Workers Compensation Lawyer Joe Miller warns anyone who has been seriously injured: Big Brother is Watching You! It is relatively inexpensive for the workers compensation insurance company to hire a private investigator to film you whenever you are outside your home, and even inside your home if the windows are open. If you are on work restrictions, you should always assume you are being videoed. If you are doing anything beyond your restrictions, the insurance company would just love to show that footage to your doctor and get you released to full duty. Be smart. Do not give them that opportunity. For more info, please visit us online at www.TheWorkInjuryCenter.com

Although he is not a doctor, Workers Compensation Lawyer Joe Miller explains what he observes as the the downside of rejection of all pain treatment and medication based on an irrational fear of getting “hooked.”

In a recently-posted article, we discussed the various types of workers compensation benefits that may be due to an injured worker when an amputation occurs as a result of an on-the-job injury. 

Here we discuss the various types of prostheses that may be employed to help amputees return to more functional lives. 

According to Amputee Coalition, there are many different types of prosthetic devices that workers who lose an arm, leg, or other body part should know about. The devices vary depending on which limb is affected. Workers need to understand what to be expect when being fit for a prosthesis.. They also need to understand how often the prosthetic will need to be replaced and what rehabilitation treatment is required. 

There are a variety of workers’ compensation issues involved with prosthetic devices. Generally, workers should fight, to hold employers to their requirement to provide quality prosthetic devices. The primary consideration should be how well the prosthesis works – and not the price of the prosthesis. Injured workers should consult with both their physicians and their North Carolina or Virginia workers’ compensation attorney to choose the right prosthesis for their medical needs.

Prosthesis vs. Prosthetic

Prosthetics is the science behind creating prosthetic devices. It’s a field of study. The singular device amputees use/wear as a substitute limb is known as a prosthesis. The plural of prosthesis is prostheses. The aim of the prosthetic is to give the worker who requires the prosthetic as much mobility and function as possible. Prostheses are also designed to help with the wearer’s lifestyle and appearance.

Leg Amputation and Prosthetics

A worker who requires a leg amputation surgery will either have his/her leg amputated above or below the knee. 

Below the Knee (Transtibial) Amputation

This type of amputation is performed between the knee and the ankle. “The prosthesis is designed with moveable and adjustable joints and pylons. These components replicate a human thigh, ankle, and foot.” It’s generally much for advantageous for the person who needs a prosthesis that the amputation be below the knee. In general, a prosthesis works better if the amputation is below the knee.

Above the Knee (Transfemoral) Amputation

This type of surgery is performed above the knee joint. Like the below the knee prosthesis, this “prosthesis is designed with moveable to joints and pylons to replicate a human knee, thigh, ankle, and foot.”

Types of Prosthetic Legs

• Exoskeletal Prosthesis. “A wood or urethane foam prosthesis with a hard plastic shell. This prosthesis is heavier and less customizable than an endoskeletal prosthetic. But it is more durable and long-lasting.”
• Endoskeletal Prosthesis. “A prosthesis with an inner support pylon made of light-weight materials such as aluminum or titanium. Feet and knees can be swapped out. This makes the endoskeletal prosthesis easily adjustable for different activities and active lifestyles.”
• Knee Options. For workers who have an above the knee amputation, there are different prosthetic knee joints available. The prices and functionality differ. The two common kinds of prosthetic knee joints are: 
  • “Single-axis knees. Hinge-style knees that can only bend forward and backward.”
  • Polycentric knees. “Also referred to as “fourbar” knees, they can rotate on multiple axes.”

Some of the factors that workers need to consider when choosing a knee joint prosthesis are the amount of rehabilitation that is required, “the various stability and motion control options available” and the different price points.

Fitting a Prosthetic Leg

The worker/patient doesn’t generally wear the prosthesis immediately. They injured leg must heal first. Most workers who need a prosthesis use a temporary prosthesis during the first few months after the amputation. The test prosthesis should allow the worker to get the training and physical therapy he/she needs.

“A plaster cast of the residual limb or a 3D laser scanner creates a custom prosthetic socket. The initial test socket is flexible to adjust to the reduction of swelling in the residual limb. It serves to minimize pressure and abrasion.”

While you’re rehabbing your knee, you will give the prosthetic designer the information needed to make cast a final socket. 

Leg Amputation Resources

The Amputee Coalition recommends the following resources:

• Introductory Amputee Care for Lower-Limb Amputees
• What You Might Expect During the First 12-Months as a Lower-Limb Amputee
• Identifying and Managing Skin Issues with Lower-Limb Prosthetic Use

Arm Amputation and Prosthetics

The aim of an arm prostheses is to allow the user to grip and manipulate objects such as eating utensils and the things they need to live and work. The amputees are fitted either for above the elbow or below the elbow devices. “Electric prostheses can even move based on signals from the wearer’s muscles.”

