Today’s post was shared by Jon L Gelman and comes from thehealthcareblog.com
By David Do, MD
Earlier this month officials at Oregon Health Sciences University discovered that residents in several departments were storing patient information on Google Drive, and had been doing so for the past two years. Given They treated this discovery as a breach of privacy and notified 3000 patients about the incident.
While I don’t condone the storage of patient information on unapproved services like Gmail or Google Drive, this incident pretty much highlights the sorry state of information systems within the hospital and the unfulfilled need by physicians for tools that facilitate workflow and patient care.
It says something that the Oregon residents felt compelled to take such a drastic action. I don’t know what punishment – if any – those responsible were given by administrators for their “crimes.” I’ll leave it to readers to make up their own minds about the wisdom of the unauthorized workaround and the appropriateness of any punishment. But I do know that the message the incident sends is a very clear one.
We’re screwing this up. There is really no earthly reason why it should be any more difficult to share a patient record than it is to share a Word doc, a Powerpoint or yes, even a cloud-based Google Drive spreadsheet.
Why the Breach Happened
What’s going on here? Let’s say I admit a patient to the hospital. Our…
“The COHEs have proven their ability to prevent disability for workers,” said Joel Sacks, L&I director. “By improving occupational health care, they keep valuable workers on the job and reduce costs for employers.”
Two brand-new COHE sponsors include:
A coalition of 12 health-care organizations led by Franciscan Health System, that will offer COHE services covering all western Washington counties.
Group Health Cooperative, which will provide services to injured workers at 11 clinics in western Washington and one in Spokane. Patients do not need to be members of Group Health to see doctors in these clinics for work-related injuries or illnesses.
Ask us about our opinion of Group Health Cooperative as a DLI provider…
L&I has also renewed contracts with the four existing COHEs:
Renton COHE at Valley Medical Center, serving parts of King and Pierce counties.
Eastern Washington COHE, based at St. Luke’s Rehabilitation Institute in Spokane and involving medical providers throughout Eastern Washington.
Harborview Medical Center, Seattle, with COHE services at its trauma center and many of its clinics.
The COHEs provide training and organizational support to medical providers to increase their use of best practices in treating injured workers. These best practices focus on safely returning workers to full function and full employment. Examples of best practices include talking with the employer about return to work and regularly assessing a worker’s ability to do work activities.
A 2011 study found that injured workers treated by COHE-affiliated health-care providers are away from work for 20 percent fewer days than other injured workers. COHE care also reduces disability and medical costs by $510 per claim during the first year.
The new agreements are a major step towards meeting a legislative requirement to expand COHE services to all injured workers statewide by 2015, part of the 2011 workers’ comp reform.
Today’s post comes from guest author Susan C. Andrews, from Causey Law Firm.
You hear it all over the place these days: there are lots of people out there who lied and cheated to get Social Security Disability (SSD) benefits. I’m here to tell you that is a myth. You don’t have to drill down very far to find out differently. I should know, from where I sit, as an attorney who handles SSD cases. Where I sit most days is in front of a big pile of medical records—I mean HUNDREDS of pages of medical records, all belonging to the same person. You see, some of my clients have just one great big medical issue—like cancer, or Multiple Sclerosis, or Parkinson’s, and many of my clients have multiple medical problems. Either way, they have spent more time in doctors’ offices and hospitals than any of us would ever choose to do.
There is a mistaken notion floating around out there that a person can just waltz into Social Security, claim to be disabled, and voila—he’s granted benefits!
There is a mistaken notion floating around out there that a person can just waltz into Social Security, claim to be disabled, and voila—he’s granted benefits! Nothing could be further from the truth. The burden of proof is on the claimant (the person claiming benefits) to show that he or she is disabled from engaging in substantial gainful activity (SGA) for a period of at least 12 continuous months. More about SGA in a bit. That proof starts with medical records, and diagnoses made by doctors. Self-diagnosing just doesn’t cut it, even if you’ve read up on your condition all over the internet, and you’re absolutely positive you know what’s wrong with you! Sometimes we get calls from people who do not have health insurance, and even though they have a serious medical condition, they have been unable to access much in the way of health care. Sadly, some of those folks who should be able to qualify for benefits do not, because they simply do not have the necessary treatment records to document the seriousness of their conditions.
