The Lombardi Law Firm Blog

Workers Compensation: Green Leaf Tobacco Sickness for migrant farm workers

Green tobacco sickness is normally non life threatening. It is a sickness that causes nausea, vomiting, dizziness and can cause dehydration. It commonly affects migrant farm workers who harvest the wet tobacco leaves allowing nicotine to enter through skin pores during the harvesting process. Symptoms will typically last 12 to 48 hours and then dissipate. Father Crosby, a Catholic priest filed a shareholder resolution but withdrew the same when Philip Morris International agreed to develop a training program and materials to distribute to U.S. and international growers.

Tobacco harvesting is a labor-intensive industry. Harvesting leafs is done by hand.

A professor at Wake Forest University School of Medicine, in North Carolina, has done research on Green Tobacco Sickness. He calls this a work related injury or sickness that has been widely ignored. It's believed this illness to be underreported.  The sickness is also known as Acute Nicotine Poisoning.

To learn more about green tobacco sickness you can visit the National Ag Safety Database and read "Learning about Green Tobacco Sickness: Juan's Experience.  The Lombardi Law Firm blog will carry a longer article tomorrow. Read The Verdict for additional information.

There is also a description at Wikipedia.  Green Tobacco Sickness is defined as " a nicotine-induced illness of tobacco harvest workers characterized by headache, dizziness, vomiting, and prostration, caused by skin contact with wet tobacco leaves. " See the Free Dictionary

The National Institute for Occupational Safety and Health does have information. An article by the Wall Street Journal drew national attention this otherwise widely known but hardly recognized problem for migrant workers.

Green tobacco sickness 'highly prevalent' in N.C. farm workers. Science Blog, July 2001.

Tackling Green Tobacco Sickness, Wall Street Journal, March 23, 2009

"While typically not life-threatening, green tobacco sickness is a debilitating illness that causes nausea, vomiting, dizziness and, in severe cases, dehydration. It afflicts tobacco workers when nicotine on moist tobacco leaves seeps through their pores as they hand-harvest the leaves. The symptoms typically last 12 to 48 hours."

"More attention is being paid to the illness partly because the nature of tobacco production has changed. Increasingly in the U.S., tobacco is grown on larger farms, rather than the small family farms that once dominated the industry. That means more migrant workers are picking tobacco for longer periods of time, increasing their exposure."

Short description: green tobacco sickness transient, recurring nicotine poisoning in tobacco harvesters.

There is also information available at http://www.tobacco.org/news/280837.html, tobacco news and information.

For a different point of view about th tobacco settlement see the video below.

Iowa Workers Compensation: The Ames Chamber of Commerce is wrong about doctor choice bill.

The Ames Chamber of Commerce argues that workers getting to choose the treating physician will result in a higher cost for workers compensation and for that reason alone Senate Study Bill 1119 should be rejected. They Chamber is as wrong as wrong can be. I don’t believe that can be true and if it does prove to be true there is an easy solution.

First of all workers need to work or else their jobs will leave and head overseas to China; I think by now they all know this to be true. Second, employers and their insurance carriers spend an inordinate amount of money with case managers and other ancillary semi-professionals attempting to manage the care. End the tug-of-war and let the employees decide who gets to cut on them. It’s the dignified thing to do.  If the employee is choosing the doctor the employer will no longer have to spend the time and money doing this so there should be savings overall.

Lastly, if the costs do for some reasons increase then the employers and insurance carriers have another sensible option; they ca start managing the costs of medical services. There is no one in this business who is managing the medical service providers and what they charge.  Blue Cross and Blue Shield does manage cost for its insured’s so why isn’t someone doing it for the employers. It’s that simple. Stop whining and move on to more important issues.

Popcorn Lung for Iowa Workers

A verdict by a Sioux City, Iowa jury awarded $7.5 million for the death of a worker after he developed a rare lung condition, broncholitis obliterans. The worker was a butter flavor mixer with American Popcorn Company.

Ronald Kuiper, who passed away on Wednesday afternoon, was formerly employed at American Popcorn Company as a butter flavor mixer. He had been diagnosed with the rare lung condition called broncholitis obliterans, which has been linked to artificial butter flavor exposure.

The product and chemical is butter flavor containing diacetyl, a chemical which has been found by the National Institute of Safety and Health to cause severe lung injury.

