Genetic Testing and Pain Medication

A former volunteer firefighter who sustained burns and partial amputation of his fingers on both hands continues to suffer from PTSD, flashbacks and sleep disturbances. His pain management physician has ordered a genetic study to help understand how he reacts to treatment based on his genetic factors.

Genetic testing in pain management is becoming more prevalent. Just as people have differences in hair color and eye color, people are also different in their responses to pain and to medications. Modern genetic medicine may be a viable way to explain the variability of personal responses to medication and predict more effective medications for patients. In identifying genetic risks and the most effective analgesic for individual patients, clinicians may be able to improve the efficacy of medication and decrease risks posed by medications, such as overdose, addiction and death. Another consideration for bioscience testing is the potential economic feasibility. Using oral samples or swabs could provide a dramatic price decrease for genetic testing.

One doctor provided the following tips to clinicians prescribing medications:

(1)    take the medication history of prior adverse or ineffective medication effects;

(2)    check for common potential interactions with opioids;

(3)    with new medications, check the patient’s metabolic pathway for activation or excretion issues;

(4)    be mindful of and evaluate potential interactions between drugs when adding new medications;

(5)    consider formal genetic testing to evaluate opioid choices and help predict potential opioid risks.

  

Changes to Hydrocodone Classification

According to the 2012 Center for Behavioral Health Statistics and Quality, nonmedical use of prescription drugs ranks as the second most common class of illicit drug use in the United States. After more than 10 years of debate and deliberation the U.S. Drug Enforcement Administration has made a ruling that provides significant changes to hydrocodone prescriptions, which are the most commonly written U.S. prescriptions.

Under the Controlled Substances Act, as of October 6, 2014 hydrocodone combination products (HCPs) will be reclassified to a Schedule II, which would increase the controls put on it. There is a five-category progressive classification for controlled substances and the scheduling categories are based on the degree of a drug’s potential for abuse or misuse. The purpose of this change is to minimize misuse/abuse of the drugs while still ensuring patients have access to medications needed to lessen their pain.

Some of the effects of the reclassification are:

(1) all hydrocodone prescriptions will now require a hard copy to be filled (telephone, facsimile, verbal or email orders will not be accepted);

(2) Schedule II medications will not have refills;

(3) HCP prescriptions issued before October 6 and that are authorized for refilling can be refilled until April 8, 2015.

Additional information is available at www.gpo.gov.

Injured Workers Win Class Action Lawsuit for Interference of Medical Treatment

According to The Denver Post (November 14, 2012), a 2009 class action lawsuit brought by 13,521 injured workers against Wal-Mart and its service providers settled for $8 million after a three-year fight. Colorado state law prohibits outside interference in determining medical care. The suit alleged that the defendants, including Concentra Health Services, went too far in controlling the medical treatment that injured workers are entitled to under Colorado’s Workers’ Compensation Act. Concentra operated medical facilities where the Wal-Mart employees received treatment.

Concentra must pay $4 million for its part in making it difficult for medical providers to make independent assessments on how to best treat workers injured on the job. The injured workers treated at a Concentra facility will each receive $520. Among other injunctive relief, Concentra agreed to provide more training for its sales and marketing force as to state laws that regulate and prohibit interference in how care is provided.

Increase in Wage Theft Claims

According to a recent article in The New York Times (Sept. 1, 2014), more workers are claiming wage theft by their employers. Worker advocates assert that violations of minimum wage and overtime laws, erasure of work hours and wrongful takings of employees’ tips are increasing in volume.

David Weil is the director of the federal Labor Department’s wage and hour division. Since 2010, Mr. Weil’s agency has uncovered almost $1 billion in illegally unpaid wages, with a disproportionate amount of immigrant victims. Weil believes the surge in wage theft is due to underlying changes in the national business structure. As large employers increase franchise operations as well as use of subcontractors and temp agencies, these companies deny any knowledge of wage violations.

A federal appeals court in California recently ruled that FedEx committed wage theft by labeling its drivers as independent contractors to avoid having to pay them overtime. New York’s attorney general, Eric T. Schneiderman, has recovered $17 million in wage claims over the past three years and in Nashville last February nine Doubletree hotel housekeepers were paid $12,000 in back wages owed by the hotel’s subcontractor. Wage theft is prevalent in North Carolina as well. According to the N.C Department of Labor 2012-13 Wage and Hour Bureau Annual Report, 4,244 complaints were investigated. Out of an estimated $2.4 million due, almost 73% of unpaid wages (over $1.79 million) were recovered for 2,168 workers. To file a wage dispute claim in North Carolina, contact the Department of Labor’s Wage and Hour Bureau at 919-807-2796 or 1-800-NC-LABOR.

1 month left for 9/11 responders to apply for workers’ comp

Today’s post was shared by Gelman on Workplace Injuries and comes from nypost.com

First responders and volunteers who helped with 9/11 recovery efforts have only a month left to register for future workers’ compensation benefits in case they fall ill.

More than 20,000 people could be eligible, but they must register before Sept. 12.

The registration effort is part of the New York State Workers’ Compensation Board’s “Tell Us You Were There” campaign, designed to protect those who helped after the World Trade Center attacks.

