Posts Tagged ‘violence’

One of America’s Most Dangerous Jobs

Wednesday, September 13th, 2017

Kicked, pummeled, taken hostage, stabbed and sexually assaulted … would you want a job that included these risks? In One of America’s Most Dangerous Jobs, the Washington Post shines a spotlight on the dangers in the nursing profession, specifically around the violence that they encounter on the job. Citing a recent GAO report on violence in healthcare profession, the article notes that, “the rates of workplace violence in health care and social assistance settings are five to 12 times higher than the estimated rates for workers overall.”

Here’s one excerpt from the article:

“In Massachusetts, Elise’s Law, which is named for the nurse who was attacked in June, is already on the fast track to set state standards for workplace protection. Legislators were working on this months before Wilson was stabbed.

Nurses in Massachusetts were attacked more frequently than police or prison guards. When association members testified about the violence epidemic this spring, they said nurses had been threatened with scissors, pencils or pens, knives, guns, medical equipment and furniture in the past two years alone, according to the Massachusetts Nurses Association.”

OSHA reports that in surveys conducted by various nursing and healthcare groups:

  • 21% of nurses and nursing students reported being physically assaulted and over 50% verbally abused in a 12-month period
  • 12% of emergency department nurses experienced physical violence and 59% experienced verbal abuse during a seven-day period
  • 13% of employees in Veterans Health Administration hospitals reported being assaulted in a year

 

While 26 states have workplace safety standards for health-care facilities, there are no federal standards. Nursing groups say that state efforts have helped increase awareness.

NIOSH worked with various partners – including nursing and labor organizations, academic groups, other government agencies, and Vida Health Communications, Inc. – to develop a free on-line course aimed at training nurses in recognizing and preventing workplace violence. The course has 13 units that take approximately 15 minutes each to complete and includes “resume-where-you-left-off” technology. Learn more about the courses at Free On-line Violence Prevention Training for Nurses and the actual course can be accessed here: Workplace Violence Prevention for Nurses CDC Course No. WB1865

Related

 

 

 

Healthcare providers struggle with violence-related risk management

Wednesday, March 23rd, 2016

There’s no question but that healthcare workers face a growing threat of violence from patients while going about their day-to-day jobs. In a 2015 survey, the International Healthcare Security and Safety Foundation reported a 40% increase in violent crime from 2012 to 2014, with more than 10,000 violent incidents mostly directed at employees. High stress, armed patients and visitors, drug and alcohol intoxication, mental health issues and more all contribute to an increasingly dangerous environment. OSHA reports that:

From 2002 to 2013, the rate of serious workplace violence incidents (those requiring days off for an injured worker to recuperate) was more than four times greater in healthcare than in private industry on average. In fact, healthcare accounts for nearly as many serious violent injuries as all other industries combined.

Recently, Susannah Levine reported on the challenge that healthcare facilities face in her Risk & Insurance article, Hospitals Struggle with Security Risks. The article discusses the pros and cons of an armed approach to healthcare security, as well as the insurance implications of various risk management and security measures. Liability insurance may be a determining factor as to whether healthcare facilities opt for armed security or rely on less lethal tools like Tasers and sprays.

“Barry Kramer, senior vice president, Chivaroli & Associates, a health care insurance broker, said that armed security in health care settings is more of a risk management concern than a coverage issue.

“It would be highly unusual for our clients’ liability policies to exclude claims involving security guards, whether or not they’re armed with guns,” he said.

He said many health care risk managers are not equipped to manage exposures associated with licensing and certifying guards or registering the facility’s own firearms.

For facilities that lack the bandwidth to manage, train and track certifications for in-house security staff, Kramer said,third-party vendors, such as local law enforcement or private security companies, can be contracted, since they have firearms experience as well as liability insurance coverage.”

