Source: https://premiumreduction.blog/tag/fatigue/
Timestamp: 2019-04-20 14:44:12+00:00

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The updated guide, version 2.9, addresses spinal cord stimulators and the inclusion of off-label prescription drugs, particularly Lyrica as well as updating Life Tables and examples of settlements not meeting The Centers for Medicare & Medicaid Services (CMS) review thresholds, but which would still require consideration of Medicare’s interests.
The NGHP User Guide was also updated and CMS will maintain the $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibly for medicals.
Some experts suggest that the changes are another indication that CMS intends to make Medicare Secondary Payer (MSP) enforcement a priority in 2019.
The CMS launched its “What’s Covered” app to give consumers more information about their Medicare benefits. It also can be a valuable assist for injured workers with MSAs.
A study by the American Society of Safety Professionals suggests that the automation of manufacturing processes may be contributing to worker fatigue, which was found in 58% of the workers studied. Fatigue monitoring, such as wearables that monitor heart rate, are a possible solution. The report also notes three interventions to help mitigate fatigue: posture variance, chemical supplements and rest breaks.
Every year for the past decade, the National Council on Compensation Insurance (NCCI) surveys carrier executives in the workers’ compensation industry to better understand their market perspectives, needs, and challenges. Learn what keeps them up at night.
A draft report from the Pain Management Best Practices Inter-Agency Task Force, which acts in an advisory capacity for the federal government, calls for individualized, patient-centered pain management. Public comments are welcome.
A study by the Workers Compensation Research Institute (WCRI) found 33% of injured workers employed in mining and 29% in construction received opioids for certain injuries and are more likely to receive higher doses and for longer time periods. The study also found that older workers were more likely to receive opioid prescriptions compared with younger workers, with 49% of injured workers age 49 or older receiving opioids compared to 42% of workers between the ages of 25 and 39.
Meanwhile, a higher percentage – 66% to 79% – of workers who sustained fractures, carpal tunnel and neurologic spine pain received at least one opioid prescription for pain relief. It’s postulated that those in rural areas receive more opioids because there are fewer pain management options available.
A new video from the National Association of Tower Erectors highlights the importance of understanding and following the proper sequence of performing tower modifications.
Nearly half of the teen workers in Massachusetts who were injured on the job between 2011 and 2015 said they did not receive health and safety training from their employer, according to a Massachusetts Department of Public Health annual report on teen worker safety. Four industries – accommodations and food service (37 percent), retail trade (19), health care and social assistance (11), and construction (4) – accounted for more than 70 percent of all work-related injuries involving teens in the state.
NIOSH recently introduced checklists to help employers assess damp areas and identify mold. The Dampness and Mold Assessment Tool has two versions – one for general buildings and one for schools – as well as a four-step assessment cycle.
Stressing the importance of lightning awareness while working outdoors, the Center for Construction Research and Training (CPWR) has published a hazard alert and toolbox talk addressing the topic.
The USG U.S. Chamber of Commerce Commercial Construction Index (CCI) is a quarterly economic index designed to gauge the outlook for, and resulting confidence in, the commercial construction industry. While earlier reports indicated that the shortage of skilled workers affected schedule performance and jobsite efficiency, the September index added a new dimension – 80 percent of contractors agree that the skilled labor shortage also impacts jobsite safety and it’s the number one factor increasing safety risk on the jobsite.
Tighter time schedules are the number two factor and exacerbate the safety risks. Aggressive scheduling may cause contractors to use workers with less experience or training, and can push employees to work longer hours, which can lead to shortcuts and compromised processes.
Addiction and substance abuse issues also decrease worker and jobsite safety. Almost 40% of contractors say they are highly concerned about the safety impacts of worker use/addiction to opioids, followed by alcohol (27%) and marijuana (22%). Notably, the report showed that while nearly two-thirds of contractors have strategies in place to reduce the safety risks presented by alcohol (62 percent) and marijuana (61 percent), only half have strategies to address their top substance of concern: opioids, which is a newer growing concern.
Language barriers also are a leading safety risk, particularly in the Northeast (34%) and West (31%).
To address safety risks caused by workforce shortages, contractors believe the most effective strategies are an improved safety culture and more leadership training.
General Contractors in the Northeast are relying more than others on leadership training for supervisors. Large contractors are using safety-enhancing technology (47%) more than small contractors (27%).
