Author Archives: Leila A. Early

The 12 Things You Must Do If You Are Hurt At Work

Today’s post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

Injured workers call me all the time asking me what they need to do to make sure they protect their legal rights.  If you are hurt on the job, whether it is due to an acute traumatic injury (like cutting yourself on a saw), cumulative-trauma injury (like carpal-tunnel syndrome) or some other job-related injury, there are several basic things you should do. If you do not do any of the things on the list below, you may lose your rights under Iowa’s workers’ compensation law. 

Although there may be rare exceptions to this list,  following it will leave you reasonably secure that your rights are protected:

  1. Report the injury. By “injury,” I mean almost any condition including but not limited to (a) an acute traumatic injury, (b) a cumulative-trauma injury, or (c) a disease or a hearing loss. You should report the injury to your supervisor or company nurse (for clarity we’ll just call these people your Supervisor from here on out), making clear your injury was caused by work. Under Iowa law, you need to make the report within 90 days of the date of your injury.
  2. Make sure your Supervisor prepares a company accident report.  If your Supervisor won’t prepare the report, Continue reading

Official Disabilities Guidelines Now Covers Diabetes

Today’s post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

While diabetes is not a work injury or illness, it can have a serious impact on the rate at which an injured worker recovers. For instance, people with diabetes may have a much harder time healing from a foot or leg injury. The latest edition of the annual Official Disabilities Guidelines (ODG) has been released, including the latest ODG volume on treating patients. ODG Treatment is the nationally recognized standard for medicine in determining the scope and duration of medical treatment in workers’ compensation.

For the first time this year, ODG Treatment includes a chapter on diabetes. According to the American Diabetes Association, there are nearly 26 million people in the United States who have been diagnosed with diabetes, and an estimated 7 million more people suffering who have not yet been diagnosed. Clearly, the implications of diabetes on workers’ compensation are significant.

Intoxication, Work, And Workers' Compensation Don’t Mix

Today’s post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

Most of us know that, for both professional reasons and in the interest of safety, remaining sober while on the job is essential. However, it is important to also recognize that workers who are intoxicated at the time that they sustain a work injury stand a far lower chance of ever collecting workers’ compensation.

If the blood test shows the presence of alcohol or drugs, odds that the employee will be able to collect workers’ compensation are much lower.

This is because of the intoxication defense: if an employer can prove that intoxication was the cause of the workers’ injury, then they employer is not required to provide workers’ comp for that injury.

Now, there are some notable Continue reading

Suicides in the U.S. Military: An Epidemic; What about Workers’ Compensation?

In 2012, suicides in the U.S. military were at a record high of 349, which was higher than the 295 American combat deaths in Afghanistan in 2012. This number is up from 301 in 2011. The Pentagon has had a difficult time dealing with this epidemic, which likely stems from military personnel being in combat for more than a decade in Afghanistan and Iraq, complicated by anxiety over being forced out of the military due to a “shrinking force.”

In 2011, 65% of soldiers who attempted suicide had a history of behavioral problems; however, only 45% of those who actually killed themselves had such a history. If there are signs that these service members were asking for help, they were not getting the help that they needed.

What’s interesting is that the U.S. military keeps statistics on suicides, and when the numbers go up to alarming rates the  hope is that something will be done to investigate. For years, workers’ compensation lawyers have heard about suicides from employees who did not get proper medical care, who could not handle the abuse that sometimes happens within the system, and who could no longer stand the pain of permanent injuries, disability and resulting depression. But where are the statistics on these deaths? The insurance industry either has this information or it could get it. As a matter of public policy, should they be required to report it?

PTSD and Police Officers at the Newtown Massacre

First responders may develop PTSD after a traumatic event.Post-Traumatic Stress Disorder (PTSD) is a type of anxiety disorder that can occur after a person has seen or experienced a traumatic event that involved the threat of injury or death. In civil war battles a soldier may be sitting next to his best friend when a cannonball takes off his friend’s head. The horror of such events put some soldiers out of action. Similarly, police officers have a higher incidence of PTSD/Anxiety Disorders than the general public due to the gruesome scenes and situations that they witness in their occupation. Classic symptoms of PTSD fall into three main categories: (1) reliving the event (such as nightmares and flashbacks); (2) avoidance (including feeling detached, numb, and avoiding things that remind them of the event); and (3) arousal (including difficulty concentrating, startling easily, and difficulty falling asleep).

