Author Archives: Thomas Domer

Work-Related Falls Cause Serious Injuries And Death

“It’s not the fall that gets you” the old skydiving joke goes, “It’s the sudden stop at the bottom.” Falls are one of the greatest dangers in workers’ compensation. We fear many other perils, but more than half a million people die worldwide each year after falling. Falls are the second leading cause of death by injury, after car accidents. In the United States, falls cause over 30,000 deaths per year (more than four times the number caused by drowning and fires combined). Nearly three times as many people die in the U.S. after falling as are murdered by firearms.

As a cause of injury, falls are even more significant. More patients go to Emergency Rooms in America after falling than from any other form of accident according to the Centers for Disease Control and Prevention. Falls account for nearly three times the number of those injured by car accidents. The cost is also huge. Falls account for more than one-third of Emergency Room budgets and often lead to more expensive injury claims. 

Since falls can happen anywhere at any time to anyone, it is not surprising they are prevalent. The most dangerous spots for falls are interior settings of every day life such as supermarket aisles and stairways. Any fall can change life profoundly, taking a worker, for example, from a healthy life to a grave disability instantly.  Interestingly, scientists are now encouraging people to learn how to fall to minimize injury. Training in how to fall can actually help determine the outcome of the injury.  (The Week, September 8, 2007). Most research in the area of falls relates to “balance maintenance,” how we perform activities like standing, walking, and transferring without losing balance. Another factor in the seriousness of the injury after a fall is what condition one is in at the time of the fall. A Yale School of Medicine study ( published in The Journal of American Medical Association in 2013) found the more serious a disability one had beforehand, the more likely you will be severely hurt by a fall. Scientists studying falling are developing “safe landing” responses to help limit damage from falls. The key, apparently, is to roll and to try to let the fleshiest parts of your body absorb the impact. Young people often break their wrists because they shoot their hands out quickly when falling. Older people break their hips because they do not have their hands out quickly enough. Most scientists indicate if you are falling, protect your head first. Significant research in this are continues.

Trump Dumps Workplace Safety

When FBI Director James Comey calls President Trump a liar, the world takes notice, but when Trump lies about workplace safety, the world takes little notice.  Trump’s administration has recently provided significant “relaxation” in the government’s approach to occupational safety.  The administration recently delayed action on a rule that would require the employer to electronically report workplace injuries so they can be posted for the public.  OSHA has also put off enforcement of an Obama-era standard for silica, a mineral linked to a disabling lung disease and cancer.  I’ve dealt with many silica exposure claims in Wisconsin particularly coming from the Kohler Corporation in Kohler, Wisconsin where silica is a necessary ingredient in many bathroom fixture manufacturing processes.  The administration has also proposed changes in beryllium exposure limits.  After 40 years of development a new rule under the Obama administration was set to lower workplace exposure to beryllium a mineral linked to a lung disease estimated to kill 100 people annually.  The nation’s largest beryllium producer had agreed to back the new restrictions.  A few weeks ago as the rule was going into effect the new administration proposed changes that many expect may exempt major industries from this tougher standard. 

When asked about the Trump administration’s approach to workplace safety a White House spokesman said “The President and his administration care very much about worker safety…”  Yet another lie.  See also Under Trump, Worker Protections Are Viewed With New Skepticism

Trump’s Budget Cuts and Social Security Disability: Is “Fraud Suspicion” Underlying the Cuts?

Budget Director Mick Mulvaney echoed the mantra of many conservative Republicans who suspect that folks who are Social Security Disability recipients are fraudulent.  “If you are on disability insurance and you’re not supposed to be, you are not truly disabled, we need you to go back to work.”  This conservative trope reflects, without any evidence to substantiate it, the same kind of misinformation about employee fraud that pervades perceptions of workers’ compensation fraud. 

As I have often written about in the past, the public’s perception of injured individuals (whether collecting workers’ compensation or Social Security Disability benefits) is vastly overinflated.  The statistics indicate only about one-sixth of one percent of injured workers in Wisconsin are fraudulent.  That’s about 2 in 10,000.

The Trump administration budget proposed up to $64 billion in cuts to Social Security Disability Insurance expenditures, directly contradicting Trump’s campaign promises not to cut Social Security.  The cuts stem mostly from new program rules and processes, and requirements for mandatory participation by program applicants to move disabled beneficiaries from SSDI to work.

