Worker's Compensation- Christensen Law

Oklahoma Workers’ Compensation Act 2011

Recent Changes To Workers’ Compensation In Oklahoma

Recently, there were some pretty big changes in the way workers’ compensation is processed and handled in Oklahoma. Christensen Law is here to provide the most important changes regarding these law changes.

Written by: D. Wade Christensen, JD*, J. Clay Christensen, JD**, L. Nazette Zuhdi, JD, LLM***, Adam W. Christensen****, JD, MBA, and S.Sandy Sanbar, MD, PhD, JD*****

On May 24, 2011, Governor Mary Fallin Christensen signed the new and extensively modified Workers’ Compensation Act (WCA), which took effect on November 1, 2011, and directed the administrator of the workers compensation court to reduce the fee schedule by 5 percent.*^ The following summarizes most of the new provisions of the WCA:

  • The Court will consist of 10 judges, no more than seven will be assigned to Oklahoma City and no fewer than three will be assigned to Tulsa. The WCA will not apply to certain employees including volunteers; sole proprietors, persons  providing services in a medical care or social services program; persons who employ relatives; persons employed by employers who are liable under certain Acts of Congress; persons employed in agriculture who have certain gross annual payrolls; real estate brokers; persons employed by youth sports league; owner-operators, and drive-away owner-operator.
  • Injuries that do not occur during the employment relationship or in the course of employment are excluded, as are some injuries which occur from certain willful acts, willful failure to act, drug use, and horseplay.
  • The time period a worker can file a claim is shortened from two years to 90 days;
  • Public state entities are required to provide workers’ compensation benefits, paid out of their respective funds, to employees and certain elected officials and to insure against liability for workers’ compensation with CompSource Oklahoma.
  • Voluntary mediation is available to any party to a claim, and the Court may also order mediation in any case.
  • The employer is required to provide an injured employee with medical care within seven days of actual knowledge of an injury, without admission of compensability. The physician selected by the employer will become the treating physician. If the employer fails to do so, or in the case of an emergency, the injured employee may select a physician at the expense of the employer. f there has been a previous contract with a certified workplace medical plan, the employer will select a treating physician from within the network of such plan and the claimant may apply for a change of physician as set out in the plan. Where the employee is not covered by the plan, the employee may be granted one change of treating physician for any affected body part. A maximum of two changes of physician are allowed in a claim.
  • A new Workers’ Compensation Medical Fee Schedule will be established in January 2012 with maximum rates that medical providers are permitted to be reimbursed for.
  • The Court will create and maintain a list of licensed physicians to serve as independent medical examiners and, at any time, may appoint an independent medical examiner to assist in determining any issue before the Court. After receiving a medical examiners report, the Court is required to submit reasons if it does not follow the opinion of the medical examiner.
  • The WCA established the use of nationally recognized treatment guidelines for injured workers. The Court will determine permanent impairment or disability and must be supported by medical testimony. The physician’s opinion of the nature and extent of permanent partial impairment must be based on the “American Medical Association’s Guides to Evaluation of Permanent Impairment.”
  • The WCA encouraged early return to work by utilizing rehabilitation. Injured employees will be entitled to physical rehabilitation. Injured employees will be entitled to physical rehabilitation. Injured employees will be entitled to physical rehabilitation services and Vocational Rehabilitation Director to help injured workers return to work. No person will be adjudicated to be permanently and totally disabled, unless first having obtained an evaluation through vocational rehabilitation services, which are limited to 52 weeks and may be extended in certain circumstances.
  • And, a formula will be established that limits claims for legal services based on the type of case and disability.

*First Gentleman of Oklahoma; Owner, Christensen and Associates;

**Owner and Managing Director, Christensen Law Group

***Chair, Health Law Section, Christensen Law Group

****Attorney, Health Law Section, Christensen Law Group

*****Of Counsel, Health Law Section, Christensen Law Group Address for all: 210 Park Avenue Suite 700, Oklahoma City, OK 73102.

