February 2012 Archives

February 28, 2012

 

In March, UCLA chemistry professor Patrick Harran and the UC Board of Regents will be facing an ordeal they likely never anticipated: a court arraignment on felony charges related to a 2008 laboratory fire that killed Sheri Sangji. They face three counts each of willfully violating occupational health and safety standards. According to the Los Angeles Times, the charges are thought to be the first stemming from an academic lab accident in the United States.

By way of background: In December 2008, Sheri Sangji was working with t-butyl lithium, a substance that ignites on contact with air. A drop spilled on her clothing causing an instant conflagration. She suffered second and third degree burns over 40% of her body, and died 18 days after the fire. In the wake of this accident, Cal/OSHA imposed a $31,875 penalty, citing safety lapses and lack of training. (Chemjobber has followed this case diligently . See all his posts on the Sheri Sangji case, with the most recent at the top.)

UCLA officials call the recent criminal charges outrageous, saying this was a tragic accident and Sangji had been trained to do the dangerous work she was doing. But a 95-page Cal-OSHA investigative report contradicts that defense, saying Sangji was neither experienced nor well trained, terming the risk "foreseeable," and stating that the death was preventable had Sangji worn appropriate clothing. Further, "The report states that UCLA, by repeatedly failing to address previous safety lapses, had "wholly neglected its legal obligations" to provide a safe environment in campus labs and that Harran was personally responsible."

In the wake of Sangji's death, we posted about this tragic incident a few times. First, we raised the issue of why university labs aren't safer, suggesting, among other things, that lab safety be added as a criteria of evaluation for federal funding sources. We got some push back from commenters who thought that such a suggestion was naive and that health and safety personnel were unqualified to oversee "exotic" scientific protocols. We followed with a response to these criticisms, as well as provided links to other articles and places where the death was being discussed by students, scientists, private lab workers and safety professionals. (See More on the
UCLA lab death of Sheri Sangji
.)

While Harran and UCLA are facing charges, this is apparently not a random or isolated incident. In December, Beryl Lieff Benderly of Science Careers posted Taken for Granted: A Blueprint for Safety Action Now. Here's an excerpt:

Issued in October, a CSB report entitled Texas Tech University: Laboratory Explosion lays out in 23 pages of straightforward, nontechnical language what went wrong in a near-fatal 2010 incident on the Lubbock campus and what needs to be done to prevent anything like it from happening again.
The report goes far beyond the usual accident investigation's list of technical mishaps. It views the maiming of Texas Tech University (TTU) graduate student Preston Brown not as an isolated series of individual errors but as the predictable outcome of a culture, set of values, and system of organization prevalent not only at TTU but also at many other campuses. Having collected at least "preliminary information" on 120 other such incidents, CSB declares itself "greatly concerned about the frequency of academic laboratory incidents in the United States."

Academia has evaded some of the scrutiny that private employers face in safety standards. The issue of lab safety still sparks controversy. Many still think that the environment is too exotic and too specialized to incorporate safety standards and that regulations would stifle creative research work. That's little more than obfuscation and foot dragging. Lieff Benderly posted another article Taken for Granted: How to Live With Danger outlining the contrast between chemical laboratory safety and that of another industry, airlines.

In The Sharp Knife of a Short Life, the blog Chembank frames the issues well:

"Changing the culture of an institution--especially one as intractable as chemical academia--is extraordinarily difficult. But so long as we forgo meaningful changes in favor of cosmetic ones that we don't even bother to sustain anyway, we will continue to experience frustration and tragedy. One wonders what magnitude of disruption is necessary for our community to commit itself to improvement. Apparently, it is much greater than the death of a twenty-something student."


We repeat a comment that we made in 2009:

Some workplaces come by safety voluntarily with a commitment from the top. Other employers - even generally well meaning employers - don't truly embrace safety until they have had paid some very steep price. Sometimes that price is a gut-wrenching human one, as when a worker dies; other times, the toll is purely economic, in high workers comp costs, ruinous lawsuits, and bad publicity. Unfortunately, money is often the best change agent. That, and the push provided by standards and enforcement under OSHA.