Some of the police officers who responded to the shootings in Newtown, Connecticut are suffering from PTSD, calling it the worst crime scene they ever walked into. They are suffering from severe emotional distress and shock and have been unable to return to work due to the trauma they witnessed. Unfortunately, PTSD is not covered by workers’ compensation in Connecticut. Therefore they have been forced to use vacation and sick time to cope with the situation.

Our law firm has represented multiple police officers who have developed PTSD as a result of the gruesome scenes and situations they have been involved in at work. Fortunately, PTSD may qualify as an occupational disease under North Carolina workers’ compensation law. Hopefully the Connecticut legislature will amend their statutes in light of the school shootings to help these police officers get medical care and get back to work as quickly as possible.

The SMART Act and Workers’ Compensation

United States Congress

Medicare should not pay medical bills that are the primary responsibility of a third party. When they do, they want to be reimbursed, and all parties understand that concept, but the problem is the lengthy delays and lack of due process. The SMART Act, which was signed into law by President Obama on January 10, 2013, amends and reforms the Medicare Secondary Payer Act to improve the reimbursement process. It is located in Title II of H.R. 1845 and entitled “Strengthening Medicare Secondary Payer Rules.”

Section 201 requires CMS to maintain a secure web portal with access to claims and reimbursement information. Payments for care made by CMS must be loaded onto the portal within 15 days of the payment being made. The portal must also provide supplier or provider names, diagnosis codes, dates or service, and conditional payment amounts. Moreover, the portal must accurately identify that a claim or payment is related to a potential settlement, judgment or award. After several steps, the parties may download a final conditional payment amount from the website. If there is a dispute over the conditional payment amount, CMS must respond/resolve the dispute within 11 days or the proposed resolution by the claimant/applicable plan will be deemed accepted. In terms of appeals, CMS must draft regulations that give applicable insurance plans limited appeal rights to challenge final conditional payment amounts. This process will go into effect around April of 2013.

Section 202 states that by November 15th of each year (beginning in 2014), CMS is required to calculate and publish a threshold for liability claims. If an amount owed is under that threshold amount, CMS is barred from seeking repayment.  Section 205 states the statute of limitations for conditional payment recovery by CMS is three years after the receipt of notice of a settlement, judgment, award, or other payment made.

The SMART Act applies to workers’ compensation cases, so it is important to understand the law and how it will be applied in the future. Read it and follow its implementation closely.

Holding Individuals Accountable For Workplace Safety Violations

British Petroleum (BP) supervisors Donald J. Vidrine and Robert Kaluza were indicted on manslaughter charges in the deaths of 11 fellow workers in connection with the 2009 Deepwater Horizon explosion in the Gulf of Mexico. David Rainey, a BP deepwater explorer, was charged with obstruction of Congress and lying about the size of the spill. These indictments were in addition to a record $4.5 billion in criminal fines that BP agreed to pay for the disaster, which will be paid out over 5 years.

 Mr. Vidrine and Mr. Kaluza were negligent in their supervision of key safety tests performed on the drilling rig, and they failed to phone engineers on shore to alert them of problems in the drilling operation. These charges carry maximum penalties of 10 years in prison on each “seaman’s manslaughter” count, 8 years in prison on each involuntary manslaughter count and a year in prison on a Clean Water Act count. Mr. Rainey obstructed Congressional inquiries and made false statements by underestimating the flow rate to 5,000 barrels a day even as millions were gushing into the Gulf. He faces a maximum of 10 years in prison.

 By charging individuals, the government was signaling a return to the practice of prosecuting officers and managers, and not just their companies, in industrial accidents where reckless and wanton conduct is involved. The practice of charging individuals was more prevalent in the 1980s and 1990s but has recently been a rare occurrence, with company fines being the only penalty sought. Some wonder if the $4.5 billion criminal settlement is enough to penalize a corporation after 11 people were killed, and that if a culture of  disregard for safety exits in a corporation that is “too big to fail” then the only way to stop that culture is to send those who knew about it to jail. We shall see.