Laboratory Workers and Contacts Warned of Accidental Flu Pandemic

Safety in the laboratory workplace is critical, as many research laboratory employees contract exotic diseases that become workers' compensation compensable events. Limited knowledge of the facts of the exposures creates yet another level of concern and anxiety as employees attempt to cope with unusual symptomatology.

Aerial spraying pesticides to fight mosquitoes raises concerns over compensability for exposures

Based on reports from the  United States Centers for Disease Control (CDC) arial spraying of pesticides has been mandated in Texas because of the number of reported cases of West Nile Flu. Questions are now being raised as to the availability of workers' compensation benefits for workers who suffer illnesses flowing from the consequences of pesticide exposures.

The arial spraying of Dallas County commenced last night  with two planes being utilized, and will be continuing over the next few evenings in order to battle the mosquito population that is spreading the disease. The population is being requested to remain indoors to avoid exposure.

The state of Texas is not the only area in the United States where West Nile Flu is now spreading and preventive measures are being taken to stem the potential of an epidemic of illness. Throughout United States during 2012 there has been an increase in the amount of cases it being reported. See the CDC map above.

In most jurisdictions, workers' compensation benefits are available as a result of occupational exposures. There is the potential for a surge of claims as the network of benefits programs remains unprepared, especially in its beleaguered state. More preparation needs to be undertaken to handle such potential consequences such as a West Nile epidemic.

Read other blog posts about flu

The Urgent Need for Workers Compensation Flu Pandemic Planning

Sep 15, 2009

The 2009 influenza pandemic (flu) has created a new framework of acts and regulations to respond the World Health Organization's (WHO) phase 6 pandemic alert. Governmentally imposed employment disruptions resulting...

http://workers-compensation.blogspot.com/

Compensating Adverse Flu Vaccine Reaction Victims

Oct 24, 2009

As the US flu vaccination program rolls out, the numbers are also growing for those who have reported adverse consequences from the H1N1 vaccine. The victims and their families are also lining up for benefits available in ...

http://workers-compensation.blogspot.com/

Workers' Compensation: The Compensability of a Swine Flu Pandemic

Apr 24, 2009

The CDC has reported that Swine flu has impacted the US in the past: "Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were ...

http://workers-compensation.blogspot.com/

Workers' Compensation: OSHA Sets H1N1 Flu Employer ...

Nov 27, 2009

The OSGA directive closely follows the prevention guidance issue by The Centers for Disease Control (CDC) to prevent the spread of H1N1 flu. The purpose of the compliance directive is "to 

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Comp Maybe Going Viral in Florida Over Dengue Fever

The Workers' Compensation in Florida may be in for yet another assault of claims as dengue virus rages from Ket West spreading north.  The Centers for Disease Control has now issued yet another report and alert concerning this wide spread viral condition. 

Viruses have, historically,  been a problematic challenge to the Workers' Compensation systems. Last flu season the government Federalized the flu compensation program. As this virus spreads, especially with the challenge of the Gulf Oil spill on the compensation system, the State of Florida will need to gear up to operationalize a response.

An estimated 5 percent of the Key West, Fla., population—over 1,000 people—showed evidence of recent exposure to dengue virus in 2009, according to a report from the Centers for Disease Control and Prevention (CDC) and the Florida Department of Health.

After three initial locally acquired cases of dengue were reported in 2009, scientists from the CDC and the Florida Department of Health conducted a study to estimate the potential exposure of the Key West population to dengue virus.

Dengue is the most common virus transmitted by mosquitoes in the world. It causes an estimated 50 million-100 million infections and 25,000 deaths each year. From 1946 to 1980, no cases of dengue acquired in the continental United States were reported, and there has not been an outbreak in Florida since 1934.

"We're concerned that if dengue gains a foothold in Key West, it will travel to other southern cities where the mosquito that transmits dengue is present, like Miami," said Harold Margolis, chief of the dengue branch at CDC. "The mosquito that transmits dengue likes to bite in and around houses, during the day and at night when the lights are on. To protect you and your family, CDC recommends using repellent on your skin while indoors or out. And when possible, wear long sleeves and pants for additional protection."