The study dove deeper into the most impactful way to achieve a strong safety culture. It presented a list of practices associated with a strong safety culture and asked contractors to select those with the highest impact on safety outcomes. Training at all levels topped the list (67%). More than half (53%) of contractors believe that ensuring accountability at all levels has a high impact. Other indicators include improving communication (46 percent), demonstrating management’s commitment to safety (46 percent), improving supervisory leadership (43 percent) and aligning and integrating safety as a value (42 percent).
The top strategies contractors are using to reduce safety risks caused by substance abuse are testing, prescreening before hiring, education, communication oversight by supervisors, zero tolerance policies, counseling, and access to rehab.
The labor shortage in the construction industry is projected to last another three years, requiring increased emphasis on safety training and supervision. Four out of five (80%) contractors said they experienced some competitive advantage from their safety programs, although larger companies with more resources and expertise gain a greater advantage. They cite insurance, liability, and new business as top benefits.
Even a few injuries can push worker comp rates sky high, raise the experience modifier, reduce bidding opportunities, lower morale, and put more pressure on workers who are already expected to do more with less. A renewed emphasis on safety that is inclusive and forward thinking will help curb the risks.
Americans are known as a 24/7 society and often take pride in their sleep deprivation. Although some workers experience fatigue at work because of their lifestyle, the workplace is the root of fatigue for many workers. And, according to a study by the National Safety Council (NSC), 74% of employers underestimate the prevalence of fatigue in the workplace and 73% do not communicate with employees about fatigue.
Overtime, high risk hours (night or early morning), demanding jobs that require sustained attention physically and/or mentally, long shifts, quick shift returns, and no rest breaks are among the top fatigue risk factors identified by the NSC. The common argument made by employers is that productivity will be reduced if steps are taken to address fatigue. And the current employee shortage in many areas has exacerbated the problem.
Yet, as the work schedule progresses, workers tire naturally as they use up energy. Too few breaks and long shifts add to the strain on body and mind, leading to reduced alertness and lack of concentration. But employees are reluctant to say they are too tired to do their job safely for fear of being perceived as lazy, uncooperative, or losing needed overtime pay.
The result is not only a decline in productivity, but also increased accidents and near-misses. According to the NSC, 32% of reported injuries and near-misses are due to fatigued employees. Workplace fatigue problems can be cured, but the hurdle is recognizing the correlation between incidents and fatigue and developing solutions that are compatible with productivity objectives.
Rather than adopting the attitude “that’s just the way things have to be to get the work done” understanding how the workplace is set up, how the work is handled, and how fatigue is a serious, costly risk can guide employers to develop a plan that mitigates risks and maintains productivity levels.
A U.S. employer with 1,000 workers could lose about $1.4 million annually because of the effects of sleep deficiency, according to recent research from the National Safety Council (NSC) and the Brigham Health Sleep Matters Initiative. An estimated 40 percent of the workforce suffers from an undiagnosed sleep-related ailment, such as obstructive sleep apnea or insomnia. Sleep disorders can cause employees to miss work and experience performance and productivity issues, as well as increases in their health costs. They also can lead to work-related incidents and injuries.
Organizations now can see their portion of those costs – and their potential savings by implementing sleep health programs – with the new Fatigue Cost Calculator.
The National Institute for Occupational Safety and Health (NIOSH) has launched a software platform called ERHMS Info Manager to monitor the health and safety of emergency responders. ERHMS Info Manager tracks and monitors emergency response and recovery worker activities during all phases of emergency response following a natural disaster or other public health emergency.
Emergency medical services workers have higher rates of work-related injuries than the general workforce and three times the lost workday rate of all private-industry workers, according to a new fact sheet from NIOSH. The fact sheet identifies the actions that caused the most injuries and provides tips to prevent injuries.
Workers who frequently drill concrete can reduce their exposure to noise, silica and vibration by regularly replacing dull drill bits with new, sharp ones, according to a recent study from the Center for Construction Research and Training, also known as CPWR. In three experiments the research team showed that a worker’s exposure to noise, tool vibration and airborne silica dust increases substantially as a bit wears down from continued use.
The Network of Employers for Traffic Safety is offering a free online toolkit to help employers keep workers and their families safe on the road.
The toolkit includes an interactive distracted driving self-assessment in which users answer questions about their driving habits. Other resources include fact sheets for employers and employees, pledge cards, a PowerPoint presentation, and graphics for social media and email use.
Coventry has released the fourth and final installment of their 2016 Drug Trends Series, this one focusing on specialty medications and closed formularies. Specialty drugs are not utilized widely in workers’ comp, just 1.1 percent, but they do make up just about 5 percent of overall prescription costs. In the managed care world, utilization of specialty medications rose by 19.4 percent in scripts per claim and they saw a 7.9 percent increase in cost.
