Tag Archives: Mental Health

Mental health care provider shortage hits injured workers in rural Nebraska particularly hard

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The shortage of mental-health care providers in Nebraska makes it harder for rural residents to get prompt care for mental injuries on the job; harder to prove cases for mental injury at work

Nebraska has a shortage of mental-health practitioners that is particularity serious in rural areas. This shortage of mental health providers delays and impairs the recovery of injured workers in Nebraska who suffer a mental injury as a result of physical injury or a mental injury on the job. It also makes these claims harder to prosecute.

Quick Review: Who gets mental injury benefits in Nebraska

Unless you are a first responder as defined by Neb. Rev. Stat. 48-101.1, an injured worker can only be covered for a mental injury if it is related to a physical injury. This can happen with any kind of injury, but in my experience it is most common with head injuries.

First responders in Nebraska, can collect for purely mental or “mental-mental” injuries. The definition of first responder has been generally expanded from police and firefighters to include corrections officers and mental health technicians in our state mental hospitals.

Volunteer firefighters are also eligible for workers’ compensation benefits including mental-mental benefits.

How the lack of mental health care providers effects a workers’ compensation claim

I believe the first drawback for injured workers is delayed treatment. Delayed treatment can lead to more severe permanent injuries

Maybe when everything goes smoothly in a workers’ compensation case, which usually isn’t happening if an injured worker is calling a lawyer, a delay in treatment can lead to longer payment of temporary total disability benefits.

But even assuming those temporary benefits are fair, workers’ compensation benefits aren’t designed to fully compensate employees for work injuries. But workers give up full payment for the promise of prompt payment of benefits. But if mental health practitioners aren’t available, injured workers will not get prompt medical treatment for a mental injury.

The lack of mental health providers in rural areas deprives rural workers a substantial part of the so-called grand bargain of workers’ compensation – prompt payment of defined benefits for work injuries.

Another element of the grand bargain are less formal rules of evidence and procedure that should make it easier to prove cases for injured workers. But again, the lack of mental health providers in rural areas makes it harder for rural workers to take advantage of that aspect of the grand bargain as well.

But even if mental-health practitioners are available, they may not qualify as expert witnesses under Nebraska workers’ compensation law.

Many mental health treaters aren’t qualified to testify by report

In Nebraska only a psychologist or a medical doctor is qualified to testify to submit a written report about a mental injury in a workers’ compensation case. The inability of physicians’ assistants or nurse practitioners to testify by report is already a problem for Nebraska residents in more remote areas of the state. The same issues would apply to counselor who isn’t a psychologist who treats an injured worker for a mental injury.

But while the small town nurse practitioner and counselor who treat mental work injuries don’t qualify as so-called Rule 10 experts in the Nebraska workers’ compensation court, the hired gun MDs and PhDs in Lincoln, Omaha or Denver who insurers and claims administrators send rural workers to do qualify as Rule 10 experts.

Lawyers for injured workers can sometimes fix these issues. Sometimes MDs or psychologists will endorse the findings of counselors. Other times a plaintiff’s lawyer can arrange for a medical examination. But neither of those approaches is fool-proof when it comes to litigation. But even when those tactics work in a case, they often don’t address the problem that an employee is not receiving prompt mental health treatment when it is needed.

Other solutions?

A lawyer would be free to call a counselor to testify live at a workers’ compensation trial, but that depends on the counselor’s willingness to cooperate in litigation. (Sure, you can subpoena a witness, but that’s not a great option.)

Congress looks likely to pass increased funding for mental-health in response to publicized mass-shootings in Uvalde, Texas and Buffalo. Hopefully the funding is adequate to help address the mental-health care provider shortage in Nebraska.

The offices of Rehm, Bennett, Moore & Rehm, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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The Effects of Not Working

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In our practice of helping people prevail over the setbacks encountered when dealing with work-related injuries and employment issues, our hardworking clients often find themselves in an unfamiliar position: not working. Factors such as one’s age and gender can significantly impact how long one might remain unemployed, how one uses his or her time while not working, and how it may affect one’s health and family relationships. The effects of unemployment can be particularly harsh on families with children.

A May 2014 study from the Bureau of Labor Statistics shows that, on average, women 55 and older experience the highest rates of long-term unemployment and the longest spells of unemployment. Average duration of unemployment among women 55 and older was higher than men of the same age and higher than both men and women in other age groups. This study was cited in a June 2014 issue brief from the National Women’s Law Center called Long-Term Unemployment: Spotlight on Women and Families, written by Joan Entmacher, Katherine Gallagher Robbins and Lauren Frohlich.

Men and women also behave very differently when not working. A December 2014 New York Times, CBS News and Kaiser Family Foundation survey found that women spend 33 percent more time volunteering and 34 percent more time exercising while not employed. Men, on the other hand, were more likely to do both activities less when not working, compared to when working. Men are also more likely to engage in non-exercise leisure activities such as reading, watching TV and surfing the Internet.

