• Injured workers who must travel 20 miles or more roundtrip for medical care are entitled to collect $0.55 per mile. Special consideration also is given to employees who are totally disabled.
• Chiropractic treatment is allowed for workers’ compensation patients, if the employer or the employer’s insurance company grants permission. As many as 20 visits are allowed, if medically necessary. If additional visits are needed, the chiropractor should request this authorization from the Industrial Commission.

If youv'e missed any of the previous tips, find them here.

But here's the truth:

• Patients have the right to ask the Industrial Commission for permission to see a doctor of their choosing. However, if an injured person is treated by a physician without first getting permission, his or her workers’ comp benefits might be in jeopardy. If a patient comes to you under these circumstances, advise them that an attorney can help ensure that benefits are protected.

For more tips on how to help injured people navigate the complex workers' compensation system in North Carolina, click here. Our attorneys and paralegals at the Deuterman Law Group also are available to answer questions and provide counsel to injured workers.

In the haste to get back to work and to a steady paycheck, people can cause irreversible physical damage, and they may also jeopardize their ability to collect on a workers' compensation claim.

• Some injured workers will want to return to work before they are medically able to do so. While injured workers are justified in their fear of reprisal for missing work because of an injury, strongly discourage them from returning to a job for which they are physically unprepared. Candidly explain the risk of re-injury. And while it’s true that some people are fired for filing a workers’ compensation claim – even though the law forbids such retaliation – being fired is preferable to derailing recovery or creating a worse medical problem by returning to work too soon. Let your patients know that there is legal recourse if they are fired. Patients can file a wrongful termination claim themselves with the Industrial Commission, but many will find it helpful to have an attorney advocate on their behalf.

You can find my entire series of tips here, and stay tuned throughout the week for more advice on helping injured workers under your medical care.

I've been sharing information about things that doctors, nurses and other healthcare workers can do to help injured patients as they navigate the complicated workers' comp system in North Carolina. There are quite a few unique benefits available to injured workers, but without a doctor's recommendation patients may not be able to receive these benefits.

My aim is to arm health care professionals with the information they need so they can attend to the unique needs of injured workers while providing them with medical treatment.

Did you know, for instance, that:

• Injured workers may be entitled to additional benefits beyond compensation for lost wages and traditional medical care. The standard in North Carolina is whether or not the recommended treatment is reasonably likely to effect a cure, give relief from symptoms (including pain relief) or lessen the period of disability. Under this standard, in cases of catastrophic injury, North Carolina’s workers’ compensation law allows for things like home and vehicle modifications, medical devices in the home such as hospital beds, in-home attendant care, motorized wheelchairs, etc. So long as these devices/modifications meet the standard recited above and are prescribed by a treating physician, they should be covered by the Workers’ Compensation insurance company.

Knowing more about how workers' compensation laws are structured in North Carolina will help healthcare professionals attend to the other needs of injured workers during the course of medical treatment.

You can find other entries in this series here:

Here's today's tip:

• Encourage you patient to keep a calendar or journal to document important facts relating to the work injury and ongoing treatment. In their journals, patients should record details of how the injury occurred, who witnessed it and how and when it was reported. Additionally, injured workers should make note of any medical appointments in their journals, recording any medical procedures that were conducted and instructions they received from healthcare workers. Finally, patients should write about any symptoms or additional medical problems they’re experiencing and any harassment they encounter from employers, coworkers or the insurance company regarding the work injury. Workers’ personal journals have proven to be invaluable in presenting a workers’ comp claim to the N.C. Industrial Commission.

Knowing more about how workers' compensation laws are structured in North Carolina will help healthcare professionals attend to the other needs of injured workers during the course of medical treatment.

You can find other entries in this series here:

Now for today's tip:

• Keep detailed records of the patient’s treatment and any conversations you have about the injuries. Detailed medical records, which accurately reflect the patient’s symptoms, treatment and the progression of their recovery, are crucial in workers’ compensation claims. Many cases end up in litigation simply because medical records lack details or are ambiguous.

But many doctors, physicians’ assistants and nurses find that while they can help these patients with their medical problems and physical recovery, treating someone with a work injury presents a unique set of challenges – not all of them medical. 

Indeed, injured workers and their families must deal with a host of issues as they try to heal and rebuild their lives after being hurt on the job. There are emotional and financial burdens, and a seemingly endless amount of bureaucratic red tape to navigate when filing a workers’ compensation claim.

Additionally, injured workers face tremendous external pressure from family members, coworkers, employers and insurance companies to return to work so they can start earning a paycheck again. It’s also not unusual for injured workers to pressure themselves to return to work before they’re physically ready because they feel obligated to do so or feel “less than” because they’re out of work and collecting unemployment benefits. 

When we started the Deuterman Law Group six years ago, one of our founding principles was that we would treat clients as people, not as cases, and that we would attend to the whole person. It’s our job to ensure not only that our clients receive the maximum workers’ compensation and medical benefits available to them, but also to assist them as they adjust to a new “normal” following an injury.

