Not Expanding Medicaid: Deadly Consequences

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Today’s post comes from guest author Charlie Domer from The Domer Law Firm in Milwaukee.

As previously discussed in my blog post from last year, Nebraska’s Gov. Heineman has refused to expand Medicaid under the Affordable Care Act. Although the Legislature attempted in 2013 and 2014 to expand Medicaid, it has not passed with a filibuster-proof majority.

Whether it is for politics or short-sightedness, Heineman misses the positive impact an expansion of Medicaid would mean to all of Nebraska, including its working families. The benefits of expanding Medicaid to Nebraska’s workers are outlined here.

As I wrote almost a year ago, and as Mr. Domer’s blog post below suggests, the governor’s response in this 2013 Omaha World-Herald article of essentially “eat an apple a day” and go ask your church for some help just doesn’t cut it anymore. I don’t know of too many churches handing out health coverage for an emergency appendectomy or for melanoma screenings. The coverage gap of when a person isn’t eligible for subsidies but would have been eligible for expanded Medicaid looms large for many families and workers: many of them will go without health insurance altogether.

Because there are definitely Nebraskans who are “too poor for Obamacare and … too rich for Medicaid,”even though they’re working, they can look forward to potential “dire health consequences,” as Mr. Domer writes, without insurance. I hope the 2015 Nebraska legislative session will be the year for more working Nebraskans to improve their health through the Unicameral passing expanded Medicaid coverage.

Please take a moment to ready this story out of Pennsylvania: Study: Many Will Die if Medicaid is Not Expanded.   As part of the Affordable Care Act (“Obamacare”), an expansion of Medicaid was intended.  Medicaid essentially is the joint federal-state program to provide health insurance to low income individuals and families.   The federal government strongly encouraged this expansion by the states, by offering to pay for that expansion for many years.   Unfortunately, the US Supreme Court–in upholding the constitutionality of the bulk of Obamacare–did strike down this Medicaid expansion.  The Supreme Court decision left it up to the state’s themselves to decide whether to expand Medicaid for their residents or not.

In many Republican-led states, the decision was made to not expand Medicaid.  As seen in this article, Pennsylvania was a state that declined to expand.  Wisconsin, with Republican Governor Scott Walker, also decided not to provide this expanded Medicaid coverage to the the state’s low income individiduals.  (Check out the story here and here.) 

Now comes news that failure to expand Medicaid may actually result in increased deaths among the affected population.  The failure to have this expanded coverage, according to the study examining Pennsylvanis, will result in thousands of deaths due to individuals foregoing necessary medication, medical treatment, and preventative screening. Additionally, the expansion failure will result in “catastrophic medical expenses and tens of thousands of cases of untreated depression, diabetes and missed screening tests.”   This is a truly scary scenario–and an avoidable one.

In Wisconsin, Gov. Walker is suggesting that these individuals can now obtain health insurance throught the federal-run exchanges.  The real issue is whether these low-income individuals can truly afford the premiums and whether they actually qualify for the federal subsidies.  These lower-income individuals were the one supposed to be covered by Medicaid expansion–not by the exchanges.    Based on the Pennsylvania study, if these individuals are ineligible for Medicaid and cannot secure health insurance elsewhere, dire health consequences (or even death) loom as possibilities.

OSHA Enforcement Cases Involving Temps On the Rise

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Today’s post was shared by Gelman on Workplace Injuries and comes from ohsonline.com

I am so glad to see that temporary workers are being included more in OSHA enforcement. It is just frustrating that it took an injury to a worker in New Jersey for one of the companies in the article below to be inspected through “a referral from the Maplewood Fire Department,” according to the article.

Our firm’s blog has included articles focused on temporary workers and their special challenges when it comes to workers’ compensation in 2012 and earlier this year.

The short article below that is today’s focus came from a business and industry publication, so I think it serves to put its readers on notice for OSHA’s renewed focus “on the safety of temporary workers.”

