Workers' Compensation

Need a Doctor for a WA Workplace Injury?

You have 20,000 providers to choose from – – but ONLY if they’ll see you under your workers’ compensation claim… 

The Department of Labor and Industries issued an announcement trumpeting the success of the new Medical Provider Network:

May 21, 2014: TUMWATER — Injured workers in Washington state can now choose from more than 20,000 health-care providers in the Department of Labor & Industries’ (L&I) medical network. The network went live in 2013 to serve workers who need ongoing medical treatment for job-related injuries or illness.

“We have more than doubled the size of our network since it began,” said Vickie Kennedy, L&I’s assistant director for Insurance Services. “Ready access to high-quality care helps our injured workers quickly return to good health and their jobs.”

L&Idata show that 99 percent of injured workers statewide live within 15 miles of at least five primary-care providers who are in the network. Patients also have access to a broad range of specialists through the provider network.

Injured workers in Washington can see any doctor for their first visit when a claim is filed, but only network providers can deliver ongoing treatment. Workers can search for providers at www.FindADoc.Lni.wa.gov; the directory is updated daily.

The medical provider network is part of the historic 2011 workers’ compensation reforms designed to improve outcomes for injured workers, reduce disability and cut costs for the state’s workers’ compensation program. The standards for providers to be admitted to the L&I network are similar to those of other health networks in Washington state and around the country. Requirements include proof of medical liability insurance and professional licenses that are free of restrictions.

Our experience, however, is that these numbers are artificially bloated and do not reflect the reality faced by injured workers seeking a treating provider. Several clinics in the state have closed their practices to workers’ compensation claimants, leaving their current patients scrambling to find new attending physicians and refusing to take on any new patients with workers’ compensation claims. Many of those that will still provide treatment to injured workers limit their practice to only take on claims that are less than one year old, or claims that do not have legal representatives involved.  Many of the major medical providers – large hospitals, clinics, etc.. – had all of their physicians register with the Department of Labor and Industries for billing purposes even if those physicians are not actively taking workers’ compensation claims.

When our clients are seeking an attending physician under their workers’ compensation claim, they will start with the FindADoc website and make phone calls until they are able to get an appointment.  In many cases, the doctors want to review medical records before setting an initial appointment.  We often send records out to a handful of doctors before finding one willing to get involved.  Claimants living outside of the major metropolitan areas can have an even tougher time finding a provider.  Many of our clients travel long distances to see their physician as there are no options close to their home.

I have participated in the quarterly meetings offered by the Department of Labor and Industries to update stakeholders about the progress in implementing the network.  The meetings are held with members of the Department of Labor and Industries and medical providers that are providing input and assistance to the Department with the design and implementation of the network.  Based on the discussions with the panel members, I believe that the Department honestly believes in the success of their network, but that their data is not telling them the whole story. 

I have made recommendations for changes that could be made to the website that could indicate the level of recent billing activity for each provider – not specific numbers, but a simple color-coded graph to indicate general levels of billing.  For example, a provider who has multiple billings submitted to the Department for payment in the current quarter could have a green icon to indicate a high level of activity.  Those providers with no current billings could have a red icon, and maybe providers with a small level but still some active billings could be orange.  The Department has access to the data for provider billings and could, in theory, tap into that data to make such a change.  I am told there is no funding for this type of improvement at this time, though.

 Photo credit: banjo d / Foter / Creative Commons Attribution 2.0 Generic (CC BY 2.0)

Workers' Compensation

“No Trauma” Does Not Mean No Injury

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

Mr. Domer describes a scenario that we run into on a regular basis in our practice – adding a medical condition not noted on the original physician’s report can be troublesome and often requires litigation.

Feel free to contact our firm for assistance with this or other issues in a Washington State workers’ compensation claim.

I’ve been investigating Wisconsin and national fraud statistics in worker’s compensation to prepare for a national presentation I am making in Cape Cod in July. One fascinating and recurring basis for denial of worker’s comp claims (and potential claims against employees for fraud) stems from an insurance carrier’s review of the initial medical report.

Often the physician or emergency room nurse, physicians assistant or First Responder will ask an injured worker “Did you have any trauma?” If the answer to the question is “no”, the medical records will routinely indicate “no trauma”. This information is translated by the insurance carrier as a denial that an injury occurred. The level of medical sophistication for an injured worker is routinely limited. Most of my clients (and based on inquiries with other workers’ attorneys, their clients as well) believe a trauma is something akin to getting hit by a bus. They do not equate the notion of trauma with lifting a heavy object such as a table or a box. The criteria for traumatic injuries in most states, including Wisconsin, is that a single incident or episode caused the injury or aggravated a pre-existing condition beyond a normal progression. In many cases a lack of “traumatic injury” at the initial medical presentation is not an accurate indication of whether a traumatic injury actually occurred.

