Legal Corner

Workers’ Compensation
ABC test applies only to wage order claims – California

Earlier this year, the Supreme Court issued a groundbreaking decision when it adopted a new legal standard known as the “ABC Test,” making it much more difficult for businesses to classify workers as independent contractors. The Dynamax vs The Superior Court of Los Angeles County case was decided for the purposes of the state’s wage orders, but some speculated it might be applied more broadly.

Recently, in Garcia v. Border Transportation Group, a Court of Appeals held that the new test is limited to claims arising under the California Wage Orders, and that other claims continue to be governed by the prior (and more employer-friendly) standard known as the Borello test. It noted: “Dynamex did not purport to replace the Borello standard in every instance where a worker must be classified as either an independent contractor or an employee for purposes of enforcing California’s labor protections…[The California Supreme Court] did not reject Borello, which articulated a multifactor test for determining employment status under the Worker’s Compensation Act.”

No coverage for injury that occurred before issuance of policy – Florida

An insurance broker scrambled to get a policy in place for an uninsured employer dated the same day of an employee injury without disclosing the incident to the insurance carrier. In Normandy Ins. Co. v. Sorto, an appellate court ruled that there could be no coverage because insurance laws preclude coverage for losses that have already taken place. The court noted agreement to assume a known loss is not insurance. Insurance is to provide protection against risk. One cannot insure against known losses; there is no risk.

Lunch break injury not compensable – Georgia

In Frett v. State Farm Employee Workers’ Comp., an insurance claims associate had a scheduled lunch break and walked to the break room to microwave her lunch, which she intended to eat outside. In the breakroom, she fell in a puddle of water and a manager instructed her to complete an incident report. While an administrative law judge granted benefits, the State Board of Workers’ Compensation reversed and a superior court judge affirmed the denial.

The board found the injury did not arise out of her employment because it occurred while she was on a regularly scheduled break and while she was leaving to attend to “a purely personal matter.” While there was precedent for compensability when a worker is entering or exiting the employer’s property, even during break times, the court said this was a mistake and disapproved of its prior decisions.

Injured employee has right to sue employer under retaliatory discharge statute – Massachusetts

In Bermudez v. Dielectrics, Inc., a worker was placed by a temporary employment agency in a manufacturing facility. She sustained work-related injuries when one of the manufacturer’s employees negligently operated a forklift and several large metal sheets fell on her foot. She received work comp benefits from the employment agency and returned to work at the manufacturer eight weeks later. A few months later, she was hired as a full-time employee at the plant.

Eighteen months later, she filed a third-party action for negligence against the manufacturer and the forklift operator. Two months later she was terminated and she sued.

While a trial judge ruled in favor of the company, an appeals court found that the workers’ compensation law specifically says a worker can initiate a third-party action in addition to receiving benefits through the comp system and that a 1971 amendment eliminated the election of remedies concept (comp remedy or a civil claim). The worker had a right to file her third-party action and she could not be fired for doing so.

Worker on business trip who witnessed killings at a restaurant awarded benefits for PTSD – Michigan

In Dickey v. Delphi Automotive Systems LLC., an employee was at a restaurant in Mexico with clients and workers when he witnessed gunmen kill several people in the restaurant. When he returned to Detroit, he was diagnosed with PTSD. The Commission held it was logical to conclude that one who witnesses a horrific, stressful, and traumatizing event such as a multiple murder could possibly be afflicted with PTSD and that the award of benefits was reasonable. The employer’s examining doctor found that his symptoms were related to the side effects from the medicine he was taking, but the magistrate relied on the opinion of the treating doctors, who were actually increasing the worker’s medications.

Murder of worker by co-worker not work related – Michigan

In Williams v. Park Family Health Care PC, a worker was killed by a co-worker who she previously dated. She had broken off the relationship because he was married and not seeking a divorce. He let himself into the building, killed the worker, set the building on fire, and killed himself.

While the court found the death occurred in the course of employment, it did not arise out of her employment. The feud was personal and not connected to her employment.

Devastating stroke after reaching MMI does not affect permanent total disability benefits – Nebraska

In Krause v. Five Star Quality Care, a housekeeper fell and fractured her right femur. After her surgery she attempted to return to work, but experienced too much pain. About 2.5 years later, she filed a petition in Workers’ Compensation Court seeking temporary and permanent disability benefits. Approximately three weeks later, she suffered a massive stroke that left her incapacitated.

The compensation court, finding that the stroke was unrelated to the work injury or treatment, found she had reached maximum medical improvement prior to her stroke and awarded her permanent total disability benefits (PTD). The company argued that the stroke cut off her entitlement to PTD benefits. The court disagreed, noting that her work-related disability did not cease once she had the stroke.

Treatment guidelines apply to out-of-state providers – New York

In Matter of Gasparro v. Hospice of Dutchess County, a home health aide sustained work-related injuries to her lower back and buttocks while employed in New York and was given a nonscheduled permanent partial disability classification. Ten years later, she moved to Nevada.

Several years later, the workers’ compensation carrier objected to payment of various medical charges from a pain management specialist in Nevada. A workers’ compensation law judge ruled in favor of the medical provider, but the Workers’ Compensation Board reversed and the appellate court agreed.

Although the Board had departed from its prior decisions on the issue, the appellate court found it was rational to require medical treatment be in compliance with the guidelines.

Unreasonable deviation from employment nixes benefits – New York

In Matter of Button v. Button, a farmhand was seriously injured in a vehicular accident as he crossed a road on an employer-owned all-terrain vehicle (ATV) from his employer-provided residence to the farm itself. His residence was across the road from the farm and his girlfriend was moving in that day. He stopped at the house and grabbed a beer and the accident occurred on the way back to the farm.

His comp claim was denied by a judge because he was engaged in a prohibited activity at the time of the accident (drinking) and, therefore, his injuries did not arise out of and in the course of employment. The Board affirmed as did the appellate court, noting there was a verbal warning about drinking on the job and that other employees testified the consumption of alcohol at work was prohibited.

Workers’ Compensation Board must determine if worker is independent contractor – New York

In Findlater v Catering by Michael Schick, Inc., a state appellate court held that a trial court’s finding that a worker was an independent contractor, and not an employee, must be reversed. It found that employment issues must be decided by the Workers’ Compensation Board and the court erred by not holding the matter in abeyance pending a final resolution.