Over 90% of all utilization review physicians’ modifications or denials of treatment that were reviewed by an independent medical review (IMR) doctor in were upheld according to a study by the Oakland-based California Workers’ Compensation Institute. About half of the IMR decisions so far this year were related to pharmaceutical requests and a small number of physicians account for a large portion of the claims.
The Workers’ Compensation Insurance Rating Bureau (WCRIB) released a report showing medical payments per claim dropped nine percent from 2014 to 2016. The researchers attribute that to a drop in utilization, there was a 10 percent decrease in paid transactions, but the average payment per paid transaction actually rose 4 percent, from $129 to $134.
The Workers’ Compensation Board released new impairment guidelines, just meeting the deadline set by the Legislature last spring. The guidelines are used to determine schedule loss of use awards, which are additional cash payments to workers who have permanent or partial loss of the use of limbs, as well as vision and hearing loss.
Rate Bureau proposes 11.3% loss cost decrease. This filing will affect policies that are effective on and after April 1, 2018, and are applicable to new and renewal policies.
Employee misclassification complaints are up 644% in first half of 2017, reflecting the state’s crackdown on misclassification, which followed a yearlong investigation by the News & Observer in Raleigh and The Charlotte Observer.
Industrial Commission has stopped accepting motions from adjusters. Determining that the filing of motions constitutes the unauthorized practice of law, the Industrial Commission will no longer accept motions for relief filed by insurance adjusters.
NCCI recommends 12.2% rate drop. Drops will vary by industry, but most are in double digits.
Chronic back pain is one of the most persistent and difficult issues to deal with in Workers’ Compensation. With an aging and overweight workforce, it will continue to be a dominant cause of work comp claims. Moreover, about 85 percent of lower-back pain is idiopathic – without a specific or known cause – making it difficult to separate the impact of aging or outside activities from legitimate work-related causes.
Within the last several years, the industry has shifted away from bed rest, medical imaging, pain medications, and surgery to more conservative care, such as exercise, customized ergonomic training, yoga, physical therapy, cognitive behavioral therapy, acupuncture, and anti-inflammatory medications.
A 2014 study by Liberty Mutual’s Institute for Safety found that early use of MRIs on injured workers complaining of back pain may lead to unnecessary procedures and even longer disability periods. Other studies have put the cost of back-pain claims using MRIs at $12,000 more than claims that did not use early MRIs.
In some cases, an MRI can trigger a recommendation of surgery even though the changes can be attributed to a normal result of the aging process. If a physician wants to find an excuse to recommend surgery, it is there. Suddenly, for the employee, the perception of the problem escalates from annoying pain to a catastrophic condition.
In an age of MRI scans, getting employees on board with alternative approaches can be challenging. Understandably, employees are afraid of doing more damage to their spine and movement and exercise can seem counterintuitive. They anticipate worsening of symptoms with certain activities. And for couch potatoes, the prospects of activity can be overwhelming and surgery can be viewed as a cure-all. Changing the mindset is an important first step.
Speaking at the recent California Workers’ Compensation and Risk Conference, Dr. Jennifer Christian, president and chief medical officer at Wayland, Massachusetts-based Webility Corp., spoke about the power of words. Don’t call it “your injury,” instead, call it “your recovery process.” Don’t say “getting you back to work.” say, “getting your life back to normal.” Don’t ask about pain; ask about progress. She urged employers and claim handlers to be on the front line and help employees overcome their fears about how long they are going to be laid up and how they can manage their job, questions doctors often find difficult to answer.
Employees will listen and buy into training if it makes them feel better. A recent article in Business Insurance highlighted a successful tailored ergonomic training program for employees of Greyhound Lines Inc. In 2010, the company saw 745 mostly musculoskeletal injuries. Most were related to material handling issues – pushing, pulling, twisting and lifting.
At the time, its training was a basic lifting program – one size fits all, regardless of what the person did. Today, safety experts study the job and come up with a tailored approach. With this customized program, the number of such claims dropped to 295 in 2016. Employees need motivation to make changes in behavior; feeling better, both on and off their job, is a great motivator.
In the article, ergonomics expert Dennis Downing, CEO of Future Industrial Technologies, Inc., noted some common, yet, ineffective practices. Likening the practice to teaching a child to swim, he said video-based training doesn’t work. You wouldn’t show a child a video, and then toss them in a pool. Offering a free lunch is also a no-no. “We had a hard time figuring out why companies were bribing employees with food,” he said of the common practice of providing ergonomics training – how to better lift, push, pull, and stretch – over a free lunch.
