Author: WorkCompAcademy

Legal documents are notoriously difficult to understand, even for lawyers. This raises the question: Why are these documents written in a style that makes them so impenetrable?

MIT cognitive scientists believe they have uncovered the answer to that question. Just as “magic spells” use special rhymes and archaic terms to signal their power, the convoluted language of legalese acts to convey a sense of authority, they conclude.

In a study appearing this week in the journal of the Proceedings of the National Academy of Sciences, the researchers found that even non-lawyers use this type of language when asked to write laws.

“People seem to understand that there’s an implicit rule that this is how laws should sound, and they write them that way,” says Edward Gibson, an MIT professor of brain and cognitive sciences and the senior author of the study. Eric Martinez PhD ’24 is the lead author of the study. Francis Mollica, a lecturer at the University of Melbourne, is also an author of the paper.

Gibson’s research group has been studying the unique characteristics of legalese since 2020, when Martinez came to MIT after earning a law degree from Harvard Law School. In a 2022 study, Gibson, Martinez, and Mollica analyzed legal contracts totaling about 3.5 million words, comparing them with other types of writing, including movie scripts, newspaper articles, and academic papers.

That analysis revealed that legal documents frequently have long definitions inserted in the middle of sentences – a feature known as “center-embedding.” Linguists have previously found that this kind of structure can make text much more difficult to understand. “Legalese somehow has developed this tendency to put structures inside other structures, in a way which is not typical of human languages,” Gibson says.

In a follow-up study published in 2023, the researchers found that legalese also makes documents more difficult for lawyers to understand. Lawyers tended to prefer plain English versions of documents, and they rated those versions to be just as enforceable as traditional legal documents. “Lawyers also find legalese to be unwieldy and complicated,” Gibson says. “Lawyers don’t like it, laypeople don’t like it, so the point of this current paper was to try and figure out why they write documents this way.”

The researchers had a couple of hypotheses for why legalese is so prevalent. One was the “copy and edit hypothesis,” which suggests that legal documents begin with a simple premise, and then additional information and definitions are inserted into already existing sentences, creating complex center-embedded clauses.

“We thought it was plausible that what happens is you start with an initial draft that’s simple, and then later you think of all these other conditions that you want to include. And the idea is that once you’ve started, it’s much easier to center-embed that into the existing provision,” says Martinez, who is now a fellow and instructor at the University of Chicago Law School.

However, the findings ended up pointing toward a different hypothesis, the so-called “magic spell hypothesis.” Just as magic spells are written with a distinctive style that sets them apart from everyday language, the convoluted style of legal language appears to signal a special kind of authority, the researchers say. “In English culture, if you want to write something that’s a magic spell, people know that the way to do that is you put a lot of old-fashioned rhymes in there. We think maybe center-embedding is signaling legalese in the same way,” Gibson says.

In this study, the researchers asked about 200 non-lawyers (native speakers of English living in the United States, who were recruited through a crowdsourcing site called Prolific), to write two types of texts. In the first task, people were told to write laws prohibiting crimes such as drunk driving, burglary, arson, and drug trafficking. In the second task, they were asked to write stories about those crimes.

To test the copy and edit hypothesis, half of the participants were asked to add additional information after they wrote their initial law or story. The researchers found that all of the subjects wrote laws with center-embedded clauses, regardless of whether they wrote the law all at once or were told to write a draft and then add to it later. And, when they wrote stories related to those laws, they wrote in much plainer English, regardless of whether they had to add information later.

“When writing laws, they did a lot of center-embedding regardless of whether or not they had to edit it or write it from scratch. And in that narrative text, they did not use center-embedding in either case,” Martinez says.

In another set of experiments, about 80 participants were asked to write laws, as well as descriptions that would explain those laws to visitors from another country. In these experiments, participants again used center-embedding for their laws, but not for the descriptions of those laws.

Gibson’s lab is now investigating the origins of center-embedding in legal documents. Early American laws were based on British law, so the researchers plan to analyze British laws to see if they feature the same kind of grammatical construction. And going back much farther, they plan to analyze whether center-embedding is found in the Hammurabi Code, the earliest known set of laws, which dates to around 1750 BC.

“There may be just a stylistic way of writing from back then, and if it was seen as successful, people would use that style in other languages,” Gibson says. “I would guess that it’s an accidental property of how the laws were written the first time, but we don’t know that yet.”

The researchers hope that their work, which has identified specific aspects of legal language that make it more difficult to understand, will motivate lawmakers to try to make laws more comprehensible. Efforts to write legal documents in plainer language date to at least the 1970s, when President Richard Nixon declared that federal regulations should be written in “layman’s terms.” However, legal language has changed very little since that time. “We have learned only very recently what it is that makes legal language so complicated, and therefore I am optimistic about being able to change it,” Gibson says.

