Thursday, February 24, 2011
Tuesday, February 22, 2011
At a time of continued debate over the role of spinal fusion surgery (lumbar arthrodesis), the results suggest that this operation "may not be an effective operation for workers' compensation patients" with certain causes of low back pain. The lead author was Dr. Trang H. Nguyen of University of Cincinnati College of Medicine.
Using Ohio workers' compensation data, Dr. Nguyen and co-authors identified 725 workers with chronic low back pain who underwent spinal fusion surgery. Spinal fusion is an operation done to fuse together adjacent vertebrae in certain types of chronic back problems. Most of the patients in the study had degenerative disc disease, herniated discs, or nerve root disease (radiculopathy).
The researchers assessed the final treatment outcomes—including return to work, disability, and use of strong pain medications (opioids)—at two years' follow-up. They compared the results of spinal fusion with those in a random sample of 725 patients who underwent nonsurgical, conservative treatments (such as physical therapy, exercise, etc).
Almost all categories of outcomes were worse for patients undergoing spinal fusion. Just over one-fourth of spinal fusion patients had returned to work, compared to two-thirds of those treated without surgery. Twenty-seven percent of patients in the spinal fusion group had repeat surgery, while 36 percent experienced some type of complication.
The use of spinal fusion surgery for chronic low back pain has increased dramatically in recent years—despite a lack of consistent evidence that it improves patient outcomes. Few previous studies have looked at the use of spinal fusion surgery, compared to nonsurgical treatment, in workers' compensation patients.
Although it's not a controlled scientific trial, the study raises questions about the long-term effectiveness of spinal fusion surgery for workers' compensation patients with chronic low back pain. Dr. Nguyen and co-authors write, "This procedure is offered to improve pain and function, yet objective outcomes showed increased permanent disability, poor return to work status, and higher doses of opioids."
Sunday, February 20, 2011
Employers and insurers regularly challenge the injured worker's right to either wage or medical workers' compensation benefits, and thousands of dollars are spent everyday, in the hiring of doctors, vocational experts and lawyers, all to prove that the worker is either not injured as he claims; his medical treatment is unreasonable; he can work in light of his injuries; or that his continuing complaints relate to some other medical condition, and are therefore not "work-related," the legal key that unlocks the system of benefits.
The goal of returning the injured worker to productive employment is given lip-service only; our system is at best inept and at worst counterproductive in failing to address the thousands of people whose injuries prevent them from returning to the type of work they customarily perform, and providing little guidance, funding or other assistance in re-education or retraining in an appropriate skill to permit return to work in a new job. The same, incidentally, is true for workers whose jobs have been outsourced. For example, an injured worker who can no longer lift or carry heavy objects, working for an employer who has no "light duty" work available, is directed to find and accept other employment.
These other jobs are typically low wage, entry level positions in which the injured person has neither experience nor interest. But the only legal issue that matters is the workers' physical ability to do the new job - not his long term future, availability of insurance or other benefits, or even the hours or location of work. The midnight desk clerk position at the local motel, or cashier position at a gas station, are perennial favorites found by insurer hired vocational "experts" seeking to aid the injured worker back into the workforce, and a lot of time and money is spent to prove these jobs suitable. There is value in that work, but it is far from suitable, in any sense other than physical ability, for many injured workers.
How much smarter would it be to redirect the money spent on proving the availability of low wage jobs, in order to justify cutting workers' comp benefits, to paying for re-education in a new field by obtaining an associate's degree at the local community college? Answer: incredibly smarter. Why doesn't it happen? Because the law imposes no obligation on insurers or employers to either evaluate, retrain or re-educate injured workers. An insurer will easily spend $10,000 to prove the suitability of a low wage job: it needs a medical expert to show physical capability, a vocational expert to show job availability, and a lawyer to present evidence of both. What would that same $10,000 buy? Probably an associate's degree.
Admittedly not all injured workers would qualify for or be interested in going back to school, but my bet is that many would if given the chance, or if they were at least advised of the availability of additional education, some guidance about how to decide what to learn, how to enroll, and continuation of benefits for 2-3 years. This outcome can happen now, but only by a combination of luck, good advice and self-direction. How many people would know about the Office of Vocational Rehabilitation, a state agency charged with, among other things, helping injured workers, unless they are told about it?
There is the potential for big gains in money saved, careers rehabilitated, and increased economic competitiveness. The legislative fix could be as simple as requiring insurers to vocationally evaluate injured workers (similar to what they do now, but earlier in the game, and for the right purpose, i.e. increased job opportunities); notify workers' of the educational and retraining opportunities that exist, and, in cooperation with local community colleges, monitor enrollment and timely completion of classes, and pay for tuition and related expenses while continuing wage loss benefits for the time required for completion and job acquisition following graduation. Workers' who without good cause don't follow through with an approved re-training program could have their benefits suspended.
