Are You Suffering From Symptoms Of Chronic Stress? Take the Stress Test!

Today's post comes from guest author Kit Case from Causey Law Firm.

Signs of Chronic Stress:
Cognitive symptoms
•          Memory problems
•          Inability to concentrate
•          Poor judgment
•          Pessimistic approach or thoughts
•          Anxious or racing thoughts
•          Constant worrying
Emotional symptoms
•          Moodiness
•          Irritability or short temper
•          Agitation, inability to relax
•          Feeling overwhelmed
•          Sense of loneliness and isolation
•          Depression or general unhappiness
Physical symptoms
•          Aches and pains
•          Diarrhea or constipation
•          Nausea, dizziness
•          Chest pain, rapid heartbeat
•          Loss of sex drive
•          Frequent colds
Behavioral symptoms
•          Eating more or less
•          Sleeping too much or too little
•          Isolating oneself from others
•          Procrastinating or neglecting responsibilities
•          Using alcohol, cigarettes, or drugs to relax

Take the Stress Test for Adults:
Thomas Holmes and Richard Rahe in 1967, examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive correlation was found between their life events and their illnesses.
Their results were published as the Social Readjustment Rating Scale (SRRS), known more commonly as the Holmes and Rahe Stress Scale.
To measure stress according to the Holmes and Rahe Stress Scale, the number of "Life Change Units" that apply to events in the past year of an individual's life are added and the final score will give a rough estimate of how stress affects health.
Note: the table, below, is from the Wikipedia page on this subject.  For a fee of $5.00, you can go directly to Dr. Rahe's website and obtain the full test materials as well as background information and details of this and other products and services available.

To measure stress according to the Holmes and Rahe Stress Scale, the number of "Life Change Units" that apply to events in the past year of an individual's life are added and the final score will give a rough estimate of how stress affects health.

Life event	Life change units
Death of a spouse	100
Divorce	73
Marital separation	65
Imprisonment	63
Death of a close family member	63
Personal injury or illness	53
Marriage	50
Dismissal from work	47
Marital reconciliation	45
Retirement	45
Change in health of family member	44
Pregnancy	40
Sexual difficulties	39
Gain a new family member	39
Business readjustment	39
Change in financial state	38
Death of a close friend	37
Change to different line of work	36
Change in frequency of arguments	35
Major mortgage	32
Foreclosure of mortgage or loan	30
Change in responsibilities at work	29
Child leaving home	29
Trouble with in-laws	29
Outstanding personal achievement	28
Spouse starts or stops work	26
Begin or end school	26
Change in living conditions	25
Revision of personal habits	24
Trouble with boss	23
Change in working hours or conditions	20
Change in residence	20
Change in schools	20
Change in recreation	19
Change in church activities	19
Change in social activities	18
Minor mortgage or loan	17
Change in sleeping habits	16
Change in number of family reunions	15
Change in eating habits	15
Vacation	13
Christmas	12
Minor violation of law	11

Score of 300+: At risk of illness.
Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).
Score 150-: Only have a slight risk of illness.

Recommended methods for relieving chronic stress include exercise (which can be modified to accommodate physical restrictions after an injury), meditation, music therapy, breathing techniques, and such simple things as companionship - from a pet, friend or family member.

Repeated Fall Injuries Results in OSHA Fines of $58,000 to NJ Employer

The U.S. Department of Labor's Occupational Safety and Health Administration has cited Beno Stucco Systems of Rochelle Park with six safety violations – including five repeat – involving fall and scaffolding hazards while employees were applying stucco to a commercial building in Westwood, N.J.

OSHA's June investigation was initiated as a result of an imminent danger fall hazard. Proposed penalties total $61,600.

The repeat violations, with $58,520 as the proposed penalty, were cited for exposing workers to fall and scaffolding hazards, and for failing to provide workers with protective helmets to prevent injuries from falling objects. A repeat violation is issued when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. Similar violations were cited in 2007, 2009 and 2011.

One serious violation, with a $3,080 proposed penalty, was cited for failing to have a competent person inspect scaffolds and scaffold components for visible defects before each work shift and after any occurrence that could affect a scaffold's structural integrity. Additionally, the company did not conduct an inspection of the job site, materials and scaffold components, to prevent employees from working without full planking, fall protection and scaffold access. A serious citation is issued when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.

