Injury Compensation Research Articles

A Primer for Workers' Compensation

Abstract Background Context: A physician's role within a workers' compensation injury extends far beyond just evaluation and treatment with several socioeconomic and psychological factors at play when compared to similar injuries occurring outside of the workplace. Although workers' compensation statutes vary among states, all have several basic features with the overall goal of returning the injured worker to maximal function in the shortest time period, with the least residual disability and shortest time away from work. Purpose: To help physicians unfamiliar with the workers' compensation process accomplish these goals. Study Design: Review. Methods: Educational review. Results: The streamlined review addresses the topics of 1) Why is Workers' Compensation Necessary? 2) What does Workers' Compensation Cover? 3) Progression following Work Injury 4) Impairment and Maximum Medical Improvement (MMI), including how to use the 6th edition of American Medical Association's (AMA) Guides, 5) Completion of Work Injury Claim after Impairment Rating, 6) Independent Medical Evaluation, and 7) Causation. Conclusions: In the ‘no-fault’ workers' compensation system, physicians play a key role is progressing the claim along and, more importantly, getting the injured worker back to work as soon as safely possible. Physicians should remain familiar with the workers' compensation process, along with how to properly utilize the AMA Guides.

Do vaccines cause epilepsy? Review of cases in the National Vaccine Injury Compensation Program.

The National Childhood Vaccine Injury Act of 1986 created the National Vaccine Injury Compensation Program (VICP), a no-fault alternative to the traditional tort system. Since 1988, the total compensation paid exceeds $5 billion. Although epilepsy is one of the leading reasons for filing a claim, there has been no review of the process and validity of the legal outcomes given current medical information. The objectives were to review the evolution of the VICP program in regard to vaccine-related epilepsy and assess the rationale behind decisions made by the court. Publicly available cases involving epilepsy claims in the VICP were searched through Westlaw and the US Court of Federal Claims websites. All published reports were reviewed for petitioner's theories supporting vaccine-induced epilepsy, respondent's counterarguments, the final decision regarding compensation, and the rationale underlying these decisions. The primary goal was to determine which factors went into decisions regarding whether vaccines caused epilepsy. Since the first epilepsy case in 1989, there have been many changes in the program, including the removal of residual seizure disorder as a vaccine-related injury, publication of the Althen prongs, release of the acellular form of pertussis, and recognition that in genetic conditions the underlying genetic abnormality rather than the immunization causes epilepsy. We identified 532 unique cases with epilepsy: 105 with infantile spasms and 427 with epilepsy without infantile spasms. The petitioners' experts often espoused outdated, erroneous causation theories that lacked an acceptable medical or scientific foundation and were frequently criticized by the court. Despite the lack of epidemiological or mechanistic evidence indicating that childhood vaccines covered by the VICP result in or aggravate epilepsy, these cases continue to be adjudicated. After 35 years of intense litigation, it is time to reconsider whether epilepsy should continue to be a compensable vaccine-induced injury.

Fence off Black Swans: The Economics of Insurance for Vaccine Injury*

AbstractBeing injured during vaccination, although infrequent, can occur, and this necessitates understanding the consequences of vaccine injuries. In this study, we analyse the impact of the risk of vaccine injuries, particularly the economic importance of vaccine injury compensation insurance (VICI) programmes for the injured, which few studies have investigated. Specifically, we examine the role of VICI on individuals' vaccination decisions by integrating an imperfect vaccine into an epidemiological‐economic model in the presence and absence of such an insurance mechanism. Our findings show that the risk of being injured is a non‐negligible risk that lowers individuals' incentives to be vaccinated. The introduction of VICI largely alleviates decision‐makers' concern about vaccine injury. Furthermore, our extended discussion shows the effect of insurance in encouraging vaccination persists under some more sophisticated scenarios.