Given these realities, I thought it would be helpful to write a couple of blog postings explaining some of the intricacies of workers' compensation laws in North Carolina. My aim is to give healthcare providers information and extra tools that will help them when treating injured and disabled workers.

Injured workers should also take note of these tips as they include information about some of the additional benefits that are available to them under the law.

Keep checking back at the blog throughout the week; I'll be posting new tips each day.

Here's the first tip:

• If a patient comes to you with an injury resulting from an accident at work or a chronic condition that was likely caused by their job, encourage that person to report the injury, if he or she hasn’t already done so. Ideally, work injuries should be reported immediately to the employer and the N.C. Industrial Commission and, in any event, within 30 days of the accident or diagnosis that the condition is work-related.

The agency will be focusing on specific industries, where certain injuries are common, and also will be examining whether some companies have been lax in reporting injuries, according to an article in the DemocratandChronicle.com

The U.S. Occupational Safety and Health Administration, created to enforce the large and growing number of worker safety laws and regulations, last week issued its "site-specific target" plan for the year, a warning, in effect, that the agency will be tougher on injury rates in specialized industries.

The plan mentioned nursing homes, where workers often suffer back and limb injuries in caring for patients, as an industry facing special attention.

But there is another program in the bureaucratic works — the National Emphasis Program — that is potentially more significant for local businesses that to this point either have escaped OSHA attention or are not in the usual range of targeted industries.

OSHA plans to examine companies that report low injury rates or few lost days due to injury with the idea that many companies have been underreporting or minimizing the need for thorough record-keeping.

The agency estimates that as many as 20 percent of all businesses fail to adequately report workplace-related injuries and illnesses. Other studies put the number as high as 68 percent.

As you can imagine, many people's opinions are a result of their own experience with the health care system, insurance, Medicare and Medicaid.

55-year-old Deborah Russell, who lives on Social Security and relies on Medicaid to pay her medical bills, favors reform.

Russell says too many hardworking people she knows - including a 49-year-old mechanic who rents a room in the same two-story house where she lives - have no insurance. "When he got sick two weeks ago, I gave him Tamiflu and some aspirin, but he didn't go to the doctor," she said of her neighbor. Any health care reform has to ensure some low-cost option for young and middle-aged adults who may need health care, Russell said.

You can read her complete story here.

The reason is simple: men are more likely to work in dangerous injuries such as construction (90 percent male) and manufacturing (70 percent male), where the bulk of workplace accidents and deaths occur. Female-dominated industries such as health care and education have fewer incidents of deaths and injuries.

Approximately 7% of fatalities in 2008 were women, leaving men accounting for a whopping 93% of all workplace fatalities. Men were over 13 times more likely to die while on the job compared with women according to the report issued by the U.S. Bureau of Labor Statistics.

Writer Katie Kelley has some thoughts on what these statistics mean for men and women in the workplace when it comes to compensation.

What's so interesting about this case is that the employee's workplace injury was unrelated to his weight. Adam Childers, a restaurant cook, was hurt when a freezer door accidentally slammed into his back. At the time of the injury, Childers weighed 340 pounds, and he later gained another 40 pounds. Doctors determined that Childers needed back surgery because of his injury, but that his obesity prevented them from performing that surgery safely.

The court in Indiana ruled that Childers' employer had to pay for lap-band weight-loss surgery, as well as the back surgery.

While many would see this ruling as a victory for injured workers, Posner is concerned that it could lead to employment discrimination against obese people:

I think this ruling hurts obese people because it places an unfair burden on the employer. I think the the Indiana Appeals thought their ruling protected fat people, but in essence it harms them. An employer will be forced to discriminate and NOT hire an overweight person because of fear of potential lawsuits

That is certainly an interesting point to ponder.

However, the law does allow people who have been hurt on the job to seek legal recourse against others whose actions and negligence caused or contributed to the actions.

These types of cases are called third-party workplace torts, and these types of lawsuits actually are quite common in cases of construction injuries.

In fact, we just read about a case in Texas, where an HVAC installer worker whose leg was crushed by falling Sheetrock at a construction site where he was working is suing seven companies, including the property owner and the project's general contractor.

The fact that that this injured man may receive workers' compensation benefits for his medical care and lost wages doesn't erase the other companies' responsibility for the accident.

Jose and Victoria Sosa claim Jose Sosa was working as a heating, ventilating and air conditioning installer...at an apartment complex in Port Arthur, Texas, when the incident occurred.

According to the complaint... another employee at the site had stacked numerous sheets of sheetrock against the wall adjacent to the room where Sosa was performing work for the defending companies.

"Suddenly and without warning the entire stack of sheet rock fell away from the wall the sheet rock was leaning against and onto Mr. Sosa," the complaint says. "The impact of the sheet rock against Mr. Sosa's body was violent and terrible. Mr. Sosa was pinned underneath the sheetrock, where his body sustained severe and permanent injuries."

Defendants named in the suit include Paha Legacy, Orion Properties, Legacy Resource Group, LRG Development, KRR Construction, KRR I Construction and KRR Development.