While returning to work is always a laudable goal (for both workers’ compensation and Social Security Disability), the last eight times that budget proposals have initiated programs to promote return to work “none of the findings reported to date show they would likely lead to a substantial reduction in case load sizes.”  http://www.researchondisability.org/docs/default-document-library/ssa-back-to-work-06-2012.pdf?sfvrsn=2

Through their contributions to Social Security, workers earn a measure of protection against disability retirement and death.  (Disability insurance protects a worker against loss of earnings due to a significant work limiting impairment, and workers earn this protection by having worked and contributed to Social Security.)  Many of my work-injured employees ultimately end up on Social Security Disability and this protection is particularly important to older Americans.  Most people receiving Social Security Disability benefits are in their 50s or early 60s and most had only unskilled or semi-skilled jobs.  Without a college degree, benefits are not significant (averaging about $1,200 per month).  However, over half of Social Security beneficiaries rely on these benefits for 75% or more of their total income. 

The proposed budget cuts to Social Security are another slap in the face to injured workers.

Recent Changes in Workers’ Comp Around the Country: Where Does Wisconsin Stack Up?

One of the benefits of participating in National organizations such as the Workers’ Injury Law and Advocacy Group (WILG) and the National College of Workers’ Compensation Lawyers is finding out how your State stacks up against the rest. Some recent cases suggest a basis for comparison.

Wisconsin was the first constitutional workers’ compensation enacted in 1911 and many other states look to Wisconsin as a progressive beacon protecting the rights of injured workers. The wattage on the beacon has been diminished by the Scott Walker administration by dividing the Workers’ Compensation Division into two administrative agencies (in an alleged move at efficiency rather than duplicity, efforts to introduce fault into a “No- Fault” system, apportioning Permanent Partial Disability to ill-defined “other factors” such as diabetes, obesity, etc. and denying workers’ compensation claims for employee misconduct.)

Some recent events around the country suggest some trends that we may see in Wisconsin. Arkansas, for example, is considering a workers’ compensation “Opt Out” bill, which would allow employers to provide less strict “alternative” medical treatment and benefits for injured workers. Similar attempts have been made in Florida, Tennessee, and South Carolina. Wisconsin, due to its Republican controlled governorship and Senate and Assembly, was also on the “hit list” of states that might be susceptible to opt out.  As of right now (and especially given the failings of “opt out” in Oklahoma, there appears to be no Wisconsin appetite for opt out).

Other quick hitting, interesting comparisons/trends from around the country:

  • An injured undocumented worker in Kansas has been awarded workers’ compensation benefits. The woman’s employer argued she should be denied workers’ compensation because she falsified employment documents. Currently in Wisconsin, undocumented workers are allowed almost all workers’ compensation benefits (expect for vocational rehabilitation benefits since there is a federal benefits component to those claims).
  • A worker in Illinois who lost his finger in a workplace accident could not sue the workplace where he was placed by his temporary staffing firm. (Wisconsin has a similar provision protecting the “borrowing” employer that contracts with a temporary staffing agency.)
  • In Alaska, three companies working an a multi-employer construction site were cited almost a million dollars for safety violations on a power plant expansion project. Since these were “willful” violations, the penalties were quite high. These findings again emphasize the extent to which employers, rather than employees, are most likely violating safety rules. In Wisconsin an employer who violates a safety rule resulting in a work injury for an employee pays a 15% penalty on top of the employee’s workers’ compensation benefits capped at $15,000.
  • In Ohio, current and retired firefighters suffering from various cancers will be able to collect workers’ compensation benefits based upon a presumption that the cancer is caused by their work exposure. Wisconsin has a similar provision for its employees regarding heart, lung, and other cancers (so long as the firefighter is not a smoker).
  • In Montana, a bill under consideration would bar benefits if the worker knowingly fails to disclose medical conditions pertinent to their job requirements. A similar provision was recently passed in Wisconsin, requiring disclosure of any pre-existing disabilities or impairments.
  • In Colorado, a bill was just introduced allowing first responders to seek benefits for PTSD without a corresponding physical injury. Wisconsin has a similar provision but the standard of “extraordinary stress” must be met for a non-traumatic emotional or mental injury.
  • In Pennsylvania, a man disabled following Legionnaires disease, which he said was caused by exposure to contaminated water while performing his job was entitled to workers’ compensation and medical benefits.
  • Wisconsin has no specifically enumerated diseases which are automatically compensable, but where the occupational exposure causing disability is a material contributory causative factor is compensable (one of the cases handled years ago by the Domer Law firm “quantified” the component of occupational exposure at less than 5%).

