Workers Comp Matters

Marijuana was once fodder for stoner comedies and standup routines. But today, medical marijuana is a serious matter in Workers’ Compensation. Fair compensation, and proper medical treatment, is not always as clear as it should be. Laws evolve by the day, state by state. Guest Jenifer Dana Kaufman is a Pennsylvania Workers’ Comp attorney who has developed a wealth of experience where marijuana law collides with fair compensation and treatment. In this episode of Workers’ Comp Matters, hear how Kaufman unraveled a complicated case and how competing state and federal laws tangle the issue of appropriate care when marijuana is involved, even when prescribed in a state where medical marijuana is legal. Intent and medical recommendations matter, but can insurers be required to pay for a drug that is technically illegal under federal law? What’s the difference between an insurer paying directly for marijuana vs. reimbursing a patient? Take a deep dive into how marijuana therapy as a Workers’ Comp issue continues to develop.

Guest Kathleen Fisher is an accomplished attorney in the field of Workers’ Compensation, but she’s also an active leader of the organization Kids’ Chance, dedicated to supporting the children of workers injured on the job. Kids’ Chance provides scholarships to the children of injured workers. When a worker is hurt, or even killed, on the job, ripples spread throughout the family. Kids’ Chance is active in all 50 states and has awarded more than 9,300 scholarships. Hear how just a Workers’ Comp claim number can translate into scholarships for children of injured workers. Kids’ Chance offers a streamlined approach, laser focused on filling the gaps a workplace injury can create. As a claimant’s attorney, you can help connect survivors with resources. Kids’ Chance is another tool in your toolbox as you help clients and families recover. Talk to your clients, ask how you can help, and learn about the services that support not just injured clients, but their families as well. Mentioned in this episode: Kids’ Chance Kids’ Chance of Massachusetts Kids’ Chance Awareness Week WooSox Foundation

Guest Robert “Bob” Wilson is a leader at Work Comp College, created to offer a deeper dive into workplace protections for employees. He’s not a lawyer or an academic type, but he’s long held an interest in the programs designed to protect workers and employers. The field of helping workers recover from workplace injuries can get better, through training, tech, and, most importantly, through a renewed focus on recovery. Wilson asks how can we bring the human element back. For attorneys representing both the injured worker and employers – even insurers – it seems we’ve forgotten about people, injured people the families who depend on them. Maybe it’s time to focus on restoring lives, not “processing claims.” Dive into the world of making injured workers whole. Go beyond “compensation” and focus on “recovery,” getting to the right doctors, the right treatment, and getting back to feeling independent and enjoying meaningful work. Workers’ Comp is there to provide financial resources when workers are injured, but Wilson believes we go beyond “comp” and get to “recovery.”

To settle or not to settle, often a question. Our guest, Jim Anderson, is a well-known Workers’ Comp attorney and a leader in the field in Mississippi. His input about “settlements” are respected, and he has led the field in helping both sides reach a solution. The best claim is a closed claim. Is it sometimes better to simply settle a case fairly, to reach an accord, than let it linger and get worse. When a significant injury is involved, going before a judge can be risky. Seeking a settlement that is fair can be a better solution. But how are settlement values calculated? This is the complicated part. Best case, worst case, and the fair target range. At what point do you make an offer? Every case is different, and there is no “standard.” By talking with each other, maybe we can understand what the worker needs and what the company is responsible for. This is Workers’ Comp, not tort cases. There is no “pain and suffering” as in a civil case, but that can be hard for workers to understand. And with older workers injured on the job, Medicare eligibility adds a whole new twist. It’s a major factor easily overlooked. A settlement isn’t always just between the insured and the worker, there are other parties to think about. This is an eye-opening episode full of insights into the fine art of settlements.

We depend on our first responders – firefighters, cops, emergency room workers – every day. They protect us from harm. But what happens when they need our help? Our guest Robert Wisniewski is a Certified Specialist in Workers’ Compensation law with the Arizona State Bar and a military veteran. Post-traumatic Stress Disorder is a real thing, PTSD. How does this fit into state Workers’ Comp protections? You can’t see these mental scars. And every state is different. Some states don’t offer benefits for these issues. The military and the Veterans Administration understand the damage we can’t see, but it’s unclear where first responders fit at a state level Remember, every state has its own rules. This is a tough one, but we’re talking about our hometown heroes. There can be a stigma, and sometimes issues don’t get reported until it’s too late, or the chain of command drops the ball. And unlike falling off a ladder or getting in a car wreck on the job, PTSD injuries may be the result of repeated incidents over a long term. It’s hard to say “when” the mental injury happened, how do you make that claim? Courts are struggling with this. Non-physical stressors may be limited to a single incident, not a working lifetime of stress. We owe first responders support and care when they need it. This is a confusing and complicated issue. But this is important.

