Inactivity at work ruled compensable for spouse’s benefits

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An unusual case has resulted in a finding for the surviving spouse of an overweight, work-at-home AT&T manager.

AT&T manager described as working long hours at home

According to a June 28 piece in Business Insurance,  “An obese AT&T manager who died of a blood clot after sitting at her work computer for long hours is entitled to workers compensation survivor benefits, a New Jersey court has ruled.

“The case of James P. Renner vs. AT&T stems from the death of 25-year-old Cathleen Renner, who worked from home and “worked all hours of the day and night” to meet deadlines imposed by her employer, court records state.

“In 2007, she called 911 because she could not breathe and was pronounced dead on arrival at a hospital.”

At issue was Ms. Renner’s overweight condition and the inactivity required of her job versus the sedentary nature of her daily life.

Work requirements versus lifestyle

A June 28 account fro The Washington Post explains:

Cathleen Renner, a 25-year employee of AT&T, died in 2007 from a blood clot that formed in her leg and lodged in her lung. She had been working overnight to finish a project in her home office in Edison, where she worked three of five days each week. Her husband filed a workers’ compensation claim on her behalf after her death, claiming the clot developed while she was at her desk.

AT&T appealed, arguing that multiple risk factors unrelated to her job caused the clot. Renner, 47, had an enlarged heart and weighed more than 300 pounds, causing restricted blood flow, according to a medical expert enlisted by AT&T. She had also recently started taking birth control pills, which increase the risk factor blood clots for all women but especially those who are overweight, according to the Mayo Clinic.

Court finds ‘prolonged sitting’ causative

“A medical expert for Mr. Renner,” says the BI report, “said that sitting for an extended period probably led to the formation of blood clots and contributed to Ms. Renner’s death, although he acknowledged she had other risk factors, such as obesity.”

The widower’s contention was that his wife’s death was brought on by working the day of her death, which required prolonged sitting. The court found that to be the case “finding that prolonged inactivity while working caused the pulmonary embolism by a material degree.”

Some fitness and health advocates recommend that office workers and others with sedentary jobs take time to stand and move around during the day, for instance, by taking stairs to a meeting, walking to lunch or even standing and moving about one’s work area.

Texas man sues after getting fired

On the Texas coast, according to a June 21 account in The Southeast Texas Record, “A Baytown man has filed suit against his employer after it allegedly terminated him for filing a workers’ compensation claim.

“A lawsuit filed against Jacobs Engineering, Inc. June 6 in Galveston County District Court insists Michael Stevenson ‘would be entitled to receive workers’ compensation benefits in the event that he was injured in the course of his employment.’

“Court papers show Stevenson sustained injuries on Feb. 16, 2010, when he lifted one end of a pipe as instructed by his supervisor.

“As a result, the plaintiff filed a workers’ compensation claim and took other steps to obtain the benefits permitted under the Texas Workers’ Compensation Act.”

Subsequently, the original petition says, Stevenson was dismissed from his job. The suit was filed for mental anguish, lost wages and benefits. Texas is the only state that has no requirement for employers to carry workers’ comp insurance, but those who don’t risk costly litigation from inured workers.  Jacobs does subscribe to workers’ comp, but state law allows relief for injured workers who are retaliated against for filing for workers’ comp benefits.

California police office pleads not guilty to five counts of fraud

An Oxnard, CA, police officer has a different sort of workers’ comp problem, according to a June 21 account in the Ventura County Star.

Woman broke wrist in fall at work, yet top state court ruled against her

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Volunteer firefighters get state help

Good news from West Virgina, according to a June 20 piece from Insurance Journal, “West Virginia’s volunteer fire departments looking to offset anticipated increases in their workers’ compensation insurance premiums can turn to a website launched by the state auditor’s office.

“Auditor Glen Gainer’s office was tasked by the Legislature with developing a program to provide reimbursements to fire departments.

“Gainer said reimbursement forms are now available on his office’s website.”

We’ve been following the plight of the Mountain State’s numerous VFD outfits for some time, most recently in this installment.

Illinois AG acknowledges ‘reform’ fell short

Another story we’ve been following is the battle for workers’ comp reform in Illinois, most recently in the same post linked above. A June 19 editorial in the Belleville News-Democrat takes Attorney General Lisa Madigan to task for not publicizing the issue enough, even though she concedes the new legislation is not real reform:

A recently enacted reform bill isn’t going to change much because it doesn’t address the crux of the problem — causation. Incredibly, in Illinois, an injury covered by workers’ comp doesn’t have to be caused by work, it just has to possibly be a contributing factor.

