Tag Archives: Workers’ Compensation

Governor Wolf Introduces Opioid Prescribing Guidelines for Workers’ Compensation Patients

by Karl Voigt

This week, Pennsylvania Governor Wolf launched opioid prescribing guidelines for workers’ compensation claimants, citing the opioid epidemic as its impeller. The Governor stated that Pennsylvania ranks third highest in the nation in the percentage of injured workers who become long-term opioid users. To counter that trend, these guidelines, which are not intended to replace clinical judgment, would advise doctors in the treatment of not just acute or post-surgical pain, but also chronic pain. To view the guidelines, click here.

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New Workers’ Comp Bill from Legislature in Light of Governor Wolf’s Veto of Their Last Effort

by Karl Voigt

April of this year saw Governor Wolf’s veto of Senate Bill 936, which called for a drug formulary for treatment of injured workers. This was a victory for injured workers. Advocates of the formulary claimed that it would have addressed the opioid epidemic and the high cost of compound creams. Opponents maintained that it would hinder doctors from treating their patients in the best way possible. Now, just weeks after that veto, the legislature has introduced a new bill that again seeks to: 1) create a formulary for pain medications and 2) limit the cost of compound creams.

With respect to the latter, compound creams can sometimes deliver medication directly. Instead of a pill, a blend of pain medications often can be compounded into a gel, cream or spray applied directly to the site of the pain and absorbed through the skin. These creams can be effective, but can also be expensive.

The new legislation, Senate Bill 1187, would seek to limit the price a workers’ compensation insurer has to pay for these creams to 110% of the wholesale price of the individual medications.

More threatening, however, is the new bill’s revived effort to create a workers’ compensation formulary. Once again, this formulary would interfere with patient care by dictating to doctors what medications they can prescribe for injuries, regardless of what they feel would be the best way to treat the injury.

The text of the bill can be found here.

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Yet Another Workers’ Compensation Act Proposed in PA Senate

by Karl Voigt

Yet another piece of proposed legislation is circulating in the Pennsylvania legislature. Senate Bill 1052 proposes that older occupational disease cases – with symptoms that may take years to manifest – be limited to the Workers’ Compensation system. As an example, asbestosis and mesothelioma cases would be brought back before Workers’ Compensation judges.
Senate Bill 1052 was prompted by a Pennsylvania Supreme Court case in which the court allowed for a civil suit in the court of common pleas when someone contracts a work-related disease outside of the 300 week “statute of limitations” for filing. Presently, if a worker discovers that he has contracted asbestosis more than 300 weeks from his last exposure, he must bring he case to the court of common pleas. It is not uncommon for a diagnosis like this to be made well after six years after exposure to asbestos.
For over 100 years, the Pennsylvania Workers’ Compensation Act has enforced a compromise between employers’ and employees’ interests. Namely, an injured worker can only sue for a work injury or disease inside the Workers’ Compensation arena, and damages are limited to medical bills and wage loss benefits. In exchange, the injured worker gets a system that works faster and more predictably than litigation in county court. This is called the “exclusive remedy”.
The Pennsylvania Workers’ Compensation Act presently disallows the filing of any Workers’ Compensation claim in the court of common pleas. These cases can result in awards for pain and suffering, whereas Workers’ Compensation cases do not allow for this type of award. This new bill, if passed, would limit claims to the less-remunerative Workers’ Compensation system.

You can find the text of the proposal here.

 

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FDA requests removal of Opana ER for risks related to abuse

by Karl Voigt

Patients who are taking the pain medication Opana are now facing its manufacturer’s withdrawal of the medication from the market.

Earler this year, the US Food and Drug Administration (FDA) concluded that Opana ER “exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death”. The drug has been available since 2006.

The manufacturer, Endo Pharmaceuticals based in Malvern PA, has been withdrawing the medication from pharmacies since June. Supplies are nearly gone and patients should consult with their physicians for a suitable alternative.

The FDA has made no secret that they intend to review other opioid painkillers.

 

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New Hope to Replace Opioid Painkillers with Safer Alternative

by Karl Voigt

Researcher led by scientists from The University of Texas have revealed the results of their extensive research into a new pain medication that may provide an alternative to addictive opioids.

You may have read on this blog how researchers have focused on the sigma-1 nerve receptor protein in developing opioid pain alternatives. However, new research more than suggests that new medicine can be made from a group of molecules that bind with a sister receptor called sigma-1, little of which until recently  has been known.