As mentioned above, Social Security’s definition of disability is the inability, due to one or more medical impairments, to engage in substantial gainful activity for a period of at least 12 continuous months. Social Security defines SGA in part by a dollar figure that usually goes up a little every year. In 2013 it is $1,040. Social Security looks at a person’s GROSS earnings, not net earnings or take-home pay. So if I’m able to gross $1,040 or more per month, I can engage in substantial gainful activity and I do not qualify for SSD. This concept is important especially for individuals with progressive conditions.
Take, for example, a person diagnosed with Parkinson’s. One famous example is the actor Michael J. Fox. His Parkinson’s affects his functioning, but he is still working. Many people with progressive conditions continue to work for some time after receiving their diagnosis. At some point, progression of the disease may force some of them to go to part-time work. When the hours worked decrease, their earnings may no longer qualify as SGA. Or—and I see this a great deal in my practice—some people begin to have more bad days than good days, and work performance is impacted. There are days so bad that they really have no choice but to call in sick. Then this begins to happen more frequently than a couple of days a month. In my experience, at that point most employers become very unhappy campers. Not only are the employees taking sick leave faster than they are accruing it, they can’t tell their employers ahead of time which days they will wake up with an exacerbation of symptoms that keep them in bed, or at least in their bathrobe, all day.
Which brings me to my final point: Many of my clients look okay to the casual passer-by. Take the guy with a serious heart problem. Well sure, if I followed him around for half a day, I’d see that he can barely exert himself without getting out of breath. But if I just passed by, he might look fine. And the day he spends at home in his bathrobe because he can hardly catch his breath—I’m not going to see him at all when he’s having one of those really lousy days. His condition may be largely invisible.
To sum it up, I’d say there’s a bit of wisdom in being slow to judge. Thank goodness we take our good health for granted—it’d be a miserable existence if I spent too much time worrying about getting sick before it actually happened. But, of course, serious illness can strike any of us when we least expect it. And on the other side of that defining moment, the world can look a whole lot different.
Today’s post comes from guest author Leonard Jernigan, from The Jernigan Law Firm.
During cancer research in 1986 an accident created the first man-made nanoparticle, an incredibly small particle which can absorb radiant energy and theoretically destroy a tumor. One type of nanoparticle is 20 times stronger than steel and is found in over 1,300 consumer products, including laptops, cell phones, plastic bottles, shampoos, sunscreens, acne treatment lotions and automobile tires. It is the forerunner of the next industrial revolution.
What is the problem? Unfortunately, nanoparticles are somewhat unpredictable and no one really knows how they react to humans. A report out of China claims that two nano-workers died as a result of overexposure, and in Belgium five males inhaled radioactive nanoparticles in an experiment and within 60 seconds the nanoparticles shot straight into the bloodstream, which is a potential setup for disaster. In a survey of scientists 30% listed “new health problems” associated with nanotechnology as a major concern.
Lewis L. Laska, a business law professor, wrote an article in Trial Magazine (September, 2012) in which he advised lawyers to become knowledgeable about nanoscience and be aware of the potential harm to workers and others who come in contact with this new technology, particularly because the EPA, FDA and OSHA have neither approved nor disapproved the use of nanostructures in products. It has been said that workers are like canaries in the cage (in mining operations), and if nanoscience is a danger then workers’ compensation lawyers will be the first to see it and appreciate it.
Today’s post comes from guest author Paul J. McAndrew, Jr., from Paul McAndrew Law Firm.
Most of us know that, for both professional reasons and in the interest of safety, remaining sober while on the job is essential. However, it is important to also recognize that workers who are intoxicated at the time that they sustain a work injury stand a far lower chance of ever collecting workers’ compensation.
If the blood test shows the presence of alcohol or drugs, odds that the employee will be able to collect workers’ compensation are much lower.
This is because of the intoxication defense: if an employer can prove that intoxication was the cause of the workers’ injury, then they employer is not required to provide workers’ comp for that injury.
Today’s post comes from guest author Laurel Anderson, from Causey Law Firm.
Facebook, Twitter, YouTube, LinkedIn, Pinterest, Instagram and other wildly popular social media websites have transformed how people both connect with each other and obtain information about other people. It has also created a change in the legal arena. For our clients who are currently applying for or receiving workers’ comp time loss benefits, or Social Security Disability Insurance (SSDI) benefits, our advice is to keep in mind the importance of privacy settings for both written information and photos on their individual accounts. While a Washington State law went into effect this weekend barring employers from requesting access to Facebook passwords, if your privacy settings are not tight, curious parties can randomly obtain information about you.
While a Washington State law went into effect this weekend barring employers from requesting access to Facebook passwords, if your privacy settings are not tight, curious parties can randomly obtain information about you.
