Need Joint Replacement and on Medicare? Better Not Be Sick.

Having a lung ailment may make it more difficult to obtain coverage for joint replacement.

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

A new Medicare rule that took effect April 1, 2016 retools Medicare payments for hip and knee replacements.  Patients with serious medical conditions such as heart disease, obesity, diabetes, and lung ailments may not be able to find an orthopaedic surgeon willing to perform the joint replacement because hospitals face financial incentives to avoid patients with a high risk of complications. 

Hospitals will be given a “target price” for total joint replacements for the patient’s entire care from the hospital stay to outpatient rehabilitation through 90 days after discharge, according to a new rule from the Center for Medicare Services.  If the reimbursement is less than the target price, the hospital may receive an additional payment from Medicare as an incentive for good outcomes.  On the other hand, the hospital may be required to pay back part of their reimbursement that goes above the target.  The rule is intended to control costs on the $7 Billion Medicare spends for hospital care and for almost one-half million beneficiaries who receive a hip or knee replacement each year.  However, since Medicare will pay only one “bundled payment” for the patient’s entire care after total joint replacement surgery, the hospital will be accountable for the quality of care through the incentives and penalties.  The surgeon shares responsibility when a patient is re-admitted to the hospital and receives a “black mark” even when the re-admission has nothing to do with the joint replacement.  An unintended consequence of this payment model may be “cherry picking” of low risk patients.  Patients claiming a work-related connection to joint replacement surgery who have been denied by Medicare may face additional hurdles in obtaining their surgery. 

Stay tuned…


Countertop Workers Face Silicosis Risk from Engineered Stone Countertops

Today’s post comes from guest author Leonard Jernigan, from The Jernigan Law Firm.

Engineered stone countertops, a popular fixture in today’s homes, pose a health risk to workers who cut and finish them. The danger stems from the material the countertops are made from, processed quartz, which contains silica levels up to 90 percent. Silica is linked to a debilitating and potentially deadly lung disease known as silicosis, as well as lung cancer and kidney disease.

While the countertops do not pose a risk to consumers in their homes, they do pose a risk to the workers who cut and finish them before they are installed. When the countertops are cut, silica particles are released into the air, which when breathed in by the workers can start processes leading to silicosis. Manufacturers of the engineered stone countertops assert that worker hazards can be reduced through the use of protective respirators and equipment designed to trap silica dust. Despite this assertion, many safety precautions taken by employers are often inadequate.

The first documented case of silicosis among countertop workers in the United States was reported two years ago. In countries such as Israel and Spain, where engineered stone products gained their popularity, many more countertop workers have been diagnosed with silicosis and have had to undergo lung transplants. The danger of silicosis in the construction industry led OSHA to recently issue new rules requiring construction workers’ silica exposure to be reduced by 80 percent beginning on June 23, 2017.


Work Force Development Center Earns Second Safety Excellence Award

Work Force Development Center (WFDC) in Mukilteo has received a second safety and health award from the Department of Labor & Industries (L&I). This one is for the center’s second worksite for aerospace assembly training.

The worksite is the ninth in the state to be recognized through the START program, which stands for Safety through Achieving Recognition Together. In 2015, the center’s first worksite was the first Washington nonprofit to ever receive the award.

The START award recognizes occupational safety and health excellence which leads to a safer workplace, lower costs and improved morale. It’s modeled after a federal program.

The WFDC is a nonprofit vocational training organization that provides apprenticeships for disabled, socioeconomically disadvantaged or otherwise at-risk high school juniors and seniors in aerospace assembly. Students earn minimum wage and high-school credit while getting valuable experience with the tools and processes in the aerospace industry to prepare them for entering the work force.

The award winning worksite specializes in using Computer Numerical Controlled machine tools that cut, drill and carve out aerospace parts from blocks of titanium, aluminum, nylon and phenolic resin.

“Learning to work safely in an industrial environment is an essential part of our students’ educational experience,” said Carmela Morelli, WFDC Director of Human Resources & Student Services. “We are so proud of our employees and students for their commitment to following the guidance of the L&I safety and health consultants.”