Attorney Fees and Incentives in Workers’ Compensation

Abe Lincoln said it best “The matter of fees is important far beyond the mere question of bread and butter involved.  Properly attended to, justice is done to both lawyer and client. . . when you lack interest in the case, the job will very likely lack the skill and diligence in the performance.”

Three states have recently addressed the issue of attorney fees in workers’ compensation cases, most recently in Alabama, where an attorney fee cap of 15% on already-low benefits was found unconstitutional. It took a judge in Alabama who had been a carpenter for 15 years and then a lawyer before he took the bench, to recognize that an attorney fee cap at 15% of a $220 weekly Permanent Partial Disability benefit would not provide sufficient incentive for attorneys to be involved in workers’ compensation claims for Permanent Partial Disability in Alabama, depriving injured workers of their constitutional rights.  Judge Pat Ballard gave the legislature in Alabama four months to cure the deficiencies in the Alabama Code.

Judge Ballard found persuasive the Florida Supreme Courts reasoning in Castellanos v. Next Door Company where the Court indicated the inflexible nature of Florida attorney fee statute made that law unconstitutional.  He also agreed with the reasoning of the Utah Supreme Court, which found its workers’ compensation attorney fee caps unconstitutional.

An attorney’s determination to take a workers’ compensation case has to do with both the merits of the case and potential for recovery of attorney fees.  In Wisconsin attorneys are not paid on any portion of the medical expenses and fees are capped at 20% of the Temporary Total and Permanent Partial Disability benefits obtained for the injured worker.  In Permanent and Total Disability claims, fees are capped at ten years of benefits.  (Routinely benefits that are further offset by the injured worker’s receipt of Social Security Disability and Long Term Disability benefits.)  As Abe Lincoln indicated long ago, “When you feel you are working for something, you are sure to do your work faithfully, and well.”  (Notes to the Ohio State Law School Graduating Class of 1858.)

Trump Lifts His Middle Finger to Injured Workers

It didn’t take long for Trump to deceive injured workers.  Despite campaign promises to help “middle class” workers,  Trump signed legislation relaxing the reporting requirements for employers when workers get hurt or ill due to their jobs.  Trump and the Republicans rolled back a rule issued by former President Barack Obama.  By ending the rule, Trump and Republicans effectively shortened the amount of time employers in dangerous industries have to keep accurate records of worker injuries – from five years to just six months.  The Republican-controlled Congress used a little-known legislative tool known as the Congressional Review Act to repeal the Obama regulation last month.  Democrats were incensed.  By signing the bill, Trump can legally prevent the Occupational Safety and Health Administration (OSHA) from requiring a similar rule in the future.

Labor leaders and workplace safety experts warn that the rollback of the OSHA recordkeeping rule will allow unscrupulous companies to cheat on their injury data and conceal ongoing hazards from OSHA regulators.  That concealment could make it harder for OSHA to identify recurring problems at certain employers and industries.  Debbie Berkowitz, a former OSHA policy adviser and advisor to the Workers’ Injury Law and Advocacy Group (WILG), now with the National Employment Law Project, indicated “This will give license to employers to keep fraudulent records and to willfully violate the law with impunity.” 

It was only a matter of time before Trump showed his disdain for injured workers and his true allegiance to business.

The Cancer Presumption in Workers’ Compensation

What is a legal presumption? 

Can a legal presumption be rebutted by sufficient contrary evidence?

Wisconsin workers’ compensation law contains many presumptions. For example, for firefighters, it is presumed that if a firefighter has cancer, the cancer is employment-related. The Statute applies to any State, County, or Municipal firefighter who has worked for ten years with at least two-thirds of the working hours as a firefighter who has cancer of the skin, breast, central nervous system, or lymphatic, digestive, hematological, urinary, skeletal, oral, or reproductive systems. For that firefighter whose disability or death is caused by cancer, the cancer diagnosis is presumptive evidence that the cancer was caused by employment. However, no presumption exists for firefighters who smoke cigarettes or use tobacco products for claims after January 2001. (Wis. Stat. §891.455 Presumption of Employment Connected Disease: Cancer)

Other presumptions in Wisconsin law include a presumption that a youthful worker (under age 27) is presumed to be able to earn the maximum wage rate by the time he reaches age 27, for purposes of Permanent Partial Disability, disfigurement, or death. For example, a McDonalds burger-flipper earning $10 per hour who has a severe burn is presumed (instead of the $200 or $300 he actually earns per week) to be earning $1,400 per week under the Youthful Age Presumption. Evidence of the worker’s likely inability to earn the maximum wage (due to cognitive or academic deficiency or similar lower earning work history) can be used to rebut the presumption and therefore limit the maximum Permanent Partial Disability or disfigurement award.