In a groundbreaking medical achievement, the first fully mechanical heart developed by Huntington Beach based BiVACOR®, has been successfully implanted in a human patient. This milestone marks a significant advancement in the field of cardiac care, offering new hope for those awaiting heart transplants.

The Texas Heart Institute and BiVACOR®, a clinical-stage medical device company, announced the successful first-in-human implantation of the BiVACOR Total Artificial Heart (TAH) as part of the U.S. Food and Drug Administration (FDA) Early Feasibility Study (EFS).

BiVACOR’s TAH is a titanium-constructed biventricular rotary blood pump with a single moving part that utilizes a magnetically levitated rotor that pumps the blood and replaces both ventricles of a failing heart. The non-contact suspension of the rotor via maglev is designed to eliminate the potential for mechanical wear and provide large blood gaps that minimize blood trauma, offering a durable, reliable, and biocompatible heart replacement. With activity, the device is auto-regulated to provide up to 12 liters of blood flow per minute, which is similar to that pumped by a healthy human heart.

The first-in-human clinical study aims to evaluate the safety and performance of the BiVACOR TAH as a bridge-to-transplant solution for patients with severe biventricular heart failure or univentricular heart failure in which left ventricular assist device support is not recommended. Following this first implantation completed at Baylor St. Luke’s Medical Center in the Texas Medical Center into a critically ill 57-year-old man who was in cardiogenic shock and awaiting a heart transplant. Four additional patients are to be enrolled in the study.

The nearly six-hour operation allowed the patient to be liberated from the vent on post-operative day three, and sit in a chair that same day. On post-op day seven, he could ambulate 150 meters. On July 17, eight days after the implant, a donor heart became available. The patient celebrated his 58th birthday and he is reported to be continuing to recover from the transplant in the hospital.

“The Texas Heart Institute is enthused about the groundbreaking first implantation of BiVACOR’s TAH. With heart failure remaining a leading cause of mortality globally, the BiVACOR TAH offers a beacon of hope for countless patients awaiting a heart transplant,” said Dr. Joseph Rogers, President and Chief Executive Officer of The Texas Heart Institute and National Principal Investigator on the research. “We are proud to be at the forefront of this medical breakthrough, working alongside the dedicated teams at BiVACOR, Baylor College of Medicine, and Baylor St. Luke’s Medical Center to transform the future of heart failure therapy for this vulnerable population.”

Daniel Timms, PhD, Founder and Chief Technology Officer of BiVACOR said, “I’m incredibly proud to witness the successful first-in-human implant of our TAH. This achievement would not have been possible without the courage of our first patient and their family, the dedication of our team, and our expert collaborators at The Texas Heart Institute. Utilizing advanced MAGLEV technology, our TAH brings us one step closer to providing a desperately needed option for people with end-stage heart failure who require support while waiting for a heart transplant. I look forward to continuing the next phase of our clinical trial.”

Heart failure is a global epidemic affecting at least 26 million people worldwide, 6.2 million adults in the U.S., and is increasing in prevalence. Heart transplantations are reserved for those with severe heart failure and are limited to fewer than 6,000 procedures per year globally. Consequently, the U.S. National Institutes of Health estimated that up to 100,000 patients could immediately benefit from mechanical circulatory support (MCS), and the European market is similarly sized.

The successful implantation of BiVACOR’s TAH highlights the potential of innovative technologies to address critical challenges in cardiac care, such as long transplantation waitlists. BiVACOR and The Texas Heart Institute remain committed to advancing the field of cardiac medicine and improving outcomes for patients worldwide.

The California Insurance Commissioner announced several appointments including naming Timothy Hyamn as the newest member of the California Insurance Guarantee Advisory (CIGA) Board of Directors, Bryan Little as the newest member of the Workers’ Compensation Insurance Rating Bureau (WCIRB) Governing Committee, Michael Golden and Nona Tirre Mirande as reappointed members to the California Automobile Assigned Risk Plan (CAARP) Advisory Board, and Ophir Bruck, Stephanie Chan, and Thomas Connell Wilson as reappointed members to the California Organized Investment Network (COIN) Advisory Board.

The Governor and California State Legislature created CAARP to provide auto insurance for motorists unable to obtain coverage in the private market due to their driving records or other extraordinary circumstances. One program within the plan — the California Low Cost Auto Program — aims to provide affordable liability insurance to income-eligible good drivers by assigning them to private insurers based upon the companies’ share of the auto insurance market. The CAARP Advisory Committee provides policy advice to Commissioner Lara on matters affecting the operation of its programs.

The CIGA Board of Governors oversees the guarantee association’s general operations and management in order to protect policyholders in the event of an insurance company insolvency. Established in 1969 by the Governor and California State Legislature, CIGA comprises all insurance companies admitted to sell homeowners, workers’ compensation, automobile, and other specified property and casualty lines of insurance in California.

