Employer Ordered to Pay for Cervical Myelopathy

The worker, a short haul freight driver, hit his head while in the employ of the defendant when moving out from underneath a trailer.  He was dazed and suffered a cut to his head but completed his route that day.  He continued to work his regular shifts, “without incident” until he began experiencing symptoms in his lower extremities a number of days later.  Then while at the bank preparing for vacation, he described upper extremity symptoms.  His arms felt heavy and weak.  His hands were numb and unresponsive.  On his vacation, the claimant traveled via motorcycle to South Dakota.  While in South Dakota, his symptoms worsened, his balance was off, he could not walk well and he was unable to return on his motorcycle.  A neurosurgeon at Fletcher Allen Health Care diagnosed him with a disc herniation that was pressing on the spinal cord rather than a nerve root (cervical spondylotic myelopathy) and performed a disc excision and fusion.  He opined the claimant suffered a disc herniation when he hit his head on the underside of the trailer and over the subsequent three weeks he developed the progressive cervical myelopathy.  The employer denied the surgery utilizing a medical opinion that the disc herniation was the result of a natural degenerative process in the claimant’s cervical spine.  The employer’s expert relied on the radiographs of the claimant’s cervical spine taken on the date of the injury which showed an advanced degenerative process, in support of his position.  He also opined that the motorcycle trip was a more likely cause of an aggravation of the pre-existing condition due to the relationship between the trip and the worsening of symptoms. Cain v. New Penn Motor Express, Inc., Op. No. 12-13WC (2013).

The Department of Labor concluded that the treating doctor’s opinion was more credible than the employer’s expert, relying heavily on the “clarity, thoroughness and objective support underlying the opinion.” See Geiger v. Hawk Mountain Inn, Op. No. 37-03 (2003) (citing the five-part test for assessing physician credibility: (1) the nature of the treatment and the length of time there has been a patient-provider relationship; (2) whether the expert examined all the pertinent medical records; (3) the clarity, thoroughness and objective support underlying the opinion; (4) the comprehensiveness of the evaluation; and (5) the expert’s qualifications). The claimant’s doctor adequately explained how the progression of symptoms, though intermittent, explained the worsening of the myelopathy subsequent to the injury.  The defendant’s expert did not adequately address how the motorcycle trip was the cause of the injury when the symptoms began prior to the trip and could not explain what specific elements of the trip were responsible for the causal relationship.  Cain v. New Penn Motor Express, Inc., Op. No. 12-13WC (2013).

Department of Labor Announces Vermont Workers' Compensation Licensing Contact

Adjusters with questions about whether attendance at the final Vermont Department of Labor’s Workers’ Compensation Adjusters’ Continuing Education is required in order to meet continuing education requirements in Vermont should contact Sandra Fraser at the Department of Financial Regulation.  Her phone number is 802-828-5923 and her e-mail is Sandra.fraser@state.vt.us.

The Department of Financial Regulation website is www.dfr.vermont.gov.         

The seminar begins at 12:30pm on Thursday October 24th, and finishes at 5pm that day.  On Friday October 25th, the seminar runs from 8:30am until noon.  This is the last continuing education conference of the cycle.  Pursuant to 8 VSA §4791 any person (other than a licensed attorney) who investigates claims and negotiates settlement of claims arising under policies of workers’ compensation insurance in behalf of insurers under such policies, or who advertises or solicits business from insurers as an adjuster, is a workers’ compensation adjuster for purposes of the statute.  In order to renew a WC Adjusters license you must attend and satisfactorily participate in a continuing education seminar administered by the Vermont Department of Labor and Industry.

The link below takes you to the registration for the October 24 & 25 conference.

http://www.cvent.com/d/z4qnkd/4W

Department of Labor Updates Change of Vocational Provider Form

Today the Vermont Department of Labor has issued an update to the Change of Vocational Provider Form (VR-8).  The Department has asked that previous versions of the Form be discontinued as of this date.  