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February 27, 2012

 

Earlier this month, Julie Ferguson blogged the hazards of unsafe trenches. Today we examine the consequences of unsafe trenching for Oscar Avalos, a laborer for a Texas-based company involved in the installation of sewer pipes. The good news for Oscar is that a jury awarded him $4.5 million for the general contractor's negligence in supervising his jobsite; a court of appeals has upheld the award. The bad news, of course, is that Avalos will never work again.

Nowak Construction, a Kansas-based company, was hired by the city of El Paso, Texas, to install new sewer lines. James Heiman, Nowak's onsite superintendent, was neither an engineer nor safety expert. In their plans submitted to the city, Nowak proposed using trench boxes for safety, a proven means of preventing trench collapse. Unfortunately, when they hired Rocking Q as a subcontractor, they did not require that Rocking Q adhere to the trench box procedure. Instead, they deferred to Rocking Q's decision to use "sheet piling" - a form of bracing in which steel plates are driven into the ground with a backhoe and then secured with chains. This alternative plan was never submitted to the city for approval.

Thus we have a jobsite where digging and maintaining trenches are a constant activity, where the original safety plan has been scrapped, and where an alternative plan is in effect. Rocking Q did not use any cross-bracing to support the street plates. Rocking Q's owner testified that no one from Nowak told him that this was unsafe or asked him to use cross-bracing. Further, an engineer representing the City visited the work site daily and never criticized the trench safety system (in itself fodder for another blog posting).

Water-soaked Trenches
On the evening of September 13, 2006, 1.15 inches of rain fell within a two-hour period. At about 7:30 the next morning, site super Heiman went to the area where the Rocking Q crew was working. He then went to work about 150-feet away, within sight of the Rocking Q crew.

Here comes the astonishing part: Heiman testified that he returned to the area at around 12:30 or 1 p.m. and saw that the street plates were not anchored in any way - they had neither chains nor cross-bracing. Heiman did not mention to anyone that he thought the site was unsafe. Just two hours later, the dirt behind a street plate collapsed, causing the plate to fall on Avalos while he was working in a trench. The unanchored plates, intended as safety barriers, were transformed by unstable earth into moving objects with catastrophic impact. Avalos was totally disabled in the accident.

Initially, Avalos's injuries were covered by workers comp. But he also sued the GC Nowak for negligence. In the course of the testimony, Novak's lack of safety oversight was exposed:

Heiman testified that the street plates were tied back with a chain. Heiman had never before worked on a job in which street plates were used for trench safety. He had some initial concerns about [the subcontractor's] system because no structural supports were used for the street plates. According to Heiman, [the sub] told him "that's the way they do it in Texas." Heiman called Mr. Nowak to report his concerns, but he also told Mr. Nowak that [the sub]'s system seemed to be working. Mr. Nowak spoke with [the sub], who assured him that the plates were being hammered into the ground properly and that a chain was being used to anchor the plates. Mr. Nowak then approved the use of street plates for trench safety.

By giving a verbal OK to the revised trench safety plan, and by not seeking El Paso's approval for the change, Nowak assumed liability for the consequences. When the trench failed, Nowak became the responsible third party for Avalos to sue.

The Eyes of a Stranger
One of the intriguing aspects of this case is the way everyone overlooked an obvious hazard, including the city's own site inspector. Trenches were routinely secured by plates driven into the ground. There were no cross braces - indeed, no requisite trench boxes - in view. Based upon the testimony, it appears that chains to secure the plates were not used consistently.

Because we are consultants, LynchRyan always has the benefit of seeing job sites for the first time. We view the work being performed with the eyes of a stranger, because we are, literally, strangers. As part of our approach to safety, we encourage companies to look at the work being done as if they had never seen it before. Routine fosters indifference. I once toured a large warehouse with the company safety director. We came across an employee awkwardly pulling a bulky box from a shelf above his head; a rolling ladder stood a few feet away. What I saw was a very unsafe practice which could easily have been mitigated by using the ladder; what the safety director saw was his buddy, Ralph. He waved to Ralph and we moved on.

