Employer Liability for "Take-Home" COVID-19.

Workplace exposure to SARS-CoV-2 has sickened workers and, subsequently, their family members. Family members might be able to recover from the employer in a negligence action using "take-home" liability theory.

Determining the influence of the Workers Compensation Board of Manitoba's opioid policy on prescription opioid use amongst WCB recipients.

BACKGROUND: Opioid medications are commonly used by Workers Compensation Board (WCB) claimants following workplace injuries. The purpose of this study is to describe the impact of an opioid management policy on opioid prescriptions amongst a WCB-covered population compared to changes in the use of these medications in the general population of a Canadian province. METHODS: We linked WCB claims data from 2006 to 2016 (13,155 claims, 11,905 individuals) to Manitoba provincial health records and compared opioid use amongst this group to 478,606 individuals aged 18-65. Linear regression was performed to examine the change over time in number of individuals being prescribed opioids for various durations and dosages of 50 or more, and 120 or more morphine equivalents (ME)/day for both the WCB and Manitoba population. RESULTS: WCB claimants totaled 2.5% of Manitoba residents aged 18-65 who were prescribed opioids for non-cancer pain. After the introduction of the opioid use policy for the WCB population in November 2011, the number of people prescribed opioids declined 49.4% in the WCB group, while increasing 10.8% in the province as a whole. The number of individuals using 50 ME/day or more declined 43.1% in the WCB group and increased 5.8% in the province. CONCLUSIONS: Opioid management programs organized by a compensation board can lead to a substantial reduction in the prescription of opioid medications to a WCB client population, including individuals who were prescribed higher doses of these medications when compared with general trends in the community.

Evaluation of the Minnesota Safe Patient Handling Act: trends in workers' compensation indemnity claims in nursing home workers before and after enactment of the law.

OBJECTIVES: The 2007 Minnesota Safe Patient Handling Act aims to protect healthcare workers from injuries caused by lifting and transferring patients. The effectiveness of the law in nursing homes is unknown. This policy evaluation measured changes in patient handling injuries before and after the law was enacted. Additionally, it assessed whether effects of the law were modified by facility levels of staffing and retention. METHODS: Workers' compensation indemnity claims for years 2005-2016 were matched to annual direct care productive hours and facility characteristics (eg, profit status, hospital affiliation and region) for all Medicaid-certified nursing homes in Minnesota. Trends in patient handling claims were analysed using negative binomial regression with generalised estimating equations. The primary predictors were time period, staff hours per resident day and staff retention. RESULTS: The patient handling indemnity claim rate declined by 25% in years 4-6 and 38% in years 7-9 following enactment of the law. Claims for all other injuries and illnesses declined by 20% in years 7-9 only. Associations between time period and patient handling claims did not vary by levels of staffing or retention. However, independent of time, facilities with annual retention ≥75% (vs <65%) had a 17% lower patient handling claim rate. CONCLUSIONS: Results suggest the law reduced patient handling claims in nursing homes. However, claim rates were elevated in facilities with low worker retention and those that were non-profit, not hospital-affiliated or in a non-metro area. Facilities with these characteristics may benefit from targeted state grants and consultation efforts.

Association of Disability Benefits and/or Litigation With Time to Return to Work After Tibia Shaft Fracture Fixation.

OBJECTIVES: We explored the association of compensation status with return to work (RTW) after tibial fracture. METHODS: Eligible patients were adults with tibial shaft fractures enrolled in the Trial to Re-evaluate Ultrasound in the Treatment of Tibial Fractures. We explored the association between disability benefits and/or litigation and RTW using multivariable discrete interval hazard analysis, adjusting for sex, age, country of residence, smoking status, body mass index, polytrauma, fracture severity, fracture gap, pain severity, and physical functioning. RESULTS: Of 330 eligible patients, 111 (34%) had not returned to full-time work 1-year after surgery. In our adjusted model, receipt of disability benefits and/or involvement in litigation was associated with delayed RTW (HR = 0.71, 95% CI 0.52-0.96). DISCUSSION: Tibial shaft fracture patients receiving disability benefits and/or involved in litigation are less likely to RTW.

Examining the impact of occupational health and safety vulnerability on injury claim reporting in three Canadian provinces.

