognizes employees for their contributions, provides opportunities for involvement, and communicates effectively.
OSHA announced on its website on May 17 that it “is not accepting electronic submissions at this time and intends to propose extending the July 1, 2017 date by which certain employers are required to submit the information from their completed 2016 Form 300A electronically. Updates will be posted to this webpage when they are available.” There was no word on when, or whether, a new deadline would be set for data submission.
Although there were indications that OSHA had beta tested a secure portal with the help of a few national employers and employment organizations, the suspension did not come as a surprise. At the time the rule was published, it was noted that the portal would be live on February 1, 2017, but, after the election, there were no updates from OSHA about how precisely the database would function or when it would go live.
There are several possibilities. The Administration may formally rollback the new rule through notice and comment rulemaking to rescind all or at least this portion of the rule. Another possibility is that the rule stands or stands without the public viewing aspects. There are two ongoing lawsuits challenging the rule, which are in the early stages of litigation. It’s possible the agency will wait for the outcome of the cases. Also, the new Secretary of Labor Alexander Acosta has only recently assumed his position, so action may be delayed until Secretary Acosta’s new team at OSHA is in place. The rule is not dead… it’s wait and see.
The electronic filing delay does not affect the anti-retaliation provisions of the rule that went into effect in December 2016. Employers must inform workers of their right to report work-related injuries and illnesses, and they can’t retaliate against employees for doing so.
According to OSHA guidance on the anti-retaliation provisions, employers must establish reasonable procedures for reporting injuries. The guidance recommends limitations on safety incentive programs and drug-testing policies that might deter workers from reporting accidents.
Business groups have also challenged this provision in court, arguing that OSHA exceeded its authority. A court denied a preliminary injunction that would have blocked the provisions; however, it is still possible the court could find it illegal.
While it is unknown how aggressive enforcement efforts will be, the rule is in effect and employers need to comply. Employers should have reviewed drug testing policies and safety incentive programs in light of OSHA’s guidance. Also, they should document informing employees of the right to report injuries without retaliation and how to report, as well as post the latest version of OSHA’s Rights poster.
OSHA has changed its policy on allowing employees at non-union workplaces to choose a union-affiliated representative for “walkaround” inspections, according to an April 25 memo sent to regional administrators.
The policy began in 2013 but was being challenged in court by the National Federation of Independent Business, with help from the Pacific Legal Foundation. Following the memo, the lawsuit was withdrawn on April 27.
Enforcement of the silica standard for construction was set to begin June 23, but has been delayed to Sept. 23. The delay is necessary for OSHA “to conduct additional outreach and provide educational materials and guidance for employers,” according to the agency.
Despite the delay, OSHA said it expects employers in the construction industry to take steps toward implementing the standard’s requirements.
Given Attorney General Jeff Sessions’ negative position, there was much speculation if there would be efforts to resolve the conflict between federal and state laws on medical marijuana, which is still considered a Schedule I drug by the U.S. Drug Enforcement Administration, but is now legal in 29 states. President Trump signed House Resolution 244, a $1.1 trillion appropriations plan that includes language that will prevent the federal government from spending money to fight medical marijuana.
On June 6, the U.S. Department of Labor withdrew Obama administration guidance on joint employment and independent contractors that expanded the definition of employees. The statement withdrawing the guidance noted: “Removal of the administrator interpretations does not change the legal responsibilities of employers under the Fair Labor Standards Act and the Migrant and Seasonal Agricultural Worker Protection Act, as reflected in the department’s long-standing regulations and case law.” It is expected, however, that employers, who can now rely on the law rather than administrative interpretations, will laud the news.
In EEOC v. M.G.H. Family Health Center, a federal district court in Michigan ruled that the health center violated the ADA when it fired a recently hired community outreach coordinator over fears that her migraines or other impairments might interfere with her job performance. According to the court, this was a textbook case of unlawful discrimination based on a perceived disability. Congress explicitly clarified in the ADAAA that “major life activity” definitions are not relevant to the question of whether an individual has suffered unlawful discrimination based on a perceived disability.
