State of the States September 23, 2022

Workers Compensation Laws

A unanimous SCOTUS decision is already impacting U.S. opioid prescription practices

NationalEarlier this year and in a rare 9-0 decision, a U.S. Supreme Court (SCOTUS) ruling clarified U.S. opioid prescription practices. With the decision, prosecutors handling cases in which physicians are charged for illegal prescription practices of opioids now must prove prescribers had criminal intent when prescribing high opioid dosages rather than being punished for simply not conforming to standardized opioid guidance. By bringing clarity to the law and requiring criminal intent to be proven in opioid prescribing practices, pain management advocates believe the ruling may help those with chronic or intractable pain gain access to more “appropriate” medical care, which includes complex dosing. In agreement with colleagues, Justice Alito summed up the court’s judgment stating that, “A doctor who makes negligent or even reckless mistakes in prescribing drugs is still ‘acting as a doctor’ — he or she is simply acting as a bad doctor. The same cannot be said, however, when a doctor knowingly or purposefully issues a prescription to facilitate ‘addiction and recreational abuse.” Pain management advocates also hope the court’s stance will reduce fears of prosecution for physicians when prescribing to chronic/intractable pain patient populations. The decision is already making an impact as the U.S. Department of Justice is reportedly dropping some cases and receiving acquittals in others taken to court. 

OSHA announced its top ten safety violations in 2022

NationalOccupational Safety and Health Administration (OSHA) staff announced the top ten safety violations of 2022 this week. At the top of the list is fall protection (general requirements), with 5,260 violations, followed by hazard communication (2,424 violations) and respiratory protection (2,185). Personal protective/lifesaving equipment and machine guarding came in at the bottom of the top ten violations, with 1,401 and 1,370 violations. Other frequently cited safety violations included those with ladders, scaffolding, and industrial trucks. 

Insurers in the workers’ compensation space mark their eighth straight year of profitability

NationalThe workers’ compensation insurance market will likely experience its eighth year of profitability despite covid and its effects on the marketplace. Insurers will see continued rate decreases through the remainder of 2022, which have already produced 40 to 60 percent reductions in most areas of the country over the last decade. While insurers have experienced a near full decade of record profits, some in the industry believe there is cause for concern. Work from home (WFH) arrangements, high hazard mega claims, and staffing shortages were identified as top issues potentially affecting the industry. As the country adapts to hybrid and remote workers, insurers worry that the new setup may change coming and going rules (commuting to and from work), which could alter judicial precedent. In addition, there is a looming concern that high-risk industries such as logging, mining, and construction are not doing enough to keep workers safe with severe claims often in excess of $3 million or more due to high medical treatment costs. These safety concerns also translate to the current state of the workforce. A lack of workers is making companies eager to rush their training programs which can put new employees at risk as data shows first year workers are more likely to be injured on the job. 

A change in the American Medical Association’s (AMA) guidelines may allow more mental injury claims in workers’ compensation

NationalThe American Medical Association (AMA) announced earlier this month the removal of the Global Assessment of Functioning (GAF) scale from its medical guidelines as a means to determine mental impairment. Some clinicians servicing injured workers with mental injury claims say it is the right move as many believe the scale to be subjective and vulnerable to reliability disputes. Organizations such as the American Psychiatric Association are one of the groups content with the redaction of the GAF, citing concern with the scale’s broadness. While experts may disagree on the GAF’s overall impact, removing the measure could allow more injured workers struggling with their mental health to better qualify for workers’ compensation. 

A state court of appeals sided with an injured worker to uphold their benefits despite delays in reporting additional symptoms

injured-workers-pharmacy-blog-virginiaA state court of appeals sided with an injured worker in a case concerning reporting delays. An injured worker in the construction industry fell from a ladder hurting primarily their lumbar vertebrae and parts of the rib. These body areas were noted in the injured worker's initial hospital visit, unfortunately, new symptoms came later. The injured worker soon discovered more areas of pain that, with a formal physician diagnosis, required more treatment. Carriers raised questions about more treatment for other extremities not initially reported. However, the court sided with the injured worker believing these injuries were inevitably due to his workplace accident and therefore compensable despite a delay in reporting such symptoms.  

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