OSHA: HAZARD COMMUNICATION GUIDANCE FOR DIACETYL AND FOOD FLAVORINGS CONTAINING DIACETYLHAZARD COMMUNICATION GUIDANCE FOR DIACETYL AND FOOD FLAVORINGS CONTAINING DIACETYL

NIOSH Science Blog: Diacetyl and Food Flavorings

A Case of Regulatory Failure - Popcorn Workers Lung

NC Dept. of Labor: Hazard Alert

Iowa Workers Compensation: Which way will the full House vote?

Iowa’s Governor Chet Culver is in favor of the bill before the legislature that would allow injured workers the right to choose their own treating physician. Join us today on The Verdict as we discuss which way the full House will vote on the bill that would allow injured workers the right to choose who treats their injuries.

Iowa Workers Compensation: Erectile Dysfunction and the work related injury

Today let’s learn about Viagra, workers' compensation lawyers, injured workers and musical ensembles. These are all entwined in one way or another.

Did you hear about the drug store at the corner of 22^nd and Westown Parkway in West Des Moines, Iowa that was broken into last week? Completely burglarized.

They stole the entire inventory of Viagra. Yeah, the police are out looking for hardened criminals.

Viagra brings instant humor to any conversation. A Russian pop group even adopted the name. We’ve all seen the commercials and I’ll venture to say there isn’t a guy on the planet who hasn’t thought or said, “Heck if I had an erection for four hours I wouldn’t be visiting the emergency room!” Well the side effect of  Viagra that we are talking about is serious and if you knew they inserted a probe into your penis, three times I believe, then you’d wince and stop laughing about that side effect.  

The official Viagra web site indicates if you take any medications with nitrates in them (like nitroglycerin for chest pain) either every day or once in a while you shouldn’t be taking Viagra.  Viagra can lead to you having a heart attack, so follow the directions.

Vigara can also be used to combat high altitude pulmonary edema (HAPE) or altitude sickness.

Can Viagra lead to situations involving death?

The short answer is yes it can. Viagra was originally being tested as a vaso dialator to combat high blood pressure. In the clinical trials they noticed one particular side effect for men that later led to it being used to treat erictile dysfunction.

Is Viagra or Cialis covered under Iowa’s Workers Compensation Act?

The short answer is yes it can be under Iowa Code Chapter 85.27, the medical benefits section.

My clients have included men with ruptured discs or more serious nerve disorders like myolapathy that result in their inability to enjoy their normal sex life. To many of us the whole thought of Viagra is funny, but to them it’s a real situation that creates a quality of life challenge. It’s a real problem for these clients that should not be ignored by the lawyer.  I’ve been successful in obtaining authorization for the workers’ compensation carrier to cover the cost of prescibing Viagra under the Iowa Workers’ Compensation Act as a reasonable medical expense. It takes a physicial examination by the treating physician and his or her prescribing the drug for treatment. Physical activity is so closely tied to psychological well being that the two go, well … hand-in-hand.

Is there case law to support the prescribing of Viagra or Cealis?

Yes. Without giving a complete list of cases here is one case you can site to your attorney or to the adjuster.

Case No. 5-2701: A deputy-level decision currently on appeal found Viagra prescriptions reasonable and necessary to treat work related sexual dysfunction. Claimant’s authorized physician retired, and defendant provided care to include a diagnostic workup of that symptom. This has not yet been accomplished.

Should I tell my lawyer I’m having a problem with having sex?

How is the lawyer supposed to know the client is having a problem?

For the lawyer to deal with the problem he or she needs to know it exists. There aren’t many male clients willing to walk into the lawyers office and lay it right out on the table. Most times I have to put things together with the seriousness of the injury, picking up on the little things the client talks about. Many times there are vague complaints but the client continues to suggest going back to see the company doctor. They may even give indications their spouse is having a difficult time, not happy and sometimes I need to just sit back in my chair and listen. Being busy it’s not easy to take a half hour to just chat about how things are going in their life. But inevitably it will save time in the future. If ignored the problem will persist. My approach is to talk while alone with the client and ask “How are things going at home?”.  As lawyers we are also counselors and have to be sensitive to who we are and what they must be dealing with.  