When the health center hired the community outreach coordinator, she was told she would be required to undergo a “post-offer” medical examination by a third party, but could begin work. While the results of the exam were normal, the third party recommended she be put on a “medical hold” and undergo a costly functional capacity evaluation (FCE) due to migraines and other medical issues resulting from injuries in a car accident that were documented in her medical files. After she had been working in the job without incident for two weeks, the health center terminated her before allowing her to complete the FCE, which she offered to pay for herself.
In granting summary judgment for the EEOC, the district court noted three things that the employer did wrong: (1) it did not engage in an individualized assessment; (2) it did not follow the recommendation of the physician to have the employee complete a functional capacity evaluation; and (3) it terminated the employee’s employment after the employee had been performing the job for two weeks without incident, even though her own physician had submitted information indicating she was able to perform the job.
Takeaways: When using post-offer, pre-employment examinations, it’s best to make the offer conditional and conduct the exam prior to the first day of employment. If the exam does reveal some concerns about the ability of the individual to perform the job, it’s the employer’s responsibility to engage in the interactive process to determine if reasonable accommodations can be provided.
Every February, the American Bar Association’s (ABA) Federal Labor Standards Legislation Committee publishes a comprehensive report of FMLA decisions handed down by the federal courts in the previous year. This handy report summarizes every FMLA decision from 2016 in a user-friendly manner.
Seventy-one percent of U.S. employers say drug use among employees has impacted their business, but only 19% of them have comprehensive workplace drug policies in place, according to a survey by the National Safety Council (NSC). While 57% test their employees for drugs, only 41% screen for synthetic opioids – the kind of prescriptions usually found in medicines cabinets and increasingly available on the black market.
The types of incidents experienced in the workplace as the result of prescription drug use are: 39% absenteeism; 39% workers have been caught taking drugs while on the clock; 32% a positive drug test indicated use; 29% a worker had been found to be impaired or showed decreased work output; 29% a family member complained; 22% another employee complained to human resources; 15% an injury or near-miss occurred; and 14% an employee was caught selling drugs in the workplace.
“Employers must understand that the most dangerously misused drug today may be sitting in employees’ medicine cabinets,” Deborah A.P. Hersman, president and CEO of the NSC, said in a statement. “Even when they are taken as prescribed, prescription drugs and opioids can impair workers and create hazards on the job.” Cognitive impairments and physical pain masked by prescription drugs can make employees engage in riskier behaviors and reduce response time.
Most employers have a drug-free workplace policy directed at illegal drugs and an alcohol abuse policy, but most don’t have a prescription drug policy. Since prescription drugs are legal, it’s been difficult to craft a policy, but many addictions begin with legal prescriptions. Even when taken as prescribed, they can impair workers and create hazards on the job.
Define the employee’s role in making the workplace safe. A drug-free workplace program (DFWP) should state what employees must do if they are prescribed medications that carry a warning label or may cause impairment. The employer can create a plan around not operating vehicles or machinery while the prescription is in use. The DFWP should also spell out the steps an employer will take if it suspects a worker is using certain medications without a prescription, in larger doses than prescribed, or more frequently than prescribed.
Add prescription drug testing to illicit drug testing. Working with legal counsel, the employer should decide if additional testing is warranted for pre-employment screening, or for pre-duty, periodic, at random, post-incident, reasonable suspicion, return-to-duty, or follow-up situations.
List the procedures or corrective actions the employer will follow when an employee is suspected of misusing prescription drugs or for an employee with confirmed prescription drug abuse.
Obtain legal advice. An attorney experienced in DFWP issues should review the policy before it’s finalized.
Train supervisory staff and educate employees. Educate managers and supervisors about prescription drug abuse and what to do if they suspect an employee has a problem. Training also is an underused tool that companies can use to make employees aware of the risks and signs of prescription drug misuse, along with company policies.
Review service coverage for behavioral health and/or employee assistance program (EAP) needs. Evaluate the behavioral health portions of health insurance policies and EAP contracts to ensure employees are covered for abuse of prescription drugs.
