Workers' Compensation

DLI Performs Two Weekend Sweeps to Target Unregistered Contractors

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.

                                               

L&I compliance inspectors target underground economy in weekend sweep – Sept. 25, 2012

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.

Consumers can check at www.HiringAContractor.Lni.wa.gov to make sure the person they hire is bonded, insured and registered. 

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.

drug and pharmaceutical-law

Drug Watch: Zimmer Knee Implants Plagued With Failure

Knee implants you thought would last decades may only last 3 years.

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

Although we have noticed an increase in the number of joint replacement procedures undergone by our clients over the past several years, very few have ended with a bad result.

If you feel that you or someone you know may have a defective knee implant, contact our office to discuss your case and receive a referral to an attorney that handles this type of claim.

Zimmer is an international medical device manufacturer based in northern Indiana. It was founded in 1927, and focuses on the manufacture of products for orthopaedic surgeries. Zimmer’s sales in 2009 were $1.76 billion, and it is estimated that the NexGen family of knee implants make up about 2% of the overall sales of Zimmer.

Flex implants are not lasting nearly as long as intended.

The Zimmer NexGen Knee Implant is not a specific device, but rather a family of devices. Within this NexGen device family, there are different models of implants: NexGen CR-Flex, NexGen LPS-Flex, NexGen High Flex, NexGen LPS, NexGen MIS.

Unlike most knee implants, the Zimmer NexGen CR-Flex is attached without the use of cement, which may cause the system to loosen or detach completely.

The Zimmer NexGen CR-Flex implant was designed to give patients better range of motion than the customary NexGen device. Scientific studies have been accumulating for years with regard to concerns over the safety of the NexGen CR-Flex. Interestingly, the U.S. Continue reading Drug Watch: Zimmer Knee Implants Plagued With Failure →

Workers' Compensation Reform

L&I Proposes No Increase in Workers’ Comp Rate for 2013

How Much of the Savings Came Out of the Pockets of Workers?

 

September 17, 2012: The Washington State Department of Labor & Industries (L&I) today announced it is proposing no increase in the average rate for workers’ compensation insurance. If adopted, this would be the second straight year with no increase in workers’ comp rates.

 

“Had the Governor and the Legislature not adopted the 2011 reforms, I wouldn’t be making this proposal today,” said L&I Director Judy Schurke. “In fact, without those reforms, we would be facing a rate increase. Instead, we’re able to keep rates down for Washington’s businesses and workers.”  Savings due to reforms are beating expectations. L&I is now projecting the reforms passed in 2011 will save $1.5 billion over four years, $300 million higher than originally estimated.

While the reforms play an important part in lowering costs, Schurke pointed to additional factors responsible for lower costs in 2013, including:

  • Fewer claims in high hazard industries like construction are resulting in fewer long-term disabilities;
  • Overall claim frequency, or the number of claims per 100 workers, has gone down by 6.2 percent;
  • L&I has held medical cost growth below 4 percent over the past five quarters and expects continuing to do so in 2013 with the new provider network and health technology assessments;
  • L&I is resolving claims more quickly as a result of Lean and other improvements.

Today’s proposal would mean an additional $82 million is placed in the State Fund reserves by the end of 2013. In the past, the State Auditor issued strong warnings about the consequences of maintaining inadequate reserves. Schurke also acknowledged the reserves are critically low by industry standards due to increased liabilities, investment losses and drawing down the reserves to hold down rates during the recession.

The Workers Compensation Advisory Committee (WCAC), which has been working with L&I on a plan to rebuild the reserves, endorsed L&I’s proposal to hold rates steady in 2013 and begin rebuilding the reserves. Washington is the only state where workers pay a substantial portion of premiums. Workers will pay about 24 percent of the premiums in 2013. The proposal to keep rates flat in 2013 is an average for all Washington employers. Individual employers may see their rates go up or down, depending on their recent claims history and changes in the frequency and cost of claims in their industry.

Every year in Washington, about 100,000 claims are filed for medical costs and lost wages due to work-related injuries, illnesses and deaths. Each year, L&I must review premium rates and make adjustments to cover the anticipated costs of claims that occur in the next year.