Below the Elbow (Transradial) Amputation

“Below the elbow amputations are performed between the hand and elbow. Prostheses are designed to replace the forearm, wrist, and hand.”

Above the Elbow (Transhumeral) Amputation

“Above the elbow amputations are performed at or above the elbow. As most of the arm is removed, a hybrid prosthesis is the best option to provide the motion of the elbow and also provide grip.”

Types of Prosthetic Arms:

• Body-Powered. “A three-harness cable system prosthesis that allows the wearer to grasp objects, flex and lock the elbow. This is the least expensive type of arm prosthesis. There are two varieties of body-powered prostheses that offer different hand functions:
  • Voluntary Open: opens the hand when applying tension to the cable
  • Voluntary Close: closes the hand when applying tension to the cable”
• Electrically Powered. “An electrically powered prosthesis that resembles a real arm. The user controls it with electrical impulses through muscles in the residual limb. This option is more expensive than a body-powered prosthesis and it needs frequent recharging. It also requires a great deal of fine-tuning to get the prosthesis to interpret the electrical signals, and may not work for all people. Most electric prosthetic arms provide basic grip functionality. But some of the latest electric prostheses have fully controllable fingers.”
• Hybrid. “A combination of both body-powered and electrical components. This type of prosthesis is generally used for above the elbow amputations. It’s specialized to enable a greater range of motion and function for the wearer.”

Fitting a Prosthetic Arm:

Many of the same principles that apply to being fitted for a leg prosthetic apply to being fitted for an arm prosthetic. With an arm prosthesis, special attention is given to how the prosthesis affects the skin.

Arm Amputation Resources

Amputee Coalition recommends the following resources for arm amputees.

• The First 12 Months After Upper-Limb Amputation
• Prosthetic Devices for Upper-Extremity Amputees
• Upper-Limb Prosthetic Components

Attorney Joe Miller has been a strong advocate for injured workers in North Carolina and Virginia for more than 25 years. He understands that a good part of every workers’ compensation is working with your doctors and medical team to help maximize your chances for the best recovery possible. He fights to get all your medical paid for the rest of your life. He also fights to show you inability to work is properly classified so you can the maximum wage loss benefits you deserve. For help with any work injury, including amputation, call attorney Joe Miller at 888-694-1671. or fill out my contact form to schedule an appointment.

Workers Compensation lawyer Joe Miller of The Work Injury Center warns about the dangers of engaging in types of jobs where it is likely that there will be no workers compensation coverage.

Workers can suffer the loss of a limb or body part for many reasons. They may be injured in a vehicle accident or a fall. Often, workers lose a limb due to being crushed or pinned by workplace machinery or equipment. Our office has represented a number of clients who are amputees, and obtained settlements for them for their workers compensation cases. We recently posted another article which discussed the workers compensation benefits that an injured worker who suffers an amputation may be entitled to. 

Here, we will focus more on the medical aspects of amputations. The recovery process often includes the need for a surgical amputation or re-work of an already-amputated limb. In the best cases, the worker can be fitted for a prosthetic device. Most workers who lose a limb or appendage need to treat with multiple doctors. Some workers are able to return to work. Many workers are disabled due to the workplace accident – and they can never work again.

What is an amputation?

According to John Hopkins Medicine, an amputation is a condition that results in the loss of a limb – usually due to injury or disease. When amputations are due to trauma, in 70% of the cases, the upper limbs are the body parts that are lost. According to the National Limb Loss Information Center, about 185,000 amputation surgeries are performed each year. 

Rehabilitation after amputation

A loss of an arm, leg, foot, hand, or other body part often affects the worker’ self-esteem, his/her ability to provide self-care, the ability to move, and the loss or decrease of other functions. Generally, amputees require extensive rehabilitation. The success and length of the rehab depends on:

• The level and type of amputation
• The type and degree of any resulting impairments and disabilities
• Overall health of the patient
• Family support

Each worker’s and each amputee’s rehabilitation is different. The main goal is to help the worker gain as much function and independence as follows, “while improving the overall quality of life — physically, emotionally, and socially.”

Rehabilitation includes some or all of the following:

• “Treatments to help improve wound healing and stump care
• Activities to help improve motor skills, restore activities of daily living (ADLs), and help the patient reach maximum independence
• Exercises that promote muscle strength, endurance, and control
• Fitting and use of artificial limbs (prostheses)
• Pain management for both postoperative and phantom pain (a sensation of pain that occurs below the level of the amputation)
• Emotional support to help during the grieving period and with readjustment to a new body image
• Use of assistive devices
• Nutritional counseling to promote healing and health
• Vocational counseling
• Adapting the home environment for ease of function, safety, accessibility, and mobility
• Patient and family education”

The amputation rehabilitation team

Workers who lose the loss of a limb often need to treat with some or all of the following doctors, health providers, and counselors. Some patients require treatment for months or years. Many workers require some type of lifelong assistance. The types of care required depends on how acute the amputation is and the availability of out-patient services.

