Category Archives: DLI

New Rules Reduce Prescription of Narcotics to Injured Workers

…measuring physical function and screening for risk may be new …

The Department of Labor & Industries has reduced the amount of time doctors can prescribe narcotics (opioids) for injured workers without agency authorization from 12 to 6 weeks.  This change takes effect as of July 1, 2013. After six weeks, L&I insurance coverage for opioids will depend on doctors’ use of best practices. The required best practices include monitoring whether workers are recovering their ability to perform normal activities and screening them for risks of side-effects or addiction. 

…best practices include monitoring whether workers are recovering their ability to perform normal activities…

“These changes will improve pain treatment for injured workers as well as their safety during recovery,” commented Jaymie Mai, L&I Pharmacy Director. “For some doctors, measuring physical function and screening for risk may be new practices,” said Mai. 

Practicing physicians who specialize in treating injured workers and in pain management worked with L&I to develop the new L&I opioid treatment guideline. The changes are consistent with the Department of Health’s pain management rules and are part of L&I’s ongoing efforts to improve pain treatment for injured workers. Doctors can find everything they need to implement the new treatment guideline, including authorization forms and helpful tools, at Opioids.Lni.wa.gov.

According to Mai, “We are pleased that high dosage levels have been coming down and we are seeing fewer deaths among injured workers due to pain medication.” Nationwide, since 2007 opioid-related deaths have exceeded accidental deaths due to motor-vehicles and firearms. Washington has been among the states with the highest rate of prescription opioid-related deaths.

Photo credit: Life Mental Health / Foter.com / CC BY

Ceremony April 23 to Mark Worker Memorial Day

The agency has hosted a ceremony for Worker Memorial Day for 20 years.

A young fisherman, a veteran truck driver, a bridge painter, and an office manager working at her desk – these are among the 66 people who will be honored this year at the 2013 Worker Memorial Day ceremony April 23rd. The parents, spouses, children and other relatives of those who died from a job-related illness or injury last year have all been invited to the Washington State Department of Labor & Industries’ (L&I) annual Worker Memorial Day ceremony.

“We honor those who died last year by pledging to do everything in our power to prevent these tragedies from being repeated.” – Director Joel Sacks

The 66 workers to be honored include young people, such as the 22-year-old college student working as a commercial fisherman, to seniors in their 80s who died from diseases caused by workplace exposure to asbestos while they were in their prime working years. Some worked in jobs considered hazardous, like logging, construction and fishing, and others were in less hazardous professions, such as insurance, research, or sales.

“Worker Memorial Day is a somber reminder that there is still much work to do to make sure every worker in Washington returns home safely at the end of the day,” said L&I Director Joel Sacks. “We honor those who died last year by pledging to do everything in our power to prevent these tragedies from being repeated.”

The ceremony begins at 2 p.m. at L&I’s central building in Tumwater, 7273 Linderson Way S.W. The agency has hosted a ceremony for Worker Memorial Day for 20 years.

Governor Jay Inslee is scheduled to attend, as well as representatives of the Association of Washington Business, the Washington State Labor Council, and the Washington Self-Insurers Association. While the relatives of all the workers who died in 2012 have been invited, the observance is also open to their friends, colleagues, and the general public.

The ceremony includes a reading of the names of the workers who died, accompanied by bell ringers from the Washington State Council of Fire Fighters. After the ceremony, the families are invited to ring the brass bell in the Worker Memorial garden on the grounds of the L&I building.

A book in the lobby of L&I’s Tumwater building contains the names of all the fallen workers. For a complete list of those being honored, visit www.WorkerMemorialDay.Lni.wa.gov.

 

To connect with L&I: Facebook (facebook.com/laborandindustries) and Twitter (twitter.com/lniwa)

Photo credit: Mauigirl 2011 / Foter.com / CC BY-ND

New Rules Proposed for Prescribing Narcotics to Treat Pain in Injured Workers

Washington has been among the states with the highest rate of prescription opioid-related deaths.

The Washington State Department of Labor & Industries (L&I) is seeking public comment on new rules for prescribing opioids (narcotics) to treat pain in injured workers.