Odškodnění újmy způsobené neozbrojenému státnímu zaměstnanci služebním úrazem

The subject of this article is the regulation of compensation for injury caused by a service accident to a civil servant. It is a sad example that service law does not offer unarmed civil servants a better regulation of injury compensation, even if they have suffered such injury because of the violence of a client to whom they were providing services in the interest of the Czech Republic. In conclusion, it is noted that even the Czech Republic cannot afford to squander the potential of its civil servants by not providing them with tangible benefits in the event of an on-duty injury, as such civil servants will not normally be motivated to perform their civil service effectively. We use the Swiss regulation and case law to depict that Swiss case law is and should be an inspiration even for Czech judges. A key observation concerns Swiss case law on the test applied in assessing whether or not mental illness is an occupational disease.

Large-scale networks changes in Wilson’s disease associated with neuropsychiatric impairments: a resting-state functional magnetic resonance imaging study

BackgroundIn Wilson’s disease (WD) patients, network connections across the brain are disrupted, affecting multidomain function. However, the details of this neuropathophysiological mechanism remain unclear due to the rarity of WD. In this study, we aimed to investigate alterations in brain network connectivity at the whole-brain level (both intra- and inter-network) in WD patients through independent component analysis (ICA) and the relationship between alterations in these brain network functional connections (FCs) and clinical neuropsychiatric features to understand the underlying pathophysiological and central compensatory mechanisms.MethodsEighty-five patients with WD and age- and sex-matched 85 healthy control (HC) were recruited for resting-state functional magnetic resonance imaging (rs-fMRI) scanning. We extracted the resting-state networks (RSNs) using the ICA method, analyzed the changes of FC in these networks and the correlation between alterations in FCs and clinical neuropsychiatric features.ResultsCompared with HC, WD showed widespread lower connectivity within RSNs, involving default mode network (DMN), frontoparietal network (FPN), somatomotor network (SMN), dorsal attention network (DAN), especially in patients with abnormal UWDRS scores. Furthermore, the decreased FCs in the left medial prefrontal cortex (L_ MPFC), left anterior cingulate gyrus (L_ACC), precuneus (PCUN)within DMN were negatively correlated with the Unified Wilson’s Disease Rating Scale-neurological characteristic examination (UWDRS-N), and the decreased FCs in the L_MPFC, PCUN within DMN were negatively correlated with the Unified Wilson’s Disease Rating Scale-psychiatric symptoms examination (UWDRS-P). We additionally discovered that the patients with WD exhibited significantly stronger FC between the FPN and DMN, between the DAN and DMN, and between the FPN and DAN compared to HC.ConclusionsWe have provided evidence that WD is a disease with widespread dysfunctional connectivity in resting networks in brain, leading to neurological features and psychiatric symptoms (e.g. higher-order cognitive control and motor control impairments). The alter intra- and inter-network in the brain may be the neural underpinnings for the neuropathological symptoms and the process of injury compensation in WD patients.

Compensation Assessment for Personal Injury Owing to Extra-Contractual Liability: Case Study on Selected Courts

Assessment of compensation for personal injury is an intricate part of the law of extra-contractual liability (torts) since such kind of injury results in loss of a job, part of a body, total permanent disability or death. As personal injury may involve irreparable harm, it challenges courts in quantifying reasonable expenses a victim incurs and determining the amount of disability indemnity. By using decisions of the SNNP and Sidama regional courts together with selected Federal Cassation decisions, this article aims to explore practices of compensation assessment for personal injury. The Civil Code, which applies in federal and state courts, requires assessment of damage and award compensation based on a rule of equivalency. Given the generality of this, courts are facing difficulties in making compensation assessments for extra-contractual wrongs that result in personal injury. The problems are related to quantifying reasonable expenses for treatment, determining the amount of disability indemnity, or deciding which kinds of pecuniary losses are included in and excluded from compensation assessment. These problems have caused arbitrary decisions of the courts for personal injury. Variation also exists among court decisions at various levels in determining the extent of harm a claimant sustains and its corresponding compensation. Lack of detailed provisions contributes to such variation, and this calls for legal reform.

