Workmen's Compensation Research Articles

European Society for Surgery of the Shoulder and Elbow (SECEC) rotator cuff tear registry Delphi consensus

The purpose of this study was to establish consensus statements via a Delphi process on the factors that should be included in a registry for those patients undergoing rotator cuff tear treatment. A consensus process on the treatment of rotator cuff utilizing a modified Delphi technique was conducted. Fifty-seven surgeons completed these consensus statements and 9 surgeons declined. The participants were members of the European Society for Surgery of the Shoulder and Elbow committees representing 23 European countries. Thirteen questions were generated regarding the diagnosis and follow-up of rotator cuff tears were distributed, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80%-89% agreement, whereas strong consensus was defined as 90%-99% agreement, and unanimous consensus was defined by 100% agreement with a proposed statement. Of the 13 total questions and consensus statements on rotator cuff tears, 1 achieved unanimous consensus, 6 achieved strong consensus, 5 achieved consensus, and 1 did not achieve consensus. The statement that reached unanimous consensus was that the factors in the patient history that should be evaluated and recorded in the setting of suspected/known rotator cuff tear are age, gender, comorbidities, smoking, traumatic etiology, prior treatment including physical therapy/injections, pain, sleep disturbance, sports, occupation, workmen's compensation, hand dominance, and functional limitations. The statement that did not achieve consensus was related to the role of ultrasound in the initial diagnosis of patients with rotator cuff tears. Nearly all questions reached consensus among 57 European Society for Surgery of the Shoulder and Elbow members representing 23 different European countries. We encourage surgeons to use this minimum set of variables to establish rotator cuff registries and multicenter studies. By adapting and using compatible variables, data can more easily be compared and eventually merged across countries.

Interpretation of the Mental Stress Taxonomy under Nigeria's Employees’ Compensation Act 2010

AbstractPrior to the inception of the Employees’ Compensation Act 2010 (“ECA”), the workers’ compensation system in Nigeria was governed by the Workmen's Compensation Act 1987 (Cap W6 LFN 2004) (“WCA”). The WCA failed to provide an adequate compensation regime for employees, notwithstanding the fact that payment of compensation stems from the employer's duty of care to the employee. Though an employer may be liable for injury, whether physical or mental, sustained by an employee, the WCA, among other things, had no provision for mental stress claims. Neither was the mental health of employees contemplated under its regime. The ECA has sought to close this gap by the provisions of its section 8. Using a comparative perspective, this article examines the dynamics as well as the challenges of applying section 8 of the ECA in the overall interest of the legal system and the labour environment.

Implementing a program to reduce restraint and seclusion utilization in a public-sector hospital: Clinical innovations, preliminary findings, and lessons learned.

The Alternative to Restraint and Seclusion State Incentive Grant was a national initiative to reduce restraint and seclusion use in psychiatric hospitals and community based mental health settings sponsored by the National Association of State Mental Health Program Directors. This initiative was implemented in a large public sector psychiatric hospital. It involved the use of a restraint and seclusion prevention project team and a Patient-Staff Steering Committee collaborating on violence prevention. It also entailed systematic data collection and case reviews, staff-training on trauma-sensitive care and other relevant topics, employee recognition, as well as the use of specific restraint prevention tools including sensory modulation, positive behavioral support plans, comfort rooms, Wellness Recovery Action Plans, modified restraint orders, and new debriefing protocols. Compared with a 4-year baseline period, a 4-year implementation phase showed a reduction in annual restraints hours by 89%, annual staff injuries by 18%, and annual Workmen's Compensation medical costs by 24%. The findings illustrate the value of implementing systemic evidence-based practices to reduce restraint use, enhance the quality of care in tertiary care settings, and promote a new, patient-centered and recovery-oriented institutional culture. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Efficacy of transdermal 4% lidocaine patches for postoperative pain management after arthroscopic rotator cuff repair: a prospective trial.