Since 1980, a few locally acquired U.S. cases have been confirmed along the Texas-Mexico border, which coincided with large outbreaks in neighboring Mexican cities. In recent years, there has been an increase in epidemic dengue in the tropics and subtropics, including Puerto Rico.

"These cases represent the reemergence of dengue fever in Florida and elsewhere in the United States after 75 years," Margolis said. "These people had not travelled outside of Florida, so we need to determine if these cases are an isolated occurrence or if dengue has once again become endemic in the continental United States."

To read more about workers' compensation and the H1N1 Flu click here.

Click here for more information on how Jon L Gelman can assist you in a claim for workers' Compensation claim benefits. You may e-mail Jon  Gelman or call 1-973-696-7900.

OSHA Sets H1N1 Flu Employer Responsibility Standard for Health Care Workers

The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has  issued a compliance directive that clearly establishes a level of employer responsibility to health care workers to prevent the spread of H1N1 flu. The establishment of the standard may allow some injured workers to circumvent "the exclusivity doctrine" in workers' compensation and hold employers responsible in the civil justice system for resultant injury or death should the employer's fail to comply with is directive.


The "exclusivity doctrine" in workers' compensation limits an employers' responsibility to only scheduled workers' compensation benefits for harm caused to workers that "arises out of" and occurs "within the course of employment." Those benefits have become increasingly difficult to obtain for a multitude of reasons.


The OSGA directive closely follows the prevention guidance issue by The Centers for Disease Control (CDC) to prevent the spread of H1N1 flu. The purpose of the compliance directive is "to ensure uniform procedures when conducting inspections to identify and minimize or eliminate high to very high risk occupational exposures to the 2009 H1N1 influenza A virus."


The CDC has reported that the H1N1 flu activity continues to be widespread in the US and remains above epidemic in proportion for the seventh consecutive week. Over 99% of all subtyped A viruses being reported to the CDC were 2009 influenza A (H1N1) viruses. A total of 171 deaths in children associated with the 2009 influenza A (H1N1) virus infection have been reported to the CDC.


OSHA announced, "In response to complaints, OSHA inspectors will ensure that health care employers implement a hierarchy of controls, and encourage vaccination and other work practices recommended by the CDC. Where respirators are required to be used, the OSHA Respiratory Protection standard must be followed, including worker training and fit testing. The directive also applies to institutional settings where some workers may have similar exposures, such as schools and correctional facilities."


"OSHA has a responsibility to ensure that the more than nine million frontline health care workers in the United States are protected to the extent possible against exposure to the virus," said acting Assistant Secretary of Labor for OSHA Jordan Barab. "OSHA will ensure health care employers use proper controls to protect all workers, particularly those who are at high or very high risk of exposure."


To read more about workers' compensation and the H1N1 Flu click here.

Compensating Sick Workers at Home with H1N1 Flu

While the United States has established a national protocol to meet the medical challenges H1N1 flu pandemic, there remains a void on how to pay workers who are ill and have been encouraged by the government to stay home.  The litigious workers' compensation adversarial system may provide benefits ultimately for those who can demonstrate that their illness "arose out of and occurred in the course of the employment," after months, if not years, of delay. 


Some states have temporary disability programs, fraught with bureaucratic delay and red tape, while the issues of denial in the workers' compensation claims become identified. If held to be compensable, reimbursement is then sought by the temperate disability plan, public or private, 


The issues of a lack of an efficient wage replacement system for those workers affected by the H1N1 flu will be addressed by Congress shortly. The chorus of advocacy is increasing as this debate advances. The following is a recent post from the occupational-environmental mailing list setting forth a pretty persuading argument to establish a plan to pay sick workers with H1N1 flu.