Workers' Compensation

Stanwood, WA Business Owner Gets Prison Time in Nearly $300,000 Disability Fraud

A Stanwood, WA business owner must spend a year in prison for a scam that defrauded state and federal disability programs and his union, U.S. Attorney Jenny A. Durkan announced Thursday.

Richard Stalkfleet, 66, of Stanwood, collected more than $295,000 in disability and pension benefits for eight years while running a wood chip distribution company that earned more than a half-million dollars annually, according to a news release from the U.S. Attorney’s office in the Western District of Washington.

Washington State Department of Labor & Industries investigators played a major role in uncovering Stalkfleet’s activities. They conducted surveillance of Stalkfleet, and found him working and driving trucks while receiving Social Security Disability and Teamster Pension Plan benefits and more than $130,000 in L&I workers’ compensation benefits, according to federal prosecutors.

Read more about Stalkfleet’s sentence and the L&I investigation in the U.S. Attorney’s news release at  www.justice.gov/usao/waw/

 

Photo credit: ABN2 / Foter / Creative Commons Attribution 2.0 Generic (CC BY 2.0)

Workers' Compensation

Summer Means Safety Reminders for Teen Workers

L&I urges workplace safety for teens as summer hiring season nears

Teens are gearing up to search for summer jobs and the Washington State Department of Labor & Industries (L&I) is urging employers, parents and others to support safety during “Safe Jobs for Youth Month” in May.

A total of 477 youth ages 12-17 were injured in the workplace in 2013, making this year’s observance more important than ever, said Mary E. Miller, occupational nurse consultant with L&I and a youth employment expert. Of the total, 156 were in the food and hospitality industries. The next largest total, 66, occurred in the retail trades. There were no fatalities.

“Teens are eager to work and may not question a workplace situation that doesn’t seem right,” Miller said. “We’re trying to ensure youth perform safe and appropriate work and employers, parents and teachers can all help.”

Gov. Jay Inslee signed a proclamation making May “Safe Jobs for Youth Month” across the state. More information is available at www.TeenWorkers.Lni.wa.gov. The agency also offers presentations from injured young workers for students. Miller can provide a separate talk for employers and teachers.

In recent years, the number of injuries has increased despite an overall decrease the past decade. Injuries in 2003 totaled 1,135. In 2011, injuries reached a low of 425 before increasing the next two years. Injuries range from lacerations, strains and sprains to more serious fractures and concussions, Miller said.

“Employers are eager to give young workers a start in the world of work” Miller noted. “The result is we need to continue to help employers provide teens with tasks appropriate to their age.”

In general, 14- and 15-year-olds may perform lighter tasks, such as office work, cashiering and stocking shelves. Work assignments for 16- and 17-year-olds can be less restrictive and can include cooking, landscaping, and some use of powered equipment and machinery. The limits on the hours of work for all minors vary by age.

Generally, if safety equipment other than a hard hat, eye protection or gloves is required, then it’s not an appropriate job for minors. All minors are prohibited from working with powered equipment such as meat slicers and forklifts, Miller noted.

In agriculture jobs, restricted job duties differ for youth. The agency has specific information on its website at its Agricultural Jobs for Teens page.

 

Photo credit: The Library of Congress / Foter / No known copyright restrictions

Workers' Compensation

Obesity Prevalence by Occupation in Washington State

Truckers, movers, and police and firefighters are likeliest to be obese. Doctors, scientists and teachers are the healthiest.

Those are the results of a first-of-its-type study the Washington State Department of Labor & Industries sponsored connecting what you do for work with obesity. The study also examined the percentage of workers in specific occupations who smoke, have adequate fruit and vegetable servings, participate in leisure time exercise and report high physical demands of their job.

“This is the first state-level study using the Behavioral Risk Factor Surveillance System data to estimate occupation-specific obesity.” 

“The objective of the research was to identify occupations in need of workplace obesity prevention programs,” said Dr. David K. Bonauto, associate medical director for L&I’s research division. “Employers, policy makers and health practitioners can use our results to target and prioritize prevention and health behavior promotions.”

The study, “Obesity Prevalence by Occupation in Washington State, Behavioral Risk Factor Surveillance System,” was published earlier this year by the Centers for Disease Control and Prevention. The study was based on more than 88,000 participants the CDC contacted in the state in odd years from 2003-2009. It found that nearly 1-in-4 workers statewide were obese.

“We know obesity poses a threat to public health,” Dr. Bonauto said. “This is the first state-level study using the Behavioral Risk Factor Surveillance System data to estimate occupation-specific obesity. All states within the U.S. could have this data if questions about occupation and industry were added to many state and national health surveys.”