For both men and women who have stopped working, the December 2014 survey found a reported decline in mental health. This decline was significantly higher in men, with 43 percent of men saying their mental health was worse, and 16 percent saying it was better. Only 29 percent of women claimed worse mental health, compared to 25 percent who claimed an improvement. According to the poll, 41 percent of men reported a decline in physical health, but women reported almost no difference in this area. One factor that this survey does not appear to consider, however, is the reason why an individual is not working. In my experience, those suffering from injuries that prevent them from returning to work would likely report different statistics concerning their health while not working.

Relationships with children are also influenced by unemployment, and this impact also differs among men and women. The December 2014 survey found that both men and women say they are spending more time with their children. However, only 22 percent of men reported an improvement in their relationships with their children. According to the poll, 60 percent of women reported an improvement. Women were also much more likely to report “family responsibilities” as a reason for not returning to work.

The New York Times, CBS News and Kaiser Family Foundation survey did not discuss the effect on children of their parents’ long-term unemployment. The National Women’s Law Center issue brief discusses this concern. Their research found that, among other things, single parents are more like to be unemployed long term (and more likely to be women), the poverty rate among families with a long-term unemployed parent was 35.3 percent as of May 2012, and unemployment and poverty hurt children by adversely affecting family dynamics and school performance. These effects can be long term, and can impact rates of college attendance and children’s future earnings. That is one of the many reasons that the firm supports Kids’ Chance of Nebraska, a nonprofit that provides scholarships to students who have a parent who either suffered an on-the-job fatality “or injuries that have had a significant adverse effect on family income,” according to the Kids’ Chance website. These $2,500 scholarships can help bridge the financial gap that occurs with an injured parent and can be used for “vocational/technical school, junior college, undergraduate or graduate programs.”

There are many reasons why an individual may find themselves in this unfortunate position, and our firm encounters it far too often among our clients who are injured at work or dealing with retaliation, discrimination or some other employment issue. We are experienced in helping our clients obtain benefits they are entitled to, such as workers’ compensation benefits, medical care, and unemployment benefits in order to help prevent the detrimental effects of not working.

The offices of Rehm, Bennett, Moore & Rehm, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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Workers’ Compensation for Psychological or Emotional Injury

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About a year ago we posted a blog from a colleague of ours, Tom Domer from Wisconsin, on this topic. However, Nebraska laws are different from Wisconsin laws on this matter, and this distinction is important.

As a reminder of that post, Mr. Domer pointed out that Wisconsin allows workers’ compensation benefits for workers who suffer from mental injuries unaccompanied by physical injury (so called “mental-mental” injuries).

Unlike in Wisconsin, mental injuries in Nebraska are only compensable if the psychiatric problem or depression is a product of a physical work-related injury (“physical-mental” injuries). An exception to this rule is that first responders (sheriff, police, state patrol, firefighters, and EMT/paramedics) may recover work comp benefits for mental-mental injuries in Nebraska.

In sum, Nebraska limits mental-mental injuries only to first responders, and limits workers’ compensation coverage for mental injuries even when they are accompanied by physical injuries.

The Nebraska courts tend to split hairs as to whether a mental injury is caused by the physical injury or whether the mental injury is caused by something else. For example, if the mental injury is shown to have been caused by the stress of work or the stress of the workers’ compensation process or litigation, the mental injury will not be covered under work comp.

In sum, Nebraska limits mental-mental injuries only to first responders, and limits workers’ compensation coverage for mental injuries even when they are accompanied by physical injuries. Therefore, it is important that if you have a mental issue after your work comp injury, make sure to report to your doctor that it is from the physical injury and not from the stress of your workers’ compensation claim, if that is accurate for your situation. If not properly reported and/or documented, your mental injury many not be covered by workers’ compensation even if the depression came soon after your back injury.

The offices of Rehm, Bennett, Moore & Rehm, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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Mental Injuries in Workers’ Compensation

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Today we’re featuring another guest post by our colleague Tom Domer of Wisconsin. Here Tom shares the legal tests that establish whether damages for mental injury will be awarded. For mental injuries following a physical injury, the standard is “Is the mental disability… related to the work injury?” For cases that don’t involve a physical injury, some states require that the stress that triggered the mental injury be extraordinary “beyond those stresses than the day to day emotional strain and tension which all employees must experience.” While these criteria can be difficult to meet, mental injuries are real and can be as debilitating as physical ones.

From time to time, headline stories appear in the national news about workers claiming compensation benefits for “mental stress” injuries.  Continue reading

The offices of Rehm, Bennett, Moore & Rehm, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Mental Injuries, Workers' Compensation and tagged , , , .