Sick At Work

When the first cases of the H1N1 virus (swine flu) were confirmed in America back in April, the Centers for Disease Control and Prevention advised that sick individuals stay home from work or school. "Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people," the CDC said."If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them." However, for many Americans, staying home from work due to illness -- or to care for a sick child -- is an impossibility because of a lack of job-protected paid sick days. In response to the threat posed by H1N1, Rep. George Miller (D-CA) has proposed legislation that would "guarantee five paid sick days to employees at businesses with 15 or more workers who are directed to stay home by management." However, Miller's plan sunsets in two years and gives employers, not employees, the right to decide when leave is taken. Plus, under Miller's plan, employees cannot use leave time to care for a sick child. The Healthy Families Act (HFA), which is also before Congress, would guarantee seven paid sick days per year to all workers at firms with 15 or more employees. "Paid sick days has always been a good, common sense idea, but, in light of the recent H1N1 epidemic, it has also become a necessary one," said Rep. Rosa DeLauro (D-CT), an HFA sponsor. "Right when more and more workers are feeling economically vulnerable and afraid to even miss one workday, we face an extraordinarily serious health risk that spreads much more quickly if the sick do not stay at home." Last week, the Obama administration officially agreed, and endorsed the HFA.

LOW-INCOME WORKERS HIT THE HARDEST: The U.S. is currently the only developed nation that does not require some paid sick leave for workers. Nearly 40 percent of private sector workers have no paid sick leave, including 78 percent of hotel workers and 85 percent of food service workers. A survey last year by the National Opinion Research Center at the University of Chicago found that "68 percent of those not eligible for paid sick days said they had gone to work with a contagious illness like the flu." As CAP Senior Fellow Ann O'Leary and Karen Kornbluh, U.S. Representative to the Organisation for Economic Co-operation and Development, pointed out in The Shriver Report: A Women's Nation Changes Everything, "too often, most low- and many moderate-wage workers cannot access even the minimum benefits provided to more highly paid workers." And this is true of paid sick leave, as 88 percent of workers in the top 10 percent of wage earners have it, compared to just 22 percent of workers in the bottom 10. "Hopefully, employers are doing the right thing and not disciplining workers who are out sick as a result of the flu," wrote Center for American Progress Senior Economist Heather Boushey. "But there's no penalty for employers who choose not to pay workers in this situation, or who refuse workers any time off at all."

A BETTER BUSINESS MODEL: Big business organizations have panned the notion of required sick leave, with the Chamber of Commerce saying that "the problem is not nearly as great as some people say," and the National Association of Manufacturers warning that the HFA "would impose an inflexible government mandate on employers, making it more difficult for manufacturers to preserve and create jobs." However, lost productivity due to sick workers attending work and infecting others costs the U.S. economy $180 billion annually. For employers, the cost averages $255 per employee per year and "exceeds the cost of absenteeismand medical and disability benefits." The National Partnership for Women and Families actually found that "while a paid sick days policy would impose modest costs, the estimated business savings total $11.69 per week per worker from lower turnover, improved productivity and reduced spread of illness." The Center for Economic and Policy Research has also concluded that "there is no significant relationship between national unemployment rates and legally-mandated access to paid sick days." "When businesses take care of their workers, they are better able to retain them, and when workers have the security of paid time off, their commitment, productivity and morale increases, and employers reap the benefits of lower turnover and training costs," said National Partnership President Debra Ness.

LOCAL EFFORTS: Two major cities -- San Francisco and Washington, D.C. -- have implemented mandatory paid sick leave policies, while a third -- Milwaukee -- has passed the requirement, only to see it tied up in court. In addition, 15 states have proposed mandatory sick leave laws. "We are all being advised by our doctors to stay home if we're sick, but that is a cruel piece of advice if you don't have paid sick time," Maine Senate President Elizabeth Mitchell said. New York City is also looking at mandatory leave, which Mayor Michael Bloomberg has expressed support for, at least for the city's large employers. New York's proposed requirement would also allow workers to stay home in the event their child's school was closed for public health reasons. "Many working parents suffered this past spring because their children's schools were closed even though their children were not sick," said Donna Dolan, chairwoman of the New York State Paid Family Leave Coalition.

To read more about flu and workers' compensation click here.

Sick Leave Pay Law For H1N1 Advances

US Senator Chris Dodd (D-CT) has announced that he is preparing legislation to pay sick workers 7 days of sick leave for H1N1 flu. While workers' compensation benefits may be paid to disabled H1N1 flu workers, the threat of delay and denial has created an emergency that Senator Dodd indicates requires immediate Congressional attention. 


