Category Archives: Workers Compensation

Truck Drivers Beware – Your Insurance May Not be What You Think

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

NOTE: The timeline for filing an injury claim with the Washington Department of Labor and Industries is shorter – only 1 year – than what Mr. Jernigan describes in his article.

There is a scam out there and truck drivers are the victims, especially if they are seriously injured in a trucking accident. It works like this: an out of work driver hears about a job and fills out an application with a national trucking company. He then gets a call saying he has been accepted as a driver, contingent on a physical exam and a drug test. The driver is then asked to show up at work on an appointed date for his first delivery job. When he shows up he is asked to “sign papers” which allow him to lease/own the truck as he drives it across the country, and he signs a contract that declares that he is an independent contractor (although in reality the trucking company controls the deliveries and is the only source of revenue for the driver). Further, he is required to purchase accident insurance through a broker designated by the trucking company and the premiums are taken out of his paycheck. Because the driver is anxious to work again and is not particularly experienced in reviewing legal documents the driver signs the papers, gets in the truck and begins working again as an interstate truck driver.

The costs of this workplace injury are now shifted from the employer/insurer to the taxpayer.

Like most of us, these drivers never expect to be in a serious accident. If they unfortunately do have an accident while driving the truck, they look to the accident policy they purchased. If they are disabled, it pays the same benefits as workers’ compensation and provides medical coverage. Many drivers think they are actually on workers’ compensation. The catch is that all benefits stop after 104 weeks (2 years). If after that time if the driver is still disabled and still needs medical care, it is a shock to find out none is available under this contract.

Is there no hope for the truck driver under these circumstances?

Why 104 weeks? Most states have workers’ compensation systems that require the claim be filed within 2 years. Since the 2-year period has run, the driver is out of luck and cannot file for workers’ compensation under state law. What happens if the driver needs additional surgery and continues to remain disabled? Most likely federal assistance programs like Medicaid or Medicare enter the picture and the costs of this workplace injury are now shifted from the employer/insurer to the taxpayer.

If involved in a serious accident, be aware of the 104-week provision and file a workers’ compensation claim before that time period expires.

Is there no hope for the truck driver under these circumstances? Although it might be a tough fight, most workers’ compensation statutes specifically state that an employer cannot contract away its obligations under the Workers’ Compensation Act. Thus, the truck driver’s legal argument is that the contract designating the driver as an independent contractor was void as a matter of law. If the employee has been the subject of fraud, equity may allow the driver to go ahead and file a claim and pursue the action even through the 2-yr period has run. Under these circumstances, certainly in North Carolina, the driver would have an opportunity to pursue this claim.

The lesson to be learned by truck drivers is not to assume that the contract you have innocently signed is valid. If involved in a serious accident, be aware of the 104-week provision and file a workers’ compensation claim before that time period expires. Finally, if you are asked to sign one of these contracts and you have options of other employment, you may want to decline this job offer and work for a company that is more ethical. Your livelihood and the welfare of your family may depend on this important decision.

Why Are Worker’s Comp Claims Down

The number of worker’s compensation claims has dropped dramatically

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

The Wisconsin Association of Worker’s Compensation Attorneys (WAWCA) just held its tenth annual worker’s compensation seminar in Madison, Wisconsin. (I presented the annual case law update.)  A report on the economic health of Wisconsin worker’s compensation (presented by a colleague on the defense side, Paul Riegel) noted reported worker’s compensation claims have dropped from 55,000 in 2001 to less than 35,000 in 2011.  Based upon the first five months of 2012 reporting, 30,000 reported claims are anticipated to be made in 2012.

Applications for hearing on those claims have also diminished, from 7,000 in 2001 to about 5,500 in 2011.  Again based upon projections, the 2012 number of Applications for Hearing will be about 5,600.

Several potential explanations for this drop were provided including:

  1. The days of asbestosis, silicosis, and similar disease may have ended due to the aging population of those of exposed before the implementation of OSHA in 1970 and the lessening amounts of these substances in the workplace.
  2. Employers argue that workplaces are simply safer, resulting in lesser claims.
  3. The safer workplaces argument is rebutted by employee and Union data that fewer people are willing to make claims in a depressed economy for fear of losing their jobs.  While Wisconsin law assesses a “one year’s wages” penalty against an employer who fires or refuses to rehire an injured worker, in tough economic times, that may not be a risk an injured worker is willing to make.  Anecdotal evidence from a variety of sources indicates viable claims, specifically for “wear and tear” type injuries are simply not being made.
  4. The impact of extending Unemployment Compensation benefits from its initial 26 weeks through multiple extensions may diminish worker’s compensation claims since another “safety net” exists.  Additionally, the availability of Social Security may diminish worker’s compensation claims.  General employment trends also suggest Continue reading

Compensation for Secondary Smoke Inhalation

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

Washington has mandated smoke-free workplaces for several years now. Although claims for medical conditions related to prior exposures are theoretically possible, meeting the criteria for having an allowable claim can be tough.

