Posts Tagged ‘police’

Officer Down: Police, PTSD and Suicide

Monday, August 13th, 2012

Last month, there was a story about a South Carolina sheriff who was denied workers comp benefits for mental distress that he suffered after fatally shooting a suspect. In Brandon Bentley v. Spartanburg County, and S.C. Association of Counties SIF, the South Carolina Supreme Court upheld a lower court denial saying that “…the use of deadly force is an expected and standard part of being a sheriff and is “not an unusual or extraordinary employment condition” that might qualify for workers’ compensation under the state’s restricted coverage for purely mental injuries. In citing statistics, the Sheriff had unsuccessfully tried to demonstrate that such a shooting was indeed an extraordinary event in Spartanburg County. “
The Court noted that it made its decision according to the law as it is written but “… the court did say the state law related to mental injuries should be updated. If South Carolina lawmakers revised state law, it would join a handful of others, wrote the court. Hawaii, Michigan, New Jersey, New York and Oregon already do not require that the conditions of employment be unusual and extraordinary in order for someone to collect compensation.” (Source: Court brings new focus on mental health of law enforcement.)
Hopefully, his community or his police force sees the wisdom of extending some counseling to this officer, despite the denial of full benefits. Re-examining this issue makes good sense. While risks may well be part of the job, people are not automatons that can shut out the emotional residue of terrible events, regardless of training. PTSD is very real, and we must get better at dealing with it. This story was brought to mind again after watching the hard-working police Chief of Aurora Colorado reporting on the gruesome task that his staff faced in responding to the tragedy. In one of his daily updates, his voice broke when he spoke of the stress and toll this took on first responders.
Left untreated, the effects of PTSD on law enforcement can be terrible. In 2012 so far, more police have died by their own hand than by gunfire. According to Badge of Life, a police suicide prevention program, there have been 73 police suicides this year vs. 19 officers killed by gunfire. Badge of Life is conducting A Study of Police Suicides. The first full study of police suicides in all 50 states was published in 2009 in the International Journal of Emergency Mental Health. At that time, the suicide rate for police officers was 17/100,000, compared to the rate for the general public of 11/100,000 and 20/100,000 for the Army.
Badge of Life points us to a documentary that is in progress on the topic, Code 9 Officer Needs Assistance. It’s being co-produced by the wife of a retired state trooper suffering with PTSD, exploring the darker side of law enforcement as it tells the stories of police officers and their families who are now suffering the mental anguish of the careers they chose, which has led some to suicide. Click the above link or the image below to see a powerful excerpt from the documentary. You can get more information on the Code 9 Facebook page.
officer-down
Related Resources
Law Enforcement Use of Deadly Force Incidents: Helping Reduce the “Second Injury”
Remember to save yourself: The importance of managing critical incident stress (PDF)
Law Enforcement Traumatic Stress: Clinical Syndromes and Intervention Strategies
Suicide Prevention Resource Center