INTRODUCTION: The workers' compensation system covers wages and health care costs associated with work-related injuries or illnesses. We explore if dimensions of occupational health and safety vulnerability are associated with differences in reporting work-related injuries to workers' compensation boards (WCBs). METHODS: We examined data from adults reporting physical workplace injuries requiring time off or health care. We explored relationships between exposure to nine hazards, risk from inadequate policies and procedures, inadequate occupational health and safety (OHS) awareness, inadequate empowerment, and reporting to provincial WCBs. Odds ratios (ORs) were calculated to assess risk from dimensions of workplace vulnerability for not reporting an injury to WCBs. RESULTS: Of 326 participants, 64% did not report injuries to WCBs. Reporting was higher among those with hazardous workplace exposures compared to those without (40% vs 22%, P = .01), lower among those with inadequate policy and procedures and inadequate awareness protections. Inadequate OHS awareness protection was related to not reporting to WCBs in logistic regression models. Women, those working part-time, workers in education, health, and public administration, and non-unionized workers were less likely to report injuries (nonsignificant), while workers with postgraduate educations were significantly less likely to report an injury compared to referent (OR = 3.89, 95% CI: 1.57-9.62). CONCLUSION: A general lack of knowledge about OHS rights and responsibilities was associated with low levels of reporting. This suggests there is a knowledge deficit among some workers, possibly amenable to joint efforts to increase rights and responsibilities related to OHS with the dissemination of information about rights to workers' compensation.

An Injury to Justice: Workers' Comp Disputes Could Tilt in Insurers' Favor.

Medicine is working to upend a recent appeals court decision that threatens to give health plans an overwhelming advantage in fee disputes in workers compensation cases.

Impact of legislative reform on benefit access and disability duration in workers' compensation: an interrupted time series study.

OBJECTIVES: To determine the impact of legislative changes to the New South Wales (NSW) workers' compensation scheme on injured workers access to benefits, insurer claim processing and work disability duration. METHODS: Population-based interrupted time series study of workers' compensation claims made in NSW 2 years before and after legislative amendment in June 2012. Outcomes included incidence of accepted claims per 100 000 workers, the median and 75th percentile insurer decision time in days, and the median and 75th percentile of work disability duration in weeks. Effects were assessed relative to a comparator of seven other Australian workers' compensation jurisdictions. RESULTS: n=1 069 231 accepted workers' compensation claims were analysed. Claiming in NSW fell 15.3% following legislative reform, equivalent to 46.6 fewer claims per 100 000 covered workers per month. This effect was greater in time loss claims (17.3%) than medical-only claims (10.3%). Across models, there were consistent trend increases in insurer decision time. Median work disability duration increased following the legislative reform. CONCLUSIONS: The observed reduction in access to benefits was consistent with the policy objective of improving the financial sustainability of the compensation scheme. However, this was accompanied by changes in other markers of performance that were unintended, and are suggestive of adverse health consequences of the reform. This study demonstrates the need for care in reform of workers' compensation scheme policy.

Plaintiff Attorney's Issues and Perspective: The Injured Worker as Claimant.

Injured workers deal with many struggles while healing, forced on them by problems within the workers' compensation system itself. The physician's role is critical in mitigating complicating factors that have a negative impact on recovery. The workers' compensation system is meant as a safety net, guaranteeing prompt medical care; therefore, the applicable causation standard is lower than scientific probability. Physicians treating injured workers must remember legal, ethical, and moral obligations to patients. Injured workers should not be treated differently from patients who suffered a similar injury at home. Nonmedical factors must be analyzed in deciding whether a person is legally disabled.

Determination of Medicolegal Causation.

Causation determination has become the gateway to treatment and reimbursement in workers' compensation and personal injury cases. The science of causation is constantly evolving, which is improving our understanding of individual physical thresholds, associated risk factors, and individual biopsychosocioeconomic factors. New laws place constantly changing legal thresholds for determining work-relatedness and proximate cause. The underlying foundation for fairness is quality science to support decisions made by the legal system to provide the injured worker the appropriate treatment to restore their function and decrease their functional impairment and/or assist in determining appropriate proximate cause in personal injury cases.

A case from India of pleural malignant mesothelioma probably due to domestic and environmental asbestos exposure: a posthumous report.

India is the largest consumer of asbestos in the world. There is no report from India of mesothelioma related to asbestos. The case is a 42-year-old man who died of pleural mesothelioma. He was exposed to asbestos domestically and from the environment since birth. Two of his close family members worked in a factory that used asbestos. The living quarter of the family was within the premises of the factory. Asbestos waste was strewn on the grounds surrounding the quarters. After decades of legal battles by workers and families exposed to asbestos, Indian courts have ordered remedial measures and compensation to people, who are exposed to asbestos at work and the environment. Mesothelioma, currently in epidemic proportions in the west where asbestos production was banned in the 1990s, could rise to alarming levels in the next decades in India if the legal remedial measures are not implemented soon.

Burnout syndrome in Europe: towards a harmonized approach in occupational health practice and research.