Hersman advised employers to work with their insurers to cover alternative therapies so that employees can avoid taking opioids or other addictive medications for chronic pain. Alternative therapies include acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, biofeedback, and others.
While 88 percent of survey respondents were interested in their health insurer covering alternative pain treatments, only 30 percent indicated they would not act on that interest by negotiating expanded coverage with insurers.
A poor choice in medical care can break a worker’s compensation case and result in significant higher premiums for several years. While the rules vary, in many states employers have the ability to direct injured employees to a doctor of the employer’s choice. Even if this is not possible, having a relationship with a competent occupational physician who understands your business and can develop confident relationships with employees will help insure your injured employees get the proper care.
Apathetic commitment to Recovery-at-WorkWhile medical treatment guidelines have gained traction in many states, they are only mandatory in a few states and often permit discretion for the treating physician. As a result, there is significant variability in quality of care and outcomes among physicians. Moreover, today many doctors seek to treat workers’ comp injuries because it is more lucrative than healthcare.
Given the option, employees will choose to go to their primary care doctor who, most likely, will grant their request. Want a few days off for work to rest? Why not grant it when it keeps the patient happy? Yet, those few days can cost the employer big bucks.
When there is a strong Recovery-at-Work commitment and the injured worker returns to work before becoming eligible for wage benefits, claims are known as medical-only claims. In 39 states (ERA states), medical-only claims are reduced by 70% on the experience modification worksheet, and usually have minimal effect on the final Mod. On the other hand, claims that also include indemnity payments are known as lost-time claims and often have a significant impact on the Mod.
This hypothetical example gives an idea of the impact on costs. A small claim ($2,791) that included indemnity had a .0360 impact on the Mod and increased the annual premium by $1,771. Since this increase affects the premium for three years, the employer will pay a total of $5,265! A second small claim ($3,230) was medical only and impacted the Mod by .0125, raising the annual premium by $615 and increasing the premium $1,845 over three years.
Limited or no focus on outcomesWhile there is a growing focus on developing outcome-based networks for workers’ compensation, fee schedules are the norm for controlling costs. When insurers point out “savings” below fee schedules, this can divert employers from focusing on the real issue – how much they are paying. Physicians and hospitals squeezed by the health care system look to maximize revenues from other sources and workers’ comp is one of the most vulnerable.
The answer is to direct care to providers who have measures of quality and outcome and deliver the best value, by delivering consistently excellent outcomes and competitive pricing. Insurance adjusters often handle upwards of 250 claims at one time; it’s unlikely they are going to have the time to identify the best provider for each of their clients.
Not a good fit for the employer or workforceWhile Occupational Medicine doctors are a good starting point, it makes sense to drill down further. From past claims employers know where their exposures are the greatest and should identify physicians with specific proficiencies needed for the injuries and hazards in their work setting. In addition, if the employer is in a regulated or hazardous industry, the physician must be familiar with regulatory compliance issues.
There are other considerations as well. If you have a bilingual workforce, the provider staff, including medical staff, should be bilingual. Equally important, the provider must be able to balance patient advocacy with employer concerns. Injured workers will respond positively to a physician if they have trust and believe the physician is their advocate, thus accelerating the return to worker and reducing the likelihood of litigation.
Poor representation in disputed casesContesting cases when it is suspected the injury is not work-related is never easy, particularly when it involves a cumulative trauma injury, pre-existing conditions, or stress. Failing to challenge cases when the injury cause is not work-related leads to paying unwarranted benefits and emboldens others to file similar claims. On the other hand, wrongly challenging injured workers needlessly drives litigation costs up and leads to morale and trust issues among the workforce.
Doctors are trained to treat injuries; causation is a secondary concern. While many states do not require that medical opinions be expressed with absolute medical certainty, it is expected that opinions be more than mere speculation and there is a probability as to the cause that can be supported.
