Category Archives: Health

NPR: Brain Affects Pain

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Brain_powerPain and chronic pain is a topic that many of our clients experience as a reality every day. This fairly recent National Public Radio report gives more details about what some of the research shows in reference to the brain and pain.

Although the headline in the original article is a flop, as people are often wrongly told “it’s all in your head,” the brain is a really important part of how the body feels, understands, and reacts to pain.

There are some potential lessons to be applied to injured workers, clients with personal-injury cases, and others who are associated with our law firm. However, as is the case with all research, be sure to speak with both your lawyer and medical professionals who know about your situation before making changes to a treatment plan.

“Our perception of pain is shaped by brain circuits that are constantly filtering the information coming from our sensory nerves, says David Linden, a professor of neuroscience at Johns Hopkins University and author of the new book ‘Touch: The Science of Hand, Heart, and Mind,’” according to the NPR article.

But sometimes those filters work differently than expected, such as when Complex Regional Pain Syndrome affects a client, an issue written about on this blog by firm partner Todd Bennett.

“The brain also determines the emotion we attach to each painful experience, Linden says. That’s possible, he explains, because the brain uses two different systems to process pain information coming from our nerve endings.

“One system determines the pain’s location, intensity and characteristics: stabbing, aching, burning, etc.

“‘And then,’ Linden says, ‘there is a completely separate system for the emotional aspect of pain — the part that makes us go, “Ow! This is terrible.” ’

“Linden says positive emotions — like feeling calm and safe and connected to others — can minimize pain. But negative emotions tend to have the opposite effect,” according to the NPR article.

A study that associate Jon Rehm recently referenced showed how the context of being appreciated at work made a difference to certified nursing assistants who were injured at work.

“… Higher-paid CNAs were injured less frequently than lower-paid CNAs. The study indicated that organizational factors really drove injury rates among CNAs. In other words, in settings where CNAs are truly valued, paid fairly and trained, the injury rates are lower. But if CNAs are treated as low-wage, high-turnover cogs in a machine, then injury rates are higher,” according to his blog post.

Finally, according to the NPR article, there is some evidence that because of how the brain interacts within different parts of itself, “that at least some people can teach their brains how to filter out things like chronic pain, perhaps through meditation,” said Stephanie Jones, an assistant professor of neuroscience at Brown University.

If you have questions about how this information can apply to your situation, please contact an experienced lawyer.

Why CNAs and Home Health Aides Should Care about the Fight over a Federal Regulation

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090429-A-0868C-005A U.S. District Court in Washington, D.C., recently struck down a federal regulation that would mandate that home health aides are paid the minimum wage and paid overtime under the federal Fair Labor Standards Act (FLSA). Though the decision will likely be appealed, this decision is still a bad decision for the men and women who do the hardest jobs in health care – home health aides and certified nursing assistants.

Why home health aides aren’t covered by federal wage laws

Home health aides were exempted from the FLSA 40 years ago in order to make caring for the elderly less expensive. However, companion care has become a big and very profitable business. An index of publically traded home-health-care stocks has consistently outperformed the stock market as a whole for the last 13 years. This profitably is due in part to the minimum wage and overtime exemptions for home health aides.

How the home health exception affects other jobs in the medical field

The federal government estimates that nearly 1 million are employed as home health aides, while private sources estimate that number as 2 million. Home health is also a fast-growing field of employment. Home health aides essentially have the same job duties as certified nursing assistants (CNAs). CNAs are generally covered by minimum wage and overtime laws, but workers with the same skills and same duties are exempt from those laws if they are working as home health aides. CNA wages are pushed down by home health aide wages, which are exempt from federal wage laws.

Why pay is about more than wages

A recent study of CNAs showed that nearly 60 percent of CNAs report injuries during a 12-month period. The injury rate is similar for home health aides. The study also showed that higher-paid CNAs were injured less frequently than lower-paid CNAs. The study indicated that organizational factors really drove injury rates among CNAs. In other words, in settings where CNAs are truly valued, paid fairly and trained, the injury rates are lower. But if CNAs are treated as low-wage, high-turnover cogs in a machine, then injury rates are higher. Low pay for CNAs and home health aides isn’t just an issue for employees. Low pay for home health aides and CNAs has been linked to poor patient care.

While the Obama administration has been criticized for being too aggressive in enforcing the FLSA, the U.S. Department of Labor announced that they will delay enforcement of the home health aide regulation until July 2015. This assumes courts will let the Department of Labor actually enforce the regulation. Anyone concerned about this issue should contact their members of Congress to support legislation that ends the home health aide exception. People should also contact their state legislators to support legislation that would ensure that home health aides are covered by state wage and hour laws.

