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.
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.
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.
Women making airplane wings, circa 1920. Seattle Municipal Archives
The Department of Labor and Industries encourages employers to offer light-duty positions to their injured workers – – the suggestion is written across the top of every time loss compensation order – – as early after an injury occurs as possible. The employer of an injured worker can offer shorter hours, a transitional job/job modifications or a new position entirely. The pay scale can be at any rate at or above minimum wage. In order to qualify as a valid job offer, a description of the position must be approved by a physician. Once approved, the job must be offered, in writing, to the injured worker with specific details including the work schedule, rate of pay and person supervising the work.
If an injured worker declines a valid job offer, time loss compensation will end.
If an injured worker declines a valid job offer, time loss compensation will end. If the employer offers a return-to-work position that pays less than the workers’ time loss compensation rate, the worker will likely be eligible for partial compensation to make up the difference. This benefit, called Loss of Earning Power (LEP) compensation, is based on a comparison of the pre-injury wage less the actual wages earned through return to work and pays 80% of the difference, up to a state-wide cap on compensation or the time loss compensation rate, whichever is less.
The claim can remain open for medical treatment if the injured worker declines a valid job offer, but no further vocational assistance will be provided. However, if the injured worker is unable to return to work and vocational retraining has been approved, the employer has a brief window of only 15 days within which to offer the injured worker a valid, full-time job or the plan will commence. Once retraining has commenced, a job offer cannot be used to derail the retraining plan.
More and more employers are watching their claim costs closely; particularly those participating in the Retrospective Rating program (see earlier post about Retro Groups for more details). Early return to work saves the employer and the Department a significant portion of the cost of an injury claim and, in some cases, allows the injured worker to maintain their wage and benefits during their recovery.
You’ve Received a Job Offer – Now What?
You should receive a copy of the job description that has been approved by your physician along with the letter offering you a job. Review and keep this job description with you as you return to work, as well as any written physical restrictions from your doctor. While at work, make sure that you are only performing duties within your restrictions to avoid additional injury.
Stay in contact with your physician and notify them of any change in your symptoms right away. If you have an increase or change in symptoms but do not feel that you require medical attention, phone your doctor’s office and leave a message to advise of the activity that brought on the increase and the type of symptoms you are noticing. This will make its way into your chart and can be reviewed by your doctor to see a progression of symptoms if one should occur after you return to work, providing a basis for further restrictions on activity or job modifications.
Keep track of your pay stubs. If you are earning less in the transitional job, file an Application for LEP Compensation (link) and attach the pay stubs to document your earnings. The LEP application forms are usually filed once or twice per month and require your employer and physician to provide information, as well. Compensation is issued upon receipt of the application form so, unlike time loss compensation, you will not receive regularly-scheduled payments of LEP compensation.
DLI’s Stay-At-Work Program
The Department of Labor and Industries’ new Stay-At-Work program is a financial incentive that encourages employers to bring their injured workers quickly and safely back to light-duty or transitional work by reimbursing them for a portion of their costs. DLI will provide an employer of an injured worker reimbursement of 50% of the base wages paid to the injured worker for up to 66 weeks, up to $10,000.00 per claim. The Department will also pay for some of the cost of training, tools or clothing the worker will need to do the light-duty or transitional work.
In a recent update, the Department released figures showing that it has paid reimbursements to over 1,200 employers in Washington State in the amount of $1.6 million
The purpose of the new incentive is to encourage more employers to return their injured workers to light-duty or transitional jobs with the doctor’s approval. This medical best practice can help the worker recover, and it also can reduce costs for the employer. The Department’s goal is to bring down costs and shorten the length of injury claims overall.
The Department provides the following video – one of three available – to outline this program:
In a recent update, the Department released figures showing that it has paid reimbursements to over 1,200 employers in Washington State in the amount of $1.6 million. The Department release fuels the concept that the program is working and that the goal of lowing workers’ compensation claim costs will be achieved but the release does not provide any data to track the results at this time.
Legislative “reforms” of the workers’ compensation system were approved by the Washington legislature in 2011, under Senate Bill 5801. These reforms addressed physicians’ care of injured workers by establishing a Medical Provider Network (MPN) and expanding access to Centers for Occupational Health Education (COHE) within the Washington industrial insurance system. COHEs are community-based organizations that use occupational health best practices to treat injured workers. There are four COHEs in Washington State – in Renton, Spokane, Everett and Seattle – that now treat about 1/3 of the injured workers in Washington State. It is the goals of this expansion to have 50% of injured workers receive treatment through a COHE by the end of 2013.