Everyone knows that trenches are dangerous. As OSHA frequently notes, "an unprotected trench is an open grave." Yet even in companies whose only work involves trenches, the hazards persist. Despite OSHA's videos, PowerPoints, brochures, and posters highlighting trench hazards - along with well-publicized fines for failure to comply - bad safety practices in trenching persist. In losing this liability case, Nowak has probably learned a painful lesson. But I shudder to think that big time lawsuits are the only effective way to motivate management to take trench risks seriously.

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February 24, 2012

 

You have to feel sorry for Erik Martin. He went to work for Quick Chek Corp in 1999 as an assistant store manager. He was promoted to store manager in the summer of 2000. He was diagnosed with Parkinson's disease that same year. After informing his supervisor of his diagnosis, she advised him to keep his illness "hush, hush." Martin complied, and never mentioned his illness to the company's HR director. Martin missed work in 2004 and 2006 due to two mini-strokes and took a two-week leave of absence in 2007 because of depression. Despite his formidable physical difficulties - unrelated to work - he returned to work as soon as he was able.

In March 2008, Martin requested and received a demotion because his medical condition, combined with the lack of an assistant manager, precluded him from satisfying his work obligations. Later that same month, Martin injured his back at work. He contacted his doctor, who instructed him to take a darvocet that was previously prescribed to Martin's mother-in-law. Martin visited the doctor the following day, at which time he was prescribed percocet to manage his pain.

Drug Policy
In keeping with company policy, Martin was drug tested two days after the injury. A few days later, he was contacted by the testing facility. They asked him to disclose the medications he was taking. He told them about his prescriptions, including the percocet, and also informed them about the darvocet he took on the day of the injury. Because he tested positive for darvocet without a prescription, the testing company reported a failed drug test and Quick Chek terminated Martin.

A reasonable person might think that Martin was in compliance with the company policy. He took a pill at the verbal direction of his doctor. Was this a "prescribed" medication? Well, that's where a problem arises.

The word "prescription" comes from the Latin "praescriptus" compounded from "prae", before + scribere, to write = to write before. Historically, a prescription was written before the drug was prepared and administered.

It appears that a "verbal prescription" is an oxymoron: if it isn't in writing, it isn't a prescription. [NOTE: the court ruling did not even address this issue.]

The HR director testified that his decision to terminate Martin was based on the failed drug test. He further testified that in his thirteen years managing human resources for Quick Chek, he never made an exception to the company's zero-tolerance drug abuse policy. The director also stated that he was not aware of Martin's Parkinson's disease until this litigation commenced.Thus Martin's termination was consistent with company policy. And in the view of the court, the termination was perfectly legal.

The court wrote:

Unquestionably, the company's drug policy was enforced in a harsh fashion against Martin. The company relied completely on the assessment of the testing company that Martin "failed" the drug test. Quick Chek operates in such a way as to delegate total discretion to interpret the drug test results to the testing company. Once deemed to have failed the drug test, an employee is terminated without exception with no apparent right of appeal. In Vargo v. National Exchange Carriers Assn., Inc., 376 N.J.Super. 364, 383 (App. Div. 2005), we held that a company need not investigate possible legal reasons for a positive drug test before taking action with regard to a prospective employee; nor should such a duty exist with respect to existing employees. NJLAD is not offended by a private company's lack of compassion in these circumstances.

Note how the court starts with a precedent involving a job applicant and then applies it to a loyal employee of long standing: "nor should such a duty exist with respect to existing employees." The court may not see any difference between an applicant and a loyal employee, but I do.

No Room for Compassion
The court "is not offended by a private company's lack of compassion." Well, I am. Zero tolerance policies back companies into a corner; their rigidity may eliminate the need for discretion, but in doing so, these policies also eliminate many good employees. A little discretion in the hands of good managers is a powerful tool toward building a positive work culture. By contrast, zero tolerance policies may provide an illusion of control over matters that are difficult to control, but they are not an effective way to run a company (or a school, for that matter). Indeed, the policy makes it difficult for the company to fulfill its promise as a great place to work:

Quick Chek is proud to be one of NJ's Best Places to Work! With 2,600 team members in over 120 stores, we strive to create a positive experience and fun environment where core values are nurtured, hard work is rewarded and leadership is cultivated.