Volunteer can pursue personal injury suit in spite of liability waiver – New York

In Richardson v. Island Harvest, an unpaid volunteer worked as warehouse assistant and signed an agreement, which stipulated he was a volunteer and would not attempt to hold the organization liable for any bodily injuries he suffered in the course of his volunteer activities. He was struck by a forklift being operated by an employee and filed a personal injury suit. While a county Supreme Court Justice granted summary judgment to the organization, an Appellate Court reversed.

“New York courts have long found agreements between an employer and an employee attempting to exonerate the employer from liability for future negligence whether of itself or its employees or limiting its liability on account of such negligence void as against public policy,” the Appellate Division said.

Insurer cannot sue third-party without involvement of injured worker – Pennsylvania

An employee of Reliance Sourcing, Inc, which was insured by The Hartford, was standing in the parking lot of Thrifty Rental Car when she was struck by a rental vehicle. The Hartford paid over $59,000 in medical and wage benefits and sought to sue the responsible parties for damages. The employee did not join in the insurer’s action, did not assign her cause of action to the insurer, and did not seek to recover damages independently.

While the defendants argued The Hartford had no independent ability to commence a subrogation claim directly against them, The Hartford argued it had filed the suit “on behalf of” the employee. In a divided decision, the Supreme Court ruled that absent the injured employee’s assignment or voluntary participation as a plaintiff, the insurer may not enforce its right to subrogation by filing an action directly against the tortfeasor. – The Hartford Insurance Group on behalf of Chunli Chen v. Kafumba Kamara, Thrifty Car Rental and Rental Car Finance Group.

Widow denied benefits for husband’s pancreatic cancer – Tennessee

In Alcoa v. McCroskey, the Supreme Court of Tennessee Special Workers’ Compensation Appeals Panel ruled that a widow failed to prove her husband’s cancer was caused by his occupational exposure to coal tar pitch, affirming the decision of a trial judge. The judge found Alcoa’s expert to be more persuasive than the widow’s expert, who relied upon a single medical article, yet that article expressly noted its evidentiary deficiencies. The employer’s expert testified that the employee possessed recognized risk factors for the development of pancreatic cancer that were wholly unrelated to his work exposure to coal tar pitch.

Department-approved settlement not sufficient to compel treatment – Tennessee

In Hurst v. Claiborne County Hospital and Nursing Home, a paramedic was injured in an ambulance accident and also alleged a psychological injury from an October 2000 incident when she encountered a severely abused infant. The claim was settled, but the agreement only addressed her psychological injury. No reference was made to the ambulance accident.

After the settlement was finalized, she filed a new claim seeking benefits for the injuries incurred in the ambulance accident. She settled the claim in exchange for the payment of permanent partial disability benefits and the promise of payment for future medical directly related to her injuries. The Department of Labor and Workforce Development signed off on the settlement, not a judge. Seven years later, she filed a motion to compel payment for medical care which a trial judge granted.

On appeal, the hospital argued that the judge lacked jurisdiction since there was no court order awarding her a right to medical treatment for her physical injuries. The Supreme Court of Tennessee’s Special Workers’ Compensation Appeals Panel found the version of the Workers’ Compensation Law applicable to the 2001 car accident did not provide any mechanism for the enforcement of a department-approved agreement that had not been approved by a judge.

Worker loses benefits for failure to attend FCE sessions – Virginia

On three occasions over a four-month period of time, an employee cancelled a scheduled (and rescheduled) functional capacity evaluation (FCE) session. The employer filed a request to terminate benefits. Although the worker did appear for a FCE one week after the hearing, the worker took no action in the nearly seven-month period between the time the employer filed the request and the date of the hearing. In DeVaughn v. Fairfax County Public Schools, the Court of Appeals upheld the decision of the Workers’ Compensation Commission that there were no mitigating circumstances excusing her lack of effort and no basis for a finding of good faith.

Drivers failure to chock wheel nixes benefits – Virginia

In Callahan v. Rappahannock Goodwill, an appellate court affirmed a finding by the state’s Workers’ Compensation Commission that a truck driver willfully violated safety rules when he failed to chock the wheel on the employer’s truck during a stop and, hence, could not receive benefits for the injuries he sustained. The record supported that the safety rules were communicated through several methods to the driver and the physical evidence supported the finding that the wheels were not chocked.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Seven emerging risks and trends to watch

Often employers don’t give emerging trends the same importance as existing practices. Here are seven emerging trends to put on your radar screen:

  1. Temporary workersWhether it’s to meet peaks in demand, a screening process for temp-to-permanent employee, or to tap a unique skill or talent, temporary workers are a vital part of today’s workforce. They also present unique risks for employers. Temp workers are less likely to return to work following an injury and are almost three times as likely to suffer non-fatal occupational injuries than direct hire employees according to a study by University of Illinois at Chicago’s School of Public Health.

    Further, classification of workers as employees or independent contractors remains a thorny legal issue. Insurers are also scrutinizing classification of workers particularly in franchises, the gig economy, and trucking industry. Despite the administration change, OSHA remains committed to overseeing and enforcing temporary workers rights.

    Keeping temporary workers safe and understanding agency/employer responsibilities is a constant challenge. While there is a tendency to be laxer with temporary workers, they need to be vetted and trained as if they would be there permanently. Expectations need to be clearly communicated. Some employers have found “buddy systems” and visual identification effective.

  2. Medical and recreational marijuanaConflicting laws, inconsistent legal rulings, zero tolerance drug policies, differing opinions about the use of marijuana as a viable alternative to relieve chronic pain, and reimbursement issues make marijuana a hot-button headache for employers. Court decisions about reimbursement for medical marijuana have been all over the place. A handful of states have found, and continue to find, that it is reimbursable (CT, MN, NJ, NM, and NY).

    While many courts have ruled that employers with drug-free workplace policies can terminate an employee who tests positive for marijuana, Massachusetts companies cannot fire employees who have a prescription for medical marijuana simply because they use the drug, but must attempt to negotiate a mutually acceptable arrangement with each medical marijuana patient they employ.

    With a tight labor market, companies lament that too many applicants test positive for marijuana during pre-employment screening, causing some to relax the practice. Others grappling with marijuana look at job functions and do not hire someone in a safety-sensitive position if they have a medical marijuana card or prohibit certified users from performing certain safety-sensitive jobs while “under the influence” of medical marijuana. Post-accident drug testing is also challenging for employers as is modified duty for injured workers treating with medical marijuana.

    A new year is a good time to review your written drug policies, clearly communication expectations and company rules to all employees, and be sure supervisors know how to recognize signs of impairment. Employers are responsible for providing their employees a safe working environment and this is one of the more vexing areas. Don’t go it alone; consult with legal counsel and insurance carriers that can help navigate the complexity.