BackgroundPostoperative pain management continues to be a challenging aspect of patient care. Lidocaine patches have shown efficacy in reducing pain in other surgical specialties and mixed results in orthopedic trials. We sought to determine the effectiveness of nonprescription lidocaine patches in reducing postoperative pain after arthroscopic rotator cuff repairMethodsPatients undergoing primary arthroscopic rotator cuff repair were recruited from 3 surgeons at a single institution. All patients of each surgeon were randomized to a lidocaine patch or control group, with crossover occurring at the midpoint. Experimental group patients received 26 4% lidocaine gel-patches. They were provided written and visual instructions to begin wearing the lidocaine patches during daytime on postoperative day (POD) 2. They were to be switched every 8 hours and removed overnight. Control group patients received normal standard of care but did not receive a placebo control. Exclusion criteria included workmen’s compensation claims, age <18 years, history of myocardial infarction, and history of lidocaine or adhesive allergies. The American Shoulder and Elbow Surgeons shoulder survey was completed preoperatively and 2-, 6-weeks, 3-, 4.5-, and 6-months postoperatively. A 14-day visual analog scale pain and medication log was completed three times daily following repair. All patients received interscalene nerve block with bupivacaine and general anesthesia.Results80 (40 control, 40 lidocaine) patients were enrolled, with 53 completing follow-up. Groups were demographically similar in age (P = .22), gender (P = .20), and body mass index (P = .77). They were similar in tear pattern (P = .95), concomitant acromioplasty (P = .44), concomitant biceps tenodesis (P = .07), and number of anchors used (P = .25). There was no difference in American Shoulder and Elbow Surgeons scores at any time points (range P = .28-P = .97). Reported 14-day pain logs were not different between study groups at any time points (range P = .07-P = .99). There was no difference in opioid consumption in the first 14 days after surgery (P = .38). The lidocaine group reported less satisfaction with their pain management beginning in the evening of POD 2 (P = .05). This continued until the afternoon of POD 8 (P = .03).ConclusionTransdermal 4% lidocaine patches are not effective in reducing pain or opioid consumption after arthroscopic rotator cuff repair and were associated with reduced patient satisfaction.

Intubation and Love, and: Hot Second

Intubation and Love, and: Hot Second Carmen Giménez Smith (bio) Intubation and Love Avert the decay of your glopping bodies at Seattle Grace. You can self-diagnose the inside and outside of each patient. Everyone is the top of their field, and they're always at work. They don't even need apartments and should have created a shared living thing at Meredith's. Seattle Grace is haunted and no one talks about that. Surgeons are gods because they cure us, but these guys don't really cure us because they're not doctors, but mimics. I'm the George Clooney some doctor said some time in the late 20th and he felt better about himself. Meredith's voiceover essentializes disaster. A nurse gets stabbed by an unstable patient who will not be crazy but rather brain-tumored. One of the top surgeons disregards a girl complaining of stomach pain who later spews blood into the air and activating his/her genius and compassion in the nick of time. Hospital procedurals are directly responsible for longer wait times in doctors' offices. I watch the show as if a facet of each character is a piece of Shonda Rhimes. Christina sharpens her teeth on her own brilliance, the cycle of workaholism, for example. She says what we had been holding in for so long. I most love Miranda Bailey's flintiness and ambition and ferocity because she's the one who has to do the most work to establish authority while the male doctors around her all have sex with their students. I interpret this whenever someone says: Someone calculate the cost of the remodeling, the unveilings, all the new signs, the weird socialist clinic, plus workmen's compensation, rampant malpractice, sexual harassment suits, financial mismanagement, humanitarian projects, and the 3D flesh printer. I bet the books aren't square. [End Page 171] In one episode a man shows up with a tree limb in his chest and I lose interest because I'm pretty sure they already did the tree in the chest meaning I already learned this lesson. I get it, Meredith. You fucking save lives. I only need 30% of the show's narcotic effect. Gossip without community. Scandal and Grey's on Hulu while I fold laundry and I can also plot a getaway with my girlfriend, but the boy's things won't pick up themselves, then I have a meeting. The emails won't finish themselves, so I give over my night to words, and the day to the house's body. An E.R. resident gets hit by a bus. A boy gets impaled by a fence, a plane crash kills and maims a bunch of them and they survive with only the broadest and most fleeting strokes of PTSD. A train crash, a character-changing brain tumor, a hostage situation, an explosion, an escaped prisoner. Shonda Rhimes lives by the book, then reinvents it chapter by chapter. Shonda Rhimes invents the twee soliloquy (2005). Shonda Rhimes kills off the entitled woman (2007). More interracial couples in what seems the entire history of television, and effortlessly, or we don't see the effort. The second time I see the first season I see compliance and the edge of her style. Even when I stopped watching, I read the recaps for about three years. They were like Christmas newsletters and I'd sometimes have to google Anatomy Arizona to see a picture. Eventually I missed the visual/aural of Seattle Grace and its plot meat. My mother dazzled me with her ability to anticipate a plot point when I was a little girl. Now I see how they make a story in the shape of my demographic fantasy life. Have you ever tried eating Seventh Seal ? Grey's is like a husband of 100 years. We don't even say a word to one another, just fall asleep at exactly the same time. A patient's backstory helps us decide who dies and who lives. Thanatos. Sometimes chaos kills someone whose death surprise us. Their stories are only allegories. Broken bodies help the surgeons process. How much is Mc Dreamy making? The show's...

