Foreign nationals working on behalf of the U.S. government "have gone without medical treatment and compensation because they were never informed of their right to the benefits. Widows and children have not received death payments for the same reason," according to the newspaper series.
 

Rey Torres dreamed of a better life for his wife and five children when he left a neighborhood of wooden shacks and burning trash piles to drive a bus on a U.S. military base near Baghdad.

He hoped to send his children to college and build a new home with the $16,000 a year he earned in Iraq — four times what he could make in the Philippines.

Then, in April 2005, Torres, 31, was killed in an ambush by Iraqi insurgents. His widow and children were supposed to be protected by a war zone insurance system overseen by the U.S. government. They were eligible for about $300,000 in compensation.

But Gorgonia Torres knew nothing about the death benefit and did not apply. When she did learn about the insurance, two years later, it was from a reporter. She has since turned down an insurance company's $22,000 settlement offer. Her only hope of receiving full compensation is a legal fight that could drag on for years.

Torres was among tens of thousands of civilian contract workers from poverty-stricken countries hired to support the U.S. war effort in Iraq and Afghanistan. In case of injury or death, they are supposed to be covered by workers' compensation insurance financed by American taxpayers. But the program has failed to deliver medical care and other benefits to many foreign workers and their survivors, a Los Angeles Times-ProPublica investigation found.

Foreign nationals aren't the only casualties in this federal debacle. Many American contractors also have struggled to get medical treatment and compensation for injuries they have suffered on the job. The Los Angeles Times and ProPublica have documented many of those cases

Applying for SSDI is a lengthy process and most claims are initially denied.

Paul Proto, who has been representing Social Security Disability claimants for more than 30 years, offers an insider's view into what it takes to get a Social Security Disability benefits claim approved.

Claims for Social Security disability benefits succeed, for the most part, on the state of the medical documentation contained in the claim file. There should be a clearly stated list of diagnoses provided by the treating physicians that interfere with full-time work activity. The record should contain medical test results that support the diagnoses. Social Security regulations refer to these as “medically acceptable objective, clinical and laboratory findings”. A person alleging back pain should be able to provide x-ray evidence of some level of disc degeneration. Someone suffering from rheumatoid arthritis can have blood studies consistent with that diagnosis. This might include positive ANA or “antinuclear antibodies”. Heart conditions that cause chest pain may demonstrate lack of oxygen to the heart (ischemia) through stress treadmill tests or EKG’s.

Regardless of the diagnosis, there should be some supporting documentation of a condition that can reasonably result in a condition that can cause the reported symptoms. This combination of symptoms and medical documentation of a condition that can cause those symptoms is only part of the equation however.

We know from experience that this can be a confusing and disappointing process for most sick and disabled people. That's why it's important to have a qualified Social Security Disability attorney or representative on your side, advocating for you to ensure that you get the benefits you deserve.

This is the first in the Deuterman Law Group's series of blog articles about alternative therapies for back injuries and pain management.

In this article, we’ll explore acupuncture, a centuries-old Chinese medicine technique that has been used to treat pain chronic pain, nausea, migraines and other painful conditions. Future articles in this series will explore reiki, massage, yoga, Pilates and other alternative treatments and pain-management techniques.

This article is presented for informational purposes only. As always, please consult with your physician and other health care providers before undertaking exercise regimen or alternative treatment.

The following is excerpted from the National Institute of Health’s National Center for Complementary and Alternative Medicine.

Acupuncture

Acupuncture is among the oldest healing practices in the world. Practiced for thousands of years in China, acupuncture involves the use of thin, solid, metallic needles inserted through the skin to stimulate various points on the body.

Acupuncture is based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Acupuncture is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles though the skin. It is intended to remove blockages in the flow of qi and restore and maintain health.

The report from a Consensus Development Conference on Acupuncture held at the National Institutes of Health (NIH) in 1997 stated that acupuncture is being "widely" practiced—by thousands of physicians, dentists, acupuncturists, and other practitioners—for relief or prevention of pain and for various other health conditions. According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by Americans, an estimated 3.1 million U.S. adults and 150,000 children had used acupuncture in the previous year. Between the 2002 and 2007 NHIS, acupuncture use among adults increased by three-tenths of 1 percent (approximately 1 million people).

During your first office visit, the acupuncture practitioner may ask you at length about your health condition, lifestyle, and behavior. The practitioner will want to obtain a complete picture of your treatment needs and behaviors that may contribute to your condition. Inform the acupuncturist about all treatments or medications you are taking and all medical conditions you have.

Acupuncture needles are metallic, solid, and hair-thin. People experience acupuncture differently, but most feel no or minimal pain as the needles are inserted. Some people feel energized by treatment, while others feel relaxed. Improper needle placement, movement of the patient, or a defect in the needle can cause soreness and pain during treatment. This is why it is important to seek treatment from a qualified acupuncture practitioner.