To participate in the program, employers must have an injury rate below their industry’s average for at least a year. They must also allow safety and health experts to visit the worksite and review workplace hazards, examine safety and health programs and interview workers and managers.

“Work Force Development Center is clearly a safety leader in the community that others can learn from,” said Lou Flores, Consultation Program Manager for L&I’s Division of Occupational Safety and Health. “This award is a tribute to the center’s hard work and commitment to making sure that trainees and employees are safe on the job and learn safe work habits that will last a lifetime.”

WFDC has 54 employees and 99 high school-age student trainees from schools in three counties at its aerospace assembly training center worksites in Mulkiteo.

Photo credit: San Diego Air & Space Museum Archives viaHackers / No known copyright restrictions


Truck Replacement Program to Improve Air Quality Scraps 200th Truck

The Northwest Seaport Alliance and Puget Sound Clean Air Agency work together to reduce diesel emissions. The incentive program helping drayage truck owners purchase newer, lower-emission trucks to improve regional air quality recently replaced its 200th truck.

The Seaport Truck Scrappage and Replacements for Air in Puget Sound 2 (ScRAPS 2) is a joint program of The Northwest Seaport Alliance and Puget Sound Clean Air Agency to reduce diesel particulate emissions in the region. It supports the NWSA Clean Truck Program’s target for all port-bound trucks to have model year 2007 or newer engines by Jan. 1, 2018.

About 2,500 trucks visit NWSA terminals each day. ScRAPS 2 encourages owners to replace trucks with engines manufactured between 1994 and 2006 with newer models built to meet updated U.S. Environmental Protection Agency standards.

Trucks with engines built after 2007 emit 10 times less particulate pollution than older ones. The PSCAA and NWSA estimate that taking 200 older trucks off Puget Sound roads will result in an annual reduction of 9 tons of diesel particulates and 114 tons of oxides of nitrogen.

ScRAPs 2 reimburses eligible truck owners for part of the cost of a new truck and demolishes and recycles the older model at local vehicle recycling facilities. Truck owners who buy a truck with a model year 2010 engine or newer receive as much as $27,000 in return; a truck with a model year 2007 to 2009 engine yields up to $20,000.

Launched in May 2014, the program was expanded earlier this month to make it easier to qualify for trucks primarily serving the NWSA’s South Harbor. Now 200 trips to either the North or South harbor qualifies truck owners for the incentive program. The program has funding to replace an additional 125 trucks.

Previous ScRAPS programs in Seattle and Tacoma targeted trucks with engines built before 1994 and replaced more than 400 trucks.

Under the Northwest Ports Clean Air Strategy, adopted in 2008, the ports of Seattle and Tacoma and Vancouver, B.C., committed to reduce emissions from all port-related sources—trucks, cargo equipment, ships and trains. The NWSA Clean Truck Program focuses on meeting the strategy’s goals for trucks.

ScRAPS 2 is funded by the U.S. Department of Transportation/Washington State Department of Transportation, U.S. Environmental Protection Agency, Washington State Department of Ecology and the NWSA.

Photo credit: Franck_Michel via Source / CC BY


Tips on Your Workers’ Compensation Claim

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

I just returned from New Orleans where I made a presentation to about 150 workers’ compensation lawyers (both for workers and for employers) on “Case and Client Evaluation In Workers’ Compensation”.

Since many in the audience represented insurance companies and employers, I paid particular attention to their response to my presentation. As one would expect, their best chance to win a case on behalf of the employer and insurance carrier occurs when several items come into play:

  1. When there is no actual report of the injury. [Worker’s Tip: No matter how small the work injury, make sure it is reported in some fashion – cell phone, voice recording, or Accident Report and the worker keeps a copy (BEST).]
  2. Failure to report that a work injury occurred to the first treating practitioner (whether Emergency Room, employer-directed medical facility, hospital, or primary care physician). The single most difficult hurdle in a workers’ compensation claim involving a traumatic injury occurs when no report of the injury is found in the initial medical record.
  3. In “Occupational Exposure” cases, no discussion with the doctor about work duties or prior incidents. (In Wisconsin, a worker can recover for workers’ compensation in one of two ways: 
    1. A traumatic injury where a single incident has caused the disability (lifting a box, falling, etc.)
    2. Occupational Exposure, where the wear and tear of a worker’s job causes the disability over time. In this latter category, workers routinely do not indicate with any kind of specificity the type of work they perform when they see the doctor.