'Bottom dog men': Disability, Social Welfare and Advocacy in the Scottish Coalfields in the Interwar Years, 1918-1939.

This article connects with and builds on recent research on workmen's compensation and disability focussing on the Scottish coalfields between the wars. It draws upon a range of primary sources including coal company accident books, court cases and trade union records to analyse efforts to define and redefine disability, examining the language deployed and the agency of workers and their advocates. It is argued here that the workmen's compensation system associated disability with restricted functionality relating to work tasks and work environments. Disability became more visible and more closely monitored and this was a notably contested and adversarial terrain in Scotland in the Depression, where employers, workers and their collective organisations increasingly deployed medical expertise to support their cases regarding working and disabled bodies. In Scotland, the miners' trade unions emerged as key advocates for the disabled.

Examining Legal and Policy Provisions on Silicosis in the Context of Sandstone Mining in Karauli, Rajasthan-India

Present study examines laws and policies on silicosis in context of sandstone mining in Karauli district of Rajasthan. Purposive sampling method was employed to select 217 respondents. FGDs and in-depth interviews were conducted to gather data. Open-ended questionnaires were developed, field tested and, used as FGDs and interviews’ guide. Data were transcribed, themes identified, and interpreted. Results reveal that there is large scale of illegal mining (95%) in a vast area of the district. The Enforcement and regulatory agencies are understaffed, lacks coordination and, capacity; lease allotment process is opaque; unsuitable sites are allotted for the mining. Monitoring and reporting system is complex. Politico-bureaucratic nexus exists. Rudimentary tools used in manual mining without protective gears; rights of the unorganized miners are grossly violated. Compensation is inadequate and hardly reaches to the silicosis victims in full. There is severe shortage of the doctors, diagnostic facilities, and training opportunities. Provisions of Mines Act, 1957, Workmen Compensation Act, 1923 or Factory Act, 1948 are grossly inadequate and outdated in context of sandstone mining in the district. These findings will have far-reaching implication in terms of informed policymaking and legislation on prevention of occupational hazards and protection of the rights of the miners.

Mental Disorder Workmen's Compensation

Mental Disorder Workmen's Compensation

Applying Lean Six Sigma tools to reduce the rate of slips, trips and falls for Joint Commission field staff

This paper presents how the Lean Six Sigma DMAIC methodology and change management tools are used to reduce the rate of slips, trips and falls (STFs) for Joint Commission field staff. The data sources included Workmen's Compensation claims data and an online survey (N = 453, response rate = 64%) administered to field staff who reported workplace STFs. The metric for this project: Falls per opportunity based upon 1,000 surveyor days had a pre-intervention (1/2007-4/2010) rate of field staff STFs of 0.339 and a post-intervention (5/2010-2/2014) rate of field staff STFs of 0.116 per 1000 surveyor days. Multiple risk factors are associated with field staff STFs consisting of environmental factors and individual behaviours. Targeted solutions included seasonal e-mails to raise staff awareness on footwear and changing weather conditions, as well as an informational pamphlet about the risks associated with walking surface conditions, carrying work-related or personal items, and type of luggage used.