• Orthopedists/orthopedic surgeons. Orthopedic doctors who are experienced limb salvage doctors work to save as much of the limb as possible, to reconstruct the limb where possible, to prepare the limb for prosthetic use, to clean the wound, and to help leave the wound looking as best as possible.
• Physical Medicine and Rehabilitation Doctors. These are physicians who typically specialize in working with patients who have suffered catastrophic injuries such as limb loss, and getting those patients back to maximum function. 
• Prosthetics and orthotists. According to the Hospital for Special Surgery (HSS) in New York,  these are certified professionals who help build the best device possible so you can achieve maximum mobility and function. Amputees are fitted before the devices are prepared.
• Psychologist/psychiatrists help workers adjust to the emotional and self-esteem problems that often accompany the loss of one or more limbs. They provide individual counseling and/or psychiatric medication. 
• Physical therapists help build strength and help improve your function and mobility so you can be as independent as possible.
• HSS Motion Analysis Lab: According to HHS, these “specialists and scientists perform gait analysis for diagnostic purposes, evaluation of outcomes, and clinical and translational research.”
• Patient counselors: HSS defines these counselors as “individuals who are high-level, functioning amputees with personal experience and perspective providing support and advice, as well as running group programs and amputee walking schools

Other doctors and rehabilitation team staff include the following health providers and professionals:

• Physiatrists
• Internists
• Occupational therapists
• Social workers
• Recreational therapists
• Chaplains
• Vocational counselors

A determination needs to be made to decide if a worker/patient who has a limb that is at risk from “infection, bone loss, soft-tissue compromise related to trauma, tumor reconstruction, or peripheral vascular disease” requires limb salvage surgery or amputation reconstruction surgery.”

Limb-salvage surgery generally includes bone grafts, tissue transplantation, and implanting internal devices. Limb reattachment may also be a possibility.

According to Pharmacy Times, there are two types of amputation categories:

• “In an open-flap amputation, the surgeon amputates the diseased area but does not close the wound. The skin is drawn back from the amputation site for several days, allowing direct access to the wound should the tissue become infected.”
• “In a closed-flap amputation, the skin flaps are sutured immediately.³ In performing lower-limb amputations, surgeons prefer to amputate below the knee, which is linked to improved outcomes. Knee-joint salvage enhances rehabilitation and requires less energy for ambulation.^”

“Prior to surgery, most patients are measured for their prostheses and receive counseling on living with an artificial limb. Prosthetic choice is individualized, ranging from externally fitted devices to patient-controlled motion robotics. “

Post-operative care for an amputation surgery generally ranges from 5 to 14 days. Most wounds heal in a month or two. Complications, according to Pharmacy Times, can include: “edema, hemorrhage, hematoma, site infections, sepsis, soft-tissue debridement, necrosis of the skin flaps, and pneumonia.” 

Many workers whose limb or appendage has been amputated suffer “phantom pain, “– the experience of pain in the limb even though the limb is no longer there.

“Along with phantom pain, 76% of patients experience phantom limb sensations, generally in the form of tingling, burning, or itching. Once thought to be psychological, phantom sensations appear to result from brain nerve-circuitry changes. Over time, phantom pain tends to decrease or disappear altogether, but when phantom pain persists longer than 6 months, prognosis for total pain relief is poor.”

The Workers Compensation Aspects of Amputation Cases

In a recently-posted article, we discussed the Workers Compensation Benefits that may occur in the case of an amputation on the job. The Workers Compensation aspects of an amputation case are generally broken down into three different types of cases. 

One-Limb Amputation-Unable to Return to Job. First, there are the cases where there are one or more limbs lost, and the injured worker is unable to return to pre-injury work due to the injuries. In these cases, a settlement is usually achieved based on the remainder of weeks in the Award. If there is an amputation to one limb, the injured worker would be entitled to no more than 500 weeks of compensation, and settlement may be achieved on that basis; however, due to the high cost of prosthetic replacement, which must typically occur every five years, the medical portion of the claim often remains open and unresolved because the settlement value would be more than the workers compensation carrier is willing to pay at once, in a lump sum. Sometimes, when the injured worker is older,  assuming the injured worker regularly takes advantage of the medical benefits available through workers compensation, a full settlement of the medical benefits may be examined and the worker and his or her attorney approached for settlement. 