It is going to take a careful assessment of the workplace, the demographics of the employees, and an analysis of the claims related to back pain to craft an effective plan. Whereas some employees may embrace new approaches with simple education, others need a multidisciplinary approach that includes more advanced psychological informed rehabilitation.
A recent study of 364 Ohio workers diagnosed with degenerative spinal stenosis who underwent back surgery found that those who underwent primary decompression, a surgical procedure to alleviate pain caused by pinched nerves, had higher return to work rates than those who had the more-invasive, more-expensive fusion surgery. The study was published in July’s Spine medical journal.
The Ohio Bureau of Workers Compensation’s new spinal fusion rule requires workers to first undergo at least 60 days of comprehensive conservative care, such as physical therapy, chiropractic care and rest, anti-inflammatories, ice and other non-surgical treatments before lumbar surgery. Conditions that require immediate intervention, such as spinal fractures, tumors, infections and functional neurological deficits, are exceptions to the rule.
The U.S. Department of Labor will again issue opinion letters to assist employers and employees in interpreting laws like the FMLA and Fair Labor Standards Act. The DOL has established a new webpage to submit requests for opinion letters and to review old opinion letters.
USCIS released a revised version of Form I-9, Employment Eligibility Verification, on July 17. Employers can use this revised version or continue using Form I-9 with a revision date of 11/14/16 N through Sept. 17. On Sept. 18, employers must use the revised form with a revision date of 07/17/17 N. Employers must continue following existing storage and retention rules for any previously completed Form I-9. Changes to the form are considered minor.
The Safe Driving Kit, sponsored by Wheels, Inc., aims to create safer roads and protect employees through multi-media resources and engaging materials. The kit addresses the key contributors to car crashes, including distraction, alcohol, other drugs, fatigue and seatbelt use. It also brings attention to lifesaving technology that helps prevent crashes.
According to research released by the Centers for Disease Control and Prevention (CDC), the average days’ supply per opioid prescription increased from 13 days in 2006 to almost 18 days in 2015. Meanwhile, nearly half of the states included in a study of opioid prescribing in workers’ compensation cases have seen reductions in the frequency and strength of opioids given to injured workers, according to a study released in June by the Cambridge, Massachusetts-based Workers Compensation Research Institute.
Brake violations prompted the removal of 1,146 commercial motor vehicles from service as part of a recent unannounced, single-day inspection blitz across the United States and Canada on May 3. According to the Commercial Vehicle Safety Alliance (CVSA), 12 percent of CMVs inspected were taken out of service for brake violations, and 21 percent were removed for other violations.
About 10,000 cardiac arrest situations occur in the workplace each year, yet only 45 percent of U.S. employees have been trained in first aid – and only 50 percent of workers know where to find an automated external defibrillator – according to the results of a survey recently conducted by the American Heart Association.
Going to bed later and waking up later on weekends than during the week – also known as social jet lag – may be linked to poor health and higher levels of sleepiness and fatigue, according to the preliminary results of a study conducted by researchers at the University of Arizona. Results showed each hour of social jet lag was linked to an 11.1 percent increase in the chances of developing heart disease. In addition, participants who experienced social jet lag were 28.3 percent more likely to report their health as “fair/poor.” The study abstract was published in an online supplement to the journal Sleep.
Factories with plastic injection molding machines that interact with peripheral equipment – such as robots or conveyors – could do more to improve safety, Canadian scientific research organization IRSST concluded in a recent study. The study was published in May along with a technical guide.
To clear up a “misunderstanding” among stakeholders, the Florida Division of Workers’ Compensation has clarified that all compounded drugs, regardless of cost, are now subject to preauthorization.
While the state faces one of the highest workers’ compensation insurance rates in the country, legislators were unable to reach a consensus on reforms.
Missouri was the only state that lacked a prescription drug-monitoring program prior to last month when the governor signed an executive order directing the Department of Health and Senior Services to create a prescription drug-monitoring program.
The new legislation redefines “maximum medical improvement (MMI)” as the point when the condition of an injured employee can no longer improve, and bans any claims for benefits beyond that time period. It also puts more emphasis on the employee proving an employer discriminated against them after they filed a workers’ compensation case.
The New York Department of Financial Services has approved the 4.5% workers compensation premium rate decrease recommended by the New York Compensation Insurance Rating Board effective Oct. 1.
