Author: WorkCompAcademy

The increasing risk of drug resistant superbug infections have been the focus of attention over the last several months as major hospitals such as UCLA report patient infections, and other health organizations are calculating what might occur should no new antibiotic be developed to combat these infections. The predicted costs to the economy and to the insurance industry are expected to be substantial. One of the several superbugs is MRSA or Methicillin-resistant Staphylococcus aureus.

Now, as strange as it may seem, a story published in Forbes and other major news media today reports that a 1,200-year-old Anglo-Saxon remedy called Bald’s Eye Salve has proven “astonishingly” effective in battling the MRSA superbug, which kills more than 5,000 people a year in the US. The potion, composed of garlic, onion or leeks, wine, and ox bile, kills up to 90 per cent of antibiotic-resistant Staphylococcus aureus bacteria in mice, according to scientists at the University of Nottingham.

The Mediaeval treatment was rediscovered by Christina Lee, an associate professor who specializes in disease and disability in the Anglo-Saxon and Viking eras, who translated it from old English. The one thousand year old Anglo-Saxon remedy for eye infections which originates from a manuscript in the British Library has been found to kill the modern-day superbug MRSA in an unusual research collaboration at The University of Nottingham.

Dr Lee, an Anglo-Saxon expert from the School of English has enlisted the help of microbiologists from University’s Centre for Biomolecular Sciences to recreate a 10th century potion for eye infections from Bald’s Leechbook an Old English leatherbound volume in the British Library, to see if it really works as an antibacterial remedy. The Leechbook is widely thought of as one of the earliest known medical textbooks and contains Anglo-Saxon medical advice and recipes for medicines, salves and treatments.

Early results on the ‘potion’, tested in vitro at Nottingham and backed up by mouse model tests at a university in the United States, are, in the words of the US collaborator, “astonishing”. The solution has had remarkable effects on Methicillin-resistant Staphylococcus aureus (MRSA) which is one of the most antibiotic-resistant bugs costing modern health services billions.

The recipe, including detailed instructions on how long to chill the ingredients (nine days at 4C), was found in the leather-bound medical textbook from the 9th Century held in the British Library. “Medieval leech books and herbaria contain many remedies designed to treat what are clearly bacterial infections,” said Dr Lee.

Microbiologists recreated Bald’s Eye Salve as faithfully as possible, even using a wine from a historic vineyard near Glastonbury, and tested it both in vitro and on wounds in mice. They compared the results to those achieved previously with the individual ingredients. “We thought that Bald’s eye salve might show a small amount of antibiotic activity, because each of the ingredients has been shown by other researchers to have some effect on bacteria in the lab,” said microbiologist Freya Harrison. “We were absolutely blown away by just how effective the combination of ingredients was.”

Although developed long before the formal scientific method emerged, such remedies could have benefited from extensive trial-and-error research to determine what worked best. Many other books survive from the period with other treatments that might be similarly effective, Dr Lee said. A global hunt for new weapons against antibiotic-resistant infections was launched last year, spearheaded by British Prime Minister David Cameron. The results of the research on Bald’s Eye Salve were presented at the Annual Conference of the Society for General Microbiology, in Birmingham yesterday.

On March 20, 2015 Kimberly Evans was arrested by Los Angeles County Probation Department’s Special Projects Team on three felony counts (550 (a)(6) PC Insurance Fraud, Count (2) 487 PC Grand Theft of Personal Property, Count (3) 72 PC Presentation of Fraudulent Claim Count) and one misdemeanor count (471.5 PC Alteration of a medical record). Evans’ actions resulted in obtaining compensation that she would not otherwise be entitled to.

Evans is a sworn peace officer with the Los Angeles County Probation Department and is assigned to a Juvenile Detention Facility as a Detention Services Officer. An investigation by the Special Projects Team revealed that Evans allegedly altered medical documentation resulting in a loss of $1,707.20 during the time period she claimed as “sick time” on her time card.

This is the latest arrest as the Los Angeles County Probation Department continues to beef up its Professional Standards Bureau to crack down on insurance fraud and employee misconduct. “Within the last year the Department added a Special Projects Team comprised of four supervisory level investigators” says Jennifer Kaufman, Senior Director, “These investigators are specially trained to recognize the signs of workers compensation and/or medical fraud.”

Evans was arrested on three felony counts and one misdemeanor count of Fraud. She was booked at the Santa Clarita Sheriff’s station in Santa Clarita and bail was set at $30,000. The Arraignment date is pending.

