Posted on Thursday, August 3rd, 2017 at 10:04 am
At the Law Offices of Joe Miller Esq. and the Work Injury Center, we are very aware of the expanded use of opioids to treat work injury pain and other pain causes. As part of our continuing effort to keep informed and keep our clients and working partners informed, we are writing to advise of the latest guidelines developed by the Centers for Disease Control in Atlanta (CDC) for prescribing opioid medications. We have previously written about the new Virginia Laws on prescribing Opioids, which pretty much track the previously enacted CDC rules.
As we have reported previously, while we certainly support law enforcement and any and all efforts to curb this horrific national epidemic of opioid deaths, we are concerned that the passing of these laws and guidelines in response primarily to the actions of criminals and thugs will adversely affect our law-abiding injured worker clients. Many of our clients have suffered extremely serious injuries and opioids are often the best and only way to substantially decrease their pain after major surgeries or surgery failures.
The Centers for Disease Control in 2016 developed new guidelines in response to the opioid prescription crisis. Opioids are chemicals that work on nerves in the brain or the body to reduce the severity of pain. They are either derived directly from the seed pods of the poppy flower papaver somniferum , which is also used to make heroin, morphine and opium, or from synthesized derivatives of the plant or synthesized chemicals.
Sadly, many people are becoming addicted, overdosing, or abusing their prescriptions. The guidelines are specifically aimed at helping primary care doctors known when to prescribe the drugs and when and how to monitor their patients. The guidelines apply to patients who have pain that lasts three months or more. The guidelines do not apply to patients who take the opioids for cancer treatment, end-of-life care, or palliative care.
According to the CDC, opioid prescription use has quadrupled since 1999. Over 183,000 people have died due to their use or misuse of opioid prescriptions since that year. The recommendations are designed to provide standard current guidelines for clinical practices. Specifically, the guidelines target the choice of opioids that are prescribed, the proper dosage, how long the drugs should be used, what sort of follow-up doctors should do, and when the prescriptions should terminate.
The full guidelines can be seen here – Guidelines for Prescribing Opioids for Chronic Pain
The purpose of the guidelines
The purpose is help physicians make recommendations when they treat chronic pain. They are a “best practices” set of standards for responsible prescribing.
Non-opioid remedies are suggested such as exercise and cognitive behavior therapy. Non-opioid drugs such as anti-inflammatories are encouraged. The guidelines state the opioids should not be the routine recommendation. Even when opioids are prescribed, the doctor should combine their use with the other non-drug therapies for maximum benefit.
Doctors are advised to prescribe the lowest possible effective drug dosage and begin the treatment by using immediate-releasing opioids instead of opioids that are extended-release or long-acting. Opioid prescriptions should only be for the time needed to manage the pain duration.
Providers should follow-up with their patients by scheduling regular appointments to see if the benefits of the opioid prescription are causing their patient harm and whether their patients are applying the non-pharmacological treatments that are available.
What’s included in the guideline?
More specifically, the guidelines focus on the following three assessment areas:
How do the 2016 CDC opioid prescription guidelines differ from prior guidelines?
There are several key differences:
Additional Centers for Disease Control activities to address the opioid crisis
In addition to offering new guidelines, the CDC is attempting to help people suffer less from opioid abuse and helping families not have to bury a loved one who overdoses in the following ways:
The Prevention for States program evaluates how the state’s activities are working including focusing on relevant success stories. How well the program does will determine future national and state efforts.
3. Some of the strategies that have been developed or are being explored – for combatting the opioid crisis at the state level are:
4. The CDC is also working to have the states promote the use of the new 2016 CDC guidelines on Prescribing Opioids for Chronic Pain and in putting strong practices to work in the neighborhoods where drug addiction is the norm. The CDC is also working to develop and implement rapid response plans.