“Most people are eligible. You should file a WTC-12 form whether you were injured or not and whether you were employed or volunteered,” the board said. “This preserves your right to future benefits, should you ever need them.”

Previous legislation guaranteeing the workers’ comp expired Sept. 13, 2010. But last year, Gov. Cuomo signed legislation that extended the deadline and expanded the list of covered illnesses.

Now WTC workers or volunteers can get benefits if they develop psychological ailments or illnesses of the upper or lower respiratory or gastroesophageal tracts.

The WTC-12 registration form is available at www.wcb.ny.gov/WTC12. Anyone with questions can call (855) WTC-2014.

In addition to Ground Zero, qualified applicants can have worked at the Fresh Kills Landfill, on barges or piers or at morgue sites — as long as it was before Sept. 12, 2002.

So far, 40,737 people have filled out the form, said Joe Cavalcante, a compensation-board spokesman.

There have been 5,165…

[Click here to see the rest of this post]

Don’t Demean FMLA Leave

Today’s post comes from guest author Charlie Domer, from The Domer Law Firm.

Workers do not have many rights.  It’s an unfortunate mantra I recite to many of my injured worker clients.  Of course, union protections exist in certain settings.  Protections against discrimination and harassment exist if unlawful conduct occurs.  However, in most circumstances, Wisconsin employees are “at will” employment–meaning they can be fired for any reason or no reason at all.

An “at-will” employee who is forced to miss work for their own serious health condition (or for a child’s health condition) can face a difficult situation.  Missing work can put their employment status in jeopardy.   In these situations, the protections provided by the federal and state Family and Medical Act are crucial.  While FMLA leave only applies to certain employment settings (generally those with over 50 employees), the FMLA can provide job protection for a certain amount of unpaid weeks while an individual is out of work.

Given this invaluble security, a recent Milwaukee Journal Sentinel caused me concern (“Agency scrutinizes family medical leave in Milwaukee County“).  The article raised questions about the amount of Milwaukee County workers using FMLA leave.  The article certainly paints this type of leave in a negative light, even suggesting the potential “abuse” of this FMLA leave by employees.

 FMLA leave is unpaid leave.  Unless an employee has other available/accrued leave benefits, when they are off on FMLA leave, the employer is not paying wages.  The employee is off work, not getting paid.  Thus, FMLA provides some job protection for the employee, but the employee is not getting rich being off work.  I find it questionable that many employees are abusing a benefit that does not pay them anything.  Demeaning the FMLA is concerning.

 

 

 

 

Inmate to receive $30,000 for being placed in solitary confinement

Today’s post was shared by The Workers’ Injury Law & Advocacy Group and comes from www.post-gazette.com

A lawsuit settlement made public Tuesday brings to $386,000 the total paid by the state in relation to lawsuits stemming from the hazing of sex-crime inmates on the State Correctional Institution Pittsburgh’s F Block.

Robert Veith, 52, of the Hill District, is due $30,000 in settlement of his lawsuit claiming that he endured eight months of solitary confinement after he spoke out against tampering with another inmate’s food, according to his attorney, Steve Barth. Documents filed in U.S. District Court indicate that the case is voluntarily dismissed.

Veith, a repeat burglar, thief and robber, “spoke up against someone tampering with someone’s food who may or may not have been a pedophile,” Mr. Barth said. “He just said, ‘Hey, man, leave him alone.’ ”

That evening, according to Veith’s lawsuit, corrections officers Harry F. Nicoletti and Kevin Friess searched his cell and “assaulted him and he was slammed to the ground.” According to the lawsuit, Veith was then assigned to restrictive housing, in which the inmate leaves the cell for just an hour a day.

Five months into that punishment, then-Superintendent Melvin Lockett exonerated Veith of wrongdoing, according to the lawsuit. But Mr. Lockett was fired before Veith could be returned to the general population, and as a result the inmate lingered in solitary for three extra months, according to the lawsuit.

On F Block in late 2010, several corrections officers…

[Click here to see the rest of this post]

Florida Employers May Lose Their Limited Liability/Exclusive Remedy Defense

“Decimated.” That is the word the Honorable Circuit Court Judge Jorge Cueto used to describe what’s left of Florida’s Workers’ Compensation Act after a series of reforms, notably in 2003, which attacked injured workers’ rights and benefits. After 2003 Florida became one of the most restrictive workers’ compensation jurisdictions in the nation. As it currently exists, Florida’s Workers’ Compensation Act does not provide any benefits for permanent partial disability and medical benefits are very limited.

There is a delicate compromise between employees and employers. Employees give up potential negligence claims against their employer (including damages for pain and suffering) in exchange for access to medical care and disability benefits. Employers thereby avoid lawsuits and are protected from claims by their employees under what’s called the “exclusive remedy” defense. This is the essential trade-off of any workers’ compensation act.

So what happens when you take away almost all of the employee’s rights through legislative reforms every year? Well, according to Judge Cueto, employers lose their immunity for civil lawsuits by employees. As a result, employers may now be vulnerable to lawsuits from their employees for work-related accidents where the employer was negligent, and seek damages, including pain and suffering, from their employer.

It will be interesting to watch developments in Florida as they unfold. However, it should also serve as a reminder about consequences of stripping away injured workers’ benefits under delicately balanced workers’ compensation acts in the future.