shieldFDNY EMS RETIREES ASSOCIATION

News

Closure eludes EMT's kin

BY DORIAN BLOCK
DAILY NEWS STAFF WRITER

Wednesday, March 12th 2008, 4:00 AM

David Mark and Elizabeth ReeveCataffo/News

The family of a paramedic who worked for months in the Ground Zero morgue to give closure to the families of 9/11 victims is still looking for their own closure two years after her death.

Emergency Medical Technician Deborah Reeve worked for several months sorting body parts at the morgue following the terrorist attacks of Sept. 11, 2001.

In addition to exposing herself to death on a massive scale, she breathed asbestos fibers that her doctors say killed her.

On Tuesday, Fire Commissioner Nicholas Scoppetta, dozens of her colleagues, her husband and fellow paramedic, David, and her two children, Elizabeth, 12, and Mark, 8, met at Jacobi Medical Center's EMT Station 20 to dedicate a plaque in her honor.

"We understand your pain is not diminished," Scoppetta told her family in the locker room Reeve visited daily. "Debbie's sacrifice, and of course yours, is recognized."

The turnout impressed David Reeve, but the sentiments were not enough for the man who buried his wife of 14 years at age 41.

Reeve fought for medical coverage during her last year of life as she battled mesothelioma, an aggressive form of lung cancer, and she was the first EMT worker to receive a $30,000-a-year disability compensation.

Her funeral was paid for by the Fire Department - her death was classified as one in the administrative line of duty.

But her husband and children were left $90,000 in debt from medical bills after she died.

"I am angry at the way the state, city, the federal government have not taken responsibility," said David Reeve. "My wife is the tip of the iceberg. Someone has to 'fess up to what happened.

"Whatever governmental agency is responsible, people have gotten sick because of it. People have died because of it. We are not clamoring for millions of dollars. All these people, they just want the health care necessary."

"They didn't have a 110-story building fall on them, but they didn't play chicken. They didn't run away," Reeve added. "There was a job to do, and they did it."

Others in attendance agreed.

"This is not just one person, an anomaly. People are sick," said Marianne Pizzitola, president of the FDNY EMS Retirees Association, who helped Reeve fight for her compensation.

"A death in the administrative line of duty - what the hell is that?"

Reeve said he hurts when he hears of new 9/11 workers diagnosed with disease caused by Ground Zero, but he is too busy working as a paramedic and learning how to care for his daughter, who is growing up without a mother.

"She's looking more like her mother every day," he said. "Try as I might, I do good, but I can't do what she would have done."

dblock@nydailynews.com

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This letter appeared in the City Hall News 2/14/08

Dear Editor,   

 In “State of the Unions: Ground Zero Fire Fight” (January 14, 2007), much of the story was lost in translation. Members of the FDNY EMS Officers Union and FDNY EMS Retirees Organization want us to fight for their freedom and privacy in health care.

 The FDNY compels employees to participate in their World Trade Center Medical Monitoring & Treatment program (WTCMM&T) and eliminates their ability to receive care at any other WTC Medical Monitoring & Treatment center.  FDNY previously required retirees into this program as well.   Retired members demanded the freedom to choose their healthcare providers and our organizations fought and won their freedom.  

 Congresswoman Carolyn Maloney drafted an extensive piece of legislation seeking funding for monitoring and treatment centers here in NY and throughout the US for First Responders that came to help NY and retired NY Responders that moved away.  We applaud this bill, and take issue with only one provision; a requirement restricting FDNY employees [Firefighters and EMS only] and retirees in the NY area to receive care from the FDNY WTCMM&T program - again, eliminating the ability to seek care at any other approved center, anywhere else in the metropolitan area.  While many employees and retirees are happy with their care at FDNY like retired Lt. Tom Carlstrom, many others are not.  Some do not live close to the FDNY WTCMM&T center, others facing disability or psychological illnesses such as PTSD prefer not to return to the FDNY for care. 

 While we appreciate the importance of keeping the FDNY group together, it is of equal importance that members are satisfied with the level of care and comfortable in revealing their personal health information to their employer.   Compassionate medical and psychological treatment and support for our First Responders requires choice of health care centers and providers.  Under this provision, an FDNY responder dissatisfied with their healthcare in the compelled program does not have the ability to seek care elsewhere.  It should be noted that our NYPD counterparts and other City responders are not bound by such restrictions - they are afforded the freedom to choose their healthcare provider.  FDNY are the only WTC responders compelled to attend an employer based program.  Our members seek freedom and privacy from the FD and in our opinion it is not simply the right thing to do, it is also in keeping with State Laws and Federal Regulations. 

 

Our organizations joined together to work on behalf of our members.  These members deserve to receive WTC healthcare from any approved program and should not be compelled into an employer based program.  If we did not have members supporting this initiative we would not be on this path.  We support those members that are comfortable with their care at the FDNY WTC program, and we support those members who prefer to receive treatment elsewhere.  