I wonder what Erik Martin thinks of the company's "core values." When his illness prevented him from doing his job, he requested and was granted a demotion. When his illness prevented him from working, he took (unpaid) time off and focused on recovery. When he was injured at work, he followed his doctor's orders and his company's procedures. Martin's loyalty and perseverance are admirable qualities, but they did not buy him much in the corporate offices of Quick Chek or the courtrooms of New Jersey.

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February 22, 2012

 

There's breaking news in the ongoing criminal investigation into the Upper Big Branch Mine disaster that killed 29 miners in 2010. The Charleston Gazette's Ken Ward Jr. reports that a mining manager has been charged with conspiracy. supervisor Gary May is charged with plotting "with others known and unknown" to provide advance warning of inspections, concealing violations, falsifying records, and taking steps to conceal actual work conditions. He is also charged with disabling a methane monitoring system a few months before the explosions.

May is the third person to be charged in the ongoing criminal investigation and is said to be cooperating with investigators. Ward reports that, "Next week, former Massey Energy security director Hughie Elbert Stover faces up to 25 years in prison when he is sentenced by U.S. District Judge Irene Berger after being convicted of lying to investigators and trying to destroy evidence about Massey's practice of warning underground workers of impending government inspections."

At his Coal Tattoo blog, Ward offers more context about May and the charges against him. Ward, other industry observers, and other media indicate that the way the charges are structured would seem to indicate that the investigators are looking to upper levels of the organization. It would seem that there are more shoes to drop in this sad saga.

For ongoing coverage of Massey's UBB mine disaster, see Coal Tattoo / Upper Big Branch Disaster and the Upper Big Branch Mine Disaster archives at The Charleston Gazette.

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February 22, 2012

 

Insurance Regulatory Law is this week's host for Cavalcade of Risk #151 - and it's a challenging one!

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February 21, 2012

 

Dr. Paul Volkman specialized in mitigation of pain. Did he ever. From 2003 to 2005 he was the most prolific prescriber of Oxycodone and related opioids in the entire country. He was recently sentenced to four life terms in prison for the deaths of four patients. There were eight additional overdose deaths associated with his practice, but these lacked enough evidence to prosecute. Patients came from hundreds of miles away and were charged $125 to $200 in cash for visits to see a doctor. Volkman's distribution system had a devastating effect on southern Ohio, where he based his practice.

Prosecutors said Volkman rarely, if ever, counseled patients on alternate treatments for pain, such as physical therapy, surgery or addiction counseling. Volkman denied the allegations and said he always acted in good faith. A month before his conviction, he dismissed his attorneys and defended himself. His skills as an attorney appear to be totally in sync with his skills as a physician.

Street Creds and Credentials
Volkman went to work at the Tri-State Health Care and Pain Management clinic in southern Ohio in 2003. The clinic was operated by Denise Huffman and her daughter Alice Huffman Ball, who have pled guilty to one count of operating Tri-State as a business whose primary goal was the illegal distribution of prescription drugs. Denise has been sentenced to 12 plus years in prison; her daughter is serving five years. Both testified against Volkman, as did a horde of witnesses including pharmacists, police investigators, clinic employees and patients who received pills from Volkman.

What is striking about this case is the harsh sentencing. Four life terms is the kind of sentence you rarely see applied to white collar criminals; Volkman was sentenced as if he were a run-of-the-mill (pun intended) drug kingpin, which, minor differences aside, he was.

Through the wonders of the internet, we learn that Volkman had a three star rating from his patients and earned his medical degree at the University of Chicago Pritzger School of Medicine in 1974, followed by a residency at Duke Medical Center. After that, well, something went terribly wrong. Nonetheless, with his impressive creds, he's sure to be a very popular man for the rest of his highly circumscribed life.