As a lawyer if you ignore the possibilty of this being a problem you don’t deserve to have the privilege of representing the client.

And clients if it’s a problem and difficult for you to bring up, drop the lawyer an email and bring the issue up. And please don’t misuse the drug. Here is a story about a Russian man who took up the challenge by two women that he couldn’t have sex for an entire day. He did but with a bottle of Viagra, then had a heart attack and died.

Whatever you do don’t abuse Viagra, it’s a drug that can kill you.

So don’t be stupid about it.

By the way, the Via Gra pop group video is really pretty good. I wouldn’t call it Hard Rock but then again it’s not Soft Rock either. Sorry, I just couldn’t let that one pass though my brain without writing it. Remember boys will be boys.

Nu Virgos is the name used to promote the group VIA Gra (??? ???) outside of Russia, Ukraine and other nearby countries. The name VIA Gra is both a reference to the drug Viagra and a play on words, since the first three letters stand for "vocal-instrumental ensemble" in Russian, and "Gra" means "Game" in Ukrainian. VIA Gra is a Ukrainian/Russian girl group that hit the charts in these countries in September 2000 with their first single "Popytka No. 5". Their first success outside the Russian language area was in May 2004 with the single "Stop! Stop! Stop!", an English version of their 2002 Russian song. The group is known for their frequent lineup changes, with 11 different individuals having at one time been in the group. The group was co-created by Dmitriy Kostyuk and Konstantin Meladze. Kostyuk is the manager of the group and the co-producer of the group's albums. Meladze is the writer of the group's songs and the co-producer of the group's albums.

Choice of doctor bill isn’t about choice so much as it’s about controlling the outcome

The choice of doctor bill in the Iowa Senate is getting a lot of press lately. There are stories here, here and here. After 28 years of practicing workers compensation I’ll throw in my two-cents, for what it’s worth. I’ll warn you at 54 I’m cranky, have little tolerance for being patronized and say it like I see it. If that’s too much for you then you needn’t read any further.

The Issue: Iowa’s workers’ compensation laws don’t allow the injured worker the right to choose the treating physicians. Treating physicians under Iowa law are selected and paid by the employer; which in many instances is a workers’ compensation insurance company. There are a few self-insured manufacturers in Iowa; they tend to be quite vocal about wanting control over selecting the company doctor.  There is a bill before the Iowa Senate that would change which party has the right to select the treating doctors. The bill would allow injured workers the right to say which doctor can cut on them. Now you know the issue – it’s who will pick and then pay for medical treatment.

The employer’s position is being stated in the Des Moines Register by someone from Pella Corporation. Pella is a good business in Iowa and no one would want to see them go. Being a good corporation is only part of the game though; being a good citizen is also essential. When employers say it’s about getting the injured employee to the right doctor I find it hard to believe. Qualified doctors are all around Iowa. This isn’t Tanzania, Africa. We are talking the Midwestern United States. This isn’t about an employee picking his or her family doctor versus the employer having specialized knowledge and access to which doctors know best how to treat a particular injury. Let’s not patronize the people of Iowa. Posit all you want but let’s not be insulting to the good people of Iowa and their elected officials; they weren’t born yesterday.

Here is what I mean:

“Myron Lynn, compensation manager for Pella Corporation, says the doctors companies choose are familiar with the kinds of injuries workers suffer and can save time in diagnosing injuries a family doctor rarely sees. "It's access to quality medical care, getting the person quickly to the right doctor whose specialty is treating the kind of injury that the individual has, working with the physician to get the person back to work as quickly as medically advisable to do so," Lynn says, "and back to full wages."

The position Mr. Lynn states is disingenuous at best. Those doctors the employer selects aren’t specialists that only they have access too. Injured workers have the same access to any of the orthopedic surgeons available in the market place. What the employers really are talking about is controlling the words that the doctor speaks and when. The doctors know to sing the right tune or they won’t be on corporate America’s workers’ compensation dance card.

