It’s never funny when a worker is injured on the job, but some cases do raise eyebrows. In their annual look into some “unusual” Workers’ Comp cases, Jud and Alan uncover some incidents that challenged the system, some by just being so weird.

Where did my ladder go? A worker on a rooftop was stuck when others removed the ladder and left the job. Desperate to get down, he jumped, suffering back and foot injuries. Is the worker to be blamed for intentionally jumping, or was he left with no choice? 

The falling clipboard case. From the Supreme Court of Idaho, a helicopter pilot died in a crash when a passenger dropped a clipboard that struck the tail rotor and damaged it. Who’s liable? What’s an accident, and where does civil liability intersect with Workers’ Comp?

A tryst in France, during a work trip, and the ensuing heart attack? Squeezing an oversized customer into a tiny mermaid-style wedding dress? Messing around with a flammable can of tire glue (at work)? Just as workers do unusual things, the courts also rule in unexpected ways. We can all learn from cases like these.

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode:

Thomas A. Robinson, WorkCompWriter.com

“Krinitt v. Dept of Fish and Game,” Justia.com

“The Surprisingly Broad Scope Definition of Workplace Accidents in France,” Proskauer

“Lea v. David Bridal of Greensboro, Inc. (2019)” Findlaw

“Zerofski's Case,” Massachusetts, 1982

“Employee Loses Testicle to Boss's Golf Swing: Court Affirms Boss's Liability,” FindLaw

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With the rise of artificial intelligence, it makes sense to think about the use of AI analytics in Workers’ Compensation case outcome management. What types of tools lead to efficient claim management, including shorter claim durations and better outcomes?

Guest Ryan Murphy has spent his career understanding and developing case management systems. As vice president of product at the third-party Workers’ Comp benefits administrator CorVel Corporation, he works with clients and analyzes and develops solutions that remove friction and deliver successful resolutions for clients and work.

We’ve come a long way from the days of “snail mail” and faxes. Today’s tech allows case management specialists to incorporate operational efficiency technology and help workers and employers resolve cases and get injured workers back to their lives. 

But as Murphy explains, tech isn’t a replacement for human communication and compassion, it’s a partnership. Data analysis, data aggregation, and claim summarization can help human case managers reach better conclusions faster. Every industry is being transformed by emerging technologies, Workers’ Comp is no exception. Be a part of the future today.

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode:

Previous episode of Workers’ Comp Matters, “A New Approach to Workers’ Comp: Being Nice?” with Claire Muselman

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Recovering from a workplace injury takes time, patience, and in many instances, professional case management. Guests Cindy Bourbeau and Annie Barach with Massachusetts-based Medical and Life Care Consulting Services explain how nursing case management professionals help injured workers through recovery and the Workers’ Compensation program.

Misconception that they are “spies” for insurers in claims cases. In reality, medical case management professionals help patients understand and work through Workers’ Comp, advocating for them and helping insurance companies understand necessary care to ensure a full recovery. 

Licensed case managers help with medical evaluations programs of care that help injured workers return to their jobs and get on with their lives. At times, our guests explain, there are complications in the system that are akin to “untangling a web.” 

Hear how professional case managers help coordinate care, medicines, logistical concerns, insurance, treatment approvals, and therapy, helping patients maximize recovery and return to the best lives they can. 

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

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Mental health plays a big role in workplace efficiency and safety, but it seems employers and employees view the topic differently. Guest Joseph Toppe, a longtime journalist and managing editor of the insurance news website PropertyCasualty360.com shares an interesting study from Pie Insurance. 

In recent years, employee mental health has become a more prominent issue. You don’t see the physical injury, but the injury may be there just the same. Where do employers see the risks of mental health, and how does that compare to workers’ needs? Employers and employees don’t agree. 

There’s a disconnect over workplace mental health that needs to be addressed. There needs to be a discussion. You can’t see a mental health injury the way you see a physical injury, but those injuries are real. And the evolution of AI and automation is only adding to the employee stress.

