Falls Cause Rising Number of Brain Injuries in Older Adults

Today’s post comes from guest author Anthony L. Lucas, from The Jernigan Law Firm.

According to the latest report from the CDC, from 2007 to 2013, the rate for traumatic brain injuries that resulted in emergency department visits, hospitalizations, or deaths increased 39 percent. Traumatic brain injuries contribute to about 30 percent of all injury deaths. It was initially believed that the increase in brain injuries was caused by rising awareness of sports-related head injuries in children and young adults. However, after researchers reviewed the data, they found that the biggest driver in the increase of brain injuries was due to older adults.

The rate for reported brain injuries for elderly Americans increased 76 percent from 2007 to 2013, much greater than any other age group. This increase is believed to be due to falls. Many times they are not reported, and according to Dr. Lauren Southerland, an Ohio State University emergency physician “what may seem like a mild initial fall may cause concussions or other problems that increase the chances of future falls – and more severe injuries.

To address fall-related brain injuries, the CDC has developed the STEADI (Stopping Elderly Accidents and Injuries) initiative to help primary care providers address their patients’ fall risk. The CDC has also launched a HEADS UP awareness campaign to help individuals recognize, respond to, and minimize the risk of concussion or other serious brain injury.

Premiums Drop Again for Wisconsin Employers!

In yet another sign of the stability of Wisconsin’s worker’s compensation system, premiums for work comp insurance decreased by 8.46% for the state’s employers.   The work comp administering agency just released a press release detailing that beneficial decrease.

This is the second year in a row that work comp premiums have gone down–and there is a net decrease for the rates in the past decade.  

Much of this success, as the press release indicates, arises from the efforts of the Worker’s Compensation Advisory Council.   As we’ve discussed before, this group of labor and management members steadies the system, producing reasoned and vetted changes to the Work Comp Act.  The press release indicates “the Council recommends changes to law to ensure it keeps up with today’s industries and trends.”   This Council process aims to protect the law (and the insurance rates) from partisan swings.

Other states, in stark contrast, may experience wild swings in the substance of their work comp laws–depending on political changes.  Such changes introduce uncertainty and risk–and corresponding insurance rate increases.  Wisconsin, however, remains largely protected from these changes because of the Council’s efforts.

Stable–and decreasing insurance premiums–make Wisconsin a great place for work comp insurance companies and for employers (both big and small).  With decreasing rates for employers, the current climate suggests no need for drastic changes to a Work Comp Act that works for Wisconsin.

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.

Opioid Task Force, Recent Studies, and CDC Opioid Recommendations

Today’s post comes from guest author Kristina Brown Thompson, from The Jernigan Law Firm, in North Carolina.

Wisconsin’s Worker’s Compensation Advisory Council is also looking at the issue of opioid use.

The North Carolina Industrial Commission recently joined many other states (i.e. Massachusetts) in tackling the issue of opioids in the workers’ compensation cases by creating a Workers’ Compensation Opioid Task Force. The goal of the task force is to “study and recommend solutions for the problems arising from the intersection of the opioid epidemic and related issues in workers’ compensation claims.” According to the Chair, “[o]pioid misuse and addiction are a major public health crisis in this state.” 

As of last June, a study by the Workers’ Compensation Research Institute (WCRI) noted “noticeable decreases in the amount of opioids prescribed per workers’ compensation claim.” From 2012 – 2014, “the amount of opioids received by injured workers decreased.” In particular, there were “significant reductions in the range of 20 to 31 percent” in Maryland, Massachusetts, Michigan, Oklahoma, North Carolina, and Texas. 

Additionally last March, the Centers for Disease Control and Prevention (CDC) issued new recommendations for prescribing opioid medications for chronic pain “in response to an epidemic of prescription opioid overdose, which CDC says has been fueled by a quadrupling of sales of opioids since 1999.” 

Currently, the CDC’s recommendations for prescribing opioids for chronic pain outside of active cancer, palliative, and end-of-life care will likely follow these steps:

1.  Non-medication therapy / non-opioid will be preferred for chronic pain.

2.  Before starting opioid therapy for chronic pain, clinicians should establish treatment goals and consider how therapy will be discontinued if benefits do not outweigh risks.

3.  Before starting and periodically during opioid therapy, clinicians should discuss with patients known risks and realistic benefits of opioid therapy. 