“To say we’ve reformed the workers’ comp system is a gross overstatement,” Madigan told us.

So why didn’t Madigan publicly advocate for meaningful reform while the bill was in the spring legislative session?

Madigan frequently uses the bully pulpit to advocate for legislative and other changes, everything from cracking down on meth dealers to opening up public records.

This spring she championed bills to strengthen the prevailing wage, protect consumers when a car dealership shuts down, crack down on meth repeat offenders and others. She vigorously opposed a bill to allow automatic rate hikes for public utilities. She called for Apple and Google to address privacy issues and Pabst Brewery to lessen the alcohol level in its new drink Blast.

But not even one press release on workers’ comp reform, which she said is a top issue for Illinois.

More coverage and response can be found at the following links:

• “Radogno asked Madigan to participate in talks“
• “We have to keep working for real worker’s compensation reform“;
• “Illinois AG: Workers’ Comp Bill Doesn’t Go Far Enough.”

Alabama Supreme Court rules against injured grandmother

This next case, from Alabama, is one we find particularly disturbing due to the state Supreme Court’s ruling against an injured worker. However, it does show the importance of retaining a trained, experienced workers’ compensation attorney because the various laws and statutes can be so complicated and open to interpretation, especially if an injured worker makes statements that later come back to hurt the case.

Workers give up legal rights in return for coverage

To be sure, we don’t think any party involved should get away with gaming the system, whether it be employee, employer, medical provider, insurance carrier–or the authorities in charge of the system. That being said, we do believe in the fundamental precept of workers’ compensation, that workers injured on the job sign away their right to sue the employer in exchange for workers’ comp protection for injuries sustained while working and in the course of employment.

One attorney’s summation

From an Alabama attorney’s blog, a summary of the case, posted in April:

Last week, the Alabama Supreme Court issued it’s opinion in the case of Ex Parte Patsy Patton d/b/a Korner Store (In re Lana T. Brown v. Patsy Patton d/b/a Korner Store).  Ms. Brown worked as a cashier at the Korner Store, which is a gas station/convenience store.  She walked to the deli counter to refill her coffee cup, and when she began walking back to the front of the store, she “inexplicably fell, breaking her wrist”.  She filed a workers’ compensation claim, which was denied by Korner Store, contending that the fall was attributable to an idiopathic characteristic or was due to some unexplained, but not work related, cause.

The cause of injury: work as assigned? or work on the job?

In a bit of murky reporting, this Alabama TV station’s report does get one thing right: “The injured worker could not prove it happened because of the work she was assigned to do, and in turn the supreme court said the company would not be held responsible.”

Introduction of ‘idiopathic factors’

Here’s the crucial passage from the ruling itself:

“The principal ‘fault line’ that has been revealed by the application of the ‘arising out of’ requirement by Alabama courts is the distinction between accidents that are at least partially attributable to an affirmative employment contribution and those that are attributable solely to what are called ‘idiopathic’ factors, a term that ‘refers to an employee’s preexisting physical weakness or disease’ that is “ ‘peculiar to the individual” ’ employee. Ex parte Patterson, 561 So.2d 236, 238 n. 2 (Ala.1990). Thus, a fall may, under the appropriate circumstances, properly be deemed an accident arising out of employment․ In contrast, a fall may, under the appropriate circumstances tending to show an idiopathic factor, not be an accident arising out of employment․

‘She did not know why she fell’

According to this version of the ruling, the injured worker’s statements may have weighed against her:

The employee had noticed no hazardous material on the floor of the store where she fell at the time of her fall, nor is any such material apparent from the videographic recording of the fall, and she testified that she did not know why she fell. The employee’s injured wrist was later placed in a cast, and she returned to work the following day; she continued to work normally for the employer until leaving her employment in January 2005 to care for her grandchild, and the employee admitted that she did not believe that she was disabled from working should she choose to do so.

Lesson is, look for a really good attorney

What’s particularly galling is that this injured woman not only declined the scam-opportunity to “milk” the situation for extended time off and attendant benefits but also that she hopped right back to work the next day, on duty, ready to attend more customers of the store. Furthermore, she didn’t claim a long-term, debilitating injury. And it sounds as though she would’ve stayed at the store but her grandchild needed her more.

True, it’s not fair–at least reading from the various sources: From what I’ve read, Lana Brown should absolutely be compensated for her wrist injury.

