Tag: 2014 News

Los .Angeles. officials wanted to make absolutely sure the city’s trash truck drivers would not get caught sleeping in their trucks – a sight sure to enrage taxpayers or possibly attract a TV news camera. So they laid down a set of break time rules prohibiting naps and placing other restrictions on where and how drivers could have lunch. But the Los Angeles Times reports these rules have the city facing a $26-million legal payout, most of it for more than 1,000 trash truck drivers who said they were improperly barred from catching a few winks during their 30-minute meal breaks. The City Council, meeting behind closed doors, moved ahead Wednesday with the payout, designed to end an 8-year-old class-action lawsuit. The drivers would receive an average of $15,000 each in back pay, according to Matthew Taylor, their attorney. He argued that they effectively were required to remain “on duty” – but not paid – during nine years of meal breaks.

Taylor said the no-napping rule created dangers on the road involving heavy city garbage rigs. “It’s a hazard to the public if you have commercial truck drivers who are fatigued and are not allowed to take a nap during their breaks,” he said. In addition to banning naps, the Bureau of Sanitation also prohibited drivers from congregating in large groups or traveling to locations away from their pickup routes during lunch breaks. Those rules were abandoned last summer.

City lawyers warned council members that they might have to pay as much as $40 million if the court battle over the drivers’ work rules continued. A Superior Court judge and a state appeals court panel have already sided with the drivers. “The city does impose duties during meal periods: the duties to stay awake and to avoid congregating,” trial court Judge John Shepard Wiley Jr. ruled in 2011. “The drivers are thus subject to the city’s control during their meal periods.”

Some lawmakers expressed outrage at the rulings, saying the work rules had a legitimate purpose. “I just am appalled that a court can take it upon themselves to assert that we have to retroactively pay [workers] for lunch breaks that were in fact taken by our employees,” said Councilman Paul Krekorian, who added that the city’s unions signed off on the work rules. Krekorian, who heads the council’s Budget and Finance Committee, would not discuss Wednesday’s closed-session deliberations. But three other officials familiar with the lawsuit, who asked to remain anonymous because they were discussing a confidential legal matter, told The Times the council voted to go ahead with the $26-million settlement. Those sources said the only opposing votes were cast by council members Joe Buscaino and Mitchell Englander. Both declined to comment.

City officials said the contested work rules were intended to guard the public image of the trash collection service and enhance safety. By limiting the number of workers who could gather in one spot for a meal, the city kept large numbers of oversized trash trucks from being parked together in a single neighborhood or in restaurant parking lots, said Enrique Zaldivar, who runs the sanitation bureau. The no-sleeping rule, Zaldivar said, was imposed to ensure members of the public would not see trash truck drivers asleep in or near their vehicles.”It’s impossible for the general public to know whether a driver is on duty or not while sleeping, he said. “So we felt it was prudent to not have any sleeping occur when the driver is in public view, or during any time that could be construed as on duty.”

The work rule dispute dates back to 2006, when trash truck driver Jose Gravina filed a lawsuit alleging he was routinely denied meal breaks owed after five hours of work. Gravina had been disciplined for napping during his meal break, his lawyer said. Gravina’s case received class-action status in 2011, the year he retired. After losing at the trial court level, city lawyers appealed, arguing state meal break regulations do not apply to employees of cities like Los Angeles, which operate under voter-approved charters. An appeals court also sided with the drivers, saying issues of vehicle and public safety trumped any local governance concerns. Councilman Mike Bonin called the court rulings in the case “obscenely ridiculous,” saying the image of a city employee in uniform in a city vehicle sleeping would be “an affront” to his constituents. Krekorian said the public would also draw the wrong conclusions upon seeing multiple trash trucks parked outside a restaurant. “It looks as though they’re not tending to their duties,” he said.

People injured in an accident or at work sometimes file for monetary compensation, and according to some studies those who file tend to have worse long-term health than those who do not. A new survey of Australian accident victims found that claims stress often comes from confusion about the process, delays and related medical assessments. Those who were most stressed by filing a claim tended to have higher levels of disability years later.

