The Workers Compensation Injured Workers Bill of Rights
Injured workers have experienced in the last several years a massive effort to limit workers compensation benefits. This has directly harmed decent hard working people and their families. Improper medical care and attention, and the reduction of benefits have resulted in poverty, depression, and second class status for those whose only crime is that they were injured on the job. It is a national shame and there are countless personal and family tragedies from such unfair treatment. We invite you to search for the real truth and to demand that all those legitimately injured be treated with respect and dignity. We may be your father or your mother, your sister or brother or just a friend or neighbor. But we are injured...we do not want a windfall we just want justice. We invite all who are interested to join our efforts. We have compiled what we believe to be the basic rights all injured workers should be entitled to as human beings. We present them for your consideration:
An injured worker shall have the right to select his own physician or at a minimum to be able to switch to a doctor of his choice after 30 days of treatment.
An injured worker shall have the right to a prompt hearing on any dispute, within 90 days of a request. Additionally in emergency medical or financial situations there should be a right to a hearing within 30 days to issue provisional orders on such emergency matters.
An injured worker shall have the right to have considered in his disability his loss of earning capacity along with any physical or mental impairment.
An injured worker unable to return to his trade or occupation as a result of a work injury shall have the right to an independent vocational assessment and to vocational rehabilitation if reasonably appropriate, with the goal being a return to the highest earning capacity possible within a reasonable time frame. Vocational rehabilitation benefits shall be at the same rate as temporary disability benefits.
An injured worker shall have the right to an impairment rating and disability determination which assesses chronic pain and depression along with any physical impairment. And if work related activities contribute to, result in or aggravate pain, limitation or impairment the claim shall be compensated.
An injured worker unable to return to substantial gainful work shall be entitled to permanent total disability benefits for as long as the disability continues.
An injured worker shall have the right to a non-party independent medical exam, paid by the insurer if there is a question concerning the treatment or opinions of the treating provider. All partisan IME's are to be banned.
An injured worker shall have the right to benefits based on his true take home pay including overall wage benefits and to permanent disability benefits based upon his disability not simply impairment.
An injured worker shall have the right to a second opinion, paid by the insurer, with a doctor of his choice, if surgery is being recommended. Any surgery can be declined without adverse consequences.
An injured worker shall be treated with dignity and respect by those within the wc system, to include doctors, nurses, adjusters, attorneys and judges..to the extent that the first priority and loyalty shall be to recovery and fundamental fairness. If not, substantial penalties should be imposed.
The physician treating the injured worker shall have the presumptive right to order any diagnostic tests or evaluations. The presumption can only be overcome by clear and convincing evidence which must be furnished within 20 days of any denial.
An injured worker shall have the right to all legal entitlements for his disability without offsets.
An injured worker shall have the right to realistic cost of living increases in his benefits and to have those benefits pass to his dependents upon his death.
An injured worker shall have the right as the ultimate consumer of medical services to be informed of the doctors education, experience and contractual arrangements with insurers when treatment commences. Additionally, the state shall monitor all doctors and maintain a record of complaints by injured workers concerning doctors which can lead to removal of the doctor from the ability to treat such workers for numerous or major complaints.
An injured worker shall have the right to privacy of his medical records. They are to be sealed and otherwise nondisclosable except as concerns claims by the worker , for statistical purposes only or to permit an accommodation in employment.
The Workers Compensation Injured Workers Bill of Rights was developed by members of the Injured Worker's of America (IWA), a division of The MedaKate Organization, November 22, 1998. This group includes Injured Workers, Physicians, Attorneys, and Registered Nurses. Please print them out and give them to your Physician, Attorney, Unions, Medical Facilities, Therapist, and the General Public.
http://www.workerscompensationinsurance.com/articles/billofrights.htm
After reading this Bill of Rights which is attended for Injured Workers then read the the post below which the Bill of Rights is not being up help in my case in any fairness to the injured worker at all for the past year.
The Digest has gone above and beyond for my cause and with the support from it's members educating eachother and knowing that in NV this is really happening with no one coming forth and saying this is wrong!
