Tips for Healthcare Workers Treating Injured Workers

At some point in their medical practice, most healthcare workers will treat a patient who was injured on the job.

But many doctors, physicians’ assistants and nurses find that while they can help these patients with their medical problems and physical recovery, treating someone with a work injury presents a unique set of challenges – not all of them medical.

Indeed, injured workers and their families must deal with a host of issues as they try to heal and rebuild their lives after being hurt on the job. There are emotional and financial burdens, and a seemingly endless amount of bureaucratic red tape to navigate when filing a workers’ compensation claim.

Additionally, injured workers face tremendous external pressure from family members, coworkers, employers and insurance companies to return to work so they can start earning a paycheck again. It’s also not unusual for injured workers to pressure themselves to return to work before they’re physically ready because they feel obligated to do so or feel “less than” because they’re out of work and collecting unemployment benefits.

When we started the Deuterman Law Group six years ago, one of our founding principles was that we would treat clients as people, not as cases, and that we would attend to the whole person. It’s our job to ensure not only that our clients receive the maximum workers’ compensation and medical benefits available to them, but also to assist them as they adjust to a new “normal” following an injury.

I believe that most healthcare professionals who are treating injured workers want the same for these patients and realize that their obligation to them extends beyond providing basic medical care. But workers’ compensation isn’t taught in medical school, so most doctors, nurses and medical office staff don’t know how else they can help these patients. And they may also be unaware of additional services available to injured workers – at no extra cost to the patient – as a result of their workers’ compensation benefits.

I offer the following suggestions and insights into the intricacies of workers’ compensation law in North Carolina that I hope physicians and other healthcare workers will find useful as they're  treating injured and disabled workers:

  • If a patient comes to you with an injury resulting from an accident at work or a chronic condition that was likely caused by their job, encourage that person to report the injury, if he or she hasn’t already done so. Ideally, work injuries should be reported immediately to the employer and the N.C. Industrial Commission and, in any event, within 30 days of the accident or diagnosis that the condition is work-related.
  • Keep detailed records of the patient’s treatment and any conversations you have about the injuries. Detailed medical records, which accurately reflect the patient’s symptoms, treatment and the progression of their recovery, are crucial in workers’ compensation claims. Many cases end up in litigation simply because medical records lack details or are ambiguous.
  • Encourage you patient to keep a calendar or journal to document important facts relating to the work injury and ongoing treatment. In their journals, patients should record details of how the injury occurred, who witnessed it and how and when it was reported. Additionally, injured workers should make note of any medical appointments in their journals, recording any medical procedures that were conducted and instructions they received from healthcare workers. Finally, patients should write about any symptoms or additional medical problems they’re experiencing and any harassment they encounter from employers, coworkers or the insurance company regarding the work injury. Workers’ personal journals have proven to be invaluable in presenting a workers’ comp claim to the N.C. Industrial Commission.
  • Some injured workers will want to return to work before they are medically able to do so. While injured workers are justified in their fear of reprisal for missing work because of an injury, strongly discourage them from returning to a job for which they are physically unprepared. Candidly explain the risk of re-injury. And while it’s true that some people are fired for filing a workers’ compensation claim – even though the law forbids such retaliation – being fired is preferable to derailing recovery or creating a worse medical problem by returning to work too soon. Let your patients know that there is legal recourse if they are fired. Patients can file a wrongful termination claim themselves with the Industrial Commission, but many will find it helpful to have an attorney advocate on their behalf.
  • Injured workers may be entitled to additional benefits beyond compensation for lost wages and traditional medical care. The standard in North Carolina is whether or not the recommended treatment is reasonably likely to effect a cure, give relief from symptoms (including pain relief) or lessen the period of disability. Under this standard, in cases of catastrophic injury, North Carolina’s workers’ compensation law allows for things like home and vehicle modifications, medical devices in the home such as hospital beds, in-home attendant care, motorized wheelchairs, etc. So long as these devices/modifications meet the standard recited above and are prescribed by a treating physician, they should be covered by the Workers’ Compensation insurance company.
  • Many injured workers believe that they don’t have the right to choose their own doctor and that they must see a physician assigned by the N.C. Industrial Commission or their employer’s workers’ comp insurance company. Patients have the right to ask the Industrial Commission for permission to see a doctor of their choosing. However, if an injured person is treated by a physician without first getting permission, his or her workers’ comp benefits might be in jeopardy. If a patient comes to you under these circumstances, advise them that an attorney can help ensure that benefits are protected.
  • Injured workers who must travel 20 miles or more roundtrip for medical care are entitled to collect $0.55 per mile. Special consideration also is given to employees who are totally disabled.
  • Chiropractic treatment is allowed for workers’ compensation patients, if the employer or the employer’s insurance company grants permission. As many as 20 visits are allowed, if medically necessary. If additional visits are needed, the chiropractor should request this authorization from the Industrial Commission.