5. Improving the way data is tracked and used to help monitor the crisis
Categories of opioids
The CDC examines these four types of opioids:
Opioid analgesics (commonly referred to as prescription opioids) have been used to treat moderate to severe pain in some patients. Natural opioids, semi-synthetic opioids, methadone (a synthetic opioid), and some other synthetic opioids are commonly available by prescription.
Fentanyl is a synthetic opioid that is legally made as a pharmaceutical drug to treat severe pain, or illegally made as a non-prescription drug and is increasingly used to intensify the effects (or “high”) of other drugs, such as heroin.
Why the opioid epidemic is growing
Opioid deaths are rising across most every demographic including men, women, all races, and most ages. Over 60% of drug overdose deaths now involve an opioid. Some of the data statistics for opioid use are as follows:
According to the CDC, in 2015 there were nearly 62 deaths each day due to opioid abuse – over 22,000 for the year. This was a increase of 3000 over the number of prescription opioid deaths in 2014. A good part of the increase was due to the use of synthetic opioids other than methadone. One of the leading synthetic opioids that concerns law enforcement and is believed to be causing the increase in deaths is illegally-made or obtained fentanyl or carfentanyl. Carfentanyl has been previously described as a weapon of mass destruction and chemical weapon and is 10,000 times more powerful than morphine and 100 times more potent than fentanyl. The DEA issued a dire warning to the public regarding carfentanyl in 2016. Even casual contact with a small amount of the drug can cause sickness and death.
It can be hard to determine the exact cause of opioid deaths because the data doesn’t distinguish between legally and illegally-made fentanyl. The CDC is trying to address this disparity.
Between 1999 and 2014:
In about 20% of drug overdose fatalities, the death certificate does not list the specific drug that caused the death. Adding to the problem of determining which drugs caused an overdose death is that often multiple drugs (such as a prescription opioid and heroin) are found in the patient.
Prescription opioids are involved in more overdose drug fatalities than any other drug. It is believed that the proportion of deaths cause by prescription opioid use is actually higher than is being reported. Two of the reasons for the increase in opioid overdose deaths are believed to be:
Other risks from opioid use besides overdose deaths are abuse, addiction, and abuse
The prescription opioid epidemic affects more than 1,000 people each day.
Speak with an experienced North Carolina and Virginia workers’ compensation attorney today about opioid abuse
Attorney Joe Miller Esq. has been helping injured workers for over 25 years. He has helped thousands of employees get just recoveries. Part of his work as a workers’ compensation lawyer is helping clients work with skilled medical professionals to get the medical attention and care that is required. To learn more about your work injuries and the issues in treating them, please call (888) 694-1671 or fill out our contact form.
Posted on Wednesday, August 2nd, 2017 at 8:00 am
Attorney Joe Miller Describes the Joe Miller Law/Work Injury Center Seven-Step Elite Case Evaluation Process and what to expect when you call our office.
Posted on Monday, July 31st, 2017 at 8:35 am
Learn more about different workers’ compensation benefits from attorney Joe Miller.
Posted on Friday, July 28th, 2017 at 9:17 am
Learn more about what to do if you’re injured on the job from The Workplace Injury Center and attorney Joe Miller.
Posted on Saturday, July 22nd, 2017 at 6:00 am
Learn more about what workers’ compensation is from The Workplace Injury Center and attorney Joe Miller.
Posted on Wednesday, July 19th, 2017 at 9:00 am
In response to the growing nationwide and statewide opioid epidemic, the Virginia Board of Medicine recently adopted new rules to respond to the health danger of opioids and buprenorphine, two medications given for acute and chronic pain. These new regulations are largely based on the CDC Guidelines which came out in 2016. On March 15, 2017, the new regulations were signed by Governor McAuliffe and became active as the law in the Commonwealth of Virginia on July 1, 2017. Additional regulations have been proposed.
