FW: Direction of Care

[Guest guest]

“Steering” of injured workers issue not the result we wanted. Dear colleagues as you can see from the post below from Shilts Director of the Workers Comp Division the Division will not be following our recommendation of a disclosure statement with signature lines for the employer and the worker to sign validating that the employer explained to the injured worker what their treatment rights are. We were outnumbered during the Administrative Rules hearing they entire anti-worker/dark side was there in force including interestingly the MCOs and the IME vendors in fact if you needed any evidence of the current anti-worker system right now all you had to do is look around that room and see who showed up. I need you all to continue to fully document any cases of an employer requiring injured workers to treat with the local Occ Med Clinic which is usually the case or the company doctor/nurse or urgent care clinic in direct violation of Oregon law and they get those documents to me. Remember the strongest result is for an injured worker to tell their story if you can get them to do it and to file a formal complaint. We will not allow this issue to “go quietly into that good night” we will continue to make noise and keep the issue on the radar screen as long as the “steering” continues….. Vern Saboe, DC From: vsaboe [mailto:vsaboe@...] Sent: Monday, October 03, 2011 2:42 PM'Shilts L'Cc: 'Bruyns Fred H'; 'Willingham '; 'Savage Louis D'; 'REP Kennemer'; 'REP Schaufler'; 'Rep Esquivel'Subject: RE: Direction of Care Hi , No it isn’t the result we had hoped for and the requiring (“steering”) of injured workers to treat with a particular clinic or provider will continue as will the reality of the issue usually resulting in the old “he said, she said” and as such little ability for the Department to act. The strategy of the disclosure language form with signature lines for the employer and the worker validating that the employer indeed informed the worker of their treatment rights was in hopes of better address this “he said, she said” situation as in if the employer could not produce said document nor the worker (because it was never given and the conversation never took place) that employer could more easily be sanctioned in some manner. In our view the stakeholders who would like the current situation to simply continue were more than over-represented during the Admin Rule hearing for and I found it most interesting how one of the most vocal indiduals opposing our suggestion was a representative from Oregon Health Systems MCO…how is it they a managed care organization, even had a “dog in this fight?” No worries we know very well the answer to this question and workers remain at a dreadful disadvantage especially in this economy. On a personal note I do thank you for all you do and I fully understand the difficult position you are in as Administrator, Vern Saboe, DC FACOOregon Chiropractic Association From: Shilts L [mailto:john.l.shilts@...] Sent: Monday, October 03, 2011 1:43 PM'vsaboe'Cc: Bruyns Fred H; Willingham ; Savage Louis D; VANWINKLE TheresaSubject: Direction of Care Dr. Saboe: I wanted to give you a “heads-up” that WCD will not be adopting a rule requiring a revision to the Form 3283 with signature lines to be used by employers to give workers notice of their medical treatment rights. Nor will we be requiring that the notice of medical treatment rights be signed by the employer and the injured worker or that copies of the signed notice be provided to the injured worker or saved by the employer. I know you are very concerned about the issue of workers being directed to care providers other than their choice. I am too. However, after a very well attended stakeholder meeting on the issue, which we conducted as an external advisory committee meeting pursuant to consideration of administrative rulemaking, I don’t agree that amending this form or requiring signatures will accomplish what we both want to accomplish: that workers know about their rights to select a provider and that employers don’t interfere with those rights. The advisory committee meeting provided no clear support to change our current approaches regarding this form and, in fact, there was significant opposition to the idea expressed. However, the meeting clearly provided me with input that the issue of employer restriction of choice should remain a focus of the department’s regulatory efforts. This was supported universally. Though we are not implementing the specific solution you presented, we intend to take some actions to target the concerns raised by your proposal and supported by committee members. There is strong benefit to having the department provide education and information to employers, workers, and providers about this issue. As we have done earlier, we will send another specific industry notice to all Oregon employers that reminds them of the worker’s right to choose his or her provider. This notice will be sent in the next few months. Other notices that cover the worker’s rights to choose their care provider, including those on signed Forms 801 and 827, as well as the existing language on the Form 3283, shall continue to be required. There is also strong benefit in the department investigation of and intervention in allegations of direction of worker care. This is one of the most important ways to prevent inappropriate direction of care from happening. We continue to take every specific complaint about employer restriction of choice seriously. We will follow up on each specific complaint we receive. We will investigate allegations and continue to provide education to employers and issue civil penalties, if necessary, as a way to discourage and prevent a violation of a worker’s right to select a care provider. While you correctly point out we no longer have an investigator position on staff, the division has over 65 compliance specialists who are quite capable of investigating the facts surrounding allegations and determining the right response, including when an administrative rule or law has been violated. We have adequate staff to review the complaints we receive about this issue. Finally, it is clear there is specific concern in the chiropractic physician community about worker direction of care. To that end, I offer our expertise to the Oregon Chiropractic Association, as well as any other interested provider group, if you decide to develop specific educational materials to assist your patients or their employers in understanding the rights of workers in the workers’ compensation system. While I know this isn’t the specific outcome you had wanted, I hope you see that your concerns are not being ignored. Please contact me if you want to discuss this further. Shilts, AdministratorWorkers’ Compensation Division(503) 947-7551john.l.shilts@... Shilts, AdministratorWorkers' Compensation Division(503) 947-7551john.l.shilts@...