Injury Compensation Claims Research Articles

Screening for feigning in a civil forensic setting

This study compared the effectiveness of the Structured Inventory of Malingered Symptoms (SIMS; Widows & Smith, 2005) and the Miller Forensic Assessment of Symptoms Test (M-FAST; Miller, 2001) at screening for feigned psychiatric and neurocognitive symptoms in 308 individuals undergoing neuropsychiatric evaluation for workers' compensation or personal injury claims. Evaluees were assigned to probable feigning or honest groups based on results from well-validated, independent procedures. Both tests showed statistically significant discrimination between probable feigning and honest groups. Additionally, both the M-FAST and SIMS had high sensitivity and negative predictive power when discriminating probable psychiatric feigning versus honest groups, suggesting effectiveness in screening for this condition. However, neither of the procedures was as effective when applied to probable neurocognitive feigners versus honest groups, suggesting caution in their use for this purpose.

The psychology of injured workers: Health and cost of vocational rehabilitation

In the vocational rehabilitation of injured workers the influence of the worker's personality has been neglected. This is despite there being substantial evidence that in chronic pain certain personality factors are significantly related to poorer outcomes. This is a preliminary study that has examined the relationship between personality factors, personality psychopathology and rehabilitation outcomes in injured workers. Data from structured clinical interviews, self report and rehabilitation outcome (cost) were gathered from 36 injured workers with recognized compensation claims for physical and/or psychological workplace injury. Personality factors were associated with poorer outcome, particularly cost and health. Individuals with extreme personality traits experienced poorer health and vocational rehabilitation outcomes. The combination of high Neuroticism and low Extraversion which is a pattern often characterized as anxious and socially avoidant was found to be consistently related to poor health outcomes. The results indicate that considering the type of personality characteristics of injured workers may have important theoretical and practical implications.

Magnetic Resonance Imaging for Low Back Injuries

Workers' compensation claims resulting from low back injuries are a major concern for U.S. employees and employers. Employees seek resolution of their injuries and related symptoms and rapid return to gainful employment. Employers are eager to help them, as they must absorb the health care and disability costs incurred. Health care providers involved with workers' compensation claims are charged with providing appropriate services to meet the needs of both employees and employers. Magnetic resonance imaging has become the gold standard for diagnosing low back injuries. This study provided data necessary for health care providers to design protocols using magnetic resonance imaging in managing workers' compensation claims for low back injuries.

Alcohol consumption and incidence of workers' compensation claims: a 5-year prospective study of urban transit operators.

Numerous studies have linked alcohol impairment on the job to occupational injury. Few studies have looked at the association of nonwork drinking and occupational injury. This study examines first workers' compensation claims after a baseline assessment of alcohol consumption and other occupational variables in 1836 transit operators participating in a medical examination for driver's license renewal. A proportional hazard model was used for the analysis. Individuals with higher alcohol consumption were more likely to be male, have more years of driving, and have a higher job-stress score. When these variables were controlled for, individuals with higher alcohol consumption were more likely to have a workers' compensation claim over the follow-up period. Individuals reporting a consumption of 10 to 14 drinks per week had a hazard of 1.30 (p = 0.03), and those reporting 15 or more drinks per week had a hazard of 1.27 (p = 0.05) compared with individuals reporting no drinks consumed per week. This study indicates that drinking off the job is associated with workers' compensation injury claims. Because it is presumed that most drinking was done outside work, due to high public scrutiny of city transit operators, these results suggest that experience in life outside of work may influence work outcomes. Research should be conducted to identify the mechanisms (e.g., drinking before work, hangover, fatigue) of such effects.

The relationship between safety climate and injury rates across industries: The need to adjust for injury hazards

Previous studies have suggested that strong safety climates (shared perceptions of safe conducts at work) are associated with lower workplace-injury rates, but they rarely control for differences in industry hazards. Based on 33 companies, we assessed its association with injury rates using three rate based injury measures (claims per 100 employees, claims per 100,000 h worked, and claims per US$ 1 million payroll), which were derived from workers’ compensation injury claims. Linear regression models were used to test the predictability of safety climate on injury rates, followed by controlling for differences in hazard across industries gauged by national industry-specific injury rates. In the unadjusted model, company level safety climate were negatively and significantly associated with injury rates. However, all of the above associations were no longer apparent when controlling for the hazardousness of the specific industry. These findings may be due to over adjustment of hazard risk, or the overwhelming effects of industry specific hazards relative to safety climate effects that could not be differentiated with the statistical power in our study. Industry differences in hazard, conceptualized as one type of injury risk, however need to be considered when testing the association between safety climate and injury across different industries.

