What’s Happening to North Carolina’s Workers’ Compensation Act? (Part III)

In Part I and II of this series we discussed the legislative power shift in 2010 and identified four significant changes.  Here are some more legislative changes, all imposed after 2010:

5.   Even If The Claim is Denied the Employer Can Still Get An IME.

Before 2010, although an employer might be able to get the employee’s medical records once the claim was filed, if the claim was denied the employee took the position that the employer had no right to force the employee to go to an insurance-selected physician for an IME.  That has now changed.

6.   In Second Opinion Rating Evaluations Certain Medical Evidence Can Be Ignored.

An employee has an absolute right to get a second opinion about the extent of a permanent injury, if dissatisfied with the impairment rating given by the insurance-selected treating physician.  Occasionally, this new physician, who was selected by the employee, would make a medical finding that the employee needed further medical treatment or would diagnose another medical condition that had not been evaluated by the treating physician.  This new information would be the basis of a motion to the Industrial Commission for additional medical care.  New legislation states that as to any opinions unrelated to the rating the Commission “must either disregard or give less weight” to these medical opinions.

7.   Restrictions on the Ability to Change Physicians.

Before 2010, the employee had the right to petition the N.C. Industrial Commission to change physicians.  Occasionally there were personality conflicts between the employee and the insurance-selected physician, or the physician would be ignoring certain complaints, or not reporting the complaints in the medical records.  When these matters were brought to the attention of the Executive Secretary’s Office, the Commission had the discretion to authorize a change of physician.  New legislation now requires that the Plaintiff prove by a “preponderous of the evidence” that a change is necessary.

8.   Greater Difficulty Getting Second Opinion for Employee.

Before 2010, the employee could select a physician for a second opinion examination and request the Industrial Commission to approve this physician.  Now the employee must first request approval “in writing” from the employer and attempt to jointly agree on a new physician.  If this effort fails, then the employee can seek approval from the Industrial Commission.  This new procedure is a roadblock to allowing the employee quicker access to a different medical provider.

 

Part IV of the series will discuss other changes, including administrative changes, to the Act.  Stay tuned.

 

 

 

Ladder Accidents on the Rise

When my husband and I purchased our home, we immediately bought a forty-foot ladder because obviously we would be cleaning our own gutters and needed the biggest ladder possible to reach the roof. Our first attempt to use the ladder was miserable. We could barely lift the ladder. After a few pathetic attempts to use the ladder, we realized this was a stupid idea and outsourced the job to professionals. Looking back now, it was crazy to even consider using the ladder given the sloped terrain of our yard and given the height of the home. 

According to the American Journal of Preventive Medicine, ladder accidents are on the rise in the United States. From 1990 to 2005, reported ladder accidents increased fifty percent (50%). That’s over two million people, or 136,000 people a year, treated for injuries sustained while on a ladder. Despite the risk of using a ladder, it seems that many still do not follow common safety precautions. The four main problems are: (1) selecting the wrong type of ladder, (2) using old or damaged ladders, (3) incorrect use of ladders, and (4) incorrect placement of ladders.

In my situation, we were likely using the wrong ladder, incorrectly, and certainly did not have it correctly placed. We’re lucky we didn’t end up in the ER. Ladders need to be treated like any dangerous tool. OSHA recommends significant training before allowing employees to use ladders. According to the Bureau of Labor Statistics, fifty percent (50%) of all ladder-related accidents were due to individuals carrying items as they climbed.  To avoid a potentially life-changing injury, encourage your friends and family to practice ladder safety. Avoid using a ladder alone, and always make sure you are using the correct ladder and have it set up properly.