A good medical expert will not only be well qualified, but must be able to write a good report that clearly explains their opinions. Understanding how a physician handles disputed cases is key to avoiding unnecessary litigation costs.
Unnecessary use of emergency room servicesWhen injured workers use emergency room services, they are likely to be told to take time off and medical costs are likely to be much higher. The only time an injured employee should go to the emergency room is when there is a 911 emergency or when there are no other available treatment options. Emergency rooms are busy places and their primary task is to make sure people are not in imminent danger. There’s no time to consider Recovery-at-Work possibilities.
Furthermore, there’s a higher possibility of an inaccurate diagnosis. More than one-third of reports from consulting physicians for orthopedic injuries in emergency rooms were inaccurate, including 30% of open fractures that were described as closed, according to findings detailed in AAOS Now , a publication of the American Academy of Orthopedic Surgeons. According to the author, musculoskeletal conditions, a common workers’ comp injury, are the most commonly missed injuries in emergency departments.
Emergency departments rarely communicate with the employer, don’t usually set up follow-up visits or provide ongoing care, and common treatment plans often include rest and no work activity for days or weeks following an injury. All of which means delays, lost time, and added cost to the employer.
Worker outcome surveys are a key component of The Workers’ Compensation Research Institute’s (WCRI) work. An independent, not-for-profit research organization, it provides data and analysis aimed at improving workers’ compensation systems. Measuring workers’ access to care, satisfaction with care, return to functionality, recovery at work, and earning history, the surveys are designed to give injured workers a voice in the discussion of how workers’ compensation can be improved, as well as assess how they fare in the system.
Among workers who had worst claim outcomes, 48% had a strong fear of being fired after a workplace injury. There may be real justification for concern or a more general lack of trust in the employer.
Those concerned about being fired from the workplace retain attorneys.
Back in the mid 1990s, a study of back injury cases in New Hampshire showed a strong correlation between prolonged disability and the injured worker feeling their supervisor was negative and unsupportive.
Some of the words used by claims adjusters and employers can have very negative impacts on the message. Words such as claimant, adjudication, pending investigation, etc., focus on conflict and the process, ignoring the person who actually had the claim.
Another study found that when the claims handler expressed empathy, engaged in active listening skills and took the time to explain benefits claim outcomes improved.
Simply asking the worker “do you feel you will be able to return to your regular job without restrictions in 4 weeks” is an excellent predictor of disability duration. If the injured worker says “no” they are usually correct.
If you do not have company policy and practices aligned with messaging, you will not get positive messaging from supervisors. Company culture starts at the top.
The medical providers and case managers also can have a significant impact on the claims outcomes.
Takeaway: Most employers understand that the initial response to an injury, continual and effective communication, and workplace satisfaction are critically important for positive claims outcomes. Yet, injured employees’ perception of their work environment and lack of communication with injured employees remain major drivers of “permanent disability.” If they feel their needs aren’t being taken into account or they are being treated unfairly, they are less likely to return to work and more likely to retain an attorney. It requires constant vigilance to be effective.
Injured workers in Illinois are more likely to lawyer up than any of 18 states studied by the WCRI, while only a small fraction of injured workers in Wisconsin and Texas had legal representation. Attorneys represented workers in 52% of Illinois claims with more than seven days of lost work time. New Jersey was a close second at 49%, with Georgia following at 41%, then California at 40% and North Carolina fifth at 38%.
Explaining the high rate of attorney involvement in Illinois, the researchers noted that the state bases permanent partial disability benefits on several factors in addition to physical impairment. It also may be more difficult in Illinois to terminate temporary disability benefits than in other states. Also, the difference between maximum permanent partial disability and temporary total disability benefits is much wider in Illinois than in other states. The maximum TD rate in Illinois is $1,362, while the maximum PPD rate is $775, providing an incentive for injured workers to keep their cases open.
