Category Archives: Workers’ Compensation

File a Workers’ Comp Claim – Get Fired

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

A new study from the Workers Compensation Research Institute (WCRI) indicates trust or mistrust in the work relationship plays a significant role in the outcome of a workers’ compensation claim.  In a recent benchmark study in Iowa by WCRI, almost four out of ten workers interviewed reported they were concerned they would be fired or laid off after they were injured. 

The Iowa study reflects similar results in Wisconsin and other benchmark states.  All workers who were interviewed received workers’ comp benefits and experienced more than a week of lost work time.  Additional findings noted two-thirds of the injured Iowa workers had other health conditions (having smoked for ten years or had diabetes or lung conditions).  Obviously those with significant pre-existing conditions had predictably worse results.

Workers’ Compensation Medicare Set-Aside Accounts and Supplemental Coverage

When an injured worker is a Medicare beneficiary due to age or disability, a Workers’ Compensation Medicare Set-Aside (WCMSA) account will often be required as part of a settlement  of their workers’ compensation claim.  The funds in a WCMSA are set-aside in order to pay for future medical or prescription drug services related to the work related injury, illness, or disease that would normally be covered by Medicare. Once the funds in a WCMSA have been used appropriately, then Medicare can start paying for Medicare-covered services related to the work-related injury, illness, or disease. The WCMSA cannot be used to pay for any medical items or services that Medicare does not normally cover.

Workers’ compensation insurance provides 100% coverage of medical treatment for accepted medical conditions. Medicare, however, requires an 80/20 sharing of medical costs. Without a Medicare supplemental (also called “Medigap”) insurance policy, the injured worker would be required to pay significant co-pays and deductibles.  Supplemental insurance is not required by Medicare, but may be advisable to cover the cost sharing required by Medicare, especially if the beneficiary has other medical conditions that are not related to the work injury, illness or disease. However, the premiums for such supplemental coverage cannot be paid out of the WCMSA funds.

While Medicare does not provide coverage for prescription medications, WCMSA funds can be used to pay for medications related to the work injury, illness or disease. If there is a likelihood that the injured worker will exhaust the funds in their MSA, then purchasing a Medicare Part D prescription drug plan may be advisable to prevent the injured worker from having to pay full price for their medications once the MSA funds are exhausted. However, the financial benefit of having this coverage should be weighed against the cost of plan (2013 national average was $30.00 per month) since the MSA funds cannot be used to pay for the plan itself.

 

For more detailed information about workers’ compensation MSAs and supplemental coverage, visit www.Medicare.gov.

 

Are You Misclassifying Your Workers and Committing A Fraud?

To avoid misclassifying your workers follow these tips:

  • Don’t make assumptions. If you are a business owner you should consult a tax professional and an attorney to ensure you are complying with IRS and labor laws when hiring staff or contractors.
  • If contracting with staffing companies or labor brokers, make sure those agencies are properly classifying its workers as employees. Companies can be held responsible for labor violations of their contractors.
  • Consider filing a SS-8 Form (Determination of Worker Status) with the IRS and ask that agency to determine whether the worker is an employee or independent contractor.
  • Be aware that contractors set their own schedules and pricing, and perform the work as they see fit. If you want control over these areas, make sure you hire an employee.
  • Check the workers’ compensation policies of any subcontractor you hire. (Look out for “ghost policies,” which aren’t designed to cover known employees.)
  • Don’t rely on excuses such as “He only works a few days a week.” “She agreed to be an independent contractor.” “They use their own tools.” “He’s done this for so long he doesn’t need my supervision.”

Thanks to McClatchy DC!

 

Number of N.C. Work-Related Deaths Nearly Doubled in 2014

The number of workers killed last year on the job in North Carolina has nearly doubled according to the state Department of Labor. A total of 44 people were killed in work-related accidents, all but one of the workers was classified as male, and all of the deceased workers were classified as “laborers” by the Labor Department. In 2013, there were only 23 deaths.

Labor Commissioner Cherie Berry analyzed the deaths and found that many accidents occurred between 60 and 90 days on the job, and a few workers were killed on the first day of their employment. This is largely related to lack of proper safety training before starting construction jobs.

In order to combat this increasing statistic, Builders Mutual Insurance Company worked with Commissioner Berry to create public service announcements about common hazards on construction sites. These ads are aired on Univision, and will be aired through March of this year.

Original Article found here:  http://www.newsobserver.com/2015/01/22/4496586_number-of-nc-workers-killed-on.html#storylink=misearch

Help for Chronic Pain Patients

According to a recent news article by Rachel Noble Benner, a mental health counselor, chronic pain is defined as pain that lasts longer than three months. It affects more than 100 million sufferers in the United States alone, and for those who suffer from chronic pain caused by an illness or injury it may seem as if there is no end in sight to their misery.

Chronic pain is not merely one symptom or a limited experience like acute pain; it is usually accompanied by depression, fatigue, changes in appetite and trouble sleeping. It can hold sufferers back from wanting to socialize with family and friends, and it reduces their quality-of-life.

Chronic pain requires treatment by physicians using a holistic approach in order to relieve symptoms. Physical therapists should be able to reactivate injured muscles and retune a hyper-excited nervous system; exercise will help recover a patient’s nervous system by re-teaching nerves the difference between normal and harmful sensations, and counseling on a regular basis should help establish strengths, manage depression and anxiety, and develop relaxation techniques.

 

Original post in the Washington Post by Rachel Noble Benner

Reposted in News & Observer 1/20/15 http://bit.ly/1J3vquV

 

 

Medical Procedures: What do they cost?