The Sosas blame the defending companies for numerous safety violations, for failing to provide a safe workplace and for failing to provide workers' compensation insurance, among other alleged acts of negligence.

Quite possibly, according to a study published in the latest issue of the Journal of the American Medical Association.

Researchers from the Medical College of Wisconsin compared workplace injury risks for workers in renewable energy industries compared to traditional fossil fuel industries.

Their findings? Switching to renewable energy could prevent 1,300 worker energy deaths over the next decade and also reduce the number of workplace injuries for the industry.

Jobs, such as mining, that associated with the energy industry are extremely dangerous and account for thousands of workplace deaths, workplace injuries and occupational illnesses every year. For instance, only agriculture is more dangerous and deadly than mining.

[Researchers] examined the human health risks associated with traditional fossil fuels, such as coal, oil, and natural gas, relative to renewable energy sources such as wind, solar, and biomass. Wind and solar energy appeared to offer less risk of workplace injury and death than traditional fossil fuel industries, as the dangerous energy extraction phase is minimized or eliminated in wind or solar energy production. Biomass, comprised of biofuels, organic waste, and wood derived fuels, currently accounts for more than half of US energy renewable consumption and does not appear to offer a significant safety benefit to US workers relative to fossil fuels.

“The energy sector remains one of the most dangerous industries for US workers. A transition to renewable energy generation utilizing sources such as wind and solar could potentially eliminate 1300 worker deaths over the coming decade,” says Dr. [Steven] Sumner.

A common rap against renewable energy is that it is more costly to produce. But this new research actually shows that when the hidden costs of energy production (worker injuries and deaths, environmental costs, etc.) are taken into account, those savings evaporate.

Risk of workplace injury and death among energy workers is a hidden cost of energy production, known as an externality of energy. Externalities of energy production include a whole host of problems from damage to the general environment to adverse effects on human health caused by pollution to injury and death among workers in the energy sector.

The researchers reviewed the occupational cost of energy production in the traditional and new energies and noted that while fossil fuel energies have historically been priced lower than renewable energies, the additional hidden costs, or externalities of energy, especially adverse effects on human health have often not been taken into account.

 

 

The trend continues, according to the Las Vegas Sun:

Since October, the number of people waiting to have a claim processed has jumped more than 30 percent, from about 556,000 to 736,000 last month. Although most of those initial claims will be denied, many will end up before an administrative law judge on appeal. Nearly 750,000 people are waiting for a hearing before overwhelmed judges.

Now  according to the newspaper, there's evidence that some overloaded administrative law judges, who hear Social Security Disability cases on appeal, are being forced to take shortcuts to meet quotas.

The Social Security Administration requires that administrative law judges hear 500 to 700 cases a year, which many judges are saying is an unrealistic caseload. The growing backlog is making the burden even harder to bear.

Ultimately, disabled workers are suffer and will continue to suffer until the system is overhauled.

“No one ever says, ‘do a sloppy job,’ ” said Marilyn Zahm, executive vice president of the Association of Administrative Law Judges. “But to pretend you can keep pumping out decision after decision and spend the requisite amount of time on each case is foolish. That’s shortchanging people, and the system will lack integrity if you do not require everyone to do a good job.”

“Corners are being cut in order to accommodate a backlog and at the end of the day everyone is going to suffer,” she said. “People have a right to expect due process ... At a certain point, no more corners can be cut.”

The fear, she said, is that legitimate claims may be rejected or fraudulent claims accepted in the rush to do business.

Indeed, the pressure and disciplinary threats have caused some judges to take shortcuts, Zahm said.

“Hearings are being shortened, not all information in the file is being reviewed, not all medical reports are being obtained, and full and legally defensible decisions may not be rendered, either because due consideration hasn’t been given or the decision is poorly written,” she said. “When people have too much work to do in the amount of time allotted to do it, you get sloppy work.”

The Social Security Disability can't continue to function this way. If the system isn't overhauled -- if more administrative law judges aren't hired and trained -- to hear cases, more legitimate claims will be denied. And disabled people will have to go through multiple layers of appeals before receiving the benefits to which they're entitled.

Tommy Thompson, a 41-year-old Albermarle man, has a doozy of a tale regarding his experiences with the Social Security Administration.

Thompson, who was born with a partial arm on one side and no arm on the other, started collecting $700 per month in Social Security Disability payments six years ago. Two years ago, Thompson got a teaching job and informed the Social Security Administration to discontinue his payments.

But Social Security told him by law the payments had to continue for nine months in case the job didn't work out. Then in December SSA told him they'd overpaid him $192.

Thompson thought he'd gotten the mess straightened out after visiting his local Social Security office and meeting with an employee there who told him he didn't owe the money after all.

But four months later, another bill arrived for $722.

Turns out that one was a mistake too.

For the moment, it looks like the matter is settled and Thompson won't be asked again to repay any money to the Social Security Administration.

But you never know...

For Thompson's full story and to watch an interview about his experiences, visit WSOC Action 9.