 For some unknown reason, we have met with resistance from Labor, FDNY and those who drafted the Zadroga Act.  We find it quite ironic that if the honored NYPD Detective Zadroga were with us today, he would have the choice of centers to provide his care.  

We are at a loss to understand the motives to restrict care to the FDNY program.   After all, there are established “Centers of Excellence” all mandated with the same goal; to help WTC responders and collect data to identify ongoing health needs.  There is no compelling reason to force any member into a program that restricts his basic healthcare rights. Labor needs to unite in amending the Zadroga Act to support medical freedom and privacy while providing the data to drive funding.

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Council to Pass Motion on 9/11 Treatment Aid; Compels U.S. Funding; EMS Officers Want FDNY Alternative

By ARI PAUL

Two Federal lawmakers pushing a bill to secure Federal funding for medical treatment for workers and residents suffering 9/11-related ailments testified Feb. 6 before a joint City Council committee hearing, while Fire Department unions continued to argue over one aspect of the bill.

The Chief-Leader/Pat Arnow

FREEDOM OF CHOICE: EMS retiree advocate Marianne Pizzitola (center), urged that the Zadroga Act be changed to allow firefighters and EMS workers to seek medical monitoring and treatment outside the FDNY program. Joining her is former EMT Stephen Hess, left, and Tom Eppinger, president of EMS Officers Local 3621 of District Council 37.

The Civil Service and Labor and Lower Manhattan Redevelopment Committees heard testimony from U.S. Reps. Jerrold Nadler and Carolyn Maloney pressing for passage of a resolution supporting the James Zadroga Act, named for a Detective who died from what many believed to be 9/11-related illness, which is now in the U.S. House of Representatives.

'A National Scandal'

"This is a national scandal," said Congresswoman Maloney of the fact that many 9/11-responders cannot afford medical treatment.

Congressman Nadler explained that the Zadroga Act, if passed and signed by the President, would "ensure that everyone exposed to toxins at Ground Zero has a right to be medically monitored, and that anyone who is sick as a result is entitled to treatment and compensation, no matter how you were affected or where you live."

Council Speaker Christine Quinn assured the lawmakers that the Council would pass the resolution on Feb. 13 and that it would reach out to other city councils nationwide to build support for the act. The Council's Lower Manhattan Redevelopment Committee Chairman Alan Gerson lamented that the Federal Government has not yet enacted the bill.

"It is a moral stain on us that we have not done so," he said. "Why do you even have to have a hearing? This should be an issue beyond discussion."

Will Improve Treatment

Mr. Gerson, who voiced strong support for the resolution in favor of the Zadroga Act, added that medical monitoring would lead to more research, which would improve medical service.

"We don't know everything that we need to know," he said. "More needs to be provided. And this bill will assure that."

Congressman Nadler added that the Zadroga Act had the support of 66 other Representatives as well as Mayor Bloomberg, Governor Spitzer and the State AFL-CIO. District Council 37 and Community Board 1 in lower Manhattan also voiced support.

Representatives of Local 3621 of DC 37, which represents Emergency Medical Service officers, took issue with a provision of the bill that would keep all FDNY uniformed employees in a treatment and medical monitoring program run by the FDNY.

Wants Right to Go Outside

"We need this bill; it just needs a little tweak," said Local 3621 President Tom Eppinger.

He said that FDNY uniformed employees should have the right to seek medical treatment and monitoring outside of their employer's program.

"While many employees and retirees are happy with their care at FDNY, many others are not," Mr. Eppinger said. "It should be noted that our NYPD counterparts and other uniform and civilian city responders are not bound by such restrictions - they are afforded the freedom to choose their healthcare provider."

Testifying with Mr. Eppinger, Uniformed FDNY EMS Retirees Association President Marianne Pizzitola claimed some members of Local 3621 have not made their 9/11 ailments public because they feared termination without proper compensation from the FDNY.

Former Emergency Medical Technician Stephen Hess testified that he was fired by the department as a result of his 9/11-related illnesses, and without a disability pension and soon to be without health insurance, he said he is facing a financial crisis.

He has been getting treatment at Mt. Sinai Medical Center, and called for the change in language to the Zadroga Act.

'Can't Go Back'

"I would not want to be mandated to return to the FDNY, and see no reason to when Mt. Sinai has helped me where the FDNY did not," he said.

Council Member Gerson and Civil Service and Labor Committee Chairman Joseph P. Addabbo vowed to look into the matter before voting on the resolution.

But Patrick J. Bahnken, who as president of DC 37 Local 2507 represents EMTs and Paramedics, saw no problems with keeping firefighters and EMS employees in an FDNY monitoring program, and his reasoning was personal. It was discovered through his participation in the FDNY monitoring program in December, he said, that he had renal cancer in the early stages, and he was able to get swift treatment. He rejected claims by Mr. Eppinger and Ms. Pizzitola that participation in the program violated confidentiality.

"This conjecture should be readily dismissed," he said. "My case is factual. At no time was I ever subjected to any exam without my consent, and never was my confidentiality breached."