Truck drivers were the most obese, nearly 39 percent. The proportion of current smokers was highest also for truck drivers, who – with computer scientists and mechanics – had the lowest proportion of adequate servings of fruits and vegetables. “Truckers are likely influenced by the availability of food choices, such as fast food and convenience stores,” Dr. Bonauto noted.

The study has its limitations. Because researchers used self-reported height and weight, there might be an underestimate of obesity. Also, the body mass index results don’t distinguish between fat and muscle mass. Police and firefighters, for instance, had a high prevalence of obesity but also had the highest proportion of vigorous leisure time physical activity.

Those with less education and an income less than $35,000 had a significantly higher likelihood of being obese, according to the study. Workers who had regular servings of fruits and vegetables and adequate physical exercise were less likely to be obese.

 Photo credit: kennethkonica / Foter / Creative Commons Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)

Hanford Workers

Hanford Challenge Responds to Vapor Exposures at Hanford Tank Farms

Hanford tank farm workers use Geiger counters to measure radiation.

As of March 27, 2014, nearly 20 workers had reported symptoms related to chemical vapor exposure in Hanford’s tank farms in the prior two weeks. Hanford Challenge, a watchdog group overseeing Hanford’s impact on workers, citizens and the environment, reported on the vapor exposures. 

Hanford Challenge provides unique services for Hanford workers who are ill or injured and employees who have raised concerns and are suffering reprisals.  They also conduct environmental sampling to monitor for radioactive and chemical contamination and work with Tri-Party agencies to address their findings and occasionally works to influence legislation that affects the site, including lobbying and attending hearings.


“Hanford has a duty to protect the workers at the site. They are doing an important cleanup and yet their lives and health are being sacrificed for expediency.  WRPS calls these vapors ‘smells’ in their press statement – discounting the serious harms that could result from exposure.”

– Hanford Challenge Executive Director, Tom Carpenter.

Hanford Challenge has been a staunch advocate of protecting workers from chemical vapor exposure through supplied air, increased monitoring of the full spectrum of the 2,400 toxic chemicals that have been found in Hanford’s tanks, and policies that acknowledge the uncertainty and inaccuracy of vapor monitoring, as opposed to the position frequently taken by the contractor and DOE that “we couldn’t detect elevated levels of chemicals following the exposure, so nothing happened”.

In 2004 Hanford Challenge won the battle for workers over Hanford’s cavalier attitude towards the chemical harms inherent in these vapors, after NIOSH, the DOE and the State of Washington all filed reports agreeing with our investigative findings.  However, it took another five years to get the contractors to make substantial improvements in the program to protect workers from these vapors.  Because of contractor turnover and shifts in management, there appears to be significant backsliding on protections for workers from chemical vapor exposure. 
 
Hanford Challenge is extremely concerned about the workers who have been exposed and what measures DOE and the contractors will take to support these workers and protect others at the site.  Symptoms of exposure include nausea, metallic taste in the mouth, dizziness, headache, flushed skin, accelerated heart rate, among others.  Past exposures have led to toxic encephalopathy, neurological damage, and long-term chemical sensitivity.

 

If you, or someone you know, has been exposed to vapors at Hanford, visit Hanford Challenge’s homepage or click here for Hanford Challenge’s document that contains a list of resources and suggested actions when exposure occurs.

 

Many of the dangerous chemicals in Hanford’s tanks are hard to detect.  Routine tank vapor monitoring only looks for ammonia and total organic carbons, not the full suite of chemicals.  Monitoring post-exposure is often performed hours after the incident, producing unreliable readings that rarely monitor for more than ammonia and total organic carbons.  Many of the dangerous chemicals need to be analyzed within hours of the sample being taken.  In the past these samples have sat for months on a shelf before being analyzed, at which point the results are no longer relevant.  Hanford Challenge calls on the contractor and the Department of Energy to support workers who have experienced symptoms of exposures, to step up monitoring of chemical vapors, and to take protective measures for all workers entering the tank farms.  
 

Watch the King5 News coverage of this developing story, here.

 Photo Credit: WA Dept of Ecology EcoConnect

Uncategorized

Transforming Apprenticeships for the 21st Century

UPS apprenticeship

Today’s post was shared by US Dept. of Labor and comes from social.dol.gov

On Wednesday, President Obama and Vice President Joe Biden visited Pennsylvania to announce new actions to enhance job-driven training across America. A key focus of the president’s remarks was how apprenticeships are one of the clearest paths to good, high-paying jobs. As he mentioned, 9 out of 10 apprentices get hired for full-time jobs after completing their program, and the average starting wage for apprenticeship graduates is more than $50,000. Expanding apprenticeship opportunities will give more Americans a chance to secure a foothold in the middle class.