Public hearings on the proposed rates will be held in:

  • Tukwila, Oct. 23, 10 a.m., L&I office.
  • Bellingham, Oct. 23, 1 p.m., Public Library Lecture Room.
  • Spokane, Oct. 24, 10 a.m., CenterPlace Event Center.
  • Richland, Oct. 25, 10 a.m., Community Center Activity Room.
  • Tumwater, Oct. 26, 10 a.m., L&I Auditorium.
  • Vancouver, Oct. 29, 10 a.m., Red Lion at the Quay, Quayside Portside Room.

More information regarding the rate proposal is available at www.Rates.Lni.wa.gov. The final rates will be adopted in early December and go into effect Jan. 1, 2013.

 

“Evidence-based coverage decisions have reduced unnecessary care and avoided $27 million in annual costs.”  (Emphasis added.)

 

Translation: Denying requested treatment costs the State less than authorizing it. – Ed.

 

Background Information:

  • On average, workers’ comp rates have increased less than 3 percent per year since 2006. This is lower than L&I’s anticipated rate of medical and wage inflation.
  • When calculated as a percentage of payroll, which is how rates are calculated in other states, the proposed 2013 overall rates would be equal to a 2.2 percent reduction.
  • Without savings from the reforms, the 2013 break-even rate would have been about 4 percent instead of minus 4.2 percent. The break-even rate is the amount needed to cover projected costs for the next year. L&I will use the difference between the break-even rate and zero – $82 million – to begin restoring the workers’ comp reserves.
  • The elements of the 2011 workers’ compensation reforms have various effective dates, beginning in 2011 and continuing through 2013. Savings estimates are now at $1.5 billion over four years, with continued savings in future years.
  • As a result of Lean and other initiatives, we are seeing a downward trend in the duration of younger claims.
  • L&I has held medical cost growth below 4 percent over the past five quarters and estimates doing so in 2013 with the new provider network and health technology assessments. Our medical costs are 26 percent less than the average workers’ comp program in the U.S.
  • Evidence-based coverage decisions have reduced unnecessary care and avoided $27 million in annual costs.
  • In 2011, the number of long-term disability claims per 100 workers fell by 6.2 percent, the largest decline since 1995. Long-term disabilities account for 85 percent of workers’ comp claim costs.
  • When hiring picks up in construction and other high-risk industries, we can expect an increase in long-term disability injuries. That’s why it’s important to examine safety practices now and be ready to bring more people back to work safely.
  • Workers’ comp insurance rates are based on the likelihood of an injury. Rates for almost half of the job classifications will change 1 percent or less next year.

workers comp basics, workers comp qa, Workers Compensation, workplace injury

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.

Return to Work

DLI’s New Stay at Work Program

DLI Notice of Workshops on the Stay at Work Program

The following was released by DLI as a public notice:

The Department of Labor & Industries (DLI) has reimbursed more than 1,000 employers almost $5.5 million to help retain injured workers in light duty jobs, but many businesses around the state remain uncertain how the program can benefit them.  To help, L&I is holding workshops across the state to explain the new Stay at Work program, which provides up to half of a worker’s base wages for up to 66 days or $10,000 per claim if the employer places their injured workers in light-duty or transitional work. 

The free, 90-minute workshops provide an overview of the program, explain how to apply for the reimbursements, the requirements, benefits, and how participation can help reduce claim costs for participating businesses. To sign up for a workshop or learn more about the program, visit www.StayatWork.Lni.wa.gov, or call 1-866-406-2482.

The current workshop schedule is:

  • Yakima – Sept. 11 from 9 -10:30 a.m. and 2 – 3:30 p.m., 15 W. Yakima Ave., Suite 100.
  • Everett – Sept. 13, from 10 ­- 11:30 a.m., 729 100th St. SE.
  • Kelso – Oct. 8, from 9 – 10:30 a.m. and 2 – 3:30 p.m., 711 Vine St.  
  • Everett – Nov. 8, from 10 – 11:30 a.m., 729 100th St. SE.
  • Spokane – Dec. 11, 9 – 10:30 a.m. and 2 – 3:30 p.m., 901 N. Monroe St., Suite 100.
  • Tukwila – Dec. 13 from 10 – 11:30 a.m., 12806 Gateway Drive South.