  3. Mental health and PTSDThe debate about mental health coverage under workers’ comp is not new, but continues to gain traction with rising incidents of workplace violence, PTSD, efforts to reduce the stigma associated with mental health, and general concern of stress in the workplace. Workers’ Comp compensability for mental-mental and mental-physical injuries, either by statute, regulation, and/or case law vary widely by state and many states are reexamining their statutes, particularly for first responders.

    Moreover, the effect of depression, anxiety, and other mental health issues on delayed return to work, increased claims costs, and workplace violence are being addressed in return to work efforts and employee assistance programs. Increasingly, mental health is also being incorporated into health and wellness programs.

  4. Ergonomics and wearablesA recent survey by Marsh Risk Consulting (MRC) found that companies are not doing enough to tackle emerging risks, including ergonomics and wearables. Ergonomics typically is one of the top three causes of workplace injuries, but advances in technology offer opportunities to manage and mitigate the risks. Wearables can measure body stresses and provide data, alerts and real-time monitoring to modify behavior and enable managers or other senior workers to make corrections before an injury occurs. They can also provide data for potential engineering and productivity improvements.

    While wearables are here to stay, they need to be integrated strategically. Some things to consider are how they complement existing safety efforts and culture, the cost-benefits, and the risks. Data privacy risks, ethical considerations, and liability exposures for employers all need to be considered when implementing programs using wearables. As with the introduction of any new technologies, employee acceptance is key.

  5. Robotic and human interactionAnother emerging risk needing more attention identified in the MRC survey is the rapid growth in collaborative and mobile autonomous robots that is increasing the threat of injury from human and robot interaction. Whereas robots used to work in isolation, technology has evolved so that many now work alongside humans. A common myth is that the collaborative robot is safe out of the box, yet the manufacturer does not control how it is programmed or used. Every collaborative robot system is unique and the risks must be assessed.

    In addition, employees may resist the introduction of such systems, particularly when they fear losing their job. Smart employers prepare employees for the future of work by systematically and intentionally reskilling and upskilling them.

  6. Alternatives for pain management and the opioid prescription drug crisis2018 was an active year for state legislation regarding prescription drugs in workers’ compensation and more is expected in 2019 to stem the opioid crisis. The industry has seen positive results and continues to seek new ways to address the problem.

    A Hartford survey on opioids in the workplace had troubling results. Over three-quarter of workers don’t feel trained to help colleagues navigate addiction, 64% of human resource professionals say they are unprepared to handle opioid addiction, and only 34% of workers feel the company has the resources to deal with the problem.

    Employers need to step up by educating employees about the risks of the misuse of opioids, identifying those at risk of misuse and getting appropriate help, assessing current workplace drug policies and scope of drug testing, and strengthening employee assistance programs. In addition, working to expand coverage of alternatives for pain management that offer a more holistic approach, such as cognitive behavioral therapy (CBT), mindfulness, physical and occupational therapy, relaxation training, and exercise will help employees gain confidence in their ability to manage their pain.

    Some employers use telemedicine to keep employees engaged with virtual face-to-face meetings between patients and psychologists. Medical marijuana may hold promise for the future, but science is too limited and it remains classified as a Schedule I drug under federal law. It behooves employers to stay abreast of new developments.

  7. Natural disastersThe country has seen its share of devastation this year and the recent dire report on climate change from the US Global Change Research Program suggests it will continue on an increasing scale. For those affected, the implications for workers’ comp are huge – expediting benefit payments and medical care to injured workers directly affected, workplace injuries during disaster recovery, and disruption of business operations. The National Council on Compensation Insurance (NCCI) states that when a natural disaster creates a temporary interruption of normal business activities, this can validate a change in an insured’s operations, and can prompt carriers to consider a change in governing classifications if the employer continues to pay its employees while they are unable to work.

    Businesses should always expect the unexpected. Staying ahead of risks during disasters requires an assessment of the unique risks that can potentially arise in your location and developing a comprehensive plan that addresses employees, infrastructure, and business continuity.

Employers that move beyond the familiar traditional issues and anticipate and address emerging risks become industry leaders.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

 

The possibilities of telemedicine in workers’ comp

While more and more insurers are offering telehealth as part of their health plans, the highly regulated workers’ comp industry is just getting its feet wet. Telemedicine is the use of electronic communication technologies to provide medical services to injured workers without an in-person visit. This fast-paced, instant ability to connect with a medical professional can help a claim to start out right and stay on track. It can be utilized for a range of physician-led services, including initial injury treatment, specialty consultations and follow-up care.

There are several advantages:

  • Immediate attention to minor injuries
  • Fewer emergency room visits
  • More physician and specialist availability
  • Ideal for rural and remote areas
  • Removes transportation obstacles
  • Fewer missed appointments
  • “Stay-at-work” visits improve early return-to-work
  • Aid in management of chronic conditions
  • Initial assessment and evaluation for injuries when access to immediate medical care is limited, such as overnight shifts and remote travel
  • Lower costs

Yet, there are a number of barriers:

  • Employee uneasiness with receiving remote care from an unfamiliar provider
  • Physical examination limited
  • Jurisdictional and regulatory issues
  • Lack of physician fee schedules for telemedicine
  • Start-up technology costs
  • Cybersecurity threats
  • Lack of regulations and policies for licensing and privacy
  • Misdiagnosis

Telemedicine is designed to supplement, not replace, in-person care. For some injured workers, it may be a viable option. As this continues to take hold in workers’ comp, strategies to address the barriers are developing. The types of telemedicine services covered, provider requirements, and reimbursements vary across states and continue to evolve.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Safety risks soar with workforce shortage

The USG U.S. Chamber of Commerce Commercial Construction Index (CCI) is a quarterly economic index designed to gauge the outlook for, and resulting confidence in, the commercial construction industry. While earlier reports indicated that the shortage of skilled workers affected schedule performance and jobsite efficiency, the September index added a new dimension – 80 percent of contractors agree that the skilled labor shortage also impacts jobsite safety and it’s the number one factor increasing safety risk on the jobsite.

Tighter time schedules are the number two factor and exacerbate the safety risks. Aggressive scheduling may cause contractors to use workers with less experience or training, and can push employees to work longer hours, which can lead to shortcuts and compromised processes.

