By SHERRY
HALBROOK
It's hard to imagine a more miserable turn of events than
getting hurt or ill on the job and then failing to get
needed treatment or Worker's Comp pay because your claim
or request are bogged down in the system.
PEF's Workers' Compensation Committee has heard plenty of
horror stories from members facing just that dilemma, so
it has turned for help to the state AFL-CIO and to PEF
stewards at the state Insurance Fund (SIF). The fund
provides about 40 percent of all the Workers'
Compensation insurance coverage in the state, including
insurance for all state employees.
The result: Help is on the way.
The state AFL-CIO has developed the "Workers
Compensation Navigator Program" to train union
members as guides to help injured or ailing coworkers
move through the Workers' Comp system effectively and
efficiently.
And PEF stewards at the state Insurance Fund who have
expertise in claims processing are available to help
other members who find themselves confused or tangled in
red tape.Learning
to navigate
In late September, 55 PEF
members and staff and even some state managers received
12 hours of Navigator training, including three hours
focusing on the PS&T Contract and state Civil Service
law, in Albany and the union would like to get another
100 trained over the winter.
"The Navigator Program informs and invigorates
people who can help their fellow members get through the
Workers' Comp experience," said PEF Executive Board
Member Bernie Kahn, who chairs the union's Workers'
Compensation Committee.
"Not only will these Navigators be able to help
coworkers, they will form a group of activists who
understand Workers' Comp and who can respond to
legislative proposals on that issue," Kahn said.
"They will combine an understanding of how the
system is supposed to work with the practical experience
of trying to help the people affected by it."
Kahn praised the efforts of Art Wilcox and Ed Donnelly at
the state AFL-CIO and PEF Health and Safety Director
Jonathan Rosen in making the Navigator Program a reality.
"I can't give enough credit to Jonathan Rosen and
staff in that department for all they did to pull the
September training together," Kahn said.
He also stressed the value of working with the AFL-CIO
and other labor and management groups.
"Networking with other unions and people is very
important in our continuing efforts to help our
members," Kahn said. "We pooled funds from
three different areas of the union's budget to pay for
this training and we opened it to certain managers who
deal with Workers' Comp.
"This is really a win-win program to help get
workers well and back on the job as soon as possible.
It's the best thing for the workers and means management
doesn't have to hire and train someone new to replace an
experienced person," Kahn added.
Division 240 to the
rescue
Meanwhile, PEF stewards at
the state Insurance Fund are providing invaluable help to
employees throughout state service.
PEF Division 240 steward Rocco Brindisi is PEF Health and
Safety Chair at SIF and an associate workers compensation
claims examiner in Buffalo.
"We're a resource to PEF field reps or other union
representatives who are trying to help members with their
claims," Brindisi said. "We identify the
problems, speak to the case manager and find out if
necessary information or forms are missing."
Missing documentation is often the stumbling block that
prevents speedy processing of claims or requests for
treatment, according to Brindisi.
"For the SIF to make payments or authorize
treatment, we need written requests from the attending
physician," he added.
SIF simplifying the
process
Recognizing the need to
improve processing, the SIF moved last year to make the
process more efficient and easier for injured or ailing
workers to deal with.
"Claims used to have to go through five or six
people who would each be doing something different with
it and all at the same time," Brindisi said.
"About a year ago, SIF changed that so that a case
is assigned to one person who does all of those steps and
manages the case from beginning to end."
Kahn and Brindisi all stressed that no assistance from a
trained Navigator or a PEF steward at SIF is meant to
substitute for the advice of a workers' comp attorney or
licensed hearing representative.
"In fact, the Navigator Program manual has a list of
workers' comp law firms, hearing reps and occupational
health clinics where workers can turn for help,"
Kahn said.
"A great deal needs to be done, but I'm really glad
to see how much everyone is doing now to start improving
this system and help people through it," he added.
"Filing a Worker's Comp claim shouldn't mean adding
insult to injury."
|