Groups Oppose Legislation Aimed to Change Wisconsin’s Advisory Council

Wisconsin’s Worker’s Compensation Advisory Council serves as the driving force behind the state’s historically stable and first-rate work comp system.  Wisconsin gets its injured workers back to work faster than virtually all states in the country.  We have extremely low litigation rates (a recent study showed only 13% of work injuries require an attorney).  We have stable and falling work comp insurance premiums–an 8% decrease for 2017.  

These are the marks of a great work comp system thanks to the Advisory Council.

So, of course, some legislators want to blow it up!   This is a classic example of a fix looking for a problem!

Republican legislators recently introduced legislation (AB 308) to drastically alter the makeup of the Advisory Council.  Traditionally, the Advisory Council’s makeup is five management, five labor, and three non-voting insurance members appointed by Secretary of Dept. of Workforce Development (DWD).  After Council deliberations, they produce a biennial “agreed upon” bill, which is then submitted to lthe egislature that, in turn, generally accepts the bill.   As the DWD site proudly prounces:

One of the most important and enduring principles of the Council is maintaining the overall stability of the worker’s compensation system without regard to partisan changes in the legislative or executive branches of government. The Council provides a vehicle for labor and management representatives to play a direct role in recommending changes in the worker’s compensation law to the Legislature.

The 2017 introduced bill proposes to alter only the makeup of the “labor” side of the Council.  The proposal would reduce the amount of organized labor representatives on the Council in proportion to the amount of unionized workers in the state.  

When a hearing occurred last week on this bill in the assembly labor committee, the legislature faced overwhelming opposition to this measure.   A story on WorkCompCentral (Stakeholders Line Up Against Bill Aimed at Reducing Union Role on Advisory Council) detailed that opposition from the system’s stakeholders–including a broad array of the insurance company community.   The insurance companies know that any major change to the Council could create uncertainty in the system.  With uncertainty, there is risk.  With risk, there are increased costs and insurance premiums.

There is no need to change the current Council makeup, especially in light of the beneficial metrics the current system produced–and continues to produce.  The five organized labor representatives continue to be the best representatives–with the broadest expertise and breath of knowledge–for all workers, whether unionized or not.   

We hope this proposed legislation is dead on arrival.  The Advisory Council system works for Wisconsin.  An attack on the Council is an attack on the system’s stability.

 

Cutting Corners Costs Lives: Non-Union Work Sites Twice As Dangerous As Union Sites

This large inflatable rat is a common sight at protests of non-union worksites in New York City.

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

As an attorney who practices in the metropolitan area, I often find myself traveling into New York City. I am amazed at the amount of construction that I see; the cityscape is changing and evolving rapidly. This construction boom means more business, a steady paycheck for workers, and more money for the city and state. Unfortunately, with the rise in construction also comes a rise in safety violations, injuries, and fatalities.

The New York Committee for Occupational Safety and Health (NYCOSH) recently issued a report called Deadly Skyline regarding construction fatalities in New York State. A summary of their findings notes that from 2006 through the end of 2015, 464 construction workers died while on the job, with falls as the leading cause of death. When a fatality occurred, safety violations were inherent in more than 90 percent of the sites inspected by the Occupational Safety and Health Administration (OSHA). The report pointed out that non-union work sites had twice the safety violations of union sites, and in 2015, 74 percent of the fatalities occurred on non-union projects with the majority of the fatalities involving Latinos.       

It is painfully obvious that shortcuts and cost-saving measures result in injury and death. Many employers use misclassification as a means to save money. Misclassification occurs when an employee is labeled as an “independent contractor” so that a business owner doesn’t need to pay Workers’ Compensation insurance, Social Security, Medicare, or unemployment taxes. Some even resort to paying employees off the books as well in an effort to save money. This may not seem troublesome until you realize that this is a one-sided deal that really only benefits the employer. According to the NYCOSH report, misclassification of workers allows an employer to skirt the safe workplace requirement as OSHA does not cover independent contractors.

Employers must provide Workers’ Compensation insurance for their employees, and typically must notify their Workers’ Comp carrier as to the number of employees they have and the type of work they do. A risk analysis is performed and then employers are assigned a premium to pay in order to cover their workers in case of injuries. If injuries occur, premiums may be increased accordingly. Obviously employers in high-risk businesses must pay more for their premiums than those with employees involved in low-risk jobs. As injuries on misclassified workers do not add to an employer’s bottom line, there is less incentive to provide safety measures if it cuts into profits.

