High-Risk Occupations and Workers’ Compensation

Even though careful and diligent employers work hard to reduce the chance their employees will sustain a work-related injury, injuries are eventually inevitable.  Some professions are pretty low risk, such as typical office work.  However, there are other jobs that involve an inherently higher level of risk.  Understanding which professions more often lead to injury or even death can help you take measures to reduce the risk to your employees.

One category of people who are at high risk for workplace injuries is those who work at great heights.  This includes people such as window washers, roofers, and painters.  In recognition of the extra risk involved in working at great heights, some professions have extra workers’ compensation coverage requirements in terms of sole proprietors and the inability to opt-out of carrying workers’ compensation insurance.

Unsurprisingly, first responders also work in high-risk occupations.  It is obvious that police officers risk life and limb on a daily basis while dealing with criminals.  In addition, EMTs face risk by being required to go into unknown circumstances with injured or very ill people.  EMTs also can potentially be injured when lifting and moving incapacitated patients.  Similarly, firefighters may have to shift heavy objects in order to save fire victims.  They also obviously face risk of burns and heat-related injury.  Moreover, they can be exposed to dangerous chemicals while on the job.  The California Labor Code contains extra provisions to protect first responders’ ability to receive workers’ compensation benefits.

Truck drivers are also in a high-risk occupation.  There is a level of risk involved any time you are in a vehicle on the road.  Distracted and impaired drivers are a very real danger.  Moreover, some cargo carried in large trucks is hazardous, such as chemicals or gasoline.  Employers should take careful measures to make sure their trucks are in good working order.  Keeping the vehicles in good repair will help make sure the driver and passengers stay safe, as well as protecting others on the road.

Doctors, nurses, and other healthcare professionals also face high risk in their occupations.  They are regularly exposed to potentially contagious and even life-altering diseases.  Moreover, some patients can be combative or violent.  Finally, there is a risk of injury from lifting and moving patients.

If you are a business owner and your employees are in high-risk occupations, it is important for you to understand your rights and responsibilities.  We can help you understand the workers’ compensation system and how your business fits within it.

Helping Your Employees with Occupational Illnesses

Employers take many measures to make sure their workplace is as safe as possible.  Keeping the workplace free from hazards is an essential step to keeping your customers and employees safe.  When making your business safe, you likely think about dangers such as a slippery floor or heavy machinery with outdated safety updates.  Unfortunately, many employers overlook the very real danger posed by occupational illnesses.  These include conditions such as carpal tunnel syndrome, ulcers, or back injuries.  Conscientious employers should take measures to help their employees avoid occupational illnesses.  As an employer, there are measures you can and should take to help your employees avoid and deal with their occupational illnesses.

One of the best ways to identify and avoid occupational illnesses for your employees is to create an injury and illness prevention program.  The focus of an injury and illness program is to identify potential sources of injuries, and then making a plan to help manage and control those dangers.  For example, if your business requires employees to perform repetitive motions, such as lifting boxes and turning to put them away, an illness and injury program can help provide training to employees on how to properly lift boxes to avoid injuries as well as making sure employees take breaks at regular intervals.

Another way to help your employees is to provide information and awareness information about occupational illnesses.  While employees are likely aware of the dangers of carpal tunnel or even repetitive motion injuries, they may be less familiar with how to prevent other injuries, such as developing asthma or even certain psychological injuries.

Encouraging your employees to stay healthy and take appropriate breaks from work can also help to reduce the incidences of occupational illnesses.  Keeping your employees healthy and fit can help keep them strong, making it less likely they will develop those injuries.  Breaks are also extremely important.  For example, taking regular breaks from typing can reduce the chances of an employee developing carpal tunnel or exacerbating prior nerve damage.  Although some employers may feel frustrated at frequent breaks, making sure the employee never develops the injury in the first place will save time in the long run, as the employee will not need to miss work for treatment of the injury.