Several new efforts will help double the number of apprenticeships over the next five years, a goal the president laid out in his State of the Union address. For the first time, the Labor Department is making $100 million available help more workers participate in apprenticeships. The grant competition will launch this fall and will be funded by fees employers pay through the H-1B visa program to hire temporary high-skilled foreign workers.

Using these existing funds, the new American Apprenticeship Grants competition will focus on partnerships between employers, labor organizations, training providers, community colleges, local and state governments, the workforce system, nonprofits and faith-based organizations. These partnerships will help expand tried-and-true apprenticeship models to newer, high-growth fields like information technology, health care and advanced manufacturing; making sure…

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Uncategorized

Obama announces $600M to support apprenticeships

Today’s post was shared by US Labor Department and comes from www.mid-marketpulse.com

Before apprenticeships can help narrow the country’s growing skills gap, Americans will have to bridge a much deeper cultural divide: a deep-seated bias toward college.“Millions of parents and kids see apprenticeships and really valuable on-the-job learning opportunities as vocational consolation prizes best suited for those who are not cut out for a 4-year degree,” said Mike Rowe, host of the Discovery Channel’s “Dirty Jobs” series in testimony before the U.S. Senate Commerce Committee.

New federal initiatives from the White House and Capitol Hill are challenging that perception. Yesterday the White House announced $600 million in grant programs to support job-driven training programs like apprenticeships.

A $500 million competition will award grants to community colleges that partner with businesses to provide collaborative job training programs that can be expanded on a national scale.

To increase apprenticeship programs, a second competition will provide $100 million for American Apprenticeship Grants in high-growth fields such as information technology, high-tech services, healthcare, and advanced manufacturing. According to the White House, 87 percent of apprentices are employed after completing their programs, and earn an average starting wage over $50,000.

“It’s never been more important for our folks to be trained for the jobs that are there — and for the jobs of the future,”…

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Wage and Rates

Wage Theft Another Assault on Workers’ Compensation

Today’s post was shared by Gelman on Workplace Injuries and comes from www.nytimes.com

As corporate America devises new methods to reduce wages it also assaults the injured workers’ benefit safety net, including workers’ compensation insurance. That results in rate benefits going down and premium bases becoming inadequate to pay ongoing claims. Today’s post is shared from nytimes.com and is authored by its Editorial Board.

When labor advocates and law enforcement officials talk about wage theft, they are usually referring to situations in which low-wage service-sector employees are forced to work off the clock, paid subminimum wages, cheated out of overtime pay or denied their tips. It is a huge and underpoliced problem. It is also, it turns out, not confined to low-wage workers.

In the days ahead, a settlement is expected in the antitrust lawsuit pitting 64,613 software engineers against Google, Apple, Intel and Adobe. The engineers say they lost up to $3 billion in wages from 2005-9, when the companies colluded in a scheme not to solicit one another’s employees. The collusion, according to the engineers, kept their pay lower than it would have been had the companies actually competed for talent.

The suit, brought after the Justice Department investigated the anti-recruiting scheme in 2010, has many riveting aspects, including emails and other documents that tarnish the reputation of Silicon Valley as competitive and of technology executives as a new breed of “don’t-be-evil” bosses, to cite Google’s informal motto.

The…

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Uncategorized

When Experience Pays: Paid vs. Unpaid Internships

Today’s post was shared by US Labor Department and comes from social.dol.gov

Every spring, as college students nationwide prepare for finals and pull all-nighters to wrap up their spring semesters, many simultaneously ramp up their search for the perfect internship. The Wage and Hour Division understands that these “foot-in-the-door” opportunities can provide invaluable experience and have a great impact on future career paths. But when can internships be unpaid, and when must interns be considered employees? When must these programs pay not just in terms of experience, but in cold, hard cash?

Labor Department interns

Just like many college officials, parents and students, the Wage and Hour Division is concerned that interns work under conditions that are in compliance with federal law. If you in fact are an “employee,” you must be paid properly. A fair day’s work deserves a fair day’s pay.

The Fair Labor Standards Act, as interpreted by the Supreme Court, provides criteria for what is and is not legal regarding payment for internships. Six criteria must be applied when determining if an internship can be unpaid:

  1. The internship, even though it includes actual operation of the facilities of the employer, is similar to training which would be given in an educational environment;
  2. The internship experience is for the benefit of the intern;
  3. The intern does not displace regular employees, but works under close supervision of existing staff;
  4. The employer that provides the training derives no immediate advantage from the activities of the intern;…

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Published by Causey Wright