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FILE NAME: Pennsylvania (PA) DATE: 1941 May DOC#: PA008 DOCUMENT DESCRIPTION: PA Medical Journal Article - Compensation and Occupational Disease Laws LUME 4 4 MBER 8 . . THE.. PENNSYLVANIA MEDICAL JOURNAL MAY, 1941 $ 3 .0 0 per year 3 5 c per copy Published Monthly by THE MEDICAL SOCIETY OF THE STATE OF PENNSYLVANIA 2 3 0 STATE STREET, HARRISBURG TABLE OF CONTENTS ETTERS EATRE A R T IC LES State D epartm ent of Public A ssista n c e Medical Service Lewis T . Buckman. M.D., Wilkes-Barre, Pa. Continuous Spinal A nesthesia William T. Lemmon, M.D., and George W. Paschal, Jr., M.D., Philadelphia, Pa. . . . . Round-Table Conference on Peripheral V ascular D isease ........ A Survey o f Dysm enorrhea in a G roup of Student Nurses and the M edical Treatm ent by Means of Benzedrine Sulfate Walter J. Larkin, M.D., Scranton, P a.......... The M aternal and Child H ealth P ro g ram of the Departm ent of H ealth Paul Dodds, M.D., Harrisburg, P a................ Inflammatory D iseases of the Pericardium Herman \V. Ostrum, M.D., Philadelphia, Pa. Symposium on Diabetes M ortality Studies of D iabetes Edward S. Dillon, M.D.. Philadelphia, Pa. Treatm ent of D iabetes in Childhood Anna O. Stephens, M.D., Laurel ton. Pa. M anagem ent of P regn ancy in D iab etes Roland D. Porter, M.D., Abmgton. Pa, . . T reatm ent o f D iabetes in the A ged J. West Mitchell M.D., Pittsburgh, Pa. . . The Surgical Diabetic Frederick A. Bothe. M.D.. Philadelphia. P a...................................................................... Modern Diabetic Care Joseph T. Bearriwoori, Jr., M.D.. Philadel phia. P a............................... ........................ . 963 971 97S 982 994 998 1000 1003 1008 1011 1015 1018 1022 ED ITO RIA LS Chemotherapy Invokes Caution ........................ 1027 Health and the Public ........................................ 1028 Signed Editorials .................................................. 1029 Midicofiim Service ...................... 1030 Last Words to a Jury . .................................... 1030 TU BER CU LO SIS A BSTRA CTS 1033 REDUCED NUM BER OF H O SPITA L IN TER N S AND R ESID EN TS CREA TES S E R V I C E P R O B L E M ................ .......... 1035 O FFIC ER S' D EPARTM ENT Amendments to Constitution and By-Law s . . . Sharing the Burden .......................... ................ Payment of 1941 Dues ........................................ List of County Medical Societies of Pennsyl vania ...................................................... ................ A. M. A. Meets Next Door to Pennsylvania . Call to Special Meeting .................................... .. Minutes of Special Meeting of the Board of Trustees of The Medical Society of the State of Pennsylvania .................................................. Compensation and Occupational Disease Law s The Section on Medicine .................................... The Section on Pediatrics .................................. 1039 1039 1041 1042 1043 1043 1044 1046 1047 1048 COUNTY SO CIETY REPO RTS 1053 T H E W O M A N 'S A U X IL IA R Y .. 1073 M ED ICA L NEW S . . . . . . . . . . . . 1079 B O O K R E V I E W S .................. ........... 1084 Notice of change of address should give both old and new address, and state whether the change is permanent or temporary. The Jolsnal may not be held responsible for opinions expressed in papers, discussions, communications, or advertisements. The adver ting policy of T h e P en n s y l v a n ia M edical J ournal is governed by the rules of the Council on Pharmacy and Chemistry of the American Medical Association, Advertising rates wifi be sent on request. Entered as second-class matter at the Post Office in Harrisburg. Pa., under the Act of March 3, 1879. Acceptance for mailing at special rate of postage provided in Section 1103, Act Oct. 3, 1917, authorized Sept. 11, 1920. Office of Publication. 23G State St., Harrisburg, Pa. Copyright, 1941. bv The Medical Society of the State of Pennsylvania. 963 M ay, 1941 T h e P ennsylv ania M edical J ournal uating "practical nurses" after their attendance upon a course of lectures. H. B. No. 675 was prepared by the Pennsylvania State Nurses Association. The latter bill, if enacted, would require all holding themselves out to the public as practicing nurses to be licensed by the state as registered nurses, or licensed attendants (so-called practical nurses). No. 675 also provides the authority for the Nurses' Board to regulate and approve schools of nursing in the state for "licensed attendants" as well as the familiar R.N., the " attendant" to meet requirements set up by the State Nurses' Board in a 9 months' training course spent in a school and not merely a course of lectures. House Bill No. 675 also sets forth the following re strictions: Quoting: "Section 14. This act confers no authority to practice medicine or surgery nor does it prohibit " ( a ) Gratuitous nursing of the sick by friends or members of the family, " ( b ) Incidental care of the sick