Ultimately, Stay at Work is projected to save $32 million annually by keeping workers on the job and reducing the chance of long-term disability. And getting injured workers out of their homes and back in the workplace has additional benefits – studies show that people off work longer than six months have only a 50 percent chance of ever returning to their job, while those who get back to work enjoy faster recovery times and improved lifelong health.

 

Trust your instincts – if things don’t feel right, they likely are not right.  Seek guidance prior to accepting or declining an offer of light-duty employment.

 

DLI Information for Injured Workers

The following is excerpted from the DLI website section on this topic:

The Department of Labor and Industries will reimburse your employer 50% of your base wages if they are able to find an eligible light-duty job for you. DLI will also cover expenses such as training and tools related to the light-duty job. If your employer offers you a job that your doctor approves and you choose not to accept it, you won’t be eligible to receive time-loss compensation. However, you aren’t required to accept any job that would exceed the restrictions set by your doctor.

 

DLI offers this cheery video – one of three – on the topic of the Stay at Work Program:

 

 

Our Perspective

As the DLI notice, above, indicates, it seems that many employers are not aware of the benefits available to them under this relatively new program, including significant incentives to offer accommodation to injured workers. 

We have seen both success stories and nightmares surrounding light-duty job offers from employers.  When applied appropriately and administered with a sense of caring, a light-duty job can be beneficial to an injured worker.  Returning to work can improve morale, maintain healthcare benefits for the worker and/or their families, and assist with a gradual return to full duties.  However, some offers of light-duty work are engineered to drive a worker to quit after accepting the job, which can remove the worker’s eligibility for time loss compensation.  Or, in other cases, the job may start out as light duty but the tasks requested may slide back towards regular duty levels, either intentionally or through habit, leading to increased symptoms or new injuries.

Trust your instincts – if things don’t feel right, they likely are not right.  Seek guidance prior to accepting or declining an offer of light-duty employment.

safety gear, safety rules, Workers Compensation

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 Imagining A World With No Workers’ Compensation Lawyers →

Safety

BP Cherry Point refinery cited for willful and serious workplace safety violations, fined $81,500

Image © BP p.l.c.

The Washington State Department of Labor & Industries (DLI) has cited the BP Cherry Point petroleum refinery in Blaine for six violations, including one “willful violation,” of workplace safety and health rules related to management of pipeline and refinery processes. The proposed penalties total $81,500.

 

A willful violation is the most significant civil classification that can be issued.

 

A willful violation is the most significant civil classification that can be issued. It is used when DLI alleges that the violation was committed with intentional disregard or plain indifference or substitution of judgment with respect to worker safety and health regulations.

DLI began the inspection in February after a major fire caused the refinery to shut down for a period of time. One employee was nearby when the fire erupted, but he was able to escape without harm.

The fire occurred when a corroded “deadleg” pipe ruptured. Deadlegs are pipes that aren’t often used but still must be monitored for integrity for when they are needed to carry material used in the refining process.

DLI cited the company for a “willful” violation for not ensuring that inspection and testing procedures for process piping followed recognized and generally accepted good engineering practices for all deadleg piping circuits. The proposed penalty for the willful violation is $65,000.

The five additional violations cited were for failing to comply with Process Safety Management standards, the requirements for managing hazards associated with processes that use highly hazardous chemicals.

The company has until Sept. 13 to appeal the citation.  A copy of the citation is available upon request.

For more information about this or other DLI news, click here.

Politics

Politics Then and Now — A Labor Day Reflection

Do you remember the politics of 1956?

For those of you — particularly the younger generation voters — who watched the pageantry of the Republican National Convention and saw the platform of the Tea-Party-dominated Republican Party, you may find it enlightening to put that platform in the historical context of what the Republican Party used to stand for – supporting workers’ rights, securing benefit programs and securing the rights of labor unions.