According to the article in Reuters Health, study author David M. Studdert of Stanford University in California said past studies have compared people who filed for compensation to people who did not, but those groups might have different types of injuries to begin with. Another aspect to consider is that people who file claims have an incentive to exaggerate their symptoms to receive more compensation for longer. “The novelty of this study was to look within a group of claimants to test whether those who reported experiencing the most stress also had the slowest recoveries,” Studdert said. “They did.”

He and his colleagues polled a random selection of more than 1,000 patients hospitalized in Australia for injuries between 2004 and 2006. Six years later, 332 of the patients who had filed for workers’ compensation or another accident claim told the researchers how stressful the process had been. Claims can take four to five years to conclude, Studdert noted. A third of the claimants reported high stress from understanding the claims process and another third were stressed by delays in that process. A slightly smaller proportion said repeated medical evaluations and concern for the amount of money they would receive were sources of stress.\Negative attitudes from doctors, friends, family or colleagues, on the other hand, did not seem to be common sources of stress.

People with the most stress tended to score higher on a disability scale and have higher levels of anxiety and depression and lower quality of life, the researchers reported in JAMA Psychiatry. “While it’s intuitive that the compensation process is going to be stressful for some claimants, what is less clear is whether that stress has a substantial impact on recovery many years after the injury,” Studdert said. “We were surprised by the size of the compensation effects on outcomes like level of disability and quality of life – they were fairly strong,” he told Reuters Health.

“There is much debate at the moment about the role of ‘systems,’ in this case ‘compensation systems’ on health outcomes,” said Michele Sterling, who studies injuries and rehabilitation at the University of Queensland in Herston, Australia. She was not involved with the current study. “If it can be established which parts of the process cause stress and/or poor outcomes or recovery then the system could look at targeting these specific areas and improve them,” Sterling told Reuters Health. “Some insurance regulators are already trying to do this in some areas.” This study deals with severe injuries that require hospitalization, and her own research focuses on more minor injuries, she noted, but the relationship between stress and health is likely the same, she said. She has found that posttraumatic stress symptoms predict poor recovery, and that could be worsened by stresses in the claims system, she said.

“Our study joins many others that show the rate of mental health problems among people who are injured is astonishingly high,” he said, adding that medical systems are excellent at treating physical injuries but not as good at treating mental conditions Studdert said. “I think the point that needs to be made is that those managing these systems, insurers or workers’ compensation boards, or no fault automobile compensation schemes, should realize that they are undermining their own mission of getting workers back on their feet if the process is unnecessarily stressful,” said Katherine Lippel, who studies occupational health and safety law at the University of Ottawa in Ontario, Canada and was not involved in the study. The authors suggest that compensation schemes could be redesigned to get the process over with quicker and make it easier for patients to understand, which could alleviate some sources of stress.

Studies such as this one may be a basis to seek apportionment of permanent disability based upon causation. New Labor Code sections 4663, subdivision (a) and 4664, subdivision (a) eliminate the bar against apportionment based on pathology and asymptomatic causes. Thus, under the post SB 899 workers’ compensation system, apportionment of permanent disability shall be based on causation (§ 4663, subd. (a)), and the employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment. Creative trial work coupled with a comprehensive forensic presentation may accomplish a persuasive argument to apportion away the effects of stress from the disability after a physical industrial injury.

The Bee reports that Sacramento County Superior Court has swallowed a 23 percent budget cut over the last five years. With 230 of 800 employees gone, the pain is acute in every aspect of court operations. Twenty-five court counter windows have closed. Courts remain open, but the wheels of justice grind so slowly that a lot of people have given up. Statewide, civil filings dropped 43 percent over three years ending in fiscal 2011-12. “Access to justice has been hurt badly, and it affects everybody in the community,” said Robert Hight, the court’s presiding judge. In Sacramento, the queue at family court can take seven hours. Small-claims courts are on life support, if they operate at all. And getting a trial date is not a guarantee there will be a courtroom available that day. Some local trials have been continued to a later date multiple times, for months at a time.

The cuts hurt companies large and small, say business advocates. A worker who needs a restraining order but fails to make it to the front of the line will have to go back another day. The attorney whose trial was bumped will have to prepare for trial all over again. “I think some people are giving up,” Hight said. Couples frustrated with family court split and don’t file, he said. And some business owners resolve disputes outside the court system. They pay for private alternative dispute-resolution services instead of using the tax-supported justice system.