Under the proposed rules, doctors who prescribe opioids for injured workers for more than six weeks must use best practices that include monitoring whether workers are recovering their ability to perform normal activities. 

The Department is gathering public comment on the proposed rules and holding a hearing on April 23, at 1 p.m. in Tukwila, WA.  All written comments must be received by 5 p.m. April 23rd.

The rule changes are part of L&I’s ongoing efforts to improve the safety and effectiveness of treatment for pain among injured workers in Washington state. Nationwide, since 2007 opioid-related deaths have exceeded accidental deaths due to motor-vehicles and firearms. Washington has been among the states with the highest rate of prescription opioid-related deaths.

“Our goal is to provide high-quality care and keep injured workers safe while they are recovering,” commented Dr. Gary Franklin, L&I Medical Director. “We’re making progress. We’re seeing fewer deaths among injured workers due to pain medication. The new rules are the next step in reducing ineffective and dangerous use of these powerful drugs.” 

L&I coverage can continue after six weeks when doctors use best practices spelled out in the rules. The new requirements will not apply to the treatment of acute pain following surgery or within six weeks of injury, or to prescriptions for workers being treated for catastrophic injuries. The changes will make L&I’s rules consistent with pain management rules implemented by the Department of Health in 2011 and 2012.

To gather public comment on proposed rules, a hearing will be held on April 23, at 1 p.m. in Tukwila, at the L&I office at 12806 Gateway Drive S. Written comments may be sent by mail to Jami Lifka, Department of Labor & Industries, PO Box 44321, Olympia, WA  98504-4321; by e-mail to Jami.Lifka@Lni.wa.gov; or faxed to 360-902-6315. All comments must be received by 5 p.m. April 23.

 

Photo credit: massdistraction / Foter.com / CC BY-NC-ND

What’s New for Independent Medical Exams in Washington State

The Department of Labor and Industries has adopted changes to the Washington Administrative Code regarding the: 

  • credentialing,
  • approval,
  • removal,  and
  • regulation of independent medical examination (IME) providers.

The rules are effective February 25, 2013.

These rules establish clear guidelines that a medical provider must follow to become an approved IME examiner. They also set the standards for IME examiners and firms to continue to receive referrals for IMEs. Rules governing the termination, suspension and discipline of IME providers and IME firms are also outlined.

Detailed information relating to this rule is provided in the CR-103 filing documents. View the CR-103 and the adopted language here.

 

 

Photo credit: <a href=”http://www.flickr.com/photos/pedrovezini/4933885107/”>Pedro Vezini</a> / <a href=”http://foter.com”>Foter.com</a> / <a href=”http://creativecommons.org/licenses/by-nc-sa/2.0/”>CC BY-NC-SA</a>

 

 

Seattle Shooting – Another Case of Workplace Gun Violence, and Another Call to Action

By working together we can bring an end to gun violence in America

    

 

     A man entered a Seattle bar late Sunday night, January 27, 2013, and confronted his ex-girlfriend, brandishing a gun.  The gunman shot both his ex-girlfriend and the doorman before the gunman was fatally shot by Seattle police.  Both the ex-girlfriend and the doorman were taken to Harborview Hospital with non-life-threatening injuries.  Both were victims of senseless gun violence, but the doorman is also a workers’ compensation claimant due to this occurring while he was on-the-job.

 

2012 has been the worst year for these events in modern US history, with 151 victims injured and killed.

 

     Quoting an article published by Mother Jones (Mother Jones Investigates: The NRA Myth of Arming the Good Guys), Washington CeaseFire shared that there have been at least 62 mass shootings in the last three decades, attacks in which the killer took the lives of four or more people (the FBI’s baseline for mass murder) in a public place—a school, a workplace, a mall, a religious building. Seven of them have occurred this year alone. Along with three other similar though less lethal rampages—at a Portland shopping mall, a Milwaukee spa, and a Cleveland high school—2012 has been the worst year for these events in modern US history, with 151 victims injured and killed.

