Tag: Workers Comp

A federal workplace safety investigation into a maintenance technician’s fatal electrocution found an Ashland, Alabama,  cabinet manufacturer might have prevented the incident by following required safety standards, the Occupational Safety and Health Administration said Tuesday.

OSHA investigators determined the 33-year-old employee of Wellborn Cabinet Inc. was exposed to a 277-volt circuit while replacing a light fixture in a paint booth on March 16.

OSHA cited Wellborn Cabinet with eight serious violations for not verifying that circuit elements and equipment parts were de-energized before allowing an employee to install light fixtures, and for failing to use energy isolating devices for hazardous energy.

Agency inspectors also identified violations for the company’s failure to ensure employees wore eye protection when spraying coatings, paints and finishes, and for allowing workers to utilize an A-frame portable ladder to access the top of a paint booth.

OSHA has proposed $115,188 in penalties.

 

 

The Kentucky Supreme Court unanimously ruled that a claimant does not need a permanent injury to reopen a claim.

Maria Jimenez worked for Lakshmi Narayan Hospitality Group at a Holiday Inn in Louisville. She suffered injuries in August 2014 when she slipped and fell while cleaning a bathroom.

An administrative law judge awarded Ms. Jimenez temporary total disability benefits from August 2014 through April 2015. The ALJ also determined that Ms. Jimenez did not sustain a permanent injury and was not entitled to future medical benefits.

In July 2019, Ms. Jimenez filed a motion to reopen due to a change in disability after being diagnosed with cervical disc disease and depression. She also sought an award of permanent partial disability benefits.

The ALJ granted the motion, and the reopened claim was assigned to a different ALJ, who found that Ms. Jimenez established a worsening of her condition and awarded permanent partial disability benefits and reasonable medical expenses.

The Workers’ Compensation Board reversed because the original ALJ had found she did not sustain a permanent injury.

The Court of Appeals then reversed, ruling that Ms. Jimenez’s claim was not barred and that the board had misconstrued state law on reopening claims.

The Kentucky Supreme Court in a Sept. 22 decision clarified that state law allows the reopening and review of any award or order when there is fraud, newly discovered evidence, a mistake or a change of disability. The court said Ms. Jimenez’s efforts to reopen her workers compensation claim due to a change in her disability are covered by the statute

WorkCompCentral is a sister publication of Business Insurance. More stories here.

 

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The U.S. Centers for Disease Control and Prevention has revised its guidelines to say that universal masking in health care settings may not be required if community transmission levels of COVID-19 are low.

The new guidelines also state that health care professionals “could choose not to wear” masks “when they are in well-defined areas that are restricted from patient access,” such as staff meeting rooms, when community spread of COVID-19 is not high.

However, even if masking is not universally required, it remains recommended for individuals in health care settings who have had close contact with a patient or visitor with COVID-19 or suspected to have COVID-19 or other respiratory infection. The guidelines mention runny nose, coughing or sneezing as signs of infection. Masking is also recommended if a health care worker resides or works in a unit or area of the facility experiencing a COVID-19 outbreak.

The guidelines state that universal use of masks “could be discontinued as a mitigation measure once no new cases have been identified for 14 days.”

Health care “facilities might also consider using or recommending (masks) when caring for patients who are moderately to severely immunocompromised,” the guidelines state.

The CDC also wrote that as community transmission levels increase, “the potential for encountering asymptomatic or pre-symptomatic patients” with COVID-19 infection also

“likely increases” and in “these circumstances, health care facilities should consider implementing broader use of respirators and eye protection by (health care professionals) during patient care encounters.”

The U.S. Occupational Safety and Health Administration, which has historically updated its guidelines following CDC recommendations and is expected to institute a permanent COVID-19 standard for health care workers by the end of the year, has not updated its COVID-19 page since August 2021.

 

A study examining how injured workers interpret and react to adverse effects from work injury and claims processes found that an improved understanding of unfairness in the system and better communication from employers and claims organizations can improve outcomes.

Researchers at the University of Waterloo in Ontario, Canada,  conducted interviews with 36 injured workers finding that workers reacted in a number of ways and stages when faced with “procedural” unfairness: they were passive, they fought back, they quit pursuit of the claim, they quit their job, or they won or continued to fight.  

“Feeling confused, angry, frustrated, unsupported, disappointed, determined, optimistic, and wary were common emotions,” according to the study, made public on Monday and published in the Journal of Occupational Rehabilitation in the summer.

The university sought “precarious workers,” or “those who earn low or inconsistent wages. Often, they are uncertain how to access work compensation programs or are reluctant to speak up for fear of losing their jobs. The types of injustices faced by workers in the study included being laid off during a claim, receiving inadequate modified work or medical attention, employer claim suppression and unresponsive claim adjudicators.”

The study concluded that “identifying unfairness and its emotional, behavioral, and material effects on workers is important to understand implications for compensation systems” and that “understanding and recognizing unfairness can equip employers, legal representatives, compensation boards, and physicians, to address and prevent it, and provide worker resources.”