“This isn’t just a workers’ rights issue – it’s a public health emergency. Families shouldn’t have to choose between staying healthy and making ends meet,” said Dodd. “But if staying home means you don’t get paid, that’s an impossibility, especially for families struggling to make ends meet in this tough economy.”

“Workers should have paid sick leave as a matter of basic fairness,” Dodd continued. “But now sick leave is a matter of keeping Americans safe from this pandemic – and from the next one, whatever it may be.”

To read more about influenza and workers' compensation, click here.

He said, "It’s a matter of fairness for workers. It’s a matter of safety."

The CDC reports that H1N1 flu is now widespread in 48 states and may have infected as many as 5.7 million Americans. Fatalities amount to 672 Americans, which includes 129 children.

NIOSH: H1N1 Flu Is A Serious Risk to Healthcare Workers

The National Institute for Occupational Safety and Health (NIOSH) has declared that 2009 H1N1 Influenza poses a serious risk for healthcare personnel. With at least 4 deaths of nurses being reported in the media, NIOSH has stepped up its efforts to gather and analyze the prevalence of illness and fatalities among health workers.

"Healthcare personnel are at increased risk of occupational exposure to the 2009 H1N1 virus based on their likelihood for encountering patients with 2009 H1N1 illness. In contrast to seasonal influenza virus, 2009 H1N1 influenza virus has caused a greater relative burden of disease in younger people, which includes those in the age range of most healthcare personnel. For some healthcare personnel, this higher risk of exposure and illness may be compounded by the presence of underlying illness which places them at higher risk of serious flu complications, such as asthma, diabetes, or neuromuscular disease. Of particular concern to the healthcare workforce, which is largely female, is the fact that pregnant women are among those groups considered to be at higher risk of severe infection from 2009 H1N1."

For more articles on Workers' Compensation and the Flu Pandemic click here. 

Latex Allergy Adverse Reaction Caused by Swine Flu Shot

Just as health care workers and first responders have started to line up for H1N1 flu shots, an adverse reaction to latex has been reported. This development adds further to to the compensable risks resulting from adverse reactions to the vaccine.


Latex allergy claims have long been held compensable in workers' compensation courts throughout the country. The original claims arose out of exposure to latex protein in gloves that came into use as a result of the AIDS epidemic.


A case of latex allergy reaction has been reported in Australia during a vaccination program. While the vaccine and the vial are supposedly latex free, the packing material may not be, and that may have trigger the reaction.  One in 100 people are thought to have an allergy to latex. 


Reactions to latex may be mild or transitory or may be a permanent sensitization causing hives, shortness of breath, total disability and possible death.


For more articles on Workers' Compensation and the Flu Pandemic click here. 


To read more about compensable latex allergy claims click here.

HIPPA Privacy Modifications Under Presidential Emergency H1N1 Flu Order

Under the emergency declaration for H1N1 flu signed by President Obama on October 24, 2009, the HIPPA Privacy rule is not waived according to Federal HHS interpretation; however, "the Secretary of HHS may waive certain provisions of the Rule under the Project Bioshield Act of 2004 (PL 108-276) and section 1135(b)(7) of the Social Security Act."
 
Those modifications are:
 
"If the President declares an emergency or disaster and the Secretary declares a public health emergency, the Secretary may waive sanctions and penalties against a covered hospital that does not comply with certain provisions of the HIPAA Privacy Rule:

•  the requirements to obtain a patient's agreement to speak with family members or friends involved in the patient’s care (45 CFR 164.510(b)) 
• the requirement to honor a request to opt out of the facility directory (45 CFR 164.510(a)) 
• the requirement to distribute a notice of privacy practices (45 CFR 164.520) 
• the patient's right to request privacy restrictions (45 CFR 164.522(a)) 
• the patient's right to request confidential communications (45 CFR 164.522(b)) 

"If the Secretary issues such a waiver, it only applies:

1. In the emergency area and for the emergency period identified in the public health emergency declaration.

   2. To hospitals that have instituted a disaster protocol.  The waiver would apply to all patients at such hospitals.

   3. For up to 72 hours from the time the hospital implements its disaster protocol.

"When the Presidential or Secretarial declaration terminates, a hospital must then comply with all the requirements of the Privacy Rule for any patient still under its care, even if 72 hours has not elapsed since implementation of its disaster protocol. 