Workers' Compensation Claims for Needlestick Injuries Among Healthcare Workers in Washington State, 1996-2000

To characterize accepted workers' compensation claims for needlestick injuries filed by healthcare workers (HCWs) in non-hospital compared with hospital settings in Washington State. Descriptive study of all accepted workers' compensation claims filed between 1996 and 2000 for needlestick injuries. All Washington State HCWs eligible to file a state fund workers' compensation claim and those who filed a workers' compensation claim for a needlestick injury. There were 3,303 accepted state fund HCW needlestick injury claims. The incidence of needlestick injury claims per 10,000 full-time-equivalent HCWs in hospitals was 158.6; in dental offices, 104.7; in physicians' offices, 87.0; and in skilled nursing facilities, 80.8. The most common mechanisms of needlestick injury by work location were as follows: for hospitals, suturing and other surgical procedures (16.7%), administering an injection (12.7%), and drawing blood (10%); for dentists' offices, recapping (21.3%) and cleaning trays and instruments (18.2%); for physicians' offices, disposal (22.2%) and administering an injection (10.2%); and for skilled nursing facilities, disposal (23.7%) and administering an injection (14.9%). Nurses accounted for the largest (29%) proportion of HCWs involved, followed by dental assistants (17%) and laboratory technicians and phlebotomists (12%) in non-hospital settings. Rates of needlestick injury claims increased for non-hospital settings by 7.5% annually (95% confidence interval [CI95], 4.89% to 10.22%; P < .0001). Rates decreased for hospital settings by 5.8% annually, but the decline was not statistically significant (CI95, -12.50% to 1.34%; P < .1088). HCWs were exposed to hepatitis B, hepatitis C, and human immunodeficiency viruses in non-hospital settings. There was a difference in the incidence rate and mechanisms of needlestick injuries on review of workers' compensation claim records for HCWs in non-hospital and hospital settings.

The Anti-Vaccination Movement in England, 1853–1907

The Anti-Vaccination Movement in England, 1853–1907

Silica Sampling and Analysis: Legal Issues Evolving from Regulatory Standards and the Role of ASTM E 1132

Abstract Regulation of crystalline silica is a current priority on the rulemaking agendas of both the Occupational Safety and Health Administration (OSHA) and the Mine Safety and Health Administration (MSHA). OSHA's draft standard has raised issues concerning which sampling and analytical procedures will be incorporated into the new regulation, and utilization of ASTM E 1132 is being considered as part of a comprehensive regulatory scheme for respirable crystalline silica. Citations supported by governmental determinations form the basis for “negligence per se” findings in tort litigation and constitute evidence of overexposure relative to worker's compensation and personal injury claims. This paper analyzes health issues associated with crystalline silica exposure, the rise of silica-related tort litigation, regulatory developments at the federal governmental level, the role of voluntary consensus standards, and recommendations for remedial action to minimize risk of harm to workers and the general public.

Examining the associations between physical work demands and work injury rates between men and women in Ontario, 1990–2000

Aims: To describe the decline in injury rates between 1990 and 2000 within occupations stratified across three levels of physical demands and gender, adjusting for industry, in Canada’s largest province....

Establishing the Possible Radiogenicity of Morbidity and Mortality from Participation in UK Nuclear Weapons Development

To succeed in compensation claims for radiogenic injuries induced by their participation in the United Kingdom's atomic and nuclear weapons tests of the 1950s and 1960s, the 22,000 nuclear test veterans will have to satisfy Hill's Principles of Causation. Although they are blocked by legal restraints from suing the Crown, the evidential case for the veterans has been strengthening in recent years to a point where it would probably succeed in a UK court of law. The delay in mounting such a case has worked in favour of the veterans; if the legal constraints are removed, their chances of success are greater than if they had gone into court a decade ago. The article examines the evidence in support of their claims in relation to each of Hill's Principles.

The Effects of a Back-Belt on Lumbar Disc Deformation During Stoop Type Lifting

2367 Low-back pain and injury are responsible for a major portion of lost workdays and injury compensation claims. The use of back support belts has been forwarded as a counter measure towards reducing low-back injuries in the industrial setting. PURPOSE: The purpose of this study was to determine if a back support belt relieves stresses encountered by the lumbar spine during stoop type lifting and potentially reduce the risk of injury. METHODS: Twelve male subjects (49.7 ± 3.7 years) performed two sessions of stooped type lifting with a loaded milk crate (11.5 kg), at 4 repetitions per minute, for 15 minutes in accordance with the NIOSH lifting equation. One lifting session was performed without a support belt, while the other with a support belt. Three sets of fluoroscopic images were collected with the subjects positioned at the initiation (flexed trunk), mid-range, and completion of the lift (erect standing). The first series of images were collected under a no-load condition, while the second (no support belt) and third series (support belt) of images were collected with the subjects lifting the 11.5 kg milk crate. Images were imported into AutoCAD where lumbar disc deformation and joint angles were measured by calculating changes in position of adjacent vertebra (L3-4 and L4-5). A reduction of disc deformation was deemed indicative of reduced stress. RESULTS: Analysis of variance revealed that compressive and shear disc deformation were reduced while in the erect trunk posture for the support belt condition (p< .05). No significant reduction in disc deformation was detected while in flexed trunk postures for the support belt condition (p>.05). CONCLUSIONS: During stoop type lifting, support belts provide a measurable amount of stress reduction of the lumbar spine when the trunk is in the erect posture, with little effect during flexed trunk positions.Figure

