Category Archives: Retraining

Watching a Paraplegic Walk!: A Work Comp Success Story

The ReWalk Device

I just witnessed someone without the use of their legs actually walk!

A young paraplegic—supposedly bound to a wheelchair on a permanent basis—used a robotic device and actually stood upright and walked forward.  The emotions involved defy adequate description, especially for someone included on the team that made this event happened.

http://www.cbs58.com/clip/13165226/technology-and-generosity-help-local-man-to-walk-again

Click here to watch the amazing video of a paraplegic walking!

This story begins, like many work injuries, with an unexpected traumatic event.  On November 13, 2008, Matt Nevaranta was a 22-year-old working a construction job in hopes of saving enough money to continue his college career.  Those dreams were cut short when 3,000 pounds of metal forms fell on Matt, severing his spinal cord.  Matt was lucky to be alive.  However, the injury damage resulted in permanent paraplegia—an inability to use his legs and all bodily functions below his waist.   Matt presumably was constrained to a wheelchair for his life.

For many individuals, such an injury could drastically alter their outlook on life.  Matt, though, is a unique young man, who I had the privilege to get to know and represent as his worker’s compensation attorney.  Despite his condition, Matt remained positive and persevered daily.  He continued to better himself since his traumatic injury.

Matt vigorously pursued his educational opportunities.  After the initial shock and recovery from the injury, Matt reenrolled in college, beginning online.  He ultimately attended full-time at Cardinal Stritch University (in Milwaukee, WI)—actually driving himself and using his wheelchair for classes.  While many worker’s compensation insurance companies demean or question the motivation level of injured workers, Matt disproved those misplaced assumptions.  Matt graduated from Cardinal Stritch in the spring 2016 while his bachelor’s degree.  Moreover, he volunteers at the Milwaukee County Courthouse in a legal clinic, and he now has applied for law school!

Matt also forcefully pursued his physical betterment and the necessary medical equipment.  Under the Worker’s Compensation law, an injured worker receives medical treatment that is reasonably required to cure and relieve from the effects of the injury.  (Wis. Stat. Section 102.42(1)).   In Matt’s case, his worker’s compensation insurance company provided a number of medical items since the injury, including a seated wheelchair, an upright wheelchair, and home and car accommodation modifications.  None of this treatment, however, resulted in Matt walking.

ReWalk allowed Matt to walk.  ReWalk is a wearable robotic, motorized exoskeleton that allows individuals with spinal cord injuries to stand upright and actually walk.   During my representation, Matt asked if his worker’s compensation insurance company would pay for the ReWalk device.   Matt met all of the necessary criteria (as established by ReWalk) and had medical clearance to obtain the device.  More importantly, Matt’s treating spinal cord specialist and psychologist provided their medical opinions about the significant physical and psychology benefits involved in the potential use of this device.

A legal battle ensued.   In part, due to the “not-cheap” device cost, the worker’s compensation insurance company denied payment for the device.  The insurance company also hired their own “independent” medical record reviewer to question the benefits of the device.  We filed numerous medical literature studies showing the physical benefits of an upright motorized exoskeleton for paraplegics (notably, many of these devices have been used to assist returning military veterans).  We also filed medical opinions noting the potential cardiovascular, gastrointestinal, spasticity, life expectancy, and psychological benefits to the device.

The dispute over the ReWalk device went to a worker’s compensation trial.  (Note that worker’s compensation attorneys cannot receive a fee on medical treatment expenses, so this was pro bono representation).  Matt testified about his desire to use the ReWalk device.

And we won.  In a first-of-its-kind case in Wisconsin, the administrative law judge ruled that the ReWalk exoskeleton device was a reasonably required medical treatment or modality to cure and/or relieve from the effects of the work injury.  Thus, the worker’s compensation insurance company was ordered to pay for the device.

The parties struck a subsequent reasonable deal for the cost of the device to avoid further appellate litigation.  As part of this deal, we worked with the amazing crew at Marquette University’s physical therapy department (shown in the video clip in detail), who provided further training to Matt free of charge.   Matt now goes to training at Marquette, and I was privileged to watch Matt in action.

I watched a paraplegic walk!

Such a worker’s compensation success would not be possible without an entire team supporting Matt, including the efforts from Domer Law, Matt’s family, the ReWalk team (especially Craig Peters), the physicians at Froedtert/Medical College of Wisconsin (especially Drs. Merle Orr and Brad Grunert), and Marquette University physical therapists.  But, of course, none of this would occur without the personal drive to excel found in Matt Nevaranta.  Great work Matt, and I wish you nothing but continued success.