Prevalence of malpractice claims after arthroscopic shoulder surgery: analysis of 69,097 procedures from a national registry in Norway

BackgroundSystematic analysis of compensation claims following patient injuries is helpful in improving patient safety. The objective of the current study was to assess compensation claims after arthroscopic treatment of rotator cuff ruptures, impingement, and acromioclavicular joint osteoarthritis reported to the Norwegian System of Patient Injury Compensation and evaluate if there was regional variation on the risk of patient injuries leading to an accepted compensation claim.MethodsData from the Norwegian System of Patient Injury Compensation and the Norwegian Patient Registry (NPR) from 2008 to 2018 were collected. Demographics (age and sex) and type of claim and reasons for accepted claims were obtained from the Norwegian System of Patient Injury Compensation, while the number of arthroscopic procedures was collected from NPR. The treating institutions were grouped on geography according to Norway’s four regional Health Trusts and private institutions and the effect of geography on the probability of an accepted claim was estimated.ResultsNPR registered 69,097 shoulder arthroscopies during the study period, of which 216 (0.3%) compensation claims were filed for patient injury. A total of 38% of the claims were accepted, representing 0.1% of the arthroscopic procedures. Infection (37.8%) was the most common reason for accepted claim, followed by no surgical indication (15.9%) and wrong surgical technique (12.2%). We found a statistically significantly increased odds ratio for a claim being accepted in both the smallest and largest regional Health Trusts compared to the other regional Health Trusts and private institutions.ConclusionsCompensation claims due to patient injury following shoulder arthroscopy are rare (0.3% of patients file a claim, of which a third is accepted (0.1% of all shoulder arthroscopy patients)). The most common reason for accepted claim was infection followed by lack of indication.

Role of Bio-Psychosocial factors in return to work following a compensable knee injury

Objectives The purpose of this study was to examine the relationship between work status and biomedical factors, psychosocial factors, occupational factors, physical disability, and barriers to full recovery. Methods This study was a cross sectional evaluation of workers with an active compensation claim following a work-related injury to the knee joint. Results Data of 60 consecutive injured workers, mean age, 47 ± 14, 40 (67%) males were used for analysis. Thirty-one (52%) patients were unable to work and 29 (48%) patients were working at the time of assessment. Patient’s age, gender, range of motion, and strength did not have a direct relationship with work status (p > 0.05). Obesity had a negative impact on work status (p = 0.035). Depression (p = 0.001), anxiety (p = 0.002), and the fear avoidance of the Optimal Screening for Prediction of Referral and Outcome (OSPRO-YF) scale (p = 0.019) showed higher levels of psychosocial issues in the non-working sample. Patients with 3 or more barriers (p = 0.020) and higher disability score (p = 0.004) showed an inferior work status. Discussion Presence of obesity, depression, anxiety, fear-related beliefs, higher reported disability, and accumulative number of barriers are indicative of poorer recovery and a less successful RTW after an occupational knee injury.

Dental injury offenses and compensation imposed by Spanish courts, before and during Covid-19. A cross-sectional study

Injuries to the dentofacial region caused by third parties can affect physiological, sensory and esthetic functions with legal repercussions. The personal and social circumstances generated by Covid-19 and the governmental measures taken to control it, have increased the risk factors for violence and with it, the resulting injury rate. The aim of the present investigation was to compare the amount of civil liability for dental injury crimes agreed by Spanish courts, in certain Autonomous Communities, before and during the pandemic situation caused by Covid-19. For this purpose, a analytic cross-sectional study was carried out by analyzing sentences from the database of the Judicial Documentation Center. A comparison of means (one-way ANOVA) was used on the amount of compensation between the different years, and between the Autonomous Communities of Madrid, Catalonia Cataluña, Andalusia, the Canary Islands and the Valencian Community. It was observed that the year 2020 stood out for the increase in the number of cases of dental injury offenses. For its part, the Autonomous Community of Andalusia showed the highest amount of compensation during the pandemic, although the highest number of cases corresponded to the Community of Madrid. The statistical analysis yielded a probability of more than 0.05, which eliminated the possibility of significant differences in each of the comparisons.