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February 16, 2012

 

Health Wonk Review - Jason Shafrin has posted the Health Wonk Review: More than Birth Control Pills edition at Healthcare Economist. And there is indeed much more than birth control in this issue: politics, health care reform, the Affordable Care Act, and a grab bag of other timely topics. Check it out!

CDC calls prescription drug problem "epidemic" - The CDC weighs in on the prescription drug abuse problem, calling it "epidemic" and "the fastest growing drug problem in the United States." Risk & Insurance offers a concise summary. And on the same theme is a story about how New Jersey has implemented a Prescription Drug Monitoring Program. "In unveiling the program last month, state officials related that one patient obtained more than 2,500 doses of oxycodone and methadone in a four-week period. The patient presented what are now believed to be forged prescriptions to three pharmacies on 14 separate occasions, spread out his visits among the pharmacies, and paid sometimes with cash and sometimes by insurance."

Affordable Care Act: What if... - What if the Supreme Court overturns the mandate? At Managed Care Matters, Joe Paduda looks at what the repeal of the mandate would mean for workers comp.

Marijuana & impairment Roberto Ceniceros recently discussed the issue of marijuana use and impairment. He cites a recent Louisiana appeals-court ruling that upheld benefits for an injured worker who showed positive in a post-injury test for consumption of marijuana and a prescription drug.

Emerging Risks: Exploding Hog Farms - Hog farmers take note: the Minnesota Daily covers reports of a mysterious foam that has caused Midwest swine barns to unexpectedly explode. The foam can build up to heights of four feet on manure pits. "The foam traps gases like methane and when a spark ignites it causes an explosion. About a half dozen barns in the Midwest have exploded since the foam was discovered in 2009. / In mid-September 2011, a barn in Iowa was added to the growing number of barns taken down by the foam. In the explosion, 1,500 pigs were lost, and one worker was injured."

Contractors in conflict zones - At Risk Management Monitor, Jared Wade discusses contractor deaths in Afghanistan as reported in a recent New York Times article. He notes that, "In 2011, for the first time, there were more civilian contractors working for U.S. companies that died in Afghanistan than there were U.S. soldiers." He follows up with excerpts and links to a prior Risk Management story on working in the world's most dangerous locations

Economy & Insurance - Global financial woes will not derail the economy, according to Robert Hartwig, President and Economist at the Insurance Information Institute, who has been a reliable forecaster and source of information on both the overall economy and the impact on the insurance industry. He sees opportunities for insurers beyond waiting for rate increases. Read more in Chad Hemenway's story at Propertycasualty360: Hartwig: U.S. Insurers Should Look at 'New Trajectory of Growth'

Aging & Construction Work - The Center for Construction Research and Training analyzed 100,000 workers comp construction industry claims for the
state of Colorado to understand the relationship between the claimant
age and costs by the causes and natures of injuries and illnesses. Consistent with other aging studies, the report says "Older construction workers filed a small percentage of the total workers' compensation claims; however, when they did file a claim the associated costs were greater." Review the key findings: The Role of Age on the Cause, Type, Nature and Cost of Construction Injuries (PDF)

News briefs

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February 13, 2012

 

A couple of years ago we blogged the performance incentive program at Smurfit-Stone Container Corporation in California. The performance numbers were stellar, but not necessarily because the work was performed safely. Instead, the company conspired with local medical providers to secure limited treatment outside of the workers comp system. Two supervisors pled no contest in conspiring to deny comp benefits to injured workers.

With the recent conviction of chiropractor Robert Schreiner, we see into the black box of the conspiracy. Workers complaining of work-related problems were referred to doctors like Schreiner - giving rise, alas, to a new and ominous definition of provider network. In one instance a worker complained about a neck and shoulder injury. Schreiner denied that the problem was work related, saying that it was caused by carrying a back pack as a child. He provided a handful of treatments and then encouraged the worker to file the claim under his health plan to continue treatments. When the worker persisted and filed a comp claim, he was fired.