by friends or by domestic servants primarily employed in household duties as long as they do not practice nursing within the meaning of this act. " ( c ) Domestic administration of family remedies by any person. " (d) Nursing services in case of an emergency." This discussion was followed by a motion by Dr. Mayock, seconded by Dr. Brennan and unanimously carried, instructing Chairman Palmer of the Committee on Public Health Legislation to attend the public hear ing on H. B. No. 67S on Apr. 1, and if called upon, to endorse its objectives. Upon motion duly carried, the special meeting of the Board of Trustees adjourned at 4 p. m. Respectfully submitted, R obert L. A nderson, Chairman, F r a n k A , L orenzo, Clerk, W alter F. D onaldson, Secretary. Apr. 14, 1941. COMPENSATION AND OCCUPA TIONAL DISEASE LAWS In.the present legislature there promises to be some action concerning the Workmen's Compen sation Law. The two undersigned co-operating committees believe that the basic facts in com pensation and occupational disease laws as they apply to physicians should be common knowl edge among physicians. Therefore, as a joint enterprise, summaries of the present laws have been; made and are herewith printed. In the June issue of this J o ur n al will appear a syllabus for- ' ~refrestrer-roaise-in-indusin ai health. The summaries of these two laws will be necessary foundation stones in such a course. Please file them where they will be easily ac cessible. Credit for the compilation of these rsums goes to Milton Rose, M.D.. professor of public health, Medical School of the University of Pennsylvania, and Charles-Francis Long, M.D., chairman of the Committee on Industrial Health of The Medical Society of. the State of Penn sylvania. (Signed) C o m m it t e e on I n d u s t r ia l H e a l t h , C o m m i t t e e on W o r k m e n 's C o m p e n sation L aw s, The Medical Society of the State of Pennsylvania. Present Status of Pennsylvania W orkmen's Compensation Act This resume abstracts the Pennsylvania Workmen's Compensation Act as it now stands. Please note that it is not a physician's, not a lawyer's, not an insurance carrier's, not an employer's act; but it is a workmen's compensation act. 1. What employments are covered? All employments are covered except those which are casual and not in the regular course of the employer's business, so-called "home work," domestic service, ami agriculture. Although theoretically the act is not compulsory, in industrial practice it is generally considered so. 2. Who is paid? The worker, in cash. 3. Who pays? The employer or his insurance carrier or the state fund. 4. How is the cash paid? No compensation is paid for the first 7 days cf disa bility. After that, compensation is provided for per sonal injuries by accidents "in the course of employ ment." a. Compensation is payable at the rate of 6643 per cent of wages with a maximum of $18 per week and a minimum of $9 per week, or full wages if such wages are less than $9, with an absolute minimum of $5 per week. b. Permanent total disability is payable for 500 weeks with a maximum of $7500. c. Compensation is payable for loss of arm, hand, leg, foot, eye, and fingers for certain specific periods. d. In case of death by industrial accident, compensa tion is payable to the widow for a maximum of 300 weeks with payments continuing to dependent children until the age of 16. In addition to compensation, funeral expenses up to $200 are provided. 5. What other benefits does the injured worker re ceive? During the first 60 days after disability, the employer must furnish reasonable surgical and medical services, hospital treatment, medicines and supplies, with a maxi mum cost exclusive of hospital treatment of $150. If the employee refuses such medical treatment, he forfeits his right to compensation for any injury of aggrava t~iori of existfng-dissb illty--wkieh--may be at tributed to his refusal to accept treatment. If the employer refuses to furnish medical treatment the employee may procure such services and collect tin cost from his employer. 6. Who chooses the doctor? The employer only has the right to choose the phj sician through whom services are to be rendered to tli injured employee. In all instances his permission 1 treat must be obtained, oreferablv in writing. The Pennsylvania Medical J ournal May, 1941 ' 1 er * nent that ranct; men su h arc oyer's !r ami ry, ia : state f disair permploy- >/d per ek and i wages $5 per 3 weeks md, leg, s. mpensa- o 300 children nsation, rker re- imployer services, 3 maxi130. inent, he ajury or T be -at reatment, allect the the phyed to the fission to 7. Must an employee undergo medical examination? Yes. The injured employee is required to submit to medical examination upon request of the employer or upon order of the Workmen's Compensation Board, at the expense of the employer. Refusal to submit to such examination forfeits the employee's right to compensation. The employee may haye a physician of his own selection, to be paid by him, participate in any such examination. 