Domestic Workers in South Africa

After decades of deliberate exclusion from labour laws and social protection in South Africa, domestic workers have slowly been able to taste the fruits of years of laborious fights for recognition, inclusion, and dignity. On 19 November 2020, the Constitutional Court ordered the inclusion of domestic workers in the Compensation for Occupational Injuries and Diseases Act (COIDA). This marked another victory for domestic workers. Textual inclusion is a relatively easier feat compared to the real challenge of implementation to give effect to such inclusion. The monitoring of implementation and progress of domestic workers who have benefitted from this inclusion has been relatively underexplored. This study explores the progress made in the development of social protection followingthe recent inclusion of domestic workers in COIDA, together with the implementation of this law. The article uses desktop research to investigate barriers to the development and implementation of social protection in the domestic work sector. The article highlights the importance of multi-stakeholder collaboration, clear policies from the Department of Labour, and the provision of constructive support for employers in the domestic work sector to facilitate compliance with COIDA.

Perspectives of telehealth access and implementation in people recovering from serious transport injury, health care providers and compensation system staff during the COVID-19 pandemic in Australia

IntroductionBefore the COVID-19 pandemic, few injury compensation schemes supported access to service-delivery via telehealth. The aim of this qualitative study was to explore the perspectives of people recovering from serious transport injury, health care providers, and senior staff of a transport injury compensation scheme, in relation to the uptake and implementation of telehealth during the COVID-19 pandemic, and its ongoing use. MethodsSemi-structured interviews were undertaken with 35 participants, including 15 seriously injured patients, 16 health care providers and 4 compensation scheme staff. A thematic analysis was performed using a framework approach. ResultsThemes identified included the need to provide continuity of care via telehealth during the pandemic for patients recovering from injury, and the associated organisational and technical support needs. It was noted that some types of services worked well via telehealth, including psychology, while others did not, including physical assessments. The convenience of telehealth was highlighted, in relation to reduced travel. However, there were often safety fears relating to falls, and communication issues with injured people. ConclusionsThis research found that the majority of injured patients and health care providers had benefitted from the introduction of service delivery via telehealth during the pandemic for some types of services. Participants saw opportunities for continued benefit post-pandemic, particularly for improving equity of access to health care for people with barriers to mobility and travel.

A review of China's compensation program for adverse reactions following immunization.

Vaccination is a compelling measure to battle infectious diseases and protect public health. However, because of the constraints on human cognition, it is difficult to ensure that vaccines are safe. Adverse reactions to immunization can cause individual injury. In numerous countries, no-fault programs have been established to compensate individuals for vaccine-related injuries. China also established a vaccine injury compensation system with its own unique characteristics. The Vaccine Administration Law was promulgated in 2019 to establish a compensation system for those who experience adverse reactions following immunization; nevertheless, the compensation system is imperfect. Even when the applicable terms are applied to deal with vaccine-related injuries, some issues remain, such as unreasonable diagnosis and evaluation procedures for adverse reactions, excessively strict standards regarding proof and inconsistent compensation standards across the country. Therefore, to provide effective compensation for vaccine recipients, it is important to clarify the standards of proof and establish a sensible vaccine injury compensation system that includes Corona Virus Disease 2019 vaccine-injury compensation.

Construction industry workers’ compensation injury claims due to slips, trips, and falls – Ohio, 2010–2017

Problem: Compared to other industries, construction workers have higher risks for serious fall injuries. This study describes the burden and circumstances surrounding injuries related to compensable slip, trip, and fall (STF) claims from private construction industries covered by the Ohio Bureau of Workers’ Compensation. Methods: STF injury claims in the Ohio construction industry from 2010–2017 were manually reviewed. Claims were classified as: slips or trips without a fall (STWOF), falls on the same level (FSL), falls to a lower level (FLL), and other. Claim narratives were categorized by work-related risk and contributing factors. Demographic, employer, and injury characteristics were examined by fall type and claim type (medical-only (MO, 0–7 days away from work, DAFW) or lost-time (LT, ≥8 DAFW)). Claim rates per 10,000 estimated full-time equivalent employees (FTEs) were calculated. Results: 9,517 Ohio construction industry STF claims occurred during the 8-year period, with an average annual rate of 75 claims per 10,000 FTEs. The rate of STFs decreased by 37% from 2010 to 2017. About half of the claims were FLL (51%), 29% were FSL, 17% were STWOF, and 3% were “other.” Nearly 40% of all STF claims were LT; mostly among males (96%). The top three contributing factors for STWOF and FSL were: slip/trip hazards, floor irregularities, and ice/snow; and ladders, vehicles, and stairs/steps for FLL. FLL injury rates per 10,000 FTE were highest in these industries: Foundation, Structure, and Building Exterior Contractors (52); Building Finishing Contractors (45); and Residential Building Construction (45). The highest rate of FLL LT claims occurred in the smallest firms, and the FLL rate decreased as construction firm size increased. Discussion and Practical Applications: STF rates declined over time, yet remain common, requiring prevention activities. Safety professionals should focus on contributing factors when developing prevention strategies, especially high-risk subsectors and small firms.