The Crisis in Virginia
At least 1400 people died in Virginia in 2016 from Drug Overdoses, with the biggest increases from 2015—175 percent—coming from powerful opioids such as Fentanyl or Carfentanil being laced into street heroin, according to The Virginia Department of Health and law enforcement. While Fentanyl is 10 times more potent than heroin, Carfentanil can be 10,000 times stronger. The drug is generally only prescribed for large animals, such as elephants.
In 2015, opioid overdose deaths accounted for 79% of all overdose deaths in Virginia.
Our Concern as a Workers Comp Law Firm
While this is certainly a horrific crisis that must be dealt with, as a law firm trying to help severely injured workers, we are concerned that the new regulations merely make our clients unwitting victims of regulations designed to combat illegal behavior mostly by young drug addicts and drug dealers. We agree something must be done, but at what cost? When we start hearing our clients— who have just had hardware literally screwed into their bones— complain of excruciating pain, what are we to do when the doctor says, after only 2 weeks, that he can no longer prescribe our client any more pain medication due to these new regulations?
The current approved regulations apply to medical doctors, osteopathic practitioners, podiatrists, and physician assistants. Nurses have adopted similar regulations for nurse practitioners who have the authority to prescribe medications. There are some exceptions. The regulations don’t apply if a person is being treated for pain (chronic or acute) related to cancer and patients who are getting palliative or hospice care for their pain. The regulations also don’t apply if the patient is being treated for pain as a hospital patient, while in a nursing home or in assisted living facility – if that facility uses just one pharmacy source. Medical providers may also be exempt if the patient is part of a federal or state clinical trial.
Summary of the Regulations
Acute pain is defined as pain that happens during the normal course of a disease or condition (such as a workplace injury) or because of surgery where controlled medicines are prescribed for three months or less.
Chronic pain is defined as pain that happens outside of any disease or any condition where controlled medicines can be ordered for more than three months.
Opioids and treatment of acute pain under the new regulations
The regulations provide that prescribers of opioids must:
· First duly consider non-pharmacologic and treatments that don’t involve opioids before prescribing opioids.
· Prescribers must conduct a history and a physical exam, assess the risk of the patient for abuse and conduct a Prescription Monitoring Program query pursuant to the Virginia Code
Various bills and proposals had different conditions for pain medicine prescriptions. The regulations that were passed will became law on July 1, 2017 and will sunset on January 1, 2022 unless further legal moves are made.
Prescribing opioids for acute pain treatment under the regulations
When doctors and others with authority to prescribe opioids do fill out the prescription for opioids, they must start the patient with short-acting opioids and not long-acting drugs because of the concern by the Virginia Board of Medicine that the likelihood of addiction increases with long-acting opioids. The amount given should not be more than a 7-day supply unless there are “extenuating circumstances.” If opioids are given pursuant to surgery, they shouldn’t be prescribed for more than 14 days in a row unless there are “extenuating circumstances.”
The regulations suggest that prescribers review the Centers for Disease Control information on morphine milligram equivalent (“MME”). The regulations provide additional requirements on prescribers on how to handle pain management medicines for acute pain.
If other medications such as benzodiazepines are prescribed along with the opioids, the prescribers must document a “tapering plan” so that the lowest effective does is prescribed. Doctors need to document all the prescriptions for acute pain that they make. The documentation requirements are very strict. Doctors, nurses, and others who are allowed to prescribe opioids can be subject to disciplinary action for noncompliance.
Prescribing Opioids for Chronic Pain
The second part of the new Virginia regulations covers opioid prescription for chronic pain. Prescribers must conduct a physical exam of the patient and take an oral history. The doctor or other prescriber must also evaluate the patient’s mental health. Mental health can be a key factor in determining the probability the patient who uses opioid will become addicted.