Treatment may take place over a period of several weeks or more.

Some insurance companies may cover the costs of acupuncture, while others may not. It is important to check with your insurer before you start treatment to see whether acupuncture is covered for your condition and, if so, to what extent.

Finding an Acupuncture Practitioner

Health care providers can be a resource for referral to acupuncturists, and some conventional medical practitioners—including physicians and dentists—practice acupuncture. In addition, national acupuncture organizations such as (which can be found through libraries or Web search engines) may provide referrals to acupuncturists.

The American Academy of Medical Acupuncture maintains a searchable database of physicians who offer acupuncture services. The National Certification Commission for Acupuncture and Oriental Medicine has listings of nationally certified acupuncture practitioners at its Web site.

Before making an appointment with an acupuncturist:

• Check a practitioner's credentials. Most states require a license to practice acupuncture; however, education and training standards and requirements for obtaining a license to practice vary from state to state. Although a license does not ensure quality of care, it does indicate that the practitioner meets certain standards regarding the knowledge and use of acupuncture. (You can search for licensed acupuncturists in North Carolina at the Web site for the North Carolina Acupuncture Licensing Board.)
• Do not rely on a diagnosis of disease by an acupuncture practitioner who does not have substantial conventional medical training. If you have received a diagnosis from a doctor, you may wish to ask your doctor whether acupuncture might help.

Now, a new book "The Retail Revolution: How Wal-Mart Created a Brave New World of Business" by Nelson Lichtenstein "offers the best account yet of the myriad problems that Wal-Mart employees endure, including the elaborate measures the company has taken to avoid paying workers' compensation to employees injured on the job," according to The Big Money.

Lichtenstein's is just one of several recent scholarly examinations of Wal-Mart's rise and the cost of its success. Go here to read a review of several Wal-mart books.

Two books mentioned in the blog are To Serve God and Wal-Mart: The Making of Christian Free Enterprise by Bethany Moreton and Lichtenstein's The Retail Revolution: How Wal-Mart Created a Brave New World of Business.

Many injured and disabled workers also will develop depression – creating a double whammy of physical and emotional pain that can prolong recovery and lead to additional health problems.

The stress and financial burdens of being out of work combined with physical pain and the loss of identity that many out-of-work people injured people experience quite often leads to associated depression, according to medical research and our own experience with clients at the Deuterman Law Group. Unfortunately, so-called secondary depression is often under diagnosed, according to a 2005 article in trade journal Risk & Insurance.

 It is important for anyone who is suffering from depression to seek treatment, especially those who have an injury or disability that prevents them from working. Studies have linked pain with depression, and there’s evidence that depression can slow recovery from an injury or illness.

“Depression may increase your response to pain, or at least increase the suffering associated with pain,” according to the Mayo Clinic. “Conversely, chronic pain is stressful and depressing in itself. Sometimes pain and depression create a vicious cycle,”

A 2005 British study revealed that 20 percent to 30 percent of people injured in car accidents or on the job had their recovery impacted by depression and other psychological factors.

In workers’ compensation cases, depression that is the result of a work injury may be compensable. In other instances, depressed individuals may qualify for Social Security Disability.

If a client is experiencing symptoms of depression, it’s important that they are evaluated by a qualified medical professional, who can prescribe a course of treatment that may include therapy, anti-depressants or a combination.

It’s also important that clients share this information with their attorney and paralegal, as this may be important to the case. We may be able to we may be able to offer additional help and referrals to a support groups, community resources and medical professionals who can help our clients deal with these problems and overcome their depression.

Only a qualified medical professional diagnose depression, but the following is a list of symptoms:

• Loss of interest in normal daily activities
• Feeling sad or down
• Feeling hopeless
• Crying spells for no apparent reason
• Problems sleeping
• Trouble focusing or concentrating
• Difficulty making decisions
• Unintentional weight gain or loss
• Irritability
• Restlessness
• Being easily annoyed
• Feeling fatigued or weak
• Feeling worthless
• Loss of interest in sex
• Thoughts of suicide or suicidal behavior
• Unexplained physical problems, such as back pain or headaches

The Mayo Clinic also offers a depression self-assessment tool online.

Most applications are denied the first time, and it often takes several rounds of appeals before a disabled person can begin collecting benefits. It's not unusual for people to wait a year or two to be approved.

Imagine what would happen if you were sick or disabled for a year or two, unable to work, with no money coming in. How would you pay for medical treatment? How would you pay your rent or mortgage? How would you cover your bills?

How many people are just one paycheck away from homelessness?

Consider the story of Maggie Dato, a disabled California woman out of work, evicted from her home, denied Social Security Disability benefits, facing mounting medical bills and living out of a camping trailer that she is about to lose.