Some of this information was provided by Attorney Dan Stern of Harrisburg, PA.
Thursday, February 10, 2011
The Occupational Health and Safety Administration (OSHA) is investigating the death of a worker who suffered a traumatic injury on Jan. 14 at a Chesapeake Appalachia gas well site in Sullivan County.
The Chesapeake Appalachia gas well site where the traumatic injury occurred on Jan. 14, 2011 is located on Elsroy Hill Road in Fox Township in Sullivan County. The worker who was injured on Jan. 14 at Chesapeake Appalachia's Fox Township site was transported by helicopter to Geisinger Medical Center in Danville, and he later died, Sullivan County Coroner Wendy Hastings confirmed.
He was pronounced dead by Montour County Coroner Scott Lynn, she said.
Hastings said she did not know the name of the worker who died.
A preliminary report from first responders at the scene was that the worker had suffered a traumatic head injury.
Chesapeake Energy has referred questions about the incident at the Fox Township site to Patterson-UTI Drilling Co., which is the company that the worker who died was working for. Patterson-UTI Drilling Co. was a contractor hired by Chesapeake Appalachia to work at the gas well site in Fox Township, according to Brian Grove, senior director for corporate development for Chesapeake Energy.
Patterson-UTI Drilling Co. has refused to provide any information to The Daily Review about the worker's death, saying in a written statement that Patterson-UTI Drilling "does not comment on confidential personnel matters involving individual employees."
In a separate section of the same article, the Review reported that Nomac drilling was fined $7,000.00 for safety violations related to a gas worker fatality in 2010 in Towanda Township. This amount of a fine does not seem like enough of a "sting" to Nomac's bottom line in order for them to change their practices. But it's at least something. In many, many instances, employers are not fined at all by OSHA, who is an overworked and under-funded agency.
Friday, February 4, 2011
Given the fact that my office is in the heart of the Marcellus Shale gas fields in Northeast Pennsylvania, my firm has seen a huge increase in the amount of workers who have been injured while working at the gas drilling sites and/or working for the gas industry in other capacities, such as water tanker drivers, welders and general laborers. These gas industry cases have some unique issues that arise given the type of work performed and the type and location of employer.
1. One of the more common questions that arise is which state’s workers’ compensation law should apply? You would think that this would not be an issue since the injured worker was injured while working in Pennsylvania. And that is what Pennsylvania’s law calls for—if you are injured in PA then PA workers’ compensation law applies. But what I have been seeing in some cases is the employer attempting to apply the law of the state in which the employer is from. Many of the businesses that work in the gas fields are not based out of Pennsylvania, but are based out of states like Oklahoma, Texas and Tennessee, to name a few. For example, one of the largest gas companies working in this area, Chesapeake Energy, has corporate headquarters in Oklahoma City.
In many instances, these employers argue that the employee was actually hired in the other state and is thus subject to that state’s workers’ compensation laws. Once again, this is not accurate. In these cases, it does not matter where the employee was actually hired because once the injury occurs in Pennsylvania then that’s the state that will apply. Pennsylvania has one of the strongest workers’ compensation laws in the nation.
2. The second issue that I often see in these cases is injured workers fearful of actually reporting work injuries due to the threat of losing one’s job and being sent packing. Of course, this fear is prevalent in most industries, but it appears to be a big problem in the gas industry. One of the issues is that a lot of the workers are from out of state and they are paid a significant amount of money at these jobs. The idea is that if they “rock the boat” and complain about a work injury, then they will be sent back home and would be “blacklisted” and never be able to work again at a gas drilling site.
3. The most important issue, in my opinion, is that it’s dangerous work! I have seen many more fatalities in this industry than in any other type of industry in which I represent injured workers. There are more fatalities in the Marcellus Shale gas industry than even long haul truck drivers who are subject to truck crashes every day. It seems that at least once a month there is a newspaper article about the death of another gas worker. Just this week, in Potter County, a worker who was walking on a pipeline was struck by a truck and suffered a fatal injury. At this point I cannot tell if it is just dangerous work by nature or a significant lack of safety procedures on the drill sites. It is probably a combination of both, however.
If you are a gas industry worker and have been injured, please talk to an experienced workers’ compensation attorney before you sign anything for your employer.
Thursday, February 3, 2011
A man was killed near a gas well pipeline after being accidentally struck by a truck. Authorities say 50-year-old Joseph Craig was walking on a gas pipeline in
on Tuesday. While on the pipe a truck struck him. The West Branch Township coroner pronounced Craig dead at the scene. State police say no charges are filed after an investigation revealed the driver of the truck didn't see Craig. Potter County