 

What’s Happening to North Carolina’s Workers’ Compensation Act? (Part II)

 

In 2010 after the Republican Party took complete control of the legislature for the first time since 1898, changes to the system began. As death benefits and funeral expenses were being increased, along with an increase in wage loss benefits, current injured workers were told that new proposals would not affect their claims. True enough, but anyone who was injured after June 24, 2011 would see some fairly drastic changes in benefits:

 

  1. 500 Week Cap On Total Disability Benefits.
    Absent extroardianry circumstances (such as a brain injury) disability benefits would stop after 500 weeks (9.6 years). Thus, for a 25-year-old severely injured person who did not meet one of the exceptions, total disability benefits would stop at age 34 or 35, even though this person could no longer obtain employment in the competitive market place and had been out of the workforce for nearly a decade. For these disabled and unemployable people, the future cost of the injury will be shifted away from the workers’ compensation insurance company to the U.S. taxpayer, through Social Security and Medicare. Before this change, as long as the employee was disabled and unemployed because of his injury, he would be entitled to lifetime disability and medical benefits related to the injury.
  2. Employer Gets Credit For Social Security Retirement BenefitsIf benefits are extended beyond 500 weeks, the employer can reduce workers’ compensation  by 100% of Social Security retirement benefits. This change gives the  insurance carrier a huge financial break at the expense of the elderly and disabled who have earned retirement income.
  3. Even Catastrophic Injury Benefits Can Be Terminated If a person is disabled from a workplace injury because of a spinal injury, brain injury, or serious burns to 33% of the body, then they can get lifetime disability benefits. However, if the employer can show that this individual can return to “suitable employment” then those benefits can be terminated or suspended.
  4. New Definition of Suitable Employment After Maximum Medical ImprovementIn the above context, suitable employment means employment that the employee is capable of performing, considering his pre-existing and injury-related physical and mental limitations, vocational skills, education and experience, and is located within a 50 mile radius of the employee’s residence at the time of injury or elsewhere if there was a legitimate reason for leaving. [Before leaving the Tarheel state, be sure to get approval that the move is legitimate. Otherwise, you may get a job offer that is within the 50 mile job radius.]

Part III will discuss further changes to the workers’ compensation system. Stay tuned.

What’s Happening to North Carolina’s Workers’ Compensation Act? (Part I)

In this four-part series we will take note of specific changes to the Workers’ Compensation  Act in North Carolina since 2010, when the Democrats lost control of the Legislature. The Act was created in 1929. Its purpose was to take care of the human wreckage caused by workplace injuries and to make the employer pay for these injuries as a cost of doing business. In exchange for this new no-fault system, the employee gave up the right to sue the employer in civil court and the right to a jury trial; damages for pain and suffering were not allowed; and the employee got limited but supposedly quick payment of disability benefits. The employer paid for 100 percent of medical care, but was given the right to select the medical providers.

 

In 2012 Republican Pat McCrory, the former mayor of Charlotte and a Duke Power employee for many years, was elected governor.  The Democrats had been in control of the state for decades and prior to 2010 Democratic governors had appointed all the  current Commissioners (7) to the Industrial Commission, and  most Deputy Commissioners (20)  were hired by the Democratically appointed Chair of the Commission.  North Carolina has always been a business-friendly state, and before 2010 it was consistently ranked in the top five as one of the best places to do business. It’s a “right to work” state and although some unions are present, the state has always been considered anti-union.

 

From time to time pro-business Democratic legislators would attempt to overhaul the Workers’ Compensation Act. Major legislative changes were made in 1994, for example, and various amendments have been made since then, nearly always initiated by the business community. In 2008 when the national economy crashed, North Carolina’s went with it and what was left of the old manufacturing base of tobacco, furniture and textiles took a nose dive. Unemployment soared to 11.4% by 2010. Fewer employed workers meant fewer claims, less losses and relatively low premiums for workers’ compensation insurance. Wages are relatively low in this state, and you only get two-thirds of your average weekly wage. Additionally, there is a cap on the amount of weekly  disability benefits that can be recovered. For instance, in 2010 the maximum benefit was $834 per week or $43,368 per year (if you had a job paying $86,000.00 per year, plus other benefits,  that’s nearly a 50% drop in income as a result of the workplace injury). If you had a low paying job ($7.20 an hour for 40 hours), your disability rate would be $193.34 per week.  Once the compensation rate is set it never goes up, no matter how many years you may be disabled.

 

With this background in place as the new legislature came in, it immediately began to make changes to the system. Two of the changes were good for injured employees : (1) death benefits went from 400 weeks to 500 weeks, along with an increase in allowed funeral expenses from $3,500 to $10,000.00, and (2) wage loss claims (where an employee goes back to work but at a reduced rate of pay) went from 300 weeks to 500 weeks.