The California Organized Investment Network (COIN) was established in 1996 within the Department of Insurance to guide insurers on making financially sound investments that yield environmental benefits throughout California and social benefits within the State’s underserved communities. Commissioner Lara has prioritized COIN investments which drive affordable housing, support small businesses, combat climate change, and encourage investors to utilize diverse investment managers more. The COIN Advisory Board provides guidance to the Commissioner and the COIN program to meet its mission and chief priorities.

The WCIRB Governing Committee sets policy, oversees WCIRB management, and reviews all issues involving pure premium rates, classifications, rating plans, rating systems, manual rules and policy, and endorsement forms. The WCIRB is a private organization licensed by the Department for the purpose of collecting, analyzing, and compiling rating data, with funding coming from assessments of its insurance company members. All workers’ compensation insurance companies in California are required by law to be members of the WCIRB.  

The next CAARP Advisory Committee meeting is August 20 and August 21, 2024, the next CIGA Board of Governors meeting is August 13 and August 14, 2024, the next COIN Advisory Board meeting is November 7, 2024, and the next WCIRB Governing Committee meeting is September 25, 2024.

More details are available at: www.insurance.ca.gov/boards. Public members of the CAARP Advisory Committee receive $250 per meeting. All other positions are uncompensated.

Javier Hidalgo claimed injury to various body parts while employed by defendant Ducoing Management Inc., as a laborer on January 26, 2023.  On October 11, 2023, the matter proceeded to trial on several issues including earnings. The employee claimed $1,658.46 per week. The employer/carrier claimed $620.00 per week.

Hidalgo testified that he was hired to work full time, was to be provided lodging. He lived at a hotel during his employment, and would be at different locations. One week he would be in San Francisco and the following week in Sacramento. He agreed that the employer provided the lodging.

According to the Applicant, he was hired 3 months prior to his injury. On the first day of work he went to Modesto. He was taken there by a person and then on the same day at the end of the workday he was taken to Oakland. He was then provided lodging in Oakland. He was in Oakland for about a week. He was provided lodging the entire time he was in Oakland and given money for food. After being in Oakland, he went to Salinas and then Sacramento where the employer also provided food and lodging.

He estimated that he worked about 75 out of 90 days for the employer. He stated he was still provided a hotel by the employer for the 15 days he did not work. He worked in Bakersfield for about week. That is the last location he recalled working at.

Applicant was provided with lodging for the entire three month period and never went back home or to Orange County. During the three months he worked there if he had any mailed he used the foreman’s P.O. box in Oakland. He stated he was injured in Bakersfield which resulted in hospitalization for about a week at a trauma hospital then he was sent to a rehabilitation hospital. Thereafter, he went to stay with his sister.

About 15 years ago he worked with the same employer doing the same work and that lodging was not provided during that employment.

According to an employer’s witness, the Applicant stayed at hotels or lodges that the employer paid for. The employer did not give Applicant any money directly for lodging. Lodging was considered a business expense. The employer made the arrangements for lodging and covered for lodging outside of Anaheim. The employer would not cover for any lodging near Anaheim. Applicant was given a per diem check for food. The company only gave money for food to employees working off-site outside of Anaheim. The per diem for food was provided when traveling.

After a trial the WCJ found, in pertinent part, that applicant’s lodging and food allowance are considered part of his wages; that applicant’s weekly earnings are $1,439.10 a week.

The Defendant filed a Petition for Reconsideration, which contended in part that the WCJ erred in considering applicant’s lodging and food allowance as part of his wages. Reconsideration was granted in the panel decision of Hidalgo v Ducoing Management Inc -ADJ17503090 (March 2024).

Labor Code section 4453(c)(1), provides that “[w]here the employment is for 30 or more hours a week and for five or more working days a week, the average weekly earnings shall be the number of working days a week times the daily earnings at the time of the injury.” With respect to whether specific items, such as food and lodging, are included in the computation of average weekly earnings, the WCAB panel looked to section 4454 which states “average weekly earnings shall not include any sum which the employer pays to or for the injured employee to cover any special expenses entailed on the employee by the nature of his employment, .”

Remuneration is defined by Black’s Law Dictionary as “Payment; reimbursement. Reward; recompense; salary; compensation.” (Black’s Law Dict. (6th ed. 1990) p. 1296, col. 1.)

The analysis of whether lodging and meals are “remuneration” as opposed to “special expenses” is outlined in Burke v. Workers’ Comp. Appeals Bd. (2009) 74 Cal.Comp.Cases 359, as follows: In the context of employment, remuneration is payment or reward for services rendered. The plain meaning of “remuneration” does not include reimbursement for costs or expenses. When an employee’s expenses “entailed by the nature of [her] employment” are paid by an employer, an exchange of services for payment does not take place and the applicant does not obtain an advantage from the transaction. Determining whether fuel, lodging, and meals are “remuneration” or “special expenses” requires an analysis of several factors including whether they were provided in exchange for services, whether they are an advantage to the applicant, and whether they are provided to the applicant only while the applicant is performing employment duties.