Here is what the employees face. They are injured, off work, earning 3/4rds of what they normally do and trying to make ends meet on the home front. Already nervous and facing an uncertain future they have little if any control over the medical care and opinions. They are totally beholden to this tug-of-war between the big insurance business, the AMA and some lawyer trying to help them get back to square one with the bills and work. Even if you’ve never been involved in such a claim you should be bright enough to figure out the little guy is backed into a corner with a six-shooter half loaded with bullets. You may wonder how bad it can get. Well allow me to give you one example. I’m familiar with a doctor in central Iowa who will treat an injured worker and as soon as the medical treatment is finished he is known to say the injury isn’t work related. Why would it take orthopedic surgeon months to come to the sudden realization an injury he’s treated for months is not work related? You may wonder why that is. Well it’s really pretty simple. There is no co-insurance or schedule of fees for workers’ compensation medical treatment. There is no trying to get the co-insurance payment from the patient or worse yet, a waiver of the co-insurance as negotiated by BCBS. In other words the reimbursement rate is higher. And why would the workers’ compensation carrier continue to send injured workers to this doctor. It’s all about money. They know these are compensable injuries. They know we know. But because they can generate a report from a ‘credible physician’ that says otherwise they have a 50-50 chance of walking away and paying less or even nothing.

Doctor’s Position: If a surgeon is licensed by Iowa’s Board of Medicine, then so be it they can slice and dice with the rest of them; it’s really about what comes out of their mouths at the conclusion of the doctor-patient relationship that matters to those who choose the “who”. Doctors aren’t dumb; they know how to get employers to keep sending them a stream of patients. If the doctors don’t cozy up the patient and limit their opinions on permanency, restrictions and when to send the injured patient back to work, then the steady stream will continue to break the threshold of the clinic entrance door. And they know that if they are too friendly in their opinions to the injured employee, then the clinic door bell will stop ringing. For the doctor’s it’s about paying the overhead. They are simply caught in the middle and probably want to be left alone to treat their patients without interference from case mis-managers, insurance mal-adjusters and attorneys trying to straighten out or to bend the facts.

Let’s not try to fool each other this isn’t about it having access to a better cadre of medical experts; it’s about controlling the expert opinions.  The doctors that regularly deal with workers’ compensation patients just want to know who to send the bill. Whoever has the out right choice rules the roost and they will suck up to either, just to get the bill paid. But what if they didn’t have to suck to either? Then what?

Employer’s Position: If Pella Corporation really wants to do what is right by their injured employees then they would allow them to choose their own doctors, but they don’t and won’t. And all of us involved in the system know why.

Employee’s Position: Many of these employees have serious medical conditions that require surgery that can kill them. Many employees feel degraded by this system that takes from them the right to be taken seriously. It’s their body. They should have the absolute right to say who gets to cut on it.

The Iowa Industrial Commission Position: When they are awake they are sick and tired of seeing what they see and hearing what they know to be true but politically they aren’t allowed to voice. If it were them they would want to know they had the choice of which surgeon to choose. That said they don’t want any more work and would rather see a system in place that reduced the tension and acrimony within these claims.

The Politicians Position: The politicians just want the campaign contributions to keep coming in. This isn’t brain surgery. Employees don’t contribute like the Iowa Medical Association contributes to political campaigns. And politicians don’t worry about “the employer” selecting their treating physicians. After all they get special handling by insurance companies. When did any politician not get to  select their doctors?

“Republican Sen. Pat Ward of West Des Moines said she thinks those are isolated incidents.

“There’s no question that misdiagnosis occurs on occasion and that’s a very sad thing,” Ward said.

Ward predicted that one of every 100 injured workers is satisfied with their care from their employer-chosen doctor. To change the law would add unnecessary expense for businesses, she said.”

I believe there is a better way.

The “Pool of Doctors” Solution: Here is a solution falling somewhere in between what both want. Let’s first set forth each of their positions. Any doctor could apply to the Iowa Industrial Commission for privileges to be in a workers’ compensation medical pool. Any doctor in the medical pool could be selected by the employee for appropriate treatment. The employers would have the right to object to any doctor in the pool but once into the pool the employee could select them for treatment.

A pool of doctors would give the employer the right to encourage all of their company doctors to submit their names into the pool. The employees would not be allowed to go outside the pool unless doctors within the pool were not qualified to treat the condition or didn’t have privileges in the hospital system where the employee resided. Physicians outside the pool could be selected by agreement or application to the Industrial Commission.

Truthfulness would be restored to this system and doctors like Dr. No Causation would find themselves out of work.