 

The next blog (Part II) will show other significant changes to the system.  Stay tuned.

 

Injured Workers Fear Losing Jobs After Getting Hurt On the Job

One of the first questions injured workers frequently ask is “Will my employer fire me for getting hurt at work?” Answer – legally, they cannot. The North Carolina Retaliatory Employment Discharge Act (REDA) strictly forbids an employer from firing an injured worker for filing a workers’ compensation claim.  

However, that doesn’t stop an injured worker from worrying and stressing over how the accident will affect his or her job with the employer. The added worry and lack of understanding of the Workers’ Compensation Act by both parties sometimes leads to confusion, doubt, and unnecessary stress. Occasionally an injured worker with a serious accident will decide not to file a claim because s/he is worried about how it will affect his/her relationship with the employer. Both sides can lose when this happens. The employee is now stuck with significant medical bills and the employer runs the risk of losing a very good worker.

The Workers Compensation Research Institute (WCRI) recently published an article confirming the stress encountered by many injured workers. The study found that workers who are concerned that they may be fired after filing a workers’ compensation claim have longer disability durations than workers who feel secure in their employment. These workers were also less satisfied with their medical care.

Despite the fact that the Workers’ Compensation Act is a no-fault system, it’s clear that injured workers and employers could use ongoing education about workers’ compensation claims. When an injured employee is able to return to work, and feel secure about his/her position with the company, everyone wins. 

Supreme Court Rules in Favor of Electronics Plant in Poisoned Water Case

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

WASHINGTON — Landowners who say a North Carolina electronics plant poisoned their drinking water missed a filing deadline, the Supreme Court ruled on Monday.

The decision, in a 7-to-2 vote, is likely to affect similar suits from the families of thousands of former Marines over what they say was toxic pollution at Camp Lejeune, also in North Carolina.

The case decided on Monday concerned a 1980 federal law that made it easier to sue over environmental contamination, which can be hard to discover and may cause symptoms only decades later. The law said state statutes of limitations do not begin to run until plaintiffs learn of, or should have discovered, the harm in question.

The plaintiffs in Monday’s case said their drinking water had been contaminated between 1959 and 1985 by a plant in Asheville, N.C., run by CTS Corporation. They sued in 2011, after a 2009 report from the Environmental Protection Agency.

Both sides agreed that the suit was not barred by North Carolina’s statute of limitations. The question for the justices was whether a separate state law — a 10-year so-called statute of repose — was displaced by the 1980 federal law.

Justice Anthony M. Kennedy, writing for the majority, said no. The second state law, which started to run when CTS took its “last culpable act,” barred the suit, he wrote. CTS sold the Asheville property in 1987; the plaintiffs did not sue until 24 years later.

Justice Kennedy relied on a congressional…

[Click here to see the rest of this post]

Transitional ‘Light’ Duty Jobs: What Are They and Do I Have to Take One?

Today’s post comes from guest author Brody Ockander, from Rehm, Bennett & Moore.

When injured at work, your doctor may give you work restrictions that prevent you from returning to your regular job. In these situations, there are three things your employer can do:

  1. Tell you that they have no jobs within your restrictions
  2. Give you a transitional duty (or “light duty”) job within your restrictions
  3. Force you to work your regular job in violation of your restrictions

If it’s #3, call a lawyer immediately and inform your doctor that your employer is not following the doctor’s orders.

If it’s #1, you would be taken off work and you would be entitled to workers’ compensation benefits for temporary disability until you are released back to work or until your employer accommodates your work restrictions.

If it’s #2, it not always clear what the result will be. This “transitional duty” option is when your employer returns you to work but not at your normal job. Instead you are given a different, temporary job while you are on restrictions.

Problems arise with these transitional jobs when your hours are cut, your pay is cut, or you are asked to do a job that is unreasonable. Often, if you refuse to work a transitional duty job that is in your restrictions, you could forfeit your right to obtain work comp payments for temporary disability while you are on those restrictions and off work.