Unfortunately, more people from all walks of like can probably identify with Deto these days. Mass layoffs have left hundreds of thousands out of work, and many are struggling to pay their bills and provide for their families even if they're receiving unemployment benefits. If they're struggling, how can injured and disabled people who can't work and who aren't receiving any benefits make it?

Arrigo got sick with a severe lung disease from inhaling vapors and toxic fumes at the cleanup site. He had to stop working in January 2008, but Zurich North America, the insurance company providing workers' compensation coverage for his employer, denied Arrigo's claim.

[Arrigo] called himself a poster boy for thousands of sick 9/11 responders caught between the slow-moving state compensation board and insurance firms that skillfully game the system to fight claims.

In addition to Arrigo's devastating illness, his family suffered incredible financial hardship as a result of his inability to work.

Ill and unemployed, Arrigo also fell behind on his rent. The family was evicted from their Staten Island home and forced to move into two cramped rooms with Arrigo's brother in Long Beach, L.I.

But this is a good news story. Arrigo this week won workers' comp benefits -- $400 a week plus $20,000 in back payments.

In his column, Blackburn explains that by setting an unreasonable fee schedule for attorneys who represent injured people in their workers' comp claims, Florida is guaranteeing that more and more deserving people will be denied medical benefits and financial compensation.

When the fee schedule was put in place:

the percentage of claims denied by insurers rose from one-fourth to more than one-third of all claims. The percent of cases in which the injured worker appealed the denial dropped considerably...

After the 2003 law change that made it harder to fight a denial of benefits, the insurance companies began deciding that 35 percent of the employees who get hurt in Florida had only an ouchie when they broke their arm or are trying to turn a hangnail into prostate cancer or are generally malingering.

 

A 2003 law set extreme caps on the amount attorneys could charge for their work on workers' compensation cases. The Florida Supreme Court struck down that law as unreasonable. But five days ago, Florida Gov. Charlie Crist signed a new law that places similar caps on attorneys fees in workers' compensation cases.

In the case that the Florida Supreme Court ruled on, for example, attorneys for a nurse seeking $3,200 in back wages and medical expenses for a back injury earned just $8 an hour for handling the claim because of fee caps. The opposing attorneys, who worked for the insurance company, collected $150 an hour.

The Miami Herald reported:

Trial lawyers, who opposed the new law, disagree. They say the fee caps will make it difficult for injured workers to find legal representation.

Paul Anderson, a board member for the trial lawyer group Florida Justice Association, has predicted more workers will be denied claims and will turn to taxpayer-supported public assistance programs to cover their medical expenses. He said the new law eventually will result in another legal challenge.

 

The Salt Lake Tribute reported on a spike in the number of independent contractors with one employer in Utah, which officials say is a sure sign that the so-called contractors have been misclassified.

In the most recent data available, Utah saw a steep one-year jump in the number of independent contractors who have only one employer -- a typical indicator that the worker has been misclassified, Bill Starks, state director of unemployment insurance, said. Two years ago, 200,000 independent contractors reported only to one employer. Last year, the number swelled to 300,000.

Plenty of people are legally classified as independent contractors. These people, often also called W9 employees or freelancers, perform work for a variety of different employers or clients, set their own hours and derive their income from multiple sources.

But many companies assign the "independent contractor" designation to employees. In doing so, they avoid having to pay for costly workers' compensation coverage to these workers though they are legally obligated to provide this protection.

There's a pretty good rule of thumb for knowing a worker's contracting status: If he only works with one company, that business sets his hours and the company's success is tied to the worker's success, the company should probably consider him an employee, not an independent contractor. That means that company needs to issue a W-2 tax form -- and pay taxes, Social Security and unemployment and injury insurance on the employee's behalf, at a cost of about 30 cents more on the dollar.

Tourists visit Las Vegas for the gambling and the glitz and glamour, and in recent years, many of the city’s older casinos have been demolished to make way for newer, bigger, glitzier models. And in a city that literally never sleeps, the pressure is on to get these buildings constructed quickly so that the casinos can reopen and start raking in the money.

Because of lax oversight by OSHA and state regulators, negligence at construction sites and safety shortcuts, twelve construction workers died in 18 months. But after Berzon's series, people in power took notice and took action. And the deaths ceased, proving that good public service journalism can make a difference. 

Construction workers had been dying at a rate of one every six weeks in the $32 billion building boom on the Las Vegas Strip. But deaths stopped last year after the Las Vegas Sun exposed serious safety flaws on the sites and detailed how lax oversight by safety regulators failed to prevent accidents.

The stories forced state and federal investigations and became the subject of hearings in the U.S. House and Senate. Sens. Barack Obama, Hillary Clinton, Ted Kennedy, Harry Reid and others sent a letter to President Bush demanding safety reforms in the Labor Department.