Along with leaders from the Uniformed Firefighters Association, Mr. Bahnken has stated that keeping firefighters and EMS workers in an FDNY-based program was important because it preserved the integrity of the research that would be used to argue for more Federal funding in the future.

'Should Pool Data'

Ms. Pizzitola later responded by saying that the research could still be collected if members had the choice to go to other treatment centers. "They should be pooling this information and they're not," she said.

Mr. Eppinger added in his testimony that James Zadroga would support the change in the legislation if he were alive. Joseph Zadroga, the father of James Zadroga, has said he sided with Mr. Eppinger and Ms. Pizzitola over the issue of FDNY monitoring.

"I really think it's kind of unfair to send them [into FDNY monitoring]," he said in a phone interview last month. "I don't see why they're trying to do this, but apparently that's what they're doing."

In his testimony, Uniformed Fire Officers Association Treasurer Edward Boles said that in addition to the resolution, City Council Members should join with union leaders and residents to go to Washington to rally in support of the Zadroga Act.

"We need to take this show on the road," he said. "Let's take buses. Let's go down there."
 

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November 23, 2007

Can Get Outside Monitoring
EMS 9/11 Retiree Win


By ARI PAUL

Emergency Medical Service retirees suffering from ailments related to 9/11 rescue and recovery work have earned the ability to opt out of the Fire Department medical monitoring program, an EMS retiree advocate announced Nov. 16.

Marianne Pizzitola, president of the Uniformed FDNY EMS Retirees Association, said that a representative of the National Institute for Occupational Safety and Health at the Centers for Disease Control, which provides funding for World Trade Center medical treatment and monitoring, informed her that retired department members could seek treatment outside of the department.

Wants Outside Option

Local 3621 of District Council 37, which represents EMS officers, has fought its parent union for supporting a bill in Congress, the James Zadroga Act, that, while providing Federal funding for such treatment, would require FDNY employees and retirees injured or made sick by 9/11 work to use an in-house monitoring program.

"Our members should have a right to refuse participation just like anyone else," Ms. Pizzitola said.

The NIOSH Web site currently states, "If you are a former employee or a retiree of the FDNY, you may call the FDNY Bureau of Health Services (718-999-1858) or visit the following Web site for information about the FDNY program:  , or you may call 888-702-0630 or click on http://www.wtcexams.org/contactus.html to obtain information about other options."

Local 2507 of DC 37, which represents Paramedics and Emergency Medical Technicians, supported keeping its members in the FDNY monitoring and treatment program because the program's research was prompting Congress to provide more funding, said its president, Patrick Bahnken.

"The FDNY EMS Retirees are pleased with NIOSH's finding that retirees cannot be forced into a monitoring program that is based at their former employer with no other choices for care," Ms. Pizzitola said in an e-mail. "Shame on DC 37 for trying to compel us to 'go with the flow' and stop going against the grain. I sat in a meeting at their office two weeks ago and had to listen to them tell us we had 'no issue' and that I 'was the problem.' Seems like they did not do their homework, as usual."

For 9/11 Ailments
EMS Officers Fight FDNY-Only Monitor


By ARI PAUL

The union representing Emergency Medical Service officers is battling its parent union over a piece of Federal legislation it believes would unfairly limit members injured on 9/11 in choosing how they receive medical care.

Thomas Eppinger, the president of Local 3621 of District Council 37, and Uniformed FDNY EMS Retirees Association President Marianne Pizzitola said that the proposed James Zadroga Act, which would provide Federal money for medical monitoring and treatment, would force department members, including EMS employees and retirees, with 9/11-related ailments to be monitored by the Fire Department. Both DC 37 and the American Federation of State, City and Municipal Employees support the bill in its current form.

'Shouldn't Be Forced'

"The FDNY has a good program, just as Mt. Sinai and the consortiums, but our members should not be forced into an employer-based program because the FDNY, DC 37 and AFSCME International think it is best for our members to give their bodies to science," Ms. Pizzitola, who is also Local 3621's pension consultant, said in an e-mail. "Our members should have a right to refuse participation just like anyone else."

Mr. Eppinger, Ms. Pizzitola and one of the local's retired members met with DC 37 and AFSCME officials at DC 37's lower Manhattan headquarters Oct. 30 to voice their opposition to this aspect of the bill.

"Essentially, what it boils down to is that they don't care," said Roger Moore, a retired EMS Lieutenant whose 9/11 injuries left him unable to walk. "If I want medical service, I have to go back to the Fire Department."

Mr. Moore, who lives in New Hampshire, said that forcing him into department monitoring would require him to spend time and money to come to Brooklyn at least once a year in order to be eligible for medical treatment.

Local 3621 has been highly critical of the FDNY and the city's ability to provide medical care to members injured or made sick by their recovery and rescue work at the World Trade Center site. Mr. Eppinger and Ms. Pizzitola have testified to the City Council's Civil Service and Labor and Fire and Criminal Justice committees that their members are often unfairly denied Workers' Compensation payments and Line of Duty Injury claims.