Two-Limb Amputation or impairment—Unable to Return to Job. In those circumstances where there is tragically a loss of more than one limb, or even where one limb is not amputated, but clearly is damaged to the point of having significant permanent impairment in the limb, then the injured worker would not be limited to the 500-weeks of benefits, but would be eligible for lifetime compensation benefits. This is because the “loss” of two limbs is considered a permanent and total disability. This would obviously entail a much higher potential settlement value than a settlement that is limited to 500 weeks. Again, though, due to the high cost of prosthetic replacement, which must typically occur every five years, the medical portion of the claim often remains open and unresolved because the settlement value would be immense—and more than the insurance carrier is willing to pay at this point. That does not mean a medical settlement may never occur. The insurance carrier may want to wait until the injured worker is much older to consider closing out the medical portion of the claim.  

Return to Work and One-Limb Amputation. If the injured worker is able to return to work at an equal or greater wage than before the accident, despite the amputation– as is often the case in younger workers– there is still the potential value due the injured worker for the permanent partial impairment rating of the amputated limb. This would not be a final settlement, but would be a number of weeks of compensation paid to the injured worker based on the percentage of impairment assigned by his or her doctor. In some cases, such as an above-the-knee amputation, that would obviously be 100%, but in others, such as a below-the-knee amputations, it may be less. 

Virginia and North Carolina Workers’ Compensation Attorney Joe Miller Esq. understands the short-term and long-term needs of workers who lose a limb, whether it be a hand, foot, arm or leg – due to a workplace accident. He works with your doctors to understand what treatments you’ll need and for how long. He’s helped thousands of employees get the workers’ compensation recoveries they deserve. To schedule an appointment, call lawyer Joe Miller at 888-694-1671. or fill out my contact form.

Workers who lose a limb due to any type of accident are entitled to unique workers’ compensation benefits because of their injuries. The benefits may be unique because the medical needs are different than most other injuries and because many workers may be entitled to scheduled pay benefits for a specific number of weeks – based on the specific body part(s) that were amputated. Whether the claim for those benefits becomes a significant part of the claim really depends on whether the injured worker is able to return to work at the same or greater pay than pre-injury. 

Medical expenses

Injured employees who suffer a workplace accident are entitled to have their medical bills paid. This includes the initial surgery to try to save as much as the limb or body part as possible, to leave the surrounding body parts as healthy as possible, and to help the worker be able to have a good fitting prosthetic. 

For most amputees (those who lose an arm or a leg), being fit for a prosthetic device and learning how to use the device requires a lot of medical treatments and care. Many victims may need to have their prosthetic device replaced every few years. Newer better devices may be available with time. The cost of a prosthetic device can run $5,000 to $50,000 according to Hospital for Special Surgery. The insurance company for the employer should pay all the reasonable costs so that you can regain as much function as possible.

Workers who lose a limb or a body part usually require physical therapy, occupational therapy, and other help so that they can return to their job or be in a position to learn a new job. Many workers who suffer an amputation also need psychological counseling to help them adjust to living a life without an arm, leg, hand, foot, or other body part. In addition, many workers need pain management treatment. They may need addition medical help if infections occur.

In addition to prosthetics, there are new develops such as artificial joints and computerized anatomy that may help a worker restore function to a limb or body part that was severed.

Joe Miller and the Work Injury Center have represented, and continue to represent injured workers who have suffered an amputation injury. 

Work loss benefits

Like other workers, employees who have a part of their anatomy amputated, are entitled to 2/3rds \ of their pre-injury average weekly wage during the healing process and so long as they are unable to return to work. 

• Some workers can return to work after they have completed their medical treatment for the amputation. 
• Many workers, especially if they lose both arms, both arms, or multiple body parts have a permanent total disability and can never return to work. This means the injured worker would be able to claim lifetime benefits, not limited to the usual 500-week limit. 
• Many workers are able to return to work but to different jobs. For these workers, employer insurance companies may choose to pay for the cost of vocational rehabilitation.

Once a worker has reached the point of maximum medical improvement (no further medical treatment will improve their overall health), an evaluation is made as to the type of disability they have – a total or partial disability. 

• Workers with a permanent total disability who can’t return to work are entitled to 2/3rds of their average weekly wages for the rest of their lives.  In Virginia, this means significant permanent impairment to two or more limbs. 
• Workers with a partial permanent disability who can return to work are entitled to 2/3rds of the difference between their pay before the accident and their pay in a new job.
• Workers who have reached maximum medical improvement, and who have returned to work at either a lesser paying job or a job paying the same or more as pre-injury may qualify for the following benefits according to the North Carolina workers’ compensation law – Section NCGS 97-31. Virginia has a similar section at VA Code Sec 65.2-503. 
• Note that these figures represent TOTAL loss, i.e. the maximum payments based on the total loss of the limb mentioned. If there is not a total loss, then you multiply the weeks mentioned by the percentage loss given by the physician. 
• Note that these amounts of payments DO NOT increase the 500-week limit. So that if the injured worker is unable to return to work, and is receiving temporary total disability checks, he or she may not also receive these payments. Accordingly, these weeks generally only become relevant if the injured worker has returned to work: 

