Additional licensure and certifications aren’t unheard of in the world of occupational health. In 2016, the Federal Motor Carrier Safety Administration implemented a new rule that only doctors on their registry can perform DOT Physical Examinations for truckers and other professional drivers. This reduced the number of doctors who can perform those examinations.
When I testified on LB 408, a bill that would have implemented drug formularies for opioids under the Nebraska Workers’ Compensation Act, some doctors were testifying that there was little training in regards to prescribing opioids. Though an opioid prescription registry like the DOT examination registry wasn’t proposed, you could certainly see it proposed as a solution to the opioid problem.
But that article also shared studies that state that pain pill prescriptions are not driving the opioid epidemic. Patients with pre-existing addiction issues are more likely to become addicted to opioids and 75 percent of those who develop opioids start taking opioids in a non-prescribed manner. Furthermore, only 12 to 13 percent of ER patients who are treated for opioid overdoses are chronic pain patients.
The issue of whether Uber drivers and other so-called “Gig Economy” workers are employees or independent contractors is a hot topic among lawyers and policy makers. But last week independent contractors in the Gig Economy and beyond had a more mundane but no less serious dilemma:
Independent contractor status can be helpful for someone who wants to be an entrepreneur. But for those who just want to support themselves and family, involuntary independent contractor status can mean higher taxes, more paperwork and more risk of trouble with the IRS and state revenue agencies. Future tax days could be even more stressful if more workers are forced into independent contractor status in order to support themselves and families.
My topic will focus on working with non-English speaking clients. As we all know, non-English speaking immigrants come to this country for many different reasons, but the vast majority end up in labor jobs: jobs that cause work comp injuries. Personally, I have represented clients from over 20 countries; in Nebraska we have a surprising number of immigrants and refugees who relocate to Nebraska for plentiful jobs and cheap housing.
As a result of this melting-pot of injured workers, my seminar presentation will focus on the Ethics of representing non-English speaking clients. Specifically, I will explain what lawyers should do when a non-English speaking client contacts the lawyer; what issues may arise during litigation; and how to handle non-English speaking clients and interpreters during legal proceedings.
I recently wrote a post about immigration status and workers compensation. You can read that post here.
I will present on opioids in workers’ compensation. I plan on spending some time discussing opioid addiction as a work-related medical condition and some of the factual and legal challenges that come with opioid use in a workers’ compensation case. I will also address digestive and bowel issues that arise with opioid use and how those injuries can be covered by workers’ compensation.
Opioid addiction is a major public health and even political issue. Drug formularies are being pushed as a way to combat addiction by reducing the prescription of opioids in workers’ compensation cases. I plan on discussing why drug formularies should raise serious concerns not just from doctors, but from employees and employers. You can read my blog posts about formularies here, here and here.
Rod Rehm will be presenting on the topic of deposition preparation for plaintiffs in workers’ compensation cases. Rod is a Fellow in the College of Workers’ Compensation and has prepared hundreds of injured workers for their depositions in his long legal career. Earlier in his career Rod worked both as a prosecutor and criminal defense lawyer so he can draw on 40 plus years of litigation experience when it comes to witness preparation.
At least in Nebraska, employers are required to file First Reports of Injury with the Nebraska Workers Compensation Court. The information contained in those reports serves a similar function to OSHA logs and would allow workers, unions, attorneys and or regulators to identify recurring safety problems. Those reports are also public records. I recently testified against an insurance industry supported bill in the Nebraska legislature that would have made those reports confidential records.
Drug formularies are touted as a way to fight prescription drug abuse and contain prescription drug cost. But one major Nebraska employer appears to be questioning whether drug formularies really contain prescription costs.
The City of Omaha was echoing widespread concerns about the possibility of conflict of interests in drug formularies. Those concerns were explained by me in a blog post published last December. In short, drug formularies are administered by pharmacy benefit managers. Pharmacy benefit managers make money by negotiating discounts from drug manufacturers. This gives pharmacy benefit managers incentive to put more expensive drugs on drug formularies because they can negotiate a more lucrative discount than they could for a less expensive generic drug.