The Effects of a Back-Belt on Lumbar Disc Deformation During Stoop Type Lifting

2367 Low-back pain and injury are responsible for a major portion of lost workdays and injury compensation claims. The use of back support belts has been forwarded as a counter measure towards reducing low-back injuries in the industrial setting. PURPOSE: The purpose of this study was to determine if a back support belt relieves stresses encountered by the lumbar spine during stoop type lifting and potentially reduce the risk of injury. METHODS: Twelve male subjects (49.7 ± 3.7 years) performed two sessions of stooped type lifting with a loaded milk crate (11.5 kg), at 4 repetitions per minute, for 15 minutes in accordance with the NIOSH lifting equation. One lifting session was performed without a support belt, while the other with a support belt. Three sets of fluoroscopic images were collected with the subjects positioned at the initiation (flexed trunk), mid-range, and completion of the lift (erect standing). The first series of images were collected under a no-load condition, while the second (no support belt) and third series (support belt) of images were collected with the subjects lifting the 11.5 kg milk crate. Images were imported into AutoCAD where lumbar disc deformation and joint angles were measured by calculating changes in position of adjacent vertebra (L3-4 and L4-5). A reduction of disc deformation was deemed indicative of reduced stress. RESULTS: Analysis of variance revealed that compressive and shear disc deformation were reduced while in the erect trunk posture for the support belt condition (p< .05). No significant reduction in disc deformation was detected while in flexed trunk postures for the support belt condition (p>.05). CONCLUSIONS: During stoop type lifting, support belts provide a measurable amount of stress reduction of the lumbar spine when the trunk is in the erect posture, with little effect during flexed trunk positions.Figure

Quantification and risk analysis of occupational burns: Oregon workers' compensation claims, 1990 to 1997.

This study examined all accepted Oregon workers' compensation claims for occupational burn injuries during the period of 1990 to 1997 (N = 3,158). The Current Population Survey was used to derive employee population baselines for establishing rate estimates. It was estimated that the average occupational burn claim rate was 2.89 per 10,000 workers (95% confidence interval [CI] 2.76, 3.02). The majority of claimants (71.7%) were males, the largest proportion (32.6%) was aged 25 years or less, and almost half (48.7%) had less than 1 year of job tenure. The most frequent burn type cited was heat/scald burns (78.9%) followed by chemical burns (19.3%). Costs averaged over 1.6 million dollars annually. The average indemnity period was 16 days. Higher relative risks were found for evening workers (2.97, 95% CI 2.96, 2.98) and night workers (2.13, 95% CI 2.12, 2.13) compared with dayshift workers. Kitchen workers had the highest burn rate of all occupations, with 62.5 claims per 10,000 workers.

Methodologic issues in the use of workers' compensation databases for the study of work injuries with days away from work. I. Sensitivity of case ascertainment.

Case ascertainment costs vary substantially between primary and secondary data sources. This review summarizes information on the sensitivity of state administrative databases in workers' compensation systems for the ascertainment of days-away-from-work (DAFW) work injuries for use in modeling studies. Review of the literature supplemented by data from governmental or organizational reports or produced for this report. Employers currently appear to provide workers' compensation insurance coverage for 98.9% of wage and salary workers. Wage and salary jobs account for approximately 90% of jobs in the United States. In industries such as manufacturing, the fraction of covered jobs is probably closer to 98%. In Minnesota, the number of DAFW cases ascertained by the Bureau of Labor Statistics' annual survey of occupational injuries and illnesses is approximately 92-97% concordant with the number of wage compensation claims for injuries producing DAFW over the period 1992-2000, once adjustments are made to permit direct comparisons of the numbers. The workers' compensation databases provide information for more than 95% of the total DAFW resulting from work injuries. Covariate estimates are unaffected by this less than 5% loss because effects appear dependent on time from injury. Statewide workers' compensation administrative databases can have substantial utility for epidemiologic study of work injuries with DAFW because of their size, using high sensitivity for case ascertainment as the evaluative criterion.

Insurance Company and Car Crash Related Person Injury Compensation Claims

Insurance Company and Car Crash Related Person Injury Compensation Claims

Non-fatal injuries in the West Virginia logging industry: using workers' compensation claims to assess risk from 1995 through 2001.