With respect to meals, Burke provides the following: “Meals are remuneration if the employee is provided with meals in exchange for services and the meals are an economic advantage to applicant. For example, in Watson v. Workers’ Comp. Appeals Bd. (Ramirez) (1980) 45 Cal.Comp.Cases 50 (writ den.), the value of meals were included in the calculation of applicant’s earnings as a waitress. The applicant was relieved of the necessity of providing herself with the meals … and, therefore, her employer’s provision of the meals was an economic advantage to the applicant.”

Because all of Hildago’s “jobsites in 2022 and 2023 were away from home, it logically follows that applicant received a per diem for all of the days worked in 2022 and 2023. However, there was no evidence presented that the per diem for meals was part of his remuneration or understood to be an economic advantage to applicant above and beyond his wages.”

Turning to whether the cost of applicant’s lodging is remuneration for purposes of calculating his average weekly earnings, the WCAB noted that “the evidence is less clear cut.”

“Upon return, the WCJ should consider whether lodging was an expense necessitated by the nature of applicant’s employment, and whether payment for lodging provided any bargained for economic advantage to applicant.”

Chronic musculoskeletal (MSK) pain affects one in three individuals worldwide. MSK pain is a leading cause of work-related disability and productivity impairment, broadly impacting all industry sectors. Productivity impairment can occur through presenteeism (i.e. decreased work performance due to pain) and absenteeism (i.e. missing working hours), and can ultimately lead to early retirement, all imposing a strain to the workforce.

MSK pain-related productivity impairment drives tremendous economic impact at the organizational and societal levels. Total costs of MSK pain-related productivity loss represent up to $335 billion annual spent, outweighing the direct impact of healthcare expenditure.

Current guidelines recommend exercise-based physical therapy combined with education and behavioral interventions as a mainstay treatment for chronic MSK pain. However, insufficient healthcare facilities and professionals, the loss of work hours and travel expenses associated with attending in-person physical therapy sessions, leave many patients with suboptimal or no care. Digital interventions have arisen as a solution to increase access, promoting higher engagement, while driving clinically significant outcomes.

Additionally, evidence suggests that MSK digital interventions are more affordable than conventional in-person rehabilitation.Independently of care delivery mode (digital or in-person), most studies focused on cost-effectiveness from a societal perspective.To date, no study has explored the potential economic impact of digital interventions from an employer perspective.

For these reasons researchers decided to investigate the impact of a DCP in promoting savings associated with recovery of productivity impairment in employees with chronic MSK pain. As a secondary objective, to explore potential savings in different industry sectors. The Study – Recovering work productivity in a population with chronic musculoskeletal pain: unveiling the value and cost-savings of a digital care program – was just published in the Journal of Occupational and Environmental Medicine.

The DCP, developed according to current guidelines,consisted of home-based exercise, education, and cognitive behavioral therapy (CBT) over up to 12 weeks. During enrollment, each participant selected the physical therapist (PT) who supervised the intervention. During the onboarding video call, the PT performed a clinical assessment and prescribed a tailored program.

Exercise sessions were performed at the patient’s convenience (recommended 3 times/week) using an FDA-listed class II medical device composed of motion trackers, a dedicated tablet with a mobile app and a cloud-based portal. The tablet displayed guided exercise sessions through videos with real-time audio and visual biofeedback provided by the motion trackers. Motion data were stored in the cloud-based portal accessible by the assigned PT to asynchronously monitor and adjust the program as needed.

Patient education was provided through a smartphone app in the form of short written articles, focusing on the pathophysiology, pain reconceptualization, active coping skills, the role of exercise, and fear-avoidance behaviors.A CBT program based on mindfulness, acceptance, commitment therapy, and empathy-focused therapy was delivered through email in the form of interactive and audio modules. Patient and PT communication was fostered through a built-in secure chat within the smartphone app available on-demand.

From 11,361 patients screened for study eligibility, 5032 employees from 50 U.S. states started the program. Significant improvements in productivity impairment were observed across all industries, yielding median cumulative savings from $151 (95%CI 128;174) to $294 (95%CI 286;303) per participant at treatment-end. Twelve-months projections estimated median savings of $2916 (95%CI 2861;2972). Additionally, significant improvements in non-work-related daily activities were observed.

These savings, estimated from real-world data, disclosed the underlying burden of presenteeism, which was the major responsible for overall productivity loss. The observed results advocate for the use of a DCP to promote productivity recovery, and to improve quality of life in non-work-related activities, consequently supporting employers in maintaining a competitive workforce, while attaining significant savings.