1. For the loss of a thumb, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 75 weeks.
2. For the loss of a first finger, commonly called the index finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 45 weeks.
3. For the loss of a second finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 40 weeks.
4. For the loss of a third finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 25 weeks.
5. For the loss of a fourth finger, commonly called the little finger, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 20 weeks
6. The loss of the first phalange of the thumb or any finger shall be considered to be equal to the loss of one half of such thumb or finger, and the compensation shall be for one half of the periods of time above specified.
7. The loss of more than one phalange shall be considered the loss of the entire finger or thumb: Provided, however, that in no case shall the amount received for more than one finger exceed the amount provided in this schedule for the loss of a hand.
8. For the loss of a great toe, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 35 weeks.
9. For the loss of one of the toes other than a great toe, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 10 weeks.
10. The loss of the first phalange of any toe shall be considered to be equal to the loss of one half of such toe, and the compensation shall be for one half of the periods of time above specified.
11. The loss of more than one phalange shall be considered as the loss of the entire toe.
12. For the loss of a hand, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 200 weeks.
13. For the loss of an arm, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 240 weeks.
14. For the loss of a foot, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 144 weeks.
15. For the loss of a leg, sixty-six and two-thirds percent (66 2/3%) of the average weekly wages during 200 weeks.

North Carolina and Virginia Workers’ Compensation Lawyer Joe Miller Esq. has earned the high respect of former clients and the legal community for his ability to win and settle work injury cases. He understands how to counter many of the arguments defense lawyers assert to try to minimize your claim. He works with orthopedists, neurosurgeons, pain management doctors, and other medical professionals to assess and document the severity of your amputation. For help now, contact attorney Joe Miller at 888-694-1671 or fill out my contact form to make an appointment.

Amputation injuries at work can happen for many reasons such as a vehicle accident, being caught or trapped in machinery or equipment, a fall from a high height. The loss of an arm, leg, hand, foot, finger or toe is life-altering for anyone. Many workers who suffer an amputation need surgery to help limit the physical damage. Victims sometimes suffer pain for the rest of their lives. Many workers who suffer an amputation need psychological counseling and therapy. Most require prosthetics to be able to walk or regain some function in the area of the missing limb. These prosthetics, as well as the supplies that enable them to function properly, entail ongoing costs that the employer and workers compensation insurance carrier will be responsible for. 

According to Amputation Coalition, a doctor supported nonprofit, the Occupational Safety and Health Administration (OSHA) data has found that most “workplace amputations occur because of unguarded machinery, lack of adequate training and appropriate practices and procedures to safeguard employees.” 

Their findings also show that 1 out of every 20,000 workers suffers a workplace amputation. The incidence rate for amputations in certain professions is higher:

• Manufacturing. 2.1 for every 10,000 workers
• Construction. 1.4 for every 10,000 workers
• Agriculture, Forestry, Fishing, and Hunting. 1.4 for every 10,000 workers

Employers should work with OSHA to help implement safety protocols. Regular inspections should be conducted. The following hazards should be reviewed:

• “Regular operation of the machine
• Setup/threading/preparation for regular operation of the machine
• Clearing jams or upset conditions
• Making running adjustments while the machine is operating
• Cleaning of the machine
• Oiling or greasing of the machine or machine pans
• Scheduled/unscheduled maintenance
• Locking out or tagging out”

According to OSHA, some of the machines that cause amputations include:

• “Power presses
• Power press brakes
• Powered and non-powered conveyors
• Printing presses
• Roll-forming and roll-bending machines
• Food slicers
• Meat grinders
• Meat-cutting band saws
• Drill presses
• Milling machine
• Shears, grinders, and slitters”

Amputations also occur when workers work with forklifts, trash-compactors, and various types of hand tools. 

The injuries can occur during cleaning, lubricating, preparing, threading, and maintaining the machines and equipment.

The following types of mechanical components are considered the most dangerous:

• “Point of operation – the area of a machine where it performs work on material.
• Power-transmission apparatuses – flywheels, pulleys, belts, chains, couplings, spindles, cams, and gears in addition to connecting rods and other machine components that transmit energy.
• Other moving parts – machine components that move during machine operation such as reciprocating, rotating, and transverse moving parts as well as auxiliary machine parts.”

Common dangers that can cause an amputation

While all mechanical motion is considered dangerous, some of the most common hazards include:

• Rotating – circular movement of couplings, cams, clutches, flywheels, and spindles as well as shaft ends and rotating collars that may grip clothing or otherwise force a body part into a dangerous location.
• Reciprocating – back-and-forth or up-and down action that may strike or entrap a worker between a moving part and a fixed object.
• Transversing – movement in a straight, continuous line that may strike or catch a worker in a pinch or shear point created between the moving part and a fixed object.
• Cutting – action generated during sawing, boring, drilling, milling, slicing, and slitting.
• Punching – motion resulting when a machine moves a slide (ram) to stamp or blank metal or other material.
• Shearing – movement of a powered slide or knife during metal trimming or shearing.
• Bending – action occurring when power is applied to a slide to draw or form metal or other materials.