*^http://www.oklegislature.gov/BillInfo.aspx?Bill=sb878

Additional Resources: http://www.workerscompensationok.com/ and http://www.owcc.state.ok.us/

Workers’ compensation allows your employees to get back to work for you faster. Let the lawyers at Christensen Law in OKC answer any of your questions. Click here to get into contact with us.

Pain Management

Chronic Pain Management: Legal And Medical Aspects With Prescription Drug Abuse Prevention

Prescription Drug Abuse Prevention

Prescription Drug Abuse has different effects depending on the severity of the abuse. As such, prescription drug abuse prevention needs to be flexible to deal with this changing severity. Christensen Law is well-versed in healthcare laws of Oklahoma and the history behind chronic pain management. Here’s an article we wrote to explain a little more about this tricky subject.

Written by: Blake Christensen, DO, Adam W. Christensen, JD, MBA, S. Sandy Sanbar, MD, PhD, JD, D. Wade Christensen, JD, J. Clay Christensen, JD, L. Nazette Zuhdi, JD, LLM, Oklahoma City

Controlled substances prescription abuse has been reported to be the fastest growing drug problem in the United States. Since 2003, more overdose deaths have involved opioid analgesics than heroin and cocaine combined.* And, for every unintentional overdose death related to an opioid analgesic, nine persons are admitted for substance abuse treatment. In 1914, the Harrison Narcotic Tax Act was the first narcotics law that prohibited doctors from prescribing opioids to addicts. In 1970, the Controlled Substances Act replaced the Harrison Act as the federal U.S. drug policy under which manufacture, importation, possession, use and distribution of certain substances is regulated. In 2005, President George Bush promoted quality pain relief with accountability by signing NASPER (National All Schedules Prescription Electronic Reporting) into law. NASPER was designed to improve patient access and prevent “doctor shopping” and drug diversion.**

In 2007, the Food and Drug Administration Amendments of 2007 gave the FDA the authority to require a Risk Evaluation and Mitigation Strategy (REMS) from manufacturers to ensure the benefits of a drug outweighed its risks through education of providers and the public. In 2009, the FDA announced a “Safe Use Initiative,” a program aimed at decreasing the likelihood of preventable harm from medication use. Finally, in 2011, President Barack Obama’s administration unveiled a Prescription Drug Abuse Prevention Plan, which focuses on four major areas: education, monitoring, enforcement, and disposal. There are also state laws, rules, policies and guidelines that address proper pain management.

The means of narcotic control is found within the federal and state laws currently in place, together with a three step-wise methodological approach to treatment from providers according to their trained skill set.***

1. The first modality is via prevention, patient education and screening. Primary care physicians and other interdisciplinary care providers play a vital role in effective treatment of chronic pain. The chronic-pain patients receiving treatment in this modality are typically the least physically and psychologically impaired. The physician should follow all existing regulations and evidence-based guidelines while having an individualized treatment plan for each patient. This level is typically the most cost-effective modality of treatment for the patient. It is also the modality where most of the laws governing controlled substances apply.

2. The second modality involves physicians who are board-certified in interventional pain management. The patients in this category are complex and display little or no progress using more conservative treatment. Interventional pain procedures can involve high-risk procedures and should only be provided by designated board-certified specialists when stringent objective medical criteria are met. These patients will often require an interdisciplinary care team and manager. They may need the help of a board-certified surgical specialist.

3. The third modality of treatment involves patients with the most physical and psychological impairment. It requires an interdisciplinary team. Psychiatric counseling may be beneficial. The patient should understand all facets of the ailment, have the support of family and friends, and have an established care team manager and interdisciplinary care team. Families need to be good reporters about the patient.

Treatment should focus on ways to manage the disease. The practice of medicine and pain management is based on patient care within the confines of the law. The law protects society from the dangers of narcotic abuse. Public policy exists to protect the public. The crux of the patient, physician, lawmaker, and public interests lies in the efficacy of information exchange. By having a well informed society, effective pain management may be achieved and laws may be understood and followed. Through information exchange of all modalities and the public, a balance may be found between drug control and drug availability.