HERE ARE THE LAWS STRAIGHT OUT OF NV STATE REGARDING MEDICAL TREATMENT & WHAT I HAVE BEEN FIGHTING FOR OVER A YEAR OF EVERY LAW BROKEN AS WELL AS STATUTES.
http://www.leg.state.nv.us/NRS/NRS-616B.html
NRS 616B.5273 Adequacy of medical and health care services, choice of providers of health care and cost controls; regulations.
1. A self-insured employer, an association of self-insured public or private employers or a private carrier shall not enter into a contract with an organization for managed care unless the organization’s proposed plan for providing medical and health care services:
(a) Will provide all medical and health care services that may be required for industrial injuries and occupational diseases that are compensable under chapters 616A to 617, inclusive, of NRS in a manner that ensures the availability and accessibility of adequate treatment to injured employees;
(b) Provides to injured employees an adequate choice of providers of health care who have contracted with the organization to participate in the proposed plan; and
(c) Provides appropriate financial incentives to reduce costs of medical and health care services without affecting the quality of any care provided to an injured employee.
2. The Division may adopt regulations to ensure the adequacy of an insurer’s panel of providers of health care established pursuant to subsection 1.
(Added to NRS by 2003, 1669)
NRS 616B.528 Restriction of or interference with communication between provider of health care and injured employee prohibited. An organization for managed care shall not restrict or interfere with any communication between a provider of health care and an injured employee regarding any information that the provider of health care determines is relevant to the health care of the injured employee.
(Added to NRS by 1999, 2212)
NRS 616B.5285 Contracts with providers of health care; prohibited acts. An organization for managed care shall not terminate a contract. ( SEE MY URL WORKCOMP1 AT BOTTOM OF PROFILE I WAS DROPPED AS A PATIENT BY WORKERS COMP NEUROLOGIST FOR NO REASON) THE REASON WAS THEY FOUND MANY THINGS AND MIS-DIAGNOSED ME THEN A MONTH LATER DROPPED ME AS A PATIENT.)
with, demote, refuse to contract with or refuse to compensate a provider of health care solely because the provider, in good faith:
1. Advocates in private or in public on behalf of an injured employee;
2. Assists an injured employee in seeking reconsideration of a determination by the organization for managed care to deny coverage for a medical or health care service; or
3. Reports a violation of law to an appropriate authority.
(Added to NRS by 1999, 2212)
NRS 616B.529 Inducements to deny, reduce or delay medically necessary services prohibited.
1. An organization for managed care shall not offer or pay any type of material inducement, bonus or other financial incentive to a provider of health care to deny, reduce, withhold, limit or delay specific medically necessary medical or health care services to an injured employee.
2. The provisions of this section do not prohibit an arrangement for payment between an organization for managed care and a provider of health care that uses financial incentives, if the arrangement is designed to provide an incentive to the provider of health care to use medical and health care services effectively and consistently in the best interest of the treatment of the injured employee.
(Added to NRS by 1999, 2213)
NRS 616B.528 Restriction of or interference with communication between provider of health care and injured employee prohibited.
restrict or interfere with any communication between a provider of health care and an injured employee regarding any information that the provider of health care determines is relevant to the health care of the injured employee.
(Added to NRS by 1999, 2212)
NRS 616C.157 Request for prior authorization: Time to respond; effect of failure to respond in timely manner.
1. An insurer, organization for managed care or third-party administrator shall respond to a written request for prior authorization for:
(a) Treatment;
(b) Diagnostic testing; or
(c) Consultation,
Ê within 5 working days after receiving the written request.
2. If the insurer, organization for managed care or third-party administrator fails to respond to such a request within 5 working days, authorization shall be deemed to be given. The insurer, organization for managed care or third-party administrator may subsequently deny authorization.
3. If the insurer, organization for managed care or third-party administrator subsequently denies a request for authorization submitted by a provider of health care for additional visits or treatments, it shall pay for the additional visits or treatments actually provided to the injured employee, up to the number of treatments for which payment is requested by the provider of health care before the denial of authorization is received by the provider.