OSHA regulations

OSHA provides standards that employers should follow to address the danger of amputations at work:

• 29 CFR Part 1910 Subparts O and P cover machinery and machine guarding
• 29 CFR 1926 Subpart I covers hand tools and powered tools
• 29 CFR Part 1928 Subpart D covers agricultural equipment

Other OSHA regulations cover maritime work

Some of the key ways to safeguard machines that OSHA recommends are:

• “Guards provide physical barriers that prevent access to hazardous areas. They should be secure and strong, and workers should not be able to bypass, remove, or tamper with them. Guards should not obstruct the operator’s view or prevent employees from working.”
• “Devices help prevent contact with points of operation and may replace or supplement guards. Devices can interrupt the normal cycle of the machine when the operator’s hands are at the point of operation, prevent the operator from reaching into the point of operation, or withdraw the operator’s hands if they approach the point of operation when the machine cycles. They must allow safe lubrication and maintenance and not create hazards or interfere with normal machine operation. In addition, they should be secure, tamper-resistant, and durable.”

New machines should come with safeguards already installed. The employer can also buy safeguards or install them before use.

Workers under 18 are banned from operating certain types of machines due to their inherit dangers. The bans include “operating band saws, circular saws, guillotine shears, punching and shearing machines, meatpacking or meat-processing machines, paper products machines, woodworking machines, metal forming machines, and meat slicers.”

In addition to filing a North Carolina or Virginia workers’ compensation claims, workers have additional rights according to OSHA. The best course of action is to prevent the amputation in the first place. If amputation injuries do occur, then experienced work injury lawyers can help the amputee get all the medical help, wage benefits, and other benefits that law allows.  Our team at the Work Injury Center has represented, and continues to represent several clients with amputation injuries. 

These additional workers’ rights include:

• The right to work in safe conditions
• The right to receive “information and training (in a language and vocabulary the worker understands) about workplace hazards, methods to prevent them, and the OSHA standards that apply to their workplace.”
• The right to review records of prior injuries and illnesses at the workplace.
• The right to file a complaint with OSHA asking OSHA to inspect the worksite – if they believe the employer isn’t following OSHA rules or isn’t working to make the workplace safe. “OSHA will keep all identities confidential.”
• The right to “exercise their rights under the law without retaliation, including reporting an injury or raising health and safety concerns with their employer or OSHA. There are time limits for filing a complaint with OSHA if retaliation occurs – not more than 30 days.

Virginia and North Carolina Workers’ Compensation Attorney Joe Miller Esq. knows how traumatic the loss of an arm, leg, or any body part is. For over 30 years, we’ve helped thousands of injured workers get the full compensation they deserve. We work with your doctors and other health care providers to understand whether prosthetics or other medical advances are an option. We fight to get your full wage loss and medical benefits. When appropriate, we also seek payment for disfigurement and loss of function.  To speak with an experienced North Carolina and Virginia workers’ compensation lawyer, call lawyer Joe Miller at 888-694-1671. or fill out my contact form to schedule an appointment.

North Carolina already had one significant snowfall during December of 2018 and early in 2018, southeast Virginia was struck by a crippling blizzard. Ice, snow, and cold weather can make it extremely difficult to work – especially for construction workers and anyone who works outside. Anyone who walks outside may slip and fall on the ice. Well-known dangers, although rare in our neck of the woods,  include hypothermia and frostbite.

Some examples of outdoor work include:

• Construction work
• Snow cleanup crews
• Police officers
• Firefighters
• Sanitation workers
• Emergency medical technicians
• Highway maintenance crews
• Landscapers
• HVAC Technicians
• Utility Workers
• Refuse and Recyclable Collectors
• Surveyors

Cold weather can be relative. Some climates are known for their cold weather and people there understand what steps are needed to protect roads, pipes from bursting due to freezing, and most of all people. Other climates including southern climates often don’t understand how to respond to cold weather and the city crews with their meager supplies and equipment are quickly overwhelmed when extreme winter weather takes over. It is not their fault; it is simply such a rarity that it is not worth the expenditure to purchase the extra equipment.

The OSHA Cold Stress Guide

As with all worker’s compensation claims, there is no requirement to prove fault. If an accident at work causes the employee to be injured, the employee has a right to demand wage loss benefits and payment for the medical costs to get healthy again. The employer is generally liable even if it did everything it could to prevent the accident.

Employers and employees should both understand the risks of working in cold weather and to how to minimize those risks. The Occupational Safety and Health Administration does have some guidelines on what employers can do to help any worker who works outside in extreme cold or a combination of cold and wet weather.