DC 37: 'Programs Identical'

She said that the FDNY, by denying all recent 9/11 LODI claims, "removes members from pay, they lose their insurance and cannot support themselves. Yet they want to force me into a medical monitoring program and take care of me? Where is the logic in this?"

A DC 37 safety official defended its position on the bill.

"DC 37 is working with other unions locally and nationally to ensure that our members - the first-responders - have access to good health care and the funding necessary to keep the World Trade Center medical monitoring and treatment program up and running," said Lee Clarke, DC 37's director of occupational safety and health.

She believed that keeping FDNY members and retirees in a department-based program was not a problem.

"They're two programs being funded by Federal monies," she said. "The programs are identical."

Local 2507 President Patrick Bahnken, who represents EMS technicians and Paramedics, did not think the Zadroga Act in its current form would necessarily restrict EMS members' access to medical care and said that department monitoring was overall beneficial.

'Must Join to Benefit'

"The purpose of the program is to track the data to develop trends to justify further funding," he said. "The Fire Department, like it or not, has the most comprehensive medical records pre- and post-9/11 that have the ability to demonstrate trends. It is the engine that is really driving a lot of this legislation. You cannot expect to get the benefits of the monitoring program without participating in the program."

Ms. Pizzitola and Mr. Eppinger wrote a letter Oct. 31 to U.S. Rep. Carolyn Maloney, a key sponsor of the Zadroga Act, asking her to amend the bill, and sought to meet with her to make their case.

"This program affects all firefighters and EMS personnel," Ms. Pizzitola said, "yet we appear to be the only ones that believe that freedom is a right we are entitled to and are fighting for it."

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November 2, 2007

Insists It's WTC-Related
Detective's Dad: ME Tilted Death Finding

By ARI PAUL

It wasn't the toxic chemicals or the biohazardous pieces of human remains from Ground Zero found in Det. James Zadroga's lungs that killed him, Chief Medical Examiner Charles Hirsch told the dead man's family, but rather his abuse of prescription drugs.

Neither Detective Zadroga's father nor advocates for first-responders believed him, however.

In an Oct. 19 meeting with the Zadroga family at its New Jersey home, Dr. Hirsch explained that the death of a non-smoker who died of pulmonary injuries in 2006 at age 34, was in no way related to his hundreds of hours working at Ground Zero, but rather resulted from crushing his prescription drugs, mixing the particles with a liquid and injecting the fluid into his bloodstream. He told the family that those particles penetrated his lungs.

Disagreed With N.J. ME

The conclusion contradicted a New Jersey Medical Examiner's findings and those of the NYPD Pension Fund Medical Board, which both determined Detective Zadroga's ailments were due to exposure to toxic chemicals at Ground Zero.

"I was floored that day he told me that," said Joseph Zadroga, the Detective's father, in a phone interview Oct. 26.

He asked the ME to look straight at both Detective Zadroga's photo and his six-year-old daughter and explain that the death was due to drug use. But Dr. Hirsch wouldn't do that, he recalled.

"I tried to talk, but he wouldn't listen to me at all," Mr. Zadroga said. "I said, 'you got all this paperwork here saying he's got this, this, this in his lungs. And he said, 'I don't know, they're just there.' At that point I knew it was useless to talk to him."

'Mean-Spirited Act'

Mr. Zadroga said he showed photos of his son's lungs, which were 90-percent black, to the ME. Dr. Hirsch's reaction, he claimed, was that those were normal lungs. Mr. Zadroga also said the ME offered no evidence of track marks on his son's arms or collapsed veins to substantiate the claim that he was an intravenous drug user.

The Zadroga family's attorney, Michael Barasch, noted that prior to 9/11 James Zadroga was drug-tested nearly every month as a member of the street crime and homicide apprehension units, and that he always tested negative for illicit drugs. He added that even if Dr. Hirsch's assertion was correct, it was indisputable that Detective Zadroga had been prescribed those same drugs for a 9/11-related illness.

"It was the most mean-spirited, disgraceful act I've ever seen by a doctor," Mr. Barasch said.

Calls to the ME's office seeking comment were not immediately returned.

Detectives Endowment Association President Michael J. Palladino questioned the ME's initial denial this month that Detective Zadroga's death was 9/11-related, noting that Dr. Hirsch had not personally inspected the body.

'Junk Science'

"If there's junk science, that's what it is," said Marianne Pizzitola, president of the Uniformed FDNY EMS Retirees Association, which advocates for emergency responders injured due to their work at the World Trade Center site.

Linking Detective Zadroga's name to drug use might harm the passage of James Zadroga Act, a bill in the U.S. Congress that would secure Federal funding for medical treatment for 9/11 rescue workers, Mr. Barasch said.

Ms. Pizzitola, like Detective Zadroga's father, believed Dr. Hirsch's position was based on Mayor Bloomberg's denial that 9/11 first-responders have gotten sick from their work. The Mayor and Dr. Hirsch have maintained that the Office of the Chief Medical Examiner is an independent and non-political entity. In 1989, Dr. Hirsch told this newspaper, "We have done things that have made this office more humane to the people that we serve."