Health Wonk Review, Valentine’s week edition, and other news of note

Thursday, February 17th, 2011

When is healthcare like a box of chocolates? Find out over at Colorado Long Term Care Insider, where Louise & Jay Norris host an excellent Valentine’s Week Edition of Health Wonk Review.
Other news of note:
Tasers & cop claims – Roberto Ceniceros of Comp Time has an interesting post on how taser use by police is reducing injury rates and comp claims because it provides a low-impact way to subdue suspects. But tasers are also used on cops-in-training, sometimes resulting in serious injuries.
The straight dope – Joe Paduda has a do-not-miss post on narcotic opioids in workers comp and Cephalon’s role, in which he discusses how drugs like Fentora & Actiq, which are FDA approved only for cancer patients, are being promoted to workers comp patients. (One court ruling stated, “data suggested that more than 80% of patients using Actiq did not have cancer,” and “oncologists accounted for only 1% of Actiq prescriptions filled at retail pharmacies in the U.S.”) Cost is a huge issue, but Joe points out that it is not all about the money: Actiq has been linked to dozens of deaths from overdose.
Medical marijuana – Last week, Michigan court rulings dealt a double blow to medical marijuana. One of the Michigan rulings upheld the firing of a Walmart employee who had been proscribed the drug to control symptoms of his brain cancer, a case we posted about last year: Walmart: Shopping for Souls in Aisle Three. (Also see our recent post: Medical Marijuana in the Workplace: Dude, Lock Me Out!.)
Insurer market share – Cyril Tuohy of Risk & Insurance offers a short journey through the latest insurance industry statistics, including some great stats about market share: This Just in: Known and Lesser Known Facts About the Industry
Not something you see every dayCompNewsNetwork informs us that the Ohio Bureau of Workers’ Compensation has recently snagged a record $830,000 in restitution from a prior fraud conviction. The case was truly egregious – an anesthesiologist who bilked the system for $60 million in fraudulent claims – while contributing to at least two deaths in the process. Dr. Jorge Martinez was sentenced to life in prison for “the first known conviction involving a criminal charge of health care fraud resulting in death after the overdose of two patients seeking treatment for work related injuries.”
Illegal immigrant update – Peter Rousmaniere’s Working Immigrants blog is your in-the-know source for tracking the latest issues and stats on the topic. Via the Pew Hispanic Center, he informs us that the 2010 illegal population in 2010 remains about the same as in 2009: about 11.2 million, of which 8 million are in the workforce, and 58% of which are Mexicans. See more detail: Estimate of illegal immigrant population in 2010.
Good WC bookmark – We are adding WorkCompWire as a bookmark in our sidebar and you should keep it handy too. It’s a good source of news and opinion – check it out!
Savings on complex care – Yvonne Guilbert points out that overlooking simple facts can add significant costs to a claim very quickly. She asks carriers what they are missing on complex claims that might be costing them money.
Market pulse – At PropertyCasualty360, Caroline McDonald talks about why buyers shouldn’t get too comfortable with low workers comp rates. One of the primary sources for the article is our friend Mark Walls of Safety National – who is also well know as the founder of LinkedIn’s Work Comp Analysis Group.
Diversity – Jared wade posts that 18 insurance firms are among the best companies for LGBT employees to work for – “scoring a perfect 100% as a Best Place to Work for their ‘support equality for lesbian, gay, bisexual and transgender employees,’ according to HRC.”
Distracted driving in NY – A sign of things to come? In New York, drivers will get two points for talking on hand-held cell phones. A two-point penalty has already been in place for texting while driving. At that rate, auto insurance sure could get expensive quickly for compulsive phone-o-philes.
Mental health – CCOHS, the Canadian counterpart of OSHA, makes the case for why employers should care about mental health at work.