Blue Cross Blue Shield has created an online pricing tool to help patients compare prices of about 1,200 non-emergency medical procedures. Patients can now search for the best financial deal for services offered within North Carolina.

 By exposing this previously undisclosed information, patients are now able to go and see services according to the databases average procedure costs. The pricing tool also reveals the most expensive and most affordable option for each procedure.

In order to look up costs and doctors available to preform your procedure, you first access the pricing tool at: http://www.bcbsnc.com/content/providersearch/treatments/index.htm#/ . Then, you enter the treatment or service you would like in the first blank, your current location, and how many miles you are willing to travel for the service. Once you have entered all of this information, you just click search and your results will be immediately displayed. You can organize your results by cost, provider name, or distance.

 

To see the original article by John Murawski in The News and Observer explaining the pricing tool, click below:

http://www.newsobserver.com/2015/01/31/4516241_blue-cross-pricing-tool-could.html#storylink=misearch

Pacific Topsoils Fined $199,000 for Safety Violations Related to Death of 19-year-old

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

The Department of Labor & Industries (L&I) has cited an Everett company for multiple safety violations related to the death of a worker last July. Nineteen-year-old Bradley Hogue was killed by a rotating auger while working inside the hopper of a bark-blower truck at a Duvall home.

Pacific Topsoils has been cited for two willful and 14 serious violations, with penalties totaling $199,000. The employer has also been identified as a severe violator and will be subject to follow-up inspections to determine if the conditions still exist in the future.

“The loss of this young man’s life is a tragedy that could have been prevented if the employer had followed basic safety and health rules that protect workers from moving machinery,” said L&I Assistant Director Anne Soiza. “We hope this citation and the penalties serve as a deterrent so that nothing like this ever happens again.”

Following the July incident that killed Hogue, L&I issued a bark and mulch-blower hazard alert to warn others in the landscaping business of the danger of working in hoppers while the equipment is running.

The L&I investigation found that Pacific Topsoils’ workers were regularly assigned to clear jams in the bark-blower truck hoppers while the hoppers were operating. This exposed them to three very hazardous elements: a floor conveyor belt, two rotating-screw conveyors (angled augers) and a rotating stir rod. Exposure to any of these parts of the equipment could potentially result in entanglement, causing severe crushing injuries or death.

Working in and around this type of extremely hazardous equipment requires “lockout/tagout” safety procedures to prevent machinery from starting up or moving during service or maintenance by workers.

The employer was cited for two willful violations. The first was issued for not ensuring lockout/tagout procedures were regularly used; it carries a penalty of $56,000. The second willful violation was issued for not training the employees in the proper use of those critical procedures; it carries a $52,000 penalty.

Additionally, working in the hopper of bark-blower trucks exposed workers to “confined space” hazards. Confined spaces, like hoppers, are areas large enough to accommodate a worker, but aren’t designed for continuous employee occupancy and have limited ways to enter or exit.

When a confined space has one or more hazardous characteristics, such as moving machinery or a potential for engulfment that may harm workers, it’s considered a “permit-required” confined space. That means employers must control access to the area and use a permit system to prevent unauthorized entry. Anyone working in or around a permit-required confined space must be trained and there must be safety measures and rescue procedures in place.

Twelve of the serious violations cited were for failure to implement safe work practices when entering a permit-required confined space. Two other serious violations were cited for not having an effective accident prevention program and for failure to document lockout/tagout procedures. Each of these violations carries a $6,500 penalty.

A willful violation can be issued when L&I has evidence of plain indifference, a substitution of judgment or an intentional disregard to a hazard or rule. A serious violation exists in a workplace if there is a substantial probability that worker death or serious physical harm could result from a hazardous condition.

The employer has 15 working days to appeal the citation. Penalty money paid as a result of a citation is placed in the workers’ compensation supplemental pension fund, helping workers and families of those who have died on the job.

For a copy of the citation, please contact L&I Public Affairs at 360-902-5413. 

Health Care Testing: A New Frontier for Worker’s Comp

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

As a worker’s compensation lawyer, I see many news stories through the prism of how the news event or trend will affect injured workers in the worker’s compensation system. A federal judge in Minnesota has ruled that Honeywell, Inc. can begin penalizing workers who refuse to take medical or biometric tests. 

The EEOC had claimed Honeywell’s policy violated the Americans With Disabilities Act and the Genetic Information Nondiscrimination Act. They filed a lawsuit in Minneapolis on behalf of two Minnesota employees of Honeywell.

The tests Honeywell required their employees to take measured blood pressure, cholesterol, and glucose, as well as signs that employee had been smoking. Employees who declined to take the test could be fined up to $4,000 in surcharges and increased health costs. Honeywell said the program is designed to “encourage employees to live healthier lifestyles and to lower health care costs.” Honeywell says the testing promotes employee well-being. Management also indicated “We don’t believe it’s fair to the employees who do work to lead healthier lifestyles to subsidize the healthcare premiums for those who do not.”

The ramifications of such testing for worker’s compensation immediately come to mind. In any kind of an occupational exposure claim, such tests could be used to help deny worker’s compensation claims for employees who smoke, are overweight, have diabetic condition, claims involving occupational back conditions, carpal tunnel claims, and any kind of respiratory complaints. Another “slippery slope” may be the use of these kinds of testing to actually screen prospective employees, since the employer rationale would be that hiring folks with those pre-existing conditions would cost the employer more money.