However, the takeaway here is not that the system is bucked against you, so just give up.

No, the message is this: None of the states have perfected a fair way to always come to the correct decision in cases of workplace injury; therefore, you need to know that compatible, trained and experienced attorneys are available to give you legal advice and counsel through a maze of rules and regulations.

We can help you find an attorney

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

More claims filed from Menard facility; Illinois lawmakers must return for special session

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The West Virginia workers’ comp program is back in the news.

Daily Mail questions state agencies’ loss ratios

We’ve covered their significant problems concerning volunteer fire departments and homeowners they serve–which is ongoing, as we’ll see in following discussion. But now a report from the Charleston Daily Mail finds problems with the state’s military affairs and public safety agency:

Among three of the largest agencies in state government — military affairs and public safety, health and human resources, and transportation — military affairs and public safety racked up the worst workers’ compensation record over the past five years.

A Daily Mail analysis of data provided by the state Offices of the Insurance Commissioner shows that from 2006 to 2010 the Department of Military Affairs and Public Safety paid workers’ compensation insurance premiums totaling $18.4 million and had claims that cost $10.8 million.

That’s a loss ratio of .586, which means that for every dollar in premiums collected, nearly 59 cents was paid out for lost time and/or medical expenses. That ratio is destined to get worse because some recent accidents inevitably cost more over time as some workers incur additional medical expenses or are unable to return to work.

Best record cited

The story lists several agencies with millions in premiums and millions in claims but cites the Division of Criminal Justice Services as having “the best record in the division, paying $19,619 in premiums while incurring claims that cost only $584 during the five-year period.”

Volunteer fire department revoked–must start over due to lack of coverage

As we wrote in November 2010, lack of workers’ comp coverage for West Virginia’s volunteer fire departments could result in either in higher costs to community homeowners via VFD membership hikes or through much larger homeowners’ insurance premiums. It’s a big deal for the Mountain State because most fire departments are VFDs–the state has very few full-time, “regular” outfits.

One of the VFDs, the Big Wheeling Creek VFD of Marshall County, was shut down in February but hopes have rekindled for it resurrection. From a June 15 piece in The Intelligencer/Wheeling News-Register:

Out of operation since February, the future of the Big Wheeling Creek Volunteer Fire Department will be announced Thursday.

The department was taken out of service in February by the West Virginia State Fire Marshal’s Office for failure to provide workers’ compensation for its volunteer members.

The lack of coverage was found after an audit of Big Wheeling Creek’s department showed it had not paid for the benefits for several months. Providing such benefits is required by the state fire marshal in all volunteer departments.

A June 16 article from The State Journal says the VFD will have to be reorganized:

Along Big Wheeling Creek in Marshall County, they are looking for new people to start a new fire department.

After the cease and desist order the former department received earlier this spring, the State Fire Commission made it official this week and revoked their certification.

In the meantime, fires in the area have been handled by neighboring departments: Stone Church, Dallas, Mozart and Mount Olivet.

Officials are grateful for those departments stepping into the breach, but they said they need a new department and new people to run it.

Illinois still grappling with systemic flaws

Meanwhile, drama continues unabated in Illinois’ scandal-ridden workers’ comp program, which has been the subject of an intense, partisan battle for reform.

According to this June 16 account, “Republican lawmakers told local business leaders Thursday that the spring legislative session in Springfield featured a welcomed smattering of bipartisanship but left unfinished two issues critical to Illinois employers: workers compensation reform and the capital bill.”

Rep. [Dan Brady, R-Bloomington] also said he was disappointed in the outcome of efforts to reform the state’s workers comp system — often Exhibit A in descriptions of Illinois as unfriendly to businesses.

The overhaul passed last month would reduce medical fees by 30 percent, saving companies at least $500 million, and allows employers to organize medical networks for handling cases.

But Brady said the final bill, now awaiting the governor’s signature, didn’t address what’s called “primary causation,” which would essentially raise the burden-of-proof threshold for workplace liability. The overhaul added American Medical Association guidelines to state law to help determine impairment, but Brady said the guidelines ended up too “watered down.”

News-Democrat reveals 2011 claims from correctional facility

Part of the scandal, much of it revealed by reportage of the Belleville News-Democrat (BND.com), has involved the amount of workers’ comp claims from the Menard Correctional Center, many from guards’ claiming repetitive stress injury stemming from operating cell locks but also including a claim by the warden. A June 12 BND.com piece says the claims have continued into 2011:

Nausea causes blackout; worker trips over dog in her home

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It’s enough to make you sick, some of these stories about people abusing the workers’ comp system.