Disconnect between employer and employee perception of value of productivity over workplace safetyIn a recent survey, Employee Perceptions in Workplace Safety, by the National Safety Council (NSC), over one-third of the employees surveyed claimed that workplace safety is secondary to performing tasks. This perception was even much higher in certain industries: 68% in agriculture, forestry, fishing and hunting; 58% in construction; and 45% in manufacturing or industrial facilities.
The report also found that 32% of respondents agreed that employees “are afraid to report safety issues,” and 30% agreed “employees are resistant to working safely.” Of those surveyed, 39% agreed that management does only the “minimum required by law” when it comes to employee safety. 32% feel management ignores an employee’s safety performance when determining promotions.
On the other hand, 71% stated that safety training is part of orientation, and 68% of those surveyed agreed that employees are well trained in emergency practices. 62% say everyone is involved in solving job safety issues. 63% of employees feel they work in areas or at stations that are ergonomically correct.
Takeaway: Even in companies that have a safety strategy aligned with their organizational goals, there can be a safety-vs.-production dichotomy. This can come from unrealistic deadlines, poor supervision, inadequate communication, lack of accountability, workers’ perception that personal productivity solely drives raises, or a high tolerance for risk among some employees. Find out how your employees view safety and productivity. Are there conflicts, if so, what are they and how do they resolve them? Many successful companies have demonstrated that high value on safety and productivity can co-exist and help achieve long-term profitability.
Motor vehicle crashes are leading cause of workplace fatalities and roadways are getting more dangerousIt’s not falls, fires, explosions, or chemical exposure that kills workers the most on the job; it’s motor vehicle crashes. According to the Bureau of Labor Statistics, Census of Fatal Occupational Injuries Summary, 2015 (latest data available), roadway incident fatalities were up 9 percent from 2014 totals, accounting for over one-quarter of the fatal occupational injuries in 2015.
Drivers are often lulled into a false sense of security with hands-free and in-vehicle technology. An NSC survey found that 47% of motorists are comfortable texting while driving. There’s also a false sense that summer is a safer time to drive with better weather and road conditions. However more auto accidents occur during the summer time than any other time of the year.
According to the NSC, the increased serious injuries and fatalities from motor vehicle crashes continue a troubling multiyear surge that experts believe is being fueled, in part, by more people driving while distracted by cellphones, infotainment screens, and other devices. Other factors include an improving economy, lower gas prices, and younger, more inexperienced drivers.
And then there are the challenges that face the trucking industry. Heavy and tractor-trailer truck drivers incurred 745 fatal work injuries in 2015, the most of any occupation.Truck drivers also had more nonfatal injuries than workers in any other occupation. Half of the nonfatal injuries were serious sprains and strains; this may be attributed to the fact that many truck drivers must unload the goods they transport. A driver shortage, a rapidly aging driver population, as well as issues with driver fatigue, obesity, and other co-morbidities challenge the industry. And in many delivery zones, there has been an increase in pedestrian strikes, not caused by drivers but by distracted pedestrians.
Takeaway: Any company utilizing vehicles for business purposes – even if those vehicles are employees’ personal cars – can feel the impact of rising accidents. The average work-related motor vehicle injury claim costs $72,540, which is twice as much as other work-related injuries. Those who have not instituted policies to minimize distracted driving need to do so. Random checks on compliance with the policy and discipline for non-compliance are key. Employers can also strengthen hiring practices and use fleet telematics, when appropriate.
These policies should be regularly communicated to help reinforce the message. There are good public awareness campaigns, including an informative website, distraction.gov, in which employers can download forms to use in obtaining a pledge to not engage in distracting activities while driving. Recently, the NSC created a webinar offering recommendations not only on eliminating distractions in vehicles, but also on how to be alert and react to the actions of other distracted drivers on the road.
Fatalities in construction outpace employment growthThe number of fatalities among construction workers climbed to 985 in 2015 after dipping to 781 in 2011, an increase of 26% compared to employment growth of 16%. Fall-related fatalities increased at a faster pace – rising 36% to 367 in 2015, according to the report by the Center for Construction Research and Training (CPWR).
55 percent of fatal falls came from heights of 20 feet or less.
33 percent of fatal falls involved falls from roofs, 24 percent involved ladders, and scaffolds and staging accounted for 15 percent.
Fatal falls in residential construction rose to 61 in 2015 from 26 in 2011.
Roofers continue to experience the highest rate of fatal falls to a lower level: 31.5 per 100,000 full-time workers, although this represents a decrease from 39.9 in 2014.
Workers at an increased risk of fatal falls include Hispanic workers, foreign-born workers, and workers 55 years and older.