Here is the platform of the Republican Party of 1956, when President Dwight D. Eisenhower was seeking re-election to a second term:

“The Eisenhower Administration will continue to fight for dynamic and progressive programs which, among other things, will:

  • Stimulate improved job safety of our workers, through assistance to the States, employees and employers;
  • Continue and further perfect its programs of assistance to the millions of workers with special employment problems, such as older workers, handicapped workers, members of minority groups, and migratory workers;
  • Strengthen and improve the Federal-State Employment Service and improve the effectiveness of the unemployment insurance system;
  • Protect by law, the assets of employee welfare and benefit plans so that workers who are the beneficiaries can be assured of their rightful benefits;
  • Assure equal pay for equal work regardless of sex;
  • Federally-assisted construction, and maintain and continue the vigorous administration of the Federal prevailing minimum wage law for public supply contracts;
  • Extend the protection of the Federal minimum wage laws to as many more workers as is possible and practicable;
  • Continue to fight for the elimination of discrimination in employment because of race, creed, color, national origin, ancestry or sex;
  • Provide assistance to improve the economic conditions of areas faced with persistent and substantial unemployment;
  • Revise and improve the Taft-Hartley Act so as to protect more effectively the rights of labor unions, management, the individual worker, and the public. The protection of the right of workers to organize into unions and to bargain collectively is the firm and permanent policy of the Eisenhower Administration.”

Health

Are You Suffering From Symptoms Of Chronic Stress? Take the Stress Test!

Signs of Chronic Stress:

Cognitive symptoms

•          Memory problems

•          Inability to concentrate

•          Poor judgment

•          Pessimistic approach or thoughts

•          Anxious or racing thoughts

•          Constant worrying

Emotional symptoms

•          Moodiness

•          Irritability or short temper

•          Agitation, inability to relax

•          Feeling overwhelmed

•          Sense of loneliness and isolation

•          Depression or general unhappiness

Physical symptoms

•          Aches and pains

•          Diarrhea or constipation

•          Nausea, dizziness

•          Chest pain, rapid heartbeat

•          Loss of sex drive

•          Frequent colds

Behavioral symptoms

•          Eating more or less

•          Sleeping too much or too little

•          Isolating oneself from others

•          Procrastinating or neglecting responsibilities

•          Using alcohol, cigarettes, or drugs to relax

 

Take the Stress Test for Adults:

Thomas Holmes and Richard Rahe in 1967, examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive correlation was found between their life events and their illnesses.

Their results were published as the Social Readjustment Rating Scale (SRRS), known more commonly as the Holmes and Rahe Stress Scale.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Note: the table, below, is from the Wikipedia page on this subject.  For a fee of $5.00, you can go directly to Dr. Rahe’s website and obtain the full test materials as well as background information and details of this and other products and services available.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Life event Life change units
Death of a spouse 100
Divorce 73
Marital separation 65
Imprisonment 63
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Dismissal from work 47
Marital reconciliation 45
Retirement 45
Change in health of family member 44
Pregnancy 40
Sexual difficulties 39
Gain a new family member 39
Business readjustment 39
Change in financial state 38
Death of a close friend 37
Change to different line of work 36
Change in frequency of arguments 35
Major mortgage 32
Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Child leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Spouse starts or stops work 26
Begin or end school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in working hours or conditions 20
Change in residence 20
Change in schools 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Minor mortgage or loan 17
Change in sleeping habits 16
Change in number of family reunions 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violation of law 11

Score of 300+: At risk of illness.

Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).

Score 150-: Only have a slight risk of illness.

 

Recommended methods for relieving chronic stress include exercise (which can be modified to accommodate physical restrictions after an injury), meditation, music therapy, breathing techniques, and such simple things as companionship – from a pet, friend or family member.

 

Health

Chronic Stress: The Cascade Effect

Stress is how the body reacts to a real or imagined stressor — a stimulus that causes stress. Acute stressors affect a bodily organ in the short term; chronic stressors over the longer term. Chronic stress is the state of prolonged tension from internal or external stressors which may cause various physical manifestations such as asthma, back pain, arrhythmias, fatigue, headaches, irritable bowel syndrome, ulcers, and suppression of the immune system. Chronic stress takes a more significant toll on the body than acute stress. It can raise blood pressure, increase the risk of heart attack and stroke, and induce symptoms of anxiety and depression.