임금근로자의 산업재해에 대한 성인지적 분석

The statistics of occupational injuries and illnesses is one of the most important indicators of worker's safety and health in the field of occupational safety and health. The conventional statistics was produced without consideration of gender difference. This study was planned to investigate the difference of occupational injuries and illnesses by gender because that recently female workers was increased through the change of industrial structure such as from manufacturing dominated to service dominated structure. Statistics of occupational injuries and illnesses collected by workmen's compensation insurance system that have no information about gender composition of population. Economically active population survey was used to calculated the rate of occupational injuries and illnesses by gender. The distribution of estimated rate of occupational injuries and illnesses by industry, occupation and the type of accident were different between male and female employees, but those by the size of enterprise, age of the injured, the duration of the first recuperation, and job tenure were similar between male and female employees. This study has shown that gender sensitive approach may be applied to policy of occupational safety and health because that gender neutral perspective may not discover the fact of gender specific problems.

Trends and Characteristics of Occupational Injuries in Thailand, 2002-2010

Occupational injuries are important health problems in Thailand and cause significant health impacts on workers, in addition to economic loss. Data was obtained and analyzed from National Injury Surveillance (NIS) System for describing epidemiology of agricultural injuries and from Workmen's Compensation Fund (WCF) statistics for identifying trends and characteristics of injuries and deaths in industrial and business workers during the period of 2002-2010. Results from NIS showed that 17,481 agricultural injuries were reported and accounted for 16.9% of all injuries, with 96 deaths (case fatality rate of 0.5 per 100 workers). Leading causes of occupational injuries were struck by thrown or falling object, fall from height and contact with agricultural machinery. Most cases occurred in the afternoon during 1-6 pm (44.2%). The WCF statistics revealed that rates of injuries among industrial workers had decreased from 31.4 per 1,000 workers in 2002 to 16.5 per 1,000 workers in 2010. Young workers aged 20-29 years old (46.4%) were more likely to get injured and die than that of other age groups. Puncture and penetrating wounds were the most common injuries (41.0-43.9%). Leading causes of deaths were vehicle accident, fall from height and unintentional electrocution. The outcomes of this study could be used to develop guideline and strategy on surveillance system and prevention of occupational injuries in Thailand.

The emergency department, injury control, and safety promotion

Historically, accident and emergency services were provided by workmen's compensation plans, railway companies, and municipalities in the United States and most European countries. It was not until...

The Unorganized Workers Social Security Act, 2008 - An Approach to Provide Basic &amp; Contingent Social Security to the Unorganized Workers in India

The Unorganized Workers Social Security Act, 2008 - An Approach to Provide Basic &amp; Contingent Social Security to the Unorganized Workers in India

Industrial Distributions of Severe Occupational Injuries among Workers in Thailand

In industrializing countries, occupational safety and health have been affected by globalization. However, a lack of reliable data prevents evaluation of this situation. Therefore, we examined industrial distributions and risks of severe occupational injuries among workers in Thailand, which is one of the few industrializing countries that compiles nationwide data. Data on workers who made claims for occupational injuries from 2007 to 2009 were extracted from the Workmen's Compensation Fund records in Thailand. Among 501,334 claimants, we evaluated the industrial distributions of severe occupational injuries (i.e., permanent disability and death). We then examined the associations between industry and those injuries, using proportionate ratios (PRs) between each industrial category and the overall distribution of occupational injuries. The number of workers in manufacturing making claims for severe occupational injuries was the largest among all industrial categories (319,114/501,334 injuries), although the total number of occupational injuries recently declined. Additionally, workers in manufacturing experienced severe occupational injuries more often compared with the overall distribution of occupational injuries. The PRs (95% confidence interval) for manufacturing were 1.17 (1.14-1.20) in men and 1.33 (1.27-1.38) in women. After adjusting for individual characteristics, the results did not substantially change. Manufacturing seems to have the largest burden of occupational injuries in industrializing countries like Thailand.

