| Coalition of University Employees (CUE) | 2855 Telegraph Ave., Suite #302, Berkeley, CA 94705 Contact CUE (510) 845-2221 (phone), (510) 845-7444 (FAX) |
This is from an UPTE email sent out to UC Berkeley UPTE members and forwarded onto a UCB library staff list.
Here is some information concerning your rights in the workplace and the importance of adding a note to your personnel file that you want to select a treating physician (MD, chiropractor, or acupuncturist) in case you become injured on the job.
1. The California Commission on Health and Safety and Workers' Compensation, with the help of UC Berkeley's Labor Occupational Health program, has produced some basic fact sheets on workers comp that are available on the Web (in PDF format).
(They can also be obtained from LOHP at 2-5507, now located in the old Extension building on Fulton St., 4th floor.)
By the way, one of the things UCB does--which may be illegal for other employers--is to force employees to use all their sick leave before filing for disability . . .
2. Nolo Press, a self-help law firm in Berkeley, has two books that are particularly relevant to UC Employees: "Your Rights in the Workplace" and "Take Charge of Your Workers' Compensation Claim: A Complete Guide for Employees." Their 800 line is 1-800-992-6656.
3.Workers have a right to select a treating physician before they are injured, by filing a note or form with their department. It should include the following information (including your and a witness's signature):
From:(Name)
(Address)
Date:___________________________
To:Personnel Department/Administrator
To whom it may concern:
I, _____________________________, declare that if I sustain an injury or illness in the course of my employment with ____________________________ and require medical treatment, the following named doctor or medical group is hereby selected to provide and direct all necessary care:
Doctor/Medical Group:______________________________________________________________
Address:____________________________________________________________________________
Phone:________________________________
Thank you.
Witnessed:
Signed:
Unless this form is on file, a worker who gets injured will be forced to use the "company doctor" for at least 30 days and perhaps longer now, with the increasing use of HCOs (health care organizations), which among other things provide managed care for work-related injuries. (As you know, the ethos of managed care is like that of the gardeners who mow, blow, and go; and unfortunately, cumulative trauma injuries are not amenable to that kind of treatment.)
Below is an article about the importance of designating a doctor in advance (used with permission).
In the case of a repetitive strain (AKA repetitive motion or cumulative trauma) injury, whether or not you have selected a treating physician in advance, you need to get help immediately (including making some changes in how you do things and how long you do them). If it looks like the University's insurance carrier (Applied Risk Management) is going to take 3 months just to determine if your injury is work-related, get help even if it means you have to pay for it out-of-pocket.
(Check to see if there's a local RSI or injured workers support group to offer advice about treatment professionals. Some Web sites also give tips or have links to these groups; check "The RSI Page", which lists books, has a "Find-A-Doc" section, and has multiple links. Despite it's title, it goes beyond computer injuries; another is http://www.tifaq.com, which has links to injured worker groups all over the country, including AWRI--Americans with Work Related Injuries--which has other links to groups like "Prairie Law," an online discussion forum about Workers' Comp.) You need to be proactive in making sure that you get appropriate help to avoid permanent disability. If you are being treated for a cumulative trauma injury and within 4-6 weeks see no signs that the treatment is making a difference, you need a DIFFERENT kind of treatment, and YOU need to make sure you get it. "The doctor knows best" is a form of denial (which I learned the hard way); and, as we say in the RSI support network, "Denial is not just a river in Egypt."
WORKERS' COMP: DESIGNATE A TREATING PHYSICIAN BEFORE YOU ARE INJURED. By Julius Young, Attorney at Law, Boxer & Gerson, Oakland (835-8870) http://www.boxerlaw.com
No one wants to think that they will be injured at work. But injuries do happen, and workers are well advised to take steps to protect their interests in the event of industrial injury. Should you be injured at work, the most important person in the workers' compensation system is your treating physician. Except in cases where an injury is denied in the first place, the treating doctor's opinion is presumed to be correct. Among the issues subject to this rebuttal presumption are issues of your returning to work, temporary disability payments, need for continuing treatment, need for vocational rehabilitation and monetary compensation for residual permanent impairments. Should issues about your entitlement to benefits go to a judge for decision, the judge will probably pay special attention to your treating doctor's reports.
Many workers find that the care from company designated "doc in the box" industrial clinics are impersonal, unsympathetic, and even downright substandard. Many company doctors and company-designated clinics have cozy relationships with employers, which make it difficult for the injured worker to get top-flight care. In some cases it appears that employers bring pressure on company designated clinics, interfering with the normal doctor patient relationship. A call from the claims examiner or the employer to the company clinic may result in the worker being released to work prematurely (or in some cases, held off work or forced into retraining unnecessarily). A call from the claims examiner to the company doctor accusing the worker of being "a fraud" may severely prejudice the worker's treatment. Video surveillance of the employee may be shown to an unsympathetic company doctor who then dismisses the worker's pain. So how can this be avoided? The key is for the worker to maintain control of medical treatment.
Although an injured worker can "self procure" treatment at any time with any doctor, such treatment will not be paid for by the workers' comp insurer except in extreme circumstances. To have doctor bills paid by the industrial carrier, certain procedures must be followed.
In order to be treated by a doctor of your choice within the first 30 days of injury, you must designate your choice of physician in writing before your injury occurs. This means you should put a written statement in your personnel file designating your "personal physician" now. The statement can be very simple, merely specifying the doctor you choose. If you sustain an industrial injury, you can then begin treating with that personal physician immediately following your injury. Note that the physician you designate could be (but need not be) your regular doctor or family doctor that you see under your regular group medical or HMO plan. Or it could be some other doctor you have seen before or some doctor or facility you think you would choose to see if you were hurt. (A treating physician under California Workers' Compensation may be a medical doctor, a doctor of chiropractic, or a licensed acupuncturist.)
What if you have not predesignated a doctor in writing before your industrial injury? You will be forced to treat with your employer's doctor for at least 30 days following the injury. Although a provision exists to change doctors within 30 days, it is a difficult and seldom used procedure.
After the first 30 days of injury you can designate a doctor of your choice even if you have not predesignated a doctor. Insurance companies frequently contend that the injured worker only gets one change of treating doctors. Not so, in a 1995 case, Ralphs Grocery v. WCAB, the California Court of Appeal made it clear that under Labor Code 4600 California injured workers actually have the right to change doctors more than once. The courts have noted that if an employer concludes the employee is doctor shopping and abusing the right to choose a treater, the insurer's remedy is to allow the requested change of doctors and then (under Labor Code 4603) to petition the administrative director of the Division of Industrial Accidents for an order allowing the insurer to designate a new list of doctors from which the worker would be forced to choose.
Keep in mind that your treating doctor's assessment of your disability status and opinion as to what medical tests, treatment and medication you need will be presumed correct. Having a sympathetic and competent doctor on your side who will advocate for your interests is a major plus for any injured worker. Having the injured worker in control of his or her medical care is the watchword for workers' comp these days! Act now and avoid hardship later: pre-select a doctor for any work injuries!