Policy changes can ensure accountability and consequences to unfairness, the study found.

 

 

After falling in calendar year 2020, aggregate medical payments rebounded in 2021 and increased about 5.5% to $1.9 billion, according to a report by the Workers’ Compensation Insurance Rating Bureau of California.

The WCIRB attributed the increase in aggregate payments to increases in average payments per transaction last year. And the increase in payments per transaction “was largely because of the 2021 fee schedule updates to medical-legal and evaluation and management services.”

While the approximate 559,000 claim total in 2021 was unchanged from 2020 and both years included about 13 million paid medical transactions, the WCIRB reported that the average payment per claim increased 5.7% to $3,374 and the average paid per transaction increased 5.6% to $146.

“Evaluation and management services experienced the largest percentage increase (5%) in share of medical payments in 2021 compared to 2020, which was mostly driven by increases (13%) in paid per transaction,” according to the WCIRB report. “The higher paid per evaluation and management transaction was mostly due to the 2021 updates to the reimbursement allowance for evaluation and management services.”

The Division of Workers’ Compensation in March 2021 updated the evaluation and management billing section of the fee schedule to align with changes made by Medicare.

The DWC in April 2021 adopted a new Medical-Legal Fee Schedule that created a flat fee of $2,025. The payment covers review of up to 200 pages of records, with an additional payment of $3 per page thereafter. As a result, the share of medical payments for medical-legal services increased 18% in 2021 and average payments per service increased 21%.

The WCIRB reports physicians’ offices remain the leading place of service, accounting for the highest share of medical payments, 58%, and the highest share of medical transactions in 2021 with 82%. The WCIRB said this was in part the result of higher use of telemedicine services compared with previous years.

WorkCompCentral is a sister publication of Business Insurance. More stories here.

 

 

In separate enforcement actions, the Oregon Occupational Safety and Health Division on Thursday announced fines totaling more than $144,000 to two contractors for repeat violations of fall protection rules.

The separate citations issued to Corvallis, Oregon-based Iron Head Roofing LLC and Canby, Oregon-based JMJ Construction LLC included the same violation of implementing adequate fall protection systems – such as a personal fall restraint system or other measures – where workers are exposed to falling six feet or more to a lower level.

For Iron Head Roofing, which was fined $78,000, it was the fifth time since May 2019 that the company committed the same violation. For JMJ Construction, facing a $66,900 fine, it was the fourth time since February 2020 that the company committed the same violation. The companies’ previous violations of the six-foot trigger-height requirements were cited as part of separate Oregon OSHA inspections at different worksites.

 

 

 

 

The U.S. Senate on Thursday read through legislation that would expand the federal occupational illness program for energy workers.

S. 4928, which was referred to the Committee on Health, Education, Labor, and Pensions, would amend the Energy Employees Occupational Illness Compensation Program Act of 2000 to expand the ways beryllium sensitivity can be established for purposes of compensation.

The bill would also extend the authorization of the Advisory Board on Toxic Substances and Worker Health of the Department of Labor.

No further details on the legislation were available as of Friday.

 

 

 

 

The Idaho Supreme Court unanimously ruled that a self-described livestock transportation broker was the statutory employer of a driver injured while attempting to load a cow onto a truck for delivery.

As documented in Eldridge v. Agar Livestock LLC, Agar Livestock LLC would “dispatch” loads of livestock to owner-operators of trucks. Once the load was delivered, Agar Livestock would deduct its “brokerage fee” and remit the remaining funds to the truck owner-operator.

Agar Livestock, which never employed drivers, was in a “brokerage agreement” and “trailer lease agreement” with Meissen Trucking. The agreements had overlapping terms regarding hauls and compensation.

In January 2018, Agar Livestock dispatched a Meissen truck pulling a trailer that Meissen leased from Agar Livestock. As the driver Mr. Eldridge was attempting to load cattle into Agar Livestock’s trailer, a cow charged, struck him between the shoulder blades, shoved him into a gate, trampled him and rendered him unconscious.

Mr. Eldridge filed a workers compensation claim against Meissen, Agar Livestock and others. Meissen was initially represented by an attorney who had argued that Mr. Eldridge was an independent contractor and not an employee of Meissen. However, after pre-hearing depositions, Meissen’s counsel moved to withdraw. Meissen failed to retain new counsel after the original attorney withdrew, so the Industrial Commission entered default against the company.

The commission determined that Mr. Eldridge was an employee of Meissen. Because Meissen failed to carry workers compensation insurance, the commission found Agar Livestock was liable for Mr. Eldridge’s benefits as his statutory employer.

The Idaho Supreme Court explained that a statutory employer is liable for compensation to an injured employee of an employer “under” it if that employer has failed to obtain workers compensation insurance. A “category one” statutory employer is “any person who has expressly or impliedly hired or contracted the services of another.”

The court said the commission properly found Agar Livestock was a “category one” statutory employer of Eldridge because it had contracted the services of his employer, Meissen, to fulfill shipment contracts for clients.

WorkCompCentral is a sister publication of Business Insurance. More stories here.