There are nine evaluation items that must be recorded:
1. Current treatment for pain and past treatments
2. How intense the pain is and the scope of the pain
3. The diseases and conditions (such as injury) that are causing the patient’s pain
4. How the pain is affecting the patient’s physical and emotional health – including his/her quality of life and daily activities such as sleeping, eating, and walking
5. The patient’s history of addition, substance abuse, and psychiatric problems – and those of any family members
6. The results of a urine test to determine what drugs are in the patient’s system or a serum medication test
7. A Prescription Monitoring Program query – as defined in the Virginia Code
8. The risk of substance abuse based on the patient’s prior history
9. A request to see and examine prior medical reports and records
Prescribers of opioids are also required to review the safe and best way to store controlled medications that contain opioids and the proper way to dispose of them. Prescribers must also discuss with patients, where the opioid prescriptions are not effective, a methodology for terminating the use of the opioids.
As with acute pain prescriptions, prescribers of opioids for chronic pain management should consider other less risky alternative and properly document use of MME medications.
The new Virginia regulations require that prescribers document the reasons for opioid prescriptions that last more than three months and if benzodiazepine and other medications are used with opioid medications, the prescriber must document how the lowest doses can be achieved.
Prescribers must routinely monitor the patient for signs of an opioid use disorder. If such a disorder is present, the physician or other prescriber should begin a treatment plan, refer the patient for evaluation and treatment, and review the case with a qualified healthcare professional.
Patient treatment plan, according to the Virginia Board of Medicine, must include detailed requirements including detailed documentation of the patient’s progress, including diagnostic evaluations and risks of abuse, misuse, or diversion – and other steps that can be taken.
Patients who are being prescribed opioids for chronic pain should be told of the risks, alternative remedies, and benefits of opioid medications before any treatment plan begins. The informed consent must be in writing before the prescriptions can be started. The informed consent should be properly documented. The informed consent must have the patient’s signature and must also disclose the treatment conditions, when treatment will cease, and any behaviors that require a referral.
There should also be a signed treatment agreement. The Medical Society of Virginia has a template of an informed consent form. The treatment plan should include the patient’s consent to obtain serum medication levels or urine drug screening, the Prescription Monitoring Program query and identify any other prescribers or pharmacies that are dispensing the opioids.
Prescribers must periodically review how the treatments are working – at least once every three months. Precise documentation is a must. If the patient is not responding well to the opioid medications, the prescriber has to document the reason for continuing the opioid prescription and what other treatment options are being considered.
The Prescription Monitoring Program query must also be conducted every three months. Urine tests or serum tests must be given every three months to see how well the patient is doing and what other medications he/she may be using. After the first year of opioid treatments, the tests can be done once every six months. As with acute pain, doctors and other health care providers who write opioid prescriptions should evaluate any opioid use disorders.
Prescribers, according to the Virginia Medical Board’s regulations, must also refer patients for new evaluations and treatments when needed or if the chronic patient has an opioid use disorder.
Documentation should be detailed and ready for review. Prescribers must include in their documentation of chronic pain:
1. An oral history and physical exam
2. The patient’s past medical history
3. The records of prior treatment doctors and healthcare providers
4. Laboratory test results, diagnostic statements, and therapeutic results
5. Any evaluations and consultations with other doctors
6. The goals of treatment
7. A review of the risks and benefits that were disclosed
8. An informed consent and a treatment agreement plan
9. Descriptions of any treatments
10. All medications the patient is taking including type, dosage, quantity, any refills, and the dates of the prescriptions
11. The patient instructions
12. What reviews have been given, when, and the summaries of the reviews
The third part of the Regulations – Buprenorphine Prescriptions-Used to Battle Addiction
Buprenorphine is one of the most common types of medications used in attempting to battle heroin or other opioid addiction. It actually reverses the effects of opioids and is fast-acting. Commonly prescribed names are Naloxone, and Narcan (nasal spray). Some of the regulations promulgated by the Virginia Medical Board are:
1. Acute pain – buprenorphine is not indicated for acute pain if the setting is an outpatient setting unless there is a primary diagnosis of addiction.
2. There are specific regulations indicating how doctors, physician assistants, and nurse practitioners are able to obtain waivers to allow them to prescribe Buprenorphine/Naloxone in an outpatient setting. There are certain waivers that must be obtained through the DEA.