Schreiner is headed to jail to serve a mostly symbolic sentence of 30 days, to be followed by three years of probation. Perhaps he can provide some adjustments to his fellow inmates. Confined spaces sure can mess up the spine.

Faking Safety
Smurfit-Stone was bought out last year by RockTenn. You can still read about the company in Wikipedia. Here is the (unattributed) description of the company's safety program:

Smurfit-Stone has been an industry leader in safety performance since 2001 [NOTE: the conspiracy to under-report claims began in 1999!]. In 2007, Smurfit-Stone's U.S. operations had an OSHA recordable case rate of 1.05, the best in company and industry history. This represents an 84 percent improvement in the company's recordable case rate since the implementation of Smurfit-Stone's SAFE process in 1995.The SAFE process, which stands for Smurfit-Stone Accident-Free Environment, promotes five core beliefs: 1.All injuries are preventable 2.Safety is everyone's responsibility 3.Working safely is a condition of employment 4.Training employees to work safely is essential 5.Safety is good business

As litigation has proven, Smurfit-Stone's low OSHA case rate has less to do with safety than with a conspiracy to under-report claims. Perhaps the SAFE program stood for something else: Screw All Forsaken Employees. Aggressive safety goals are a good business practice; circumventing the workers comp system is not just a bad practice, it's illegal. Just ask Robert Schreiber.

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February 9, 2012

 

A little more than a week ago, family members and coworkers watched helplessly as 39-year old Raul Zapata was buried alive when a wall of dirt fell on him at a residential construction worksite in Milpitas, California. Zapata was working in a 12-foot deep ditch, the foundation of a 5,800 square foot home in a gated community. The cave in was extensive enough that it took two days to rescue his body. Zapata and his coworkers should not have been working at all that day because three days prior, the city had issued a stop work order to the construction company, U.S. Sino Investments Inc. The order was issued after a city building inspector determined that the ditch was a safety hazard due to a lack of adequate shoring to prevent a cave-in.

To add insult to injury, the employer did not have workers' comp insurance. They also lacked a permit, a state requirement for any projects deeper than five feet. In a case of closing the barn door, the Contractors State License Board has since suspended U.S.-Sino Investment's general building contractor license for this failure. The flouting of the stop work order, the failure to get a trenching permit and the failure to carry workers comp coverage - these are not unsurprising accompaniments to trenching fatalities. Fatalities are often preceded by multiple citations or warnings and violators are often serial violators. It's not uncommon for OSHA to issue mulitple "willful" citations related to trenching failures. OSHA defines a willful violation as one "committed with an intentional disregard of, or plain indifference to" OSHA requirements, the highest level of citation, carrying fines of $5,000 to $70,000 per incident.

Two workers a month are buried alive in trench collapses. Most of these tragedies are avoidable simply by following OSHA standards, which mandate that all excavations 5 feet or deeper be protected against collapse. It's a stroke of luck that no other workers were killed at the Milpitas site - it's not uncommon for rescuers to rush to the aid of a victim and become entrapped themselves when an a secondary collapse occurs. Trench rescues require speed, precision, and expertise.

To help curtail fatalities that OSHA describes as "entirely preventable," in October they released new trenching safety guidance, including the following safety materials:

Fact sheet: Trenching and Excavation (PDF)
Quick Card: Working Safely in Trenches (PDF)
Poster: An unprotected trench is an early grave (PDF)

Other resources:
Trench safety - an eleven-lesson tutorial based on the latest OSHA requirements for construction excavation safety.
OSHA - Confined Space
Constructing a better trench rescue (PDF)

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February 7, 2012

 

I watched the Superbowl with a group of friends on a 60" High Definition TV, sipping a few beers and compulsively downing munchies. My team lost (but to my mind, second place in a league of 32 teams is not all that bad - kind of a silver medal). I find the organized mayhem of football fascinating, as if J. S. Bach were being performed by a deranged, full contact orchestra. A number of years ago, my then 4 year old daughter Julia called the game "all fall down." She was right in more ways than she knew.