Who chooses the Medical Care? 

The employer provides medical care reasonably suited to treat the employee’s injury, and has the right to choose the medical care. If the employee is dissatisfied with the care offered, the employee should discuss the problem with the employer or insurance carrier. In certain situations the employee may wish to request alternate care. If the employer, or insurance carrier, does not allow alternate care, the employee (through appropriate proceedings) may apply to the workers' compensation commissioner for alternate medical care. (85.27)

If the employer-retained physician gives a rating of permanent impairment, which the employee feels is too low, the employee does have a right to another examination by a doctor of the employee’s choice at the employer’s expense. (85.39)

What types of benefits does the law provide?

Medical Benefits - The law provides for the payment of all reasonable and necessary medical care incurred to treat the injury. This includes reasonably necessary transportation expenses. Mileage for use of a private auto is reimbursed at a rate set by the state of Iowa, currently at 58.5 cents per mile. (85.27)

Under certain circumstances an employee who has to leave work for medical treatment may be eligible for payment of lost wages. (85.27)

While a contested case proceeding or a dispute on reasonableness of a fee is pending, the medical care provider cannot seek payment of its charges from the employee. (85.27)

Iowa Workers Compensation – Sixteen tons, what do you get… Saint Peter don't you call me 'cause I can't go … I owe my soul to the company store…

The bill before the Iowa Legislature that would grant workers the right to choose their own treating physician isn’t about jobs so much as it’s about respect for another human being and their right to control their own body and what is going to happen to it.

When a worker in Iowa is hurt on the job and needs medical care, it’s covered under the employer’s workers’ compensation insurance. One of the initial decisions is to choose a treating physician. Under Iowa’s workers’ compensation law it is the employer that has the right to choose the treating physicians. So long as what that physician does is “reasonable” the employer can continue to direct the medical care.

But choosing a treating physician really isn’t about what labor backs or employer’s bottom line.

To those not involved with the Iowa workers’ compensation system it may seem like not that big of deal but it is to someone needing surgery. The moment you realize surgery is going to be required that decision becomes the watershed of how you may live the rest of your life. In selecting the physician the employer also selects the anesthesiologist, the surgical team and the hospital. That’s about as un-American as you can get. It’s about as far removed from the Bill of Rights as China is from allowing criticism of corrupt government officials taking bribes and letting dairy producers add melamine to infant formula.

Doctor’s know who has the right to choose them and the doctors can’t help but cozy up to the insurance companies with their opinions. Doctors that are thought by the insurance industry to be “too liberal” are in most instances simply professionals that care deeply for their patients. Those doctors will often times exercise discretion in favor of the patient; rather than what the insurance company wants them to do. The doctors who put marketing ahead of patient care will always cow-tow to the wishes of the insurance adjuster and the case mismanagers. These doctors most workers know as the company doctor because they associate them with the company. This part of Iowa’s workers compensation system reminds me of the town described in the Tennessee Ernie Ford song, Sixteen Tons.  More on that in a minute.

A doctor pandering to the insurance industry isn’t anything new and wouldn’t shock anyone. But consider for a moment that the “insurance industry” isn’t just a big company with educated people running the ship. Insurance adjusters may or may not have a college education. Insurance adjusters aren’t doctors. They don’t hold a medical degree. If the adjuster does have an education that education, or lack thereof, may or may not include subjects like anatomy, physiology, psychology and other subjects that prepare them to understand how to make decisions about medical care. It’s not like that pimply faced kid just out of business school knows anything about medicine. You would think the doctor controls medical care decisions but he/she does not. In practice the adjuster isn’t likely to just go along with the doctor. In my 28 years of practicing workers’ compensation law, the adjuster micro-manages, second guesses and overrides the doctor’s advice. Essentially what happens is the adjuster gets to practice medicine by substituting his or her own judgment for that of the doctors. Yes you can do that test; no you can’t do this one. Yes you can perform and X-ray but no to the CT scan or MRI. Surgery? Why now? Let’s try conservative treatment first and see if a miracle happens. To hell with the idea of permanent nerve damage in the spine; stay the course, no surgery.