3. Important especially for folks suffering from anxiety in addition to the pain: Anti-anxiety Medications containing Benzodiazepine, such as Lorazapam (Valium) or Xanax, can cause an adverse reaction when used with opioids. So the regulations require that if the physician is prescribing both the anxiety medication and the opioid, Naloxone MUST also be prescribed.
4. The Virginia Board of Medicine also requires that health care providers refer patients who are being prescribed buprenorphine to treat addiction to a mental health care provider for counseling or give the patient their own counseling – provided everything is documented. Mental health care providers include “a person who provides professional services as a certified substance abuse counselor, clinical psychologist, clinical social worker, licensed substance abuse treatment practitioner, licensed practical nurse, marriage and family therapist, mental health professional, physician, professional counselor, psychologist, registered nurse, school psychologist, or social workers. . .”
There are many additional requirements for health providers who prescribe Buprenorphine such as:
· Urine drug tests
· Pregnancy tests for women who might be pregnant
· Prescription Monitoring Program tests for HIV, Tuberculosis, and Hepatitis B and C) if indicated
· A tapering plan when buprenorphine is combined with other medications
Patients who take buprenorphine should start with 8mg/day or less. The health care prescriber should see the patient once a week and document any occasions for subscribing more than 8mg/day. Dosages over 16 mg/day require detailed medical documentation and dosages over 24 mg/day are specifically forbidden.
If buprenorphine is being prescribed for addiction treatment, then, as with chronic pain prescriptions, health care prescribers need to conduct urine drug tests or serum drug level tests at least once every three months during the first year and, at least, once every six months for the second year and beyond
Patients who are 15 years or younger should not be prescribed buprenorphine as part of a treatment plan for addition until the FDA gives its approval. Patients who are getting buprenorphine for addiction treatment should be monitored to see if their chronic pain is improving. Patients who have unstable psychiatric problems should get psychiatric help and treatment before buprenorphine is considered.
Summary and Our Take on these Regulations
The new laws were enacted in response to the rising dangers of Opioid Addiction and Abuse and the growing crisis in response to the rise in deaths due to overdose from opioids.
Unfortunately, for many of the severely injured workers’ compensation clients who we represent, which clients frequently require ongoing, severe pain management, these regulations simply mean more “hoops” to jump through in order to obtain relief from their unrelenting pain. This is in addition to the already burdensome issues which often accompany obtaining prescriptions in workers compensation cases, such as miscommunications or lack of approval from the comp adjusters or disconnects between the pharmacies and comp adjusters.
Our take on this is that while opioid addiction and overdose deaths from drugs like heroin and fentanyl are horrific problems which much be addressed, severely injured workers should not have to pay the price or be lumped in with criminals, and common drug addicts who abuse themselves and routinely break the law in order to feed their addiction.
We do applaud the efforts to make sure doctors are monitoring patients to make sure that opioids are being used for actual, real pain and are not the first drug of choice, particularly in cases where there is a history of addiction for the patient. We certainly do not want our clients to have the added problem of opioid addiction added to their work injuries.
That being said, we do have many clients who undergo spinal fusion surgeries and other highly invasive surgeries that often entail implantation of hardware and severe pain that may last for many weeks or even months; but now, under these new regulations, the surgeon must provide proof of “extenuating circumstances” to provide opioids beyond two weeks after performing surgery. This will cause needless suffering of our clients—mostly due to the reckless actions of a small minority of criminals and drug dealers.
The truth is most pain practices are already heavily regulated and follow certain protective protocols already in existence. Our office has already has a “warning letter” that goes out to every client we represent who enters a pain management program which basically states: beware of running afoul of the protocols of your pain management physician’s practice. Most of these doctors require you to sign a pain management “contract” which states that you will religiously take all of your medications as prescribed, be subjected to urine screens at each appointment, obtain no outside prescriptions even remotely considered pain medication or anxiety medication, stay off of illicit drugs such as marijuana, and bring all prescribed pills to each and every appointment to undergo a “pill count.” If anything seems out of place, these physicians will routinely eject you from the practice, which could result in damage to your workers compensation claim, and of course, difficultly and interruption in your course of pain management, which can be devastating in the most severe cases.