Alternative Health Series: Yoga Useful for Stress Release, Exercise and Pain Management

This is the latest in a series of blog articles about alternative therapies for injuries and pain management.

This time, we turn to yoga, the ancient Indian mind-body practice that has become a mainstream form of exercise, stress release and pain management.

Future articles in this series will explore massage, Pilates, Reiki and other alternative treatments and pain-management techniques. You can access all articles in the Alternative Therapies Series by clicking here.

This article is presented for informational purposes only. As always, please consult with your physician and other health care providers before undertaking an exercise regimen or alternative treatment.

The following is adapted and excerpted from the National Center for Complementary and Alternative Medicine, Yoga Today and Yoga Journal.

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Treating Injured Workers: Chiropractic care may be covered

We round up our series of tips for healthcare professionals treating injured workers with some information about chiropractic care and mileage reimbursement.

  • Injured workers who must travel 20 miles or more roundtrip for medical care are entitled to collect $0.55 per mile. Special consideration also is given to employees who are totally disabled.
  • Chiropractic treatment is allowed for workers’ compensation patients, if the employer or the employer’s insurance company grants permission. As many as 20 visits are allowed, if medically necessary. If additional visits are needed, the chiropractor should request this authorization from the Industrial Commission.

If youv'e missed any of the previous tips, find them here.

 

 

Treating Injured Workers: Workers can request to see a doctor other than the one assigned by the N.C. Industrial Commission

Many injured workers believe that they don’t have the right to choose their own doctor and that they must see a physician assigned by the N.C. Industrial Commission or their employer’s workers’ comp insurance company.

But here's the truth:

  • Patients have the right to ask the Industrial Commission for permission to see a doctor of their choosing. However, if an injured person is treated by a physician without first getting permission, his or her workers’ comp benefits might be in jeopardy. If a patient comes to you under these circumstances, advise them that an attorney can help ensure that benefits are protected.

For more tips on how to help injured people navigate the complex workers' compensation system in North Carolina, click here. Our attorneys and paralegals at the Deuterman Law Group also are available to answer questions and provide counsel to injured workers.

Treating Injured Workers: Beware of returning to work too soon

Today's tip for healthcare professionals treating injured workers deals with the problems that can arise when an injured person returns to work too soon.

In the haste to get back to work and to a steady paycheck, people can cause irreversible physical damage, and they may also jeopardize their ability to collect on a workers' compensation claim.

  • Some injured workers will want to return to work before they are medically able to do so. While injured workers are justified in their fear of reprisal for missing work because of an injury, strongly discourage them from returning to a job for which they are physically unprepared. Candidly explain the risk of re-injury. And while it’s true that some people are fired for filing a workers’ compensation claim – even though the law forbids such retaliation – being fired is preferable to derailing recovery or creating a worse medical problem by returning to work too soon. Let your patients know that there is legal recourse if they are fired. Patients can file a wrongful termination claim themselves with the Industrial Commission, but many will find it helpful to have an attorney advocate on their behalf.