Addiction and substance abuse issues also decrease worker and jobsite safety. Almost 40% of contractors say they are highly concerned about the safety impacts of worker use/addiction to opioids, followed by alcohol (27%) and marijuana (22%). Notably, the report showed that while nearly two-thirds of contractors have strategies in place to reduce the safety risks presented by alcohol (62 percent) and marijuana (61 percent), only half have strategies to address their top substance of concern: opioids, which is a newer growing concern.

Language barriers also are a leading safety risk, particularly in the Northeast (34%) and West (31%).

 

Strategies to reduce safety risks

To address safety risks caused by workforce shortages, contractors believe the most effective strategies are an improved safety culture and more leadership training.

  • Improving the safety climate on jobsites (63 percent)
  • Improving the firm’s safety culture (58 percent)
  • Providing more leadership training for supervisors (48 percent)
  • Tracking and assessing safety records (34 percent)
  • Using safety-enhancing technologies (33 percent)

General Contractors in the Northeast are relying more than others on leadership training for supervisors. Large contractors are using safety-enhancing technology (47%) more than small contractors (27%).

The study dove deeper into the most impactful way to achieve a strong safety culture. It presented a list of practices associated with a strong safety culture and asked contractors to select those with the highest impact on safety outcomes. Training at all levels topped the list (67%). More than half (53%) of contractors believe that ensuring accountability at all levels has a high impact. Other indicators include improving communication (46 percent), demonstrating management’s commitment to safety (46 percent), improving supervisory leadership (43 percent) and aligning and integrating safety as a value (42 percent).

More general contractors consider empowering and involving employees (58%) and demonstrating management commitment (55%) to have a high impact on safety outcomes, compared with trade contractors (35% and 34%, respectively.)

The top strategies contractors are using to reduce safety risks caused by substance abuse are testing, prescreening before hiring, education, communication oversight by supervisors, zero tolerance policies, counseling, and access to rehab.

The labor shortage in the construction industry is projected to last another three years, requiring increased emphasis on safety training and supervision. Four out of five (80%) contractors said they experienced some competitive advantage from their safety programs, although larger companies with more resources and expertise gain a greater advantage. They cite insurance, liability, and new business as top benefits.

Even a few injuries can push worker comp rates sky high, raise the experience modifier, reduce bidding opportunities, lower morale, and put more pressure on workers who are already expected to do more with less. A renewed emphasis on safety that is inclusive and forward thinking will help curb the risks.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

 

OSHA watch

Compliance date for parts of general industry beryllium standard delayed

The compliance date for certain ancillary provisions in the beryllium standard for general industry is extended to December 12, 2018. The final rule published in the Aug. 9 Federal Register, states that the compliance date applies to requirements for methods of compliance, beryllium work areas, regulated areas, personal protective clothing and equipment, hygiene facilities and practices, housekeeping, communication of hazards, and recordkeeping.

New compliance assistance resources available for Silica Standard

  • A customizable slide presentation can be used to help train construction workers.
  • A five-minute video shows how to protect workers from exposure to silica dust.
  • A series of short videos demonstrates the proper use of specified dust control methods for six common construction tasks.
  • An FAQ page provides answers to frequently asked questions about the Respirable Crystalline Silica Standard for Construction.

Tips on forklift safety and maintenance

New QuickCards are available in English and Spanish to aid employees and employers in the safe operation and proper maintenance of forklifts.

Guidance explains how to use the 300 log to look for trends

That was no accident encourages employers to use the 300 Log not just as a paperwork exercise or a way to look at past performance, but as part of a company’s road map to finding and fixing hazards.

Redesigned regulations webpage provides easier navigation

The Law and Regulations webpage that features information on standards and rulemaking now can be searched by keyword or number and includes the latest updates on active rulemaking. The page also features information buttons to explain regulatory language that may be unfamiliar to some users.

Free workplace violence prevention webinar available online

A free 60-minute webinar on preventing workplace violence in healthcare settings is available from The Joint Commission, a long-standing national alliance partner. The webinar includes an overview of Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, as well as a discussion of a multi-hospital intervention study that reduced violent events.

Name-and-shame strategy still prevalent in news releases

While the rate of releasing public statements about enforcement actions taken against employers is significantly lower under the Trump administration than the Obama administration (463 a year to about 150), the tone in these press releases has not changed. Most include harsh and embarrassing quotations from senior officials. Stakeholders argue that the press releases are based merely on allegations of violations and are published prior to companies being afforded a hearing.

Enforcement notes

California

  • Roofing contractor, Petersen-Dean, Inc., faces $146,004 in fines for repeat violations of exposing workers to fall hazards.
  • New York-based Outfront Media Inc, an outdoor advertising company, faces proposed penalties of $32,435 for serious safety violations after a worker suffered third-degree burns as well as an inadequate heat illness prevention plan for its outdoor workers.

Florida

  • G&H Underground Construction faces $57,738 in proposed penalties for allowing the use of unguarded machines after an employee suffered a throat laceration at a worksite in St. Augustine.
  • Archer Western Construction Inc., an Atlanta-based company, faces $33,259 in proposed fines for safety violations after two employees suffered fatal injuries while performing trenching activities at a Miami worksite.
  • The Holly Hill-based paving company, Pavemax Corp. faces $16,814 in proposed fines for safety violations after an employee suffered fatal injuries at an Orange City worksite, including failure to train and provide a place of employment free from recognized hazards.

Illinois

  • HB Fuller Company, operating as Adhesive Systems Inc., faces $587,564 in proposed penalties for 18 health and safety violations at its facility in Frankfort. The company was cited for failing to: provide employees with respirator fit tests and respirators appropriate for hazardous atmospheres; require bonding and grounding when transferring flammable liquids; ensure that electrical equipment was approved for use in hazardous atmospheres; and conduct a personal protective equipment assessment.

Mississippi

  • After Nissan North America Inc. contested two violations, an administrative law judge of the OSHRC vacated one serious citation but affirmed the other and assessed a $12,675 penalty. The law judge affirmed the violation of training requirements in an employer’s energy control program after determining that the evidence established that the exposure was reasonably predictable and training the technicians was required.

New York

  • The OSHRC affirmed two serious citations previously vacated by an administrative law judge against a commercial laundry facility, Angelica Textile Services Inc., in Ballston Spa. A single grouped penalty of $7,000 was assessed for inadequate isolation and verification procedures for a permit required confined space and of lockout/tagout procedures. However, the review commission reclassified the penalties as serious rather than repeat violations.

Pennsylvania

  • Grove U.S. LLC. was cited for exposing workers to struck-by hazards after three employees suffered fatal injuries when a 300-ton crane collapsed at the company’s Shady Grove facility. The company faces proposed penalties totaling $14,976, the maximum amount allowed.

