Author Archives: Edgar Romano

Should Genetic Medical Information Be Given to Workers’ Compensation Insurance Companies?

Federal law provides that employers with 15 or more employees cannot discriminate against employees because of genetic information.

Today’s post comes from guest author Leonard Jernigan from The Jernigan Law Firm.

Under a 2009 Federal law called GINA (the Genetic Information Nondiscrimination Act), employers with 15 or more employees cannot discriminate against employees because of genetic information. That information may include a past or present medical history (for example: breast cancer, diabetes, depression, or colon cancer) of family members.  GINA prohibits disclosure of this sensitive information by employers and prohibits the employer from even making a request for such information. If they have this information, it must be kept in a file that is separate from the regular personnel file.

The EEOC (Equal Employment Opportunity Commission) has made regulations, effective January 10, 2011, to enforce this federal statute and allows an action for damages, including punitive damages, reinstatment and back pay, and reasonable attorney’s fees.

In the workers’ compensation setting, this information is sometimes gathered by medical experts conducting independent medical exams, by nurse case managers who may seek to find out any and all medical information about the injured worker’s family as well as the injured worker, or by family physicians who have made non-work-related entries in the medical records.  However, GINA has allowed an exception to the overall thrust of the legislation by stating that if the information is relevant to the workers’ compensation claim, it can be disclosed. The legislation gives no definition of the term “relevant” and makes the interaction between the health care provider, the carrier, the employer and the employee complicated, to say the least. Lawyers who represent employees and employers should be aware of GINA and protect sensitive genetic information from disclosure, and claimants should make sure their physician is aware of it as well.

 

 

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7 Tips for Healing

Today’s post comes to us from our colleague Leonard Jernigan of The Jernigan Law Firm.

Many people are confronted with death or disability whether as a result of an accident or otherwise. We do our best to help those who were wronged by another or hurt on the job to receive compensation for their injuries. But compensation cannot cure the underlying problem, only help to make life more bearable. True healing is as much a mental as a physical process.

The following tips for healing have been adapted from the writings of Dr. Bernie Siegal, the author of many books including Love, Medicine, and Miracles; Peace, Love, and Healing; and 365 Prescriptions for the Soul. We hope you find these tips helpful in your healing process.

  1. Accept your illness: you know the illness is there, but you also know the future will be something you can handle so it’s no longer a burden.
  2. See the illness as a source of growth: our primitive nervous system tells us that if we have a loss you grow something to replace what was lost.
  3. View your illness as a positive redirection in your life: your whole life changes when you say that something is just a redirection. You are then at peace.
  4. Understand death or recurrence is not a failure if steps 1,2 or 3 are accomplished, but a further choice or step: when you accept the inevitability of death (which comes to all of us ) you begin to realize that the time you really have is right now.
  5. Learn self-love and peace of mind and the body responds: when you believe you are a worthwhile person, and you tell yourself that you are here to give something to the world, your immune system responds positively. Continue reading →

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The Origins of Workers’ Compensation in the United States

Today’s post comes from guest author Jay Causey from Causey Law Firm. We also attended the 40th anniversary symposium. New York’s workers’ compensation system has helped generations of workers cope with their on-the-job injuries.

Today’s post is a film on the history of workers’ compensation, presented by the Workers’ Injury Law & Advocacy Group at the National Symposium on the 40th Anniversary of the National Commission on Workers Compensation, which in 1972 found the state workers’ compensation systems to be inadequate and unfair.

This film is a great reminder that the workers’ compensation systems we work under today were created to correct issues with unsafe workplaces and the effects of injuries on the job during a time when workplace safety was not yet a reality.  We need to remember our history, lest the lessons hard-won be forgotten.

[youtube http://www.youtube.com/watch?v=kVx948coJck?rel=0]

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Why Wait? A Case Study…

Today’s post comes from guest author Kit Case from Causey Law Firm.

I reviewed a workers’ compensation claim for a potential client nine months ago.  At the time, I told him of several items that I saw as upcoming issues in his case and shared my opinion about why it would be important for us to start clearing those issues off the deck sooner rather than later.  Would he be found employable with no services or would he receive just a bit of training to allow him to continue working in his field as a welder but in a lighter-duty capacity?  Would the onset of depression be addressed under the claim and taken into consideration when making employability decisions?  Would his level of permanent impairment be under-rated through the typical Independent Medical Evaluation (IME) process or would his surgeon be willing to provide a rating that more accurately reflects his limitations?  I shared my concerns about his case, explained the process I would recommend for addressing these concerns and discussed the fees and costs to be expected.  He indicated he wanted to go forward with representation.