Consider for a moment that you are the injured worker. The doctor, that you didn’t select and who really doesn’t even like you has made it clear from the beginning he thinks your just another injured worker trying to get rich off of workers compensation benefits. (The concept of getting rich off of w.c. benefits is just a popular myth. Remember no one every got rich off of $200.00 a week when the bills are $1,500.00 per week.)  The doctor ignores most of what you say, mischaracterizes what you do say and ignores 90% of the questions you ask. You get the picture there isn’t a lot of love in the exam room. So here you are with this doctor now wanting your approval to cut into your back, down to the spine and then with hammer and chisel remove bone spurs and a ruptured disc. If he screws up you’ll live the remainder of your life confined to a wheel chair if lucky, if not so lucky lying in bed or a coffin.

So who selected this surgeon and what made him so qualified? It’s not like anyone gave you the doctor’s credentials and asked you what you think; quite the opposite. You’re pretty much told it’s none of your business, just be quiet and answer his questions. Most of the time there is a high priced spy, called a case manager, hired by the insurance company, who tells the doctor what’s good for the patient and what the insurance company will tolerate to authorize.  She’s probably there looking not too happy that surgery is being recommended. At this moment the doctor just wants you to okay him cutting on you.

Which brings me back to the song Sixteen Tons. All you can think of is, “Saint Peter don't you call me 'cause I can't go, I owe my soul to the company store.” Sixteen Tons sold 20 million copies. Twenty million people knew enough about the company doctor to realize he shouldn’t be cutting into their spine without having first been selected by the patient. Choose your version from YouTube and then sing along, … another day older and we’re deeper in debt….

Tennessee Ernie Ford – 1956 – 20 million copies sold.

Johnny Cash – Live performance. A bit hazy.

Johnny Cash updated version with workers loading coal in a mine.

 SIXTEEN TONS

Some people say a man is made outta mud
A poor man's made outta muscle and blood
Muscle and blood and skin and bones
A mind that's a-weak and a back that's strong

You load sixteen tons, what do you get
Another day older and deeper in debt
Saint Peter don't you call me 'cause I can't go
I owe my soul to the company store

I was born one mornin' when the sun didn't shine
I picked up my shovel and I walked to the mine
I loaded sixteen tons of number nine coal
And the straw boss said "Well, a-bless my soul"

You load sixteen tons, what do you get
Another day older and deeper in debt
Saint Peter don't you call me 'cause I can't go
I owe my soul to the company store

I was born one mornin', it was drizzlin' rain
Fightin' and trouble are my middle name
I was raised in the canebrake by an ol' mama lion
Cain't no-a high-toned woman make me walk the line

You load sixteen tons, what do you get
Another day older and deeper in debt
Saint Peter don't you call me 'cause I can't go
I owe my soul to the company store

If you see me comin', better step aside
A lotta men didn't, a lotta men died
One fist of iron, the other of steel
If the right one don't a-get you
Then the left one will

You load sixteen tons, what do you get
Another day older and deeper in debt
Saint Peter don't you call me 'cause I can't go
I owe my soul to the company store

20 Million Reasons Why Iowa Workers Should Have the Right to Choose the Treating Physician

Brain Damage Caused By Manganese Contained In Welding Fumes: Will Manganese Prove to be the Next Asbestos?

According to the United States Bureau of Labor Statistics, in 2006 there were approximately 462,000 welding, soldiering, and brazing workers. The occupation was expected to grow only about five percent between the years 2006 and 2016. Aside from the fact that employment for welders is expected to “grow more slowly than average,” job availability for welders remains optimistic due to employers’ reports of inability to find qualified welders. But, while welders can rest easy that there are still jobs available in this tough market, there remains a dark side to the trade.

Manganese, a toxic metal, is contained in welding fumes, which can cause parkinsonism. Parkinsonism is a neurological syndrome that is characterized by tremors (involuntary muscle movement), hypokinesia (diminished movement of body muscles), rigidity (muscles tighten), and postural instability (sensation of instability).

Manganese is a naturally occurring element that is required for animals and humans to function normally, and exposure to low levels of manganese in the diet is essential to maintaining good health in humans. The average daily intake of manganese through food is between 1 and 5 milligrams per day.

Those welders affected have trouble completing everyday tasks such as driving, eating, and brushing their teeth. What were once mundane tasks have now become the most mentally taxing.