"Regardless of the activation of an emergency waiver, the HIPAA Privacy Rule permits disclosures for treatment purposes and certain disclosures to disaster relief organizations. For instance, the Privacy Rule allows covered entities to share patient information with the American Red Cross so it can notify family members of the patient’s location.  See 45 CFR 164.510(b)(4)."

Similar rule modifications were invoked during the Katrina disaster.

To read more about medical record privacy and workers' compensation, click here.

Compensating Adverse Flu Vaccine Reaction Victims

As the US flu vaccination program rolls out, the numbers are also growing for those who have reported adverse consequences from the H1N1 vaccine. The victims and their families are also lining up for benefits available in the workers’ compensation system as well as the Federal program. The existence of these programs have received little publicity and may be difficult for the public to navigate without adequate representation. 

The US Centers for Disease Control and Prevention (CDC) announced this week that pandemic activity has now increased in the US. Tom Frieden, MD, director of the CDC, said, "We have had up until now many millions of cases of pandemic influenza in the U.S. And the numbers continue to increase." President Obama signed an Executive Order declaring the Swine Fu as a national emergency. Hospitalization and death rates have increased, yet again. Over 60 million have been immunized early for seasonal flu, so that providers would be available to administer  H1N1 vaccine when it becomes available. . 

Even though the supply has been tardy for the H1NI vaccine, the companies that supply the product have promised an additional flow of supply to meet the demand. The European pharmaceutical companies, Novartis’s Focetria, GlaxoSmithKline’s (GSK’s) Pandemrix, and Baxter’s Celvapan are under contract to supply a huge volume of vaccine to the US. Novartis alone has a $979 million contract to supply H1N1 vaccine to the US Department of Health and Human Services (HHS) which amount to 251 million does and the total 35% projected US supply. It is anticipated that the US supply may not arrive until the first quarter of 2010.

A recent Washington Post-ABC News Poll reflects that Americans are more worried than ever about the H1N1 flu. In a matter of weeks, from August 2009 to October 2009 those reportedly worried about getting the H1N1 flu increased from39% to 52%.  The CDC has been reluctant to advertise the need to about the vaccine because the supply has been limited and they were attempting to avoid public panic. Their program will pick up as the supply becomes increasingly available.

Adverse effects from the flu vaccine already are being reported. Deaths have been reported associated with the deaths of at least four nurses with 2009 H1N1The Vaccine Adverse Event Reporting System (VAERS) is a national vaccine safety surveillance program co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS is a post-marketing safety surveillance program, collecting information about adverse events (possible side effects) that occur after the administration of vaccines licensed for use in the United States. The data is publically available through the CDC WONDER on-line database.

Workers’ Compensation programs have provided compensation benefits in the past resulting from adverse reactions to vaccines. In many jurisdictions, vaccinations afforded to employees resulting in a benefit to the employer against possible disastrous business consequences, have been considered to be “a mutual benefit.” Therefore, any disease arising from such vaccination has been deemed compensable.

Additionally, a Federal program has been established to shield the vaccine producers from liability claims. On October 1, 1988, the National Childhood Vaccine Injury Act of 1986 (Public Law 99-660) created the National Vaccine Injury Compensation Program (VICP). The VICP was established to ensure an adequate supply of vaccines, stabilize vaccine costs, and establish and maintain an accessible and efficient forum for individuals found to be injured by certain vaccines. The VICP is a no-fault alternative to the traditional tort system for resolving vaccine injury claims that provides compensation to people found to be injured by certain vaccines. The U. S. Court of Federal Claims hears the claims.

As of July 1, 2005, trivalent influenza vaccines have been added to the Table under this Category. Trivalent influenza vaccines are given annually during the flu season either by needle and syringe or in a nasal spray.  All influenza vaccines routinely administered in the U.S. are trivalent vaccines covered under this Category.  