    On Tuesday, January 22nd, Washington CeaseFire presented the results of a statewide poll conducted by Alison Peters Consulting. The poll of 600 randomly selected registered Washington voters reveals a strong preference for stronger gun safety laws on both Eastern and Western sides of the state. The poll has a margin of error of plus or minus 4 percent. Findings included :

  • 76% of state residents support tighter gun laws;
  • 87% support a state law to require that everyone who buys a gun at a gun show undergo a background check;
  • 66% support a state law to ban semi-automatic assault weapons;
  • 68% are in support of a state law to increase mandatory penalties for youth firearm possession, starting with house detention at the first offense ;
  • 68% would support a state law to limit ammunition clips on guns to 10 bullets;  and,
  • 66% of respondents are in support of a state law requiring the signature of local police on every concealed weapons permit application.

     Washington CeaseFire states that it’s time to end gun violence in America, noting that gun deaths outnumber traffic fatalities in Washington and nine other states.  Now is the time to make our voices heard.  Please consider participating in a candlelight vigil and march on February 9, 2013 in Seattle, Washington, co-sponsored by CeaseFire.  More than 1000 people attended a similar march held in January (see prior post for details) and it is hoped that the upcoming vigil and march will draw more attention to this issue.

Worker’s Death Leads to Citation for WA Department of Natural Resources

 

The Department of Labor & Industries(L&I) provided the following information in a press release on January 11, 2013.  L&I noted that it has cited the Department of Natural Resources (DNR) for 15 worker-safety violations following an investigation into the drowning death of a DNR diver last summer.  The citation carries a proposed penalty of $172,900.

 

The deceased diver, David Scheinost, age 24, was one of a four-person dive team from the DNR Aquatic Resources Division that was collecting geoduck samples to test for paralytic shellfish poisoning from the Manzanita and Restoration Point geoduck harvest tracts off Bainbridge Island on July 24.

 

Two SCUBA (self-contained underwater breathing apparatus) divers had deployed on their third dive of the day when the victim surfaced in distress and called out that he couldn’t breathe. The others were unable to reach him before he slipped below the surface and was gone. His body was found three days later.

 

The L&I investigation into the dive-safety policies and practices at DNR found:

 

  • 370 occurrences over a six-month period in which divers were deployed without carrying a reserve breathing-gas supply.
  • DNR did not ensure a designated person was in charge at the dive location to supervise all aspects of the diving operation affecting the health and safety of the divers.

 

L&I concluded that these were “willful” violations, which means they were committed with intentional disregard or plain indifference to worker safety and health regulations.

 

“Commercial diving involves risks that unfortunately lead too often to tragedies like this incident,” said Anne Soiza, assistant director of L&I’s Division of Occupational Safety and Health. “These significant risk factors require advance planning, properly maintained equipment and strict adherence to procedures to ensure the protection of workers’ lives on each and every dive.”

 

In addition to the two willful violations, L&I cited DNR for eight “serious” and five “general” violations for not complying with standard safe-diving practices and procedures, including failure to:

 

  • Have an effective safety and health accident prevention program and training program.
  • Ensure that divers maintained continual visual contact with each other.
  • Inspect and maintain equipment.
  • Have a stand-by diver available while divers are in the water.

 

In Washington, state and local governments must provide safe workplaces for their employees just like private businesses, including following the minimum workplace safety and health rules. L&I is responsible for workplace safety and health and investigating workplace deaths for all private, state and local government worksites.

 

DNR will have 15 working days to appeal the citation. As with any citation, penalty money paid 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.

 

Not mentioned in the L&I notice sent out today is the information from Bainbridge Island police, reported by the Seattle Times on September 4, 2012, that Mr. Scheinost was also suffering from “acute cocaine intoxication” at the time of his salt-water drowning, according to the death certificate.  It is not clear whether this was factored into the penalty ordered by L&I.

 

Out-of-State Work-Related Injuries: What You Need to Know

Bedford, TX Construction Site

If you are a Washington resident working for an employer who operates in Washington and you are injured in another state, you probably have a Washington State workers’ compensation claim. Additionally, you might have a valid claim in the other state, as well. If you are injured outside Washington, or whatever state in which you normally work, it is important to evaluate your options and file wherever you might have a legitimate claim. It is possible that you have remedies available to you in more than one state.

