North Carolina workers’ compensation experts are constantly on the lookout for ways to protect workers better, reduce claim costs, and speed up recovery times. A new study out of Copenhagen, Denmark could provide fresh new policy ideas for how to protect state workers from lower back injuries — by challenging what are known as “fear-avoidance beliefs.”

According to a journal called BMC Musculoskeletal Disorders, European National Research Center researchers studied over 2,600 healthcare workers to determine whether fear of lower back pain increased or decreased risk of actually developing musculoskeletal problems in the lower back area. In other words, could an anti-placebo effect develop? Could worry about hurting oneself in and of itself lead to injury?

The researchers apparently found a correlation between “fear-avoidance beliefs” and increased likelihood for getting hurt. So does this association prove that thinking fatalistic thoughts causes injury? Or could something else be driving the association?

If indeed it can be determined that thinking negative thoughts — that is, being afraid of going to work or doing certain on-the-job tasks — could cause injury, policymakers could work from this concept to develop a battery of solutions that could help drive down North Carolina workers’ compensation claims and costs. For instance, perhaps human resources managers could identify particularly pessimistic workers or workers who are otherwise afraid of certain pieces of machinery and retrain them to be less afraid and more “ergonomically ready” to tackle tasks.

If, on the other hand, the association between the development of musculoskeletal problems at work and fear of injury stems from some other root cause, then maybe modifications in worker thinking might not yield much benefit. For instance, let’s say that individuals who are more fearful of doing certain tasks are also in some other way more vulnerable to getting injured. Perhaps these individuals are malnourished, depressed/anxious or less self-confident than are individuals who demonstrate less of a fear-avoidance reaction. Perhaps one of these other factors is the key. In this scenario, the goal would be to help workers become more self confident, optimistic, etc. — rather than help them limit their fear avoidance.

If you’ve had the misfortune of developing lower back injury on the job, help is available. To navigate the system, consult a competent and battle proven North Carolina workers’ compensation attorney to discuss your situation in confidence.

More Web Resources:

BMC Musculoskeletal Disorders Study

fear-avoidance beliefs

Thanks to the efforts of the North Carolina Rate Bureau, North Carolina workers’ compensation insurance policy rates will plunge nearly 10% for 2010. Wayne Goodman, the state’s Insurance Commissioner, announced the rate slash this week, which government statisticians believe will help NC employers save around $120 million in 2010. An Insurance Department spokeswoman argued that the rate slash would drive down the cost of doing business in the state and thus spur growth. Insiders believe that the rate slash was made possible in part by a dramatic decline in the number of North Carolina workers’ compensation claims filed. This is the second year in a row that there has been a significant decrease in NC workers’ comp insurance rates. Last year, rates were slashed 4.4% over 2008 numbers.

The rate decrease won’t help every employer. Almost all North Carolina state employers won’t be impacted. And many private employers — for instance, those employers who have to pay insurance for high risk jobs — will likely not see the benefits of these insurance rate slashes.

The rate slash does nothing to change fundamental laws and rules governing North Carolina workers’ compensation. In general, businesses that employ three or more people must pay for insurance in case an employee suffers disability, requires medical care, or requires compensation for lost wages.

Whether the motion will spur renewed business commitments in the state is an entirely different debate. The recession has hit North Carolina relatively hard, notwithstanding the state’s diverse economy and relatively resilient tech sector in the Research Triangle. Perhaps these rate decreases will incentivize businesses to take on new projects, hire new employees, and attract contracts to the state. Still, some skeptics worry that the rate slash may have a dampening effect on growth and that it will destabilize the ‘playing field’ in certain industries, artificially favoring businesses which benefit from the rate cut and hurting businesses that don’t qualify.

More Web Resources:

North Carolina Rate Bureau

Workers’ comp rates falling in N.C., Charlotte Observer, Nov 5, 2009

According to the Charlotte Observer, a recent report released by the United States Government Accountability Office (GAO) confirmed that many North Carolina workers’ compensation injuries are going unreported. The GAO found that company doctors and nurses often feel pressure from their employers not to report employee injuries.

The Observer cited the following extremely disturbing statistics:

Over a third of practitioners — in a survey of over 500 healthcare workers — were asked by employers to provide ‘insufficient treatment’ to injured workers so that injuries would not appear on company logs.