Los Angeles police and firefighters work in a culture that encourages filing “excessive” workers’ compensation claims, according to a pair of city audits released Thursday and reported by the Los Angeles Times. And taxpayers are doling out up to $28 million a year for what amount to preventable injuries. The majority of injuries claimed by firefighters in recent years occurred while doing things other than responding to emergencies, including maintaining equipment, playing racquetball and preparing food at their fire stations, according to one of the audits by City Controller Ron Galperin.

L.A. police, meanwhile, are paid for on-the-job injuries more often than officers in comparable departments, the other audit found, at least in part because other departments don’t recognize sports injuries as “job-related.” Two-thirds of city firefighters and 60% of police officers filed an on-the-job injury claim in the last three years, the auditors found, and nearly half of those employees have filed more than one claim during that time.

The city audits come months after a Los Angeles Times investigation found steep increases in payments to injured police and firefighters, who receive 100% of their salaries, tax-free, for up to a year while off work recovering from seemingly job-related injuries. Only a small percentage of claims in recent years were attributed to injuries suffered fighting fires or confronting combative suspects, The most common cause was cumulative trauma claims that are not linked to a specific on-the-job injury. A disproportionate amount of injury pay was going to employees who filed consecutive claims, reporting a new injury just as a previous leave is about to end.

The city audits found, in all, that workers’ compensation costs for sworn employees have increased by 35% over the last five years to $141 million in 2014, including salary payments while the employees were off work, medical bills and other related expenses. Surveys sent to police officers by the auditors showed 45% agreed that there is an “excessive” number of workers’ compensation claims filed at the department, while a third of firefighters believed “questionable” claims had been filed by their colleagues.

The police and fire departments are shielded from the full cost of workers’ compensation claims because they don’t have to pay the medical bills, the auditors found. Those costs, nearly $85 million over the last four years, are covered by a separate city fund. The auditors recommended that the departments be made to pay medical bills out of their own budgets because “management may not be sufficiently aware of, or held accountable for, the impact of rising claims and costs.”

The departments suffer in other ways, however. Last year, fire officials told The Times they were spending more than $51,000 per day – or nearly $19 million annually – on overtime to cover shifts left vacant by firefighters out with injuries. At the Police Department, where overtime has been severely restricted, the rising number of injury leaves meant fewer officers on the street, officials said.

California legislators granted 100% pay for injured public safety employees during the Great Depression to ensure that those protecting the public wouldn’t hesitate to chase a criminal or run into a burning building for fear of losing their livelihood. But the design of the program invites abuse, city officials across the state told The Times. Because injury pay is exempt from federal and state income taxes, the employees typically take home significantly more money when they’re not working. And time spent on leave counts toward pension benefits. That creates a perverse financial incentive to file injury claims for relatively minor ailments and to stay out as long as possible, experts said.

Beverly Myres was hired by the San Francisco Housing Authority (SFHA) in 2006 as a claims assistant. In 2007 she was promoted to workers’ compensation analyst. Myres was a member of the San Francisco Municipal Executives’ Association, and her employment with SFHA was governed by a union memorandum of understanding (MOU).

In 2009, Myres injured her right knee at work and filed a workers’ compensation claim in June 2009. She continued to work full-time without any restrictions until she had surgery on her right knee, Myres was then released to return to modified work with the following restrictions: “Seated work – stand/walk for personal needs only. No lift over 10 lbs. No drive for work. Must work in location free from tripping hazards.” Her employer indicated it would accommodate her restrictions.

Upon returning to work she experienced increased pain in her left knee. It was at first disputed that the left knee was injured as a result of employment. While seeking clarification of the cause of her left knee pain SFHA had advised the entire department that they were being laid off as a result of departmental restructuring. Myres then sued SFHA. Her first three causes of action are each titled “Disability Discrimination.” and she filed a fourth and fifth cause of action for hostile work environment harassment and wrongful discharge in violation of public policy premised on her allegations of retaliation for taking workers’ compensation leave.

According to SFHA, Myres and the rest of the department were laid off for a legitimate reason, “to restructure the department for improved efficiency” and due to reduced federal funding and a budget shortfall. Myres, on the other hand, asserted that SFHA retaliated against her for taking workers’ compensation leave. In support of this contention she called SFHA’s former special assistant to the executive director, who testified that “[t]here were a number of people in the department . . . that [her supervisors] were having trouble with. So they decided to deal with the problem by restructuring and laying everybody off.” As a result of the layoff, Myres testified that she suffered a loss of her annual salary of approximately $81,000 for almost three years, as well as fringe and retirement benefits.