Now, these restrictions and limitations on physicians will only become more onerous for our clients and their doctors. Many physicians may simply refuse to prescribe pain medications for fear of running afoul of these regulations.
Contact a skilled Virginia work injury to learn more about the medical requirements for prescribing opioids
The new Virginia regulations on opioid prescriptions have just started. Many Virginia workers’ compensation employees do see pain management doctors and other physicians to try to manage their pain. Attorney Joe Miller Esq. can help you understand how these new regulations apply to you, your doctors, and your workers’ compensation case. To learn more and to speak with an experienced legal advocate, please call (888) 694-1671 or fill out our contact form.
Posted on Monday, July 17th, 2017 at 4:51 pm
Learn more about your options when you have been injured at work from The Workplace Injury Center and attorney Joe Miller.
Posted on Friday, July 14th, 2017 at 8:34 am
What is pain management?
Pain management is that area of medicine that deals with the attempt to manage pain. Physicians who practice pain management are most often found within the practices of Orthopedic Surgery, Neurosurgery, Osteopathy, or Anesthesiology. The treatments often involve a variety of modalities, but typically involve utilization of various prescribed pain medications, and sometimes injections and in the most severe cases, the implantation of nerve devices to attempt to control a patient’s pain, short of having to undergo some kind of anatomical revision such as a spine fusion.
Glossary of Pain Management Terms
Acute: Pain that can be intense but usually lasts for a short period of time, usually shorter than six months. It usually relates to a bodily injury (such as injury at work) and ends when the injury heals. (more…)
Posted on Wednesday, June 28th, 2017 at 11:39 am
Many workers work a 40-hour shift at just one location. Most get a paycheck based on their hours of work. There are many exceptions though that an experienced work injury lawyer can help you with. Attorney Joe Miller, Esq. has been helping North Carolina employees for over 25 years. He’s handled almost every type of unusual situation that can arise. Here are a few unique work situations:
As a general rule, employees are not eligible for worker’s compensation if they are hurt on the way to work or on the way home. This is often referred to as the “Coming and Going” rule. Employees are normally only eligible for worker’s compensation while they at the job site. Employees who leave the job site during the day will be judged by whether they were running company errands or were doing personal chores.
There are a few exceptions though:
Some of the questions and answers that we will review for our clients are:
Many employers hire workers only when they need them. For example, retailers often hire employees during the winter holidays and construction companies hire crews when the weather is warmer. Non-full time workers are classified as follows:
Whether these workers qualify for workers’ compensation depends on whether the worker is classified as an employee or an independent contractor. That distinction, in turn, is based on a variety of factors. Injured workers shouldn’t automatically assume that just because they don’t get a weekly paycheck and health benefits that they are an independent contractor. The main criteria that North Carolina will use in deciding if you are an employee or not is how much control over the worker’s duties the company had. If the employer decided what hours you worked, where your worked, what job tasks you did at work, who provided the tools that used; then you may be eligible for worker’s compensation because you’re an employee, even if the company claims that you are not.
Workers such as waitresses who work for tips need to make sure they are getting the correct weekly income. Employees who are injured on the job get 2/3rds of their lost wages until they can return to work or for up to 500 weeks for more serious injuries. For waitresses, the starting point is their weekly pay which for many isn’t much more than the state minimum wage. The amount of the employees tips should also be determined. Most workers who have a work history know (and their employers know) how much extra they are getting in tips. Tips should be reported as income on the waitresses’ tax returns. If returns are reported then it should be straightforward that the waitress is entitled to 2/3rds of the tips and the wages added together. If tips were not reported, then getting 2/3rds of the tips paid for a work injury can be more difficult.