From our experience, you can now assume that claims managers, employers, and defense attorneys will search for information on the internet regarding your personal life that can impact your claim for benefits. Please make sure that any outdated information regarding your activities is removed from your personal page. Do not use social media to vent about your employer or state agencies that are the decision-makers in your claim. You may be under the impression that only your friends can see your personal page, and that you have some right to privacy. However, be aware that all of the content on your walls, including photos and instant messaging, could be potentially discoverable by your employer or opposing counsel in a litigated case if the content is relevant to your claim for benefits.
The risk is somewhat less in the SSDI arena since there actually is an agency directive to ALJs and DDS adjudicators that they are not to use social media to research claimants. We nevertheless warn our SSDI clients concerning social media, as we are not convinced that agency people are always playing by the rules, or that those rules may not soon change.
Today’s post comes from guest author Tom Domer, from The Domer Law Firm.
Washington similarly allows employers to access all prior claim records, even from other employers, when one of their employees files an injury claim. Workers’ compensation claims already had a lower privacy standard than other types of records – workers’ compensation is excluded from HIPPA protections – but this now allows easy access to all records, relevant or not, once a worker files an injury claim.
Republican legislators are feeling their oats these days. Throughout the Midwest, legislators are depriving workers of collective bargaining rights and trying to restrict workers’ rights in workers’ compensation claims.
In Missouri, workers’ compensation legislation was recently proposed that would have permitted an employer to provide a potential hire’s name and Social Security number so an employer could identify the potential employee’s prior workers’ compensation claims and the status of those claims. The Missouri Division of Workers’ Compensation estimated an online data base that would include over a half million claim records with over 10,000 records added each year.
To his credit, Democratic governor Jay Nixon vetoed this proposed online data base which would allow businesses to check a prospective employee’s workers’ compensation claims. He said it was “an affront to the privacy of our citizens and does not receive my approval.” As expected, supporters of the workers’ compensation data base (employers primarily) said the legislation would speed the hiring process and help bosses and workers. Regularly, information about workers’ compensation claims is available by written request and takes about two weeks to arrive. Supporters of the legislation indicated the law was “preventing workers’ compensation abuses.”
Wisconsin’s workers’ compensation records are subject to Wisconsin public records law, except for records identifying an employee’s name, injury, medical condition, disability, or benefits – which are confidential. Authorized requestors are limited to parties of the claim (the employee, the employer, and the insurance carrier), an authorized attorney or agent, a spouse or adult child of a deceased employee. Workers’ Compensation Division staff may provide limited confidential information regarding the status of claims to a legislator or government official on behalf of a party. In addition, workers’ compensation staff are not permitted by law to conduct a random search to determine if other injuries have been reported.
If the requestor is the same employer or insurance carrier involved in a prior injury, then access will be allowed. If the requestor is a different employer or insurance carrier but they make a reasonable argument that the prior injury and the current injury are related, access may be allowed. For example, the Department considers injuries “reasonably related” if the two injuries involve the same body areas.
Simply put, in Wisconsin, at least for the present, claimant information is confidential and not open to the public, other than to the parties to a current claim.
Today’s post comes from guest author Catherine Stanton from Pasternack Tilker Ziegler Walsh Stanton & Romano.
In addition to helping our clients receive the benefits they are entitled to through the courts and other adversarial means, we are prooud to work with our elected officials to produce legislation that will benefit working people. A few days ago, a bill we support, the Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act, was formally proposed. We encourage you to call and email your representatives and let them know that you support this law.
The press release with additional background follows:
Reps. Reichert and Thompson Introduce Bipartisan Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act
Washington, D.C. – Today, U.S. Reps. Dave Reichert (R-WA) and Mike Thompson (D-CA) introduced the Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act, H.R. 1982 into the House of Representatives.
The legislation aims to protect injured workers whose workers’ compensation claims overlap with Medicare coverage. Far too often, these claims are subjected to lengthy and cumbersome reviews by the Centers for Medicare and Medicaid Services (CMS) to determine appropriate set-aside amounts to pay for future medical costs in which Medicare may have an interest. The delays associated with this review place unfair burdens upon the injured party.
“This is a common-sense measure to ensure that hard-working Americans are not left in limbo because of inefficient bureaucratic procedures,” said Rep. Reichert. “Injured workers must have the confidence that their heath care claims will be processed in a fair and timely manner. By introducing this bill, Rep. Thompson and I aim to do just that: protect our hard-working citizens by making sure our systems serve them and their families.”
