Author: WorkCompAcademy

Chronic pain, one of the most common reasons adults seek medical care. Chronic pain contributes to an estimated $560 billion each year in direct medical costs, lost productivity, and disability programs.

High Impact Chronic Pain (HICP), is a new concept that describes those with pain lasting three months or longer and accompanied by at least one major activity restriction.

The concept of HICP was first proposed by the National Pain Strategy to better identify those with significant levels of life interference.

The National Pain strategy was core recommendation of the 2011 Institute of Medicine Report: Relieving Pain in America. Recommendation 2-2 said that “The Secretary of the Department of Health and Human Services should develop a comprehensive, population health-level strategy for pain prevention, treatment, management, education, reimbursement, and research that includes specific goals, actions, time frames, and resources.”

The National Pain Strategy, is the first national effort to transform how the population burden of pain is perceived, assessed, and treated, recognizes the need for better data to inform action and calls for estimates of chronic pain and high-impact chronic pain in the general population.

Together, the HICP population constitutes some 4.8 percent of the U.S. adult population. About 83 percent of people with HICP were unable to work for a living, and one-third had difficulty with self-care activities such as washing themselves and getting dressed. Almost 11 million U.S. adults have High Impact Chronic Pain.

Activity limitations were more common in the chronic pain population than in groups with other chronic health conditions, such as stroke, kidney failure, cancer, diabetes, or heart disease.

“By differentiating those with HICP, a condition that is associated with higher levels of anxiety, depression, fatigue, and cognitive difficulty, we hope to improve clinical research and practice,” said M. Catherine Bushnell, Ph.D., scientific director in the NCCIH Division of Intramural Research and another author of the study.

“It is crucial that we fully understand how people’s lives are affected by chronic pain. It will help improve care for individuals living with chronic pain and strategically guide our research programs that aim to reduce the burden of pain at the population level,” said Linda Porter, Ph.D., director of the Office of Pain Policy at NINDS.

Employers in California and elsewhere are closely watching case law that slowly erodes limits to employer liability for actions regarding the use of Medical Marijuana outside the workplace. A recent decision in a federal trial court in Connecticut is one of the cases that are making employers nervous about their policies.

In the case of Noffsinger v. SSC Niantic Operating, No. 3:16-cv-01938 (D. Conn.), a federal judge ruled that refusing to hire a medical marijuana user because she tested positive on a pre-employment drug test violates Connecticut’s medical marijuana law as it granted summary judgment to the job applicant on her employment discrimination claim.

Plaintiff Katelin Noffsinger was diagnosed with post-traumatic stress disorder (PTSD) in 2012 after being in a car accident. Her caregiver recommended treating her PTSD with medical marijuana, which she began using in 2015. In accordance with Connecticut Palliative Use of Marijuana Act (PUMA), plaintiff registered with the Department of Consumer Protection in November 2015 as a qualifying patient for the use of medical marijuana.

Noffsinger accepted a job offer from defendant SSC Niantic Operating Company, LLC d/b/a Bride Brook Health & Rehabilitation Center. But the offer was contingent on drug testing, and plaintiff told defendant that she was qualified under PUMA to use marijuana for medical purposes to treat her post-traumatic stress disorder. After her drug test came back positive for THC consistent with the use of marijuana, defendant rescinded its job offer.

She filed suit against the employer in federal court. After the parties conducted discovery they cross-moved for summary judgment.

Bride Brook argued that its refusal to hire Noffsinger is allowed by an exception to PUMA’s anti-discrimination provision (when “required by federal law or required to obtain federal funding”). It argued that the federal Drug-Free Workplace Act (DFWA) barred it from hiring Noffsinger because that law prohibits federal contractors from allowing employees to use illegal drugs. Marijuana is illegal under federal law.

The court rejected Bride Brook’s argument, noting that the DFWA does not require drug testing and does not regulate employees who use illegal drugs outside of work while off-duty.

Similarly, the court rejected Bride Brook’s argument that hiring Noffsinger would violate the False Claims Act. It held that hiring an employee who uses medical marijuana outside of work while off-duty would not defraud the federal government.

Bride Brook also argued that it did not violate PUMA because it did not discriminate against Noffsinger based on her status as a medical marijuana user; rather, it had relied on the positive drug test result. The court dismissed this argument, concluding that acceptance would render a medical marijuana user’s protection under the statute a nullity.

While the court held that the employer had engaged in employment discrimination, it declined to award Noffsinger attorney fees or punitive damages because those types of damages are not expressly recoverable under PUMA.

Additionally, the court dismissed Noffsinger’s claim for negligent infliction of emotional distress, because the employer did not engage in “unreasonable conduct” and Noffsinger chose to give notice to her prior employer that she was resigning before she had advised Bride Brook of her medical marijuana use.

Although this is a development at the trial court level in a jurisdiction outside of California which is not binding precedent here, nonetheless employment law attorneys who have been watching these cases evolve in Connecticut and elsewhere suggest that employers should consider the marijuana laws affecting their workplaces now, before an issue arises, and adjust their policies as necessary.