Over half of those surveyed were encouraged by their employers to ‘downplay injuries or illnesses.’

Over two-thirds reported that they knew that many employees fear that they would be disciplined if they reported getting injured.

The GAO report also found that many plants actively discouraged workers from reporting their injuries by sponsoring ‘prizes or bonuses’ for plants/branches that went for long stretches without recording injuries in their log books.

The Charlotte Observer article quoted the executive director of the National Council for Occupational Safety and Health (OSHA) saying that: ‘If healthcare professionals are being asked to not record injuries properly, then we have a pretty broken system.’

Could this systemic non-reporting of injuries be responsible for why the state has seen a dramatic decrease in claims over the past two years? And, if so, could this under-reporting also explain why employers were able to achieve a nearly 10% slash in their workers’ comp insurance rates for 2010.

As this blog reported in a separate entry, the state’s insurance commission recently approved a slash of 9.6% for North Carolina workers’ compensation insurance policies — a decision that’s projected to yield savings to employers of around $120 million annually. If these savings came as an indirect result of denying/ignoring legitimate injury claims, then the individuals charged with maintaining a fair benefits program need to make adjustments to the system to ensure equality and transparency.

If you got hurt at work — and you failed to report the injury out of fear of retaliation; or if the company doctor or nurse did not take your injury seriously — you may greatly benefit from a free consultation with a respected North Carolina workers’ compensation attorney.

More Web Resources:

OSHA

GAO

Charlotte Observer, Study: Workplace injuries are going hidden; Nov 17, 2009

If you have been injured at work — or hurt while on the way to or from a work function or while otherwise engaged in company business — you may be entitled to a wealth of North Carolina workers’ compensation benefits, including replacement for lost wages, vocational training and placement, help with medical bills, and compensation for pain and suffering. Unfortunately, if you mishandle your claim, you can miss out on these benefits.

So what are some of the common ways in which claimants ‘self-destruct’ their cases?

1. Ignoring the injury/accident.

Obviously, a claimant who falls off a ladder and breaks her leg is not likely to ignore her injury; however, not all job injuries are acute. Some are chronic. For instance, repetitive stress injuries — such as carpal tunnel syndrome, cubital tunnel syndrome, and thoracic outlet syndrome — can all significantly impair your quality of life, make job duties harder, and lead to thousands of dollars in medical bills and therapies. If you don’t report a claim in time, you may miss out on key workers’ comp benefits.

2. Failing to get appropriate treatment.

Not only can delaying your treatment lead to a worsening of your health problems or injuries, but neglecting to take proper care of yourself can provide insurance companies leverage to deny your claim. Delaying can also make it more difficult to demonstrate that the injury sustained was a direct result of your on the job accident.

3. Failing to realize that the insurance company will continue to investigate your situation even after your claim has been approved.

This shouldn’t be a problem as long as your claim is real (ongoing investigations are designed to probe for instances of North Carolina workers’ compensations fraud). But insurance companies generally do all they can to avoid paying long term claims. They may look for any loophole to deny your claim and/or reduce your coverage — even retroactively. Insurers have gone as far as to secretly videotape claimants to look for evidence to deny claims.

4. Trusting employers or insurance companies to ‘do right.’

As the old adage goes: trust, but verify. As we just discussed, insurers and employers may have sympathy for you. Some individuals may even go out of their way to help you figure out your rights and fill out paperwork. But make no mistake. These companies are in business to make money — and that means they have a strong motivation to deny claims and/or to limit them as much as possible. Thus, if you disclose too much information — or the wrong kind of information — to an insurance company investigating your claim, you could significantly impair your chances of collecting of a good settlement.

5. Settling for far too less.

Many claimants are desperate for any money to pay for medical bills, lost wages, and therapies. They thus will often quickly settle with insurance companies to get some active cash flow. However, usually an insurance company’s first offer is not the best offer. A reputable and time-proven North Carolina workers’ compensation attorney can likely help you get much more for your claim.