In small businesses, especially, claims for mental health injuries are on the rise. Do you understand this new frontier? Workers’ Comp doesn’t end with “slips, trips, and falls.” 

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Resources:

Articles by Joe Toppe

“Most U.S. Employers Say Mental Health Issues Contribute to Worker Absences,” by Joe Toppe

“New Report From Pie Insurance: Small Businesses Safety Priorities Shifting as Employee Needs Evolve, Survey Show” Pie Insurance

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Causation and Workers’ Compensation? It’s complicated, and it varies by state. The concept is that to qualify for Workers’ Comp there must be a direct link between the injury (or illness) and the workplace. But how do you prove what’s a direct result of the workplace and what was the result of a prior injury or condition? 

Here’s where it gets confusing. Every state has its own rules. There are varying degrees of required proof, pre-existing conditions, mental trauma, contributing causes, and it can be a challenge to sift through each jurisdiction’s standards. 

Hosts Judson and Alan Pierce dissect how pre-existing conditions complicate work-related injury claims. It’s not always as clear as it seems, and state-by-state regulations create even more confusion. Add in workplace psychological stresses and it goes even deeper.

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode:

“AMA Guides® to the Evaluation of Permanent Impairment: An Overview” 

“AMA Guides to Disease and Injury Causation,” by J. Mark Melhorn

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It’s not you, the Workers’ Compensation system has changed over time, and not always for the best. Guest Christopher Godfrey, with a long career in Workers’ Comp, including his current role as research director at the Workers'​ Injury Law & Advocacy Group (WILAG) and a lengthy stint running the office of Compensation Programs at the U.S. Department of Labor, offers some insights. 

Where a non-adversarial atmosphere used to prevail within Workers’ Comp, Godfrey worries it has been driven toward a confrontational system with a struggle for unilateral control. That isn’t how a program aimed at making injured workers whole and getting them back to work started out. 

Also concerning Godfrey is a lack of funding for the Federal Employees’ Compensation Program, making it difficult for injured federal workers to even find a doctor willing to accept them as patients. 

In both state and federal systems, Workers’ Comp is being buffeted by politics. Godfrey notes the government shutdown, a slowing employment environment, and even the potential for a stock market bubble threaten the system. Economics and politics can build hurdles that trickle down to how insurance companies and Workers’ Comp plans operate. Godfrey shares his personal concerns and describes what WILAG is doing today to protect the rights of injured workers.

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode:

Previously on Workers’ Comp Matters, guest Kenneth Feinberg, “’A Patriotic Obligation;” Kenneth Feinberg and the 9/11 Fund”

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Workers’ Compensation has traditionally been a bargain, a “deal” workers and employers agree to. Workers injured on the job are compensated quickly and in exchange they don’t sue their employers. But when it came to a Virginia school teacher shot and seriously injured by a young student, was there an exception to the rule? 

Recent law graduate Katie Jean won the Workers’ Compensation Lawyers John F. Burton Jr. Law Student Writing Competition with her entry “Rethinking the Intent Exception in the Case of Teacher Violence in Our Public Schools Modifying to Include Willful and Wanton Misconduct.” In it, she examines the case of teacher Abby Zwerner, shot by a 6-year-old with a documented pattern of disciplinary issues and had been seen at school with a gun.

Jean questions whether every school shooting can be ruled an accident for the purpose of Workers’ Compensation or if a known threat, with lack of corresponding action, entitles the injured teacher to sue for damages. 

It’s an interesting issue, and at least one prior case involving a teacher injured by a student the school knew about was unsuccessful. Does a teacher “assume risk” by taking a job? This is a timely discussion and a sign of our times. Listeners who would like a copy of Jean’s award-winning paper to review may email the hosts at the addresses below.