But Ms. Pizzitola thought the case of Detective Zadroga proved otherwise.

"He needs to retire," she said of Dr. Hirsch. "Fresh blood with a realistic mind needs to work in there, because this is an insult to everyone who worked at Ground Zero."

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October 26, 2007

9/11 Advocates Rip ME Finding On Cop's Death; Question Basis For Ruling It's Not WTC-Related

By ARI PAUL

Advocates for 9/11 first-responders Oct. 19 blasted the Chief Medical Examiner's determination that the death of an NYPD Detective who toiled at Ground Zero was not related to his 9/11 recovery work.

Dr. Charles S. Hirsch contradicted a New Jersey doctor's finding last week that James Zadroga, who died in 2006 at age 34, was a casualty of that work. In a letter to Detective Zadroga's father, Dr. Hirsch stated that the material in his lungs that led to his illness and eventual death did not come from the World Trade Center site.

Mayor: Still Committed

"The Office of Chief Medical Examiner is an independent office whose staff make their judgments based on the medical evidence," Mayor Bloomberg said in a statement. "Their determination in this case does nothing to change New York City's commitment to make sure that all who were affected by 9/11 get the health care they need. Just last month, we expanded the free, high-quality health services at the WTC Environmental Health Center at Bellevue Hospital - a Center of Excellence - to two new expansion sites. We will continue to push Congress to provide the Federal funding we need to care for those who are sick or may become sick and to expand research that will help to better understand the health impacts of the attacks, as well as re-open the Victim's Compensation Fund."

Detectives Endowment Association President Michael J. Palladino questioned the validity and the timing of the Medical Examiner's findings, noting that the city has been hit with several class-action lawsuits concerning 9/11-related illnesses and injuries.

"Doctors have opinions and they can agree to disagree, but I don't quite understand how Dr. Hirsch can come to such a definitive conclusion when he never examined Zadroga's body nor participated in the autopsy," he said. "I think the most important thing is that the Police Department's Medical Board had deemed Det. Zadroga ill and later on disabled as a result of his assignment at Ground Zero."

'A Political Finding'

Uniformed FDNY Emergency Medical Service Retirees Association President Marianne Pizzitola, who advocates for EMS retirees with 9/11-related injuries, believed the findings were politically motivated.

"This is just another example of how a political appointee can make a determination that is in line with the City Hall message that we are not sick or dying from 9/11," she said in an e-mail. "How can Hirsch say that after working over 450 hours at the toxic WTC site, that the pulverized concrete, fiberglass, and chemicals embedded in Officer Zadroga's lungs did not cause scarring and lead to his death?"

A New Jersey's coroner's report last year stated "with a reasonable degree of medical certainty that the cause of death in this case was directly related to the 9/11 incident."

Mr. Zadroga's family could not be reached for comment.

'Stunning and Strange'

"The fact they don't even say this was a contributory factor is just strange," said Joel Shufro, the executive director of the New York Committee for Occupational Safety and Health. "I don't know what they are basing their determination on, but it's stunning. It feels like a blow to the jaw."

A trio of New York Members of Congress introduced a bill this year that would secure funding for medical monitoring and treatment for people suffering 9/11-related illness called the James Zadroga 9/11 Health and Compensation Act. One of the sponsors of the bill, U.S. Rep. Carolyn B. Maloney, said Dr. Hirsch owed the Zadroga family an explanation.

"If the Medical Examiner is so certain that the material in Mr. Zadroga's lungs was not a result of his exposure to Ground Zero toxins, then it's incumbent upon him to tell Mr. Zadroga's family where he thinks it did come from, and why he thinks Mr. Zadroga's WTC exposures did not contribute to his death," she said in a statement.

Ms. Pizzitola maintained that the evidence was clear that Mr. Zadroga died due to his hours working at Ground Zero.

"City Hall needs a dose of reality, as no rescuer in New York had any of these types of medical problems pre-9/11, but they all have the same or similar problems post-9/11," Ms. Pizzitola said. "Coincidence? I think not."

 

 

October 12, 2007

Can't Get Expenses Paid: 'Face' of 9/11 Ills Goes Unrecognized

By ARI PAUL


A lot of New Yorkers recognize Ivonne Sanchez's face, as it appears on Spanish-language posters in subway cars encouraging 9/11 first-responders to file for Workers' Compensation. Ironically, the retired Emergency Medical Technician who toiled at Ground Zero is having trouble getting the Law Department to pay for her own medical expenses.

"They still owe me money for out-of-pocket prescriptions and travel expenses," Ms. Sanchez said in a Sept. 28 phone interview. "I've been back and forth since 2002 and have not seen a dime for any of that."