The United States Environmental Protection Agency (EPA) state that there is evidence that the brain damage caused by manganese in welding fumes can result in a greater incidence of speech impairment, tremors, and gait disturbances among welders when compared to non-welders.

Due to welders’ exposure to toxic fumes, this makes the welding industry a prime target for litigation. Lawsuits, which began in the late 1970s, hardly put a dent in the $5 billion welding-products industry due to the fact that there was no reliable scientific data proving that welding fumes, or manganese in the fumes, caused parkinsonism.

In December of 2007, a U.S. District Court Judge, Kathleen O’Malley, ordered the disclosure of welding industry payments to researchers studying the effects of manganese on welders. The order resulted in the revelation that welding companies had paid $12.5 million to 25 organizations and 33 researches. Nearly all of these researchers and organizations published findings dismissing connections between welding fumes and welder complaints. In a 2003case, and Illinois jury awarded a $1 million verdict to a welder, which resulted in a large influx of lawsuits targeted at welding companies. Again in 2005, a case stemming from a Shipyard in Mississippi settled for seven figures.

According to an article published in November, welding fumes could be the next asbestos.

Iowa Workers Compensation: What is a company doctor?

In Iowa the employer, or in most cases, the employer's insurance company has the right to select the treating physician. The injured worker has limited rights to select the treating physician. There are times the insurance adjuster will ask the worker who he wants as the treating physician, but that's unusual.

Many employees don't like the doctors chosen by the insurance company. That's not unusual because many of those doctor decisions about treatment seem to require input from the patient. Company doctors as they are called, seem to have little concern for what the patient wishes to do. You could say the company doctors don't seem to care about what the patient may want. That's not far from the truth.

Think about it for a minute. Doctors know that they are being chosen by an insurance company. Insurance company's select conservative doctors who start off thinking all workers are liars and would love nothing better than to be on workers' compensation for the rest of their lives. That's an unjustified and stupid assumption but one not entirely without a historic basis. To stay within the insurance company's favor doctors must maintain a certain distance from the patient/injured employee. Thus they remain aloof from the injured employee who is the patient.

The company doctor will almost always espouse conservative opinions towards issues like going back to work, maximum medical improvement and permanent impairment. Conservative means the less the better and get the injured back to work. The company doctor resolves any doubts in favor of the insurance company. They will endear themselves to the insurance company executives to remain within their favor. That way they keep getting referrals from the insurance company.

So if as the injured worker you're frustrated with the way the company doctor is treating you, join the rest. So is everyone else.

The limited rights you have depends on what the Industrial Commission considers "reasonable". If the doctor and the adjuster get too far off the reservation, then your lawyer can file for alternate medical care and ask for a different doctor. That's as good as it gets under Iowa's workers' compensation law.

Who chooses the Medical Care? 

The employer provides medical care reasonably suited to treat the employee’s injury, and has the right to choose the medical care. If the employee is dissatisfied with the care offered, the employee should discuss the problem with the employer or insurance carrier. In certain situations the employee may wish to request alternate care. If the employer, or insurance carrier, does not allow alternate care, the employee (through appropriate proceedings) may apply to the workers' compensation commissioner for alternate medical care. (85.27)

If the employer-retained physician gives a rating of permanent impairment, which the employee feels is too low, the employee does have a right to another examination by a doctor of the employee’s choice at the employer’s expense. (85.39)

Driver Safety: Failing to yield kills one driver and injures two others on I-35 southbound, Ames, Iowa

Garrett Chitty, 17, tried entering I-35 southbound where little room existed, stuck another truck being driven by Lewis Thomas of Cleveland, Ohio. Thomas’ truck moved over to the east striking a utility truck driven by Gary Parsons, 51 or Deposit, N.Y. Unfortunately for Parsons his truck turned on its side onto the guardrail and he was killed.

Parson’s and Thomas are entitled under Iowa law to workers’ compensation benefits. If Thomas has dependents, a wife or children, they too will be entitled to receive benefits. The wife can receive lifetime workers’ compensation benefits or the children benefits so long as they are receiving an undergraduate education. Lombardi Law Firm handles these types of cases.  The wife can get these benefits commuted to a lump sum.

In addition each are entitled to pursue a claim against the other driver, Chitty for improperly attempting to enter the highway.