In February, the New York Times discussed various approaches and philosophies that healthcare facilities employ to mitigate risk. The article by Elisabeth Rosenthal – When the Hospital Fires the Bullet – centers on the case of a 26-year-old mental health patient who was shot by police in a Houston hospital. In the course of the article, Roenthal presents various approaches to security:

To protect their corridors, 52 percent of medical centers reported that their security personnel carried handguns and 47 percent said they used Tasers, according to a 2014 national survey. That was more than double estimates from studies just three years before. Institutions that prohibit them argue that such weapons — and security guards not adequately trained to work in medical settings — add a dangerous element in an already tense environment. They say many other steps can be taken to address problems, particularly with people who have a mental illness.

Rosenthal contrasts the approach of Boston’s Massachusetts General Hospital, where the strongest weapons its security officers carry is pepper spray to that of the Cleveland Clinic, which has its own fully armed police force and also employs off-duty officers.

Guns in hospitals

Meanwhile, as risk managers struggle with the dilemma of whether to arm or not to arm, patients and visitors are often armed, enabled by state and local gun laws – just one more factor that healthcare facilities are coping with. At of the beginning of the year, Texas law allows for guns in state mental health hospitals. Campus Safety Magazine reports on how Kansas College Hospitals are preparing to allow guns on campus to comply with a new law. Gun laws in health systems vary by state – while a federal law bars guns from schools, there is no such law about firearms in hospitals.

Healthcare Violence Prevention Resources

OSHA: Worker Safety in Hospitals – Caring for our Caregivers

OSHA: Preventing Workplace Violence: A Road Map for Healthcare Facilities

OSHA: Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers

Mitigating Workplace Violence at Ambulatory Care Sites

Emergency Department Violence Fact Sheet

Healthcare Crime Survey 2015

Prior related posts

More perils for healthcare workers

Violence in healthcare: 61% of all workplace assaults are committed by healthcare patients

Report on violence & aggression to Maine’s caregivers; Injuries include bites, kicks, being hit

Annals of Risk Management: Guns and Mental Illness in New York

Wednesday, January 16th, 2013

New York has just signed into law a new gun control measure [S. 2230] that comes as a direct response to the incomprehensible tragedy in Sandy Hook, CT. While the bill touts its “first in the nation” status, with respect to its approach to mental illness, it is by no means a model for other states to follow.
The bill addresses three distinct issues relating to mental illness: first, limiting access to gun licenses for those diagnosed as mentally ill and dangerous. Second, the bill requires gun owners who reside with a mentally ill and “dangerous” individual to keep guns under lock and key. Finally, and most disturbingly, the bill requires mental health professionals to report any patient who is “likely to engage in conduct that will cause serious harm to
him- or herself or others.” In other words, the bill assumes that any individual with suicidal tendencies is a potential mass murderer. Such stereotyping is not what is needed in the mental health community.
Double Bind
S.2230 places a formidable burden on mental health professions – who not only must treat their patients, they are held accountable for predicting future behavior:

A new Section 9.46 of the Mental Hygiene Law will require
mental health professionals, in the exercise of reasonable
professional judgment, to report if an individual they are treating
is likely to engage in conduct that will cause serious harm to
him- or herself or others. A good faith decision about whether to report
will not be a basis for any criminal or civil liability.

If we have learned anything in the all-too-frequent incidences of random slaughter, the “likelihood” of homicidal acts is usually only revealed retroactively, long after the fact.
The bill goes on to read:

When a Section 9.46 report is made, the Division of Criminal Justice
Services will determine whether the person possesses a firearms
license and, if so, will notify the appropriate local licensing
official, who must suspend the license. The person’s firearms will
then be removed.