Soft law with a hard impact in local China: The role of judicial activism in reducing rural–urban discrimination during traffic casualty litigation

China’s hukou (household registration) system has undergone reforms aimed at addressing the large rural–urban divide. Importantly, it no longer distinguishes between agricultural and nonagricultural hukou. However, this reform is widely interpreted as being ‘soft’ and having little impact on reducing the rural–urban divide due to its symbolic nature. Still, this study takes a legal perspective and conceptualizes the reform as being in the form of soft law. It then applies the theory of judicial activism and proposes that soft law can be actively utilized by local courts in China as a means of reducing the rural–urban divide. Based on a novel dataset of court judgements in traffic dispute lawsuits between 2005 and 2019, this study shows that many local courts, especially in Guizhou, Zhejiang, and Jiangsu Province, have generated a substantial impact of the soft hukou reform: they invoked this reform as the reason for their decision to grant rural traffic casualties equal personal injury compensation rights as urban residents, despite no formal legislation from the national government at the time. These findings underscore the importance of investigating judicial activism at the local level and studying how local courts can creatively utilize soft law to engage in judicial activism and reduce discrimination.

Insight of a headache medicine provider in Indian Health Service: A personal and professional observation

Dr. Larry Charleston IV has received personal compensation for serving as a consultant for Allergan/AbbVie, Alder/Lundbeck, Amneal, Biohaven, Haleon, LinPharma, Satsuma, and Teva; was on the advisory panel for Ctrl M Health (stock); received grant support from the Disparities in Headache Advisory Council; served as an Expert Witness for Vaccine Injury Compensation Program. He is a non-compensated associate editor for Headache: The Journal of Head and Face Pain and serves as a non-compensated Board Member-at-Large for the Clinical Neurological Society of America. Mary Michelle Herne serves as a non-compensated member of the Advanced Practice Provider Committee for Association of Migraine Disorders.

A Prospective Natural History Study of Patients with Adult-Onset Leukoencephalopathy with Axonal Spheroids and Pigmented Glia (ALSP) (S49.008)

A Prospective Natural History Study of Patients with Adult-Onset Leukoencephalopathy with Axonal Spheroids and Pigmented Glia (ALSP) (S49.008)

Anti-IgLON-5 Associated Neurological Disease Presenting with Bilateral Optic Neuritis, Orthostatic Intolerance, Sleep-Related Movements in Setting of Testicular Mass: Expanding Clinical Phenotypes in the Disease. (P5-5.028)