"This company repeatedly neglected to implement basic, common-sense and legally-required safeguards to ensure that scaffolds were erected properly and fall protection was provided for employees working at heights of 10 feet or more," said Lisa Levy, director of OSHA's area office in Hasbrouck Heights, N.J. "OSHA will not tolerate employers jeopardizing the safety and health of workers."

OSHA and the National Institute for Occupational Safety and Health are working with trade associations, labor unions, employers, universities, community and faith-based organizations and consulates to provide employers and workers–especially vulnerable, low-literacy workers–with education and training on common-sense fall prevention equipment and strategies that save lives. OSHA has also created a new fall prevention Web page at http://www.osha.gov/stopfalls that includes detailed information in English and Spanish on fall protection standards.

Beno Stucco Systems has 15 business days from receipt of its citations and proposed penalties to comply, meet with OSHA's area director or contest the findings before the independent Occupational Safety and Health Review Commission.

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Workers’ Compensation 2013 – What Happens on the Other Side of The Fiscal Cliff?

The fiscal reality is that workers’ compensation is in greater jeopardy than ever before as the debate in Washington is not about the deficit at all. The debate is about government spending which includes health care.

Overall health care devours 18 percent of the US economy and amounts to 25% of the Federal budget.

Medical treatment for injured workers continues to be delayed, denied and limited under current workers’ compensation programs. Medical costs continue to be shifted to other programs including employer based medical care systems and the Federal safety net of Medicare, Medicaid, Veterans Administration and Tricare.

While a trend continues to emerge to offer “Opt Out” and “Carve Out Programs,” they are not global enough to solve the critical budget deficit issues. The latest emerging trend is for employers to utilize ERISA based medical care plans to efficiently delivery medical care. In NJ a limited alternate dispute-resolution procedure between unions and employers has been introduced. See “NJ Care Outs –Another Evolutionary Step” authored by David DePaolo.

The US economy continues to be very weak. This in an ominous signal for the nation’s workers’ compensation program which is starved for premium dollars. Premiums are based upon salaries and real median incomes continued their dramatic decline over the last decade from $54,841 in 2000 to $50,054 in 2011. There just may not be enough dollars available in the workers’ compensation programs to pay for present and lifetime medical care.

Even the present Federal system leaves much to be desired. Whether Federal rationing medical care becomes a reality is unknown. Physicians are under economic scrutiny as the “Doc Fix” to limit provider fees continues as a cloud over all medical programs. The agreement reached by Congress still does not resolve the 26.5% percent cut reimbursement cut to physicians who treat Medicare patients. The law merely "freezes" payment to physicians.

Workers’ compensation programs presently structured provide no real economic incentive to monitor and compensate for more favorable medical outcomes. On the other hand, the Federal government, with broad and sweeping regulatory ability, is able to continue to make strides in many areas including present incentives to hospitals and proposed incentives to physicians to provide medical treatment with fewer complications and ultimate better outcomes

Steven Ratner in the NY Times points out the dramatic increase in the nation’s health care costs. He wrote, “…no budget-busting factor looms larger than the soaring cost of government-financed health care, particularly Medicare and Medicaid.”

Solving the economic gridlock of the country will require an approach to re-invent a medical program for injured workers. A global single-payer program under Federal control will eliminate duplicative administrative State and private efforts. The Federal government has the clout to provide efficient enforcement and co-ordination.

Now that we are on the other side of the fiscal cliff, the opportunity to be creative is possible. The US needs to transition to a single-payer health care system subsuming a medical care program for injured and ill workers who suffer both traumatic and occupational conditions.

Read more about the "single-Payer System" and workers' compensation

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Class Action by Medicare Advantage Beneficiares Dismissed By Federal Court

A federal class action, by a group of plaintiffs who alleged that they were a class of Medicare-eligible individuals enrolled in a Medicare Advantage plan, and received benefits under part C of the Medicare program, was dismissed by a federal court under the preemption doctrine. In an action removed to Federal court, the plaintiffs sought to bring a class action in state court alleging that New York state law applied regarding reimbursement for for monetary settlements from third-party tortfeasors.

The court ruled that the interpretation of the secondary payer provision of Medicare part C, 42 USC section 1395W-22 (a)(4), preempted any state law provisions.