Takeaway: The findings in this report emphasize the need to reduce falls and the importance of ongoing vigilance. CPWR, OSHA and NIOSH have a variety of resources available and the Campaign to Prevent falls in construction website includes Eleven Ways to keep your fall prevention program alive all year long.
Impaired workforce: drug use at 12-year highCocaine, marijuana and methamphetamine use continues to climb among workers, though opioid use is down, according to a May 2017 study by New Jersey-based Quest Diagnostics Inc. Cocaine positivity increased 12 percent in 2016, reaching a seven-year high of 0.28 percent, compared to 0.25 percent in 2015, and seven percent among federally-mandated, safety-sensitive workers to 0.28 percent, compared to 0.26 percent in 2015. Marijuana positivity increased dramatically over the last three years with increases in Colorado and Washington double the national average. In oral fluid testing, which detects recent drug use, marijuana positivity increased nearly 75 percent, from 5.1 percent in 2013 to 8.9 percent in 2016.
Amphetamines (which includes amphetamine and methamphetamine) positivity continued its year-over-year upward trend, increasing more than eight percent in urine testing compared to 2015. Throughout the last decade, this rise has been driven primarily by amphetamine use, which includes certain prescription drugs such as Adderall.
On a positive note, heroin detection remained flat, while prescription opiate detection declined.
Takeaway: The efforts to control opiate prescribing in workers’ comp have produced promising results. However, the answer to the problem of drugs in the workplace remains elusive. The regulations governing drug testing are more restrictive, there is no established standard of what constitutes impairment when it comes to marijuana, alternatives to chronic pain treatment are still emerging, and employees often do not understand the perils of some prescription medications. In addition to a carefully crafted drug-free workplace policy, training supervisory staff to identify and know what to do if they suspect an employee has a problem and educating employees on their role in keeping the workplace safe are key.
According to a study by the U.S. Centers for Disease Control and Prevention, the risk of opioid abuse rises with lengthy prescriptions. If received a one-day prescription, 6% were still on opioids a year later; when prescribed for 8 days or more, this rises to 13.5%; when prescribed for 31 days or more, it increases to 29.9%.
President Trump repealed the so-called “blacklisting rule” that required federal contractors to disclose labor violations. The executive order had required employers bidding for federal contracts worth at least $500,000 to disclose any of 14 violations of workplace protections during the previous three years.
The Federal Motor Carrier Safety Administration’s (FMCSA) regulation that required CMV (Commercial Motor Vehicle) drivers to take breaks in the hopes of preventing driver fatigue has been suspended since 2014 so that further research could be done to understand the efficacy of the program. A study from the Department of Transportation found that stricter mandated breaks did not do much to reduce driver fatigue or improve safety. Thus, the rule will not come out of suspension.
The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults 18 to 60 years old get at least seven hours of sleep every day. A lack of sleep can contribute to cardiovascular disease, obesity, diabetes, depression, and other health issues, as well as contribute to more injuries on the job.
A series of free, confidential health screenings will be available for coal miners as part of the NIOSH Coal Workers’ Health Surveillance Program. The first set of screenings will take place from March 26 to April 15 in coal mining regions throughout Alabama. The second set will occur from May 10 to May 31 throughout Indiana and Illinois. Finally, testing will take place from July 30 to Aug. 26 throughout Eastern Kentucky.
Mine operators and workers now have access to updated hazard assessment software from NIOSH. According to the agency, EVADE 2.0 – short for Enhanced Video Analysis of Dust Exposures – offers a more comprehensive assessment of the hazards miners face by pulling together video footage and exposure data on dust, diesel and other gases, as well as sound levels.
Physical therapy is as effective as surgery in treating carpal tunnel syndrome, according to a new study published in the Journal of Orthopaedic & Sports Physical Therapy. Researchers in Spain and the United States report that one year following treatment, patients with carpal tunnel syndrome who received physical therapy achieved results comparable to outcomes for patients who had surgery. Further, physical therapy patients saw faster improvements at the one-month mark than did patients treated surgically.
A recent report in the New York Times cited a study in JAMA Internal Medicine which found death rates dropped when inspectors were onsite. In the non-inspection weeks, the average 30-day death rate was 7.21 percent. But during inspections, the rate fell to 7.03 percent. The difference was greater in teaching hospitals – 6.41 percent when the inspectors were absent, and 5.93 percent during survey weeks. While the difference may seem low, an absolute reduction of only 0.39 percent in the death rate would mean more than 3,500 fewer deaths per year.