<h3>Objective:</h3> We report a novel presentation of IgLON5-associated neurological disease with possible paraneoplastic phenomena, expanding the clinical phenotypic spectrum of this disorder. <h3>Background:</h3> Anti-IgLON5-associated neurological disease is characterized by neuroinflammatory and neurodegenerative features. Autopsies from advanced cases reveal phospho-tau accumulation in the hypothalamus and brainstem. Clinical features include sleep and movement disorders, bulbar symptoms, dysautonomia and motor neuron disease-like phenotypes. Overlap with progressive supranuclear palsy (PSP-like) is also seen. <h3>Design/Methods:</h3> A fifty-one-year-old man in general good health presented with deficits in visual fields, visual acuity and color vision. Funduscopic examination demonstrated bilateral optic disc edema confirmed by magnetic resonance imaging. Slit-lamp exam demonstrated granular-appearing optic discs and hemorrhagic telangiectasias. Treatment with high-dose steroids with taper was initiated. Early cessation of steroids caused symptom recurrence. New onset disabling orthostatic intolerance, daytime somnolence, sleep apnea, and twitching while sleeping were noted. <h3>Results:</h3> Repeat brain imaging demonstrated partial resolution of optic disc edema. Cerebrospinal fluid evaluation demonstrated normal opening pressure and glucose, 4 nucleated cells, elevated protein (82 mg/dl), and negative neuroinfectious work-up. Cytology showed rare lymphocytes and monocytes. IgLON5 antibodies were identified (1:8 titer). Whole-body PET scan demonstrated FDG-avid lesions in a testicle, with ultrasound demonstrating hypoechogenicity suggestive of infection/trauma vs burned-out tumor, representing a potential paraneoplastic etiology. His treatment regimen was escalated to monthly intravenous Cyclophosphamide infusions over 6 months. <h3>Conclusions:</h3> This patient presented with recurrent bilateral optic neuritis, evolving to develop sleep apnea, daytime hypersomnolence, and involuntary nocturnal movements. IgLON5 antibodies were detected in cerebrospinal fluid. Symptomatic response to immunosuppressive therapy, with symptom relapse on pausing immunosuppression was noted. While oculomotor abnormalities are reported in the disorder, this is a novel presentation of CNII involvement in a patient with IgLON5 antibodies. As understanding of IgLON-5 disease evolves, a low threshold for diagnostic suspicion is emphasized, as treatment may prevent irreversible neuronal damage and subsequent neurodegeneration. <b>Disclosure:</b> Dr. Varma-Doyle has nothing to disclose. Dr. Chwalisz has nothing to disclose. Dr. Linnoila has received research support from NIH/NINDS. Dr. Linnoila has received personal compensation in the range of $10,000-$49,999 for serving as a expert respondent on autoimmune encephalitis with U.S. government/DHHS/vaccine injury compensation program.

Association of Daily Physical Activity with Cervical Spinal Cord Areas in Multiple Sclerosis (S27.009)

Association of Daily Physical Activity with Cervical Spinal Cord Areas in Multiple Sclerosis (S27.009)

VACCINE INJURY COMPENSATION MECHANISM FOR ADVERSE EVENTS CAUSED BY COVID-19 VACCINES IN SOUTHEAST ASIAN COUNTRIES

Adverse events following immunization (AEFI) or vaccine injury is an issue of great concern in many nations, including Malaysia. This issue has long attracted the public's interest, but the emergence of COVID-19 disease has triggered greater interest as nations engaged in mass vaccination programs for their citizens. This is further exacerbated by the growing dissatisfaction with the traditional tort litigation system which necessitates exploring alternative ways to deal with vaccine injury cases. While the vaccine injury compensation program (VICP) has been implemented in several countries to compensate affected individuals following vaccination, not all VICP can cater to public health emergencies, especially regarding vaccine COVID-19. Malaysia, for example, has a similar program known as Special Financial Assistance Vaccine (SFA), which allows individuals to receive financial assistance if they suffer from AEFI COVID-19. Thus, this paper is intended to review and analyse the VICP in Southeast Asian countries and its implementation in Malaysia. This qualitative research was based on document review and comparative methodologies by exploring the VICP in Southeast Asia and similar mechanism in Malaysia to enrich the subject matter of the vaccine COVID-19 liability. The finding shows that the VICP program seems to be a great alternative in dealing with vaccine injury cases, especially in addressing the growing dissatisfaction with the traditional tort litigation system. Malaysia, Singapore and Thailand has its own VICP for affected individuals with COVID-19 vaccines while Myanmar, Cambodia, Timor-Leste, Indonesia, Vietnam, and the Philippines is under COVID-19 vaccine injury compensation scheme by COVID-19 Vaccines Global Access (COVAX) offered in 92 low- and middle-income nations.

Interim Analysis of Subject Impression Data for STS101 From the Phase 3 Open-Label ASCEND Study (P13-12.003)

Interim Analysis of Subject Impression Data for STS101 From the Phase 3 Open-Label ASCEND Study (P13-12.003)