After a therapist reports a potentially violent patient to the state – once again, this rather large population includes people who only threaten to hurt themselves – New York will run the names through the data base of licensed gun owners. All hits must result in license suspension. Of course, bureaucracies being what they are, it might take months for the suspension to take place. Hence, the individual who at one time exhibited psychotic symptoms or discussed violent feelings with a therapist might find him or herself months later confronted by cops on the doorstep. Such encounters will hardly be helpful for people trying to establish mental equilibrium.
Finally, the image of forcefully removing guns from the home surely presents enormous risk to gun owners and public safety officials alike. Who will do this and under what circumstances? My guess is that, given the profound implications of reporting patients to the state, most therapists will err on the side of non-reporting and rationalize their inaction, when necessary, under the heading of acting in “good faith.”
The Wrong Cohort
It is important to note that only individuals receiving treatment for mental illness will be subject to this onerous standard. Given the fractured and fragmented nature of mental health treatment in this country, the vast majority of mentally ill individuals have never received and are not about to receive any treatment. And among the violent individuals who might well contemplate an attack of homicidal proportions, few would bother to discuss it with a therapist or go through the formality of securing a gun license before buying an assault weapon.
The relatively small subset of people impacted by the New York bill – people diagnosed with mental illness who are licensed gun owners – is likely to prove statistically insignificant, as is the probability that a single mass murder can be prevented by this radical undermining of the doctor-patient relationship. Surely, there is a better way to manage what has become a remote but appalling risk of life in the 21st century.

News Roundup: Holiday Health Wonkery, Claims Webinar, Firefighter Hazards & more

Thursday, December 6th, 2012

Holiday Health Wonkery – Just a spoonful of latkes makes the medicine go down? Hank Stern hosts a Chanukah-themed Festival of Lights edition of Health Wonk Review at InsureBlog – it’s fun, interesting, and contains substantial wonkery.
Claims Webinar – Mark Walls, who many of you may know from his LinkedIn Work Comp Analysis Group fame, is hosting a complimentary 90-minute webinar on Tuesday, December 11: Take your Workers’ Compensation Claims Handling from Good to Great. Mark’s been plying his profession for 22 years, so you can’t get a better claims guide. Click through to see topics or to register.
Firefighter hazardsStop, drop, and roll: workplace hazards of local government firefighters, 2009 (PDF) – “When compared with all workers, firefighters are injured in similar ways but at a much higher rate, with work-related injuries caused by “stress, exertion, and other medical-related issues” accounting for the largest number of deaths and with risks of fatal injuries 25.7 percent higher and nonfatal injuries and illnesses over two times greater.” – BLS report by Gary M. Kurlick, economist in the Office of Compensation and Working Conditions, Division of Safety and Health Statistics, at the Bureau of Labor Statistics.
Chimp attack – Roberto Ceniceros of Business Insurance brings us the most recent development in the sad saga of the CT woman who was attacked by her employer’s pet chimp: Woman disfigured in chimp attack settles with owner’s estate for $4M. We’ve written about aspects of this horrific case in the past – see: the crazed chimp case, Exclusive Remedy” for Losing Your Face?, and (Uncompensable) Nightmare at Work.
Depression and Work Comp – Does your organization offer depression screening for injured workers? Risk Scenarios: Down for the Last Time offers case in which missed cues and poorly handled communication made a difficult workers’ compensation case much more painful than it should have been.
Mind over Matter – Osteoarthritisis is “the most common joint disorder” and occurs “due to aging and wear and tear on a joint.” Will arthroscopic surgery relieve related pain? Read about prior studies in Kneedless Surgery. For more debunking, see Gary Schwitzer’s HealthNewsReview, which has a mission of “helping consumers critically analyze claims about health care interventions and by promoting the principles of shared decision-making reinforced by accurate, balanced and complete information about the tradeoffs involved in health care decisions.” The site offers commentary, evaluations, and grading on health care journalism, advertising, marketing, public relations and other messages – a great consumer resource.
Fraud – Two pretty large cases of fraud hit our radar this week, proving that work comp fraud perpetrators can come in many flavors, even among those you pay to trust. On WorkCompWire, we learned about $2.7 million Florida fraud case involving a former correctional officer and at Managed Care Matters, Joe Paduda blogs that Pennsylvania County was defrauded by its risk manager to the tune of $490,000.
Telecommuting – In a recent Human Resource Executive, Carol Harnett makes the case that Telework is Good for Business, and she uses the experiences that many businesses had with Hurricane Sandy as examples. At LexisNexis, attorney John Stahl looks at work comp issues related to the mobile workforce and home-based employees.
Workplace Violence – The current issue of Risk Management Magazine has a Time Line of Workplace Homicides and at Risk Management Monitor, Ralph Metzner posts about preventing workplace violence.
News Briefs