As stated in a 2009 New York Times editorial, “[A]t some point, slashing state court financing jeopardizes something beyond basic fairness, public safety, and even the rule of law. It weakens democracy itself.” Since 2009 when this editorial was published, California trial courts have lost nearly three-quarters of a billion dollars in State General Fund support.

California has the largest judicial system of any state, but it has suffered the deepest financial reduction of any state, according to a new report on the state of the judiciary in Sacramento County. Statewide, the judicial branch has undergone $1 billion in cuts over the last six years. Fifty-one courthouses and 205 courtrooms have closed. After five years of court cuts, there is no fat left in the system. “People lose faith and feel it is no longer open to them,” said Tani Cantil-Sakauye, chief justice of the California Supreme Court. “It’s a nefarious way to deny people their rights.”

Because the federal Constitution gives priority to criminal cases, state budget cuts have disproportionately affected civil courts where most business cases are filed. A 10 percent cut in court funding translates to a 40 to 50 percent cut in access to justice in civil cases because that’s the only place to cut, said Nancy Drabble, executive director of the California Consumer Attorneys Association. This of course has an adverse effect on Workers’ Compensation subrogation efforts. Delays affect both employees and employers, said Allen Zaremberg, president and CEO of the California Chamber of Commerce.

Gov. Jerry Brown’s proposed state budget includes $100 million for trial court operations and $5 million to support the state judiciary. Cantil-Sakauye, chief justice of the California Supreme Court

Despite efforts by the Obama administration to ease shortages of critical drugs, shortfalls have persisted, forcing doctors to resort to rationing in some cases or to scramble for alternatives, a government watchdog agency said on Monday. At the end of the day, this will translate to increases in medical costs for payment systems including workers’ compensation. According to the article in the New York Times, drug shortages have become an all but permanent part of the American medical landscape. The most common shortages are for generic versions of sterile injectable drugs, partly because factories that make them are aging and prone to quality problems, causing temporary closings of production lines or even entire factories. The number of annual shortages – both new and continuing ones – nearly tripled from 2007 to 2012.

The analysis by the United States Government Accountability Office, released Monday, was required by a 2012 law that gave the Food and Drug Administration more power to manage shortages. The watchdog agency was charged with evaluating whether the F.D.A. had improved its response to the problem, among other things. The accountability office concluded that the F.D.A. was preventing many more shortages now than in the past – 154 potential shortages in 2012 compared with just 35 in 2010 – but that the number of shortages has continued to grow.

“We are at a public health crisis when we don’t have the medicines to treat acutely ill patients and we don’t have the basics like intravenous fluids,” said Erin Fox, a drug expert at the University of Utah whose data was used in report. The most acute shortage now is that of basic I.V. fluids, she said.

The drug industry rarely spells out the precise reason for a shortage, citing its need to protect competitive trade information. Dr. Douglas C. Throckmorton, a senior F.D.A. official who deals with shortages, said in written testimony released on Monday that 66 percent of production disruptions that led to shortages were caused by quality problems and efforts to fix them.

The 2012 law required that drug companies provide the F.D.A. with a general reason, but Ms. Fox said that it was often not specific enough to understand what was driving the shortage.

Economic factors are also contributing to the shortages. Narrow profit margins are making some drug companies reluctant to invest in fixing old production facilities. Dr. Throckmorton compared aging drug facilities to an old car, which requires significantly more upkeep than a new one. Changes in Medicare reimbursement and the role of group purchasing organizations, which buy drugs on behalf of hospitals, could also be contributing, by further reducing prices.

The F.D.A. said in a statement that it is “committed to the prevention of new drug shortages and the resolution of ongoing drug shortages, which remain a significant public health issue in the United States.”

On September 9, 2013, applicant, Eun Jae Kim, filed an Application for Adjudication of Claim alleging that she sustained cumulative industrial injury to her back and other body parts while working for B.C.D. Tofu House, Inc. (BCD) as a waitress manager. The employer asserted that upon receipt of the claim a “complete MPN package” was sent to applicant on September 18, 2013. However, on September 19, 2013, the next day, a letter was sent to the employee denying liability “as there is no policy in effect at the time of alleged injuries” and also because there was no “medical proof to substantiate whether your alleged injuries were due to your employment with BCD Tofu House.” Notwithstanding the denial letter, a delay notice was sent to applicant on September 30, 2013. The delay letter identified “Dr. David Heskiaoff” as primary treating physician, but did not schedule an initial medical evaluation. The next day on October 1, 2013 she was “informed that defendant” had selected Richard Feldman, M.D., as her new primary treating physician and had scheduled an initial evaluation for October 23, 2013.