Sick Leave Should Be Accessible to All

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Amid the debate about flu and immunizations and preventable diseases lurks a societal problem that’s getting more attention lately and directly affects the spread of those medical crises: paid sick leave for employees.

Although discussing the consequences of Ebola may be interesting, many people in the United States, including Nebraska and Iowa, are living with the consequences of pertussis (whooping cough), a rampant flu season, and measles outbreaks.

This blog has featured this subject in the past, almost exactly two years ago, when there was a flu epidemic. It was argued then, in one of the firm’s more popular blog posts, that sick people should not be forced to work and spread their germs to their co-workers and customers, in addition that working while sick tends to make people even more ill. Not having sick leave available to take becomes a public health and societal risk. In addition, not being able to provide care for sick children or loved ones results in family struggles and workers worrying, rightfully so, while they should be focused on work at work.

The issue is also affecting children, especially those who are low-income, according to the 2014 Kids Count Report in Nebraska.

A recent Marketplace Morning Report article highlighted the need for policy change through the Healthy Families Act “that would guarantee workers could earn up to seven days of paid sick leave per year.” For example, the Bureau of Labor Statistics is quoted in the story that “24 percent” of those in the restaurant industry and “47 percent of retail workers get paid sick leave.” It also shares the economic burden of the results of people who don’t get paid sick leave coming to work sick. “Underperforming at work, or even damaging equipment or products because of diminished capacity or the effects of medication is known as ‘presenteeism.’” Sickness and presenteeism costs more than $375 billion a year, according to the article.

Esther Cepeda also recently addressed both paid sick leave and presenteeism in a column: “Working while sick even when you can have the time off is a thing. Many workers take great pride in coming to work ill, and there are a fair number of their colleagues who wish they’d stop.”

Although it may be a pretty big challenge in some industries to provide paid sick time, Ms. Cepeda argues that those are the most important industries to have it, as was also argued in the firm’s flu blog post from 2013.

“Food service aside, there are any number of jobs – most of them low-wage, part-time service jobs – where you don’t want the worker to be miserably sick or mentally checked out, worried about their sick loved one, because they can’t afford to call off work and lose the pay or possibly the job.”

Also important to note, being “checked out” can lead to safety incidents and workers’ compensation claims, and having employees mired in presenteeism just isn’t good for anyone.

So as the article in this link mentions, I think it’s very important for both workers and employers to consider the importance of quality of life considerations: keeping healthy people from being exposed to sickness and supporting sick people (or people with sick loved ones) by giving them the chance to stay home and still get paid so they can focus on becoming healthy people again.

Because as Ms. Cepeda argues, it benefits all for people to be as healthy as possible.

“Those of us who have the choice or flexibility to take an available sick day must speak up for those who are penalized for life’s inevitable speed bumps. It’s ultimately in our own best interest.”

Will Protects Children, Assets, and Helps Prepare for the Unexpected

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last will and testamentOccasionally I write about topics that I think are of use to readers of the firm’s blog. Today’s focus is on a blog post that lawyer Andrew Hoffman wrote about preparing for the unexpected by writing a will.

The blog post was written to promote a new start in 2015 by reflecting on the importance of estate planning. Although estate planning is not a topic that many folks enjoy discussing, I wanted to encourage you to read this blog post from Krotter Hoffman PC, LLO, a law firm in northeast Nebraska. One of the best quotes in the blog post is this one: “The people that can least afford a will (they think), are actually the same people that need it the most – parents of young children.”

Please make the time for a will, even if you don’t think you have much to pass on to loved ones. Because, as Mr. Hoffman goes on to explain, if a person doesn’t have a will, then a judge will decide who takes care of your minor children. And whatever assets you have will also go to those minor children the moment each turns 19, regardless of their ability to manage those funds, which may include life insurance proceeds.

This information is also helpful to workers’ compensation clients or anyone who has received a lump sum settlement to plan for what happens to that money if something happens to you. Please follow up with an attorney to write your will, be safe, and take care.

Here’s a link to the original blog post:

http://www.krotterhoffman.com/#!A-New-Years-Resolution-Worth-Keeping/cutx/DC0CE14C-2B60-4E65-80F6-82C6560E60F5 titled: A New Year’s Resolution Worth Keeping.

“Just Get Off Your @ss!”

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Today’s post comes from guest author Jay Causey, from Causey Law Firm in Seattle.