(Added to NRS by 1999, 2214)
PLEASE EVERYONE READ THE ARTICLE FROM JOHN FROM POSTED MY SITUATION LAST MONTH AND AS OF TODAY I AM STILL NOT GETTING ANY OF THESE LAWS UP HELD IN ANY SENSE OF URGENCY.
EVEN INSIDE 222 BLOG ABOUT THE BROKEN SYSTEM HAS NOT YET HAD ANY ONE FROM THE MEDIA COME FORTH AND CALL HIM BACK.
An earlier post from this blog annotates the woeful and absolute outrageous treatment being heaped upon one of our members, Ron by the Worker's Comp System, including his own attorney, whose firm appeared to be in collusion with the Insurance Carriers by ceasing all pertinent services to his case apparently driven by fear of potential corporate harm through future litigation. No medical help for months. No answers from the attorney--only mis-statements. No help anywhere.
As a former vocational rehabilitation counselor, I have seen this type behavior before-and it generally stems from a surgical mistake, then when an injured worker continues to complain, the first thought emanating from the Carriers, attorneys, et. al is:
'Stop the services! Send out false information to the worker! Make outrageous claims that the worker is not complying with the various service providers! Cover your ass!'
And ad naeuseum....the spin merchants, coupled with loss prevention departments of these huge insurance conglomerates begin to work their magic--here's what they do to a lot of people who might have a legitimate complaint: they simply stop sending their monthly check. No explanation. Can you imagine the panic?
As it is, you are lucky if you receive two thirds of your normal salary while on the Comp System-and now, suddenly, you have no money to pay for anything! Most of the times, they will re-start the financial benefits, but not before causing the injured person to suffer further through stress by making them late for credit card or rent payments. Add to it a nightmarish quality- I have personally heard insurance company rehab co-ordinators, while at industry 'functions', exclaim great humor at how many people they 'put the screws to' that week.
Folks, this stuff is industry wide, and it sickens me to watch it continue. This should be considered health care reform, too, and the political writers seem to simply ignore the horrendous level of abuse perpetrated by the 'business' side of this system, while the person who is already hurt and suffering, suffers further at the hands of those who should be honestly assisting them to achieve their best level of gainful re-entry to the work world. (or determine that will never be possible)
It should be obvious to all that creating an adversarial system, instead of a truly philanthropic, medically progressive streamlined system, the worst of all possibilities occur, where delays are normal, and communication among the providers is poor, at best. Built for failure.
And, as all our members know, the Social Security Disability system certainly seems bad enough- difficult and hurtful at many turns.
At this writing, there over a million cases which are officially 'backlogged' in the Social Security Disability system. Unless you take the free course offered here at the Disability Digest, you can easily wait three full years before receiving benefits. (and that's if you're not backlogged) Three years! No excuse can be offered which might even approach credibility.
But the Worker's Comp System--if anything can be more problematic than Social Security Disability, it's this damnable system in which Ron Markowicz continues to suffer. But, some progress had been made. There may be a ray of sunshine.
While I cannot comment on case specifics, I can say that some advancement is being made on the medical side, as Ron's original physician is only now re-activating his services to him, but still faces an uphill battle against a stone-walling industry.
Also, due to many different and serious inquires to the Nevada Governor's Office, there has been progress toward publicizing Ron's case fully, exposing it for the utter disgrace it remains. As it may involve the National media, his case could be re-opened, and the proper medical procedures enacted post haste. These major corporations do not appreciate black marks against them, as stockholders are already nervous these days.
So, with enough pressure, Ron would immediately receive the attention he needs, and in the proper order, which is vital in his case.
He is truly disabled, suffering the results of several breaks in his back from a serious fall while at work, then surgical mis-feasance resulting in pieces of metal floating in his back, now invading the surrounding soft tissue, creating intractable pain.
The link to the initial information in this case is a fairly long read, including my post describing the Worker's Comp System, and the specific details of his case-then, a page of a well kept medical file which further elucidates Ron's situation. Again, if any readers have a golden rolodex, please forward this appropriately. I have included the link in the resource box.