Tennessee

  • Day & Zimmerman NPS Inc. faces $71,599 in proposed penalties for exposing employees to electric shock hazards at the Tennessee Valley Authority Sequoyah Nuclear Power Plant in Soddy Daisy.
  • Specialty Tires of Unicoi faces $6,000 in fines after a mechanic was killed when he was caught in the moving arms of an assembly machine. The company was cited for failure to have an energy control procedure and failure to conduct regular inspections of an energy control program and ensuring that employees understand and comply with such a program.
  • M&K Home Improvement faces $51,200 in penalties for exposing workers to fall hazards.

For more information.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Three ways detailed job descriptions protect employers and save costs

Clear, accurate, and detailed job descriptions can help employers avoid hiring the wrong person for the job, facilitate the return to work of injured workers, and reduce legal challenges. At the Workers’ Compensation Institute’s annual educational conference in Orlando, Jaime Sigurdsson, an exercise physiologist and director of workers’ compensation at CORA Physical Therapy in Longwood, Florida, explained that the job description should include essential job functions, knowledge and critical skills, physical demands, environmental factors, and any other explanatory information that may help clarify the job. The more specific, the better.

Some companies omit the necessary specifics. As an example, she explained that a requirement for a worker to lift 50 pounds doesn’t explain if it’s once or several times a day. It also does not separate method from function; instead of ‘lifting,’ ‘relocate’ may be more accurate.

A recent winner of the National Underwriter’s Excellence in Workers’ Compensation Risk Management Award, Kansas City-based Cosentino’s Food Store revamped its workers’ comp program in 2012 and has seen a 49 percent reduction of overall program cost on a per-employee, per-month basis. A key element of the program is a thorough job analysis.

In the grocery industry, most injuries are musculoskeletal, often related to lifting. Others include lacerations from box cutters or knives and the usual slips, trips and falls. In a recent propertycasualty360.com article, Aaron J. Greer, director of human resources for Cosentino’s Food Stores, noted the process starts with a thorough job analysis and post-offer testing, which means the workers hired are better able to handle the jobs with less risk of injury.

He recommends spending time in each department to better understand the risks employees face and then drafting the most detailed job analysis possible. To actually experience the job is eye-opening; it uncovers risks and can shed light on alternative methods of performing essential jobs.

In addition to the hiring process, a detailed job description can facilitate an injured worker’s recovery process. During recovery, workers can do a modified version of their job or a slightly different job and gradually progress to full recovery. To make this happen, the treating physician must have essential information about workplace policies, job demands and the availability of transitional work. Greer shares his job descriptions with the company’s medical providers and invites them to the stores to see firsthand how employees do their jobs, matching actions to job descriptions.

When an employer can select their physicians, it’s important to choose doctors who are experienced and understand the nuances of occupational health. A thorough job description will help ensure that workers can get back to work and function quickly – but not so quickly that they reinjure themselves. Employers who can’t influence physician selection should look to case managers or nurse triage providers who are closely aligned with the company’s recovery-at-work philosophy.

Since the Cosentino stores are open long hours, they established an open-to-close program with a dedicated phone line that connects employees to a nurse assigned to them. Well-versed in the stores’ processes, the nurse understands the detailed job requirements, and directs injured employees to the correct provider immediately. The early intervention reduces the likelihood that the claim will escalate.

When done properly, job descriptions can also protect employers from lawsuits related to the Americans with Disabilities Act (ADA) and other laws that protect workers from discrimination. While the law does require accommodations in most cases, case law has generally supported employers when an employee cannot perform the “essential job functions.” Inadequate or inaccurate job descriptions can complicate a claim and lead to bad outcomes for both the employer and the employee.

Equally problematic is overstating the job requirements. Weight loads get many employers into trouble, as demonstrated by a recent case in the 9th U.S. Circuit Court of Appeals in San Francisco, Victor E. Pfendler v. Liberty Dialysis-Hawaii L.L.C. While the job description asserted that lifting 75 to 100 pounds was an essential job function, in reality, the most that was lifted on a regular basis was about 40 pounds. The court noted, “if lifting more than 50 pounds was not an essential function of the job, he would have been a qualified individual and Liberty’s refusal to allow him to return to the (dialysis) position may have been discriminatory.”

Detailed job descriptions are a critical component of a successful Workers’ Comp program. With a robust program, the employee feels valued, protected, and knows appropriate work will be available if they are injured. It’s not a restriction; it’s a way to help them stay on the job and maintain a healthy and productive life.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Things you should know

Opioid spending down but topical medications up

A report by Coventry Workers Comp compared its 2017 data on managed claims, representing 77.6% of total comp prescriptions, and unmanaged claims. Overall drug utilization in comp was down in 2017 – especially in opioids and compounds medication, an overall industry trend – with 5.9% drops in managed claims and 7.4% in unmanaged claims.

However, topical medications prescribed in the unmanaged category of claims jumped 9.8%, compared with a 6.5% drop in the managed category. This was driven by “high-dollar, private-label topical analgesics marketed directly to physicians’ offices… contributing to the significant rise in unmanaged topical utilization per claim – demonstrating the need for continued focus on moving these transactions.”

Safety standard for wind turbine workers

The American Society of Safety Professionals has published the first U.S. industry consensus standard written specifically for the construction and demolition of wind turbines.

White paper suggests Medicare Set Asides greatly inflate costs

A new white paper produced by Care Bridge International, suggests that conventional Set Aside practices greatly inflate costs to claims payers, by as much as doubling the cost. The company is a data analytics firm, that uses a massive claims database to estimate the true exposure of future medical treatment and costs in Medicare Set Asides for workers’ compensation claims.

Health care workers, PPE and infection control: Study finds failures to follow protocol

Health care workers may be contaminating themselves and their work environments by neglecting to use personal protective equipment and follow preventive protocols, according to a study from researchers at the University of Michigan and the University of Utah. The study was published online June 11 in JAMA Internal Medicine.

CPWR offers skin cancer prevention tips for outdoor workers

Workers who spend all or part of their days outdoors have an increased risk of developing skin cancer, the Center for Construction Research and Training (CPWR) cautions in a recently released hazard alert.

Highly repetitive work in cannabis industry increases risk for musculoskeletal disorders

Employers in the marijuana industry should provide safeguards to protect workers from repetitive stress injuries, NIOSH states in a recently released Health Hazard Evaluation Program report.