Souper Salad worker billed for paramedics’ response

A teen-age restaurant worker in Idaho, says this account at KBOI TV, passed out and hit her head while falling–after cleaning up a patron’s upchuck. Nineteen-year-old Karrie Lombard came to inside the Meridian Souper Salad only to look up into the faces of “paramedics just surrounding me — they were everywhere,” she said. A manager had called the EMT crew upon realizing that Lombard was unconscious.

She told everyone she was OK and apparently thought little about the incident–until a few weeks later, when she opened a $400 bill from the county for the EMT response.

‘Not to worry’

One of her bosses told her not to worry.

“He gave me the papers to fill out for workers comp and said it was going to be taken care of,” she said.

But the bill never got paid and Lombard continued receiving statements in the mail. The news, she said, continued to get worse.

“The owners told me it wasn’t work related and there was no reason for workers comp should have to cover it,” she said.

Attorney urges follow-up in similar cases

Her attorney not only disagrees but also warns employees that  “if anyone gets into a situation such as Lombard, tell your employer that you know you’re covered and if they don’t listen, take the complaint to the Idaho Industrial Commission or even a lawyer.”

Ohio Supreme Court rules worker can sue, despite timing

A June 9 report at the Columbus (Ohio) Dispatch news site tells of the need for the state Supreme Court to rule in the case of a machine shop employee who was fired shortly after reporting a workplace injury. Despite remanding the case, however, the majority also left the burden of proof on the worker:

In a 4-3 decision, the Ohio Supreme Court ruled today that a worker injured on the job has the right to sue his boss for firing him after he was hurt but before he had a chance to file a workers’ compensation claim.

The case involved a machine shop employee canned an hour after reporting a workplace injury to the owner of Tomco Machining Company in Dayton. DeWayne Sutton, 34, of Brookville, was given no reason for the termination.

The justices sent the case back to the trial court, noting that to prevail in his wrongful discharge lawsuit, Sutton must prove his firing was in retaliation and that his boss, Jim Tomasiak, had no business justification for the dismissal.

Majority: protection against retaliation paramount

In effect, the ruling holds that the protection of state law obtains, even though a worker has not yet filed the injury case. In other words, the law holds that employers can not punish employees for reporting injuries. Therefore, any punishment that comes before the injury claim is filed is out of line. The dissent’s position is that statute’s don’t address the situation–therefore, the majority’s ruling is overbroad.

Regardless, the trial court will now re-hear the case, with the brunt of proof on the worker to show that the employer fired him merely for reporting the injury.

Appeals court finds for woman required to keep materials at home

Another employee has prevailed, for the time being at least, in an unusual case in Oregon–she tripped over her own dog, in her own home, and was injured in the fall.

Sounds a little far-fetched, right?

But the JC Penney salesperson-and-decorator was required to maintain workspace both in her auto and at her home as part of her employment. From a June 3 piece at Business Insurance:

The workers compensation claimant in Mary S. Sandberg vs. J. C. Penney Co. Inc. was a custom decorator selling window treatments and bedding. She spent much of her workweek traveling to appointments, meeting customers at their homes or working from her home.

Employer required home office

Court records show that she was required to have an office in her car, where she kept fabric samples and pricing guides. Her employer also instructed her to store excess products at her home or find another place for them.

Consequently, she stored samples in her garage and was walking from the back door of her home to her garage to replace fabrics in her van when she tripped over the dog, fracturing her right wrist.

Nonprofit to return millions used for workers’ comp

A June 2 article concerns a $17 million reimbursement of funds that had been diverted to a workers’ comp system:

A nonprofit that manages New Hampshire’s public employees’ health insurance risk pool is repaying the health insurance pool $17 million diverted to support a workers’ compensation program.

The Local Government Center’s board announced Thursday it will repay its HealthTrust the money taken over a six-year period to support the program with a loan.

No charges are mentioned in the story, merely that the LGC has entertained questioned of “appropriateness” and voted to restore the funds.

We can help you find an attorney

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Illinois scandal updated–with report from ’08–as legislature resolves reform bill

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‘Human nature’ to gamble?

An opinion piece at a Pennsylvania news site brings up an unusual topic: injured workers who gamble away workers’ comp benefits.