When domestic violence finds its way to the workplace

Wednesday, June 20th, 2012

The deceased: a police officer. A nurse in training.
The perpetrators: A prison guard. A surgeon.
These recent deaths were two of the approximately 5,000 on-the-job fatalities that occur each year, and both both were related to domestic violence. We mention the professions of the parties involved simply because domestic violence is often assumed to be an issue that doesn’t happen to “people like me” or that it primarily occurs in certain economic strata. These myths and stereotypes are part of the reason that it can be such a hidden problem.
In the case of Officer Kevin Ambrose, a 36-year veteran of the Springfield MA police department, he was shot and killed in the line of duty while protecting Charlene Miller and her baby from a former boyfriend. Miller was also shot but survived; Miller’s baby was unharmed, largely thanks to Officer Ambrose’s courage. The assailant, Shawn Bryan, a Rikers Island corrections officer, took his own life after the shooting.
Last week, Jacqueline Wisniewski was stalked and gunned down in Buffalo Hospital. Her murderer was a surgeon at the hospital, her coworker and a former boyfriend. The hospital and nearby schools were locked down for a few hours after the incident because it was unclear if this was a targeted incident or a shooting spree. Timothy Jorden, a trauma surgeon at the hospital and a former army Special Forces weapons expert, was identified as the assailant by witnesses and an all points bulletin was issued. He was found dead at his home two days later.
These tragic events are part of a phenomena called “domestic abuse” or “domestic violence” – misleading terms at best. The word “domestic” softens the edges of a brutal reality, and implies that it is something that happens behind closed doors, not our business. Yet it is indeed something we should be making our business and it is clearly not something that is confined to the home. Increasingly, the violence plays out or culminates in the workplace as assailants are stalked; it also takes the lives of working police officers and first responders.
According to a recent report in the Annals of Epidemiology, homicide is a leading cause of occupational death in U.S. women. There were 142 homicides among women at work resulting from intimate partner violence from 2003 to 2008. While the rate of homicides in the workplace has been trending down, the percentage of homicides against women at work increased in 2010 to 13 percent. Those at highest risk were in the health care, production, and office/administration professions. More than half the homicides occurred in parking lots and public buildings.
Types of workplace violence
Work violence generally falls in one of four buckets. It is helpful to segment them by type because the risk management and prevention measures can vary. The types of violence include:

  • Criminal outsiders, which includes robberies, rapes, and random violence by strangers. This type of violence is common in organizations that handle money, financial transactions, and drugs. Risk mitigation can include staff training and addressing environmental issues such as better lighting, customer/worker barriers, lockboxes, alarms, and closed circuit videos.
  • Organizational clients – this is violence committed by customers, patients, or other recipients of the business services. Healthcare workers in particular suffer many incidents at the hands of patients and family members. These might include rage-related incidents and incidents related to mental health issues or persons under the influence. Risk mitigation measureless include staff training and environmental controls.
  • Lateral or worker on worker violence, which includes the so called “going postal” incidents and retribution for firings or other work-related issues. Although these incidents are the ones that make the headlines, they are the least common. Mitigation measures include better hiring practices, such as background and reference checks, zero tolerance policies that are enforced (including anti-bullying measures), manager and supervisor training, anger and stress management training for workers, availability of an EAP. Particular measures may need to be taken at points of high stress, such as layoffs or job loss.
  • Domestic violence – this involves an employee involved with a spouse or significant other; it also includes coworkers who might be coincidentally caught up in events or first responders who are injured when trying to help the victims. This is the most difficult one to address since it stays “underground” until a serious point of escalation. The best way to deal with this potential is proactively as part of an organization’s health and wellness effort by publicizing the issue and publicizing the availability of resources to help. More and more progressive companies are addressing the issue. The Corporate Alliance to End Partner Violence is a national nonprofit organization dedicated to partnering with businesses to help reduce the costs and consequences of partner violence at work. From policies and programs to legal issues and legislation, CAEPV is a credible source for information, materials and advice. It’s an excellent source of best practices for corporate programs to prevent partner violence and offers concrete help for employers in starting a workplace program.