Wisconsin Law Changes: Retraining Benefits Made Better

Injured workers now have greater access to vocational retraining benefits. The new law changes, while providing a number of employer-friendly provisions, also contained pro-worker enactments—especially for those injured workers who need to go back to school.

A major public policy goal of the worker’s compensation system is to restore an injured worker’s pre-injury earning capacity, meaning get the worker back to the wages they made before getting hurt. To facilitate that goal, if an injured worker has permanent limitations that do not allow them to return to their injury job, the worker can pursue vocational retraining benefits. Under Wisconsin law, these benefits are meant to compensate a worker during the entire schooling period. The insurance carrier is responsible for weekly maintenance benefits (at 2/3 of the employee’s average weekly earnings) during every week the worker is in school, as well as tuition, book, travel and meal expenses during school. Many retraining programs are for approximately two-year associate degree programs, but, depending on the worker’s pre-injury wages, the paid-for program could involve a bachelor’s degree or beyond.

In a victory for workers, the 2016 new law allows for prospective vocational retraining benefits. Historically, when a vocational retraining claim was “ripe” for presentation at a hearing was uncertain. Some administrative law Judges indicated that a retraining program only became viable and ripe for hearing when the worker actually was attending classes. Unfortunately, many injured workers—who cannot return to their former employment and have no other source of income—do not have the financial ability to go to school on their own. As such, these workers could not enroll in or begin school unless the workers’ compensation insurance carrier was ordered to pay for prospective schooling.

The legislature clarified this issue, and effective March 2, 2016, Judges have the authority to issue prospective orders for vocational retraining benefits (Wis. Stat. § 102.18(1)(b)2., as amended by 2015 Wis. Act 180). Specifically, a carrier can be ordered to pay for a future course of instruction, along with the corresponding vocational retraining benefits/expenses, for either a DVR-sponsored or private rehabilitation counselor program.

Another pro-worker provision of the 2016 law is that injured workers are now allowed to work up to 24 hours per week while undergoing vocational retraining without those earned wages reducing their weekly worker’s compensation maintenance benefits (the 2/3 wages). Previous law required the reduction in work comp benefits for this part-time—thereby creating a disincentive to work. The new law (effective March 2, 2016) acknowledges the practical reality for a worker returning to school. The injured worker now can engage in part-time school and part-time work, maintaining the worker’s connection to the labor market.

Vocational retraining benefits can be difficult for an injured worker to pursue, but the new 2016 law makes it easier.

More Expensive and Difficult: G.E.D. Changes in 2014

An injured worker with permanent limits who cannot return to their injury employer generally is entitled to vocatational retraining benefits.  The worker’s compensation carrier covers the whole package: weekly benefits (at 2/3 of wages), plus meals, mileage expenses, and fee expenses during every week in school.  Full cost of tuition and books is also covered!

In many instances, however, workers have not been in a school setting since they began their work career–often many years in the past.  As such, a traditional full-time academic retraining program may be a daunting challenge.  Many of these workers do not have a high school degree, and therefore, they need a G.E.D/H.S.E.D. before they can even contemplate an official associate degree (or even bachelor’s degree) program.  Under Wisconsin law, retraining benefits are possible while attempting a G.E.D. program–especially if the the program requires regular attendance and has formal instructors in a classroom setting.  (See example Schneidewend v. Randstad Staffing Services USA Inc., WC Claim No. 2004-001650 (LIRC Dec. 17, 2009).

As both an advocate and (somewhat) a social worker, we strongly encourage a GED program for an injured worker who was knocked out of their former field or profession due to an injury.  If the worker was formerly in a physical field (e.g., construction or concrete), a GED is an absolute requirement to the necessary academic degree that would restore the previous earning capacity. 

I read with some concern that the GED testing standards are changing in 2014.  (See “Raising the G.E.D. Bar Stirs Concern for StudentsNew York Times, 10/11/13).  Apparently, the test will be harder and, unfortunately, more expensive.  Regardless of the academic basis for these changes, there is concern about a worker’s ability to restore a lost earning capacity with a higher GED standard.  A worker–long absent from an academic setting–faces a number of hurdles to successful completion of a program, including functional abilities, pain levels, family or child care constraints, and monetary issues.  If there are further barriers before a worker can even have the opportunity to complete a school or degree program, the worker may never successfully get back to their level of income before an injury.     

On a final note, a harder GED program may obligate a worker’s compensation insurance carrier to pay vocational retraining benefits  for a much longer period of time–during the entire time the worker/student tries to pass the new test!