Historically, and into the present, opioid medications like oxycodone and OxyContin can combat pain effectively. Unfortunately, to maintain efficacy, doctors have to increase the dosage. Further, these medications are physically addicting and can lead to reliance on non-prescription opioids.

All of us know very well of our country’s opioid crisis. The President’s Commission on Combating Drug Addiction and the Opioid Crisis has even urged President Trump to declare a federal state of emergency. Every day 142 Americans die of a drug overdose, most from heroin.

This is an entirely new class of medication that will hopefully not be addictive, and perhaps even more effective than opioids.

The downside is, of course, the drug must go through the laborious process of testing and approval. For more, read here.

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House Bill 18 Postponed

by Karl Voigt

“Formulary.”

If House Bill 18 passes and you’re a workers’ compensation recipient, that’s a word you’re going to have to get used to.

And likely another word:

NO“.

This new legislation is intended to reduce costs for insurance companies by limiting the types of drugs that doctors can prescribe for you. Which means that a panel of people who have no idea who you are is going to decide what medications you can and can’t take. House Bill 18 would enlist a private company to create a list – or “formulary” – of medications that are “allowed” to treat Pennsylvania injured workers. Non-formulary drugs would need a doctor’s special authorization that they are “medically necessary”.

While opponents of the Bill have procedurally postponed a vote, it may make its way back out of the House Labor & Industry Committee.

In short, it made its way back to committee pending legislators meeting with municipal and state police unions as well as health care providers. If their concerns are addressed, the bill can be amended and sent to the floor for another vote.

The Pennsylvania Bar Association remains opposed to the Bill.

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When Do You Need an Attorney for Workers’ Compensation?

by Karl Voigt

When do you need an attorney for Workers’ Compensation? For those of you who read my posts on Avvo.com, you know that I am by no means a salesman for lawyers. I often encourage Workers’ Compensation claimants to stick it out, and not enter into a fee agreement with a Workers’ Compensation lawyer until they actually need one. I usually say, “you’ll know when you need one.” Lawyers costs money. The general rule is that, once you go to Worker’s Compensation court with a lawyer, 20% of your checks are going to be paid to that lawyer as a fee.

Some recent experiences have really started to change my opinion. And I’ve been practicing Worker’s Compensation law for 26 years now. I have recently seen some very poor behavior from employers and adjusters right at the beginning of the case that makes me think injured workers should have lawyers working for them from day one.

Usually, right at the inception of a claim, the insurance company doesn’t have a lawyer working on its side. There’s an insurance adjuster who makes the initial decisions. Often bad decisions – for the injured worker.

I had someone contact me recently who had just hurt his low back at work. Okay, it happens; people get hurt and that’s what Worker’s Compensation is designed to address. What supposed to happen after that is the employer reports the injury to its Workers’ Compensation insurer and the injured worker gets medical treatment. If the employee can’t work because of the injury, he gets paid wage loss benefits.

So this gentleman hurt his back, immediately told his employer, who essentially disregarded him. His employer wouldn’t even let him know who his Worker’s Compensation insurance company is.

So, after I spoke with him, I used my own resources to track down the identity of this employer’s insurer. Then I contacted that insurance company, trying to hunt down the identity of the person responsible for handling this work injury claim. “No such claim,” they said. Okay, so the employer pay no heed to the law that says that all work injuries must be reported to the carrier within 24 hours.

My efforts now forced the employer into reporting the claim and a file was opened, a claim number generated, and an adjuster assigned. Under ordinary circumstances, the claimant might have simply gone on working in pain, allowing his employer to string him along.

The worker then discussed his case with the adjuster, who actually told him he was compelled to treat with a doctor chosen essentially by her! This would allow her to “twist the arm” of a doctor who was contracted with the carrier. This doctor, knowing who buttered his bread, would be more inclined to make medical decisions favoring the employer, rather than

Before this conversation with the adjuster, we had a discussion about his medical care. Anyone who’s well-read here or on Avvo.com know about the captive period, where a carrier tries to control the initial medical care given an injured worker. Based on the facts, we had decided that he could treat with his choice of doctor. The employer posted no list of physicians from which to choose, nor had the worker signed the “rights and responsibilities” form requisite for the captive period to be enforceable. Therefore, he could not be forced to treat with a company doctor.

But for our conversation, he could have been railroaded into substandard medical care.

All this in the space of just a few days.

Well, not every case goes like this at its inception. Some go smoothly, as it should. However, I suspect more cases like go this one would have when the worker doesn’t have counsel from the start. So, it certainly can’t hurt to get counsel involved from the very beginning. It can only set you in the right direction.

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