Who pays when a graduate student gets hurt? : Safety Journal Club Discussion, December 1, 2020

Led by:
Ralph Stuart, Keene State College

The discussion format on December 1 was to read snd comment on an abridged version of the C&EN article “Who pays when a graduate student gets hurt?” found at https://cen.acs.org/safety/lab-safety/pays-graduate-student-hurt/98/i42

The group comments and discussions were then organized around 5 questions:

  1. Who are the stakeholders in this story (either at BU specifically, or more generally)?
  2. What do you think are the 3 most important take away messages from this article?
  3. What other aspects of the grad student experience does their legal status as employees impact? 
  4. What opportunities are there for addressing the confusion these questions raise?
  5. How does this confusion impact the safety culture of 1) specific institutions and 2) higher education in general?

Who Pays? Discussion summary

1. Who are the stakeholders in this story (either at BU specifically, or more generally)?

  • As a current graduate student, I would assume that I was working in the capacity of an employee of the institution here.
  • I’ve always assumed that graduate students are employees of the institution. Their checks have the university’s name emblazoned on it. I have come across situations, as described in the article, while as department chair where graduate students were treated as students when convenient and as employees when convenient. “When convenient” seems to be the operant term.
  • The grad students are the people with the most potential for contact with the hazards bc they are frequently the hands doing the actual work.  Can it be that they have the least safety net?  Plus they are in a poor position to fight back bc they need to recoup the time and money invested in their degree so suing the institution isn’t a go to option.
  • This advisor person does not seem to be involved after the initial response. Isn’t there a duty that the advisor / responsible PI advocate for the student throughout the bureaucratic mess that ensued? Perhaps the institution’s response would’ve been more robust if a faculty member had been more actively involved with seeking a remedy.
  • In my experience, who the stakeholders are varies by institution and even within institutions. Higher education has a complex financial structure that confuses many discussions about money.
  • Is there a difference between how public/private institutions should/could react?
  • Are there conflicting stakeholders? The graduate student, the PI, the institution (here BU), risk management, workman’s comp, the state, all have different agendas.
  • As the article indicates, it’s not a question EHS folks can usually answer accurately and often nor could Risk Mgmt. The unit’s business pro was best suited and able to do so.
  • This reflects the broken USA healthcare system. Thus, the needed fix is political. In the interim, anyone, including a student of any level, should assure health insurance. Under 25 qualifies for parent’s program, if any. Most students, including graduate students and post-docs, will qualify under the ACA for coverage assistance. Worst case is to purchase private medical insurance, often out of the price range for students.
  • Compensability determinations are currently made by our Worker’s Comp group.  If there are complexities in the decision there is confusion about where to go and who to talk to.  The Business Manager in the home department is a good source of information.
    • Seconded. There is a lot of confusion in the air that needs to be clarified case by case
    • My experience is that there is a lot of variation in the expertise of departmental business managers. In addition, the departmental clerical staff at our institution has been cut in half over the last year due to covid impacts.

2. What do you think are the 3 most important take away messages from this article?

  • I wonder if because of the assumption that paycheck = employee, most graduate students assume they are covered by workman’s comp and don’t even bother to ask. This is an important take away. Students should ask when they come in how the university really views them and what their legal position it.
  • WC has been very beneficial to employees. They are covered by law. The issue is the unclear status of a graduate student whose “employment” is linked to their education. Again, that is a question for legislation to resolve. Each of us must have medical protection while waiting for this to happen.
    • While I can appreciate that this question has a long history, it IS news to current graduate students.
  • Shouldn’t financial responsibility for medical care be part of Planning For Emergencies done by institutions?
    • Emergency planning and workers compensation policies do tie together.
    • Planning for Emergencies in labs is often as confusing as WC due to local resources (campus and municipal), diverse types of hazards needed to prepare for, and local politics.

3. What other aspects of the grad student experience does their legal status as employees impact?

  • Expectations and compensation for working hours
  • Access to personal protective equipment
  • Termination process concerns
  • When I was a grad student I was told by our student government to only say “hurt at school” so that my personal insurance would not reject a claim
  • A lot of places do try to list post-docs as students. I don’t think that is clear cut everywhere either.