Generally speaking (with exceptions for some agricultural jobs), temporary workers qualify for workers’ compensation, though that coverage does not replace wages from your main job if the temporary job is a second job. Workers’ compensation laws and systems vary by state, so if you or a loved one is injured on the job, please speak with an experienced workers’ compensation attorney about your specific situation.

Today’s post shared from OshOnLine.com illustrates a new enforcement effort by OSHA that will improve the work environment for all Americans.OSHA’s emphasis on the safety of temporary workers is being driven home by a series of enforcement actions. The latest case announcement on June 19 involved the Macon, Ga., facility of a company named California Cereal Products Inc., which OSHA has cited for exposing full-time and temporary workers to electrical, fall, and noise hazards, with proposed penalties totaling $40,600. OSHA opened an inspection last December based on a complaint.

“The employer has failed to protect full-time and temporary workers from easily identified workplace hazards that can result in death or permanent disability,” said Bill Fulcher, director of OSHA’s Atlanta-East Area Office.

The case against beverage bottling company Maplewood Beverage Packers LLC and temporary employment agency Corporate Resource Services Corp. in Elizabeth, N.J., also began with a December 2013 investigation, but it started with a referral from the Maplewood Fire Department after a temporary worker was injured falling from a ladder. OSHA has proposed $182,270 in penalties. “Host employers and staffing agencies are jointly responsible for ensuring worker safety and health,” said Kris Hoffman, director of OSHA’s Parsippany Area Office. “Employers must protect all workers from job hazards-both permanent and temporary workers.”

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Workers’ Compensation Benefits: Iowa vs. Nebraska Law

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The workers’ compensation benefits under Iowa law for permanent injuries are typically greater than those available under Nebraska law. As such, finding a way to bring a claim under Iowa law can be of primary importance if there is a potential jurisdictional issue between the two states.

Iowa Code 85.71 provides the framework for helping to resolve this issue. Put simply, an injury that occurs inside the borders of Iowa is most likely going to qualify to be brought under Iowa law. However, even injuries that occur outside the borders of Iowa can still be covered under Iowa law in certain common instances as detailed below:

1. The employer has a place of business in Iowa and:
       a. the employee regularly works at or from that location;
       b. the employee lives in the state of Iowa.

2. The employee is working under a contract of hire made in Iowa, and the employee regularly works in Iowa.

3. The employee is working under a contract of hire made in Iowa and sustains an injury for which no remedy is available under the workers’ compensation laws of another state.

4. The employer has a place of business in Iowa, and the employee is working under a contract of hire that provides that the employee’s workers’ compensation claims will be governed by Iowa law. 

An injured employee also needs to be careful about filing in a different state than Iowa. Under Iowa Code 85.72, the Iowa action will be stayed pending the resolution of that claim in another state. This means that the Court cannot take up any issues in Iowa while there is another pending legal action in another state concerning the same date of injury.

The difference in benefits between the two states can amount to tens of thousands of dollars. Additionally, there are a number of differences in the laws of the two states that can play a role in how the claim is handled, including the appropriate statute of limitations, which dictates how soon a claim must be filed in Court. As such, it’s important to contact an attorney licensed in Iowa and Nebraska to discuss these differences so we can help you decide which state’s law is better for you and to help you navigate the relative pitfalls in each state.

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.

Workers’ Comp Covers Heat Injuries

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The Great Plains is nearing the calendar start of summer. Please be aware of the heat and what its effects can be on workers, on children and the elderly, and on pets. No one is safe in a closed-up car, for example.

Prolonged exposure to excessive heat and humidity can result in injuries and diseases covered by the workers’ compensation laws. Workers with heat exhaustion, strokes, heart attacks and skin conditions may be entitled to lost-time benefits, medical expenses and permanent disability benefits if the condition is serious.

It also appears that extreme weather is going to continue into this summer season, with some damage already to homes, crops and property. When storms do come, be sure it’s someone’s job to keep the crew safe from sudden weather, regardless of the industry. Enjoy the summer, and contact an experienced workers’ compensation attorney if there are questions about a specific incident that occurred at work.