You can find my entire series of tips here, and stay tuned throughout the week for more advice on helping injured workers under your medical care.

Treating an Injured Worker: Workers' comp may cover home and vehicle modifications

I hope you're finding my series of tips about worker's compensation and benefits available to injured and disabled workers law helpful.

I've been sharing information about things that doctors, nurses and other healthcare workers can do to help injured patients as they navigate the complicated workers' comp system in North Carolina. There are quite a few unique benefits available to injured workers, but without a doctor's recommendation patients may not be able to receive these benefits.

My aim is to arm health care professionals with the information they need so they can attend to the unique needs of injured workers while providing them with medical treatment.

Did you know, for instance, that:

  • Injured workers may be entitled to additional benefits beyond compensation for lost wages and traditional medical care. The standard in North Carolina is whether or not the recommended treatment is reasonably likely to effect a cure, give relief from symptoms (including pain relief) or lessen the period of disability. Under this standard, in cases of catastrophic injury, North Carolina’s workers’ compensation law allows for things like home and vehicle modifications, medical devices in the home such as hospital beds, in-home attendant care, motorized wheelchairs, etc. So long as these devices/modifications meet the standard recited above and are prescribed by a treating physician, they should be covered by the Workers’ Compensation insurance company.

Treating an Injured Worker: Injured workers should keep a journal

Today's is the third installment of my series of tips for healthcare professionals who are treating injured or disabled workers.

Knowing more about how workers' compensation laws are structured in North Carolina will help healthcare professionals attend to the other needs of injured workers during the course of medical treatment.

You can find other entries in this series here:

Here's today's tip:

  • Encourage you patient to keep a calendar or journal to document important facts relating to the work injury and ongoing treatment. In their journals, patients should record details of how the injury occurred, who witnessed it and how and when it was reported. Additionally, injured workers should make note of any medical appointments in their journals, recording any medical procedures that were conducted and instructions they received from healthcare workers. Finally, patients should write about any symptoms or additional medical problems they’re experiencing and any harassment they encounter from employers, coworkers or the insurance company regarding the work injury. Workers’ personal journals have proven to be invaluable in presenting a workers’ comp claim to the N.C. Industrial Commission.

Treating an injured worker: Detailed medical records key in workers' comp cases

I'm continuing today with my series of tips for healthcare professionals who are treating injured or disabled workers.

Knowing more about how workers' compensation laws are structured in North Carolina will help healthcare professionals attend to the other needs of injured workers during the course of medical treatment.

You can find other entries in this series here:

Now for today's tip:

  • Keep detailed records of the patient’s treatment and any conversations you have about the injuries. Detailed medical records, which accurately reflect the patient’s symptoms, treatment and the progression of their recovery, are crucial in workers’ compensation claims. Many cases end up in litigation simply because medical records lack details or are ambiguous.

 

 

 

 

Treating injured workers presents unique challenges for healthcare professionals

At some point in their medical practice, most healthcare workers will treat a patient who was injured on the job.

But many doctors, physicians’ assistants and nurses find that while they can help these patients with their medical problems and physical recovery, treating someone with a work injury presents a unique set of challenges – not all of them medical. 

Indeed, injured workers and their families must deal with a host of issues as they try to heal and rebuild their lives after being hurt on the job. There are emotional and financial burdens, and a seemingly endless amount of bureaucratic red tape to navigate when filing a workers’ compensation claim.

Additionally, injured workers face tremendous external pressure from family members, coworkers, employers and insurance companies to return to work so they can start earning a paycheck again. It’s also not unusual for injured workers to pressure themselves to return to work before they’re physically ready because they feel obligated to do so or feel “less than” because they’re out of work and collecting unemployment benefits. 