Lahkwinder Singh and his corporation, Lovely Singh Inc., have been convicted for the illegal trafficking of pharmaceuticals.

While doing business as a franchise of shipping company Postal Annex, Lovely Singh Inc. facilitated the shipment of controlled pharmaceutical drugs such as hydrocodone, Xanax and oxycodone through the mail.

Lahkwinder Singh, the CEO of the company was sentenced i to 36 months in federal prison. The 36-month sentence is one of the longest imposed in the Southern District of California for a structuring conviction.

Singh’s closely held corporation, Lovely Singh, Inc., was ordered to forfeit $1,000,000, and serve a 5-year term of probation.

Singh owned and operated Postal Annex franchises in Lemon Grove, California, under the name Lovely Singh. According to the complaint, Singh engaged in a multi-year pattern of cash transactions below the $10,000 threshold to avoid detection by banks and law enforcement, with the intent to deposit Lovely Singh’s cash proceeds free from scrutiny.

The plea agreement admits that Singh and his co-defendant Lovely Singh Inc. distributed Schedule II controlled substances to persons throughout the United States.

Couriers imported pre-packaged quantities of controlled substances into the United States from Mexico and delivered them to the Postal Annexes. The substances were then illegally sold for prices ranging between $1 and $100.

The plea agreement also states that Singh attempted to set up $2,955,521 of currency transactions through 469 cash deposits at several domestic financial institutions. Singh conducted multiple deposits of less than $10,000 in cash on the same day. He also made deposits into at least 19 different bank accounts over the course of several business days.

These deposits were conducted with the purpose of avoiding a Currency Transaction Report, which is the report a financial institution must file for cash deposits exceeding $10,000 during any banking day. These cash deposits included money received in return for shipping controlled substances from the Postal Annex stores.

Singh was ultimately charged with and found guilty of Structuring Currency Transactions with One or More Financial Institutions.

Holly Merrill-Miller pled no contest to misdemeanor workers’ compensation fraud. The Honorable Lawrence Brown sentenced Miller to 3 years probation and ordered her to pay $8,382.31 in restitution.

Holly Miller was a 33-year-old nursing assistant with Sutter Health when she allegedly suffered an injury to her wrist.

On September 22, 2015, she claimed a patient grabbed her hand, twisted it and repeatedly jerked it, causing pain and swelling.

Miller was placed on restricted duty by the treating physician, but she complained her pain was getting worse.

Images were taken, which didn’t show an obvious injury. However, Miller continued to complain of increased pain and stress. After canceling several medical appointments, she was returned to work.

In November 2015, surveillance was conducted on Miller which showed her using her right hand without any apparent limitations or pain.

When the treating physician saw the video surveillance, he stated it was at odds with what Miller stated she could and could not do. Miller reiterated her complaints. The physician explained he had seen surveillance videos of her activity levels and was returning her to work with no restrictions.

This case was investigated and prosecuted by the District Attorney’s Insurance Fraud Unit

A former president of Purdue Pharma, the controversial drug manufacturer widely considered to have ignited the opioid epidemic through its aggressive marketing of OxyContin, has been awarded a patent for a new opioid addiction treatment. Dr. Richard Sackler is one of the six individuals on the patent issued in January, the Financial Times first reported Friday.

Critics expressed concern that Sackler, whose family is worth an estimated $13 billion largely from Purdue’s sale of opioid painkillers, now stands to profit further from medication that treats addiction to the very drugs peddled by his family.

The patent covers a new formulation of buprenorphine in a wafer form. The medication is shown to help people struggling with opioid addiction, and the Food and Drug Administration has already approved the drug in tablet and film form.

Sackler, who served as Purdue’s president from 1999 to 2003, was instrumental in pushing OxyContin’s sales through one of the largest pharmaceutical marketing campaigns in history. The campaign worked: Doctors previously averse to prescribing opioids for pain management due to their addictiveness were convinced by Purdue’s aggressive tactics that OxyContin was safe to prescribe.

Purdue later admitted that its marketing campaign was a sham.

The company was ordered to pay $635 million after it and three top executives pleaded guilty to misleading doctors about the addictiveness of OxyContin and its potential for abuse between 1996 and 2001. Put into perspective, the fine represents less than one-quarter of the sales revenue OxyContin generated for the Sacklers during that six-year period.

Purdue’s legal woes are far from over. The company is currently facing over 400 lawsuits from cities across the country in addition to 26 lawsuits by state attorneys general for downplaying the risks of OxyContin as part of an allegedly fraudulent marketing scheme to boost sales of OxyContin

Purdue has denied the allegations in the lawsuits and has recently taken steps to address the opioid crisis it helped create. The company has backed safer prescribing practices and announced Wednesday it’s contributing $3.4 million to a company developing a low-cost emergency medication for suspected opioid overdoses.