Non-spinal musculoskeletal malpractice suits against radiologists in the USA—rates, anatomic locations, and payments in a survey of 8,265 radiologists

The objective of this study was to present the characteristics of non-spinal musculoskeletal malpractice suits with attention to rates, anatomic location, and payments in a survey of 8,265 radiologists. The malpractice histories of 8,265 radiologists from 36 states were evaluated from credentialing data required of all radiologists participating in the network of One Call Medical, Inc., a broker for imaging tests in workmen's compensation cases. Twenty six hundred of the 8,265 radiologists (31.5 %) had at least one suit. Of the 4,741 total claims, 627 (13.2 %) were related to the bones and soft tissues. Four hundred seventeen (66.1 %) of them involved the musculoskeletal system other than the spine. A cause was known for 400. Of these, 91.8 % (367/400) resulted from an alleged failure to diagnose. The foot was the most common site with a rate 6.00 cases/1,000 radiologist's person years (95 % confidence interval (CI), 4.68-7.68), and the hip was second with a rate of 5.30 cases/1,000 person years (95 % CI, 4.15-6.76). The highest median payment related to ankle injuries with a median settlement of $72,500 (interquartile range (IQR), $40,000-$161,250). The state in which the highest median settlement occurred was Maryland ($125,000; IQR, $95,000-$230,000)) whereas Utah had the highest rate of suits (5.24 cases per 1,000 person years; CI, 3.03-9.04). Claims regarding foot and hip injury were the most common, but ankle settlements incurred the highest awards.

Spinal-related malpractice suits against radiologists in the USA—rates, anatomic location, percent of adverse judgments, and average payments

To present overall rates, anatomic location, percent of adverse settlements to the radiologists, and average payments to the plaintiff in spinal-related malpractice suits in a survey of 8,265 radiologists. The malpractice histories of 8,265 radiologists from 36 states were evaluated from credentialing data required of all radiologists participating in the network of One Call Medical Incorporated, a broker for CT/MR in workmen's compensation cases. Two hundred twenty-six of the 8,265 radiologists (31.5%) had at least one suit. Of the 4,741 total claims, 627 (13.2%) were related to the bones and adjacent soft tissue. Two hundred and ten (32.9%) involved the spine. Of these, 70.2% (134/191) were settled in favor of the plaintiff. One hundred and sixteen (68.2%) involved the cervical spine with an average settlement of $483,156. Lumbar cases accounted for 28 (16.5%) of spinal suits, with an average settlement of $119,272. Thoracic cases (26) accounted for only 15.3% of spinal cases and had an average settlement of $481,608. An allegation of spinal malpractice resulting in a settlement or judgment against the radiologist occurred at a rate of 29.5 cases per 1,000 radiologists' person years. Of the three spinal regions, the cervical spine was the most frequent anatomic site of a malpractice suit and among all those cases settled incurred the highest payment in judgment to the plaintiff.

Historical review of the List of Occupational Diseases recommended by the International Labour organization (ILO)