Health practitioners and decision makers in the medical and insurance systems need knowledge on the work-relatedness of burnout. To gather the most reliable information regarding burnout diagnosis and recognition in Europe, we used an 8-item standard questionnaire sent by e-mail to occupational health specialists identified via the Network on the Coordination and Harmonization of European Occupational Cohorts (OMEGA-NET) within the European Cooperation in Science and Technology (COST) Action. Participation rate was 100%, and the questionnaire was completed for 37 countries. In 14 (38%) countries burnout syndrome can be acknowledged as an occupational disease. However, only one country included burnout on the list of occupational diseases. The results showed a high variability in burnout diagnosis, in assessment of its work-relatedness, and in conditions allowing compensation of patients. These results reflect a lack of graded evidence on burnout and its determinants. The ongoing research on burnout conducted in the frame of the OMEGA-NET COST Action should be helpful through facilitating standardization of both existing and new data on burnout, a priority outcome requiring harmonization.

Recovery Within Injury Compensation Schemes: A System Mapping Study.

Purpose Many industrialised nations have systems of injury compensation and rehabilitation that are designed to support injury recovery and return to work. Despite their intention, there is now substantial evidence that injured people, employers and healthcare providers can experience those systems as difficult to navigate, and that this can affect injury recovery. This study sought to characterise the relationships and interactions occurring between actors in three Australian injury compensation systems, to identify the range of factors that impact on injury recovery, and the interactions and inter-relationships between these factors. Methods This study uses data collected directly from injured workers and their family members via qualitative interviews, analysed for major themes and interactions between themes, and then mapped to a system level model. Results Multiple factors across multiple system levels were reported by participants as influencing injury recovery. Factors at the level of the injured person's immediate environment, the organisations and personnel involved in rehabilitation and compensation processes were more commonly cited than governmental or societal factors as influencing physical function, psychological function and work participation. Conclusions The study demonstrates that injury recovery is a complex process influenced by the decisions and actions of organisations and individuals operating across multiple levels of the compensation system. Changes occurring 'upstream', for instance at the level of governmental or organisational policy, can impact injury recovery through both direct and diffuse pathways.

¿Mejor prevenir que indemnizar?. Los accidentes de trabajo en Argentina, 1915-1955 / Better to prevent than indemnify? Work accidents in Argentina

En sincronía con la sanción y la reglamentación de la Ley de Accidentes de Trabajo en la Argentina (1915) se impulsaron una serie de medidas para prevenir los accidentes laborales y las enfermedades profesionales. Las mismas fueron diseñadas en forma asistemática y espasmódica tanto desde las agencias estatales como también por los sectores industriales. El artículo indaga en los debates legislativos, las revistas oficiales y profesionales y en los soportes gráficos con el objetivo de mostrar que en la gestión tanto gubernamental como privada, en el período estudiado, primó la lógica indemnizatoria por sobre la preventiva, y ambas estrategias se conjugaron como mecanismos de resolución de los desajustes del trabajo. Estudiar cuáles fueron las políticas preventivas y a quiénes se dirigió la difusión gráfica y las recomendaciones es una vía para analizar las inclusiones y exclusiones en el proceso de delimitación de las políticas sociales. La relevancia de este punto radica en que sobre el dilema de la responsabilidad individual o responsabilidad social, se ha construido gran parte del corpus legal en torno a las políticas sociales

In line with the sanctions and regulations of the Work Accident Law in Argentina (1915), a series of measures were adopted to prevent work accidents and professional diseases. They were designed in a non-systemic and spasmodic fashion by both state agencies and industrial sectors. Based on the investigation of legislative debates, official and professional journals, and graphic materials, this article shows that an indemnifying approach prevailed over a preventive approach in governmental and private management bodies during this period and that the two strategies were combined as mechanisms for resolving work problems. Study of the preventive policies, poster campaigns, and target audiences of recommendations is one method to identify those who were included in social policies and those who were excluded. The relevance of this issue lies in the fact that a large part of the corpus of law on social policies has been constructed around the dilemma of individual or social responsibility

Misconduct, Self-inflicted Injury, and Suicide in Workers Compensation: A Review of the Australian Legal Framework.

The no-fault principle is one of the pillars of workers' compensation schemes operating in the States, Territories and the Commonwealth in Australia. This article examines the strength of this principle having regard to provisions common to all jurisdictions which disentitle workers where there is evidence of serious and wilful misconduct or self-inflicted injury. It examines the legislative framework of these provisions in detail noting some differences in approach and effect. The article also traces the origins of these provisions and how they have been applied since enacted. We conclude that the no-fault principle remains robust and intact in Australian workers' compensation schemes.