On the other hand, workers had low legal representation in Wisconsin (13%),Texas (14%), Michigan (17%), and Indiana (18%). In Wisconsin, the lower attorney involvement is likely due to limits on lump sum settlements, and an administrative process for resolving disputes. In Texas, caps on attorney fees for both plaintiff and defense attorneys, the prohibition of lump sum settlements of claims, which is the main driver for attorney representation, and an efficient dispute resolution process that does not necessitate attorney involvement all contribute to reduced attorney involvement. The researchers concluded that a more self-executing system limiting settlements significantly reduces attorney involvement.
More insights to attorney involvement can be found in a 2010 study by WCRI, Avoiding Litigation: What Can Employers, Insurers, and State Workers’ Compensation Agencies Do?
The study found that workplace trust issues, fear of claim denial and injury severity are the main reasons for attorney representation in workers’ compensation claims. It’s important to point out that a simple delay in paying a medical bill or an erroneous interpretation of a communication is enough to stoke the worker’s fear that the claim was going to be denied, thus leading to attorney involvement. The most effective way to counteract this fear is through reassurance and the building of trust.
Takeaway: Treating injured employees with respect, clearly explaining the process, and making them feel confident that they will get the treatment they need and that their job is secure will help reduce uncertainty and fear.
Case to watch: Do employers have to offer disabled employees reassignment to another job if there are more qualified candidates?
In December, the 11th U.S. Circuit Court of Appeals (covering Florida, Georgia, and Alabama) ruled in EEOC v. St. Joseph’s Hospital Inc. that the ADA “does not automatically mandate reassignment without competition.” The ruling conflicts with other appellate court decisions, and legal experts speculate that it is an issue likely to be heard by the U.S. Supreme Court.
The conflicting appellate court rulings on the issue means employers’ obligations will vary depending on the circuit in which they operate.
A U.S. District Court refused to dismiss a discrimination charge filed by a worker who was terminated after she continued to need accommodations for her broken arm, a work-related injury. She worked for Kingsport, Tennessee-based Eastman Chemical and tripped and fell and broke her arm, requiring two surgeries. The company put her on light-duty assignment but eventually terminated her arguing it could not accommodate her temporary activity restrictions on an ongoing basis because there were several essential job duties she could not perform. The worker filed suit under the ADA.
In Alanis v. Metra, an employee began suffering from a variety of fragrance-sensitivity symptoms such as difficulty breathing and speaking after ten years on the job. She was seen by her employer’s medical provider who concluded that she could return to work but gave her 30 days to obtain a psychological clearance exam. A week later, she again experienced symptoms and claimed that she was unable to speak and could only communicate through text messages, in writing or by whispering and was determined to be “medically disqualified” from working.
She took FMLA leave and a few months later her treating physician released her to work. However, she had not had the psychological clearance exam and when she did she was diagnosed as having a fragrance sensitivity, but was allowed to return to work a few months later.
The company made every effort to accommodate her requests for accommodation, which included flexible work hours, a modified dress code, limitation on extended talking, periodic rest breaks, self-paced work-load, and efforts to create a fragrance-free workplace. But she was not satisfied and filed suit, alleging discrimination based on the fact that she was Hispanic and retaliated against because of her disability.
The District Court for the Northern District of Illinois found that there was no evidence of discrimination or retaliation because no adverse employment action was taken. Furthermore, the Court found that the company had gone above and beyond to grant her requests for accommodation, specifically noting the changes made to reduce the existence of odors in the workplace.
Chiropractor Michael Barri, his company, Tri-Star Medical Group, and a newly formed nonprofit called the Coalition for Sensible Workers’ Compensation Reforms, filed a constitutional challenge seeking a peremptory or alternative writ of mandate blocking the state from suspending providers from the workers’ comp system and staying their medical liens when the providers are linked to fraudulent activities. Barri pled guilty to receiving illegal kickbacks to refer patients to Pacific Hospital during the spinal surgery kickback scheme.
The First District Court of Appeal took only two days in rejecting the request. The Division of Workers’ Compensation is moving to suspend providers and stay liens under new authority granted to it by the passage last year of SB 1160 and AB 1244.