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode:

“Virginia Teacher Shot by 6-Year-Old Student Can Proceed With $40M Lawsuit, Judge Rules,” NBC News

“Charge in Abby Zwerner's $40M Lawsuit Will Go to Jury Trial,” 13NewsNow

“Vallandigham V. Clover Park Sch. Dist.,” Casemine

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Hot enough for ya? Guest Sebastian Negrusa Ph.D. is a researcher at the Workers’ Compensation Research Institute (WCRI) and the co-author of the recent WCRI study “Impact of Excessive Heat on the Frequency of Work-Related Injuries.”

What role does excessive heat in the workplace play in employee injuries? Turns out, it’s a lot. In temperatures of more than 90 degrees, the risk of injury on the job increases by a significant 5%-6%. Excessive heat, the study finds, impairs both cognitive and physical abilities, leaving workers more likely to make mental and physical errors and suffer injuries at work. 

Part of an employer’s duty is to prevent injuries at the workplace, and Negrusa’s study aims to help employers better understand the added risk in high-temperature environments. Some states and the federal government are currently looking at workplace heat standards and safeguards. 

Hear what occupations and employee groups are most vulnerable to these stressors and how employers can protect workers on the job (and what Workers’ Comp attorneys need to look for when representing injured workers). 

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode

“Impact of Excessive Heat on the Frequency of Work-Related Injuries,” WCRI, by Sebastian Negrusa, Olesya Fomenko, Vennela Thumula

“Heat-Related Illnesses in the Workplace—A WCRI FlashReport,” WCRI, by Vennela Thumula, Olesya Fomenko

“Florida Blocks Heat Protections for Workers Right Before Summer,” NPR

“‘It’s Getting Hotter’: Bill Aims to Implement Strategies to Protect Outdoor Workers in High Temps,” Boston 25 News

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What happens when a first responder is hurt on the job or suffers from job-related post-traumatic stress? We depend on these heroes among us, always there when we need them most. But many must depend on Workers’ Comp professionals to help them when they are injured.

Guest Paolo Longo is a partner with the law firm Bichler & Longo PLLC in Orlando, Florida. He specializes not only in helping injured workers, but also those injured workers who happen to be first responders. 

While physical threats are ever-present, PTSD is more common than many know. The hard part is getting victims and doctors to open up and talk about it. Police, fire, and corrections professionals are tough people. But the stress and injuries they suffer are real.

How do first responder Workers’ Comp cases differ by state? Where do some issues fall under the so-called “presumption law?” First responders today are exposed to hazardous materials, toxic smoke, and traumatizing situations. As advocates push awareness of the physical and mental challenge they face, it’s up to Workers’ Comp attorneys to stay current. 

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode:

“Is PTSD Covered Under Workers’ Comp?” Bichler & Longo blog

Pulse nightclub shooting, Wikipedia

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Let’s talk about the “exclusive remedy,” what it means, why Workers’ Comp matters, and the exceptions. The concept of exclusive remedy is based on the principle that in exchange for care and benefits, a worker injured on the job may surrender some options for additional remedies. 

If you’re covered by Workers’ Comp, the ability to challenge the employer in court for injuries and pain and suffering may be limited. Workers’ Comp is the remedy. We are covered by Workers’ Compensation because that can be a good thing, but we may give up the right to sue. Ideally, it’s a fair deal for workers and employers. “The Great Bargain.”

But there are twists and turns. Negligence, bad faith, family medical leave needs, disabilities, “double compensation,” and third-party interests all add to the puzzle. When does an injured worker get the “green light” to seek compensation outside of the exclusive remedy? 

And what about non-injury damages like defamation, malicious prosecution, slander, or mental anguish? Or what if a “leased” employee (think temp agencies) is hurt? While the exclusive remedy simplifies the management of workplace injuries in many cases, it’s not always as clear as it seems, and it’s important to know where the exceptions lurk. The goal is always to make injured workers whole. Every case matters. 

If you have thoughts on Workers’ Comp law or an idea for a topic or guest you’d like to hear, contact us at [email protected] or [email protected]. 

Mentioned in This Episode:

Green v. Wyman-Gordon

Foley v. Polaroid

Longever v. Revere Copper & Brass Inc.

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