The Department of Labor and Industries provides this video to explain the COHE model:
We expect many workers to be placed in a bind in January if their longtime treating physicians have not yet taken steps to enroll in the Medical Provider Network.
Effective January 1, 2013, all injured workers residing in Washington State will be required to obtain treatment from a provider who has filed the proper paperwork and been approved by L&I to be a member of the Medical Provider Network. The following types of providers will be REQUIRED to be members in order to treat injured workers: physicians, chiropractors, naturopathic physicians, podiatrists, ARNPs, physician assistants, dentists and optometrists. Physical and Occupational therapists, initial office visits or emergency room visits, and all out-of-state providers, are excluded from this requirement.
The Department’s goal in establishing this Network is to establish standards for caregivers of injured workers that are similar to those used by most other health insurance companies across the nation. The Department is also developing criteria for terminating providers from the network, as well as designating a “Top Tier” level that will provide incentives for Network providers who demonstrate “best practices”. What the Department considers best practices is not defined, but presumably will include encouraging physicians to insure their patients are returned or released to work sooner rather than later.
As of 8/14/12, the Department had enrolled 13,000 individual and group providers in Washington State into its Network. This month, the Department will be forwarding notices to all injured workers who currently treat with providers that have not yet signed up to be a member of the new Network. Workers will be asked to encourage their providers to file the paperwork necessary to join the Network so they will be allowed to continue to provide treatment to them.
See if your doctor has been approved to participate in the new Medical Provider Network on the “Find a Doctor” page.
The Department provides an updated listing of providers that are currently signed up with the Medical Provider Network on its “Find a Doctor” page. If you do not see your medical provider on this list, you should discuss with your doctor their plans for enrolling as soon as possible.
We expect many workers to be placed in a bind in January if their longtime treating physicians have not yet taken steps to enroll in the Medical Provider Network. If you discover your treatment provider does not intend to enroll in this required program, you will want to request a referral to another provider.
Feel free to contact Causey Law Firm for questions or concerns about requirements for transferring care and any other questions you have regarding the new Network.
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!
Washington’s minimum wage applies to workers in both agricultural and non-agricultural jobs,
Washington’s minimum wage will increase to $9.19 per hour beginning Jan. 1, 2013, the Department of Labor & Industries (L&I) announced today.
L&I calculates the state’s minimum wage each year as required by Initiative 688, approved by Washington voters in 1998. The 15-cent-per-hour increase, from $9.04 to $9.19 an hour, reflects a 1.67 percent increase in the Consumer Price Index (for Urban Wage Earners and Clerical Workers, CPI‑W) announced earlier this month by the federal Bureau of Labor Statistics (BLS).
The CPI-W measures average price changes for goods and services purchased by urban wage earners and clerical workers. The goods and services it monitors include basic living costs such food, clothing, shelter, fuels, and services such as doctor visits.
The 15-cent-per-hour increase, from $9.04 to $9.19 an hour, reflects a 1.67 percent increase in the Consumer Price Index (for Urban Wage Earners and Clerical Workers, CPI‑W) announced earlier this month by the federal Bureau of Labor Statistics (BLS).
According to the BLS’ Sept. 14 announcement, about 80 percent of the increase was due to a jump in gasoline prices, which rose an average of nine percent over the past 12 months.
Washington is one of 10 states that adjust the minimum wage based on inflation and the CPI. The others are Arizona, Colorado, Florida, Missouri, Montana, Nevada, Ohio, Oregon, and Vermont.
Washington has the highest minimum wage, followed by Oregon, which recently announced its 2013 minimum wage will rise 1.7 percent, or by 15 cents, to $8.95 per hour.
Washington’s minimum wage applies to workers in both agricultural and non-agricultural jobs, although 14‑ and 15-year-olds may be paid 85 percent of the adult minimum wage, or $7.68 in 2012.
More information on Washington’s minimum wage is available at Wages.Lni.wa.gov. Employers and workers also may call 360-902-5316 or 1-866-219-7321.
Today’s post comes from guest author Todd Bennett from Rehm, Bennett & Moore.
CRPS cases can be just as complex and complicated as the condition itself. Contact Causey Law Firm for assistance if you, or someone you know, has CRPS and is dealing with an injury or disability claim with the Department of Labor and Industries and/or the Social Security Administration.