Human nature cannot be repealed. So it’s hardly surprising that some unemployed people gamble away their workers’ compensation at casinos. Gamblers, after all, often try to cover big losses with bigger bets, despite the proven long odds. Why wouldn’t some people who have lost their jobs try to cover those losses at a slot machine or black jack table?

Neither the state Department of Labor and Industry nor the state Gaming Control Board has hard data on how many unemployed Pennsylvanians have gambled their workers’ compensation benefits because there is no way to track it. But the issue arose at a recent state Senate hearing on extending benefits for about 45,000 of the more than 450,000 Pennsylvanians receiving workers’ compensation.

Unemployed versus injured

I don’t quite get the qualified distinction of “some unemployed people” and “workers’ compensation.” Why would an injured employee be unemployed? I can understand an injured worker having to miss work while recuperating, but if employees are dismissed because they filed for workers’ comp benefits, that cause for litigation and further redress.

One idea: block workers’ comp debit cards

That point aside, the opinion goes on to note that a state senator says that “jobless patrons spend millions of dollars in workers compensation benefits at casinos,” and that she has proposed legislation that would require casinos to “block workers’ comp debit cards from their automated teller machines. By regulation, casino ATMs must reject debit cards issued by the state Department of Public Welfare.”

The whole thing sounds odd, to me. Why are injured workers receiving money in the first place, regardless of whether by direct deposit or transfer to a card? Seems to me the injured worker would receive treatment from the medical provider, who then would bill the workers’ comp insurance carrier for payment. Sounds like another state in need of workers’ comp reform, as we have been covering in preceding posts.

Extra effort results in bill’s passage–finally

Speaking of which, Illinois has finally passed a measure that will be sent to the governor soon, following an epic battle that we most recently discussed here. As reported June 5, in a long, thorough behind-the-scenes piece, “Ultimately, the overhaul was approved 62-43. Gov. Pat Quinn has said he plans to sign it, potentially saving Illinois businesses more than $500 million, largely by cutting fees to doctors for treating work-related injuries.

“The story behind the resurrection of the workers’ comp overhaul is a classic Springfield tale of power and persuasion. It demonstrates the hard-bargaining agenda legislative leaders set during the spring session, with the state facing serious questions about its business climate.”

It’s an able bit of reporting and a dandy read, not only for those in Illinois who are following along blow-by-blow but also for residents of other states who recognize the need for upgrading workers’ comp systems.

However, scandal news continues to emerge

In related news, the Belleville News-Democrat–which has broken several significant pieces concerning the Illinois workers’ comp scandals, cites a 2008 study in its story headlined “Study: Guards’ duties did not cause injuries; but CMS OK’d millions in workers’ comp claims“:

Three years ago, officials at a state agency became suspicious when dozens of guards from the Menard Correctional Center filed workers’ compensation claims for debilitating injuries from turning keys and manually operating cell locking devices.

Central Management Services, the agency that processes workers’ comp claims, brought in an expert to do on-site evaluations of whether those duties could cause repetitive trauma injuries, including the most common — carpal tunnel syndrome.

A 17-page report by Midwest Rehabilitation Inc. of Springfield, received Sept. 30, 2008, stated that the duties of guards at the Chester prison did not approach even minimal levels on its Stress Index.

The index is a method of measuring the potential for repetitive trauma. A score below 3 is considered safe. None of the Menard guards’ duties tested, including operating a crank that opens 24 cells at one time, scored higher than 1.5, according to the report.

But instead of challenging the taxpayer-paid settlements — which ranged from $20,000 to $100,000 — CMS continued to approve payments to guards for repetitive trauma. They turned over copies of the 2008 report to the Illinois Department of Corrections and attorney general’s office, then filed it with no investigation.

In most workers’ comp cases, a state arbitrator gives final approval to claims after a treating physician provides an opinion that the injury exists.

Hundreds of claims, millions of dollars

According to BND, the claims from Menard workers–mostly guards–eventually exceeded 230, with about half having been settled for nearly $7 million.  In total, counting all prison staff and a variety of complaints, claims of nearly 400 have resulted in payouts of nearly $10 million, “including a carpal tunnel settlement of $75,678 for the warden. Millions more in medical fees were billed to the public.”

We can help you find an attorney

Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Workers compensation is paid to employees who are injured in the course of employment. Workers’ compensation eliminates the right of the worker to sue for compensation through a personal injury claim, and instead, requires the employer to pay medical expenses, rehabilitation costs, and wage loss compensation. If the worker dies from their occupational disease or workplace injury, the company will also pay beneficiary benefits or death benefits to surviving family members.