When we started the Deuterman Law Group six years ago, one of our founding principles was that we would treat clients as people, not as cases, and that we would attend to the whole person. It’s our job to ensure not only that our clients receive the maximum workers’ compensation and medical benefits available to them, but also to assist them as they adjust to a new “normal” following an injury.

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OSHA to take a harder look at certain industries and companies with low workplace injury rates

OSHA, responsible for enforcing worker safety regulations, will be doing more to ensure that companies are following those laws and accurately reporting workplace accidents and injuries.

The agency will be focusing on specific industries, where certain injuries are common, and also will be examining whether some companies have been lax in reporting injuries, according to an article in the DemocratandChronicle.com

The U.S. Occupational Safety and Health Administration, created to enforce the large and growing number of worker safety laws and regulations, last week issued its "site-specific target" plan for the year, a warning, in effect, that the agency will be tougher on injury rates in specialized industries.

The plan mentioned nursing homes, where workers often suffer back and limb injuries in caring for patients, as an industry facing special attention.

But there is another program in the bureaucratic works — the National Emphasis Program — that is potentially more significant for local businesses that to this point either have escaped OSHA attention or are not in the usual range of targeted industries.

OSHA plans to examine companies that report low injury rates or few lost days due to injury with the idea that many companies have been underreporting or minimizing the need for thorough record-keeping.

The agency estimates that as many as 20 percent of all businesses fail to adequately report workplace-related injuries and illnesses. Other studies put the number as high as 68 percent.

Alternative Therapies Series: Acupuncture for Pain Management

 

This is the first in the Deuterman Law Group's series of blog articles about alternative therapies for back injuries and pain management.

In this article, we’ll explore acupuncture, a centuries-old Chinese medicine technique that has been used to treat pain chronic pain, nausea, migraines and other painful conditions. Future articles in this series will explore reiki, massage, yoga, Pilates and other alternative treatments and pain-management techniques.

This article is presented for informational purposes only. As always, please consult with your physician and other health care providers before undertaking exercise regimen or alternative treatment.

 

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Depression can slow recovery from work injury

 

Many injured and disabled workers also will develop depression – creating a double whammy of physical and emotional pain that can prolong recovery and lead to additional health problems.

The stress and financial burdens of being out of work combined with physical pain and the loss of identity that many out-of-work people injured people experience quite often leads to associated depression, according to medical research and our own experience with clients at the Deuterman Law Group. Unfortunately, so-called secondary depression is often under diagnosed, according to a 2005 article in trade journal Risk & Insurance.

 It is important for anyone who is suffering from depression to seek treatment, especially those who have an injury or disability that prevents them from working. Studies have linked pain with depression, and there’s evidence that depression can slow recovery from an injury or illness.

“Depression may increase your response to pain, or at least increase the suffering associated with pain,” according to the Mayo Clinic. “Conversely, chronic pain is stressful and depressing in itself. Sometimes pain and depression create a vicious cycle,”

A 2005 British study revealed that 20 percent to 30 percent of people injured in car accidents or on the job had their recovery impacted by depression and other psychological factors.

In workers’ compensation cases, depression that is the result of a work injury may be compensable. In other instances, depressed individuals may qualify for Social Security Disability.

If a client is experiencing symptoms of depression, it’s important that they are evaluated by a qualified medical professional, who can prescribe a course of treatment that may include therapy, anti-depressants or a combination.

It’s also important that clients share this information with their attorney and paralegal, as this may be important to the case. We may be able to we may be able to offer additional help and referrals to a support groups, community resources and medical professionals who can help our clients deal with these problems and overcome their depression.