He addresses a topic that is a struggle for folks in many occupations, whether they think about it or not: sitting. This blog post struck me because in addition to the workers Mr. Causey writes about below, there is another group of people who don’t have a whole lot of choice when it comes to taking breaks: truck drivers who sit just as long, if not longer, as many office workers in a day. Although Mr. Causey takes a slightly lighter approach to the topic, it should be of serious long-term concern and consideration. Because many just don’t have the luxury of taking many or frequent breaks.

So how can business owners and employees work together to make sure workers are as healthy as possible at their jobs (and also can help keep insurance costs down)? Now that’s a good question that demands not only thought but also action.

Here’s another “helpful hint” about your own health, for attorneys and clients who may be tuning in to our blog. Nothing here directly related to workers’ compensation, except to the extent that overall good health can ward off injury and illness.

A Kansas State University study in 2013 concluded the people who sit for four hours or more each day are at a substantially greater risk for developing cancer, diabetes and heart disease. And the risk for degenerative disease continues to increase at a consistent rate for six hours, eight hours, and more, of daily sitting.

The further finding of the study was that the increased risk of disease was not correlated with high or low body mass index, meaning that outside factors, such as poor eating and other negative lifestyle habits are not nearly as significant as the risk factor of just sitting.

A report from Northwestern University earlier this year found that, over age 60, every additional hour spent sitting doubles the risk of becoming disabled.  And, somewhat disappointingly, additional exercise has no impact on the disability risk. Australian researchers recently found that people whose job or other circumstances require prolonged sitting, but who just regularly stood up and moved around frequently, were better off than sitters who did 30 minutes of exercise each day.

None of the foregoing is intended to diminish the importance of regular exercise in our daily lives, but the lesson is: don’t stay chained to your desk and computer. Stand up and walk around when you’re on the phone, do laps around the office, walk to a coworker’s office instead of emailing – – do whatever it takes to get out of the sitting position as often as possible.

Your author manages his law firm mostly on his feet. After reading about the issue with sitting, he stood and walked, without sitting, for four hours at a firm event last week. (He’s now training himself to stand — and rock back and forth on his feet– for long periods when watching TV at home.  Houseguests will be fully advised.)

OSHA Cites Nebraska Food Supplement Plant for 10 Violations

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vitamin-food-supplementsWorker safety is essential, and one way to help ensure worker safety is through inspections by the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA). Records of these inspections are often very important documents in workers’ compensation cases after a worker has been injured on the job.

In its first OSHA inspection ever, a Geneva, Nebraska, food supplement plant was cited for 10 safety and health violations and also earned a spot in OSHA’s Severe Violator Enforcement Program, according to a recent news release. The proposed fine was $101,200.

“Bioiberica Nebraska is a subsidiary of Bioiberica S.A. based in Barcelona, Spain. The company, which produces products for the pharmaceutical, food supplement and functional foods industries, employs 322 workers worldwide and 11 at the Geneva site.”

I appreciate OSHA holding this manufacturer accountable, especially with some of the problems that came to light with the inspection. The willful violations alone netted the company $84,000 in fines, according to the citations list.

“The three willful violations were cited for exposing workers to injuries, such as electrocution, burns, crushing, lacerating, amputating or fracturing body parts,” according to the OSHA news release. “These violations included failure to develop written procedures, provide training, and implement a program with locks, tags or other hardware to prevent machines from starting up while employees performed service and maintenance of machinery. A willful violation is one committed with intentional, knowing or voluntary disregard for the law’s requirement, or with plain indifference to employee safety and health.”

I am particularly troubled by one of the serious violations that was mentioned in the citations list. “Employees had not been provided training to recognize, evaluate and control exposure to hazardous chemicals. Hazardous chemicals used in the facility include, but are not limited to, diatomaceous earth containing up to 44% crystalline silica,” according to the listed citation.

I have written about the silica standard and referenced it in regard to its use in Nebraska and Iowa as a raw material, but its use in manufacturing processes and other industrial uses can also definitely be dangerous, especially with workers having no information or training about such hazardous chemicals. The OSHA news release regarding Bioiberica Nebraska’s inspection bears out this concern.

“Silica exposure can cause silicosis, an irreversible lung disease, and other health hazards,” according to the news release.

Although OSHA fines are often decreased once a company is in compliance and shows proper documentation, I hope that this company will be more diligent in providing a safe workplace immediately. Being put in the Severe Violator Enforcement Program means this employer and its workers can look forward to more OSHA inspections in the future.