The criteria for filing a claim under the VICP are the following:

• You may file a claim if you received a vaccine covered by the VICP and believe that you have been injured by this vaccine.
• You may also file a claim if you are a parent or legal guardian of a child or disabled adult who received a vaccine covered by the VICP and believe that the person was injured by this vaccine.
• You may file a claim if you are the legal representative of the estate of a deceased person who received a vaccine covered by the VICP and believe that the person’s death resulted from the vaccine injury.
• You may file a claim if you are not a United States citizen.
• Some people who receive vaccines outside of the U.S. may be eligible for compensation. The vaccines must have been covered by the VICP and given in the following circumstances:
• the injured person must have received a vaccine in the U.S. trust territories; or
• if the vaccine was administered outside of the U.S. or its trust territories:
1. the injured person must have been a U.S. citizen serving in the military or a U.S. government employee, or have been a dependent of such a citizen; or
2. the injured person must have received a vaccine manufactured by a vaccine company located in the U.S. and returned to the U.S. within 6 months after the date of vaccination.
• In addition, to be eligible to file a claim, the effects of the person’s injury must have:

1. lasted for more than 6 months after the vaccine was given; or
2. resulted in a hospital stay and surgery; or
3. resulted in death.

The VICP program has paid over $1.8 billion dollars from 1989 through 2009. Over 2,300 families have been paid to date with over 2,200 attorneys representing clients in such matters. "Compensated" are claims that have been paid as a result of a settlement between parties or a decision made by the U.S. Court of Federal Claims (Court). Approximately 18% of the benefits were paid to adults who received vaccines during the existence of the program. Since the program was expanded to adults who received vaccinations, the proportion of benefits to adults under the program has  increased proportionally. Nearly 52% of program awards in 2007 and 2008 went to adult vaccine recipients.

As the H1N1 vaccination program unfolds, those who suffer adverse reactions will be seeking benefits from both, the State workers’ compensation programs, as well as the VICP. Adequate dissemination of information concerning eligibility and procedural access to the programs will be of great benefit to the victims and their families.

For more articles on Workers' Compensation and the Flu Pandemic click here. 

CDC Reports Flu Widespread - Is the US Workers’ Compensation System Ready?

The US Centers for Disease Control (CDC) has announced that Flu is now “widespread” in 41 States and that deaths attributed to both pneumonia and influenza have increased and exceed what is normally expected for this time of the year.  The workers’ compensation system has never faced a challenge as extensive as what appears unfolding on the horizon. The method and manner of the delivery of benefits will be further complicated by, the broad spectrum of needs from protecting the spread of the disease, as well as treating those who are ill.

Forty-one states are reporting widespread influenza activity at this time according to the CDC. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Texas, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.  

Last month the CDC released a guide to business to prepare for the threat of the Flu. Despite the fact that the CDC has directed ill healthcare workers to stay home, workers’ compensation commentators continue to infer that Flu claims should be absolutely defended, and in fact, ill healthcare workers and sick employees should be held to a higher standard of proof to obtain benefits.

As challenges to mandatory vaccination programs meander thorough the courts, and voluntary/mandatory absenteeism programs are implemented, the ability of the system to quickly reimburse wages for lost time from work and provide medical benefits for treatment of the contagious disease, remains questionable. Should claims be filed by even a percentage of those workers who become ill, the system, which itself is anticipated to be overtaxed, may not be able the handle the volume on an emergent basis.

So far there has been silence about  workers’ compensation flu pandemic planning. While the Federal and State governments have rules and regulations in their arsenal to meet the challenge, this is an issue where workers’ compensation should be first in line to deliver benefits to sick workers.

For more articles on Workers' Compensation and the Flu Pandemic click here.

CDC Issues H1N1 Flu Guidance to Healthcare Personnel-"stay home"

In an urgent need to protect healthcare workers from H1N1 Flu, the today CDC has issued guidance on infection control measures to prevent transmission of 2009 H1N1 influenza in healthcare facilities. The CDC continues to recommend that healthcare workers take time away from work if they are ill. The issue unanswered is whether workers' compensation insurance will pay temporary disability benefits for the absence?