In Washington, occupational exposure claims of any type can be allowed if there is a link between a medical condition and a work exposure AND if the exposure represents a distinctive condition of employment. In other words, if many people across the general population have similar exposures then the claim would not be allowed.

Feel free to contact us to discuss your circumstances and see if a workers’ compensation claim is possible for you.

Recent article indicates some public health departments are offering incentives to create smoke-free policies in buildings. The idea is to reduce the exposure to second-hand smoke.

While substantial strides have been made in many states to provide both smoke-free public places and smoke-free workplaces, the dangers of secondary smoke inhalation remain. Continue reading

Aging “Baby Boomers” and Workers’ Compensation Part 2

Today’s post comes from guest author Tom Domer from The Domer Law Firm. Earlier this month, Mr. Domer was honored by the Workers Injury Law & Advocacy Group (WILG) with a Lifetime Achievement Award for his career representing injured workers.

Last week, we started talking about some of the NCCI’s interesting conclusions about the implications of “Baby Boomers” in the workplace (see Part 1 of this article). In today’s post, we discuss these conclusions in more detail. The frequency of injury has steadily declined since the mid-1990s, with age group differences in frequency largely eliminated.  The decline in frequency has occurred for all age groups.  The differences among age groups in the early 1990s had almost completely disappeared by 2010.

A longstanding worker’s compensation maxim that “younger workers have much higher injury rates” is no longer true.  For example: the injury rate for workers age 55-64 was 16% lower than the frequency for all workers in the mid-1990s but actually 1% higher in 2010, indicating that the differences have clearly narrowed.

Lastly, in terms of severity of claims, older workers certainly cost more, primarily due to higher wages and increased medical costs for older workers.  The severity of medical costs Continue reading

Surprising Findings On Baby Boomers and Worker’s Compensation (part 1)

Today’s post comes from guest author Tom Domer from The Domer Law Firm. Earlier this month, Mr. Domer was honored by the Workers Injury Law & Advocacy Group (WILG) with a Lifetime Achievement Award for his career representing injured workers.

What is the impact on worker’s compensation from aging Baby Boomers who have postponed their retirement, working much longer than the previous generation? In a recent study by the NCCI (National Council Compensation Insurance) some interesting and surprising conclusions resulted. It is not surprising that the number of older workers is increasing. The study looked at the frequency and severity across age groups and tried to identify factors that accounted for the severity of injuries between older and younger workers.

Among the key findings are the following:

  • The major difference among age groups occurs between the 25-34 and the 35-44 age groups. All workers 35-64 appeared to have similar costs per worker. These reassuring findings suggest an aging workforce may have a less negative impact on the lost cost per worker than many analysts originally thought.
  • Many workers’ compensation professionals have the belief that younger workers have a much higher injury rate. That appears not to be true any longer. Differences in frequency by age have virtually disappeared.
  • The major factor involving older workers involves severity. Older workers tend to have more shoulder rotator cuff claims and knee injuries while younger workers have more back and ankle sprains.
  • Higher wages for older workers are a key factor leading to higher costs for older workers. On the medical side, more treatment per claim has increased medical costs.

The study indicated that older workers account for an increasing share of the U. S. workforce. In particular, the share of workers age 55-64 has been growing steadily. The number of workers Continue reading

Misdiagnosed Worker Can Amend The Cause Of Injury More Than 2 Years Later

Today’s post comes from guest author Matthew Funk from Pasternack Tilker Ziegler Walsh Stanton & Romano. Washington State claims can include conditions diagnosed after the initial filing of a claim, as well. Please feel free to contact us to discuss the specifics of your case if you are facing a similar situation.

The Appellate Division Third Department issued a decision (Searchfield v. Lowe’s Home Centers) that is interesting case because it pertains to the establishment of an injury that was originally misdiagnosed.

  • In October 2005, an employee was injured at work while lifting a hot water heater. As a result of the injury the employee went to the emergency room. He was diagnosed by an emergency room physician with myofascial strain of the legs and hips.
  • A November 2005 physician’s report diagnosed the claimant with hip/thigh sprain and sciatica. The later medical reports focused on the groin, lower back and leg pain.
  • In July 2006, a Law Judge established the claim for a work related injury to the claimant’s lower back. However, the employee continued to report worsening symptoms in his hip area.
  • In 2009, the claimant saw an orthopedic surgeon. The doctor performed a MRI of the right hip. The MRI revealed a right hip labral tear that required surgury. According to the surgeon the claim was originally misdiagnosed and the claimant had, in fact, sustained injuries to his right hip as a result of the October 2005 accident.
  • The claimant applied for a hearing to amend the claim for the right hip.
  • The Judge ruled that the right hip claim was time barred (pursuant to Workers’ Compensation Law Section 28). This states that a claim for a causally related condition must be made within two years of the date of accident.
  • On appeal the Board Panel reversed and the Appellate Division affirmed the Board Panel.

