On-the-Job Injuries Resulting from Equipment Malfunctions: Neurorehabilitation, Worker’s Compensation and Alternative Courses of Action
As we have discussed in prior blogs, workers’ compensation is a construct mandated by law and applicable to certain categories of employers. It is intended to provide employees with medical care and reimburse wage loss sustained as a result of work-related injuries.
Some of the rationales behind workers’ compensation are: (1) to preclude the injured employee from having to prove “fault” by the employer for creating or allowing the circumstances that caused the injury, providing that it was jobrelated, (2) to ensure that acute, rehabilitative and, if needed, neurorehabilitative and other medical care is provided for the employee to achieve successful sustained outcomes and (3) to provide at least some reimbursement of lost wages resulting from the incident. The amount of lost-wage reimbursement is set by statute, varies by jurisdiction and generally depends upon the individual’s prior earnings history.
From the standpoint of the employer who provides workers’ compensation coverage as required by law, except under limited circumstances, workers’ compensation is the sole remedy of the employee. Stated otherwise, unless certain facts exist that remove the occurrence from the scope of what would otherwise be an on-the-job injury subject to “sole remedy” rule, the employee is precluded from litigation with the employer for the occurrence.
Important to understand is that the entire scheme of workers’ compensation benefits, including the payment of lost wages, is dictated by the laws of the governing state. Furthermore, regardless of whether the employer is insured or self-insured for workers’ compensation, adjusters and workers’ compensation nurse case managers are involved at every step of the way in managing the medical care and rehabilitation of the individual.
All of the foregoing applies regardless of whether the on-the-job injury was a minor one, such as a cut that got infected, or a catastrophic injury that involved the malfunction of, for example, a forklift on which the prongs failed and dropped heavy boxes of washing machines on a worker. If the latter, a full protocol of acute, rehabilitative, neurohabilitative and virtually all other aspects of post-acute rehabilitation would be demanded to address the individual’s resulting difficult and challenging diagnoses and to achieve the best possible outcome. At NeuLife, the process would start with NeuLife’s multidisciplinary team, joined by family and the client, if possible, developing a customized Client Goal Plan.
Among the factors to consider in the worker’s compensation equipment malfunction incident for the reason that it is so catastrophic and demanding of such a very broad range of post-acute care to achieve the best possible outcome, is that the individual’s care will be managed as discussed above. This can potentially lead to a disagreement between the post-acute care provider of rehabilitation and neurorehabilitative services as to what is best to achieve successful and sustained outcomes for the individual. This disagreement may arise from differing views of “neurorehabilitation.” Neurorehabilitation is a medical process intended to help an individual recover from a nervous system injury and to minimize or to compensate for functional alterations resulting from a catastrophic injury. Neurorehabilitation endeavors to use the skills and attitudes of the individual and his or her family and friends in doing so. It promotes remaining skills of the individual, and strives to create additional ones, to allow the individual to work at the highest level of independence possible for him or her. It also encourages the individual to rebuild self-esteem and a positive mood. Thus, it helps him or her to adapt to the new situation and to become empowered for successful and committed community reintegration.
In contrast, because workers’ compensation limits the remedies of the employee in return for not having to prove negligence or “fault” by the employer; it has clearly defined parameters. Part of the workers’ compensation construct is that the workers’ compensation insurer (or the employer or its third-party administrator, if self-insured), together with the adjuster and the workers’ compensation nurse case manager are the initial arbiters of the healthcare provided, including neurorehabilitative services. The care provided may seem to be more medical than behavioral, in part, because neurobehavioral care is less “tangible.” The workers’ compensation insurer may be concerned that since neurobehavioral care and outcomes are less “tangible” than the medical aspect, the injured employee may be exaggerating his or her condition — malingering — and, therefore, they may overlook the “softer” side of the care that is required for complete recovery and movement toward independence. Therefore, the parties involved in obtaining and paying for the rehabilitation, specialized rehabilitation and other components of post-acute rehabilitation may disagree with the individual who has been catastrophically injured, or his or her representative, as to the proper course of care. Although there are specialized workers’ compensation courts to hear and decide these matters, the processes take time to resolve, yet neurorehabilitative and post-acute services are best administered as soon as possible so as to achieve the best possible outcome for the individual who sustained a catastrophic injury.
The professionals at NeuLife, including its team of neurologists, RNs and therapists are expert in the provision of innovative, clinically relevant services, including the development of the individualized Client Goal Plan, and delivery of neurobehavioral and neurorehabilitative services. NeuLife’s goal is to provide post-acute rehabilitation to its clients to achieve the best possible outcome for those who have even the most difficult and challenging diagnoses.
NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve maximized, sustained outcomes that exceed the expectations of all persons served.
NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.
2725 Robie Avenue
Mount Dora, Florida 32757