Attorney Joe Miller Esq. has helped thousands of injured workers get the full workers’ compensation benefits they’ve earned. In many cases, he had to argue the exceptional or unique case. To see if you’re eligible and to get the best recovery the law allows, please call us at (888) 694-1671 or complete the contact form.
In any work injury case, it is necessary to prove the following in order to be paid your benefits:
Each of these elements can be complicated. The good news is that injured and ill workers do not need to prove the employer was negligent or reckless. Fault is not an issue in work injury cases. Your doctors or independent physicians can usually confirm that your injuries are what is preventing you from doing your job.
It is the work-related issue that can often lead to litigation. An experienced Virginia work injury lawyer like Joe Miller can help you convince an insurance company or the worker’s compensation hearing officer that your accident was indeed work-related. Some common work-related issues that often arise in Virginia are:
The case gets tougher if you deliberately violated a safety rule or safety law. If you committed a crime at work, and were injured while doing so; then you probably won’t get Virginia worker’s compensation.
North Carolina and Virginia law differ significantly as to these concepts. In Virginia, a showing by the employer of a deliberate rule or safety statute violation could completely bar your claim, whereas in North Carolina, such a violation would only decrease your weekly comp checks by 10%.
Other example diseases include hepatitis suffered by a lab technician or a contagious disease suffered by a healthcare worker at a hospital. The employee does need to also show that the work conditions were what directly caused the disease.
There is one key difference between an occupational illness and a work injury caused by a fall or a specific workplace accident. An occupational illness can accumulate over time – that is the worker doesn’t have to prove any specific incident triggered the illness or disease.
Attorney Joe Miller Esq. has helped thousands of injured workers during the past 25 years. He has the skills and experience to handle the tough cases and the exceptions to the rule. He understands what arguments to make to challenge arguments that injuries weren’t work related. For strong advocacy, please call (888) 694-1671 or fill out the contact form.
Posted on Monday, June 26th, 2017 at 11:34 am
Many North Carolina and Virginia workers suffer serious burn injuries at work. While employers are required to follow a variety of federal, state, and industry standard guidelines – employees in both states are entitled to workers compensation benefits regardless of employer fault. In serious burn injury cases, the employer’s insurance company or self-insurance is required to pay for all the reasonable surgeries, doctor visits, and medications the employee needs to be able to manage the pain and be able to maximize the chances of recovery. If multiple skin grafts are needed and the burns are deep and extensive, the cost for the medical care can become quite expensive.
Whenever a worker suffers any type of burn injury, it is crucial to get medical help as soon as possible. The burn victim should immediately contact the supervisor and then get emergency help.
If a person’s clothing catches fire, the first priority is to be able to put out the flames. The person should be helped to stop, drop, and roll. All burned clothing should be removed from the worker. The worker should then be given something to wrap their body in such as a jacket or blanket. All burn victims who catch fire will need emotional help as well as physical help.
According to the Centers for Disease Control (CDC), any jewelry, belts, and rings should be removed immediately because burned areas often swell.
There are three types of burns – first, second, and third degree
Electrical jolts, shocks, or burns often aren’t visible like thermal burns – though the damage is often deep underneath the skin. The electrical burn can cause heart problems and even cardiac arrest. Many electrical burn victims suffer breathing problems and loss of consciousness in addition to heart problems.
The best treatment is to seek immediate medical help. In addition, care should be taken to remove the burn victim from any electrical source by using an object that doesn’t’ conduct electricity. The source of the electricity that caused the burn should be cut off. Cardiopulmonary resuscitation (CPR) may be required.
Mining and other industries are especially prone to cause serious chemical burns
According to the Mayo Clinic,, strong acids, lyes, paint thinners, and gasoline are among some of the causes of chemical burns. If an employee has a chemical burn:
If the employee is in shock (is pale, fainted, or has difficulty breathing), the chemical burn is deep (penetrating the first layer of the skin), or the burn involves the eyes, hands, feet, face, buttocks, groins, or a major joint – then emergency medical help should be called for.