4. What opportunities are there for addressing the confusion these questions raise?

  • I wonder if the National Labor Relations Board should /could get involved in mediating this nationally, or do these laws need to reside, legally, at the state level?
  • One idea is to develop a FAQ list that grad students should ask about safety before accepting a fellowship offer would be helpful to the grad student in evaluating the offer and the PI in framing the offer as desirable. This could be a national resource
  • Given how much Workers Comp varies by state, I am deeply skeptical of a successful unified approach to rectifying it across the U.S.  I think a state by state approach is much more likely to be effective (though inefficient perhaps).  So, then perhaps a college by college approach to encourage (require?) a unified set of best practices to be implemented locally might lend itself to the missing broad scale aspect.
  • Some institutions require that PI’s provide health insurance for graduate students and postdocs. Conversely, some universities do not require mandatory health insurance. There are no unified policies. At my university, we require that PI’s or the institution to provide health care for our graduate students doing research.
  • UC Davis has its own Fire Dept with EMTs making at least initial treatment quick, easy, and at no cost to students.
    • Related to ambulance costs and American healthcare, one of the concerns that has been raised is the cost for undergrads that call an ambulance for medical emergencies (lab or non-lab). If the university’s ambulance service responds it’s free, but if they are unavailable an outside service responds. This can lead to bills (after insurance) of >$1,000. This creates a disincentive to calling for medical help when needed.
    • This is an important point. I stress in lab safety training I do that the institution expects the lab worker to call 911 in case of emergency. For some people, this call is a significant financial risk
    • This is one of the reasons why graduate students will often drive other grad students to the hospital. They just saved >$1,000
  • What is the incentive to NOT consider graduate students to be employees?

5. How does this confusion impact the safety culture of 1) specific institutions and 2) higher education in general?

  • This unfortunate outcome (in addition to a GSR not having medical bills paid) was that they wouldn’t go for any treatment for fear of the costs. We saw this occur frequently (and quite sadly).
  • If one cannot feel that an accident can be recovered from financially, I imagine it would inhibit more dangerous lines of research. It may also inhibit students from feeling that the institution actually cares about their safety and well-being.
  • What kind of work performed by students does the ruling pertain to?  Could laws be strengthened if WC-type coverage is extended to students who do certain types of hazardous work, such as laboratory research?
  • It’s sad that it takes a meeting with an attorney before the institution decided to pay. Although this article is only one perspective, it seems there was a genuine lack of caring behind the initial inaction. Although the administration seemed to say some of the right things, what they didn’t do was cover the student’s bills first and figure out how those bills might be accounted for later.
  • How can there we build a constructive safety culture when people on the front lines of the work are having experiences that leave them distrustful of the institutions?

Discussion of Emergency Response issues

  • TFA does not pose the risk of systemic toxicity that HF does. Here is one study demonstrating this difference and pointing out that PEG 400 is recommended as a topical treatment on some SDS’s, https://drive.google.com/file/d/16QsUsw3MoYcnIhm9akXF4piUUajNOCue/view?usp=sharing
  • We had an HF Committee (including our Occ Doc and Occ Nurse).  We required grab ‘n go kits with instructions for the Emergency Dept to follow.  They could/should just call Poison Control at 800-222-1222 – purposefully easy to remember! 🙂
  • One piece of helpful advice for people who work with exotic chemicals is to bring the SDS to the Emergency Room with you so that the ER staff will know exactly which chemical was involved. The treatment for HF is very different from the treatment of HCl, but their names sound similar in conversation
    • Is this why there is insistence that SDSs be printed out rather than relying on accessing them through a computer? We are allowed to embrace the latter, but then we wouldn’t have an easily accessible SDS to bring to the ER.
    • From Haim Weizman (he/him) : We made a video that shows TFA damage.https://www.youtube.com/watch?v=a6DrCdjedas&ab_channel=ChemUCSD

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