If the transitional duty job that is offered to you cuts your hours, you will probably be entitled to temporary disability payments in an amount to make up (somewhat) for the difference in what you were making before the incident that caused the injury and what you are now making in your transitional job.

Similarly, if your hourly rate or your wages for your transitional job are less than what you would have been earning before you were injured, you would again be entitled to temporary disability payments in an attempt to make up for the shortfall.

Where transitional duty jobs have a gray area is whether they are truly reasonable jobs that are being offered. For example, there are horror stories of employees working in the near dark for 8 hours per day or working in appalling conditions sorting paperclips for transitional duty. Whether or not you have to take a job like these horror stories without forfeiting your right to temporary disability payments depends on the facts of each specific case.

Click the link – it’s about a Walmart guy who had to do “light duty” in the bathroom for 7 hours a day: http://www.aol.com/article/2014/05/27/wal-mart-employee-claims-he-was-forced-to-spend-7-hour-shift-in/20893585/?icid=maing-grid7%7Chtmlws-main-bb%7Cdl28%7Csec1_lnk3%26pLid%3D481058

Generally speaking, however, if you are offered a transitional job within your restrictions, you should probably take that job unless you have a very good reason that you cannot. For example, in at least one Nebraska case, the court held that even having an employee relocate 300 miles for a temporary transitional job was considered a reasonable job offer. Even transitional jobs that are during different shifts than your normal shift may be considered reasonable. If a job is reasonable and you do not have a good reason for not accepting such a transitional job, you could be denied temporary benefits and be left without any pay at all while attempting to recover from your work injury.

If you have a job that sounds unreasonable, and you are contemplating whether or not you are required to accept such a job, contact a lawyer. An experienced lawyer will be able to give you a good idea of whether turning down such a job would allow your employer to deny you temporary disability payments or not.

Why We’re Still Killing Workers in the USA

Today’s post comes from guest author Jay Causey, from Causey Law Firm.

The AFL–CIO’s annual report on job fatalities is out, and provides some interesting fodder for thought.

It’s no surprise that North Dakota – – with its “wild West” environment for oil and gas extraction on the Bakken Shale was the most dangerous place – – with 17.7 deaths per 100,000 workers versus the national average of 3.4.

Nationally, 4600 workers died on the job in 2012. While that number has fallen since safety laws were implemented in the 1970s, the decline has flat-lined over the most recent decade. It was 4.2 deaths per 100,000 workers in 2006, now still at 3.4 in 2012.

The AFL–CIO report contains maps that reflect part of the reason for the stall-out: the vast majority of the states with the highest fatality rates contain the 8 million workers in states with no federally approved OSHA safety and health plan. The report graphically portrays another salient fact: the number of federal OSHA inspectors per 1 million workers has fallen from a high of 15 in 1980 to 6.9 in 2013.  OSHA has been so underfunded over recent years that it would take an average of 139 years for available OSHA inspectors to visit each workplace in their jurisdiction just once. (In some states that number is even more staggering – – 521 years for South Dakota.)

The AFL-CIO report reflects some other interesting facts concerning the demographics of workplace fatalities – – not surprisingly, being foreign-born or Latino puts a worker at a higher risk of fatality, and homicide was the number one cause of death for women in the workplace in 2012.

But, getting back to the “oil patch” in North Dakota, we see other disturbing trends in the culture of workplace injury that accompany the decreasing application of safety regulation. With job growth tripling in North Dakota’s oil patch since 2007, while workers’ compensation filings are up, many injured workers are encouraged by employers in the extractive industries not to file, with many companies working out sidebar deals with injured workers. Injury rates are being kept artificially low by rewards for not reporting. As the AFL–CIO’s safety chief, Peg Semenario, has said, underreporting warps national safety figures in an industry that is already notoriously opaque.

And the culture of creating false indicators of workplace safety will likely have tremendous implications down the line when the 2000 tons of silica-rich sand used in the cement casing of each fracking well begins to work its way into workers’ lungs. NIOSH reported in 2012 that 92 of 116 air samples at franking sites exceeded the recommended safe levels of silica, which can lead to incurable, irreversible lung disease.

 

 Photo credit: Craig Newsom / Foter / Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)