Still, employers are required to comply with “hazard-specific safety and health standards.” Employers must also “provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harm.” Employers should also use standards that are commonplace in their industry.

Risk factors for cold stress

Cold weather includes more than just looking at the temperature. It also requires looking at how wind chill makes it feel colder.

In addition to wind, the following factors can make cold weather more difficult to manage, according to OSHA:

• Wet and damp weather
• Employee fatigue
• Not being properly dressed for winter. Workers should wear layered clothing and have protection for their hands, fingers, feet, toes and face.
• Workers who are in poor health or who have certain risk factors such as diabetes, hypertension, and hypothyroidism should stay inside.

Cold weather places stress on the body by shifting blood flow, over time, away from the extremities to the body’s internal organs, the chest, and the abdomen. This shift plus any exposure of the extremities increases the body’s risk for hypothermia, frostbite, and trench foot.

What is hypothermia?

Hypothermia is a dangerous condition which happens “when body heat is lost faster than it can be replaced.” Another factor is that the body’s temperature drops to below 95 degrees F instead of its normal temperature of 98.6 degrees F. Hypothermia normally occurs at very cold temperatures. It can, however, happen even at temperatures above 40 degrees F if other elements exist. These elements include exposure to rain, sweating, or being submersed in cold water such as falling into a lake or pond.

Hypothermia symptoms. Mild symptoms include shivering and stomping one’s feet to try to get the blood circulating. More serious conditions include a falling body temperature. The worker will stop shivering and may become confused and disoriented. He/she may show signs of losing coordination. Workers may not be able to stand. Their pupils become dilated. Their pulse and breathing slow. Workers with hypothermia may lose consciousness. In tragic cases, they may if they don’t get immediate help.

Treatment for hypothermia. Any worker, supervisor, or helper should call 911 or seek immediate medical help. Some of the many common steps OSHA recommends include:

• Moving the worker to a dry, warm location
• Taking off any wet clothes and putting on dry clothes.
• Covering the whole body including the head and neck with blankets – and with “a vapor barrier.” The face should not be covered.
• If medical help is over 30 minutes away, the worker should
  • Be given warm sweet drinks (but no alcoholic drinks) which can help raise the worker’s body temperature. If the person isn’t conscious, then he/she should not be given a drink.
  • Placing “warm bottles or hot packs in the armpits, the sides of the chest, and the groin. Call 911 for additional rewarming instructions.”

If the worker isn’t breathing or doesn’t have a pulse, a call to 911 for emergency help should be made immediately. Additionally, OSHA recommends:

• That the general instructions above, other than being given fluids, should be followed
• The worker should be checked again for signs of breathing and for a pulse. The check should be for 60 seconds.
• A 911 operator or emergency medical service worker should start chest compressions – or direct someone at the site on how to perform chest compressions. OSHA’s cold weather guidelines provide that “Chest compressions are recommended only if the patient will not receive medical care within 3 hours.”

 

The dangers of frostbite?

Frostbite occurs when the skin freezes and the tissue beneath the skin is affected. The lower the temperature, the greater the risk of frostbite. The hands and face are normally the parts of the body affected. In severe cases, amputation may be required.

Frostbite symptoms include red skin with gray and white patches. There’s numbness in the body part affected. There can be a feeling of hardness in the hand, foot, or body part. In severe cases, there may be blisters.

Treatment for frostbite. Generally, the treatments for hypothermia should also be used to treat frostbite. Additional treatment considerations include:

• Do loosely cover the affected body part and try to protect that part.
• Do give the worker warm sweetened drinks – if they are alert but not if they are unconscious. Don’t give the worker any alcohol.
• Don’t do the following:
  • Don’t rub the frostbitten party of the body. This can cause more harm.
  • Don’t apply water or snow.
  • Don’t break the blisters
  • Don’t try to rewarm the frostbitten area yourself such as by placing the hand or foot in warm water. This can cause tissue damage. Instead, be sure to get medical help. Medical professionals should understand the right way to warm the affected part.

Attorney Joe Miller Esq. fights for injured workers in North Carolina and Virginia. He’s been helping workers get just recoveries for 30 years. Attorney Miller works with your doctors and independent doctors to fully understand your medical needs. To make an appointment, call 1-(888) 694-1671 or fill out my contact form.

According to the Centers for Disease Control and Prevention, nearly 9 people are killed and 1,000 people injured by a distracted driver – each day. Distracted driving is dangerous for three fundamental reasons:

• Distracted drivers aren’t looking the road in front of them
• Distracted drivers don’t have their hands on the steering wheel. This makes it tough to respond to emergencies. Careful drivers have both hands on the wheel.
• Distracted drivers aren’t thinking about how to respond to dangers such as by braking, steering into a different lane, slowing down, or taking other safety measures.