I did not hear from him again, until yesterday.  He left me a message asking for help with his claim.  I looked at the case this morning before returning his call.  He has been found to be employable with no additional retraining, so he will likely not be able to continue with his favored career but, instead, can look forward to his new line of work as a small parts assembler.  He underwent an IME that conservatively rated his level of permanent impairment and approved the job analysis for small parts assembly.  His attending physician signed the form letter to indicate concurrence with the IME results and, on this basis, the Claims Manager has found him employable and is closing the claim.  What about the depression?  Not addressed by the IME, so the Claims Manager is construing the attending physician’s signature on the concurrence form letter to mean that he is also not contending that depression is an issue, so she is denying this condition under the claim.

I know there are two sides to every argument, and I know that an employer representative would look at this same fact pattern and see a job well done, but I am a claimant’s advocate, so I share my thoughts from only that perspective.  I see a situation where I now have a 15-day deadline for filing a dispute with the Vocational Dispute Resolution Office if I want to argue that Continue reading →

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How To Deal With A Difficult Doctor (Part 2)

Today’s post comes from guest author Leonard Jernigan from The Jernigan Law Firm.

Previously, I shared a post with some tips for workers’ compensation attorneys on how to deal with difficult doctors. In this follow-up post, I’ll share a few more ideas on how to get down to the truth of the matter when the doctor on your case is tough to work with.

(8)     Explain case procedure and why you are there.

Unfortunately, I had the experience of walking into a deposition once and the first question from the physician was “What’s going on here and what’s this got to do with me?”  Just prior to a deposition is not the time to be answering this question.  Some physicians have never had their depositions taken before and they are unnerved at the prospect.  Explain the process and explain the necessity for medical testimony.

(9)     Ease tensions.

Behind every physician-patient relationship there is the potential for a medical negligence claim. Ease that fear by letting the doctor know that the client is pleased with the care of the doctor (if indeed that is true).  She may have reviewed the chart and seen something that concerns her, so reassurance of this nature is vital.  If you are aware of a potential medical negligence claim, choose your words carefully. I can assure you she will.  You should not misrepresent anything concerning this issue.

(10)   Know the medicine. 

Some of us think doctors keep up with all the latest articles and studies concerning relevant medical areas.  The truth of the matter is that HMO’s, PPO’s and other managed care organizations barely pay them for seeing patients and the last time I checked “reading medical journals” was not under the pay provision of the contract.  Therefore, understand and Continue reading →

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How To Deal With A Difficult Doctor (Part 1)

Today’s post comes from guest author Leonard Jernigan from The Jernigan Law Firm.

A doctor’s opinion is crucial to every workers’ compensation claim.  Most doctors give honest and rational opinions. As we all know, however, there are some physicians who have a different agenda and either do not take the time to properly evaluate a patient or they intentionally downplay the potential seriousness of the injury.  For attorneys working on a workers’ compensation case, the following steps may help in the search for the truth.

(1)     Check the doctor’s credentials.

It is a strange but true fact that some experts have falsified their curriculum vitae.  If a physician has lied about his qualifications, his expert opinion just went out the window.  One way to verify credentials is to check the American Medical Association’s web page.   Select “Doctor Finder” and then follow the instructions until you get to “Find a Physician” and type in the name, address and zip code.  If you are seeking a specialist, a doctor certification can be checked by phone with the AMA.  For medical doctors call (800) 776-2378.  For osteopathic doctors call (800) 621-1773, ext. 7445.

(2)     Check disciplinary records. 

According to the Federation of State Medical Boards 4,432 disciplinary actions were taken against 3,880 physicians in 1996.  There are approximately 650,000 licensed physicians in the United States.  The Federation is responsible for promoting high standards for licensure and practice, and serves as the primary center for collecting, monitoring and reviewing actions taken against physicians. (A full report can be obtained by calling (817) 868-4000.  The report is also available on their web site.  Sidney Wolfe, a physician who is director of the Public Citizens Health Research Group, a consumer watchdog organization, has analyzed this document and his report can be obtained by calling (202) 588-1000.  A list of “Questionable Doctors” can also be obtained from Public Citizen for each state.