Bureaucratic Shuffle

As part of what she describes as a constant struggle, Ms. Sanchez has also been waiting for approval on a follow-up procedure for her most recent of 11 lower-back surgeries. She hasn't been able to get her Caseworker on the phone in at least a year and she has left several messages concerning her pending authorization, she said. After finally speaking with the caseworker's supervisor, Ms. Sanchez was told her that the Law Department did not have any of her forms.

"I'm a little frustrated now," she said.

Ms. Sanchez is just one of many past and present Emergency Medical Service workers who find that their doctors don't get the bills paid by the Law Department or can't get medical authorization in a speedy fashion. Tony Vanaria, a retired Paramedic who suffers from post-traumatic stress disorder as a result of working in a morgue after 9/11, has faced similar frustrations.

"[He] is having a problem whereas the medical bills the Judge ordered paid, the NYC Law Department is refusing to pay," Marianne Pizzitola, president of the Uniformed FDNY EMS Retirees Association, said in an e-mail. "Tony gave the Judge a printout of all his medication. The Law Department told him they will not accept that as he could have printed it out himself."

Law Department officials noted that many doctors' bills go unpaid for legitimate reasons, and doctors may take the department to arbitration.

Claims Overcharges

"Doctors submit a bill and we respond by either paying it or objecting to it," said John Sweeney, the Chief of the Law Department's Workers' Compensation Division. "It's not uncommon to bill in excess, because it's not consistent with the fee schedule."

Ms. Pizzitola and Thomas Eppinger, the president of Local 3621 of District Council 37, which represents EMS officers, testified Sept. 24 about these problems to the City Council's Health and Civil Service and Labor Committees.

"EMS always fell through the cracks in my opinion," said Joseph Addabbo, the Civil Service and Labor Committee Chairman. "The bottom line is, it seems like although they're under the auspices of FDNY, in practice, when it comes to this issue of treating workers for 9/11, they seem to not be considered FDNY, and that obviously concerns me."

Mr. Addabbo promised to address the issue with the Mayor's Office.

"We've come a long way," he said. "We've got a long way to go. It is still an uphill battle."

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October 2, 2007

 

EMS Union Raps City
Flaws Remain In 9/11 Worker Aid


By ARI PAUL


Two City Council committees heard testimony Sept. 24 about alleged obstacles city agencies have presented to the medical treatment of 9/11 recovery workers and a Deputy Mayor's admission that some agencies need greater guidance on the issue.

The Chief-Leader/Pat Arnow

PROGRESS REPORT: Deputy Mayor for Health and Human Services Linda Gibbs testifies Sept. 24 during a joint session of the City Council's Health and Civil Service and Labor Committees about the 9/11 rescue and recovery workers' access to medical care. Looking on is World Trade Center Health Coordinator Jeffrey Hon.

The Health and Civil Service and Labor committees held their third hearing in a series on the issue. Deputy Mayor for Health and Human Services Linda Gibbs and World Trade Center Health Coordinator Jeffrey Hon testified on behalf of the city.

'Patchwork Approaches'

Ms. Gibbs noted that while Mayor Bloomberg was working to expand and invest in treatment services, the city needed more Federal funding. She also said that there was no uniform standard among agencies in how they communicated with employees about Workers' Compensation and medical coverage.

"What we really see is a patchwork of disparate approaches," she said. "We found a number of agencies that were eager for more guidance."

Mr. Hon testified that he was making progress on improving a Web site that provides information for 9/11 rescue and recovery workers seeking medical assistance.

Representatives for Emergency Medical Service workers painted a bleak picture of their experiences to the committees.

Tale Too Terrible to Tell

Retired Emergency Medical Technician Stephen Hess, who was a 9/11 responder, has developed asthma, sleep apnea, arthritis, high blood pressure, chronic cough and other illnesses as a result of his work at Ground Zero. He began reading his testimony at the hearing but became so overwrought that he stood up and walked into the Council Chambers' bathroom. FDNY EMS Retirees Association President Marianne Pizzitola read his statement.

The Chief-Leader/Pat Arnow

OVERWROUGHT: Marianne Pizzitola reads the testimony of retired EMT Stephen Hess (left), who claimed he is being denied access to medical care, at a City Council hearing. Looking on is EMS officers union president Thomas Eppinger.

"Not only are they refusing to take care of my mounting medical needs, they eventually fired me for becoming disabled as a result of 9/11," she read from his statement. "I was only allowed 18 months of LODI [Line of Duty Injury time) and despite the fact that the Fire Department's own doctors stated I was disabled, I was still terminated and [the New York City Employees' Retirement System] has repeatedly refused to grant me a disability pension."

Thomas Eppinger, the president of Uniformed EMS Officers Union Local 3621 of District Council 37, outlined several problems EMS workers encounter, arguing that Mr. Hess was just one example.

Coverage Cut Off

"Members have been advised that due to the NYC Law Department not paying claims, their practitioners and treatment centers will no longer care for them for free," he said.

Mr. Eppinger also lamented that EMS workers had to rely on the Fire Department for fitness evaluations.