UNIT 1 ENTERING SB 35 FROM WB 30 UNIT 2 WAS SB ON 35 OUTSIDE LANE UNIT 3 SB 35 INSIDE LANE UNIT 1 ENTERED SB 35 AND LEFT SIDE OF UNIT 1 STRUCK UNIT 2 THEN LEFT SIDE OF TRAILER STRUCK UNIT 3 UNIT 3 LEFT THE ROAD THROUGH THE GUARDRAIL AND ROLLED OVER COMING TO REST ON THE GUIDEWIRE ON WB HWY 30.

Death Benefits (85.28, 85.31, 85.42, 85.43, 85.44)

Death benefits are payable to the dependents of the employee. Benefits are first payable to the surviving spouse for life or until remarriage. Dependent children are entitled to the benefits until they reach age 18, or age 25 if they are actually dependent. Others may qualify, if there is a showing of actual dependency. Upon remarriage, if there are no dependent children, the surviving spouse is entitled to a two-year lump sum settlement. Burial expenses not to exceed twelve times the statewide average weekly wage in effect at the time of death are paid in addition to the weekly death benefits.

The End of the Mowing Season

I love the fall season for the cooler weather, but just before fall starts, there is the end of summer blues.

With the end of the mowing season fall cleanup can’t be far behind. Getting all the summer equipment winterized and stored for winter is a signal that winter can’t be far off.

Robert Uhler died in early September while working on a utility tractor. Whatever happened pinned him underneath it. The local Sheriff concluded Mr. Uhler tried to start the tractor while not on it, the tractor lurched forward and he was killed. We wish his family well.

Mr. Uhler’s incident should remind us all that safety never takes a vacation. With the cold weather coming on it’s easy to get in a hurry or to rush to get jobs completed. As you can surely see we have to keep our heads about us while getting the season-ending work done. Stay safe, watch out, think and avoid unnecessary risk.

University of Iowa opens the door to medical conflict information.

The University of Iowa announced new rules prohibiting physicians from accepting free drug samples and handing them out to patients. Also doctors and other health care workers will be prohibited from accepting gifts and must disclose financial remuneration paid by private medical companies that can create a conflict of interest with reporting research results.

“At least 25 public and private academic medical centers now have “strong” conflict-of-interest policies, according to a Sept. 3 commentary in JAMA, the Journal of the American Medical Association, by David Rothman and Susan Chimonas of the Institute on Medicine as a Profession at Columbia University.

The institute’s searchable database for conflict-of-interest policies at medical centers and university hospitals, at http://www.imapny.org/coi_database/, shows the U of I’s proposed restrictions are stricter than some, but not the most severe.”

Des Moines Register, January 22, 2009 - U of I beefs up conflict of interest rules for doctors

And if you’re wondering how much a physician can be paid take a look at the Des Moines Register’s article on January 23, 2009, U of I to bar free drug samples, gifts.

“Last year, three U of I orthopedic surgeons were included on a list of doctors across the country who accepted money from the manufacturers of artificial hips and knees.

Dr. John Callaghan, a U of I surgeon, received $2.6 million in 2007 from DePuy Orthopaedics, a Johnson & Johnson company that makes replacement joints. Callaghan said the payments were above-board royalties for other doctors' use of joint replacement devices he helped develop. The U of I knew of the financial ties, but did not know how much Callaghan made in royalties because the university-wide conflict-of-interest policy does not require employees to report payment amounts.”

That’s a lot of money. Then again it seems Doctor Callahan earned it with his participation in developing the joint replacement. Or at least someone earned the right to the royalties. What I’ve always wondered is how State of Iowa employees are allowed to get paid a salary by the State of Iowa, use state equipment and laboratories to develop patentable products and then the employee get to keep the royalties. Why aren’t the royalties owed to the State of Iowa?

Another Collapsed Construction Site Ditch Death, This One in Texas

Newton, Iowa Construction Site Wall Collapse Injures Three Workers

Three construction workers were injured on a job site in Newton, Iowa as a wall collapsed and causing the scaffolding to do the same. KCCI news reporters watched a videotape taken by a security camera from across the street at Dave’s Wholesale. The security camera footage shows the collapse, to what degree isn’t known or disclosed. The men worked for Boucher Masonry Co. from Boone, Iowa. IOSH is investigating the incident.