Prescription drug abuse prevention is the frontline tactic versus the fastest growing drug problem in America. If you have any questions about the legal side of prescription drug abuse, the lawyers at Christensen Law in OKC can help.

* http://www.cdc.gov/nchs/nvss.htm

**http://www.asipp.org/NASPER.htm

*** http://www.healthleadersmedia.com/HOM-75466-4625/Tiered-approachto-chronic-pain-targets-suffering

Christensen Law-Telemedicine Law and Medicine

Telemedicine: Law and Medicine

Telemedicine: Medical-Legal Aspects

Telemedicine article written by: Adam W. Christensen, JD, MBA, Blake D. Christensen, DO, Nazette Zuhdi, JD, LLM, Jonathon M. Miles, JD, Adrian Maurer, MD, S. Sandy Sanbar, MD, PhD, JD

Of all the professions one could think of to associate with the word precise many would probably list medicine and law among their top associations. It’s important to know what you’re talking about when it comes to these professions, doubly so when the two professions meet. To show that the lawyers at Christensen Law in OKC know their stuff, below we have an article on telemedicine written by Adam W. Christensen for Bulletin.

Telemedicine has come of age both nationally and internationally. In 1997, the Oklahoma Telemedicine Act (OTA) was passed. The OTA states that all health care service plans, disability insurer programs, workers’ compensation programs, or state Medicaid managed care program contracts are to include coverage for telemedicine services, where appropriate, as determined by a health care provider*.

Telemedicine is broadly defined under the OTA as the practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data, or exchange of medical education by means of audio, video, or data communications**. It encompasses such issues as emails, physician-patient communications and transfer of patient medical information from clinic to clinic and facility to facility. Telemedicine has demonstrated its potential to offer widespread access to medical care while at the same time reducing health care costs. Doctors can conduct video consultations with others in the same state, in other states and abroad. Telemedicine, however, does not include consultations provided by telephone or fax machine. There is no universal law of telemedicine. States take significantly different approaches to regulating it. Indeed there are many regulatory and legal issues to consider when developing a mobile app that involves exchange of healthcare information, an online health and wellness platform involving healthcare data, or another telemedicine or telehealth project. Regulatory and legal issues include:

• Privacy and Confidentiality

Informed Consent

Malpractice Due To Equipment Failure and General Liability Principles

Jurisdiction and Registration, Jurisdiction and Liability

Malpractice Liability, Negligence, Duty of Care, Standard of Care, and Negligence for Not Using Telemedicine Regulation of Telemedicine and Telehealth by State, Licensing, and Professional Disciplines

Ethical Constraints in a Given Profession (such as medicine, psychology, psychiatry, or counseling)

Insurance Issues Including Insurance Fraud, Billing and Coding, Medicare and Medicaid Fraud/Abuse, FeeSplitting, Kickback Law and Stark, and Healthcare Fraud.

Giving information on the Internet regarding generic health care conditions is legally permissible. However, giving information tailored to a specific patient, considered as diagnosis and treatment of a medical condition, is controlled by the medical licensing statutes. Telemedicine providers who don’t recognize the differences may run afoul of current law and regulation.

In Oklahoma, the health care practitioner who is in physical contact with the patient has the ultimate authority over the care of the patient and needs to obtain informed consent from the patient. If the patient wishes to utilize telemedicine, a detailed explanation of the risks and benefits and potential privacy concerns must be discussed. Telemedicine in Oklahoma is not centralized, but primarily offered through collaborative telemedicine networks and individual providers. Oklahoma supports telemedicine through the state’s high speed intrastate network, OneNet.