Only a qualified medical professional diagnose depression, but the following is a list of symptoms:

  • Loss of interest in normal daily activities
  • Feeling sad or down
  • Feeling hopeless
  • Crying spells for no apparent reason
  • Problems sleeping
  • Trouble focusing or concentrating
  • Difficulty making decisions
  • Unintentional weight gain or loss
  • Irritability
  • Restlessness
  • Being easily annoyed
  • Feeling fatigued or weak
  • Feeling worthless
  • Loss of interest in sex
  • Thoughts of suicide or suicidal behavior
  • Unexplained physical problems, such as back pain or headaches

The Mayo Clinic also offers a depression self-assessment tool online.

 

 

Simple Ergonomics Can Prevent Construction Injuries

Getting injured on the job has a costly ripple effect that hurts the worker and the employer's bottom
line. It means lost work time, workers' compensation expenses and other hefty bills.

Not all injuries can be prevented, of course. But there are some pretty easy ways to stop painful and serious injuries in the construction industry, which has more than its fair share of job-related injuries.

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Recovering From Back Surgery May Take Longer Than You Think

After suffering from pain for weeks or months after an injury from a car or a work-related accident, many people look forward to the relief from pain that back surgery will provide. Being able to return to normal, everyday activities, such as lifting a box, driving a car, or sitting or standing for long periods of time, without pain is the goal of most back surgery.

However, many people are surprised that post-surgery, the pain doesn’t subside as quickly as they would like and that the return back to normal life doesn’t happen automatically.

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Back Health: More surgeries for treating back pain, back injuries

In our last installment of the Deuterman Law Group's Back Health blog series, we highlighted some of the commonsurgeries for treating back injuries. Those included laminectomy, discectomy and IDET.

Today, we take up where we left off with a discussion of other surgical treatments for back pain, namely spinal fusion, artifical disc replacement and radio frequency ablation.

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Back Health: Common Surgeries For Treating Back Pain, Back Injuries

While many back injuries can be treated with rest, physical therapy and/or anti-inflammatory medication, some injuries are best treated with back surgery.

The prospect of back surgery can be frightening and confusing, to be sure. Surgery and other treatments may involve risks and complications and require extended recovery time. In this installment of the Deuterman Law Group’s Back Health blog, we hope to alleviate some of those concerns by explaining what happens in the various back surgery procedures.

If you’re wondering what you’ll experience during and after your surgery, be sure to educate yourself by talking with your doctor, ask lots of questions and consult other resources, such as the Web sites we refer to in this blog entry.

Remember, thousands of people undergo back surgery each year, and advancements in the field of back health now provide a range of treatment options including inpatient surgery and outpatient procedures.

We’ll explain a few here:

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Massage may offer relief for 'BlackBerry Thumb' pain

They've been called Crackberries and for good reason.

People who own BlackBerry devices can't seem to put them down. They're constantly typing and texting friends, family, the office. But handy devices such as the BlackBerry, Sidekicks, and Treos that make our hectic lives more manageable are wreaking havoc on our thumbs.

 

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Back Health: Understanding back sprains, soft-tissue injuries, bulging discs and herniated discs

Oh my aching back!

I don’t know a single person who hasn’t uttered that phrase at some point in life.

So you know that a back injury can be extremely painful. It can happen – snap your fingers – just like that. And when you injure your back, it can stop you in your tracks – prevent you from working, limit your movements, make sleep difficult, make walking difficult, make surviving daily life difficult.

In the first installment of the Deuterman Law Group’s Back Health series, we talked about the anatomy of the spine and the types of pain you might experience as the result of a back injury.

Today, we’re focusing on the most common types of back injuries -- sprains, soft-tissue injuries, bulging discs and herniated discs – and the typical course of treatment for each.

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Your Guide to Back Health and Back Injuries

Many people throughout their lives will suffer from back pain, resulting from a variety of causes and injuries.

Understanding the medical terminology doctors use in diagnosing and treating the causes of back pain can be confusing. While its always your right to ask your doctor for clarification, some patients may not feel comfortable asking a busy physician to take more time to explain things in simpler terms.