Applicant at some point thereafter identified non-MPN physician Gabriel Rubanenko, M.D., as her primary treating physician. A WCJ found that that an expedited hearing was “not appropriate” to address defendant’s provision of medical treatment through its MPN because the case was not admitted. As a result, the defendant filed a Declaration of Readiness to Proceed on October 11, 2013, with the following statement: “Claim is in delay mode. Applicant has been advised of treatment within the MPN. Defendant is attempting to provide medical tretment [sic] within the delay period, within the MPN. Applicant’s attorney has selected a non-MPN physician as primary treactmng [sic] physician. Defendant seeks an order for treatment and transfer of care into the MPN, and an order regarding no liability for non-MPN treatment with Dr. Rubanenko.”

An expedited hearing was calendered for November 13, 2013, and the attorneys for applicant and defendant appeared at that time. However, the expedited hearing did not go forward. Instead, the case was ordered off calendar by the WCJ, who wrote on the Minutes of Hearing: “As of 11/13/13 defendant confirms that case is not admitted. Not appropriate for [Expedited Hearing].” The employer filed a Petition for Removal. In his Report, the WCJ confirms that the case was taken off calendar “because the [d]efendant confirmed on the day of hearing that it had not admitted or denied liability for the alleged injury, and the 90-day time frame permitted [by section 5402(b)] to make such a decision had not yet elapsed.” The logic was that Rule 10252 of the Rules of the Court Administrator, which provides that a party is entitled to an expedited hearing and decision on the issue of “the employee’s entitlement to medical treatment pursuant to Labor Code section 4600” when “injury to any part or parts of the body is accepted as compensable by the employer.” (Cal. Code Regs., tit. 8, § 10252.) In sum, the WCJ reasoned that Court Administrator Rule 10252 precluded an expedited hearing on the issue of applicant’s medical treatment in the MPN because defendant had not accepted any part of the claimed injury as compensable even though the 90-day period allowed by section 5402(b) to make such a decision had not yet elapsed.

The WCAB granted the Petition for Removal in the case of Eun Jae Kim v B.C.D. Tofu House and Cypress Insurance Company and concluded that the WCJ erred by ordering the case off calendar instead of proceeding with the expedited hearing. The reasoning given by the WCJ in his Report for not conducting an expedited hearing on November 19, 2013 is incomplete because it does not take into account the amendment of section 5502(b)(2) by Senate Bill 863 to provide for an expedited hearing to address the question of, “Whether the injured employee is required to obtain treatment within a medical provider network…” The amendment to section 5502(b)(2) does not take into account the pre-existing Rule 10252, which requires that at least one part of the body be accepted as industrially injured in order to obtain an expedited hearing. However, to the extent the amendment to section 5502(b) is inconsistent with Rule 10252, the statutory provision prevails. The WCJ also did not address Rule 9767.6(c) of the Rules of the Administrative Director, which requires an employer to provide up to $10,000 of medical treatment within its MPN “until the date that liability for the claim is rejected.”

Section 4616.3(a), provides: “If the injured employee notifies the employer of the injury or files a claim for workers’ compensation with the employer, the employer shall arrange an initial medical evaluation and begin treatment as required by Section 4600.” Thus, section 4616.3(a), which is one of the MPN statues, requires a defendant to commence treatment within its MPN when the employer receives notice of the injury from the employee, even if the claim has not been accepted or denied and is within the 90-day delay period allowed by section 5402(b).

Accordingly, the WCAB found that the WCJ erred when he decided not to proceed with the expedited hearing on November 13, 2013 as requested by defendant. Instead, the WCJ should have conducted an expedited hearing to determine whether defendant had met its obligation to provide reasonable medical treatment through its MPN pursuant section 5402(c) and as described in Administrative Director Rule 9767.6(c), or whether defendant was liable for the reasonable cost of medical treatment self-procured by applicant.