ADA and Fitness for Duty Exams: No Fear

Tuesday, August 31st, 2010

Today we examine an interesting case where the ADA runs up against OSHA’s general duty clause, where the individual’s right to “reasonable accommodation” collides with the need to ensure the safety of the general public.
In 1999 Oscar Brownfield became a policemen in Yakima, Washington. By all accounts, he was a good cop. In 2000 he suffered a head injury in a non-work-related car accident. He returned to work about 6 months later. In 2005 the troubles began: he (wrongfully) accused a co-worker of malfeasance. He was short-tempered, storming out of a disciplinary hearing with a superior. He described moments of intense anxiety when he was not sure he could control himself. And he made alarming comments about how meaningless life had become.
Fearful of Brownfield’s mental state, his employer sent him for a Fitness for Duty Exam (FFDE). He was diagnosed with a mood disorder and disabled from work due to his “emotional volatility, poor judgment and irritibility.” The disability was considered permanent.
Then Brownfield had another auto accident. His treating physician, Dr. Gondo, released him for work: that is, he wrote that Brownfield could carry out the “physical requirements” of the job. When pressed on the issue of Brownfield’s mental state, Dr. Gondo did not back down, but he did not respond either. He simply remained silent. As a result, the Yakima police department sent Brownfield for a second FFDE, with the same result as the first. Brownfield was terminated from his job.
Claiming an ADA disability (he does appear eligible), Brownfield sued for a violation of the ADA, violation of his first amendment rights of free speech (his apparently groundless accusations against a fellow cop) and violation of the FMLA (which limits the ability of employers to require multiple FFDEs). Brownfield’s case was dismissed on summary judgment by the district court, a decision subsequently upheld by the 9th circuit court of appeals.
A Tool in the Toolbox
Employers often balk at requiring Fitness for Duty exams. They fear a violation of the employee’s rights. This case clearly indicates that those rights can and should be tempered by a clear-headed vision of business necessity. If the employee’s mental or physical condition undermines his ability to perform essential job functions safely, a fitness for duty exam is not only allowable, it is necessary. To be sure, the exam comes with a high standard: the need must be work related and it must derive from business necessity. But where these standards are met, employers must act. If the employer takes the path of least resistance and does nothing, they could easily be charged with negligent retention when and if something bad happens.
Management continuously walks a fine line between employee rights and the obligation to operate a safe workplace. Yakima took a chance in terminating Brownfield’s employment, but it appears that they did what had to be done and they did it legally. Brownfield was unable to perform his job safely. His mental state comprised a risk to himself and to the public he was oath-bound to protect. It is never easy confronting an unruly, agitated and volatile employee, but it must be done – and done in a timely manner.

Fear of Talking: The Narcoleptic Dispatcher

Monday, December 7th, 2009

Kenya Madden was hired as a police dispatcher for the Village of Hillsboro, Illinois, in July 2007. During the 10 week training period, she informed the trainer that she had narcolepsy, a disorder which causes people to fall asleep at unplanned moments. Some weeks later, she also informed her supervisor of her condition. The supervisor reacted with alarm. He had visions of Madden falling asleep in the middle of an urgent dispatch. He asked for Madden’s resignation. When she refused, he terminated her.
Madden filed suit under the ADA, alleging discrimination based upon (the perception) of a disability. This week, the case settled out of court for $10,001. Interesting number, interesting case.
There is no question that Madden’s supervisor mishandled the situation. With visions of disaster spinning in his head like demonic sugarplum fairies, he hastily put an end to the employment relationship. He did not ask for any details about the condition: how long she had experienced it; the degree to which medication controlled it; the last time she had an episode. He did not request permission to speak to Madden’s doctor. He reacted out of a fear totally out of proportion to the situation.
But Madden is not without fault. If her condition was under control, why did she feel obligated to disclose it twice (to the trainer and the supervisor)? If no accommodation was needed – and none was – then why did she bring up the issue?
We can read several things into the modest settlement: while the Village of Hillsboro mishandled the situation and violated the ADA, their actions appear to based upon the limited information provided by Madden: she could have attempted to reassure her supervisor by explaining the successful medical treatment she was receiving. She apparently was silent on the issue. A more gratuitous termination would have resulted in a six or seven figure settlement. Instead, Madden receives $10,000 for her trouble, with an extra dollar tossed in for good measure. That’s a pretty clear indication that while Madden was wronged, she may have had some responsibility for the situation.
This case illustrates a common problem in the way people perceive disability. We tend to jump to conclusions. “Narcolepsy” in a dispatcher sounds like an invitation to catastrophe.But it ain’t necessarily so. Try asking a few questions to determine just how big the risk is. Talk is cheap and talk, in situations like this, is definitely the way to go.

