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Chemical Injury in the Workplace
Workplace Counseling
Playing Industrial Hygiene to Win, Eileen Senn Chemical Protection at the Workplace
Genetic Testing
Testing for Chemicals
Worker's Compenstion Pitfalls, Barbara Rubin

Workplace Counseling/Information
Consultant to the Chemically and Electrically Sensitive for Access. Works with individuals and public entities toward improving access to housing, medical care, benefits, the workplace, education and to develop self-defense strategies for MCS/ES. E-mail Susan Molloy: susanm@cybertrails.com
 
Job Accommodation Network (JAN) provides information regarding work-site accommodation ideas. JAN Human Factors Consultants provide employers, individuals with disabilities, rehabilitation specialists and others with practical information regarding the tools and techniques necessary to accommodate workers with limitations. The goal of a job accommodation is to reduce or eliminate workplace barriers to enable an individual with a disability to enjoy an equal employment opportunity. The information should not be misconstrued as legal or medical advice. JAN provides accommodation ideas for informational purposes. www.jan.wvu.edu/media/MCS.html or www.jan.wvu.edu/media/fragrance.html
 
Business Coach for the Health Callenged. My passion is to help people dealing with health challenges and/or chronic illnesses that desire to remain employed either by choice or for economic need. I also work as a traditional business coach. All of the traditional coaching methods have to be altered for this purpose. Given my training and personal experience with battling a chronic illness, I am in a unique position to help. I have been a CFIDS /MCS sufferer who has recovered and is now experiencing good health, after suffering terribly for 4 years. Sam Hester s_hester@sbcglobal.net www.businesscoachforthehealthchallenged.com
I will give anyone referred by this website, a 25% discount on their first month's coaching! Sam Hester
 
Book
I'd Rather Be Working: A Step-by-Step Guide to Financial Self-Support for People with Chronic Illness. Gayle Backstrom. At last, a realistic look at the resources and opportunities available to those determined to thrive in the face of chronic illness. Those living with chronic illness face many unique challenges, and among the most daunting can be the search for meaningful, well-paying employment and the challenge of providing for oneself. This first-of-its-kind guide helps readers evaluate their own abilities and limitations, set financial goals, conduct effective job searches, and identify and utilize government and other resources. A refreshing, constructive look at professional and personal issues, this book is a use-it-now resource to put the reader on the road to financial stability and genuine accomplishment, featuring invaluable sections on: o Setting goals to meet abilities and limitations to Self-assessment and career guidance o Training, vocational rehabilitation, and long distance learning-and the potential earnings payoff o The Americans with Disabilities Act, recent Supreme Court decisions, and the latest developments in assistive technologies. About the Author Gayle Backstrom (Denton, TX), the author of The Resource Guide for the Disabled and When Muscle Pain Won't Go Away, has had fibromyalgia since childhood. She has taught college courses in technical writing and business communications.
Career/Self-Development Paperback o 224 pages. 0-8144-7115-3 $14.95
www.amanet.org/books/catalog/0814471153.htm

Chemical Protection at the Workplace
Playing Industrial Hygiene to Win Eileen Senn, MS, CIH. Health and safety information for those with chemical exposures in the workplace.
 
Genetic Testing
Genetic Testing in the Workplace. www.genewatch.org/HumanGen/Publications/Reports/GeneticTesting.pdf or www.google.com/search?q=cache:s0NcF6qqzkkJ:www.genewatch.org/HumanGen/Publications/Reports/GeneticTesting.pdf+paraoxonase+testing&hl=en&ie=UTF-
Testing for Chemicals
Testing for Chemical Injury Barbara Rubin. Chemically injured by pesticides, an MCS shares her knowledge and experience of toxicological testing as an aid for personal and legal protection.

Worker's Compensation Pitfalls

The following letter was sent to representatives in the NYS legislature serving on committees related to worker's compensation and health issues. The laws pertaining to injured workers' access to medical care has been an important impediment to the advancement of occupational and environmental medicine in this country for all patients. Please feel free to disseminate this letter in it's entirety to others in a position to change this system.
 
Regards,
 
Barbara Rubin
community-2.webtv.net/Raisyl/THEARMCHAIRACTIVIST
 
--------------------------
Dear Representative:
 
I am writing to you about the tragic deprivation of injured workers of competent medical care with the physicians of their choice or selected by virtue of their experience in relevant speciality areas. Also caught in the crossfire are physicians themselves, who may not openly choose to treat persons with injuries and ailments originating in the workplace because of regulations prohibiting the billing of patients or their traditional medical insurance policies. Injured workers are greatly discriminated against and constitute a minority in this country that has no legal recourse in the court system. The Worker's Compensation (WC) system varies somewhat from state to state but inequities in medical care appear to be a constant.
 