Why should employers care?
Employers are involved in domestic abuse whether they want to be or not. Futures Without Violence delineates Seven Reasons Employers Should Address Domestic Violence not the least of which are that it is a pervasive issue, it poses security and liability issues, and it results in significant lost time and lost productivity. A 2003 CDC study revealed that domestic violence accounts for nearly 8 million lost work days, the equivalent of more than 32,000 full-time jobs.
Plus, it is a morale issue. Studies show that 84% of surveyed employees believe that employers should get involved in the solution to the problem of domestic abuse. Yet there is a discrepancy, because at the time of this survey, just 13% of executives surveyed thought it was the company’s job to help solve the problem.
Workers’ comp is simply not an issue that can easily be siloed off from other aspects of a workers’ life. We certainly see that with health issues and so-called lifestyle issues that complicate worker’s comp claims. So, too, with domestic violence. While the employer may or may not be shielded from compensability in incidents of work violence, that sometimes simply opens the door to liability in the courts for other reasons: negligent hiring, lack of security, etc. While it’s important to address the safety issues directly related to the job, it makes economic sense to have health and safety be part of an overarching wellness program that addresses health-related issues that occur both on and off the job.

Violence in healthcare: 61% of all workplace assaults are committed by healthcare patients

Monday, March 5th, 2012

According to a recent NCCI Report on Violence (summary) (Full Report, PDF), “the majority of workplace assaults are committed by healthcare patients.” While there is good news in the fact that workplace homicides and assaults are on the decline, the NCCI report says this:
“The decline in the rate of workplace assaults has lagged the steady decline in the rate for all lost work-time injuries and illnesses. This reflects a notable change in the composition of the US workforce and, in particular, the ongoing increase in the share of healthcare workers, who experience remarkably high rates of injuries due to assaults by patients. This is especially common in nursing homes and other long-term care facilities. In fact, 61% of all workplace assaults are committed by healthcare patients. For assaults, coworkers make up just 7%, and someone other than a healthcare patient or coworker comprises 23%. The remainder is unspecified.”
In a post last year on healthcare workers and on-the-job violence, we talked about some of the perpetrators:
“While many assaults are by patients, friend and family members of patients also can commit the assaults. There are also rapists or muggers who are targeting healthcare settings or solitary workers; drug addicts and robbers, who are looking for medications; and domestic violence brought into the workplace. And it’s unclear why violence is on the rise. Many point to staff shortages. Others see the preponderance of alcohol, drugs, and ready access to weapons as contributing factors; others think that hospital administrators do too little in the area of prevention.”

In the list above, we overlooked a huge and growing segment: elderly patients, patients with Alzheimer’s, and people suffering from mental illness.
Prevention Tools
OSHA: Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers. See also the slide show overview version
The Emergency Nurses’ Association has issued a good Workplace Violence Toolkit.
We also found that WorkSafeBC has put together a series of excellent short video clips for various health care settings.