Today’s post is continued from last week, when we discussed the symptoms of Complex Regional Pain Syndrome (CRPS). Today we will discuss treatment options.
The job of your doctor is to identify and treat your symptoms before they become incurable. Common forms of treatment for CRPS are
Diagnosis of CRPS is made through process of elimination.
Today’s post comes from guest author Todd Bennett from Rehm, Bennett & Moore.
CRPS cases can be just as complex and complicated as the condition itself. Contact Causey Law Firm for assistance if you, or someone you know, has CRPS and is dealing with an injury or disability claim with the Department of Labor and Industries and/or the Social Security Administration.
Representing clients with chronic pain is both one of the hardest and most rewarding parts of my job.
edema, temperature, or color differences affecting a limb, and
excluding all other causes.
These criteria are vague but, because diagnosis of CRPS is elusive, they are the established criteria for a physician identifying and treating chronic pain that cannot be attributed to any other cause.
When your doctor believes the pain you are experiencing is out of proportion to your examination findings and the severity of your injury, it creates a problem. However, this is quite common when suffering from complex regional pain syndrome. While those who suffer from CRPS are often frurstrated because the exact cause of the pain cannot be proven, the medical literature confirms that this disease, and the resulting pain, is real!
L&I’s contractor compliance program has 21 inspectors around the state.
A news release issued today, below, reports that the Washington Department of Labor and Industries has performed two “sweeps” through commercial and residential construction projects – one weekend in Tacoma and another in Spokane – to determine if the contractors performing work are registered with the State. Contractors that are not registered do not pay into the workers’ compensation system, but they also often pay workers under the table.
When an injury occurs, even if the worker is successful in obtaining coverage under a workers’ compensation claim, they may still have difficulties proving the days and hours worked and the wages paid for that work, leading to other issues in the claim including reduced compensation rates. Our firm has successfully represented people who were working for an unregistered contractor with issues such as proving the injury occurred during covered employment activities to gain allowance of the claim and correctly setting the wage rates once the claim is allowed.
Unregistered contractors or those who don’t pay workers’ compensation premiums for their employees can underbid their competition and gain an unfair advantage. They also place consumers who hire them at risk. In Washington, all contractors must be registered with L&I, carry a bond and insurance.
TUMWATER – Construction compliance inspectors with the Department of Labor & Industries (L&I) swept through Pierce County this past weekend, citing more than a dozen contractors for working without being registered, an infraction which carries a $1,000 fine for a first-time offense.
“We want to show people we’re out there, even on the weekends, and that we take the underground economy seriously,” said Dean Simpson, manager of L&I’s construction compliance program. “We want unregistered contractors to know we will find them, and for honest contractors and consumers to know we’re not ignoring this problem.”
In all, the inspectors visited 77 work sites and cited 15 contractors for being unregistered, making note of another four whose status will need more work to determine if they are properly registered. In addition, several contractors were referred to other programs within L&I for possible audits or collections of unpaid premiums.
It is the latest such sweep to target the underground economy. A similar effort was held by inspectors in Spokane on Aug. 24 and 25. That team visited 68 work sites and cited 13 contractors for being unregistered, with five whose status was undetermined.
Unregistered contractors or those who don’t pay workers’ compensation premiums for their employees can underbid their competition and gain an unfair advantage. They also place consumers who hire them at risk. In Washington, all contractors must be registered with L&I, carry a bond and insurance.
For the Tacoma area sweep, the eight inspectors worked in pairs and focused on sites where tips suggested unregistered contractors were working. The teams focused on commercial construction sites on Friday, then hit residential worksites on Saturday.
“For some, it was a real surprise to see us, especially on Saturday,”
“For some, it was a real surprise to see us, especially on Saturday,” said Reed Despain, supervisor for the team. “We stopped a few registered contractors, but just explained we were out there to level the playing field.”
Working as a contractor without registration, even advertising to do so, can result in a minimum $1,000 penalty for a first offense. Penalties climb with each resulting citation. Inspectors typically issue seven such infractions in an average month.
L&I’s contractor compliance program has 21 inspectors around the state. Working both from tips and random site visits, the inspectors make sure contractors are properly registered, whether the person is a painter, tree trimmer, carpenter, concrete worker, fence installer or a handyman.
Contractors whose registration has expired or who need to register for the first time can visit www.ContractorRenew.Lni.wa.gov and get straight with the law.