One thing is for certain: telemedicine is evolving and will enhance the physician’s ability to deliver medical care. Rural hospitals, not-for-profit hospitals, public health departments, correctional and military facilities and people involved in emergency response situations like the May 20, 2013, tornado, all have need for the utilization of telemedicine.

A fully developed and sophisticated communications infrastructure is needed to transport telemedicine information. However, this infrastructure is absent in many of the area’s most in need. Perhaps in the future, there will be ways to fund the telecommunications infrastructure and site equipment. The good news is the technology is here. Perhaps political forces will team up to find ways to fund the use of telemedicine and eliminate the barriers that are stunting its growth.

Telemedicine can be a powerful tool, but the restrictions on its use are currently governed state-to-state. If you’re in Oklahoma and have any questions about how your state regulates telemedicines; the lawyers at Christensen Law in OKC can help you get the most out of this powerful tool.

*§36-6803. Added by Laws 1997, c. 209, §1, eff. July 1, 1997
** §36-6802. Added by Laws 1997, c. 209, §1, eff. July 1, 1997

Christensen Law- Physicians

Physicians : Plan Well. Live Well.

5 Factors Of Retirement For Physicians 

Doctors are a certainly very special breed. They work long hours, get very little sleep, and endure heartbreaking loss. Doctors spend their entire careers helping others and saving lives, therefore; whenever one retires we know they very well earned it. When one retires, what they may not realize is that there are a few things, in addition to the normal pitfalls, that can hamstring their retirement needs. Christensen Law is here to give some advice on what some of these pitfalls are and what doctors should do. Let’s start with an example:

Dr. Hood is 55 years of age with dreams of retiring when he is 65 and switching from practicing medicine to enjoying golf full-time. Will he be able to fulfill his dream? What issues must Dr. Hood consider now to be able to retire in ten years?

Nearly half of practicing physicians are older than 50 and approaching retirement. Unlike most other professionals, physicians should consider additional factors when planning for retirement. These five main factors are:

1. Retirement Number. Has the physician accumulated sufficient liquid savings to reach his or her proverbial retirement “number”? The “number” is the amount of savings a physician needs to maintain a desired standard of living in retirement. The proper time to set up a plan is as early as possible to capture the benefits of compounding in tax deferred accounts. If Dr. Hood does not already have a plan in place, now is the time to set up a comprehensive investment plan to reach that retirement number.

2. Succession Planning. Physicians must consider their practice exit strategy and plan their transition into retirement with the best chance of success for their patients and themselves. Strategies will differ between physicians based upon personal preferences and whether a physician is a solo practitioner or a member of a group of physicians.

3. Asset Protection. Physicians are subject to claims of malpractice and ensuing lawsuits. Asset protection is critically important. Physicians should seek advice from a licensed attorney regarding the proper use of LLCs, PLLCs, family limited partnerships, irrevocable trusts, offshore trusts, etc. These business vehicles are also useful when transferring ownership of a professional practice.

4. Accident Planning. This begins with sufficient malpractice insurance. There are two major types of malpractice coverage: occurrence-based and claims made. Occurrence-based policies protect a physician while the policy is in effect, no matter when the claim is made. Claims-made policies cover only claims made during the term of the policy and require tail coverage when the policy ends. Other insurance considerations include life and disability insurance and an adequate umbrella policy.

5. Tax Considerations. This over-arching factor should be considered concurrently with the previous four factors and requires the advice of a tax savvy CPA and/or attorney. Successful financial planning for life events and retirement requires not only the accumulation of assets, but also the protection of assets earned during the course of a physician’s career.

It is never too early to examine and implement the five factors presented in this article. The physician’s team should consist of a financial advisor for factors one, two, and possibly three and four; an attorney for factors two and three; a licensed insurance broker for factor four; and, a CPA or tax attorney for factor five. It is important for the advisor, attorney and CPA to work together to ensure all recommendations are consistent with the physician’s personal goals and objectives.

If you’re a doctor looking to retire soon, let the lawyers at Christensen Law in OKC help make sure you have everything on order.