Health Wonkery, FL money trail, work violence report & more

Thursday, February 2nd, 2012

Louise Norris jumps into the political fray with this week’s Health Wonk Review – Campaign 2012 Edition at Colorado Health Insurance Insider. It’s a great edition with some solid submissions, and we are smitten by the great historic voting photos that Louise used to punctuate the posts. Check it out.
Other noteworthy news
Follow the money – In the continuing saga of Florida’s physician-dispensed workers comp drugs and the associated costly price tag for employers, Joe Paduda looks at the behind-the-scenes opposition muscle aimed at any legislative attempts to put limits on this practice. He cites a recent research report, which tracked more than $3 million in political donations to “one Mirimar address, dozens of companies.” The Florida Independent news story goes on to say, “In suburban Tampa, a single-story building at 610 South Blvd. is home to countless political committees in Florida and all over the country, and is known as a veritable political action committee mill. A similar story lies in Miramar, where two doctors — Paul Zimmerman and Gerald Glass — run dozens of companies that, altogether, have funneled more than $3 million into state political campaigns and committees in recent years.” Joe notes, “$3.2 million total shows clearly just how important Florida is to dispensing companies and their affiliates.”
Violence in the Workplace“Workplace homicides ‘Are not crimes of passion committed by disgruntled coworkers and spouses, but rather result from robberies.’ And the majority of workplace assaults are committed by healthcare patients.” These are a few top line findings in the NCCI research report on Violence in the Workplace. Although homicides are trending down, they comprise 11% of workplace fatalities. You can download a copy of the complete report, which is part of NCCI’s ongoing research into the topic of work violence.
New blog of note – The folks at PRIUM, a workers’ compensation utilization management company, have recently launched Evidence Based, a blog that will focus on our favorite topic – workers comp – with particular emphasis on the over-utilization of prescription drugs in the treatment of injured workers. Recent posts have dealt with state efforts to control narcotics. See recent posts on Arizona: The Simple Path to Controlling Narcotics in Non-Monopolistic States and Ohio’s New Rules: A Good Start (with a Potential Gap).
Getting social – Pro tip for social media users: If you are going to file a workers’ comp claim, you should think twice about posting party pics on Facebook – judges may take them into consideration when evaluating the merit of your claim.
The Feds & Fraud – In Government Executive, Kellie Lunney explores the reasons why the federal workers’ comp program remains vulnerable to fraud. According to a study by the Government Accountability Office, limited access to data is a key culprit. “Specifically, we found that limited access to necessary data is potentially reducing agencies’ ability to effectively monitor claims and wage-loss information,” the report stated. In addition, agencies’ overreliance on self-reported data from claimants, the frequent use of physicians not employed or selected by the government, and the expense involved in conducting investigations and prosecutions have stymied efforts to stamp out fraud. GAO noted that investigations are the “most costly and least effective” way to reduce fraud, but the ability to prosecute those who cheat the system is a valuable deterrent.
OSHA Posting Compliance – Employers, did you remember to post OSHA Injury & Illness Reports on Feb 1? If not, make sure that you do. Rules require that employers post “…the official summary of all injuries and illnesses occurring in the previous year. The information must be compiled on the OSHA Form 300A or an equivalent and posted in a conspicuous place or places where notices to employees are customarily posted. The information must remain up through April 30, 2012.” For more information and to learn if this requirement applies to your organization, check out OSHA’s Recordkeeping page.
Quick takes