It has been a roller coaster of a May here on the Great Plains. Nebraska and Iowa have both been hit with weather extremes. For example, “Two days after Lincoln recorded a record low temperature and less than two weeks after the city saw significant snow, thermometers soared Tuesday.” And I saw on Facebook via Radio Iowa News, that “Sioux City reports 106 on Tuesday afternoon, beating the old record of 97, set in 2001.” Because the Journal Star says this is the earliest Lincoln’s ever hit 100 degrees (a new record), I will go out on a limb to say that we’re done with freezes for a while, which makes me think about the next season: summer and heat.

Did you know that heat issues can be covered by workers’ compensation? But prevention is preferred, so here are some links with lots of resources for those who work outside, no matter the weather, and also for those who play, garden, golf, exercise, and enjoy the outdoors. In addition, just like one’s body adjust somewhat to cold, the body also adjusts to heat, so a person who spends the summer in the air conditioning will have less tolerance for the heat than someone who spends all day outdoors. In addition, pay attention to prescription medicines, as some can cause sunburn or heat problems quicker than a person not taking that medication would experience them. The heat can also affect folks who may not be considered the traditional “outside” worker, as, for example, if one is unloading cargo from a truck to a warehouse in 100 degree heat, it can be much hotter than that in both the truck and warehouse.

One term that is mentioned on a regular basis in the media once the humidity kicks in is the “heat index,” which is defined as followed, according to http://www.weather.com/outlook/health/fitness/tools/heat: “The Heat Index is the temperature the body feels when heat and humidity are combined.” Of course this means that what it feels like isn’t the actual temperature, as it only felt like 95 when it was 100 recently because of a “dry heat.”

  • Welcome to OSHA’s Campaign to Prevent Heat Illness in Outdoor Workers
    There is a lot of information on here, and looking through some of it is a reminder that employers should expect and encourage workers to be safe when it comes to working in the heat. Employers should make an effort to encourage this safety focus by both talking about and acting on recommendations to help employees be safer and more productive.
  • Using the Heat Index: A Guide for Employers
    “Water. Rest. Shade. The work can’t get done without them.” This quote from the website is a very useful safety reminder. It looks like there are lots of opportunities through these links for conversations to occur between workers and employers about taking heat index into account when planning work.
  • NIOSH Workplace Safety and Health Topics: Heat Stress
    This site includes an overview; types of heat stress; recommendations for employers; recommendations for workers; and many other links that share resources and research about being in the heat.
  • Heat Safety Tool
    Although I’m generally easily amused, I am sincerely happy to say that there’s an app for that! Because so many people are connected with mobile technology, I am looking forward to downloading this app on my phone for the summer for personal use.
  • OSHA Quick Card
    Here’s a Quick Card resource from OSHA that folks can print out for reference points. And as neat as mobile apps are, from a practical perspective, paper does make a better fan.

So regardless of why you’re outside, enjoy, take care, and be safe!

Truck Driver or Traveling for Work, Fun? Watch for Trains at Crossings

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Crashes between trains and semi trucks, pickups, buses or cars rarely end well for the vehicle that’s not the train. It seems to me that there have been a disturbing number of these crashes that have made news nationwide within the past couple of months or so. Nebraska is not immune from this trend, sadly, as here are three examples of varying details that just happened over the course of a recent month.

Just recently, “James Hubbard of Dakota City was driving east across the tracks when his rig was hit by a northbound train,” according to a news article on Journalstar.com, Lincoln, Neb.’s, local newspaper. This television coverage gives more details. Sympathy and thoughts go out to Mr. Hubbard’s loved ones.

Another story in the past month came from within the state around west-central Nebraska, near North Platte. A semitrailer loaded with 68 cattle was hit by a Union Pacific passenger train, and no humans were hurt, although a number of cattle died, were hurt, or escaped the semi’s trailer.

Although it’s reassuring that no one was hurt in the next recent story, it’s also important to let someone know if your vehicle gets high-centered on railroad tracks. This situation, also near North Platte, elaborates on that scenario.