The logging industry has a high rate of both fatal and non-fatal injuries in comparison to other industries, and plays a vital role in WV's economy. Workers' compensation (WC) injury claims and employment data were summarized to examine patterns and rates of non-fatal logging injuries in WV from 1995 through 2001. The average annual rate of injury claims was 16.0 per 100 workers per year with rates remaining relatively steady over the 7-year study period. The highest rates of injury were a result of being struck by an object, typically trees, snags, or logs. WV loggers most often file injury claims as a result of being struck by trees and tree parts, snags, and logs. Assessment of risk is a critical component in helping regulators, researchers, and the logging industry develop viable prevention strategies to reduce the incidence and severity of logging-related injuries.

Declining trends in work-related morbidity and disability, 1993-1998: a comparison of survey estimates and compensation insurance claims.

This study compared trends in the incidence of work-related morbidity and disability across 3 sources of surveillance data in a Canadian province. Time series estimates of workplace injuries and work-related disability based on 2 panel surveys in the province of Ontario, Canada, for the period 1993-1998 were compared with rates of work-related injury and illness compensation claims during the same period. Lost-time compensation claims declined by 28.8% over this 6-year period. The incidence of self-reported work-related injury declined by 28.2%, and the self-reported incidence of work absence for work-related causes declined by 32.2%. Parallel reductions in work-related morbidity were seen in 3 independent data sources. These results support an interpretation that there has been an important reduction in injury risk in Ontario workplaces over the past decade.

Assessment of the scientific basis for genetic testing of railroad workers with carpal tunnel syndrome.

In 2000, approximately 20 railroad track workers who filed injury reports or compensation claims for carpal tunnel syndrome were tested by their employer for two genetic traits to determine the work relatedness of the condition. The testing involved deletions, variants, or mutations in the genetic coding for peripheral myelin protein (PMP22) and transthyretin (TTR). This article is an assessment of whether there is a scientific basis for such testing. A review of the scientific literature indicated that neither the scientific basis nor the population validity of the PMP22 or TTR tests for carpal tunnel syndrome were adequately established before use on railroad track workers in 2000. Although ethical and legal issues may predominate in this case, the absence of a compelling scientific basis undermines the decision to conduct the tests.

THE RELATION BETWEEN TRUNK STRENGTH MEASURES AND LUMBAR DISC DEFORMATION DURING STOOP TYPE LIFTING

Low-back pain and injury are responsible for a major portion of lost workdays and injury compensation claims. Strong well-conditioned trunk musculature has been forwarded as a counter measure towards reducing low-back injuries in the industrial setting. PURPOSE The purpose of this study was to determine if strong well-conditioned trunk muscles relieve stresses encountered by the lumbar spine during stoop type lifting and thus reduce the risk of injury. METHODS Twelve male subjects (49.7+3.7 years) performed a session of stoop type lifting with a loaded milk crate (11.5 kg), at 4 repetitions per minute, for 15 minutes in accordance with the NIOSH lifting equation. Lateral fluoroscopic images of the lumbar spine were collected prior to and following the lifting session. Fluoroscopic images were collected with the subjects positioned at the initiation (flexed trunk), mid-range, and completion of the lift (erect standing). The initial series of images were collected under a no-load condition, while the second series were collected with the subjects holding the 11.5 kg milk crate. Images were imported into AutoCAD where lumbar disc deformation and joint angles were measured by calculating changes in position of adjacent vertebra (L3–4 and L4–5). A reduction of disc deformation was deemed indicative of reduced stress. Trunk extension and flexion strength were measured with a Kin Com isokinetic dynamometer. Trunk flexion endurance was measured via a 60 second curl-up test. Trunk strength and endurance were compared to disc deformation and joint angles to determine if any meaningful relationships existed. RESULTS A significant inverse relationship was detected (p < .05) between: abdominal strength and shear deformation (flexed trunk positions), abdominal endurance and shear deformation (erect trunk), and spinal erector strength and L4-L5 joint angle (erect trunk). CONCLUSIONS Strong well-conditioned trunk musculature is associated with reduced lumbar disc deformation and presumably less stress on the lumbar spine.

Insurance Company and Car Crash Related Person Injury Compensation Claims

AbstractThe authors studied the results of whiplash related law suits in the Swedish legal system, comparing the plaintiff's and the insurance defense. Two analyses were performed, one on cases during 1999–2000 at the district court in Stockholm, and one on appeal verdicts to the court of appeal (Svea hovratt) during January 2000 to June 2002. The results demonstrated that a plaintiff in the Swedish system is at a disadvantage with regard to attorney experience, qualifications of experts, and accountability of experts. Plaintiffs prevailed in 36% of the cases, while defense won 64% of the time.