These three tips can help us as workers’ compensation lawyers win claims, more so than any “Clarence Darrow” court room techniques or strategies.

Photo credit: Art By Doc via / CC BY-NC-SA

Uber Class Action Lawsuit. Are Drivers Eligible for Workers’ Compensation Benefits?

Photo credit: Art By Doc via / CC BY-NC-SA

Photo credit: Art By Doc via / CC BY-NC-SA

Today’s post was shared by Workers Comp News and comes from

Recently, the ride-sharing program, Uber decided to settle two major class-actions lawsuits, filed in California and Massachusetts. These cases will help define how the company classifies drivers in the future.

The Purpose of the Lawsuits

The drivers in both lawsuits claimed that Uber had misclassified them as independent contractors, when they should have been employees, and that they did so to save money. A switch to hiring employees, rather than relying on independent contractors would have been a major blow to the company’s business model.

Under the terms of the settlement, Uber may continue to classify its drivers as independent contractors. This means that they are not responsible for covering payroll taxes, workers’ unemployment insurance or workers’ compensation for its drivers.

The Implications of the Lawsuits

Although Uber is not responsible for providing workers’ compensation insurance for its drivers, the lawsuits did require some changes. Uber will be paying out 100 million dollars to the drivers involved in the suit and all drivers will now be able to solicit tips from their passengers.

Uber also agreed to assist with the creation of a drivers’ association in the two states where the lawsuits were filed. This is a rare action for a company that considers its drivers to be independent contractors.

Not much information is available about what this association will be responsible for. Uber will be paying for some of the costs of the…

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Boeing Centennial – Celebrate with Furniture!

Aviation buff? Employee of The Boeing Company, past or present? Remodeling your home or office? This may be just the ticket for you.

The Boeing Company is celebrating their 100th year this July.  The Boeing Store has all kinds of commemorative items for sale, from lapel pins to t-shirts to “flypaper” – fabulous, engineer-designed paper airplanes.

For those that want to really impress, though, look no further than Fallen Furniture‘s line of custom pieces, many crafted from Boeing airplane parts. Fuselage wall art, available from 1 – 30 windows wide, or the single-window fuselage clock, pictured above.  My favorite: the chair made from a Boeing 737 cowling.  Nothing better for a high-end, aviation-themed, home or office.


The Dangers of Working with Vibrating Tools

Today’s post comes from guest author Anthony L. Lucas, from The Jernigan Law Firm.

Vibration White Finger (VWF) or “Dead Finger,” now known as Hand-Arm Vibration Syndrome (HAVS), is a chronic, progressive disorder caused by regular and prolonged use of vibrating hand tools that can progress to loss of effective hand function and necrosis of the fingers. In its advanced stages, the obvious symptom is finger blanching (losing color). Other symptoms include numbness, pain, and tingling in the fingers, as well as a weakened grip.

It is estimated that as many as 50 percent of the estimated 2 million U.S. workers exposed to hand-arm vibration will develop HAVS. Some common industries and the tools associated with HAVS are listed below:

  • Agriculture & Forestry – Chainsaws
  • Automotive – Impact Wrenches, Riveting Guns
  • Construction – Jackhammers
  • Foundries – Chippers, Grinders
  • Metal Working – Buffers, Sanders
  • Mining – Jack-Leg Drills, Stoper Drills

The time between a worker’s first exposure to hand-arm vibration to the development of HAVS symptoms can range from a few months to several years. Prevention is critical because while the early stages of HAVS are usually reversible if vibration exposure is reduced or eliminated, treatment is usually ineffective after the fingers blanch. 


Port of Seattle Boosts Summer Employment for High School Students

Nearly 100 high school students will get a jump start on their careers this summer as part of the Port of Seattle’s summer high school internship program.

“We’ve heard a lot about the shrinking middle class,” said Port Commissioner Tom Albro. “So the Port is stepping up our efforts to support family-wage jobs and to make sure there is a pipeline of trained workers for these kinds of high-demand, high-skill jobs.”

