Posted on Tuesday, September 26th, 2017 at 8:46 am
Employees can be treated by many different types of doctors depending on how the accident occurred and they type of injuries suffered. Many workers need to see multiple doctors during the course of their recovery process. Some of the doctors who treat injured workers are:
In addition to treating with doctors, injured workers will also treat with the following types of health-care professionals
Work injury attorney Joe Miller understands which types of doctors injured workers see. He often recommends doctors when the employer recommended doctors aren’t helping. He works with the doctors to determine the full extent of your injuries and to verify your long-term health needs and work restrictions. To speak with an experienced work injury lawyer who has been fighting for employees for more than 25 years, please call attorney Miller Esq. at (888) 694-1671 or use his contact form to schedule an appointment.
Posted on Monday, September 18th, 2017 at 4:33 pm
In this recent interview, attorney Joe Miller explains why your company might hire a private investigator:
Posted on Thursday, September 14th, 2017 at 10:29 am
The Medical Society of Virginia has new requirements for prescribing Buprenorphine for addiction. These are part of the new Virginia Laws passed in response to the nationwide opioid epidemic and huge uptick in deaths from opioid overdose. Buprenorphine, also prescribed under the brand name Subloxone, is often utilized as a means to treat heroin addiction. While it is a semi-synthetic opioid, and does produce some of the same euphoric effects as heroin and morphine, it is found that at low doses, administration of this drug allows the addict to discontinue heroin or morphine while reducing— and in some cases even eliminating— the severe symptoms of withdrawal that can be so debilitating for addicts.
There are eight steps that physicians should follow before prescribing Buprenorphine:
Prescriptions should be waivered by the Substance Abuse Mental Health Services Administration (SAMHSA), registered with the Drug Enforcement Agency, and comply with the federal and state laws for prescribing buprenorphine. Nurse practitioners and physician assistants must also be waivered and have a practice agreement with a waivered physician.
Before buprenorphine can be prescribed for opioid treatment, the physician should conduct and document a patient assessment that covers the following:
The physician should query (ask for results of a patient search) from the Prescription Monitoring Program before starting any treatment and during treatment.
Prepare a treatment plan that includes the following:
During the induction phase:
Initiate treatment with no more than 8mg of buprenorphine, except when medically indicated if properly documented in the medical record.
The patient should see the doctor once a week
During the stabilization phase, the prescriber should increase the dosage of buprenorphine in safe and small increments to achieve the lowest dosage without causing intoxication, withdrawal, or significant drug craving.
During the course of treatment:
Make sure the medical record includes the following documentation:
The prescriber should refer the patient to a mental health service provider as defined by the Virginia Code Section 54-1-2400.1 for counseling or should provide counseling to the patient and document the counseling in the record.
Prescribers should NOT prescribe buprenorphine if the patient is already taking any of the following medications (unless there are extenuating circumstances and a tapering plan to achieve the lowest possible documentation is properly documented):
Limitations for prescribing buprenorphine mono-products
How to work with the following special treatment populations
Speak with an experienced Virginia workers’ compensation lawyer now
Many workers who are injured are prescribed medications to manage their pain. Attorney Joe Miller works with caring qualified physicians and with the legal community to understand the latest requirements that physicians must follow. He has helped thousands of injured workers get a just recovery. To make an appointment now, please call Joe Miller Esq. by phoning him at (888) 694-1671 or using his contact form.
Posted on Monday, September 11th, 2017 at 3:41 pm
Attorney Joe Miller explains what happens if your employer denies your claim:
Posted on Thursday, September 7th, 2017 at 3:36 pm
Attorney Joe Miller of Joe Miller Law explains the process that follows your final court hearing:
Posted on Tuesday, September 5th, 2017 at 2:22 pm
Attorney Joe Miller explains what mediation is and how it can be helpful:
Posted on Friday, September 1st, 2017 at 1:08 pm
Joe Miller recently negotiated a substantial, six-figure settlement for a construction supervisor who fell off of a roof and lost consciousness. He suffered numerous other injuries which required surgical repair and fixation.
The worker’s compensation insurance company denied the claim, utilizing the willful misconduct defense, surmising that Joe Miller’s client must have been too close to the edge of the roof while performing his work, in violation of OSHA regulations and Company safety rules.
The problem that the defendants had was that the claimant could not recall precisely what had occurred, or how he had even ended up in the area where he had fallen from the roof. In addition, the one potential witness to the incident was no longer available.
Accordingly, insurance company had a difficult problem. In order to block a claim because of a violation of a statute or safety rule, it must be proven that the claimant intentionally violated the statute or rule. Unlike personal injury cases, mere negligence of an employee in performing his duties, even if the negligence is severe, does not bar a workers comp claim. Without a witness to say that the claimant clearly knew he was violating a safety rule and statute at the time of his injury, or that he otherwise intentionally ignored safety regulations, this would be difficult.
These potential problems were brought to the attention of the defense attorney prior to hearing. Approximately two weeks prior to hearing, Joe Miller engaged in negotiations with the defense attorney, which resulted in settlement of the claim for a significant six-figure sum, and in addition an agreement for full payment of all past medical bills related to the claim.
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.