European Commission adopts new rules on pilot mental health requiring airlines

Three years after the Germanwings crash in which a pilot deliberately flew a jet into a mountainside, the European Commission has adopted new rules on pilot mental health requiring airlines for the first time to carry out a psychological assessment of pilots before they hire them.

States bolster whistleblower protection

An analysis by watchdog group Public Employees for Environmental Responsibility (PEER) found that most states have expanded their whistleblower protection laws over the past 12 years, including 10 states that have done so in their most recent legislative sessions. The PEER analysis includes a report card detailing where all the states rank in different categories.

State News

California

  • Cal OSHA stronger enforcement has led to more citations and higher fines. In 2016, it inspected 813 businesses, finding 93% of them out of compliance, issuing 2,736 citations, 15% of them serious, all totaling $2.5 million in fines – nearly double the amount for the same number of citations from two years earlier.
  • Although workers’ compensation insurance rates have dropped 22% since 2014, the state still has the highest rates in the country, representing one-fifth of the premium collected nationwide with only 11% of the national workforce, according to a report released recently by the Workers’ Compensation Insurance Rating Bureau.

Indiana

  • A new procedure for submitting settlement documents to the Workers’ Compensation Board took effect Aug. 1 and will become mandatory Sept. 1. All settlement agreements and proposed orders, as well as supporting documentation, should be submitted to WCB electronically in a PDF format. WCB has provided a checklist of elements that should be included, or not included, in settlement documents.

Pennsylvania

  • The Governor introduced opioid prescription guidelines in a booklet to “help health care providers determine when opioids are appropriate for treatment of someone injured on the job.” It is one of 11 guideline booklets on the subject.

North Carolina

  • After three years of litigation, the new ambulatory surgery center fee schedule became effective June 1. The new rules.

Tennessee

  • Strict new claims-handling standards took effect Aug. 2, the first revision to the standards since they were enacted almost 20 years ago. The new rules will require greater attention to detail, better communication with injured workers, and low error rates on electronic data submissions.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Determining the risks of delayed recovery

One of the most perplexing problems in workers’ comp is delayed recovery, or relatively minor claims that become long-term, costly claims. Often the claims go unnoticed until significant dollars are spent on procedures, surgeries, and medications for an injury that should have healed long ago. While these claims may only represent 6 – 10% of all claims, they can consume 80 percent or more of medical and indemnity resources, according to Integrated Medical Case Solutions.

Yet, if identified early, proper intervention prevents the delayed recovery. Research suggests that psychosocial factors play a large role in these “creeping catastrophic claims.”

Pioneers of diagnosing and treating injured workers with psychosocial risk factors, Michael Coupland, the CEO and Network Medical Director of Integrated Medical Case Solutions, and Steven Litton developed a simple pain screening questionnaire (PSQ). Though widely used in Canada and several other countries, it is just starting to catch on with the U.S. workers’ compensation system, according to an article in Property Casualty 360°.

It includes ten questions or statements related to the injured worker’s pain attitudes, beliefs and perceptions, which the injured worker rates on a scale of 1 to 10. The article notes that one of Coupland’s favorite questions is ‘I should not do my normal work with this amount of pain,’ which gives insight into work attitudes, catastrophic thinking, and fear-avoidance behavior.

Physicians focus on the pain and physical diagnosis and prescribe MRIs, tests, surgeries, and even opioids. Costs escalate with little relief of pain. The underlying psychosocial factors go untreated and include:

  • Catastrophic thinking – or OMG! Thoughts. Despite the injury or illness, people believe they are beyond the ability to recover.
  • Fear avoidance. Workers are so concerned about further injuries, they avoid doing anything that might exacerbate the pain.
  • Anger and perceived injustice. Regardless of how long someone has worked at their company, they feel a disservice has been done to them.
  • External focus of control. Workers rely on their medical providers and others to fix them, rather than taking any responsibility for their own recovery.

Since 2013, Albertsons Safeway has used the test to determine the risk level of delayed recovery, giving it to all injured workers with indemnity claims two weeks post injury. According to a blog post by the IMCS Group, the average amount paid per claim rose exponentially with risk level. Looking at data from the 2013 – 2015:

Risk Level # of Injured Workers Average Amount Paid
Low 1,031 $2,059
Low-Moderate 307 $10,759
Moderate 145 $21,783
High 192 $26,212
Very High 148 $39,967

The injured workers who scored high or very high were given the opportunity to undergo cognitive behavioral therapy (CBT). About half agreed to do so. Unlike traditional psychotherapy, CBT is brief. The goal is for injured workers to cope with their pain, rather than be cured of it.

The blog post, Early CBT Intervention Changes Lives, Saves Money for WC Payers, explains the company created three groups of injured workers that had scored as high-risk on the PSQ to test the effectiveness of the CBT intervention. One group that participated in the CBT program; a second group that chose not to participate; and a third group of injured workers that had not been offered CBT.

Here are the results:

Group Average Total Paid
Participated in CBT $36,629
Did not participate $44,356
Were not referred to CBT $73,488

Those who engaged in CBT returned to work much sooner than those in either of the other two groups. According to an Albertsons Safeway representative, the program resulted in an estimated 30 percent reduction in total claims cost.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Fatigue: a hidden workplace risk

Americans are known as a 24/7 society and often take pride in their sleep deprivation. Although some workers experience fatigue at work because of their lifestyle, the workplace is the root of fatigue for many workers. And, according to a study by the National Safety Council (NSC), 74% of employers underestimate the prevalence of fatigue in the workplace and 73% do not communicate with employees about fatigue.

Overtime, high risk hours (night or early morning), demanding jobs that require sustained attention physically and/or mentally, long shifts, quick shift returns, and no rest breaks are among the top fatigue risk factors identified by the NSC. The common argument made by employers is that productivity will be reduced if steps are taken to address fatigue. And the current employee shortage in many areas has exacerbated the problem.

Yet, as the work schedule progresses, workers tire naturally as they use up energy. Too few breaks and long shifts add to the strain on body and mind, leading to reduced alertness and lack of concentration. But employees are reluctant to say they are too tired to do their job safely for fear of being perceived as lazy, uncooperative, or losing needed overtime pay.

The result is not only a decline in productivity, but also increased accidents and near-misses. According to the NSC, 32% of reported injuries and near-misses are due to fatigued employees. Workplace fatigue problems can be cured, but the hurdle is recognizing the correlation between incidents and fatigue and developing solutions that are compatible with productivity objectives.