As the Sun pursued the story, the newspaper reported on cozy relationships existing between safety regulators and builders. Angered by the revelations and continuing death toll, workers walked off the job at MGM Mirage's CityCenter, shutting down the largest private commercial development in U.S. history until the contractors agreed to safety improvements.

Twelve workers had died in 18 months. But after the improvements, the deaths stopped. No workers have died since June 2008.

You can read the entire Las Vegas Sun series and follow-up stories at the newspaper's Web site, as well as view OSHA inspection documents and see video coverage. If you don't have time to read the entire series -- though I would encourage you to do so -- the blog The Pump Handle has a good summary.

Sadly, many of the tragic deaths that occured on Las Vegas Strip construction sites could have been easily prevented if construction companies had followed safety rules and provided adequate equipment to workers. Unfortunately, this is the case with many workplace injuries and deaths. Often, these "accidents" are easily preventable, but so many times employers fail to follow the rules fail to provide their employees have proper tools and equipment that will keep them safe.

In Las Vegas, for example, many workers died because there were working without safety nets. These nets are supposed to be used every two floors, but in the zeal to finish the casino construction jobs quickly -- and on budget -- some construction companies scrimped on this simple, yet crucial, piece of safety equipment.

They were in essence gambling with their employees lives. And even in a town like Vegas, no one likes those odds.

We're thankful that  the Las Vegas Sun and Alexandra Berzon spotlighted this deadly issue and we congratulate them on a much deserved Pulitzer Prize.

The Florida News Service reports:

A recent study by the Department of Worker's Compensation found litigation has declined since the restrictions imposed in 2003, while the number of denied claims has steadily increased.

This is clearly reform that has come at the expense of injured workers, while benefitting deep-pocketed insurance companies. Now, the Florida big business lobby is pushing for further workers' compensation reform that would cap how much attorneys could earn on workers' comp cases.

As is the case in North Carolina, Florida Workers' Compensation attorneys work on a contingency basis, meaning they don't collect a fee unless they win benefits for the client. That fee is generally a small percentage of the total benefits. Legislators in Florida are considering setting the bar so low -- $1,500 max -- that workers' comp attorneys would lose money representing injured workers.

Who loses if that happens? The attorneys, yes, but injured workers are the real victims. Because they could be earning as little as $8 an hour on workers' comp cases, many attorneys will stop accepting them. And that means that people who deserve compensation and medical benefits won't get them.

House Bill 903 resurrects a 2003 bill that resulted in workers' attorneys being paid as little as $8 per hour, which the Supreme Court ruled last year was unfair to workers.

Rich Templin, spokesman for the AFL-CIO, says workers are suffering from denied claims.

"They're losing their houses; they're losing their families; their losing their ability to provide health care for their kids, and they did nothing wrong. All they did was go to work and get hurt. But, because the insurance company wants to maximize its profit, these people are paying the price."

The proposed Florida workers' compensation reform is an outrage. It would victimize injured workers all over again in the name of cost cutting. Call on Gov. Charlie Crist of Florida to veto the legilsation.

Last week, Ousama Karawia, the owner of International Protective Services Inc., and two company vice presidents pleaded not guilty to charges that they defrauded the California State Compensation Insurance Fund of $9 million.

The men are accused of going to extreme measures to deceive the state about the number of people employed by the private security firm.

According to an LA Times article:

 

 

The men allegedly created a shell company, International Armored Solutions Inc., to hide the true number of employees at the security firm to avoid paying higher workers’ compensation insurance premiums to the State Compensation Insurance Fund.

Authorities said Karawia told state officials that he employed about 20 workers at the new company and that it was not part of the main security firm. The company failed to pay $9.5 million in workers’ comp premiums for its 1,500 employees, prosecut

 

 

Employer workers' compensation fraud, the most common type of fraud, costs not only injured workers but taxpayers, as well. In the event of an accident, workers' on-the-job injuries may not be covered if their employer doesn't have adequate insurance, as required by law. In those instances, the burden for caring for these hurt and disabled workers falls on taxpayers and social service agencies.

Some are speculating that because of the economy, high unemployment and record layoffs that have occured as a result of the recession, some workers may be afraid to report their injuries and claim workers' compensation benefits.

That chilling revelation is likely true for many people. Some workers may  fear that could be fired for reporting a work injury and trying to collect workers' compensation benefits, but the law clearly prohibits such retaliation.

Others may be worried about how they'll make ends meet while out of work and receiving workers'  comp benefits. That's a legitimate concern, as workers' compensation does not cover and injured person's entire salary.

However, failing to report a workplace injury is a bad idea, and it may jeopardize a worker's ability to collect benefits in the future. Workers should report injuries immediately to their employer -- and definitely within 30 days. The employer is required to report injuries to the North Carolina Industrial Commission.