 

 The Three Stages of Stress – From Acute to Chronic

  • Alarm:  In this first stage, when the threat or stressor is first identified or realized, the body’s stress response is in a state of alarm. During this stage, adrenaline is produced in order to bring about the flight-or-fight response, causing sweating, raised heart rate, etc. The body’s resistance to the stressor drops temporarily below the normal range and some level of shock may be experienced. There is also some activation of the HPA Axis, producing cortisol, as discussed in our last post.

 

  • Resistance:  If the stressor persists, the body must find some means of coping with the stress. Although it begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.  As it attempts to cope with the condition that is causing the stress, the mind may try to focus on the problem, which can actually exaggerate the awareness of the problem and make it seem difficult to overcome.

 

  • Exhaustion:  third stage. At this point, all of the body’s resources are eventually depleted and the body is unable to maintain normal function. The initial symptoms may reappear (sweating, raised heart rate, etc.). Long-term damage may result, as the body’s immune system becomes exhausted, and bodily functions become impaired. The result can manifest itself in obvious illnesses such as ulcers, depression, diabetes, digestive system problems or cardiovascular problems.  It can also manifest as a chronic pain syndrome, guarding/avoidance behavior, and/or sleep disturbance.  Hopelessness can set in.

Chronic Stress and Cortisol

When the body’s HPA-axis cannot overcome a challenge and/or is chronically exposed to a threat, this system becomes overtaxed and can be harmful to the body and brain. An increased level of cortisol is one of the most dangerous outcomes of chronic stress.

Cortisol is an important hormone in the body, secreted by the adrenal glands and involved in some of the following functions: proper glucose metabolism, regulation of blood pressure, insulin release for blood sugar maintenance, immune function and inflammatory response. Normally, cortisol is present in the body at higher levels in the morning and is at its lowest level at night. Although stress is not the only reason that cortisol is secreted into the bloodstream, it has been termed “the stress hormone” because it’s also secreted in higher levels during the body’s ‘fight or flight’ response to stress, and is responsible for several stress-related changes in the body. Small increases of cortisol have some positive effects:  a quick burst of energy for survival reasons, heightened memory functions, a burst of increased immunity, lower sensitivity to pain, and helping to maintain homeostasis in the body.

 

 People are biologically ‘wired’ to react differently to stress.

 

While cortisol is an important part of the body’s response to stress, it is important that the body’s relaxation response be activated so the body’s functions can return to normal following a stressful event. Unfortunately, in our current high-stress culture, the body’s stress response is activated so often that the body doesn’t always have a chance to return to normal, resulting in a state of chronic stress, thus producing high chronic cortisol levels.

Higher and more prolonged levels of cortisol in the bloodstream like those in chronic stress have been shown to have negative effects, such as: 

  • Impaired cognitive performance (loss or poor concentration, inability to complete tasks or heightened confusion in mildly stressful situations
  • Suppressed thyroid function
  • Blood sugar imbalances such as hyperglycemia
  • Decreased bone density
  • Decrease in muscle tissue
  • Higher blood pressure
  • Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences
  • Increased abdominal fat, which is associated with a greater amount of health problems than fat deposited in other areas of the body.

When people feel stressed, stress hormones can be over-secreted, dramatically affecting the brain. Cortisol also plays a large part in post-traumatic stress disorder (PTSD) and memory. In a 2002 article in Biological Psychiatry regarding cortisol, PTSD and memory1, cortisol was noted to work with epinephrine (adrenaline) to create memories of short-term emotional events.  This effect may serve as a means to help a person remember what situations to avoid in the future. However, long-term exposure to cortisol damages cells in the hippocampus and can create impaired learning ability. It has been shown that cortisol inhibits memory retrieval of already stored information.

Cortisol secretion varies among individuals. People are biologically ‘wired’ to react differently to stress. One person may secrete higher levels of cortisol than another in the same situation. Studies have shown that people who secrete higher levels of cortisol in response to stress also tend to eat more food, and food that is higher in carbohydrates, than people who secrete less cortisol.

 

1“Depression. What happens in the brain?” Biological Psychiatry, 2002

Published by Causey Wright