If you have questions about what measures you should take as an employer, contact us today.  We can talk to you about your rights and responsibilities

Third-Party Claims

California’s workers’ compensation system is a “no fault” system.  This means that in order to recover wages and medical costs under a workers’ compensation claim, an employee is not required to prove that his or her injury is a result of the employer’s intentional or negligent conduct.  In the majority of workers’ compensation cases, there are only two parties to the case: the injured worker and the employer together with the workers’ compensation insurance provider.  However, in some cases, there will be a third party involved.  There are some cases where the employee’s injury is a result of not simple common work place conditions, but because of the negligent or intentional conduct of a third person.  Common examples include faulty equipment or a car accident caused by the negligence of the other driver.  In both of those cases, as long as the worker is acting in the course and scope of employment, the injury would be compensable under the workers’ compensation system.  However, the inquiry does not end there.  Instead, the employer and often the insurance company will bring an action against the third party to recover the costs for wages and medical benefits that had to be paid out to the injured employee as a result of the third party’s conduct.  It is important to note, however, that the case against the third party is a separate action from the workers’ compensation case.  The workers’ compensation case between the employee and the employer proceeds like normal through the typical workers’ compensation system.  The claim against the third party, however, will go through civil court just like any other tort case.  It is not uncommon for the employer to need two different attorneys, as one would be familiar with workers’ compensation while the other will be an attorney who focuses on tort cases.  Particularly when the third party claim includes a product liability case (such as where equipment is faulty), it is likely an employer will need to hire another attorney for that, as it is a specialized area of law that not all attorneys practice or are familiar with.

We have extensive experience helping our clients understand third party claims in workers’ compensation cases.  Call us today to talk about your case.

Repetitive Motion Injuries – What Is My Business Liable For?

There are a wide variety of injuries that can occur in a work place.  An employee can fall off scaffolding, get in a car accident while driving to deliver a shipment, or receive an injury from malfunctioning equipment.  Repetitive motion injuries are also a common source of work related injuries.  The most common type of repetitive stress injury is carpal tunnel syndrome.  Carpal tunnel syndrome occurs when the nerves running from the hand to the wrist are compressed through repeated motions, like typing.  There are other types of repetitive stress injuries, which could come from repeated bending or repeated use of one body part, such as repeatedly lifting your arms over your head.  Like other work related injuries, an employer can still be liable for repetitive motion injuries.

If your employee has a repetitive motion injury or shows signs of developing the injury, you need to treat the repetitive stress injury just as you would any other injury.  The employee needs to seek medical attention.  You will need to complete the same paperwork and submit it to your workers’ compensation insurance provider.  The employee will be eligible to receive replacement income, payment of medical expenses, and if necessary, reasonable accommodations when the worker is able to come back to work.

One issue that frequently arises with these types of injuries is that the worker was likely typing a lot or during similar repetitive actions in previous employment.  Employers will often wonder whether they are obligated to cover the repetitive stress injury if the condition started to develop during prior work.  Whether the injury is covered by the workers’ compensation system will be dependent on whether the injury is a pre-existing condition.  For example, if the injury was diagnosed and treated before the worker started with your business, it may very well be excluded from coverage under workers’ compensation.  However, if the pre-existing condition is one that he or she previously received workers’ compensation benefits for and the condition is aggravated by the work with your business, then the employee may very well be eligible for additional workers’ compensation benefits.  The employee will need to get a medical examination to determine whether it is part of a pre-existing condition or a new injury.

We have extensive experience helping our clients understand the workers’ compensation system.  Call us today to talk about what we can do to help you

Safety Committees

Employers work tirelessly to make sure their business is using the most beneficial business tactics and practices.  Employers know that this includes not only making sure marketing, manufacturing, and customer satisfaction is properly attended to, but also the safety of the employees.  If an employee sustains a work-related injury, he or she can file for benefits through the workers’ compensation system.  This is a no-fault system, meaning neither the employee nor the employer will be required to demonstrate who was at fault for the accident.  Although the workers’ compensation is a system that benefits both employee and employer, the optimal situation is actually to reduce the chance of employee injury as much as possible.  Forming a safety committee at your business can be one way to help reduce the incidences of workplace injuries.

A safety committee is a group of comprised of employees, typically from across different departments, and will include members of the workforce and members of management.  Properly executed and overseen, a safety committee can be one of the most effective ways to help cut down on workplace injuries at your business.  A safety committee will serve many purposes.  One purpose will be to make sure that employees are more away of the proper safety procedures in place.  The safety committee can organize more frequent safety briefings and help amend corporate safety handbooks.  The safety committee can also serve as a place where other employees can bring safety concerns to the attention of management.  Safety committees can help facilitate communication to ensure management is aware of the nature and frequency of certain risks or violations happening in the workplace.  The safety committee can also help construct an action plan to improve workplace safety, as well as develop goals and incentive programs to encourage employees to work more safely.