In New York, those suddenly ill and unemployed from workplace accidents/conditions must find the money to pay for COBRA policies (if insured at all), which are not supposed to be paying for medical care of this nature. The WC system has no "front" pay to cover such costs and few doctors accept assignment by WC. To do so will mean years of waiting for payment while debts accumulate for a given patient. The WC system also assumes the patient is committing fraud and sends them on a series of Independent Medical Evaluations (IMEs), in which the doctor is paid by those representing employers interests. The IME physician also has no legal responsibility for the accuracy of his conclusions under malpractice laws and is free to muddy the waters with statements based upon the most cursory interview/assessment in the absence of testing or even certification in relevant aspects of the case at hand (e.g. toxicology, ergonomics).
 
The injured worker cannot seek the most qualified medical care providers on their own due to limits on ability to pay for such services. Yet, such consultations might yield the definitive information which documents the injuring event or leads to an appropriate course of treatment.
 
Doctors are left with a host of unsatisfactory choices causing great harm to their patients, their own practices and to the very nature of physician training in our society. Current options are:
 
1. To accept WC assignment and go years without reimbursement while risking ultimate refusal to pay. The patient is usually unable to assume the burden of accumulated bills by that time.
 
2. To accept assignment by other insurers. If WC is awarded however, these insurers will demand return of all monies collected by doctors from work related injuries (likely all fees paid). Doctors must then return those monies and again hope for WC payments (frequently not forthcoming) or demand monies from patients who signed agreements to pay whatever was not covered by assignment to medical insurance. That again puts the physician in the position of violating law and the patient is the loser. Doctors also risk prosecution for misconduct under such scenarios.
 
3. To compromise the quality of medical services and record keeping with respect to the injured worker. Doctors may omit significant aspects of etiological information or even lie in medical records about the nature of patient's illnesses if they originate at work. They may fail to adequately research presenting problems since skirting the issue of a frank diagnosis of an occupational disease permits them to bill COBRA policies held by patients or medicare if the worker was declared disabled by the Social Security Administration (SSA). At the same time, documentation needed to prove WC claims will be missing and treatment strategies may be inadequate.
 
As a result, the social security administration and medicare become the default sources of compensation and medical care for injured workers. It saves the State Insurance Fund huge outlays and further insulates negligent employers from investigation and clean up of unsafe conditions. Of course, the injured worker cannot sue for even the most egregious of injuries in uncontested WC cases.
 
4. As the State Insurance Fund is allowed to continually review WC awards already given, a doctor who has finally received some payments stands to risk past and future fees based upon alterations in awards. Patients are often reviewed through the flawed IME process and then find their benefits reduced or eradicated on the flimsiest of excuses. By this time, legal representation (always at the expense of the worker), cannot be obtained since there are no financial incentives to WC lawyers to fight threatened reductions (e.g. percentages of back pay etc.).
 
The discrimination in obtaining medical care goes on forever. I have seen victims of this abusive process become so depressed that all quality of life is eradicated. An investigation of rates for suicide among WC applicants is definitely in order. It is also a strong factor in motivating physicians to eschew continuing education in such specialty areas as toxicology, ergonomics and other aspects of occupational diseases which diminishes their ability to offer all patients quality services. In the case of occupational medicine, the economic penalties of involving oneself has inhibited the progress of medical science in general.
 
Please review these issues and make them a priority for correction. I strongly suggest that the following remedies be considered to correct this terrible injustice:
 
1. Any ailment presented by a patient should be covered by their existing health care coverage. Illness does not wait upon definition of responsible parties for payment and physicians cannot go without fees
indefinitely while patients' debts mount without any assurances of ultimate ability to pay.
 
2. Upon award of WC benefits, the state insurance fund should be responsible for contacting the insurer who made all payments for conditions related to work injuries and reimburse them. After all, the injured worker is the victim and the employer or representative of the employer (State Insurance Fund) ought to be the responsible party taking care of the sequela for negligence or occupational risks to workers.
 
3. Many workers are uninsured and the WC process is extremely lengthy. There must be a provision which permits medical care to be obtained throughout this period. Upon refutation of claims by WC, the State Insurance fund can then seek reimbursement by the patient if no disability exists or retroactively by medicare if a disability does exist but is not considered work related.
 
The Social Security Adminstration tells us three of every ten workers will be disabled prior to retirement years. Many others will work with lessened productivity and quality of life due to impaired health. We know that a significant amount of these ailments cannot be attributed to the fragility of the human species but are related to working conditions. WC covers some of the greatest "at risk" groups in America while acting in the role of attorney for employers at no cost to them. Economics must not be permitted to bar provision of appropriate medical care to a large segment of society and to inhibit the progress of an entire branch of medical science.
 
Barbara Rubin
P.O. Box 224
Locust Valley, N.Y. 11560
Raisyl@webtv.net

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