While each employer’s situation is unique, here are some considerations:

  • Analyze the workload and staffing imbalances that necessitate excessive overtime. Look at options such as reengineering processes to reduce staff hours and cross training employees
  • Rotate shift schedules to ensure no one is always on the night shift. Rotating shifts is a best practice that entails scheduling a worker for the night shift for two weeks and then giving them time off and then scheduling for day shifts for two weeks
  • Implement the 12-hour rule: make sure employees have 12 hours off between shifts
  • Control the boredom factor by varying tasks. Employees doing monotonous work and tasks are more susceptible to fatigue
  • Provide a designated area for employees to rest. A 15-30-minute power nap when working long shifts can be a great refresher
  • Educate workers on the symptoms of fatigue, the impact of shift work on sleep-wake cycles and the best ways to manage it. Provide resources to deal with sleep disorders
  • Let employees know they share responsibility with the company for preventing fatigue and, given adequate time away from work, they are responsible for getting enough sleep
  • Use ergonomic equipment designed to reduce physical strains
  • Provide plenty of water, healthy snacks
  • Evaluate the lighting and temperature in the workplace as well as other environmental issues that can produce fatigue. Minimize humidity, noise, vibration
  • Monitor fatigue. Research technology that fits your industry
  • Have a risk management system, including reporting of fatigue-related incidents, investigation, training and auditing

Rather than adopting the attitude “that’s just the way things have to be to get the work done” understanding how the workplace is set up, how the work is handled, and how fatigue is a serious, costly risk can guide employers to develop a plan that mitigates risks and maintains productivity levels.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com

Legal Corner

ADA
Employee with mental illness can be terminated for inappropriate conduct

In Medina v. Berwyn South School District 100, N.D. Ill., a school district employer that terminated an administrative employee who recently returned from FMLA leave for major depression and generalized anxiety disorder did not violate the ADA or the FMLA, according to the U.S. District Court for the Northern District of Illinois. When she returned to work she shared an office with two other administrative assistants and when asked by the principal to translate a letter argued it was difficult to concentrate and she had too many other things to do.

When she met with the principal, she was told she was insubordinate and, feeling anxious, called her therapist who told her to call an ambulance. After hanging up on 911 twice, she placed the call and when leaving on the gurney she yelled at the principal and assistant principal in front of the students. Her doctor sent a note asking to place her on medical leave, but the district conducted an investigation and decided to terminate her due to misconduct.

She filed suit claiming she was discharged because of her disability, but the court found “when an employee engages in behavior that is unacceptable in the workplace… the fact that the behavior is precipitated by her mental illness does not present an issue under the Americans with Disabilities Act; the behavior itself disqualifies her from continued employment and justifies her discharge.”

 

Adverse action against an employee over the fear that the employee will develop a disability nixed by court

An applicant received a conditional offer of employment from Burlington Northern Santa Fe pending a medical evaluation, among other things. The company believes that hiring individuals for a safety sensitive position who have a body mass index of 40 or greater, pose a significant risk for diabetes, sleep apnea, and heart disease. While the applicant had none of these, his BMI was 47.5.

The company withdrew the offer and the applicant sued under the ADA. The company and the court agreed that the applicant was not disabled by his obesity, but the U.S. District Court, Northern District of Illinois found that there were triable issues as to whether the company treated him as if he were a “ticking time bomb” who at any time could be unexpectedly incapacitated by obesity-related conditions.

While the company pursued a business necessity defense, the court found it was impossible to determine whether it was truly necessary to exclude individuals with Class III obesity from safety-sensitive positions. Shell v. Burlington Northern Santa Fe Railway Co.

 

Workers’ Compensation
Supreme Court defines Independent Contractors – California

In a groundbreaking decision, Dynamax vs The Superior Court of Los Angeles County, the Supreme Court rejected “The Borello test,” a ten-point test which was used as a standard test for employment and applied the much narrower three factors of the ABC test: i.e., to show that a worker is free from its control, performing work outside the usual course of its business, and customarily engaged in independent work.

This case was decided for the purposes of the state’s wage orders, and not directly related to workers’ compensation, but many speculate it sets the stage for more workers being designated as employees.

 

Benefits for treatment from physician not approved by employer denied – Georgia

In Starwood Hotels & Resorts v. Lopez, the Court of Appeals overturned a judge’s order awarding an injured worker payment for treatment by the doctors she selected without the approval of her employer. The employee slipped and fell and initially went to one of the approved facilities and was diagnosed with an elbow fracture. When she returned to work, the hotel had changed management and she was assigned to a less physically demanding position, but stopped working because of continued pain and sought treatment from her own physicians. When she filed for reinstatement of her TTD benefits, Starwood requested a hearing to determine if it was liable for additional benefits.

An ALJ determined that Starwood’s hearing request had effectively been a challenge to her claim, which entitled her to choose her physician. After a series of appeals with different results, the Court of Appeals found Starwood’s hearing request was not the same thing as denying benefits, but the TTD award was appropriate.

 

Medical providers can’t charge interest on late workers’ comp claims – Illinois

In Medicos Pain & Surgical Specialists S.C. and Ambulatory Surgical Care Facility LLC. vs Blackhawk Steel Corp, the medical providers sought to recover $37,229 in interest under the Workers’ Compensation Act for long-awaited payments related to care for an employee who fell four stories off a truck in 2010. In overturning the trial court’s ruling, the appellate court found that even though the Workers’ Compensation Act provided for interest payments, the medical service providers are not members of the class for whose benefit the Act was enacted. It noted this type of dispute belongs with Illinois’ Workers’ Compensation Commission, and not in the courts.

 

Carrier’s subrogation rights upheld in spite of alleged misconduct – Illinois

In Estate of Rexroad v. Mid-West Truckers Risk Mgmt, the court ruled that a carrier’s right to reimbursement is “absolute,” and cannot be denied because of alleged wrongdoing. When there is a recovery available from third parties who are responsible for the injury, “fairness and justice require that the employer be reimbursed for the workers’ compensation benefits he has paid or will pay.”

 

Spider bite compensable – Illinois

In Jeffers v. State of Illinois/Tamms Correctional Center, an educator worked in a classroom at a correctional center that was not open to the public and was known to have pest problems in the past. She was bit and diagnosed with a brown recluse spider bite and treated with antibiotics, pain medication, and steroids.

While an arbitrator denied benefits, the Commission reversed, noting the educator was exposed to a greater risk of encountering insects and spiders at the prison than that of the general public.

 

Employee definition in Independent Contractor statute does not apply to workers’ compensation – Massachusetts

The Supreme Judicial Court ruled the state’s independent contractor statute does not determine employee status for workers’ compensation benefits. The reviewing board of the Department of Industrial Accidents noted that the law governing employment relations in the state is far from uniform.