We have been following two tracks in the saga of the NFL: the workers comp claims filed by former players in California (where benefits are easier to secure) and the lawsuits alleging that the league knowingly hid the effects of repeated concussions, resulting in dementia and other serious medical issues among retired players. While there are numerous lawsuits filed across the country, there is a movement to consolidate several of them into one big federal case, under Senior Judge Anita Brody in Philadelphia.

The stories of diminished mental capacity that have emerged over the last few years are disturbing - easily reaching the threshold where all of us who view the sport must question our complicity. For decades, the football mentality has been to keep the best players on the field, regardless of (future) consequences.

Touchdown Tony Dorsett
One of the parties to the lawsuits is the former Dallas Cowboy running back, Tony Dorsett. He was a smooth, electric runner on the field, but the mask of his helmet and pads only served to make invisible his considerable pain and suffering:

Dorsett's had surgery on both his knees, and problems with his left arm and right wrist. He says then-Cowboys coach Tom Landry once told him he could play despite a broken bone in his back. Not even the flak jacket Dorsett says he wore beneath his jersey could bring relief, the injury so painful that "tears would just start flowing out of my eyes, profusely and uncontrollably" during practices. "They would see me and just point to the training room. 'Go to the training room, get some ice and heat and come on back out here,'" Dorsett says.

That, indeed, was (and to some extent, still is) the coaching mantra: "Suck it up and get back out there!"

Presumption versus Denial
For many years, the NFL denied any relationship between the violence on the field and the subsequent mental traumas of former players. Much like the company doctors who once denied that smoking caused cancer, the league's doctors insisted that there was no demonstrable relationship between multiple concussions and dementia.

The systematic denial has ended, but the implications for hundreds of retired players are still not clear. I envision that they will eventually reach a settlement, where the league accepts responsibility for virtually any and all mental incapacity in its retirees. Much like the cancer and heart attack presumptions granted to public sector firefighters and police, the league would presume that mental disabilities among retirees are work related, with the burden of proof on a given owner to show that they are not.

While any such settlement will involved the commitment of millions of dollars, the league is so wildly popular, only a small percentage of gross income will be required.

Appetite for Sport
In the meantime, we face half a year without football. Come fall, there will be a Thursday night game every week, along with the full Sunday menu. To be sure, the players don't like the short week of preparation that Thursday games entail; they will lack the usual full week to recover from the bumps and bruises of the prior Sunday game. Oh, well, the public's appetite for America's Game is nearly insatiable. The players will just have to suck it up and get back out there...

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February 6, 2012

 

ABC news has picked up a story out of Arkansas: Zack Clement suffered a hernia while moving a refrigerator for his employer, Johnson's Warehouse Showroom. He underwent multiple surgeries, but the pain lingered, so he filed for a continuation of benefits. Among the pieces of evidence at his trial were party photos posted on his Facebook page, which show Clement drinking (and little else). When his claim for reinstatement was denied, Clement appealed, citing the unfairness of the Facebook evidence.

ABC wrote as follows:

In an opinion, written by Judge David M. Glover, the Arkansas Court of Appeals states: "We find no abuse of discretion in the allowance of photographs. Clement contended that he was in excruciating pain, but these pictures show him drinking and partying."

"Certainly these pictures could have a bearing on a Clement's credibility, albeit a negative effect that Clement might not wish to be demonstrated to the ALJ or the Commission, " Glover continues. "We hold that there was not an abuse of discretion in allowing the photographs."

Justice in the Details
At first glance, the judge's comments might be cause for alarm. An injured worker suffering from chronic pain might well be capable of having a few drinks with friends. (One can only hope that the alcohol does not interfere with any prescribed -or unprescribed - pain medications.) If the photos were the primary evidence of Clement's condition and the basis for denying the claim, Clement would have good reason to object. However, this is not the case.

In the course of his carefully reasoned findings, Judge Glover reviews in detail the medical history of Clement's claim. Even after multiple surgeries and several changes in treating doctors, Clement complained of ongoing pain. Extensive medical testing revealed no abnormalities and no evidence for the pain itself. He has been released to full duty. It is this detailed history and the lack of medical evidence that lead Glover to conclude that any further treatment would fall outside of the workers comp system. The Facebook photos are by no means the foundation of his findings. Nonetheless, he decides that the photos are a legitimate piece of the case file and admissable as evidence.