In Hillsborough County School Board v. Kubik, the 1st District Court of Appeal ruled that a Judge of Compensation Claims erred in refusing to consider the opinion of an expert medical advisor (EMA) as to the cause of a worker’s need for medical treatment, and in denying the worker temporary total disability benefits. While the EMA had not been asked to evaluate the major contribution cause of the need for ongoing treatment, the court noted an EMA’s opinion that goes beyond the scope of the issues is admissible but not afforded a presumption of correctness.
According to the Chicago Tribune, former U.S. Rep. Jesse Jackson Jr., who was convicted of looting thousands of dollars from his campaign fund, is receiving a little more than $100,000 in worker’s compensation payments. Quoting Chicago attorney Barry Schatz, who is representing Jackson in a divorce proceeding, the article notes that the benefits are temporary total disability for bipolar disorder and depression.
An employee who was struck in the left arm by an object while grinding a piece of metal was treated at an emergency room and returned to his employer to submit a post-injury urine sample. However, he did not provide enough urine to complete the test and the test administrator threw it away.
In Gianotti v. I.S.D. 152, A16-0629, the Minnesota Supreme Court overturned a decision of the Workers’ Compensation Court of Appeals (WCCA) that the opinion of a psychologist was inadequate to support the denial of a worker’s claim for mental conditions allegedly caused by a concussion and post-concussive syndrome. The employee worked as a school bus monitor and fell and hit her head when the bus stopped short unexpectedly. Medical tests did not reveal a concussion, but she continued to complain of headaches, confusion, and memory problems and eventually sought psychiatric treatment.
While a judge denied the claim for a variety of emotional and psychological conditions, the WCCA questioned the competence of the psychologist as an expert witness, an issue that was not raised on appeal, and awarded benefits. The Supreme Court overturned this ruling noting the scope of the jurisdiction of the WCCA is limited to the issues raised by parties in their notices of appeal and that the psychologist’s opinion had as solid a factual foundation as any other expert in this case.
The employee was a grinder and injured his right hand. Following an operation, he was released to work with restrictions, which did not allow him to work as a grinder. He performed largely janitorial and maintenance duties, but at one point was asked to operate a forklift. This irritated the hand and his physician advised him not to do so. When he was asked again, he refused to do so, and was placed on leave and given three days to obtain a written work restriction.
Although most states protect workers once they are hired from being fired if they file a comp claim, Mississippi does not. In Bedford Care Center of Marion v. Nicholson, the question for the Court of Appeals was whether unemployment benefits are available to a worker who was fired for having misrepresented her claims history. In a previous job, the worker received medical care for her injury in the hospital emergency room, but no indemnity benefits and she argued she did not realize medical benefits were workers’ comp.
While lower courts found she was fired for misconduct and not entitled to unemployment benefits, the Court of Appeals concluded that her inaccurate answers did not rise to the level of “willful and wanton” misconduct necessary to forfeit her entitlement to unemployment benefits.
A restaurant worker climbed an A-frame ladder into a lofted space at the restaurant and while she was working there, a coworker removed the ladder. The coworker returned the ladder, but did not fully open and lock it. The ladder collapsed and the worker fell and injured her hand, elbow, and shoulder.
In Watson v. 84 Lumber, a New Jersey administrative law judge ordered Beaumont, California-based 84 Lumber Co. to reimburse one of its injured workers for medical marijuana prescribed for neuropathic pain in his left hand after an injury suffered while using a power saw at a lumber plant. The medical marijuana was being used to help wean the worker off of opioids. This is a division level case, so this decision is not binding on other New Jersey courts.
Other states that have allowed comp payments for medical marijuana include New Mexico, Maine, Connecticut and Minnesota. In most of these cases, physicians only recommended marijuana after other treatment regimens for chronic pain were attempted without success.
In Matter of Qualls v Bronx Dist. Attorney’s Office, 2017 N.Y. App. Div. LEXIS 409, a state appellate court affirmed the Workers’ Compensation Board’s determination that a worker did not sustain a causally related disability resulting from his stroke because his physician repeatedly used cautious and indeterminate language, such as stress “may have been” or “could’ve been a contributory factor.” While the court acknowledged that the law did not require that medical opinions be expressed with absolute or reasonable medical certainty, the expert must signify a probability as to the cause and his or her opinion must be supported by a rational basis.