In addition to the 70 teens who will work at Port facilities, another 20 will work with private manufacturing and maritime-related employers. Students from the Career-Technical Education (CTE) programs at Seattle’s Rainier Beach and Cleveland High Schools will be recruited. The Port is asking local businesses to contribute by hiring the 20 interns for the summer.

“Internships can pave the way for a young person’s career path,” said Representative Eric Pettigrew. “We want to encourage them to get experience in the maritime and manufacturing sector, which can lead to jobs making an average of over $70,000 a year.”

There are also opportunities to explore family-wage careers in aviation and maritime by working at Sea-Tac Airport and within the Port’s Marine Maintenance Department. The Port is working with the City of Seattle’s Youth Employment Initiative to fill almost half of the available internships. A dozen of those interns will be taught how to design and build SharePoint solutions to solve real business problems.

“It’s our responsibility to prepare our youth for their future,” said Danial Gallagher, Interim Director of STEM and Arts at Seattle Public Schools. “Our community’s economy provides abundant opportunities in high-skill careers that provide productive livelihoods, but if we don’t prepare students for these careers, we effectively deny them access to these opportunities.”

To find out more or to apply to host a summer intern, please visit the Mayor’s Youth Employment Initiative website. You also may read more information about the Port of Seattle’s internship programs here.


Photo credit: colorblindPICASO via Source / CC BY-NC


WA Preferred Worker Program – New Incentives to Assist Return to Work

Washington’s Preferred Worker Program provides an opportunity for employers to save money when hiring experienced, highly-qualified workers. Although there is no direct monetary benefit to the injured worker, having Preferred Worker status may assist the injured worker seeking to be hired due to the benefits available to the employer. The new preferred worker benefits to encourage the employment of injured workers with a permanent disability became effective January 1, 2016.

A worker may be certified as a “preferred worker,” in the sole discretion of the supervisor or supervisor’s designee, if he or she has an open state fund insured claim for an industrial injury or occupational disease that results in a permanent disability that may be a substantial obstacle to employment.

Permanent disability is defined as

  • a physical or mental condition, caused by the industrial injury or occupational disease which is fixed and stable, and from which, within the limits of medical probability, further recovery is not expected; and
  • the attending provider or other appropriate specialist within the medical provider network has documented work restrictions that prevent the worker from returning to the job of injury; and
  • the work restrictions are supported by medical findings appropriate to the worker’s physical or mental condition.

“Substantial obstacle to employment” means 1 or more of the following limitations apply: 

  • The worker is unable to perform at least 1 of the essential functions of the job of injury. 
  • L&I finds the worker eligible for vocational retraining.
  • The worker is permanently restricted to a lower category of work, for example, a worker previously able to perform heavy work is permanently restricted to sedentary or light work.

An employer must employ the certified preferred worker in a job that

  • will continue to be available into the foreseeable future, and
  • is confirmed as consistent with the worker’s permanent work restrictions by
    • the health care provider, and
    • the credentialed vocational rehabilitation professional who meets the qualifications in Chapter 296-19A-210 WAC.

The final determination will be made by L&I’s credentialed vocational rehabilitation professional.

The employer will not be eligible for preferred worker incentives if the offered job is:

  • The job of injury with minor or no modifications.
  • Work that is beyond the worker’s medical restrictions.
  • Work that requires training beyond the usual and customary training provided by the employer to similar employees.
  • On-the-job training.

In no case will the employer receive any preferred worker benefits until all required documentation is received by L&I. The employer must submit to L&I:

  • A copy of the completed job analysis or L&I’s job description form, approved by the worker’s health care provider, and
  • The job offer, signed by the worker, and
  • L&I’s Preferred Worker Request form, available on L&I’s website, completed and signed by the employer.

After the offered job is confirmed as approved by L&I’s credentialed vocational rehabilitation professional, preferred worker benefits can be granted. The benefit start date will be no earlier than the first work day after L&I receives the employer’s completed documentation.

Photo credit: Beechwood Photography via / CC BY-NC-SA

Published by Causey Law Firm