A reminder that every case is different. Injuries occur in unusual situations that challenge how we think about Workers’ Compensation and how every state and jurisdiction applies the law differently. The “Skiing Chaperone Case,” is about a teacher who accompanies a school ski club as a chaperone. Is she eligible for Workers’ Comp if injured while skiing? Is this a work injury, or did her volunteer status exclude her? After all, skiing is fun. The answer may surprise you. A worker on the job outdoors needed to relieve himself. He was standing on a railing over a concrete slab six feet below, unzipped … and he fell and was hurt Unfortunately, he also had an elevated blood-alcohol level and an indication of drug use. So, did the “the personal comfort doctrine” apply, or did intoxication trump his claim? Plus, a law enforcement officer attending a conference partook of a “hospitality” suite, enjoying alcoholic beverages before falling off a balcony to his death; A truck driver who stepped into boiling water when he was awakened in his truck cabin; And an obese woman who got stuck in her workplace cafeteria booth, breaking a bone. These are real cases, and real people were hurt. No injury is funny or subject to ridicule. But these cases illustrate the challenges Workers’ Comp attorneys face. Every worker is important and entitled to protections, but many cases are far from clear cut.

Enjoy a deep dive into the Longshore and Harbor Workers’ Compensation Act with a veteran of the field, guest Norman Cole. The Act is a federal comp provision that covers those who load, unload, and repair ships or work in related fields. It’s a fascinating field that differs from standard state compensation rules. For one, the injured worker doesn’t have to demonstrate employer negligence, as the work is inherently dangerous. In exchange, benefits are relatively defined.  The LHWCA is unusually generous to protect this vital workforce. Six figure awards are not uncommon. Learn what you need to know about this highly specialized field of Workers’ Compensation from a 40-year veteran. If you’re working with an injured dockworker, or are considering practicing in this Workers’ Comp niche, this episode of Workers Comp Matters could be the most valuable 30 minutes you’ll ever spend.

Guest Rachel Bailit is not an attorney, she’s an actor. So why is she a guest on a show about lawyers and legal issues? As an experienced acting teacher – in addition to an accomplished actor in movies, television, and live stage – Bailit specializes in teaching acting skills to public speakers, politicians, and attorneys. Telling your story in court is acting. It’s important to use your story, your voice, and your body in concert to create a relationship with your “audience,” whether that’s a jury or a judge. It’s about effective communication. Law school may prepare you for reading, interpreting, and writing the law. But what about performing? Authenticity and confidence create your courtroom presence. Get beyond explaining your case in legal terms to making your audience “feel” your story. Learn about “getting off book,” taking your eyes off the printed page and looking into the eyes of the jury or judge. It takes practice. Rehearsal is not just for stage and screen! Understand how to recognize and replace old habits and crutches – be aware of your every word, gesture, and movement. Just like the practice of law, the art of acting requires study and effort. But you might even enjoy it.

It’s one thing when a shelf stocker slips at work and injures her back. It’s another thing entirely when a professional athlete blows a knee on the football field. Our guest this week is Jonathan Israel, senior partner at the Jacksonville, Florida, law firm RITE where he represents professional athletes in Workers’ Comp cases. Things get interesting when a case involves an athlete making millions of dollars. Even in a case of “maximum medical improvement” a player at the highest level may never return to the field, and it would be hard to match his or her former income in another line of work. How are benefits calculated? What happens when stars want to see their own doctor rather than the doctors the team is familiar with? Then there are issues of jurisdiction if a player is hurt on a road game and issues regarding a player’s status as a seasonal employee since games aren’t played year-round. When representing today’s highly paid sports stars, even issues of depositions that might become public or concerns about countersuits for a motion to tax costs become elevated. Dig into a fascinating look into a unique corner of the Workers’ Comp world.

Workers’ Compensation is primarily designed to provide two benefits: payroll replacement for injured workers and medical payments to providers. But over the years, the process has become increasingly complicated. Guest Ramona Tanabe is executive vice president and counsel for the Workers’ Compensation Research Institute (WCRI). In this episode, she explains the WCRI’s newly updated report, available now, “Designing Workers’ Compensation Medical Fee Schedules, 2022,” penned by the WCRI’s Olesya Fomenko and Te-Chun Liu. Medical fee schedules, relative worth or value of medical services, state Workers’ Compensation calculations? Whew. When 50 states have 50 different procedures, it can be hard to follow the numbers. Tanabe says it’s crucial to know how vastly different state payments are, payment gaps that have appeared, and how fee schedules can affect whether providers will accept a patient covered by Workers’ Comp. This informative episode explains how rates for patient care are calculated and implemented for clients hurt on the job.