The Commonwealth Court panel has ruled that a convenience store clerk who is permanently disabled is eligible for workers’ compensation after being shot several times while sitting in his supervisor’s parked car outside of the store after the pair had just closed up shop. Earlier in the week, he had called the police on a shoplifter, whose relatives threatened retaliation, so his supervisor had been driving him home.
The Commonwealth Court panel upheld the decision of the workers’ compensation judge, saying that the shooting was retaliation-related. The court also said that the spot he was parked in constituted the employer’s property, at a location that was a reasonable means of access and egress to employer’s store, and he was within the course and scope of employment while he was in the car.
In Lutheran Senior Services Management Company v. Workers’ Compensation Appeal Board (Miller), the Director of Maintenance for a nursing home had a serious motor vehicle accident while going into work. At times he was called in for emergencies and received “comp time.” On this particular day, he was sick and planned to call in, but his employer called that a security camera had malfunctioned and needed to be fixed and no one else was available to do so.
While the carrier denied the claim arguing that he was commuting, the Workers’ Compensation Judge (WCJ) granted the Claim Petition, noting “Claimant was sick on March 13, 2014, and except for the special need of the Employer to assure [that the] surveillance cameras became operative . . . Claimant would not have gone to work.” This would represent an exception to the “coming and going rule.” Upon appeal the Workers’ Compensation Appeal Board (WCAB), affirmed the decision of the WCJ but felt the facts represented more “special circumstances” than a “special mission,” but, still met an exception to the “coming and going rule.” The Commonwealth Court affirmed.
In Serrao v. WCAB (Ametek Inc.), the Commonwealth Court ruled that an employer is not entitled to recovery of the full amount of its comp lien from a worker’s settlement unless the employer can prove the third party was responsible for all of the worker’s compensable injuries. An employee, wearing protective overalls, suffered burns when a can of powder ignited and caused a flash fire. The employee filed a third party suit against the manufacturer of the coveralls and received a $2.7 million settlement, and the employer asserted a lien against the recovery for all of its costs related to the injury.
There was a dispute if the costs related to burns to his hands and head caused by the melting of his gloves, face shield and hood should be included. The case made its way to the Commonwealth Court that concluded an employer has the burden of proving its obligation to pay comp benefits was caused by the negligence of the third-party tortfeasor and that the tortfeasor’s payment of damages are for the same injuries for which the employer paid benefits.
In The Hartford Insurance Group on behalf of Chunli Chen vs. Kafumba Kamara, Thrifty Car Rental, and Rental Car Finance Group, the court considered how a carrier could go after a culpable third party. A carrier wanting to exercise its subrogation rights cannot force the issue by bringing a third party action on its own. Chen was waiting to rent a car in the Thrifty Car rental parking lot when Kamara accidentally hit her with one of Thrifty’s rental vehicles. Through her employer’s workers’ comp, Hartford paid almost $60,000 in medical and wage benefits. The Hartford filed a tort action against Kamara and Thrifty, asserting their negligence was responsible for Chen’s injuries, but Chen had not assigned her cause of action to Hartford and was not a party to the lawsuit.
Although a judge dismissed Hartford’s complaint, the Superior Court ruled that the case could proceed. The court noted that the Hartford was not pursuing a subrogation claim on its own behalf – it was seeking to establish the defendants’ liability to Chen. Because the carrier also was not limiting its requested recovery to the value of its subrogation claim, the court reasoned that it was not impermissibly “splitting” the cause of action Chen would have had. It’s important for carriers to use the right language in the complaint to make it clear that it is bringing the employee’s suit.
In this case, Chen is cooperating with Hartford’s effort to obtain recovery, but did not want to pursue the claim on her own. Such action could be more difficult in cases where a recalcitrant employee does not want to cooperate.

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