The CDC has defined healthcare personnel as, "....For the purposes of this guidance, healthcare personnel are defined as all persons whose occupational activities involve contact with patients or contaminated material in a healthcare, home healthcare, or clinical laboratory setting. Healthcare personnel are engaged in a range of occupations, many of which include patient contact even though they do not involve direct provision of patient care, such as dietary and housekeeping services. This guidance applies to healthcare personnel working in the following settings:  acute care hospitals, nursing homes, skilled nursing facilities, physician’s offices, urgent care centers, outpatient clinics, and home healthcare agencies.  It also includes those working in clinical settings within non-healthcare institutions, such as school nurses or personnel staffing clinics in correctional facilities. The term “healthcare personnel” includes not only employees of the organization or agency, but also contractors, clinicians, volunteers, students, trainees, clergy, and others who may come in contact with patients."

Healthcare personnel who develop a fever and respiratory symptoms should be:
• Instructed not to report to work, or if at work, to promptly notify their supervisor and infection control personnel/occupational health.
• Excluded from work for at least 24 hours after they no longer have a fever, without the use of fever-reducing medicines.

For more articles on Workers' Compensation and the Flu Pandemic click here.

The Urgent Need for Workers Compensation Flu Pandemic Planning

The 2009 influenza pandemic (flu) has created a new framework of acts and regulations to respond the World Health Organization’s (WHO) phase 6 pandemic alert. Governmentally imposed employment disruptions resulting from regulatory work disruptions to prevent the spread of disease maybe massive. While workers’ compensation was envisioned as a summary and remedial social insurance program, the challenges facing the workers’ compensation system to deliver benefits as promised may be seriously burdened.

There has been a global reaction to the 2008 influenza pandemic. On April 25, 2009, the WHO director-General Dr. Margaret Chen declared the H1N1 virus outbreak as a “Public Health Emergency of International Concern.” The international declaration indicated that a coordinated international response was potentially necessary to prevent curtail the spread of the disease that was perceived as a public health risk. Recommendations to restrict both trade and travel may follow.

The United States has structured its response on both a State and Federal level to the 2009 influenza alert. The Public Health Service Act (PHS) permits the Secretary of Health and Human Service (HHS) to access a special emergency fund, allows or the use of unapproved medical treatments and tests, and allows waiver of certain reimbursement of Medicare and Medicaid expenses, and waives penalties and sanctions for violation of the HIPAA Privacy Rule requirements. Additionally, the President may issue an emergency declaration under The Stafford Act to co-ordinate emergency relief under State and Federal programs, ie. use and distribution of anti-viral medications.

The Federal government has sweeping powers under the PHS that could disrupt employment throughout the country. Recommendations for school closings will impact children and staff well beyond the approximate 700 facilities that were closed in the Spring of 2009 during the H1N1 initial outbreak. The Federal government under the PHS has authority to quarantine (interstate and border) and to isolate. An Executive Order (E.O. 13375, April 2005) enumerates the “quarantainable diseases.” Travel restrictions may be imposed to limit the spread of a communicable disease. Employees may not be permitted to board flights under either voluntary airline restrictions or through the Federally imposed “Do Not Board” lists.

These closings and restrictions have raised issues as to what programs, if any, will be able to provide benefits to the employees because of the involuntary nature of the closings and disruptions. A recent Harvard School of Public Health study reveals that 80% of businesses foresee severe problems in maintaining operations if there is an outbreak. The workers’ compensation system could be requested to provide temporary disability benefits for occupational disease absences on a massive scale never before experienced. Pre-emption by superseding emergency regulatory actions may curtail employment that will trigger the implementation of State workers’ compensation benefits. The employer and the workers’ compensation insurance carriers will be required to pay temporary disability and medical benefits as a direct consequence of efforts to prevent the spread of a communicable disease. The carefully crafted employee-employer notification structure integrated into the workers’ compensation system may be partially or entirely disrupted by the consequences and chaos of the global health emergency.