6. Waiting too long to consult/retain an attorney.

The longer you wait to speak with an experienced attorney about your injury/accident on the job, the greater the likelihood that you will make some error of omission that could damage your claim or cause it to be dismissed altogether. The laws governing workers’ comp benefits and payouts can be extremely complicated; thus, your case may require delicate finesse to get you the most compensation and in the fairest possible terms. Furthermore, a qualified and creditable workers’ compensation attorney can help you develop a plan of action that will reduce your anxiety and uncertainty.

More Web Resources

North Carolina Industrial Commission

North Carolina Office of Economic Opportunity

Repetitive stress injuries (RSIs) cause hundreds of thousands — if not millions — of American workers chronic problems and may account for a sizable percentage of a North Carolina workers’ compensation claims. But what are RSIs? And how can workers prevent and treat them most effectively?

Theories abound to explain how workers develop conditions like carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, and tendonitis. Obviously, the etiology is complex and this blog is not prepared to offer medical advice in any way; however, a look at the dominant theories reveals much.

One school of thought considers and treats the different manifestations of repetitive stress induced trauma. For instance, a worker who complains of neck pain resulting from a typing injury may get treatment directly at the source of the pain — for instance, massage, cortisone injections, or doses of non-steroidal anti-inflammatory drugs to relieve the pain.

Another school of thought suggests that many RSI injuries result from systemic damage to the musculoskeletal system and that repairing the damage requires a broader approach. In other words, a pain in the neck that results from a typing injury may represent essentially the tip of the iceberg. The injury/insult may in fact be to the entire upper thoracic region, including perhaps the arms, chest, upper back, lower back, hands, and so forth. Moreover, the insult is not simply to muscle or nerve tissue but ultimately to the entire musculoskeletal apparatus, including connective tissues, such as tendons, ligaments, and fascia. Treatment thus focuses on a variety of modalities, including massage, trigger point therapy, stretching, resting, chiropractic, and improved posture and ergonomic practices.

Many occupations predispose to repetitive stress injuries. These include,

• Computer work
• Assembly line work
• Sewing
• Hairstyling
• Office/managerial work
• Any job that involves lifting or sorting (e.g. Postal Service work)
• Design work
• Craft work
• Any job that requires an employee to hold a position for many hours at a time — including waitressing (standing), truck driving (sitting), and athletic employment (running, twisting, etc).

Perhaps a majority of the working population in North Carolina and throughout the country may be subjected to repetitive work related traumas that can result in injury. Corrective measures can include workstation changes (to make a computer station more ergonomic, for instance); institutionalized massage therapy; better education about posture and relaxation techniques; reduced hours; enforced break times; and regular continuing education about the dangers and treatment methodologies for RSI.

If you have suffered traumatic injuries due to repetitious work, you may be entitled to significant North Carolina workers’ compensation benefits. It may behoove you to speak with a knowledgeable NC workers’ comp attorney ASAP to learn about your rights and options.

More Web Resources

Sorehand

Deborah Quilter’s RSI book

With unemployment rising across the nation, and with Congressional leaders growing ever more desperate for a solution to the healthcare mess, the political debate over workers’ compensation in North Carolina and elsewhere in the US has reached a fever pitch. Democrats have decried Republican attempts to chip into a homebuyers’ tax credit; Republicans have denounced Democratic initiatives as more “tax and spend” government meddling.

According to a recent AP article, around 7,000 Americans every day run out of workers’ comp and unemployment benefits. With North Carolina’s unemployment rate already into the double digits – 10.8% according to figures from 9/09 – lawmakers on both sides of the aisle are scrambling to deliver solutions. (The national US unemployment rate is just 0.2% shy of the 10% mark.)

What might proactive legislation mean for North Carolina workers’ compensation policy?

Analysts disagree. Some believe that increased federal involvement in extending benefits to the under or unemployed may cause problems for insurance companies and small businesses. Others counter that an infusion of federal capital could only aid the state’s teetering economy, by encouraging employers to take risks on new investments and by shoring up leaks in the North Carolina workers’ compensation benefits payment system. Insurance companies might also welcome the relief of the financial pressures on them.

Whether or not the White House’s proposed policies help or hinder the plight of unemployed workers won’t be known for some time. With so many different variables at play, it can be extraordinarily difficult to isolate the key factors ultimately driving the North Carolina economy.

On a more personal level, if you or someone you love has been struggling with NC workers’ comp benefits, it may behoove you to speak with a dedicated, experienced, and compassionate attorney about your problems before you lock into an agreement with your employer and/or the employer’s insurance company.