Although the reasons for the effect are unclear, it was suggested when docs are being monitored, diligence ramps up.
A bus driver of the Chicago Transit Authority sought to return from an extended medical leave and was cleared through a fitness exam to return to work, but failed a safety assessment and was not allowed to return to work. The Authority argued that obesity is not a disability unless it is due to a physiological disorder and the employee had not alleged a physiological disorder.
A laborer for the City of Red Bank in Tennessee, who rose to the position of Assistant to the Director of Public Works, did significant outdoor work. His job evolved and required different responsibilities, more and more of which were outdoors. He developed skin problems and was diagnosed with lupus. His dermatologist said he needed to be indoors.
After an indefinite FMLA leave lasting six months, he returned to work and bought protective clothing, but it failed to provide adequate protection. He sought another FMLA leave and his doctor ‘s certification emphatically stated that he must work indoors. When it was determined he was not qualified for the two open indoor positions, he was terminated.
The U.S. District Court for the Central District ruled in favor of the California Insurance Guarantee Association (CIGA) in its ongoing challenges against the Centers for Medicare and Medicaid Services (CMS) over the Medicare Secondary Payer (MSP) practices. CIGA faced Medicare Conditional Payment demands for three separate workers’ compensation claims that had settled. Included in the demands were diagnosis codes unrelated to the accident.
In Mason v. S.E.I.U. Local 721, 2016 Cal. Wrk. Comp. P.D. LEXIS 618 (Lexis Advance), the WCAB, reversing the WCJ in a split panel opinion, held that an employee of the County of Los Angeles, Department of Children and Family Services who was a member of S.E.I.U. Local 721 was acting as an employee of S.E.I.U. Local 721 at the time she suffered an injury while participating in a union rally. The WCAB found employment by the union, noting the injured worker was rendering service for “another,” (the union), and that the union provided transportation, food and water while at the rally, and that the services and goods provided by the union were akin to economic substitutes for wages.
In a case of first impression, the Florida 1st District Court of Appeal ruled that a worker exercising his statutory right to a one-time change in physician was not entitled to choose a new doctor in a different specialty simply because the carrier did not respond in a timely fashion. In Retailfirst Insurance Co. v. Davis, an employee who had injured his leg had received authorization for treatment with a family practice physician and later sought authorization for care with an orthopedist. The court noted that procedures exist for such a request.
In Murff v. IWCC (City of Chicago), No. 1-16-0005WC, 01.06.2017, an injured worker returned to work in a modified capacity. Later, he was determined to have reached maximum medical improvement and was awarded benefits and continued to work in the modified capacity for about six months. He was then told him that if he could not return to his old job duties, he’d have to go home, so he went on disability leave and filed a claim seeking additional comp benefits.
The Appellate Court upheld the findings of the lower courts that there was no evidence he had not suffered any material change in his physical or mental condition since the award of benefits. An increase in economic disability is not a basis for additional comp benefits.
In Lankford v Newton County an investigator with the county prosecutor’s office would smoke frequently on the courthouse roof, which was a popular place for pigeons. In 2002, he was diagnosed with COPD as a result of ammonia exposure from investigating a meth lab and in December 2007, after undergoing lung surgery, to remove half of his right lung, which contained a nodule that was suspected to be cancerous, he suffered a stroke that left him unable to work.
He filed a workers’ comp claim asserting that he was exposed to pigeon droppings during the course and scope of his employment. Doctors noted that a biopsy of his lung nodule showed the growth contained bacteria and a fungus linked to pigeon droppings. He died of complications and his wife became the claimant. The case was appealed up to the Court of Appeals, but in each case, the award of $167,811.62 in permanent total disability benefits to the deceased worker, as well as more than $500 in lifetime weekly workers compensation benefits to his wife, was approved.
In Clawson v Cassens Transport Company, a union car hauler had a pre-existing knee condition as a result of a work-related accident a few years earlier. After working for 3.5 years after the accident, his workload increased and he began working 6-7 days per week. When he complained of pain in his knee, the employer denied the claim and declined to provide medical treatment. He sought medical treatment on his own, was advised to have surgery and a doctor opined the issue was casually related to the increase in his job duties.
At a hearing, an ALJ found that although there was a pre-existing condition, the prevailing factor in causing his worsening condition was the change/increase in his job duties.