Risk, repackaged drugs, bizarre cases and other news notes

Wednesday, January 11th, 2012

Risk RoundupPolitical Calculations blog hosts this week’s Cavalcade of Risk, replete with a post rating system. Check it out.
Florida repackaged drugs issue redux – Dave DePaolo posts about a new effort to put a price cap on Florida’s repackaged drugs. He posits that changing economic and regulatory conditions might create a more favorable climate for passage. He also talks about how “capping the price of drugs has been hotly contested by the Florida Medical Association (FMA) and a company called Automated Healthcare Solutions (AHCS).” AHCS is a firm whose executives have contributed heavily to politicians to prevent such legislation. A Tampa Bay news report talks about how the state’s pill mill crackdown was held up by proponents of doc dispensing, including AHCS principals: “The two Miramar workers’ compensation doctors have helped pump about $3 million into the political system through a dozen companies in the past year.” A story in the Florida Independent covers an earnings report for top lobbyists, noting that, “Among the companies to have spent the most on lobbying is Automated HealthCare Solutions, a group whose co-chairmen have become fixtures on the political scene. According to the Current, Automated HealthCare has posted minimum lobbying expenditures greater than $300,000.” For more on why repackaging controls are needed, see Joe Paduda’s posts: Drug Dispensing by Docs and Repackagers and the myth of AWP.
The big five – Roberto Ceniceros reports that Top 5 workplace injury causes make up 72% of direct workers comp costs, according to a research report by Liberty Mutual Group. “Overexertion–or injuries caused by lifting, pushing, pulling, holding and carrying–costs businesses $12.5 billion in direct annual expenses and accounts for more than 25% of the national burden.” This was followed by falls on the same level, falls to a lower level, bodily reaction, and struck by object.
Violence in Nursing – In When it hurts to help, Victoria Ison reports on workplace violence in nursing. Many might assume most violence is perpetrated by patients or intruders but not so: “Assistant nursing professor Cindy Thomas said the most common form of violence currently seen in health care occurs between nurses. She said violence between physicians and nurses is second, and violence between patients and nurses is actually third most common.”
Strange suitsTop 10 Bizarre Workers’ Comp Cases for 2011. From an eye-related injury after hitting a bowling ball with a sledge hammer to a fall from a helicopter while attempting to capture a deer with a net – read Thomas Robinson’s picks for workers comp lawsuits with strange circumstances. Robinson reminds us that, “one must always be respectful of the fact that while a case might be bizarre in an academic sense, it was intensely real, affecting real lives and real families.”
Brief takes

Cavlacade of Risk & other news from the blogosphere

Wednesday, October 5th, 2011

Risk roundup – Jay and Louise Norris of Colorado Health Insurance Insider host this week’s Cavalcade of Risk – it’s the Colorado nature edition. Congrats to the Norrises on their 5 year blogging anniversary and 10th issue hosting the Cavalcade.
Check the facts – At Comp Time, Roberto Ceniceros tells the story of an insurer relying on a newspaper’s crime report as the basis for denying a claimant’s workers comp benefits. While this situation might seem like one that wouldn’t surface all that often, we’d make the case that it is a cautionary tale for anyone who is using social media as an investigative tool.
Culture of Caring – Dave DePaolo has an interesting post on how the culture of caring relates to a workplace where the turnover rates are high, like fast food joints. Is high-touch communication and an early return-to-work model as effective when turnover is 120%? We’d note that high turnover is not only an impediment to return to work, it’s no doubt also a factor in the number of injuries that occur. New, untrained workers have more injuries. The Bureau of Labor Statistics data shows that more than 40% of work-related injury claims are filed by workers who have been on the job for 12 months or less, and a NIOSH study found that employees 24 years old or younger are two times more likely to suffer a nonfatal injury than their older co-workers.
Medical Costs – In our last news roundup, we linked to the Kaiser Family Foundation’s recent report that average family benefits premiums are up 9%. Joe Paduda of Managed Care Matters offers his thoughts on why premiums are up so much when medical costs are flat.
Workplace Violence – Michael Fox of Jottings by an Employer’s Lawyer posts about OSHA’s new directive on procedures for investigating workplace violence complaints. He notes that two industry groups get singled out for particular focus: Healthcare and Social Service Settings and Late-Night Retail Settings.
Anniversary of Patel Memo – At Lexis-Nexis, Robin E. Kobayashi commemorates the 10 year anniversary of the Patel Memo. Bonus points to you if you know what the Patel memo is. Here is a clue: it launched an entire workers comp-related industry.
Case to watch – The EEOC is suing Texas-based BAE Systems for violating the ADA by firing a man who weighed 680 pounds. The man had worked at his job for 16 years and had logged good performance evaluations. The intersection of obesity and the ADA is one to watch.
When light duty runs off the rails Safety News Alert discusses a case of a worker who returned to work on light duty. While on light duty, he received partial disability benefits because the job didn’t pay as much as his previous position. But the employee had trouble getting along with his supervisor and asked to be laid off – which the employer granted. The employee then applied for full work comp benefits. Check out the court’s decision.
New blog Well, new to us. TexasM Mutual Insurance Company’s blog has been up and running for about 15 months now, but we just discovered it via our Twitter feed. There are some good posts, particularly some good safety information. Texas Mutual Insurance Company is the state’s leading provider of workers’ compensation insurance, with approximately 32 percent of the market. (And remember, Texas is a state where private employers can choose whether or not to carry workers’ compensation insurance coverage.)
Also of interest…