LB 408 was held in committee by the Business and Labor committee so it is unlikely it will be considered in this legislative session. Opioids abuse is a topic of high interest for political leaders so drug formularies as a way to reduce opioid use will likely be discussed further in Nebraska.
The City of Omaha has a workforce this is more heavily unionized than most other workplaces in Nebraska. In some instances, labor and management will collectively bargain how some aspects of a workers’ compensation program is to be administered. Supporters of organized labor originated the idea of “labor pluralism” during the New Deal and Post-War era. (4) Labor pluralism means that government should minimize interference between the labor-management relationship. In a unionized workplace, labor and management have a complicated relationship that is both cooperative and confrontational depending on the circumstances. A mandate from the state requiring the use of drug formularies could be as undermining labor-management relations when a labor and management have bargained about the administration of workers’ compensation benefits.
The short answer is, yes. Undocumented workers are entitled to most workers’ compensation benefits under Nebraska law. The exception is that undocumented immigrants are not entitled to the vocational rehabilitation benefit because the worker is not legally permitted to be in the country.
To some people, Nebraska law and this Kansas decision make sense, but unfortunately many people believe that undocumented workers should not be entitled to work comp. This argument fails for the following reasons:
If someone is injured at work and needs to seek medical treatment, it must be paid somehow. If it is not paid by workers’ compensation (even though the injury occurred at work), the cost of that treatment will be passed to the medical providers and the general-public. The employer will get away scot-free while everyone else would share the burden of mounting healthcare costs.
Employers should not get a benefit of hiring undocumented workers over citizens or documented workers. As stated above, if the employer does not have to pay workers’ compensation benefits for an injured, undocumented worker, the employer will be encouraged to hire undocumented workers over others as cost-savings. It is the employer’s responsibility to hire documented workers, but if it means the cost-savings of not having to pay work comp benefits, you can bet that employer will try to hire undocumented workers over others.
Similar to the previous reason, employers would be discouraged from taking safety measures to ensure the safety of its workers if it knows that it won’t be required to pay for undocumented workers’ injuries. This would make the workplace more dangerous for all workers.
Regardless of citizenship, an injured worker has an inalienable right to be treated for work injuries simply based on the fact that his/her job has made money for that employer. This is the whole point of the workers’ compensation system: to provide a quick (relatively speaking) and efficient way to get medical treatment and compensation for any worker that is injured while making money for that employer. Without the beneficiary of the work that cause the injury being required to pay work comp, this burden would inevitably be pushed to tax payers in one form or another. In other words, taxpayers should certainly want undocumented immigrants to get workers’ compensation benefits.
Workers compensation law is slightly more than 100 years old. It has become a fundamental protection for workers and their families. Sadly, insurance and business interests have been attacking this basic law for more than 25 years. The effort has been nearly continuous with legislative and administrative proposals aimed at lower benefits to workers and their families while raising profits for business and insurance.
This law firm believes we have an obligation to fight these attacks on behalf of our clients and their families. The past week is an example. Rod Rehm spoke to a group of lawyers on how to defeat these attacks at the Northwest Regional Conference of the Workplace Injury Law Advocacy Group www.wilg.org held in Whitefish, Montana. The event was attended by Michael Gruber, Brooklyn, NY, current President of WILG, Amie Peter, Edmonds WA, President-elect of WILG, Chuck Davoli, New Orleans, LA past President of WILG and chaired by Tom Murphy of Great Falls, MT along with a hearty group of workers compensation lawyer from the Northwest part of the U.S.A.
It was great to share information with and learn new and better ways to win our cases and court and continue to defend the law in the legislature. WILG is a great organization fighting for workers 24/7/365 all across the USA.
Jon Rehm testified at the Business and Labor Committee of the Nebraska Legislature on behalf of the Nebraska Association of Trial Attorneys, NATA, www.nebraskatrial.com concerning efforts to limit drug prescriptions for our clients. Our office and NATA is concerned that efforts to attack opioid addiction will harm our clients unless written carefully. Protecting good medical care for injured workers is more important than saving prescription costs for business and insurance under the guise of attacking addiction.
Testifying in the legislature is a regular part of being a lawyer at Rehm, Bennett and Moore. We actively work to protect workers’ rights in every forum we can.