In my limited experience, Facebook seems to be a platform for superficial news and, for the most part, images of the good times. It is difficult to imagine that Clement would have used this public forum to post pictures of himself suffering excrutiating pain. If he had chosen to do so, this might have provided evidence in his favor. However, his friends would likely have chided him for being such a downer and even then, the court might have dismissed the images as theatrical exaggeration.

Facebook may now be the preferred means of presenting our personal narratives, but it is unlikely to help us make our case in a court of law.

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February 2, 2012

 

Louise Norris jumps into the political fray with this week's Health Wonk Review - Campaign 2012 Edition at Colorado Health Insurance Insider. It's a great edition with some solid submissions, and we are smitten by the great historic voting photos that Louise used to punctuate the posts. Check it out.

Other noteworthy news

Follow the money - In the continuing saga of Florida's physician-dispensed workers comp drugs and the associated costly price tag for employers, Joe Paduda looks at the behind-the-scenes opposition muscle aimed at any legislative attempts to put limits on this practice. He cites a recent research report, which tracked more than $3 million in political donations to "one Mirimar address, dozens of companies." The Florida Independent news story goes on to say, "In suburban Tampa, a single-story building at 610 South Blvd. is home to countless political committees in Florida and all over the country, and is known as a veritable political action committee mill. A similar story lies in Miramar, where two doctors -- Paul Zimmerman and Gerald Glass -- run dozens of companies that, altogether, have funneled more than $3 million into state political campaigns and committees in recent years." Joe notes, "$3.2 million total shows clearly just how important Florida is to dispensing companies and their affiliates."

Violence in the Workplace - "Workplace homicides 'Are not crimes of passion committed by disgruntled coworkers and spouses, but rather result from robberies.' And the majority of workplace assaults are committed by healthcare patients." These are a few top line findings in the NCCI research report on Violence in the Workplace. Although homicides are trending down, they comprise 11% of workplace fatalities. You can download a copy of the complete report, which is part of NCCI's ongoing research into the topic of work violence.

New blog of note - The folks at PRIUM, a workers' compensation utilization management company, have recently launched Evidence Based, a blog that will focus on our favorite topic - workers comp - with particular emphasis on the over-utilization of prescription drugs in the treatment of injured workers. Recent posts have dealt with state efforts to control narcotics. See recent posts on Arizona: The Simple Path to Controlling Narcotics in Non-Monopolistic States and Ohio's New Rules: A Good Start (with a Potential Gap).

Getting social - Pro tip for social media users: If you are going to file a workers' comp claim, you should think twice about posting party pics on Facebook - judges may take them into consideration when evaluating the merit of your claim.

The Feds & Fraud - In Government Executive, Kellie Lunney explores the reasons why the federal workers' comp program remains vulnerable to fraud. According to a study by the Government Accountability Office, limited access to data is a key culprit. "Specifically, we found that limited access to necessary data is potentially reducing agencies' ability to effectively monitor claims and wage-loss information," the report stated. In addition, agencies' overreliance on self-reported data from claimants, the frequent use of physicians not employed or selected by the government, and the expense involved in conducting investigations and prosecutions have stymied efforts to stamp out fraud. GAO noted that investigations are the "most costly and least effective" way to reduce fraud, but the ability to prosecute those who cheat the system is a valuable deterrent.

OSHA Posting Compliance - Employers, did you remember to post OSHA Injury & Illness Reports on Feb 1? If not, make sure that you do. Rules require that employers post "...the official summary of all injuries and illnesses occurring in the previous year. The information must be compiled on the OSHA Form 300A or an equivalent and posted in a conspicuous place or places where notices to employees are customarily posted. The information must remain up through April 30, 2012." For more information and to learn if this requirement applies to your organization, check out OSHA's Recordkeeping page.

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