 

If you are injured outside Washington, or whatever state in which you normally work, it is important to evaluate your options and file wherever you might have a legitimate claim. It is possible that you have remedies available to you in more than one state.

 

In Washington, we have agreements with other states that provide which state’s workers’ compensation laws apply when an employer takes its employees out of state. Those agreements apply to the workers of one state working temporarily in the other state. Washington currently has such agreements with Idaho, Montana, Nevada, North Dakota, Oregon, South Dakota, Utah, and Wyoming. If you are a Washington worker sent temporarily by your employer to one of those states and you are injured there, Washington is likely the only state in which you can file a workers’ compensation claim. Conversely, if you are an employee based out of one of the states with which Washington has an agreement and you are injured while working temporarily in Washington, your home state is likely the only state in which you can file a claim.

 

But what happens if you are not simply temporarily working in one of the states with which Washington has an agreement? What if you spend a significant amount of time in both, or even other, states? What if your employer is based in one state and you are based in another? Or better yet, what if you are injured in a state with which Washington has no agreement? In all of the above scenarios, you may have the ability to file your claim in multiple states. Generally, you will have the option of filing in:

 

1)    the state in which you were injured;

2)    the state in which you primarily worked; and

3)    the state in which you entered into your employment contract.

 

Yes, and.  The United States Supreme Court, in a case that settled the law once and for all back in 1980, decided that filing multiple workers’ compensation claims in multiple states does not violate the Constitution so long as each state’s system is credited for the benefits paid by the other states’ systems. In other words, you cannot be compensated twice for the same injury, but you can elect to file in multiple states in order to maximize the benefits that each state provides. Washington State, by law, explicitly allows you to file multiple claims in multiple states.

 

With an option of two or more states that might provide coverage, you may wish to select the state with the benefit program that better suits your financial situation and your needs. 

 

It is important to know your rights when you are injured on the job out of state, because the decision as to where to file your claim will have a direct impact on you and your family. Each state has a unique workers’ compensation system with a full spectrum of benefits, compensation rates, etc…  With an option of two or more states that might provide coverage, you may wish to select the state with the benefit program that better suits your financial situation and your needs. 

 

If you have been injured out-of-state, or while traveling in service of your employer, it is important to contact a workers’ compensation professional to assess your options.

 

Photo credit: nffcnnr / Foter / CC BY-NC-SA

Meningitis and Stroke Associated with Epidural Steroid Injection Medications

Confirmed Cases of Infection – click for large map

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are coordinating a multi-state investigation of fungal meningitis among patients who received an epidural steroid injection. Several of these patients also suffered strokes that are believed to have resulted from their infection. Fungal meningitis is not transmitted from person to person. These cases are associated with a potentially contaminated medication. Investigation into the exact source is ongoing; however, interim data show that all infected patients received injection with preservative-free methylprednisolone acetate (80mg/ml) prepared by New England Compounding Center, located in Framingham, MA.

As of October 23, 2012 the CDC reports 308 cases of fungal meningitis, stroke due to presumed fungal meningitis, or other central nervous system-related infections.  Death has occurred in 23 of these cases.

None of the reported fungal infection cases have occurred in Washington State.  This may become an issue within Washington’s workers’ compensation system, though, if any cases of infection arise from Washington clinics or if claimants that live out-of-state received an injection of the tainted product in other states.  Under Washington law, a workers’ compensation claim must cover any condition that arises from treatment provided for an industrial injury under an open workers’ compensation claim.  Similarly, if a claim has been closed but such an infection occurs in the course of treating an accepted condition, an application to reopen the claim based on a worsening could, in theory, be filed.

Patients who have had an epidural steroid injection since July 2012, and have any of the following symptoms, should talk to their doctor as soon as possible:

  • Worsening headache
  • Fever
  • Sensitivity to light
  • Stiff neck
  • New weakness or numbness in any part of your body
  • Slurred speech

 

Patients need to remain vigilant for onset of symptoms because fungal infections can be slow to develop.