We continue to press our efforts towards resolving this unsettling dilemma, as justice should have it. The overarching reality is: Ron's case could be your own. He did not violate any 'rules' and was always forthcoming with his medical providers and insurance carrier. That was pre-surgery.
Today is a different story.
Best to all involved,
Update: as of this writing, Ron has terminated the services of his attorney, and suddenly, approval has been granted for an' emergency injection', treatment which has been withheld for the past four months. Real medical treatment necessary for his survival. Great news!
John Woodworth is the editor of the Disability Digest, a 50,000 member strong advocacy organization. The Disability Digest is managed by disabled individuals from a variety of professions. Mr. Woodworth has been a business owner and consultant, a vocational rehabilitation and psychiatric counselor, and an innovative business marketing specialist. He has spent the last eight years researching medical issues and legitimate work at home programs.
Disability Digest owner Brian Therrien has recently added an entire section for Veteran's help, as many medical and social services are due these individuals, with a lot of help necessary to deliver them. His free course is effective in maximizing the returning veteran's benefits, and providing updated government policies.
Regarding Social Security Disability, Brian literally wrote the book on minimizing time to qualify for, and obtain deserved benefits. His free, 11 part email course has helped literally thousands of disabled folks cut the wait time by at least half, sometimes helping to obtain benefits in a few months. Currently, one can expect to wait up to three years to obtain benefits, and additionally, there is a one million application backlog in the Social Security Disability system as of early 2009.
For free newsletter and Social Security Disability course: http://www.thedisabilitydigest.com/1.html
Disability Digest Blog: http://www.thedisabilitydigest.com/blog
To: Elizabeth Cohen
Senior Medical Correspondent
CNN News
Good Morning Elizabeth,
By way of introduction, I am the west coast editor of The Disability Digest, a 40 thousand member strong nationwide organization.
We are an group made up largely by disabled individuals from many walks of life. Our main function with the Digest is to disseminate valuable information to disabled individuals, particularly those attempting to obtain Social Security Disability benefits. We do not charge for our service, nor do we take any Federal, State, or any governmental funds to operate.
While we are used to many complaints about the Social Security System, and how difficult they are to deal with, we occasionally encounter situations which egregiously represent the worst of what a system of 'health care' can do to a person.
In this particular case, it is associated with the Worker's Compensation system, and in the State of Nevada.
As a former vocational rehab counselor, I can personally attest to how ineffective, and seemingly capricious the worker's comp insurance carriers can be. And there is no reason for this to be the case.
I have seen many situations where a client, already suffering from a loss of income of one-third (not to speak of the pain associated with case) has to deal with the insurance company when they suddenly cut off their desperately needed monthly payment.
And, for no reason.
But the case before us now represents conditions far worse than I have ever seen, truly endangering this individual's life by the insurance carrier's unwillingness to give consent to further medical treatment.
This is very serious, and despite intervention by Congresswoman Dina Titus's office, and the Nevada Governor's office, the person in question still cannot get the emergency treatment he needs. And so, I am turning to you.
To be brief, after 5 surgeries due to a serious fall, there is metal still floating in this man's back, and no one will treat him, strictly because mistakes were made during the surgeries, and lies were told, and now-----the system shuts down because it is a worker's comp case, and everyone involved is concerned about liability. Meanwhile, the patient is in intractable pain, and is in danger of serious complications if not treated immediately.
As a journalist, I understand the power which can be brought to bear by the media---especially when they are taking the position to right a wrong.
I am sending you to a blog post of mine---and at the end is another URL directing you to the specifics of the case (they are not that lengthy)
I am asking for your help by way of publicizing this case----it is absolutely unconscionable what the insurance carrier is doing to this man. At age 38, and having worked diligently in his profession for twenty years, he is in so much pain, he cannot even hold his two year old daughter to give her a hug----he must have had a horrible Father's day.
In any case, CNN is in a position to help----and I am respectfully asking for it.
Thank you for your time and consideration,
John Woodworth
Editor
The Disability Digest
john@thedisabilitydigest.com
http://www.thedisabilitydigest.com/blog/235/missing-in-action-justice-for-disabled-injured-worker/