Nebraska, however, is one of the states that definitely needs more labor inspectors, according to the recent AFL-CIO’s annual report on job fatalities, which was written about in a previous blog post. With one labor inspector for 102,255 employees (for a total of nine statewide), 92 more inspectors in the state would meet the International Labor Office benchmark for labor inspectors, which “is one inspector per 10,000 workers in industrial market economies.” Nebraska also has the dubious distinction of being one of seven states where “the ratio of inspectors to employees is greater than 1 per 100,000 workers,” according to the AFL-CIO report. The other states are Arkansas, Florida, Louisiana, Missouri, Texas and West Virginia.

So although Bioiberica Nebraska should be inspected again soon, the idea of “soon” is relative and limited by the number of inspectors available in our state. Let’s hope that efforts for safety are successful at this plant before workers’ lives are affected through death or injury.

National Prescription Drug Take Back Day Set for April 26

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Mark your calendars! As part of spring cleaning duties, I know people are sorting through the stuff in their homes, donating what they can, and figuring out how to recycle or dispose of what can’t be donated. As a mom of a child with food allergies who requires the use of epinephrine auto-injectors, I realize the challenge in making sure expired or no-longer-needed prescriptions are exposed of appropriately, because of the needles and strong medicine involved in this type of prescription. Many prescriptions should not be thrown away or, worse, flushed down the toilet to affect the water supply. Unused prescription drugs can also be dangerous to people for whom they are not prescribed, so it’s essential to dispose of these prescription drugs properly.

A number of the firm’s clients are injured workers who are often prescribed medication as a consequence of a work injury. But not all of these medications are used or needed, and some even expire, and then sit at home taking up space because folks don’t know what to do with them.

Please extend your spring cleaning to April 26 from 10 a.m. to 2 p.m. It’s National Prescription Drug Take Back Day. This program is coordinated with local law enforcement through the U.S. Department of Justice’s Drug Enforcement Administration Office of Diversion Control.

The Office of Diversion Control website gives a couple of search options to find a site near you that accepts “unused or expired medication for safe disposal.” Either search by zip code or by county/city and state via either of the two links on the site listed above.

The direct link to the search tends to “time out” and essentially sends you back to the site above, so it’s easiest to click through where it mentions “Locate collection sites” or “Click here for a collection site near you.” In addition, an 800 number, 1-800-882-9539, is available for people to ask questions about the program by speaking to customer-service representatives. But believe me when I say it’s easier to find this information on the website than it is to try to speak with someone. After a couple of easy searches on the website, I am pleased that there are what I consider a reasonable number of sites available in both Nebraska and Iowa.

Why should you and I care to make the effort of participating in a drug take-back day? This informative website from the U.S. Food and Drug Administration explains in general terms about disposing unused medicine, and it seems that dropping the drugs off at an approved site on April 26 is one of the easier options. In addition to the general good feeling people get from the act of reducing clutter, returning unused, unneeded medicines to a take-back event means we all don’t have to worry about the medicine getting into the water supply, which sometimes happens through flushing, or getting into the hands of a person who might abuse it, which can happen when meds are thrown away. See the site above for additional “Guidelines for Drug Disposal” if there’s not a drug take-back day available close by, so people can make sure medications are disposed of safely.

Thanks in advance for keeping us all safer by disposing of unneeded prescription medicine properly.

Testosterone Drug Use: Watch Out for Dangerous Side Effects

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Beware of testosterone drugs. 

Drugs to raise testosterone levels have very dangerous side effects. The drugs come in the form of prescription drugs, patches, creams, gels, deodorant or spray. These heavily promoted drugs have been linked to increased heart attacks, strokes, pulmonary embolism, blood clots, and death. For instance, men older than 65 taking such drugs are two times more likely to have a heart attack during the first 90 days of use than those who don’t take the drug. That is a sobering, if not outright scary, situation. Men younger than 65 with histories of heart disease are also twice as likely to have heart attacks during the first 90 days of use. 

Human nature and the desire to be healthy, strong and youthful appearing will draw many men to these drugs, particularly with the heavy advertising on TV, radio, online and in traditional print that the public is exposed to currently. The lure of a Fountain of Youth is hard to resist but also very dangerous. 

Sadly, there have been many other instances of new drugs that have been heavily promoted that have had dangerous side effects. The law has provided damages for the now millions of people who have been damaged by various dangerous drugs with serious side effects. I recommend looking into your legal rights if you or a loved one suffered a heart attack, stroke, pulmonary embolism, blood clots or death while taking testosterone replacement drugs or after taking such drugs. Feel free to contact me, and I can arrange for a consultation with lawyers with special knowledge, experience and good ethics to help you or your family member.