Meek-Horton v. Trover Solutions, Inc., No. 11 CV 6054(RPP), 2012 WL 6699776, (SD-NY 2012) Decided December 26, 2012

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Workers' Compensation: US Supreme Court Denies CMS-MSP ...

Oct 01, 2012

US Supreme Court Denies CMS-MSP Case - Hadden. 2012 WL 1106757. Supreme Court of the United States. HADDEN, VERNON V. UNITED STATES. No. 11-1197.Oct. 1, 2012. Opinion. The petition for writ of certiorari is ...

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Workers' Compensation: Legislation Goes to President Obama on ...

Dec 28, 2012

CMS/MSP Requires Deceased Beneficiary Information. CMS has announced that workers' compensation information concerning deceased beneficiaries must be reported by insurance carriers. "We received another question ...

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Workers' Compensation: CMS/MSP Requires Deceased Beneficiary ...

Apr 03, 2009

CMS/MSP Requires Deceased Beneficiary Information. CMS has announced that workers' compensation information concerning deceased beneficiaries must be reported by insurance carriers. "We received another question ...

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Federal Court Enjoins CMS From MSP Recovery Procedures

May 18, 2011

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Legislation Goes to President Obama on CMS Condition Payment Procedures

The US House (H.R. 1845) and US Senate has passed legislation to modify procedures for processing conditional payments under the Medicare (S. 1718) Secondary Payer Act. It establishes parameters for repording, processing and appealing issues concerning conditional payments.

Under the proposed legislation time periods for reporting by parties to CMS (The Center for Medeicare and Medicaid Services) are eased, penalities for insurance carriers are reduced, and a 3 year statute of limitations is established.

The legislation was merged into another pending bill for medical services and was rushed to a favorable vote in both the House and Senate in the last moments before Christmas.

What remains to be determined are the regulations that will be established to implement the legislation. In the past, such regulations usually set boundries for such legislation and may in the end further complicate and even prolong resolution of the issues.

Read more about "The Medicare Secondary Payer Act" and workers' compensation

Workers' Compensation: US Supreme Court Denies CMS-MSP ...

Oct 01, 2012

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Who Calls The Shots, Your Employer-Selected Doctor Or The Insurance Company?

Insurance companies sometimes tell doctors that they will not pay for procedures that the doctor says are medically appropriate.

Today's post comes from guest author Nathan Reckman from Paul McAndrew Law Firm.

In Iowa, employers have the right to control an injured worker’s medical care. This means that if you are injured at work, your employer gets to send you to a doctor of their choosing. The doctors chosen by the employer are called “authorized treating physicians.” In theory, after an employer chooses their authorized treating physician, they are required to pay for any care that doctor believes is necessary to treat the work injury. In practice, the employer and their workers’ compensation insurance company often try to interfere with the care the injured worker is entitled to by refusing to pay for procedures or tests recommended by their handpicked doctor.

Typically, when an authorized doctor suggests an expensive course of care (like surgery) the first thing the doctor will do is check with the insurance company to make sure the surgery is going to be paid for. Instead of immediately scheduling the needed surgery, the doctor will wait until the insurance carrier agrees to pay for the procedure. Doctors do this so they don’t have to worry about how they are going to be paid. Asking for this unneeded authorization from the insurance company means the insurance company now has a say in determining what individual procedures are proper for the care of the work injury.

We often see injured workers whose injury was initially accepted by the employer until the doctor requests authorization for an expensive surgery. When faced with the additional cost of surgery, the insurance carrier denies the work injury hoping the injured worker will either forego surgery or try to pay for the surgery through other means, such as their personal health insurance.

This situation may also arise when the authorized doctor recommends expensive diagnostic procedures, like CT scans, or refers the injured worker to a specialist, for example a psychiatrist for depression related to the work injury.

To make sure your rights are protected, it’s often helpful to have an experienced workers’ compensation attorney on your side if you’re facing a situation where your employer is trying to interfere with the decisions of their handpicked doctor. Injured workers should get the care that their doctor, not an insurance company, determines is medically appropriate.

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Workers' Compensation Jeopardy: Romney and Medical Costs

Nov 01, 2012

Planned changes by Mitt Romney to Medicare and Medicaid will have a dire effect on the regulations of the future cost of workers' compensation medical treatment. Proposed changes to the Federal program will indirectly ...

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Workers' Compensation: Out of State Medical Treatment Allowed By ...

Jan 22, 2011

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Happy and Healthy Holiday Season