Recovery for Scarring and Disfigurement from Burns
Often, there are terrible scars or disfigurement left on the skin as a result of severe burns. Unfortunately, under the laws in North Carolina and Virginia, separate recovery for scarring or disfigurement is extremely limited, unless the scarring is so severe that it interferes with one’s ability to work, such as restriction in the range of motion or limited use of the disfigured area that prevents you from returning to work. In that regard, such cases are treated just like a regular comp case.
In Virginia, if you are able to return to work, you are only entitled to a maximum of 60 weeks of temporary total disability payments for scarring and disfigurement.
In North Carolina, if the disfigurement is on the head or face, the maximum payment is $20,000.00. Elsewhere on the body, it’s only $10,000.00.
Also, as with all workers compensation cases, there are no payments for pain and suffering. All payments are determined by statute.
Burn injuries can require long-term medical care. Employees may not be able to return to work for months, years, or, in severe cases, never. North Carolina and Virginia attorney Joe Miller Esq. has been helping injured workers get their benefits and legal recoveries for over 26 years. He has helped thousands of employees get their full workers’ compensation benefits. For help now, please phone us at (888) 694-1671 or complete our contact form.
Head trauma of all types is a very common workplace injury. An employee can suffer a head injury due to a slip and fall, an automobile or truck accident, a piece of equipment that doesn’t work, or an object that falls from above. Head injuries can happen to:
The brain is made of soft tissue which can be easily damaged. Inside the skull is a cerebrospinal fluid layer that helps protect the brain from the skull. A concussion happens when a blow to the head causes the brain to pass through the fluid and strike the skull.
If a head injury, concussion, or brain trauma is suspected; your physician will conduct several types of tests:
Head trauma victims will often be seen by several doctors such as a neurosurgeon, a neurologist, and a psychiatrist , psychologist, or a neuropsychologist. Other professional help can include social workers, speech and language pathologists, recreational therapists, and a traumatic brain injury nurse specialist.
Some milder head injuries can heal within days, weeks, or months. In serious cases, the first thing an emergency team will examine is that the employee/patient has an adequate supply of oxygen and blood. They will also work to make sure the patient’s blood pressure is monitored.
Some serious traumatic brain injuries which can last a lifetime. Symptoms can include:
According to the Mayo Clinic, medications can include:
Surgeries can include:
Head trauma victims may need the following types of treatments:
Head injury symptoms often don’t show themselves right away. If an employee suffers any blow to the head for any reason, the best course of action is to see a physician right away. The sooner the condition is treated, the better the chances for a recovery will be. Also, delay in treatment can be taken as a sign or proof that the injury happened outside of work. Employers and insurance companies will look for any excuse to say your injuries are not work-related.
You should be paid for all of your medical bills until you reach a state of Maximum Medical Improvement. This means that your hospital, therapy, and other bills will be paid until it is clear than additional medical treatment will not help you get any better.
The amount of income you receive will depend on the extent of your recover
You may also be entitled to vocational rehabilitation. Many serious brain injury victims need occupational therapy or behavioral therapy to be able to return to their original job. In some cases, the worker can be retrained to do another job. For example, a construction worker who suffers a brain injury when a piece of equipment falls on his head from several stories up, may never be able to do physical labor again. A lot will depend on what the testing reveals are the extent of any permanent cognitive impairments you may have as a result of your brain injury.
Lawyer Joe Miller Esq. has helped thousands of employees get the workers’ compensation benefits they deserve. In some cases, he helps workers obtain a long-term settlement of your claim. He works with your medical providers to understand each and every treatment, test, and surgery that will be required and each type of therapy that help you improve your life. He cares about your recovery and your ability to pay for your medical bills and getting paid a regular income. For experienced help, please call (888) 694-1671 or fill out the contact form.