The case involved a newspaper delivery service that pays delivery agents to distribute the newspapers to subscribers. The agent had signed several contracts, indicating she was an independent contractor, was allowed to subcontract her deliveries, supplied all her own materials, purchased and collected independent contractor work insurance, and filed her taxes as an independent contractor.

To determine whether a worker is entitled to wage and hour protections, minimum wage or overtime, a three-prong independent contractor test is applied, but whether a worker is entitled to workers’ compensation depends on an analysis of twelve factors.

 

Employer cannot be ordered to reimburse for medical marijuana – Michigan

In Newville v. Michigan Department of Corrections, the workers’ compensation magistrate found that a correction officer’s injuries were sustained as a result of altercations with inmates, and prescriptions for Oxycodone, Fentanyl, and medical marijuana for back pain were reasonable and necessary. However, pursuant to the workers’ compensation law and the Medical Marijuana Act, the magistrate cannot order the employer to reimburse for the cost of medical marijuana, even though the worker’s use of marijuana helps reduce his use of prescribed opioids.

 

Failure to adequately train employee trumps employee’s violation of safety practices – Missouri

In Elsworth v. Wayne Cty., an employer sought a reduction in comp benefits because an employee had failed to wear a seat belt or safety hat. An 18-year-old employee had been on the job less than a month when the dump truck he was driving overturned, leaving him in a vegetative state for the rest of his life. In making its decision, the Commission determined that the employer had not adopted any training program and had not monitored employee compliance with any rules.

 

Supreme Court upholds statutory benefits for Mesothelioma claims – Missouri

A constitutional challenge to a 2014 statutory amendment that allowed workers to collect a lump-sum payment of benefits if they develop occupationally caused mesothelioma was rejected by the Supreme Court in Accident Fund Insurance Company; E.J. Cody Company Inc. v. Robert Casey, Dolores Murphy. In Missouri, employers have the option of accepting liability for occupational diseases under Section 287.200.4 or taking the risk of defending against a civil suit. In this case, the employer accepted liability and insured the risk.

The Supreme Court ruled that the statute providing the enhanced benefits is not unconstitutionally retrospective. As such the widow and the eight adult children were entitled to benefits. Section 287.200 is unlike other workers’ compensation provisions in that it does not condition a child’s recovery upon dependency status.

 

Increase in impairment and level of disability necessary for a change in benefits – Nebraska

In Moss v. C&A Industries, a laborer employed by a temporary agency suffered serious injuries when a crane dumped a load of iron on him and he has not worked since. After there were complications from his first knee surgery, he was found to be permanently and totally disabled. Later, the court approved a right knee arthroplasty, noting the altered gait from the left knee surgery caused the injury.

When he sought a modification of benefits, the court found under Nebraska law a worker must show a change in impairment (physical condition) and disability (employability and earning capacity). Since there was no change in disability, the appellate court said the compensation court erred in modifying his award.

 

Withdrawal of partner does not nullify Workers’ Comp coverage – New York

In Matter of Smith v Park, a father and son operated a farm business as a partnership and subsequently, the father withdrew. A minor-aged boy was killed in an accident and his mother argued that there was no insurance in effect at the time. However, the appellate court ruled that a change in partners did not void the workers’ compensation insurance policy, nor the carrier’s acceptance of liability for the death of a teenage employee.

 

Injured employee cannot sue employer’s alter ego entity – New York

In Buchwald v. 1307 Porterville Road, an Appellate Court ruled that an employer’s immunity from civil suit is extended to the employer’s corporate alter egos. The employer had formed two single-member-owned LLCs on the same day for the purpose of running a horse farm. One entity owned the property and leased it to the other entity, which employed the injured worker. According to the court, an entity can establish itself as the alter ego of an employer by demonstrating that one of the entities controls the other, or that the two operate as a single integrated entity and, in this case, they integrated or comingled assets, had the same insurance policy, and were jointly operated. Since the real estate owner was the alter ego of the employer, it was also protected by exclusive remedy.

 

Fatal heart attack compensable in spite of health risk factors – New York

In Matter of Pickerd v. Paragon Envtl. Constr., Inc., a construction worker suffered a heart attack while assisting a coworker with the removal of an underground gasoline tank and died three days later. He was a smoker and had high cholesterol and there was conflicting testimony from physicians as to what caused the heart attack.

In awarding benefits, the appellate court noted the decedent’s work need not be the sole agent of death; it was sufficient if it was only a contributing factor.

 

Smoking break injury not compensable – North Carolina

A city employee, working on a utility crew, smoked his first e-cigarette during a lunch break in a city truck at a gas station and had a coughing fit. He stepped out of the truck, passed out, and injured his right hip, back, and head and could not return to his former position. He was diabetic and had not been taking his meds.

The case went through several appeals and, in each case, the court determined he was not eligible for benefits. His fall was due to underlying medical conditions and his personal decision to smoke. It was neither work-related nor dictated by his employer.


For new employee unexpected weight of box makes lifting injury compensable – North Carolina

In Doran v. The Fresh Market, Inc., et al.,a cheese specialist had worked in his position for nine weeks, and he described his job as routinely involving lifting boxes up to 25 pounds. He injured his shoulder and arm when he lifted a box that had no weight displayed and was heavier (40 lbs) than he thought. While the company argued against benefits, noting that a new worker would “basically have no regular routine,” the court observed that new conditions of employment don’t become part of a worker’s regular course of procedure until he “has gained proficiency performing in the new employment and become accustomed to the conditions it entails.”

 

Coming and going rule nixes foreman’s benefits – Pennsylvania

In Kush v. WCAB (Power Contracting Co.), The Commonwealth Court ruled that an electrical foreman was not entitled to workers’ compensation benefits for his injuries from a car accident that happened while traveling to a job site. He worked for two employers and managed multiple jobs during the day. Typically, he drove directly from his home to his assigned job site.

While managing nine jobs, he suffered injuries in a car accident driving to a job site where he had worked almost exclusively the week leading up to the accident. Compensation was denied based on the “coming and going rule” and upon appeal, the foreman argued he had no fixed place of employment and his employment contract covered travel time, exceptions recognized under the rule. However, the Commonwealth Court upheld the denial, noting he had a fixed place of employment because he was reporting to the same location each day until the project was complete and he was not paid for travel time.

For Cutting-Edge Strategies on Managing Risks and Slashing Insurance Costs visit www.StopBeingFrustrated.com