May 2010 Archives

Clearly, texting while driving has become a serious issue. In this case, reported by Fox 4 News in Kansas City, police officers in Missouri who were working the scene of a car crash, became victims in another crash and escaped serious injury, if not death. A driver who was allegedly texting while driving simply didn't notice that the highway lanes had been reduced to one lane, so he crashed into two stopped police cars. The cars were so badly damaged, they are considered "complete losses." Being a police officer is risky business. Now wreckless driving caused by "texting" should be added to the list of risks they must endure.

Earlier this week, Joe Paduda posted Medicare Set-Asides - the real problem. He focuses on the issue of drug costs in these complex claims, citing drugs account for up to 40% of the medical spend, particularly in older claims. He also shares strategies worth considering to assist in the management of such claims. 

Earlier this week, Jon Coppelman made a post titled Dueling Disabilities on Lynch Ryan's weblog Workers' Comp Insider. In the article, he discusses the complexities involved in a case where two employees have severe allergic reactions. The accommodation made for one employee, Emily who is highly allergic to paprika, allows her to bring her assistance dog to work. Her dog is trained to sniff out paprika, and although awkard at times, allows her to have a somewhat normal life. The dog is trained to alert her to any impending paprika encounters.

So, what's the rub? Even though Emily's assistance dog was approved by her employer, the City of Indianapolis Department of Code Enforcement, the first day Emily brought her dog to work, it caused an asthmatic reaction in a co-worker who has severe allergies to dogs. So, Emily's boss made an on-the-spot decision to nullify Emily's accommodation. Emily filed suit, citing discrimination and failure to accommodate.

This poses a real problem for management. What's the best solution? In this case, as Mr. Coppelman points out, by creating a safe workplace for one individual, another is put at risk. We have written about allergies and workers' compensation before. See our post titled Smell This. As allergies worsen and more cases like this emerge, I predict allergies is a topic we'll see more often in the wonderful world of workers' compensation.

In an excellent article called Chronic Pain In-Depth Series written by Peter Rousmaniere, workers' comp expert and columnist for Risk and Insurance, Peter points out that while chronic pain claims account for only 5% of lost-time claims, the costs of those claims equal 30% of all lost-time payments in the first year alone. Pain management is a huge issue in America, impacting all aspects of our healthcare system. Many workers' comp experts have researched and written extensively on the issue, including:

Read Chronic pain management in workers' comp plus an archived article titled Workers' Comp Drugs: Paying Too Much...for the Wrong Medicines by Workerscompinsider.com

Joe Paduda writes on pharmacy issues frequently. His blog post Washington's smart policy on opioids highlights how one state decided to manage the issue of chronic pain management.

We have also addressed issues involving pain management in earlier posts including Oxycontin Reformulation and Compounding Fraud.

If you manage workers' compensation claims, partner with a company like Total Medical Solutions who can provide you with the clinical expertise and oversight needed to ensure your claims are on the right track. A good workers' compensation complex care partner will help you develop a plan for your chronic pain claims and can help you identify claims that should be montiored closely so that they don't spiral out of control.

 

A recent post on Safety News Alert titled Video captures moments leading to worker fatality, tells the story of an accident at a Cintas laundry facility in Tulsa, Oklahoma that lead to a worker's death. Part of the accident was captured on video and shows how the worker climbed onto a large conveyor to remove stuck clothing on the way to an industrial dryer. One camera captured Eleazar Torres Gomez as he was pulled into the huge dryer. ABC News included the video in their coverage of workplace safety and OSHA on Nightline, and a link to the video is included in the article.

The video and piece by Nightline also covers what OSHA administrator David Michaels calls an epidimic of programs that discourage workers from reporting injuries.

As a result of the investigation following Gomez' death, OSHA has fined Cintas $2.75 million for violations of safety rules involving the dryers.

Honda's experimental Bodyweight Support Assist device makes walking and stair-climbing easier for people in rehabilitation therapy or who are elderly. It will be on display at the "Why Design Now?" exhibition at the Cooper-Hewitt, National Design Museum, Smithsonian Institution in New York, NY from May 14, 2010 through January 9, 2011. The exhibition showcases the work of designers from around the world and demonstrates how essential design and innovation are to some of society's most urgent human and environmental issues. The designers whose works are on display are being recognized for enhancing the human experience by inventing solutions that are as beautiful as they are just. 

Although we have seen a steady increase in the number of people who telecommute for work over the past three decades, it seems as though the idea still hasn't caught on in Texas. At least not when it comes to workers' compensation claims. 

Traveling Saleswoman in Austin Denied Workers' Comp Benefits

According to the article Workers' comp claim denied because of home office, in Austin's American Statesman newspaper, a workers' compensation claim is now headed to the Texas Supreme court to determine whether a traveling saleswoman who had a home-based office is entitled to workers' comp benefits. The accident occurred in 2003 when Liana Leordeanu was driving home after a business appointment when she lost control of her car and slammed into a rock embankment.

What if she hadn't gone to the business appointment?

She suffered massive head trauma, was in a coma for three months, lost an eye and underwent 26 surgeries. The appointment was for business, she was driving a company car toward her company-paid home office. But Texas workers' comp law limitations and arguments made by the insurer in the case, American Protection Insurance, have so far thwarted Ms. Leordeanu's attempt to win workers' compensation benefits.

Watch for Outcome in Texas Supreme Court

This case is sure to gain more national attention and will most likely be surrounded in controversy. So, telecommuters in Texas and all Americans who work from home, this is a case to watch. The Texas court system will hear arguments over what should be covered by workers' comp as it relates to telecommuters and traveling work / sales professionals.

For more on telecommuting, here's an interesting look at what U.S. companies could save if more people worked from home. Telecommuting by the Numbers in Inc. Magazine.

While complex cases make up a small percentage of overall workers' comp cases, the medical costs associated with these types of claims are significant. A complex claim is defined as one that includes more than one body system, with separate diagnoses and more than one physician involved in treating the patient. There's no mystery as to why the cost of care is high for these claims. Care is provided in either a home or hospital setting and the life of the claim is long, often for the life of the claimant.