“The last thing injured workers should have to worry about is if needless bureaucracy is going to prevent their medical bills from being paid,” said Thompson. “This bill will make sure hard working families’ medical claims are processed efficiently and quickly, it will reduce bureaucratic headaches for businesses, and it will save taxpayers money. I will continue working with Congressman Reichert to get this bipartisan bill signed into law.”
Background
The Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act establishes clear and consistent standards for an administrative process that provides reasonable protections for injured workers and Medicare. It would benefit injured workers, employers and insurers by creating a system of certainty, and allows the settlement process to move forward while eliminating millions of dollars in administrative costs that harm workers, employers and insurers.
The legislation has widespread support from groups such as the American Insurance Association, the American Bar Association, the National Council of Self-Insurers, Property Casualty, Insurers Association of America, UWC-Strategic Services and the Workers Injury Law and Advocacy Group (WILG).
Today’s post comes from guest author Roger Moore from Rehm, Bennett & Moore.
Recently, the Wall Street Journal reported that the Social Security Administration (SSA), frustrated by the backlog of applications for disability benefits, started pressuring the 140 doctors the agency uses to help evaluate some of the claims. In an effort to encourage the quick processing of claims doctors were paid a flat rate of $80/case in stead of the previous $90/hour to review the cases. Many times these cases have hundreds of pages of records to be reviewed and can turn on a few sentences.
In this setting it’s every more important to seek the help of a treating physician in offering a supportive report.
Also, doctors were assigned to evaluate conditions that were not in their areas of expertise. One of the more interesting quotes came from Neil Novin, former chief of surgery at Baltimore’s Harbor Hospital, who worked for Social Security part time for about 10 years. He said “People who shouldn’t be getting [disability] are getting it, and people who should be getting it aren’t getting it”. In my experience Continue reading Shortcuts at the Social Security Administration Mean Mistakes→
Today’s post comes from guest author Jon Rehm from Rehm, Bennett & Moore.
Employee rights in the workplace took a step backward with the Vance and Nassar decisions made by the U.S. Supreme Court. So what does this mean in concrete terms for employees?
Vance: The main takeaway from Vance is that employees must tell upper management and human resources about workplace harassment. This has been federal law in the Court of Appeals for the 1st Circuit (Maine, Massachusetts, New Hampshire, Puerto Rico and Rhode Island) and the 8th Circuit (Nebraska, Iowa, North Dakota, South Dakota, Minnesota, Missouri and Arkansas). In order to sustain a workplace harassment claim under federal law, employees must now be able to show that management knew about harassment and that management failed to take effective action against the harassment.
Nassar: Nassar made it more difficult to prove retaliation under federal law. In the 5-4 majority decision written by Justice Samuel Alito, the court wrote that it was concerned about the increase in retaliation claims filed in the EEOC and the potential for “frivolous litigation.” The effect of this case is that even more retaliation cases will be decided by judges under summary judgment instead of being decided by juries.
However, just because it is harder to bring a discrimination or retaliation case under federal law doesn’t mean that an employee can’t bring a case under state law that could be more favorable to the employee. But employees pursuing wrongful termination cases in state court should be aware that state court judges oftentimes follow federal court judges in interpreting state fair-employment laws. State court judges might find the Supreme Court’s concerns about “frivolous” retaliation suits to be well founded.
I think Justice Alito was off base in his concerns about “frivolous” retaliation where employees who are about to get fired file complaints in order to preserve their job or set themselves up for a wrongful termination lawsuit. Any competent employee-rights attorney knows that retaliation suits are difficult to win. I turn down about 9 out of 10 people who call my office who claim they were wrongfully terminated. Wrongful termination suits are costly and time consuming. I am not going to invest time and money in a suit where I will likely get dismissed and possibly face financial sanctions under court rules and also possibly be opened up to paying costs to the prevailing employer under federal fair-employment law. I am doubly suspicious of employees who are fired shortly after they file discrimination or other claims. Employers know that if they fire someone after filing some sort of complaint that it appears to look bad. But courts will uphold that reason if they had a legitimate reason to fire the employee. In other words, the employee who knows they are skating on thin ice and then files a complaint is going to lose a wrongful termination case. The decision in Nassar won’t stop disgruntled employees from filing claims with fair-employment agencies, it will just make it more difficult for employees with legitimate wrongful termination claims to obtain justice.
Earlier this month officials at Oregon Health Sciences University discovered that residents in several departments were storing patient information on Google Drive, and had been doing so for the past two years. Given They treated this discovery as a breach of privacy and notified 3000 patients about the incident.