"Currently there is Federal legislation that has been introduced that includes a provision for all FDNY members to be forced into the FDNY monitoring and treatment programs for WTC Health," he said. "Many of our active members will not admit to their illnesses during this exam out of fear. They are afraid that once they inform their employer they are ill, they will be placed on sick leave, and after they exhaust their leave banks they will be without a paycheck and, worse, terminated. As a result of members not going on record that they are ill, they secretly suffer and the health issues only get worse."

High Illness Rate

Out of Local 3621's 415 members, 65 have admitted to having 9/11-related illnesses, Mr. Eppinger testified. Civil Service and Labor Committee Chairman Joseph P. Addabbo asked if the union had expressed its concerns to the Bloomberg administration. Mr. Eppinger replied, "We've gotten nowhere with the city Law Department." Liaisons for U.S. Reps. Jerrold Nadler, Carolyn Maloney and Vito Fossella told the committees about the importance of the James Zadroga 9/11 Health and Compensation Act. This bill, as Congresswoman Maloney's representative said, would "ensure that everyone exposed to Ground Zero toxins has the right to be medically monitored and that anyone who is sick as a result has a right to treatment."

Mayor Bloomberg has voiced support for the bill and Council Speaker Christine C. Quinn introduced a resolution supporting it the following day.

After the hearing, Mr. Eppinger expressed optimism that the two committees would work to make things better for his members.

"These guys are great," he said. "They're fantastic. Nobody wants to hear that first-responders are getting screwed."

Invoking the post-9/11 mantra of "Never Forget," Council Health Committee Chairman Joel Rivera had a message for the EMS worker representatives at the conclusion of the hearing.

"Don't give up," he said.

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September 28, 2007

Treatment on Hold
Ill WTC Medic Gets Brush-Off by City

By ARI PAUL


Tom Carlstrom's 450 hours of 9/11 rescue and recovery work began inside the North Tower of the World Trade Center minutes before it collapsed. As an Emergency Medical Service Paramedic, he had set up a triage station at the tower and then evacuated before the collapse, moving to a mobile emergency room where he stayed until 9 a.m. the next day.

The next few months he worked on the pile and in the morgue. Like many first-responders, he did not wear a respirator, because they were not made available, until December.

'Got Sicker and Sicker'

"I knew I was getting sicker and sicker." he said. "I had the 9/11 cough. But everybody had it and I just figured it would go away."

It wasn't until the anniversary of 9/11 in 2004, after he had been promoted to Lieutenant, that Mr. Carlstrom found out how serious his health problems were. He collapsed coming up the ramp at Ground Zero after leaving flowers and could barely breathe. He spent the next several days in a hospital intensive-care unit. Since then, he has been diagnosed with asthma and reactive airway disease. Doctors believed that he might have sarcoidosis and gastroesophageal reflux disease as well, he said. At the age of 54, his first day of retirement was Sept. 11, 2006.

He had been seeing a pulmonologist regularly at a lung center for the last three years near his Long Island home. Even though a Workers' Compensation Judge had ordered the Law Department to pay his medical bills without prejudice, Mr. Carlstrom said, he received a call from his doctor's office Aug. 27 informing him that the doctor had only been paid once by the Law Department and that he could no longer see the doctor unless he came with a "pre-approval" form.

Mr. Carlstrom called the Law Department and left messages urging someone to look into his case, but he has yet to hear back.

'Ignored Court Orders'

"It's just so wrong," Mr. Carlstrom said. "They've been ordered by the courts, for God's sake, to pay these bills and they don't do it. I don't know how they get away with it."

Thomas Eppinger, the president of Uniformed EMS Officers Union Local 3621 of District Council 37, has testified to the City Council about doctors not receiving payments from the Law Department, leaving EMS workers unable to get medical attention.

"That's not unusual, that's a common occurrence," Mr. Eppinger said of Mr. Carlstrom's case. "That's been going on for years."

Mr. Eppinger was unsure about what more his union could do to ameliorate the situation, and Marianne Pizzitola, the president of the Uniformed FDNY EMS Retirees Association, lamented that neither the State Workers' Compensation Board nor the State Insurance Department could do much to compel the Law Department to pay Mr. Carlstrom's doctor.

'Mayor Could Stop Them'

"The one person who controls the Law Department is Mayor Bloomberg," Ms. Pizzitola said. "He can stop this behavior and he doesn't. [The Law Department is] a political entity. They're not a real insurance company."

John Sweeney, Chief of the Workers' Comp Division at the Law Department, said it often does not pay bills in full or at all if there are problems such as the fees going beyond the set schedule. Normally, if the department objected, he said, it would contact the doctor to resolve the problem.

"There are a lot of doctors who don't get paid for legitimate reasons, and because we've made a mistake too," he said. "I would suggest he contact us."

Mindy Roller, the Deputy Chief of the division, found the situation odd.

'Let Doctor Reach Out'

"If a doctor is telling his patient he can't treat him and hasn't reached out to us, it's an unusual circumstance," she said. "The doctor should reach out and we should deal with it appropriately."