More Web Resources:

Jobless Benefits To Be Extended, Click on Detroit, Nov 5, 2009

Unemployment Extension Clears Senate, US News and World Report, Nov 4, 2009

Mission Hospital — which employs about 6,000 people and has been under the gun for mishandling numerous North Carolina workers’ compensation cases — has been ordered by the NC Industrial Commission to pay penalties for botching employee claims.

North Carolina’s Deputy Commissioner ordered the hospital to remunerate Terry Cawthorn for attorney’s fees and to pay for a sizable percentage of her benefits. Mission has come under fire for violating North Carolina workers’ compensation rules in separate cases. The Court of Appeals and other arbitrators found that Mission had done things like:

• Denied benefits despite ‘overwhelming evidence’ that money should have been paid out to a claimant;
• Failed to authorize payments for medicines for a woman who was so depressed that she had to be sent to a psychiatric ward;
• Hid evidence of an employee who cried at work after returning to her job following an injury;
• Contradicted the findings of the hospital’s own expert in order to deny a claim of psychological trauma.

Mission Hospital released a statement to the effect that the Commission’s sanctions don’t necessarily imply that the hospital admitted fault. However, notably, the hospital has yet to deny allegations that it tried to stop real and valid claims from going through.

More Web Resources:

Asheville CItizen-Times, Mission Hospital audit to look at workers’ compensation program, November 9, 2009

Asheville Citizen-Times, Asheville Mission Hospital workers comp sanctions ‘unusual’, October 31, 2009

On 9/1/09, the NC State Court Of Appeals released an unpublished decision in the case of Duffy v. Hanesbrands, Inc, finding for the claimant in this pivotal North Carolina workers’ compensation case.

The matter centered around whether the claimant, Duffy, had contracted carpal tunnel syndrome (CTS) while working for her present employer or while training as a sowing machine operator prior to working for Hanesbrands, Inc. The employer argued that the company was not responsible for Duffy’s North Carolina workers’ compensation benefits because, in her old line of work, she had been exposed to conditions that could have precipitated CTS; and that the work she did for the company did not expose her to any unusual additional risks for CTS. The prosecution responded that the work Duffy had done at Hanesbrands Inc indeed put her at risk for CTS – she spent up to 12 hours per day doing repetitive manual tasks with her fingers; moreover, she didn’t come down with symptoms until after she had worked at the company for over a year.

Given that carpal tunnel syndrome and other repetitive stress disorders are relatively common in the sowing industry – definitely more common than they are among the general public – the appellate court found for the plaintiff, reasoning that Duffy was likely exposed to extra hazards while working for her employer.

This key North Carolina workers’ compensation ruling may pave the way for other CTS and repetitive stress injury claimants to seek and secure better benefits and compensation packages.

More Web Resources:

Sewing instructor able to stitch CTS condition to employment, Risk and Insurance, 9/1/09

On December 3rd, 2008, a construction worker named Hussein Montalovo died when a girder collapsed after temporary supports (“strongbacks”) broke while he was in a vulnerable position. Montalovo’s family has reportedly collected some North Carolina workers’ compensation benefits from the state’s Industrial Commission, but the family seeks more damages from potentially culpable parties, including two engineering firms, the bridge’s contractor, and even the State’s Department of Transportation.

Suing for negligence is very different from filing for North Carolina workers’ compensation. To prove negligence, you must meet a higher burden of proof. At the same time, if you win a negligence case against an employer, contractor, insurance company, or other entity, you can potentially collect more money to pay medical bills, afford therapies, and mitigate (to some extent) pain suffered.

To more forward with a North Carolina workers’ compensation or personal injury claim, it may help to work directly with an experienced attorney. Given the legal complexities – as well as the sheer number of entities that can be involved in disputes such as the case of Montalovo – it’s easy for claimants to experience confusion and make statements that could make it more difficult to prosecute a claim or law suit.

More Web Resources:

Family of construction worker killed in Oak Island bridge collapse suing DOT, StarNewsOnline.com, Oct 23, 2009

Family of construction worker killed in Oak Island bridge collapse suing DOT, Morning Star, Oct 24, 2009