To make construction sites safe, NYCOSH recommends adequate education and training as well as legislation to punish those whose willful negligence causes a death. They also recommend passage of the NYS Elevator Safety bill that requires the licensing of persons engaged in the design, construction, operation, inspection, maintenance, alteration, and repair of elevators. It would also preserve Section 240 of the New York Labor Law, commonly referred to as the “scaffold law,” which governs the use of scaffolding and other devices for the use of employees. Weakening the Scaffold Law would shift safety responsibility from owners and general contractors who control the site, to workers who do not control the site and are in a subordinate position.

It is a true tragedy when someone is maimed or killed in an accident that could have been prevented. Not every employer engages in these tactics, and most workplaces are generally safe spaces for workers. However, even one death is too many. 

 

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

Work Comp Budget UPDATE: Committee Votes to Preserve Court Reporters & LIRC

Last week, the all-important Wisconsin Joint Finance Committee voted on two major issues impacting worker’s compensation in our state.   On both votes, Joint Finance removed the two Budget proposals, opting, instead, to keep the current well-run and efficient system!

As we reported in a previous post (MORE changes to Work Comp: Elimination of Court Reporters & Appeals Commission?), the Budget Bill proposed dramatic changes to Wisconsin’s top notch worker’s compensation system: (1) eliminating the use of live court reporters in litigated hearings; and (2) eliminating the independent appeals commission (Labor and Industry Review Commission, or LIRC) that reviews judge decisions.  

After public hearings on these proposals and lobbying efforts from various industry stakeholders, the Joint Finance Committee voted to preserve the current structure of the work comp system.  

LIRC: 

Indeed, the Committee rejected the Budget proposal to eliminate the LIRC–retaining the second-level appeals commission that has helped shape Wisconsin work comp law virtually since its inception in 1911.  While some vacant staff positions go away, LIRC remains in place for future appeals of work comp, unemployment, and equal rights cases.   As the LIRC website states:

LIRC is an independent Wisconsin administrative agency established to provide a fair and impartial review …  The commission’s decisions provide consistency, stability, and integrity to the programs for the employers, employees, insurers, and citizens of the State of Wisconsin.

As part of keeping LIRC, the Committee also voted for the Wisconsin Supreme Court to conduct a further study about LIRC’s interpretation of the statutes.   The upshot of the vote is for LIRC to remain for the next biennium.

Court Reporters:

The Committee also voted to keep the status quo and retained the use and funding for court reporters in litigated worker’s compensation hearings.   These stenographic court reporters are necessary to the efficient functioning of the system by ensuring decorum in the court room, properly managing exhibits, making sure parties do not talk over each other, and creating an accurate and legitimate transcript.  The initial Budget propsal involved eliminating court reporters in exchange for ill-defined audio recording equipment. Many system stakeholders (employees, employers, and carriers) raised signficant concerns about having six to seven figure case exposures decided based on unknown or questionable audio technology.  The costs of such “equipment” were also not described or budgeted.

As part of the Joint Finance Committee deliberations, the state’s Legislative Fiscal Bureau provided options for the use of court reporters: eliminate them, keep them, or keep them but submit the issue for further study. The Committee selected the later option, which involved keeping the current use and funding for the all-important court reporters.  

Furthermore, the Commitee requested a study to be conducted (and submitted to the Advisory Council) about the viability and use of potential audio recording equipment.  This makes good sense.  We are a first-in-the-nation work comp system.  If there is technology that exists, we need to research it and make sure it works efficiently and cost-effectively for our work comp system.  Let’s get it right!  Ultimately, we may discover (like many other states have) that live in-person court reporters still beat out any potential audio recording equipment.   

Next steps:

First, I’d like to thank the state legislature’s Joint Finance Committee for their thoughtful consideration of the concerns from the work comp stakeholders. 

As to procedural issues, following the Joint Finance Committee votes last week (and further completion of the votes on other major issues), the Budget ultimately proceeds to the full legislature and then to the Governor’s desk for approval or veto.

As of right now, the Joint Finance Committee recognized what many stakeholders preach: the Wisconsin work comp system works well now, so avoid dramatic changes that could upset the historic stability.