 

Typically in this outbreak, symptoms have appeared 1 to 4 weeks following injection, but it’s important to know that longer and shorter periods of time between injection and onset ofsymptoms have been reported. Therefore, patients and physicians need to closely watch for symptoms for at least several months following the injection.

As of October 23, 2012 the CDC reports 308 cases of fungal meningitis, stroke due to presumed fungal meningitis, or other central nervous system-related infection meeting the outbreak case definition, plus 3 peripheral joint infections (e.g., knee, hip, shoulder, elbow). No deaths have been associated with peripheral joint infections.

The CDC’s guidance to patients has not changed as a result of the expanded voluntary recall of all NECC products, announced October 6. Patients who feel ill and are concerned about whether they received a medication from one of the NECC products recalled on September 26 should contact their physician.

 

Application Deadline Extended for Safety and Health Investment Projects (SHIP) Grant Program

Australian Safety Alert

Washington workers, employers and other groups can participate in the SHIP Grant Program to improve workplace safety, with grants of up to $150,000.  I have spoken with many people over the years with tales of scary workplaces or, in many instances, workplaces that are only slightly unsafe – these are just as likely, if not more likely, to result in an injury than one where obvious mistakes are being made.  The news release from the Department of Labor and Industries at the end of this post sets out the workshop schedule for learning more about it’s program for preventing injuries. Follow the link, below, for full details about this program and the assistance available to grant seekers of many stripes working towards a common goal.

 

The 2011 Legislature gave statutory authority to place the SHIP grant program as a permanent program within the Division of Occupational Safety and Health at the Department of Labor and Industries. Previously, the SHIP grant program had operated with budget provisos from 2007 – 2011. To date the program has funded 41 safety and health grant projects. The materials and products developed through completed grant projects are available through the SHIP Program and on the L&I/DOSH website. 

 

All proposals should be designed to develop and implement innovative and effective return-to-work programs for injured workers.

 

Grant limits and other criteria — the following criteria will apply to all SHIP grant applications:

  • Eligibility requirements for SHIP grants are listed on the application form and in WAC 296-900-175.
  • Grant requests for this round will not exceed $150,000.
  • Funding for grants approved during this cycle may occur beginning late fall 2012.
  • Successful applicants will be required to attend a grantee orientation to receive specific guidance and information about managing their SHIP grant experience.
  • Project duration for projects approved for this cycle should not exceed 12 months.
  • Products and materials developed or created through a SHIP grant must be available for distribution by SHIP to others who can benefit from them.

 

Learn how to apply for grant money from L&I at free workshop

Do you have an innovative idea for improving workplace safety and health or helping injured workers get back on the job? If so, the Department of Labor and Industries (L&I) would like to hear from you and may help fund your project.

 

In other words, L&I will give you money for your great idea!

 

A series of free one-hour workshops starting Oct. 2 will explain the basics of L&I’s Safety and Health Investment Projects (SHIP) Grant Program. The current grant cycle for Return-to-Work applications is open until further notice.

Workshops are currently planned for:

  • Olympia – 1 to 2 p.m. Oct. 2, 805 Plum St. SE, 2nd Floor SHIP Conf. Room
  • Kennewick – 1 to 2 p.m. Oct. 9, 4310 W. 24th Ave., Room C24
  • East Wenatchee – 11 a.m. to noon Oct. 10, 519 Grant Rd., Room C16
  • Mount Vernon – 10 to 11 a.m., Oct. 23, 525 E. College Way, Ste. H, Room C20
  • Tukwila – 1 to 2 p.m. Oct. 24, 12806 Gateway Dr. S, Room C20
  • Tacoma – 10:30 to 11:30 a.m. Oct. 30, 950 Broadway, Ste. 200, Room 503
  • Vancouver – 10:30 to 11:30 a.m. Nov. 2, 312 SE Stonemill Dr., Ste 120, Room C49

To register, please visit www.Workshops.Lni.wa.gov or call 800-574-2829.