Month: June 2018

Alternatives to opioids for treating chronic pain

Posted on by Patty Busse

As America grapples with the consequences of opioid painkiller addiction, the medical community is finding other ways to help individuals with chronic pain — both chemical and non-chemical.

Exercise is one of the most simple, yet promising alternatives.

“Exercise not only promotes healing because it increases circulation, but it also has been shown to reduce your pain level,” said SFM Director of Medical Services Ceil Jung, RN, BSN, CCM. “Studies have shown that exercise is the best way to treat your pain in many cases.”

The idea can seem counterintuitive at first, as it seems like exercising will make pain worse, Jung said, but studies have shown the opposite.

A study published in the journal Clinical Rheumatology showed that programs including aerobic, resistance and flexibility exercises significantly reduced pain in those with chronic pain conditions.

It’s all about helping people regain function so they can do the things they want to do.

Another study published in the Annals of Internal Medicine showed that a weekly yoga class increased mobility for chronic low back pain sufferers more than other common types of treatment, according to Harvard Medical School .

In some cases, doctors might inject pain relief medication in the area that’s hurting to help patients get to the point where they feel they can exercise, Jung said.

Other chronic pain treatment options

In addition to exercise, doctors are turning to a number of other options to treat chronic pain, including:

  • Other medications and supplements
    The Centers for Disease Control and Prevention recommends acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (aspirin, ibuprofen) as first-line treatment for low back and other types of chronic pain. Turmeric is a natural anti-inflammatory that’s easier on the stomach than pills.
  • Acupuncture
    This traditional practice, which originated in Asia, of inserting hair-thin needles into the skin at certain points of the body is now an accepted, mainstream practice for treating chronic pain.
  • Lifestyle changes
    Getting enough sleep, eating healthy, quitting smoking and losing weight can all be effective in reducing chronic pain.
  • Cognitive behavioral therapy
    This form of talk therapy helps people learn to change negative thoughts and behaviors and improve coping skills so that they can regain function and change their perception of pain.
  • Addressing psychological and social contributors
    Pain may originate from a biological source, but psychological and social factors influence how an individual experiences it. Because of this, treating those other contributing factors, such as anxiety or depression, is sometimes used to treat chronic pain.
  • Virtual reality
    Studies show that virtual reality technology can be used to reduce all types of pain. 

These represent just a small sampling of the many treatments available. While treating chronic pain can be complex, it can make a huge difference in people’s lives.

“It’s all about helping people regain function so they can do the things they want to do,” Jung said. “Finding solutions to treat chronic pain really gives people their lives back.”

Teach your employees about trench and excavation safety

Posted on by Patty Busse

In the United States, trench and excavation hazards cause more than 100 deaths and 1,000 injuries every year. Eventually, all excavations and trenches will cave-in, but knowing proper safety procedures and what hazards to watch for will greatly reduce the risk of injury.

The National Utility Contractor’s Association (NUCA) is holding a safety stand down week for trench and excavation safety from June 18-23. This event, endorsed by OSHA, provides companies with an opportunity to have a conversation with employees about trench and excavation hazards and best practices to prevent injury. Take a break to talk about trench and excavation safety, plan a safety event or provide training for all workers.

Cave-ins pose the greatest risk and are much more likely than other excavation-related accidents to result in worker fatality. Keep an eye out for warning signs, such as bulges in the walls of the excavation and cracks running parallel to the edge.

Other trench and excavation risks include:

  • Asphyxiation due to lack of oxygen
  • Inhalation of toxic materials
  • Exposed utility lines, underground and overhead
  • Falling objects
  • Water in the excavation
  • Moving machinery near the edge of the excavation could cause a collapse
  • Vehicle traffic

Trench and excavation safety recommendations

When doing trenching and excavation work, a competent person capable of identifying and correcting hazards and who has the authority to stop work must be present. Prior to beginning work, underground utilities should be located. Before an employee enters the excavation, test the area for hazardous atmospheres such as oxygen deficiency and high concentration of combustible gas or other hazardous substances. If detected, clear away prior to entry.

Depending on the depth of a trench, different safety requirements are necessary. Access or egress must be provided for an excavation of four feet or greater. If an excavation is more than five feet then a protective system of either a bench, slope or shield must be in place. When the excavation exceeds six feet, fall protection is required.

Examine equipment used for protective systems for damage that could impair its function. Remove and replace damaged equipment.

Spoil piles should be a minimum of two feet away from an excavation’s edge and placed so that rainwater runs away from the excavation. Ladders are required to enter or exit a trench and must be within 25 feet of all workers. Employees should not work outside of a trench box or shoring. All workers need appropriate personal protection equipment: hard hats, safety boots, safety glasses and Class II high visibility vests.

By following these safety recommendations and keeping aware of your surroundings, you can significantly reduce the risk of injury.

Other resources

Visit SFM’s resource catalog for more construction safety materials.

Are your workers independent contractors or employees?

Posted on by Patty Busse

As an employer, you have different requirements for how you must treat workers considered employees, and those considered independent contractors.

From a workers’ compensation perspective, you are required to provide coverage for lost wages and medical costs due to work injuries for an employee, but not an independent contractor.

It’s important to know whether those who do work for you are considered employees or independent contractors under the law. It’s not always simple to determine.

IRS and workers’ compensation laws can define independent contractors differently

Don’t assume that someone considered an independent contractor for tax purposes is automatically considered one for workers’ compensation purposes.

The Internal Revenue Service may have different criteria than your state for establishing whether a worker can be considered an independent contractor versus an employee.

Every state is different, but in most states, for a worker to be considered an independent contractor for workers’ compensation purposes, the worker must have:

  • Control over how the work is performed
  • Ability to realize financial loss or gain based on how a project goes
  • Ownership of equipment to complete the job
  • Compensation on a per-job basis

These are just some basic criteria, and most states have additional requirements beyond these. Get details through your state’s department of labor. For example, the labor departments in Minnesota , Wisconsin and Iowa provide additional information online.

Tips for working with independent contractors

If you hire a subcontractor that lacks the proper workers’ compensation coverage, or doesn’t qualify as an independent contractor, it could put you at risk for liability if a work injury occurs, depending on which state the work is being performed in.

Here are some tips to avoid this situation, where applicable:

  • Confirm that the subcontractor is an independent contractor as defined by your state’s laws.
  • If the subcontractor uses employees, ask for a certificate of insurance as proof of workers’ compensation coverage.

Subcontractors with no employees can choose whether to purchase workers’ compensation insurance for themselves in most states. If they do have coverage, ask for a certificate of insurance for verification. Note that certificate of insurance verification alone does not qualify a subcontractor as an independent contractor. They still must meet all of the state’s criteria.

If they don’t have coverage: Request a copy of the subcontractor’s independent contractor registration form if applicable in your state. Some states have a registration process for independent contractors, and some don’t. Otherwise, ask for a copy of the subcontractor’s current license.

Note that a contractor registration form alone does not qualify a subcontractor as an independent contractor. You should also:

  • Check to see that the subcontractor is registered with the state as a business entity.
  • Request a Certificate of Insurance for General Liability covering the dates the work was performed with limits of at least $300,000.

Your agent can help

If you need help determining whether a subcontractor is an independent contractor or employee, don’t hesitate to ask your agent for help. This way, you’ll understand the implications for your workers’ compensation premium right away, rather than finding out you owe more than expected at the time of your premium audit.

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