In a recent cancer case, the Pennsylvania workers’ compensation board found a firefighter cannot receive workers’ compensation benefits for prostate cancer because he failed to show his cancer was work-related despite a statutory presumption for firefighters. The firefighter began working for the City of Philadelphia in the 1970s and retired in 2006 after a diagnosis of prostate cancer. He filed a workers’ compensation claim saying his cancer stemmed from carcinogens he was exposed to while working as a firefighter, such as diesel fumes from fire trucks, second hand tobacco smoke from co-workers, and smoke from burning debris he encountered while fighting fires. Note he also acknowledged he smoked an average of a half pack of cigarettes daily since the 1960s. His doctor’s testimony that his carcinogen exposure caused the prostate cancer was rebutted by the City’s physician indicating that prostate cancer is typically more of a “disease of aging than it is of external influence.” The Judge, in denying the claim, noted “Any elevated risks for prostate cancer among firefighters might also be explained by other factors, such as detection bias, ethnicity and geography.”

The cancer presumption in Wisconsin (for non-smoking firefighters) would be more difficult to rebut, but factors such as family history may prove the “other evidence” necessary to rebut the presumption.

The High Cost of Fat

A recent study in the Journal of Occupational and Environmental Medicine, the official publication of the American College of Occupational and Environmental Medicine, in September 2016 reported that obese and overweight workers are more likely to result in higher costs related to workers’ compensation claims, especially for major injuries.

In a study analyzing 2,300 workers in Louisiana, Dr. Edward Bernacki of the University of Texas—Austin found that workers’ compensation costs and outcomes for obese workers (defined as a Body Mass Index of 30 or higher) incurred higher costs related to their workers’ compensation claim. This study noted that after three years about 10% of claims for significant injuries were still open, meaning the worker had not yet returned to work. Obesity and overweight did not play a role in the delayed return to work. However, for workers with major injuries, overweight was associated with higher workers’ compensation costs. In the group with the higher Body Mass Index, costs averaged about $470,000 for obese workers, $270,000 for overweight workers compared to $180,000 for normal weight workers (with a Body Mass Index between 25 and 30). The study made adjustments for other factors including the high cost of spinal surgeries and injections and, after making the adjustment for these factors, obese or overweight workers with major injuries were twice as likely to incur costs of $100,000 or more. Significantly, Body Mass Index had no effect at all on costs for closed claims or less severe injuries.

Previous studies (including a study in the Journal of Occupational and Environmental Medicine in 2015 linked obesity to a higher rate of workplace injuries and a longer time off. However, the cost effects were not studied until this recent assessment. The new results indicate obesity is a significant risk factor for higher costs in major workers’ compensation injuries.

One significant finding in the study was that more than three-fourths of the workers’ compensation claimants were overweight or obese. Further studies are planned. Previous studies include those from the National Council on Compensation Insurance, Inc. (NCCI) “How Obesity Increases the Risk of Disabling Workplace InjuriesEditor’s Note:  According to most studies, there is a strong correlation between Body Mass Index and injuries such as ankle fracture severity and increase risk of osteoarthritis. For workers’ compensation practitioners, one wonders whether these studies are a prelude to an assault on the “as is” doctrine. Each of us in our own practice can recognize some of the wide-ranging effects in costs of obesity, from special procedures for hospital treatment of obese patients such as open MRIs and more extensive surgical procedures to a reduced fuel economy in commercial vehicles due to fat drivers. Additionally, the cost of treatment for obese patients with work-related injuries increases the work-related injury potential to medical staff (lifting, transferring, etc.). Increasing admissions of severely obese patients leads to a corresponding increase in medical workplace injuries related to lifting and maneuvering obese patients. Workers’ compensation practitioners may see obesity as yet another “pre-existing condition” to surmount in future causation and extent of disability battles.