This series of blogs, entitled Back Health, is designed for injured people seeking more information about common back injuries, including symptoms and treatments. And we've attempted to explain things in simple terms, so you won't need a medical degree to understand what's going on with your back.

Read on for the first installment in our Back Health Series. This one focuses on the anatomy of the spine.

Please remember, this information is for educational purposes only. If you are suffering from back pain, please consult a doctor. Do not try to treat yourself.

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Recovering from a back injury

Associated Press reporter Andrew Welsh-Huggins writes about his experiences with a back injury and his successful -- though lengthy -- recovery.

It's an interesting article that shows just how debilitating back injuries can be. The writer, a distance runner, outlines his long recovery and also highlights some of the realities of back injuries:

  • The most common type of pain reported by adults in the United States, with more than one in four reporting some back pain lasting at least a day in the past three months. Eight of every 10 people in the United States will suffer from lower back pain at one point in their lives.
  • The most common reason injured workers file for workers’ compensation claims, accounting for about one in every five U.S. claims for workers’ compensation.
  • The leading cause of disability in the United States military.
  • The leading cause of disability in people under age 45 and the third-leading cause in people older than that, after cancer and heart problems. One study found that two of every three people aged 20 to 60 reported some type of spinal pain in a given year.
  • The leading cause of missed work time or doctor’s visits after headaches and cold symptoms.

Back pain at work: Strategies to prevent aches

Found a useful article in the MayoClinic.com site called "Back pain at work: Strategies to prevent aches, pains and injuries". The page also has links to other related back pain topics that may be of use.

Kids' Chance Success Stories

Kids' Chance first came to be in 1988 because of the initiative taken by the Workers' Compensation section of the Georgia Bar. Jeff Kight one of the earliest recipients, who is now an attorney, talks to radio host Attorney Alan Pierce on Workers Comp Matters about how Kids' Chance helped him attend college.

Kids' Chance Scholarships Available to Children of Injured Workers

Like us, you know how deeply family members can be affected by a workplace injuries, both financially and emotionally. The impact of such injuries is long lasting. A family's struggles and challenges don't disappear once we obtain a verdict or a settlement or payment of their medical expenses.

They persist.

But at least there's help out there from groups like Kids' Chance of North Carolina, a scholarship program meant to help the children who become unwitting casualties of workplace injuries.

Kids' Chance of North Carolina scholarships are available to any student between the ages 16 and 25 whose parent's on-the-job injury or death resulted in a substantial decline in family income.

Scholarships in the amount of $4,500 annually may be used to pay for high school, technical school or college tuition, books, housing, meals or transportation. Another goal of Kids' Chance is to prevent students from dropping out of school. So scholarship recipients may also use the money to contribute to the family income.

For more information about Kids' Chance of North Carolina, visit www.kidschancenc.org. Scholarship applications are available from Deuterman Law Group by calling 373-1130 or online at www.deutermanlaw.com.

Great article about Kids' Chance scholarships program for children of injured workers

Check out Lorraine Ahearn's column from Sunday's News & Record about Kids' Chance of North Carolina.

The organization, which Deuterman Law Group supports financially and in other ways, provides scholarships to high school and college students who had a parent killed or catastrophically injured on the job.

Next month, we'll begin selling cookbooks to benefit Kids' Chance at our offices. They're just $10.

And if you know of a student who might be eligible for a scholarship, we have applications. Just visit our Web site or email our PR person at amyjoyn@bellsouth.net and she'll send you the details.

Angel Food Ministries offers economical groceries

One of our paralegals recently found this wonderful resource for our clients, Angel Food Ministries. This is a program that is sponsored by the federal government and many local churches in our area. The basic concept is there is a monthly menu that consists of many items such as meat, pasta, veggies, eggs, and so on. The price for the items is $25.00. It is a wonderful deal for the amount of food that is included. You can also purchase additional specials as well. Food stamps and cash are accepted. The $25 worth of food should feed a family of 4 for one week or a senior citizen for one month.