After trial, the jury returned verdicts in favor of the employer on four of the five causes of action. With respect to hostile work environment harassment, the jury found in Myres’s favor and awarded her $35,000 in noneconomic damages. Post judgment interest was awarded in the amount of 10% and Myers was awarded attorney fees and costs. Both parties appealed. SFHA primarily contends on appeal that that the jury’s harassment verdict is not supported by substantial evidence. Myres also appeals from the judgment, arguing that various evidentiary and instructional errors affected the jury’s verdicts in favor of SFHA on her causes of action for failure to reasonably accommodate her disability. With the exception of post judgment interest in the amount of 10%, the Court of Appeal found no prejudicial errors, and after reducing the interest to 7% affirmed the judgment in the unpublished case of Myres v SFHA.

One of the issues raised by Myres was the collateral source rule. Myres filed a motion in limine to exclude evidence of collateral sources of income. She argued that any such evidence of post injury sources of income was irrelevant, as it could not be used to offset a backpay award on her retaliation and wrongful discharge causes of action. The trial court denied the motion. Over Myres’s “collateral source” objection, SFHA’s expert economist detailed the payments Myres received from retirement, social security disability, and worker’s compensation disability between September 1, 2010, and the date of trial. Ultimately, he opined that there was only a $500 difference between Myres’s expected compensation, had she remained employed by SFHA, versus the compensation she received in retirement and disability benefits after separation.

The Court of Appeal agreed that some of the collateral source income should not have been admitted. However, it was not prejudicial error. “In this case, however, we find it unnecessary to remand for a new trial. Under section 12940, subdivision (h), it is an unlawful employment practice ‘[f]or any employer . . . to discharge, expel, or otherwise discriminate against any person because the person has opposed any practices forbidden under this part or because the person has filed a complaint, testified, or assisted in any proceeding under this part.’ We agree with SFHA that, as a matter of law, Myres could not recover for FEHA retaliation on the basis that she was terminated for taking workers’ compensation leave. Taking workers’ compensation leave is not protected activity under FEHA.” Thus the verdicts against her on the discrimination causes of action were affirmed.

But, the Court of Appeal agreed there was evidence in support of her claim of a hostile work environment. Her employer made comments before her injury such as “that other SFHA employees taking workers’ compensation leave were “malingerers,” abused the system, and filed “fraudulent claims.” Another comment was “How can the workers’ comp person be out on workers’ comp?”

Over the next 35 years, multidrug-resistant tuberculosis will kill 75 million people and could cost the global economy a cumulative $16.7 trillion – the equivalent of the European Union’s annual output, a UK parliamentary group said on Tuesday. If left untackled, the spread of drug-resistant TB superbugs threatens to shrink the world economy by 0.63 percent annually, the UK All Party Parliamentary Group on Global Tuberculosis (APPG TB) said, urging governments to do more to improve research and cooperation.

According to the report in Reuters Health, “the rising global burden of multidrug-resistant TB and other drug-resistant infections will come at a human and economic cost which the global community simply cannot afford to ignore”, economist Jim O’Neill said in a statement. O’Neill, a former chief at investment bank Goldman Sachs, was appointed last year by British Prime Minister David Cameron to head a review into antimicrobial resistance.

The bacteria that cause TB can develop resistance to drugs used to cure the disease. Multidrug-resistant TB fails to respond to at least isoniazid and rifampicin, the two most powerful anti-TB drugs, according to the World Health Organization (WHO). The UK parliamentary group’s cost projections are based on a scenario in which an additional 40 percent of all TB cases are resistant to first-line drugs, leading to a doubling of the infection rate. The WHO said last year multidrug-resistant TB was at “crisis levels”, with about 480,000 new cases in 2013. It is a manmade problem caused by regular TB patients given the wrong medicines or doses, or failing to complete their treatment, which is highly toxic and can take up two years.

The group urged governments to set up a research and development fund, target investments into basic research and increase support for bilateral TB programs. “We need better tools to deal with this new threat, but since TB primarily affects the poorest and most vulnerable in society, there is little commercial incentive to develop new drugs,” said Nick Herbert, co-chairman of the APPG TB. The fight against TB, the world’s second deadliest infectious disease after HIV, is also hampered by a lack of an effective vaccine, the APPG TB said. The only TB vaccine, BCG, protects some children from severe forms of TB – including one that affects the brain – but is unreliable in preventing TB in the lung, which is the most common form of the disease.

TB, which spreads through the coughs and sneezes of an infected person, killed 1.5 million people worldwide in 2013, according to the WHO. Putting that number into perspective can be done by comparing the death rate for Ebola, the infection that has caused recent international media panic. The CDC reports the entire Ebola international death count as of this month to be less than 11,000. The risk of death by TB is magnitudes higher than the risk of death by Ebola infection.

The workers’ compensation community is not immune to the cost effects of out-of-control superbugs. Infectious diseases can become a costly problem in worker’s compensation claims. Claims can arise as a result of infections on the job, infections during treatment for an industrial injury, or infections to health care workers.