(3)     Communicate, communicate, communicate.

It is important to find out as much as you can about the physician involved in your case.  See if he is listed on the internet.  If he has written any articles, see what the focus is.  Ask other physicians, nurses, hospital employees and others in the community about this person.  Now, with this information in hand, schedule an appointment to talk with the doctor.  Try not to schedule it during his lunch break, or while he is seeing patients.  You want his undivided attention and you will not get it if he is thinking about some medical crisis sitting in the next room.

(4)     Build a relationship. 

Lawyers who specialize in workers’ compensation are likely to see the same physician Continue reading →

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How To Manage Worry Without Medication

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 3 of 3 in a series about the dangers of psychological stress and how to cope with it.

For the last few weeks we’ve been talking about the very real medical dangers of worry. For injured or disabled workers, worry can add an additional and very significant burden on the body. In this post, we’ll talk about some of the ways that worry can be treated or even avoided.

Much of the time treatments are simply medications that increase GABA. Cognitive therapy is prescribed depending upon insurance coverage. Addressing the physical and mental effects of excessive worry can aid in recovery from an injury or disability and can increase levels of success in vocational retraining efforts. In rare cases, worry and anxiety can become permanent fixtures in a person’s life, and the effects of this condition can result in ratable permanent impairment. But, the greater part of lay and scientific literature lists non-medicine tips to reduce worry, fear and anxiety to a more modulated level, thereby providing some relief from this constant invader that often creates unproductive and hurtful periods in life.

Here, summarized, are six tips cited in the literature to help manage worry without medication:

  • Separate out toxic worry from good worry: Good worry amounts to planning. Toxic worry is unnecessary, repetitive, unproductive, paralyzing, frightening, and in general, life-defeating.
  • Get the facts rather than letting your imagination run away. Analyze the problem and take corrective action.
  • Develop connectedness in as many ways as you can: family, social, information and ideas, organizations and institutions. Never worry alone.
  • Touch and be touched: in addition to massage therapy, seek out hugs and laughter – being around children or family can help.
  • Be good to yourself. Exercise, eat well, get enough sleep, meditate, do yoga and be aware of over consumption of substances detrimental to your health, such as alcohol.
  • Sing, read, cry, do what you love, look for what’s good in life and don’t sweat the small stuff.

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The Very Real Dangers Of Worry (Part 2)

Today’s post comes from guest author Kit Case from Causey Law Firm. It is part 2 of 3 in a series of posts about the dangers of worry.

Previously we posted on how worry can affect the lives of injured or disabled workers. In today’s post, we’ll talk about some of the specific effects of worry on the body.

The physical reactions to excessive fear and anxiety (worry) initiate a chain or cascade of pathological events by stimulating the amygdala area of the brain (fight/flight response), releasing neurotransmitters to the cortex. There, the fear or anxiety, whether real or imagined, is analyzed in detail and the analysis is returned to the amygdala where, in normal situations, the fear response is shut off by amino-butyric acid (GABA). GAD worriers may not have high enough GABA levels to shut off this pathway. Consequently, there are constant marked secretions of glucocortocoids and catecholamines that increase blood sugar levels. Marked levels of epinephrine and norepinephrine dilate blood vessels in skeletal muscles and other adrenergic (adrenal) stimulations that in turn create modifications in breathing, increased temperatures, sweating, decreased mobility of the stomach, bowels, and intestines, constrictions of the sphincters in the stomach and intestines.

Simply said, constant fear and anxiety result in debilitating amounts of stress hormones like cortisol (from the adrenal glands) and hormones that cause blood sugar levels and triglycerides (blood fats) to rise significantly. This process, if not shut off or modulated, can cause premature coronary artery disease, short-term memory loss, digestive problems, and suppression of the natural immune system. The scientific literature is now implicating constant stress, such as constant work stress or toxic fear and anxiety, in causing large weight gains in the midriff area which can greatly exacerbate orthopedic injuries, particularly of the spine or knees, and can lead to increased incidences of diabetes and cancer.

Worry causes increased mortality and morbidity. It is that simple.

For information on how to treat and avoid worry, check in with us later this week for the next installment in this 3-part series.

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