In addition, though not in Nebraska, here are links to three other recent accidents between trains and trucks: one in California, one in Indiana, and one in Florida. According to the news reports, no one was hurt, though all situations were definitely dangerous.

Because attorneys and staff members of Rehm, Bennett & Moore work with injured truckers through the website truckerlawyers.com and various related social-media outlets, I am convinced through my interactions with truck drivers that the vast majority are extremely safety-conscious and careful. But I urge all, regardless of what kind of vehicle you drive, to have a renewed diligence at train crossings.

In fact, my family lives within a mile of a set of very busy train tracks, and on any given day, I usually cross tracks around Lincoln, Neb., around 10 times. So although it is sobering that it takes another person’s death as a reminder, I, too, will encourage my friends and family to follow through on these tips that can be found on the Operation Lifesaver website, which is an excellent resource for truckers and all drivers.

  • “Trains and cars don’t mix. Never race a train to the crossing — even if you tie, you lose.
  • The train you see is closer and faster-moving than you think. If you see a train approaching, wait for it to go by before you proceed across the tracks.
  • Be aware that trains cannot stop quickly. Even if the locomotive engineer sees you, a freight train moving at 55 miles per hour can take a mile or more to stop once the emergency brakes are applied. That’s 18 football fields!
  • Never drive around lowered gates — it’s illegal and deadly. If you suspect a signal is malfunctioning, call the 1-800 number posted on or near the crossing signal or your local law enforcement agency.
  • Do not get trapped on the tracks; proceed through a highway-rail grade crossing only if you are sure you can completely clear the crossing without stopping. Remember, the train is three feet wider than the tracks on both sides.
  • If your vehicle ever stalls on a track with a train coming, get out immediately and move quickly away from the tracks in the direction from which the train is coming. If you run in the same direction the train is traveling, when the train hits your car you could be injured by flying debris. Call your local law enforcement agency for assistance.
  • At a multiple track crossing waiting for a train to pass, watch out for a second train on the other tracks, approaching from either direction.
  • When you need to cross train tracks, go to a designated crossing, look both ways, and cross the tracks quickly, without stopping. Remember it isn’t safe to stop closer than 15 feet from a rail.
  • ALWAYS EXPECT A TRAIN! Freight trains do not follow set schedules.”

Being armed with information is important, so here are links to three more Operation Lifesaver sites:

Crossing Collisions & Casualties

Grade Crossing Fatalities by State (Top 15)

Collisions by State (Top 15)

In addition, Operation Lifesaver does outreach specific to truck drivers and company safety programs, so contact them to learn more about taking advantage of those training options.

The reality is that just as all drivers need to avoid distractions and drive defensively, it is imperative that truckers, those traveling for work, and really, all drivers, pay attention to what’s around them, especially when it comes to crossing train tracks.

Why We’re Still Killing Workers in the USA

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Today’s post comes from guest author Jay Causey, from Causey Law Firm in Seattle. Mr. Causey writes about some important issues in workers’ compensation with a focus on the oilfields of North Dakota. This is especially striking because both Nebraska and Iowa have sandpits that supply the sand used in fracking, so some workers here face the same challenges with silica that workers in North Dakota do. Please go to this previous blog post, Proposed Silica Standard Needs to Be Strengthened, for more information about issues with silica.

I find the AFL-CIO’s report extremely interesting but also frustrating because so many workers are still dying on the job. Members of Rehm, Bennett & Moore will be writing occasional blog posts from the annual report on job fatalities in the coming months. Posts will include a focus on Iowa and/or Nebraska or a big-picture commentary on the state of workers in the nation these days.

I appreciate Mr. Causey’s work in bringing this report to promote both thought and action for increased worker safety. One point that comes to mind is that Mr. Causey writes, “the vast majority of the states with the highest fatality rates contain the 8 million workers in states with no federally approved OSHA safety and health plan.” A contrast between Nebraska and Iowa’s workers’ compensation systems is that Iowa does have a federally-approved state plan and Nebraska does not. Visit https://www.osha.gov/dcsp/osp/stateprogs/iowa.html to get more information about Iowa’s state plan. Please contact a workers’ compensation attorney who is familiar with the laws in your state if you have specific questions.