Annals of Compensability: Violence as a “Normal” Working Condition

Thursday, September 22nd, 2011

Here is a very interesting case from Pennsylvania, where the definition of “normal working conditions” is fraught with terror (and which, as a result, closes the door to comp compensability while potentially opening another to lawsuits). But in our excitement to discuss this intriguing case, we get ahead of ourselves.
Greg Kochanowicz worked as a manager for the Pennsylvania Liquor Control Board. That might sound like an enforcement job, but ironically, his job was selling liquor from a retail outlet. On April 28, 2008, a masked man entered the store, pointed two guns at Greg and a co-worker, and forced them to empty the safe and cash register. The robber prodded the back of Greg’s head with one of the guns. After getting the cash, the robber used duct tape to tie Greg and his co-worker to chairs in the office. There was no physical harm – just the threat of violence if Greg did not cooperate.
Following this incident, Greg suffered from anxiety, depression and flashbacks. He was too traumatized to return to work. Diagnosed with PTSD, he collected temporary total benefits under workers comp for what Pennsylvania calls a “psychic” injury. (It is worth noting that in 1981 Greg’s brother was stabbed to death in a robbery, an incident for which Greg received no counseling or support.)
Abnormal Justice
Greg’s employer appealed the WCJ ruling. A split panel of judges (4-3) reversed the finding of compensability on the basis that armed robberies were a “normal” working condition – and only “abnormal” working conditions lead to compensability for PTSD/”psychic” injuries. That’s a very interesting notion, indeed.
In its reversal, the appeals court noted that robberies were quite common among the Liquor Control Board stores: in the five county area, there were 99 robberies since 2002, an average of one a month. In addition, employees were acutely aware of the risks. They received a written pamphlet entitled “Things you should know about armed robbery.” Greg had read the booklet and received training related to it. In fact, he followed the employer’s written protocol to the letter, thereby avoiding bodily harm to himself and his co-worker.
The appeals court is saying that armed robberies should come as no surprise to liquor board employees. They have been forewarned. And in the view of a majority of the judges, forewarned is foreclosed: there can be no compensability for a psychic injury as a result of normal working conditions. (Had Greg been shot, however, he would have had a compensable injury.)
OSHA to the Rescue?
The appeals court states that having a gun pressed to the back of the head is a “normal” working condition. If this is indeed true, then the employer has put employees in a workplace that is fraught with risk. This is something employers are not allowed to do.
Here is OSHA’s General Duty Clause:

“Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”

If the court is correct, if armed robberies are a “normal” working condition, then the employer has failed to eliminate an unacceptable risk. By leaving unarmed employees in high risk areas, they are out of compliance with OSHA standards. Given their knowledge of the likelihood of robberies, they should place armed guards in each store, particularly in evening hours. Their failure to protect employees from an all-too-routine hazard is unacceptable and may be grounds for lawsuits.
This case is wending its way toward the PA Supreme Court, where the arguments of the dissenting judges, led by Renee Cohn Jubelirer, are likely to prevail. Greg will probably qualify once again for workers comp. Yes, he received training in violence; he was well aware of the risks in his job; he even handled the situation with exemplary composure. But there is nothing normal about having a gun pressed into the back of your head, unless you are an actor taping a cop show for cable TV.