The Appellate Division stated that the early medical reports reflect initial concerns relating to the claimants hips. Also, there was supporting medical evidence that the claimant’s ongoing pain was the result of a labral tear in the right hip, a condition which is often misdiagnosed as a low back injury. The Court went on to add that the claimant could not have filed a claim for a causally related right hip injury at the time of the accident because it was not properly identified and diagnosed.

This case is important as it allowed the amendment of a claim for a serious injury that misdiagnosed early on in the case. You can find the entire court decision here.

Imagining A World With No Workers’ Compensation Lawyers

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

On January 13, the North Carolina Department of Labor announced that 53 people died on the job in North Carolina in 2011. Labor Commissioner Cherie Berry was quoted as saying: “the real tragedy is that all of the these fatalities could have been avoided.” I wholeheartedly agree. 53 deaths is 53 too many. When I see news stories about explosions and other tragic events that needlessly harm or kill workers, often spewing toxic chemicals into the surrounding environment harming entire communities, I can’t help but think about how it all could be avoided if companies embraced a culture that puts safety first and simply followed the proper guidelines and procedures. I see companies spend a lot of time and money to fight the Occupational Health and Safety Administration (OSHA) over fines and penalties but rarely see the same effort being put into protecting their workers in the first place.

Employers, I challenge you to make safety as much of a priority as profits. Stop wasting time and money fighting against worker safety and instead focus your efforts on saving lives.

It may be hard to believe given my chosen profession as a workers’ compensation lawyer but if I had my way, workers’ compensation lawyers like me would be obsolete. We’d go the way of horse-drawn carriages and 8-tracks. We exist because many companies treat worker safety as an afterthought. The workers’ compensation system provides employers with immunity from lawsuits for most on the job injuries — they are required to buy workers’ compensation insurance, so why bother spending more to protect workers if they get no return on that money spent? Continue reading

What’s so dangerous about hotel room cleaning? It turns out, a lot.

Today’s post comes from guest author Edgar Romano from Pasternack Tilker Ziegler Walsh Stanton & Romano.

Hotel housekeeping may not seem dangerous, but it can be grueling physical labor. A recent study published by the National Institute for Occupational Safety and Health reported that tasks including dusting, vacuuming, changing linens, making beds, and scrubbing bathrooms may lead to a range of injuries. Some of the most common ones include: Continue reading

Should your doctor have access to surveillance videos of you?

Today’s post comes from guest author Charlie Domer from The Domer Law Firm. It is particularly relevant now, at a time when we are seeing a spike in the number of cases where surveillance video is being used to bring claims to a halt here in Washington State.

A dozen attorneys in Montana representing injured workers made headlines petitioning their Supreme Court to stop State fraud investigators sharing surveillance videos with doctors of worker’s compensation claimants. About 14,000 Montana residents are covered by the State Fund and the Fund’s Investigative Unit conducts video surveillance on about 500 claimants each year and shows the videos to claimants’ treating physicians. This practice raises questions about physician-patient privilege and patient privacy.

In Wisconsin and most other States, the physician-patient privilege is waived by an employee who reports a work-related injury. The waiver only extends, however, to any condition or complaint reasonably related to the work injury. Considerable debate sometimes arises over which treatment records are reasonably related to a claim. A broken toe, for example, is not likely relevant to an asthma condition but a prior Hepatitis-C claim may be. Employers and insurers may attempt to obtain records from a medical provider without a release, and practitioners must provide reports to the employer, insurer, employee, or Worker’s Comp Division within a reasonable time after written request.

The Fund’s Investigative Unit conducts video surveillance on about 500 claimants each year and shows the videos to claimants’ treating physicians… In Wisconsin and most other States, the physician-patient privilege is waived by an employee who reports a work-related injury. The waiver only extends, however, to any condition or complaint reasonably related to the work injury. 

Insurance carriers and employers also defend or deny worker’s compensation claims through surreptitiously obtained videos. The videos Continue reading

A Word Of Caution On Facebook

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

A word of caution to injured workers: use Facebook at your own risk. An Arkansas Court of Appeals has held that Facebook photos can be used to deny worker’s compensation to an injured worker. The photos showed a man drinking and partying at a time he claimed he was in excruciating pain. The Appeals Court found there was no abuse of discretion in allowing the photographs into evidence because they had a bearing on his credibility.

Our office routinely cautions injured workers against any Facebook postings after a work injury for just that reason. While clients may feel that this impinges on their “private” life, they need to be aware that the insurance company will scour the internet, past employment histories, and medical records for any information that can be used in defense of a claim. Whether or not the photos are related to the injury or the need for medical care, they can often affect client credibility. In fact, we have dismissed several claims because of Facebook postings—and had to salvage some settlements due to post-compromise social media postings! Tom Domer is one of the editors of the national magazine for the Workers Injury Law and Advocacy Group (WILG) called the Worker’s First Watch. This month’s issue contains an article (starting on page 37) on the dangers of social media and its use against injured workers and worker’s compensation proceedings (the link is to a PDF document).