 

The new form is available at the following link:

http://labor.vermont.gov/FormsPublications/WCFormsandPublications/VRForms/tabid/185/Default.aspx

Vermont Workers' Compensation Conference To Be Held October 24 & 25

The Vermont Department of Labor’s Workers’ Compensation Adjusters’ Continuing Education is scheduled for October 24 and 25^th at the Hilton Hotel, Burlington, Vermont.   The seminar begins at 12:30pm on Thursday, finishing at 5pm and runs from 8:30am until noon on Friday.  This is the last continuing education conference of the cycle.  Pursuant to 8 VSA §4791 any person (other than a licensed attorney) who investigates claims and negotiates settlement of claims arising under policies of workers’ compensation insurance in behalf of insurers under such policies, or who advertises or solicits business from insurers as an adjuster, is a workers’ compensation adjuster for purposes of the statute.  In order to renew a WC Adjusters license you must attend and satisfactorily participate in a continuing education seminar administered by the Vermont Department of Labor and Industry.

The link below takes you to the registration for the October 24 & 25 conference.

http://www.cvent.com/d/z4qnkd/4W

 

The Hilton Hotel, Burlington, Vermont has a block of rooms has been secured for the conference. The link below will provide access to easy online reservations. Guests can also contact 1-800-Hiltons using the code: VTD for the discounted rate.

http://www.hilton.com/en/hi/groups/personalized/B/BTTVTHF-VTD-20131023/index.jhtml

State Auditor’s Report Focuses on Vermont’s Workplace Safety Efforts for State Employees

The Vermont State Auditor, Doug Hoffer, has issued an audit of The Office of State Employee Workers’ Compensation and Injury Prevention (WIP).  The WIP is responsible for administering the state’s workers’ compensation program and for prevention of workplace injuries for state employees.

According to a press release from the Vermont State Auditor’s Office the audit found, “shortfalls, failures and gaps” in injury prevention efforts and errors in the data collection system. The transmittal letter from the Auditor noted, prior recommendations of the WIP to improve safety for state employees, were adopted by less than two thirds of the Departments with high workers’ compensation claims.

As a result of the report, the Vermont State Auditor has urged the state to make a “stronger commitment to workplace safety.”

The press release is located at:

http://auditor.vermont.gov/sites/auditor/files/WCP%20press%20release%207-22-13.pdf

The link for the transmittal letter from the Auditor’s Office is located here:

http://auditor.vermont.gov/sites/auditor/files/Final%20WCP%20transmittal%20letter.pdf

A link for a three page summary of the audit is located here:

http://auditor.vermont.gov/sites/auditor/files/Final%20WCP%20highlights.pdf

The link for the full 55 page audit is located here:

http://auditor.vermont.gov/sites/auditor/files/Final%20WCP%20report.pdf

Department of Labor Creates "Health Care Provider Report" Form

The Vermont Department of Labor has created a new form to assist physicians in providing the employer/carrier with information regarding the treatment of an injured worker.  The form is called the “Health Care Provider Report” and is also known as the HCP1. The form is not required to be filed.  The Department describes this as a tool to assist in obtaining relevant medical information regarding workers’ compensation injuries/illnesses. 

The form is a one page document that provides basic information such as: The employee’s name, address, date of birth and phone number; Information regarding the injury itself, such as, the date of the injury, the body part injured, the date of the examination, the diagnosis and whether the injury was work related; A line is provided for documenting test results, interpretation of the results, what medications are prescribed and what the treatment plan is; and there is a section for a brief comment on return to work.

This form is not required.  It does not change the law that requires that any provider seeking reimbursement for services must provide legible, supporting documentation. Vermont Workers’ Compensation Rules, Rule 40.021(C).  That supporting documentation is described as, “documentation for each service provided which is sufficiently detailed to allow for the review of the medical necessity of the service and the appropriateness of the fee charged.” Vermont Workers’ Compensation Rules, Rule 40.021(E).

The link to the new form is:

http://www.labor.vermont.gov/Portals/0/WC/healthcareprovidersrpt.pdf

Is An Injury At the Company Picnic Compensable?

The leading commentator on workers’ compensation law has concluded that "Even if the employer is the sponsor of a regular annual company picnic, the employment connection may be inadequate if there is nothing more--no compulsion of any kind to attend, no pep talks or other business, no transportation, no wearing of uniforms." 1A Larson, at § 22.23(a).  For a company picnic to be compensable the facts must support that the event was sufficiently related to the claimant's employment.  Factors to consider are: whether the picnic took place on company time; whether the participants are paid for their attendance; whether people who do not attend the picnic are required to work; whether a percentage of the employees not participate; and whether  the company uses the occasion for any politicking amongst its employees. Delorme v. Johnson Printing Co., Opinion No. 4-90WC (1990); Michael Riley v. Norrell Services Opinion No. 20-95WC (1995).  There must be a correlation between obligations of work and the activity.