Types of distracted driving

Common examples of distracted driving including

• Texting while driving
• Speaking on a smartphone or cell phone
• Using a GPS system
• Eating while driving
• Adjusting the radio
• Looking at a video
• Conversing with passengers especially those in the back seat
• Personal grooming
• Drinking a beverage such as coffee or soda
• Smoking

Drivers who are tired or who are under the influence of alcohol are also unable to anticipate, control, and respond to emergencies.

A momentary lapse of even a second can be fatal or cause catastrophic injuries. A car travelling at 60mph is travelling 88 feet per second – which is about 4-5 car lengths.

The CDC reports that teenagers have an especially high likelihood of driving while distracted:

• Drivers less than 20 years of age have the highest rate of distraction-related fatal accidents
• In 2015, nearly two in five high-school students said that they sent an email or text while driving in the previous 30 days. Many of these young drivers also admitted that they didn’t wear a seat-belt while they were sending these emails and texts.

Texting while driving laws in North Carolina

North Carolina enacted a strong texting while driving ban that applies to all drivers though it is especially tough on novice drivers. The law provides that adult drivers can speak on their cell phones while behind the wheel but they can NOT text while the car is in motion. The texting while driving ban applies to reading, sending, or composing a text message. It is not illegal to text if the car is stopped or is parked. Violators can be stopped by a police officer and ticketed even if they haven’t committed another traffic offense.

Drivers under the age of 18 (novice drivers) can’t text while driving. They also can’t use a cell-phone (even a hands-free phone). Novice drivers can also be stopped if they haven’t committed another traffic offense.

Bus drivers are also banned from using a cell phone while their bus is in motion – in addition to the texting while driving fan.

Texting while driving in Virginia

In Virginia, it is unlawful for any person to operate a moving motor vehicle on the highways in the Commonwealth while using any handheld personal communications device to:

1. Manually enter multiple letters or text in the device as a means of communicating with another person; or
2. Read any email or text message transmitted to the device or stored within the device, provided that this prohibition shall not apply to any name or number stored within the device nor to any caller identification information.

Fines are $125.00 for the first offense and $250.00 thereafter.

The dangers of driving while tired

Nearly 20 percent of all fatal car crashes are caused by a driver who is too tired – as reported by the AAA Foundation for Traffic Safety, The foundation also found that young drivers, those between 19 and 24, were the most likely to drive while fatigued. While nearly all drivers understand the dangers of driving drowsy, most drivers still drive – even though it puts their lives, the lives of passengers, the lives of other car occupants, and the lives of pedestrians at risk.

Indicators a driver is drowsy

Drivers and occupants of the cars need to know when they need to avoid getting into the car if they’re tired or when to get off the ride if they’re getting sleepy. They’re no reason to risk a life to get somewhere a little faster. Drivers should plan to take regular rest stops. They should know where the hotels are where they can stop and sleep. Some of the signs of drowsy driving include:

• Yawning constantly
• Not remembering the most recent leg of a journey
• An inability to focus
• Shifting into other lanes of traffic
• Tailgating or getting too close to other drivers
• Near misses

• Traveling too fast
• Going through red lights
• Failing to stop for stop signs

Some recommendations for sleepy drivers include:

• Making regular rest stops for every 100 miles or for every several hours of driving time
• Get plenty of sleep before you plan a long drive
• Keep your sleep/awake patterns
• Try to have another driver so you can take turns

• Avoid medications that might make you sleepy
• Avoid relying on caffeine to keep you awake
• Don’t trust that having the radio on will keep you from getting drowsy
• Avoid using cruise control

Some automakers who are aware of the dangers of drowsy driving are working to install technology that senses when a driver is tired. The cars sound alarms and even force the car to stop. Alas, that technology does not currently exist with any reliability. All drivers are responsible for any deaths or injuries they cause due to drowsy driving.

Talk with a respected North Carolina car accident lawyer as soon as possible

In many cases, when a teenager or young driver causes death or injury, the young driver is not the owner of the vehicle. Attorney Joe Miller Esq. can explain when you can also sue the owners of the vehicle in North Carolina under the “Family Purpose Doctrine.”  The car owners are generally the people who have liability insurance to pay for all your damages if the driver caused your injuries or the death of a loved one. If there is not enough insurance to cover you claim, you may be entitled to payment for your pain and suffering and economic losses from your own uninsured or underinsurance policy.

In addition, if you were on-the-clock for your employer or your travel was connected to a business trip at the time of your accident, we can, of course, handle any Workers Compensation aspects to the claim as that is also a specialty of our firm. To make an appointment with an experienced North Carolina car accident attorney, please phone (888) 694-1671 or fill out the contact form.

We are happy to announce that Joe Miller Law has been nominated for the Costal Virginia Magazine’s “Best of” 2018! You can vote for us by following this link.