There are particular traits of employees you may want to focus on when deciding who would be best suited to serve on a safety committee.  You want to look for employees who are respected by their co-workers, as these types of employees are more likely to get results.  Committee members need to be familiar with the processes of their departments, as well as receptive to new ideas as to how to improve conditions.

If you have questions about how your business can protect itself from workers’ compensation claims, call us today.  We can talk about your business and what can be done to protect its future.

When Does the Subsequent Injuries Fund Pay On a Claim?

California law requires that the majority of employers carry workers’ compensation insurance to provide for their workers in the event that they sustain a work-related injury during the course and scope of their employment.  Unfortunately, some employers either do not carry this insurance or even do not realize that they are required to do so.  California Labor Code § 3351 defines “employee,” and the definition is broader than most people realize, including even workers such as handymen, nannies, and minors.  In the event an employee sustains an injury, the Uninsured Employers Benefit Trust Fund (UEBTF) may provide funding for the employee.  If the employer is illegally uninsured and fails to pay the compensation awarded to the employee by the Workers’ Compensation Appeals Board, the employee may submit a claim to the UEBTF for payment of his or her claims.

The Subsequent Injuries Benefits Trust Fund (SIBTF) is another source of compensation for injured workers.  Under California Labor Code § 4751, employees who had a previous permanent disability or impairment at the time he or she sustained another injury in the work place can apply to the SIBTF for compensation.  To be eligible for compensation from the SIBTF, the injury from the current employment combined with the previous disability or employment must have the combined effect of at least a seventy percent permanent disability for the worker.  Moreover, the new injury must cause at least thirty-five percent of the permanent disability.

Note that an employer does not have to be illegally uninsured for an injured employee to be eligible to receive benefits through the SIBTF.  The SIBTF is meant to help pay a portion of the permanent disability compensation for permanently disabled workers for qualifying workers, as described above.  If an employee qualifies to receive benefits through the SIBTF, the employer will pay only the portion of permanent disability that is attributable to the injury received through the current employer.  The SIBTF will pay the remainder of the benefits owed to the employee.  The purpose of the SIBTF is to encourage employers to hire workers who are already permanently disabled without fear that they will be held responsible to pay benefits that are attributable to a permanent disability incurred through previous employment.

We have extensive experience in assisting our clients understand the repercussions of all types of workers’ compensation claims on their business.  Call us today so we can talk with you about your business and its responsibilities.

Medically Required Equipment

Workers’ compensation is a system established to help provide fair reparation and payment to employees who have sustained work-related injuries.  The variety of injuries meant to be covered under this system is broad, although not without some limitations.  In addition, the treatments covered by the workers’ compensation system range from physical therapy to acupuncture to prescription medication.  The type of treatment that is covered will depend heavily on what is prescribed by the employee’s treatment physician.  In some cases, a physician may determine an employee’s injury requires medical equipment to treat.

There are important differences between medical equipment and medical supplies.  The workers’ compensation system has borrowed the definition of “durable medical equipment” from the Medicare system.  Durable medical equipment means medical equipment that is reusable, and necessary for treatment of the employee in his or her home.  Note that this means certain items such as latex gloves or hypodermic needles would not qualify as DME, as they are not reusable.  Moreover, an electric scooter that the employee never uses in the home, but rather simply uses to get around the local grocery store also probably would not qualify.  Note that not all Medicare rules have been adopted by California in this area.

Under the workers’ compensation system, a physician may bill for and be reimbursed for dispensing medically necessary durable medical equipment.  The rate to be billed and reimbursed is capped at a particular rate established by California Labor Code 5307.1.  However, there is an exception for this if the DME device is a “dangerous device.”  A “dangerous device” is defined by California statute, and typically will be a piece of equipment that can only be dispensed with a prescription from a physician licensed in that particular field.  For dangerous devices, there is a different fee schedule or formula established by statute.

Employers should be wary, as unscrupulous individuals have exploited the provisions for DME billing.  For example, in 2014, several men were charged with many felony counts of conspiracy and submitting fraudulent claims after renting out DME in the workers’ compensation system, double billing and billing far above the actual value.  The men faced over fifty years in prison.

 

Durable medical equipment is covered under workers’ compensation, but you should consult an attorney to make sure you understand the obligations of your business.  Call us today at (714) 516-8188 if you have questions regarding Durable Medical Equipment.

Ratings and Reviews

CBLS