8. How are compensation claims settled? The act provides for settlement of compensation cases by agreement between employer and employee, such agreements being filed with and subject to the approval of the Department of Labor and Industry. If the employer and employee cannot agree upon the compensation to be paid, provision is made for bearing before a referee assigned by the Workmen's Compen sation Board. Appeals may be made from referees' decisions to the board and from the board to the courts. 9. Does the board guarantee payment of fees charged by attending physicians? Ho. Whether incurred by employer or employee, these fees must be collected from the party served. 10. In case of medical dispute, what does the board do? The board is empowered to appoint its own medical consultants. 11. How are these consultants paid? When the board appoints consulting physicians or surgeons in the course of a hearing, compensation for such services is taxed as costs, to be paid out of the Department of Labor and Industry's maintenance fund, the department being reimbursed by either employer or employee or both, as may be ordered by the Workmen's Compensation Board. 12. How may the employer insure himself against compensation risks? The employer is required to insure with the State Workmen's Insurance Fund or any authorized private insurance carrier unless he applies for and is granted the privilege of self-insurance by the Department of Labor and Industry. Pennsylvania Occupational Disease Act of 1939 1. What diseases are covered by this act? Compensable Diseases: a. Poisoning by arsenic, lead, mercury, manga nese. b. Poisoning by phosphorus. c. Poisoning by methanol and carbon disulfide, hydrocarbon distillates (including naphtha), and halogenated hydrocarbons. d. Poisoning by benzol or its derivatives. e. Caisson's disease. f. Disability due to radium or x-ray exposure. ---- 'g. . .usoning By cTTronilE efd iirl clifffiaiesT h. Epithelioma or skin ulcer due to tar, pitch, bitumen, mineral oil, or paraffin. i. Infection or inflammation of skin due to oils, cutting compounds, lubricants, dusts, liquids, fumes, gases, or vapors. j. Anthrax. k. Silicosis or anthracosilicosis. l. Asbestosis. 2. What benefits are provided? Benefits are similar to those of the Workmen's Com pensation Act (q. v.), with certain exceptions. 3. What are the exceptions? Compensation for silicosis, anthracosilicosis, and as bestosis is payable only for death or permanent total disability, with the maximum amount being $3600. In cases where occupational disease develops to the point of disablement only after an exposure of 5 or more years, compensation is payable jointly by the Commonwealth of Pennsylvania and the employer. If disability occurs during the first 2-year period after the effective date of the act, the employer's share of compensation is 50 per cent, this percentage increasing by 10 per cent for each additional 2-year period. The employer under whom the employee was last exposed to the hazards of the occupational disease shall be liable for compensation. 4. Who decides disputed medical cases? Provision is made for the formation of a medical board selected from a list of 10 physicians furnished by the deans of all legally- recognized medical schools in Pennsylvania. Of the 10 names furnished, 3 must be roentgenologists and 3 pathologists. From this list a board of 3 is selected, one roentgenologist and one pathologist. Members of the board receive a fee of $100 per case plus necessary traveling expenses. This board's duties are to hear and determine controverted medical issues in disputed claims. In addition to the usual medical examination, the employee must submit to such clinical, pathologic, and roentgenologic examinations as may be required by the medical board. In death cases, the medical board may order an autopsy. 5. Is there any further appeal from the findings of the medical board? The findings of the medical board are conclusive, subject to review by the courts on the question of suf ficiency of evidence. 194.1 SECTION ON MEDICINE The Medical Section of the 1941 Scientific Program Committee has decided this year that instead of a number of unrelated papers, which are of varying interest to the general practi tioner, each clay at Pittsburgh will be devoted to a symposium on one subject. Tuesday will be devoted to endocrinology. Dr. Max A. Goldzieher, of New York, will be the guest speaker for the day. Dr. Goldzieher is a very forceful speaker who presents his sub ject in a very interesting manner. There will be 6 other papers on various endocrine subjects embracing the latest developments in glandular therapy, diagnOsTs ofTrorTarrcraT 'endocrinetiis" orders, tests to prove diagnosis, prognosis, and general management of the various endocrine conditions. This program should be very in structive and interesting to all physicians, par ticularly the general practitioner. Wednesday will be devoted to the heart. This symposium will be put on by the Pennsylvania 1047