The U.S. District Court in Kansas City found Pacific-based DNRB Inc., a steel erection company doing business as Fastrack Erectors, guilty in the 2014 death of an employee who fell while working on a warehouse construction project in Kansas City. The court found that “Fastrack was aware of safety violations but willfully ignored them, with tragic results.” Fastrack was a subcontractor to ARCO National Construction – K.C., Inc. and the contract required that personnel who were working or present at heights in excess of six feet shall be provided adequate fall protection and Fastrack failed to do so.
A U.S. District Court judge dismissed an insurer’s request to forgo payment of workers’ compensation benefits for an undocumented landscaper’s injury. The insurer, NorGuard Insurance Co., sought a declaratory judgment that it wasn’t obligated to pay medical expenses, indemnity payments or comp benefits because the worker had entered the U.S. illegally.
In Thompson v. International Paper Co., No. COA15-1383, 01/17/2017, a worker was burned over 23% of his body in a work-related accident. His wife took FMLA leave from her job to care for her husband and, when she returned to work, she arranged her schedule to accommodate his medical needs. While the company accepted the burn injuries as compensable, it denied reimbursement for attendant care services provided by his wife. The full Industrial Commission ruled that attendant care by his wife was unnecessary after Dec. 31, 2012, but the appellate panel disagreed. While the need for care may have lessened, treating physicians had found attendant care was medically necessary.
In Neckles v. Teeter, a 68-year-old employee who had moved to the U.S. from the Caribbean island nation of Grenada had worked as a meat cutter and suffered an injury to his lower back, right hip, and right arm and leg for which he was compensated and received temporary total disability. A functional capacity evaluation concluded he couldn’t go back to his job as a meat cutter, but he was capable of a job that required light physical demands, however, a vocational rehabilitation specialist determined it would be difficult for him to get any job.
Three years later, the employer filed a form alleging the worker was no longer disabled. After a series of appeals, the Court of Appeals ruled that the worker should continue to receive TTD benefits and coverage of medical expenses. According to the court, it was necessary to look at the totality of the evidence, including age, education, work experience, work restrictions for the compensable injury, other unrelated health conditions (i.e., diabetes, gout, and angina), and trouble communicating (a thick accent).
In Saladworks, LLC v. W.C.A.B. (Gaudioso), the question revolved around whether the franchisor, Saladworks, was a statutory employer. Under Pennsylvania law, when an employee is unable to recover from its direct employer, the employee can file a workers’ compensation claim against a “statutory employer.” A Workers’ Compensation Judge initially held that Saladworks was not a statutory employer, however, the Workers’ Compensation Appeal Board reversed that decision. On appeal, the Commonwealth Court reversed the Board’s decision recognizing the difference between Saladworks’ business model and the business engaged in by its franchisee. The Supreme Court dismissed the appeal, effectively upholding the Commonwealth Court’s decision.
In Grissom v. UPS, 2017 Tenn. LEXIS 4 (Jan. 9, 2017), the Special Workers’ Compensation Appeals Panel of the Supreme Court affirmed a trial court’s award of attorney’s fees and expenses in the amount of $27,353.63, in connection with an employee’s petition to compel the employer to pay $187 for two trigger point injections. The workers’ compensation carrier had sought a peer utilization review (UR), although it had paid for earlier injections. An authorized physician provided the injections to the injured employee, but the UR provider found the injections unnecessary. Following a hearing, the trial court disagreed.
Commercial truck drivers who have at least three health issues can quadruple their crash risk compared to healthier drivers, according to a study from the University of Utah School of Medicine. Researchers examined medical records for nearly 50,000 commercial truck drivers, 34 percent of whom had signs of one or more health issues associated with poor driving performance, such as heart disease, low back pain and diabetes.
The crash rate involving injury among all drivers was 29 per 100 million miles traveled. The rate rose to 93 per 100 million miles traveled for drivers with at least three ailments. Researchers took into account other factors that can impact driving abilities, such as age and amount of commercial driving experience.
The study was published online Jan. 10 in the Journal of Occupational and Environmental Medicine.
Employee takeaway: It is well documented that truck drivers often have difficulty staying healthy because they tend to sit for long periods of time and sleep and eat poorly. With the industry facing a critical shortage of drivers, employers need to do all they can to keep their drivers healthy. There are a host of tools available to help drivers, including smart phone apps with guidance about nutrition and exercise on the road, customized in-house wellness programs, bio-screenings, coaching, sleep apnea testing and treatment, encouraging brown bagging and walking or bicycling during breaks, and so on. Some companies are ramping up their new-hire pain diagnostics, so they have a baseline for whether a new driver has pre-existing muscle pain. In an industry of high turnover and high claims, this puts the driver on notice and effectively deters claims.

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