The list of occupational diseases established in the international and national legal system has played important roles in both prevention of and compensation for workers’ diseases. This report reviewed the historical development in the ILO list of occupational diseases and suggested implications of the trends. Since the first establishment of the ILO list of occupational diseases in 1925, the list has played a key role in harmonizing the development of policies on occupational diseases at the international level. The three occupational diseases (anthrax, lead poisoning, and mercury poisoning) in the first ILO list of occupational diseases, set up in 1925 as workmen’s compensation convention represented an increase of occupational diseases from the Industrial Revolution. Until the 1960s, 10 occupational diseases had been representative compensable occupational diseases listed in Convention No. 121, which implies that occupational diseases in this era were equated to industrial poisoning. Since 1980, with advancements in diagnostic techniques and medical science, noise-induced hearing loss, and several bronchopulmonary diseases have been incorporated into the ILO occupational list. Since 2002, changes in the structure of industries, emerging new chemicals, and advanced national worker’s compensation schemes have provoked the ILO to revise the occupational disease list. A new format of ILO list appended in Recommendation 194 (R194) was composed of two dimensions (causes and diseases) and subcategories. Among 50 member states that had provided their national lists of occupational diseases, until 2012 thirty countries were found to have the list occupational diseases having similar structure to ILO list in R194.

"When the pain won′t wane it′s mainly in the brain"

Chronic pain syndromes either have no underlying organic explanation, or include patients whose chronic pain complaints (without focal deficits or significant radiographic findings) were not alleviated by surgery (in 80% of cases). Patients with chronic pain typically “turn off” members of the medical community; they are often “written off” as malingerers or psychiatric cases. The Minnesota Multiphasic Personality Inventory often shows elevations on the hysteria and hypochondriasis scales; together these constitute somatization defined as patients converting emotional distress into bodily complaints. Depression, anxiety, and borderline personality disorders are also often encountered. Secondary gain also plays a critical role in patients with chronic pain syndromes (e.g., includes avoiding onerous tasks/work, or rewards opioid-seeking behaviors). Tertiary gain pertains to the physicians’ financial rewards for administering ineffective and repeated treatment of these patients, while validating for the patient that there is truly something organically wrong with them. Self-mutilation (part of Munchausen Syndrome/Fictitious Disorders) also brings these chronic pain patients to the attention of the medical community. They are also often involved in the legal system (e.g., workmen's compensation or tort action) that in the United States, unfortunately financially rewards “pain and suffering.” The main purpose of this commentary is to reeducate spinal surgeons about the pitfalls of operating on patients with chronic pain syndromes in the absence of significant neurological deficits or radiographic findings, as such “last ditch surgery” invariably fails.

LIFTS: Lowering Injuries for Transfer Safety

More than 10% of nurses have had injuries that have allowed them to file workmen's compensation claims nationally. Ceiling mounted lifts are proven to reduce staff injuries and improve patient safety. Our hospital supports the use of ceiling mounted lifts to prevent injury in inpatient and outpatient settings. To renew our commitment to both patient and staff safety, our labor and delivery unit installed ceiling mounted lifts in every labor room and obstetric operating room. Laboring patients are immobilized with regional anesthesia requiring nurses to assist with all activities.

Assessing sub-optimal performance with the Test of Memory Malingering in Spanish speaking patients with TBI

Primary objectives: To examine the clinical utility of the Test of Memory Malingering (TOMM) with US Spanish speaking patients diagnosed with traumatic brain injury (TBI).Research design: The demographic characteristics and neuropsychological functioning of Spanish speaking patients with TBI with valid vs suboptimal performance were compared.Methods and procedures: Demographic and neuropsychological data were retrospectively collected from charts of patients who underwent neurocognitive evaluations for clinical, med-legal and workmen's compensation purposes. Slick et al. criteria for malingered neurocognitive dysfunction were employed for clinical determination of the validity of participants’ neuropsychological profiles, resulting in 16 valid and four suboptimal performers.Main outcomes and results: Valid performers obtained significantly greater scores than suboptimal performers on all trials of the TOMM and generally demonstrated less impairment across neuropsychological domains. The traditional cut-off score for the TOMM misclassified 18.8% of participants not suspected of malingering and lower levels of education appeared to reduce performance on this measure within the valid group.Conclusions: The current findings generally support the use of the TOMM with US primarily Spanish speaking patients diagnosed with TBI. However, caution is recommended when utilizing this measure with individuals having minimal levels of education. Future research with a larger sample and a non-neurological age- and education-matched sample should investigate lower cut-off scores for use with such patients.