Articles Posted in Workers’ Compensation Benefits

It should come as a shock to no one that prescription drug costs in the United States are extremely high. We do not have many of the cost control measures implemented by governments of other countries, such as Canada and Europe. In fact, Congress has actually made it illegal to purchase and ship drugs to the U.S. from Canada or Mexico, where the same drugs are cheaper.

With prescription costs being as high as they are and still getting higher each year, workers’ compensation insurance carriers are worried these high costs will make it costly to provide benefits to injured workers in need of expensive prescriptions.

In other words, as our Boston workers’ compensation attorneys can explain, large insurance companies, which collect trillions of dollars in premiums each year, are worried high prescription costs will cut into their profitability, which tends to upset investors, and that is the last thing way want. Essentially, the lobbyists from the pharmaceutical industry are having more success in keeping prescription costs high than insurance industry lobbyists are having in keeping them low or getting federal subsidies.

According to a recent article from Insurance Business Magazine, the cost increases in pharmaceuticals are due to what industry insiders call high price inflation for brand and specialty drugs. They also argue there are fewer big name drugs going generic in the near future, which in the past had served as a cost corrector, as insurance companies can require a patient to use a generic drug if one is available. While they have not said how this actually affects workers’ compensation claims, they claim specialty treatments for Hepatitis C are very costly, and this is having a big impact on the value of claims.

In context to drugs more obviously associated with on-the-job injuries, such as antibiotics, narcotic painkillers, and antidepressants, many of which are already generic, and still increasing in costs, which is contributing to higher costs for workers’ compensation claims. It is not small increases these insurance companies are claiming either, as they note some generic drugs have increase in costs nearly 1,000 percent in the past year alone.
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Anyone who has ever gone into a nail salon is familiar with the strong smell of chemicals and workers wearing face masks when doing client’s manicures. While these chemicals may not be harmful to customers who go into a nail salon a few times a month at most, they are proving very dangerous to nail salon workers who spend all day around toxic chemicals such as acetone throughout each work day.

According to a recent investigation by The New York Times, nail salon workers are being poisoned. The author focuses on the lives at one popular nail salon in New York City. When a customer opens the door, seemingly happy workers greet her and ask her to pick a color for her nails.

At the first work station, an immigrant worker trims a client’s nails while talking about her two children. She does not mention a child lost in miscarriage. Another worker is on the internet looking for reasons she had a miscarriage, as well, along with four others before the most recent one.
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Millions of tourists come to Hollywood each year to see where movies are made and see where the stars spend their free time. People generally do not expect to see a car plow through a crowded restaurant while they are enjoying the sights.

According to a recent news article from Fox News, a worker was injured when a pickup truck and car crashed in way, which sent the pickup flying through the restaurant’s front door. Authorities say workers were at the restaurant at around one in the afternoon preparing the business to open later that afternoon when the pickup truck came crashing into the restaurant, causing him to suffer serious, but not life-threatening injuries.

While first responders were primarily there to help injured workers and driver of the pickup truck, who ultimately declined to be taken to a hospital, they became concerned about structural damage to the building and were worried it could collapse causing additional injuries. In total 44 firefighters responded to the scene of this car accident, along with city building inspectors to help contain the damage and prevent a structural collapse.
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In State ex rel. Turner Constr. Co. v. Indus. Commission, a workers’ compensation case from the Supreme Court of Ohio, claimant filed for benefits in connection with four on-the-job injuries. State ex rel. Those injuries occurred in early 1992, June 2005, October 2005, and July 2007. This appeal was filed in relation to claimant’s 2007 on-the-job injury.

In 2007, claimant was employed as a bricklayer when he suffered a thoracic injury and a depressive disorder related to the single incident. In 2011, claimant applied for a permanent total disability rating. Claimant included a report from his treating physician featuring an opinion claimant was suffering from permanent disability due alone to his psychiatric illness related to the 2007 injury. The workers’ compensation commission hired an independent physician to evaluate claimant, and this doctor agreed with claimant’s treating physician that claimant was not able to work due solely to his psychiatric condition caused by the 2007 accident.
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Sather v. SAIF, a workers’ compensation appeal from the Supreme Court of Oregon, involves a claimant who filed for benefits in 2009. Prior to the date of claimant’s on- the-job injury, he suffered from a preexisting degenerative disc disease. He also had a prior medical history of lower back pain with bilateral radiation to his legs. It is common for back pain to essentially spread to other parts of the body such as the legs though a process known to doctors as radiation.

Claimant then suffered a lumbar strain resulting from an on-the-job injury. Claimant applied for workers’ compensation benefits and employer’s workers’ compensation insurance company agreed to pay his claim in connection with the lumber strain. At this point, claimant filed another petition for workers’ compensation in connection with the combined condition of this preexisting back problem and his lumbar strain. This time, employer’s workers’ compensation insurance company denied his claim. The basis for denial of his claim was their belief his work-related injury was no longer a major contributing cause of the combined condition.

Under relevant state law, claimant was authorized to challenge insurance company’s denial and requested a hearing before the workers’ compensation commission. Following a hearing, the board upheld insurance company’s denial of claimant’s workers’ compensation benefits applications for the combined condition. Once the board denied his appeal, claimant filed a timely appeal before the state intermediary court of appeals.
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Milbrandt v. Bibb’s, Inc., an appeal from the South Dakota Supreme Court, involved claimant who was injured in a work-related car accident. Claimant was injured in the car crash on May 30, 2007. He was working as a truck driver, and was forced to drive off the road by another driver and injured his head, chest, neck, shoulder and hip.

His employer approved his claim for workers’ compensation benefits and paid him. At this point, claimant negotiated a settlement with at-fault driver’s insurance company in connection with negligence resulting in the car accident.
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According to a recent news article from AL Live, a worker at a nuclear power plant suffered an on-the-job injury and was exposed to radiation during the accident.

Witnesses say worker was busy conducting an inspection of an area of the nuclear plant known as a dry well in anticipation of shutting down the number 2 reactor to refuel it. This particular dry well contained a depression, which is around 6 feet deep, and worker somehow fell into it. He fell into the hole and hit his forehead, causing a head injury.

Plant officials say it was in the depression where worker was also was exposed to radiation. A spokesperson for the nuclear power plant is saying worker was only exposed to a minor amount of radiation. The reason for the contamination was this dry well was in a layer of the reactor housing, which surrounds the actual Number 2 reactor.
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