Workers’ Compensation claims arising out of the influenza pandemic of 2009 will need to fit into the convoluted framework statutory acts and regulation. Reimbursement from the usual collateral third-party reimbursement sources may be restricted. In addition to the Doctrine of Sovereign Immunity, enjoyed by the Federal and State governments, other legislation including The “Public Readiness and Emergency Preparedness Act" (PREP Act) limits liability of others under certain specific emergency circumstances.

The enormity of the Pandemic presents a new and novel challenge to the system and one that must be considered by both Federal and State planners. Workers’ Compensation programs have adapted to emergencies before including natural disasters and terrorist attacks. The urgency of the situation requires that the system be vaccinated now.

For more articles on Workers' Compensation and the Flu Pandemic click here.

Federal Government Alerts Employers to Prepare for Flu Outbreaks

The Federal government has now taken action to alert employers and business as to what precautions should be taken in anticipation of the anticipated fall Flu outbreak. Yesterday the government revealed that deployment of vaccines would be too slow to prevent or restrain further spread this fall.

In a joint letter from the Secretaries of Commerce, Health and Human Services, Homeland Security and Labor, the Federal government has alerted employers and business of a new web site directed to encouraging prevention and containment for a resurgence in the months ahead of H1N1 Flu.

For more on this topic and workers' compensation benefits, visit the Workers Compensation Blog.

Employer Responsibility in the Flu Pandemic

The threat of the spread of flu this fall in the US is a major concern to infectious disease specialists. Healthcare workers are extremely apprehensive as the disease is beginning to spread and employers have not instituted adequate protections for workers.

In the US alone there have been 6,506 hospitalizations of H1N1 Flu patients. The CDC has reported that there have been 436 reported to date because of the novel flu infection. The World Health Organization (WHO) declared the virus a Phase-6 pandemic, the highest level of concern. Over 1,154 deaths have been reported worldwide.

The CDC has issued an Interim Guidance for controlling the spread of infection in healthcare facilities including hospitals, long-term care and outpatient facilities and other settings where healthcare is provided.

Healthcare workers have rallied to protest the firing of a co-worker who disclosed that a healthcare facility was not taken appropriate action to prevent the spread of flu at its work site. The major national unions in April 2009 warned in a report that employers were not taking adequate precautions to protect healthcare workers.

Most recently a task force of the Institute of Medicine (IOM) charged with the responsibility of making recommendations on how to protect workers from the H1N1 flu heard evidence that actions by employers could reduce the spread of the disease. It was reported the use of N95 masks provided 75% protection against lab-confirmed flu.

Workers' remedies from the residuals of the illness have now been limited. The Federal vaccination compensation program will shield the vaccine makers from liability claims. Employers will be protected against civil law suits by the exclusivity provisions of the workers' compensation system. Workers' Compensation does not encompass a roll in prevention of disease. OSHA has alerted employers to take action, but cannot compel them to do so.

It is time for employers to act to prevent unnecessary illness and death in the workplace. Simple educational and enforcement actions by employers will go along way to protect workers from the consequences of this unprecedented pandemic. While time is short and the clock is ticking away as the US flu season formally approaches, time still remains for employers to act and mandate protocols and procedures that will prevent the spread of the disease and will save lives.

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For more on workers compensation and the flu pandemic visit the Workers' Compensation Blog.

California Workers Compensation Fund Alerts Employers and Employees as to Flu

The California Workers' Compensation Fund has taken the initiative of alerting employers and employees as to preventative measures that should be taken to prevent the spread of Swine Flu. 

"To protect California workers and businesses, State Fund advises employers to educate their employees about swine flu facts, symptoms, and preventative measures and to prepare their business operations should a pandemic outbreak significantly reduce their workforce or disrupt their business operation. "

As of today there are 403 reported cases and one death according to the CDC. Numbers are expected to rise as testing has now been shifted from the CDC to the States. California has 49 reported cases.

The novel influenza outbreak (H1N1) has given rise to concern on the impact what a pandemic would cause. The Department of Homeland Security has posted information that workers' compensation programs would probably become involved in responding to the emergency. NIOSH has issued an alert concerning the impact upon psychological and social workers comparing a potential pandemic to the 911 tragedy.