The AFL–CIO’s annual report on job fatalities is out, and provides some interesting fodder for thought.

It’s no surprise that North Dakota – – with its “wild West” environment for oil and gas extraction on the Bakken Shale was the most dangerous place – – with 17.7 deaths per 100,000 workers versus the national average of 3.4.

Nationally, 4600 workers died on the job in 2012. While that number has fallen since safety laws were implemented in the 1970s, the decline has flat-lined over the most recent decade. It was 4.2 deaths per 100,000 workers in 2006, now still at 3.4 in 2012.

The AFL–CIO report contains maps that reflect part of the reason for the stall-out: the vast majority of the states with the highest fatality rates contain the 8 million workers in states with no federally approved OSHA safety and health plan. The report graphically portrays another salient fact: the number of federal OSHA inspectors per 1 million workers has fallen from a high of 15 in 1980 to 6.9 in 2013.  OSHA has been so underfunded over recent years that it would take an average of 139 years for available OSHA inspectors to visit each workplace in their jurisdiction just once. (In some states that number is even more staggering – – 521 years for South Dakota.)

The AFL-CIO report reflects some other interesting facts concerning the demographics of workplace fatalities – – not surprisingly, being foreign-born or Latino puts a worker at a higher risk of fatality, and homicide was the number one cause of death for women in the workplace in 2012.

But, getting back to the “oil patch” in North Dakota, we see other disturbing trends in the culture of workplace injury that accompany the decreasing application of safety regulation. With job growth tripling in North Dakota’s oil patch since 2007, while workers’ compensation filings are up, many injured workers are encouraged by employers in the extractive industries not to file, with many companies working out sidebar deals with injured workers. Injury rates are being kept artificially low by rewards for not reporting. As the AFL–CIO’s safety chief, Peg Semenario, has said, underreporting warps national safety figures in an industry that is already notoriously opaque.

And the culture of creating false indicators of workplace safety will likely have tremendous implications down the line when the 2000 tons of silica-rich sand used in the cement casing of each fracking well begins to work its way into workers’ lungs. NIOSH reported in 2012 that 92 of 116 air samples at franking sites exceeded the recommended safe levels of silica, which can lead to incurable, irreversible lung disease.

 

 Photo credit: Craig Newsom / Foter / Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)

Discrimination: Municipal Human-Rights Commissions Another Option for Charges

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When a prospective client calls in with a potential employment discrimination question, one of the questions I always ask is, “What city or town do you work in?” The reason I ask this question is because many larger cities in the states where we practice, such as Omaha, Lincoln and Des Moines, have separate municipal fair-employment acts that cover more employees than are covered under state or federal law.

State and federal fair-employment statutes generally need at least 15 or 20 employees for an employer to be covered by those laws. However, in Des Moines and Lincoln, an employer only needs to have four employees to be covered under those cities’ human-rights ordinances. In Omaha, an employer only needs six employees to be covered by their fair-employment ordinance.

Also, the City of Omaha explicitly covers sexual orientation under the fair-employment ordinance. Sexual-orientation discrimination is not explicitly prohibited by Nebraska or federal law. It is my belief that sexual-orientation discrimination is a form of sex discrimination that is already covered under Title VII and the Nebraska Fair Employment Practices Act. However, my opinions as to what I think the law is and what the law is are two different matters. If you are an Omaha resident who feels you were discriminated against because of your sexual orientation, you would be much more certain to have your claim of discrimination heard on the merits by pursuing a claim under the Omaha Human Rights Ordinance. While I would be willing to filing a sexual-orientation discrimination case under Nebraska law, any potential clients need to know that such a case would be a test case, and as such, this case would be under tremendous scrutiny from judges.

The drawback to filing discrimination cases under the Lincoln and Omaha municipal ordinances is that there is less opportunity for monetary award if you are successful in winning your case than you would have under state or federal law. However, some remedy for your discrimination is better than no remedy for your discrimination.