Brendan Doyle: Return-to-Work Person of the Year

Friday, June 20th, 2008

You probably have never heard of Brendan Doyle, a Rhode Island state trooper, but his story, as told by Amanda Milkovits in the Providence Journal, belongs in the hearts and minds of anyone involved in disability management. He exemplifies what great medicine, combined with ferocious determination and discipline, can accomplish.
Just over a year ago, he was punched to the ground by a low life named James Proulx, hitting his head on the pavement. His injuries were so severe, doctors discussed organ donation with his family. He was comatose, hooked up to a respirator, his skull shattered.
But he held on. Eventually, he was moved to Spaulding Rehabilitation Center in Boston, where doctors dismissed any notion that he would be able to return to work. He was paralyzed on his right side and suffered from double vision. But by the fall of last year, after doctors reattached a piece of his skull, Doyle noticed that his fine motor skills started to return. The double vision disappeared and he regained feeling and mobility in his right side.
Against All Odds
By this past spring, Doyle said he wanted to return to his job as a trooper: not a modified duty, desk job in the back of some precinct, but full duty. His supervisors, who supported him from day one, put him through rigorous retraining in firearms, pursuit driving, use of force techniques and through “shoot – don’t shoot” scenarios to test his reaction times. He endured the standard three week course of 13 hour days in the police academy. He passed every test with flying colors, even earning a master pin for firearms.
So against all odds, with no small element of luck, Brendan Doyle is back on the job. From the beginning of his ordeal, this was his one goal. By all rights he should have become permanently and totally disabled, drawing 100 percent of his trooper pay tax free for the rest of his life. No one would have questioned it. But Doyle refused to bow to this fate. In doing so, he exemplifies what the human spirit can accomplish despite ridiculous odds.
I would like to see a picture of Doyle, with his humble smile and crescent moon-shaped scar, posted over the desk of every ER and occupational doctor, every nurse case manager and claims adjuster – and every employer – to remind us that the goal of treatment for injured workers is return to full duty. Forget the odds. Look beyond the trauma of the incident itself and the dire prognosis. Anyone seeing Doyle in the days and weeks following his injury would have scoffed at the notion that he would ever be in uniform again. But that is exactly where he is today.
I hope never to meet Trooper Brendan Doyle: to do so would probably mean I was involved in an accident or going a little too fast on I-95 outside of Providence. Nevertheless, I will try to keep his image in mind. For all of us who work in risk management, cost control and safety, who focus on doing the right thing for injured workers, Trooper Doyle embodies the spirit and goal of our work. He is the Insider’s Return-to-Work Person of the Year.

Health Wonk Review, RIMS, emergency responders, mysterious pork worker illness

Thursday, May 1st, 2008

Daniel Goldberg has posted an excellent new edition of Health Wonk Review at his Medical Humanities Blog. This week’s roundup from the brainiacs of health wonkery encompasses everything from the usual health policy debates to alcopops, including a handful of posts on legal matters and new legislation.
RIMS – Joe Paduda of Managed Care Matters has been blogging his observations from RIMS this past week. He’s posted news from the pharmacy sector, notes an emphasis on outcomes, and discusses innovation.
Emergency responders – In response to a recent reader inquiry about injury rates among police, we unearthed a 2004 Rand report on Emergency Responder Injuries and Fatalities focusing on U.S. firefighting, law enforcement, and emergency medical services personnel. While a little dated, it’s still worth a read. The report notes that while data for firefighter injuries are readily available, there are significant gaps in available data for police and EMT injuries. Line-of-duty fatalities are tracked, data on the frequency, type, and duration of injuries can be harder to come by. We’d welcome any pointers to data sources from readers.
Minnesota pork plant workers to be compensated – At least 18 workers at the Quality Pork Processors plant of Austin have come down with strange, debilitating neurological illnesses. Those affected worked at or near the “head table” where compressed air was used to blow brains out of pig skulls. The brain matter turned into a fine mist, and health authorities believe that the workers’ exposure to this mist led to progressive inflammatory neuropathy, or PIN. The workers were initially denied workers compensation, but at least one worker has been notified that her claim will be honored so it sounds as though the insurer rethought matters, perhaps in light of some pending lawsuits.
Workers compensation is relatively clear cut when it involves injuries, but illnesses can pose numerous complexities and employees bear the burden of proof for demonstrating the work relatedness of the illness. With many illnesses, such as cancer, there can be delayed onset and it is difficult to prove that work and not some outside factor was the precipitating cause. In this ghastly case, medical authorities are still puzzled but have observed cases of the illness among pork workers in other states, all of whom were engaged in similar work at the “head table.” All plants have now discontinued this practice.