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There are 6.2 million work injuries reported in private industry in 2006, and 7.4 cases per 100 full time workers is what this came out to be. A little less than one in ten full times workers in 2006 had a work related injury. Lost work time, medical treatment, loss of consciousness, restriction of work or motion or transfer to another job occurred in 5.8 million of workmen's compensation.
OSHA recordable accidents include loss of consciousness, restriction of work or motion, transfer to another job, and medical treatment other than first aid. Sometimes, as you know, people get into your office or your treatment area and all they end up needing is first aid. That cut really didn’t need stitches, you decide. So therefore it’s not a OSHA recordable injury.
Epidemiology. Nine industries count for 31% of the total. So these are the top nine in numbers of work injuries: hospitals, nursing and personal care facilities, hotels and motels, eating and drinking places, grocery stores, department stores, air transportation, trucking and courier and motor vehicles.
Now a little bit about work illness. Different from work injury. Work injury is "I picked something up, I hurt my back." Cause and effect. Illness is something a little bit more vague. It usually takes repeated insults. 439,000 newly reported cases, so much much less than the 6.2 million injuries. Manufacturing accounted for three-fifths of the illnesses, 64% were disorders associated with repeated trauma, such as carpal tunnel syndrome and noise-induced hearing loss. That last one not being something you think of as repeated trauma, right off the top of your head, although it is. Work illness is probably under reported.
Reasons why employers don’t want to report work injuries: OSHA can target employers with high injury or illness rates for onsite inspections and that’s one of the reasons why an employer may not like it if you check something off as OSHA recordable.
A little about fatal occupational injuries in 2006. There were a total of 6,112. Highway traffic accidents were number one. Accounting for 22% of the total. Homicides were second, accounting for 15% of the total. Trades at risk?
In workers compensation the laws vary from state to state so the laws in Nebraska are different than the laws in Iowa. Workers comp insures an injured worker prompt but limited benefits and it limits the liability of an employer. This is kind of a trade-off that was developed in the early part of this century. With the development of the industrial age and a lot of people moving off the farm, into cities, working in big factories, lots of working conditions that were very unsafe - certainly by today’s standards. There got to be a lot of public awareness of the fact that people were getting seriously injured in their jobs, killed on their jobs.
For a worker to be able to sue an employer for some kind of damages, it has to be a really grievous act on the part of the employer. Such has happened with the asbestos companies and the reasons people are able to sue for asbestos illness is because it was known by the asbestos producers that asbestos was damaging to human health.
Workers comp was developed in an era when occupational disease was not recognized, so things like hearing loss wasn’t compensated up until probably the late 50’s. Insurance premiums are considered a cost of doing business, so those get passed on to the consumers. Under workers comp, a preexisting condition that is aggravated is compensable. Self- inflicted or suicidal acts, or acts under the influence and fights at work.
A little bit about reports. When you are generating a report some of the key things you need to have in there, if you don’t want that person to keep calling you back and writing you more letters, is you need to say, "Is it work related?" that’s what they really want to know. Is it due entirely to the workplace injury or exposure?
A little bit about records. As I mentioned, a variety of people will see them. When somebody files a work-comp claim, in most states there is an implied consent for release of information. Just by filing a claim. Now in our clinic we do have people sign a consent for release, and the American College of Occupational and Environmental Medicine does recommend that you have people sign a release of records when they file a comp claim, just to cover yourself.
Patients have a legal right to see their records, and as I said - kind of along the line of keeping separate notes.
A little bit about treatment issues. When you are treating a minor, you need to obtain written consent from the parents so that you will not be charged with battery. Treatment decisions may be suspect in the eyes of the patient. I’m sure you’ve figured this out in your previous lives already, because if that person did not choose you as their doctor.
The Americans With Disabilities Act: this usually generates a great deal of discussion. The Americans With Disabilities Act, or the ADA, forbids discrimination by employers -and it applies to those who have 15 or more employees - against individuals who currently have disabilities, are incorrectly perceived as being disabled, or have a record of disability.
Independent medical exams: I think the title is pretty explanatory what it is. It’s an examination that’s performed by a healthcare professional who’s not involved in the care of that patient, for the purpose of providing information about that examinee.
Disability exams: Just want to acquaint you with a couple of terms in disability exams. You’ve probably heard these terms before. You may know legally how to use them, but they get mixed up quite a bit. Impairment: is the degree of anatomic or functional loss. For example, my left hand is cut off. That is an impairment.