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. 

 

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.)

Undocumented Worker Arrested after Work Comp Claim

Scary news out of Massachusetts after a worker, who was undocumented, was arrested by ICE following a worker’s compensation injury.  The article can be found here: An ICE Arrest After a Workers’ Comp Meeting Has Lawyers Questioning if it Was Retaliation.   

Employees, despite lack of documentation, still perform work for their employers.  Wisconsin law, in turn, allows worker’s compensation benefits to those undocumented workers injured on the job. 

Unfortunately, many hard working employees without documentation remain fearful or tentative about filing a worker’s compensation claim.  Stories like this increase that insecurity.

(Special thanks to WILG colleague, Ryan Benharris, for sharing this news story).

As Construction Jobs Increase, So Do Work Deaths

More work-related falls and fatalities have gone hand-in-hand with the rebounding construction jobs in the economy. The data in a recent journal showed a positive correlation with fall injuries and population density and construction activity. The full article, from a data report by the Center for Construction Research and Training, can be found here (PDF link).

While the article indicates the amount of construction industry jobs still have not reached pre-recession levels, the industry as a whole is rebounding. With that increase in construction activity is a coinciding increase in falls—and even deaths. As the article points out, “fall deaths in construction are more prevalent than in other major industries.”

Interestingly, according to the data, roofers, older workers, Hispanic workers, foreign-born workers, and self-employed workers had a higher risk of fatal falls than the average among all construction workers. 

Further safety efforts (and reinforcement) are necessary in the construction industry.  The base level nature of the job, however, means that some work injuries will occur. Workers’ compensation law helps protect those workers are their families.