Mr. Carlstrom did not blame his doctor for telling him that he could no longer treat him. He guessed that the doctor continued to see him without payment because he was a first-responder on 9/11.

"They were just being great to me and they can't do it anymore," he said. "I thought they were getting paid."

Nearing the anniversary of his retirement, Mr. Carlstrom did not know how he would treat his illnesses from now on. He needs surgery on his sinuses and he is still affected by asthma and reactive airway disease. He is able to laugh at what he sees as the absurdity of the system, only to be interrupted by coughing.

Ms. Pizzitola saw him as a victim of a Law Department unwilling to pay what they have been ordered to and a Mayor who is unwilling to pressure it to do so.

"This needs to be changed," Ms. Pizzitola said in an e-mail. "But as long as politics stays the same, the city and the state will have blood on their hands."

September 7, 2007

1 in 8 Recovery Workers
City Finds Post-9/11 Trauma is Common

By ARI PAUL


Tony Vanaria was an Emergency Medical Service Lieutenant responding to an airplane expected to crash near LaGuardia Airport in early 2003 when he started to shake uncontrollably and was overcome with nausea. The thought of seeing dead bodies, which he had witnessed so many times in his career, paralyzed him.

MARIANNE PIZZITOLA: 'Things have to change.'

 

"I just fell apart," he recalled last week. "I didn't know what to do."

Common for 9/11 Workers

Mr. Vanaria, who has since retired, has post-traumatic stress disorder, as do one in every eight 9/11 recovery workers. In the days after the attacks, he sifted through body parts in the morgue at Bellevue Hospital and picked through the rubble at the World Trade Center, sometimes for more than 12 hours at a time. When he went back to his regular work with EMS, the sight of human suffering triggered a stench of rotting flesh in his nose so strong it caused diarrhea and left him unable to perform his duties.

The Health Department released a study Aug. 29 showing that 12.4 percent of 9/11 responders have PTSD, and more specifically, that 12.2 percent of firefighters, 11.6 percent of EMS workers and 6.2 percent of police officers doing rescue and recovery work have the condition. Only 4 percent of the general population has PTSD at any one time.

 

'I JUST FELL APART': Retired Emergency Medical Service Lieut. Tony Vanaria suffered post-traumatic stress disorder as a result of his recovery work after 9/11. A recent Health Department study showed that one in eight recovery workers suffered from the condition.

 

'I JUST FELL APART': Retired Emergency Medical Service Lieut. Tony Vanaria suffered post-traumatic stress disorder as a result of his recovery work after 9/11. A recent Health Department study showed that one in eight recovery workers suffered from the condition.
 

"People with PTSD are also more likely to suffer from depression and substance abuse," said Health Commissioner Thomas R. Frieden in a statement. "The [World Trade Center Health] Registry helps us gauge the persistence of these problems over time. It also helps us inform the public and the medical community about the health effects of 9/11, so that people can get the best possible care."

Warned Against Filing

Mr. Vanaria said that when he went to file for workers' compensation in 2003, he was told by then-Capt. Jay Swithers, who is responsible for handling EMS employees' workers' compensation cases, that his pay would be withheld if he filed.

The Law Department fought Mr. Vanaria's claim, but a Worker's Compensation judge ruled in his favor June 7. While Mr. Vanaria emerged victorious, he remains angry about the ordeal.

"I don't feel vindicated," he said. "I had to be abused first. I felt for the years I put in I was treated like a piece of garbage."

Marianne Pizzitola, president of the Uniformed FDNY EMS Retirees Association, said EMS workers involved in 9/11 recovery suffered PTSD acutely because their work was especially gruesome, such as trying to organize body parts in morgues.

"They weren't meant to see this," she said. "This was like putting them in the middle of a war zone."

'Things Must Change'

While Ms. Pizzitola was pleased to see the Health Department recognize the effects 9/11 recovery work had on first-responders, cases like Mr. Vanaria's kept her skeptical.

"There are not enough Workers' Compensation-approved doctors," she said. "And the Workers' Comp Board does not want to reimburse them. They've got to do something to help. Things have got to change. Do I think this report will help? Absolutely not."

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June 26, 2007

NY Daily News

Why didn't they warn us, asks 9/11 hero

 

WASHINGTON - For Lt. William Gleason, Christie Whitman has only brought pain.

Yesterday, the disabled Fire Department paramedic came to Washington to hear Whitman explain why she didn't warn him and thousands of other 9/11 responders that Ground Zero was more dangerous than they thought.

He was not satisfied.

"The sad part is, she tried to blame everyone else," said Gleason, who retired from the FDNY in 2004 as nodules started growing on his scarred lungs and his breathing deteriorated. "She was not open and honest."

Gleason, who worked out of Elmhurst Hospital Center, drove to Ground Zero on a "Gator" - a six-wheeled golf cart used to move bodies - because that was the only way to get there on Sept. 11, 2001.

He spent much of the next three days there, searching for survivors and treating some of the wounded. But there were relatively few of those, and he and fellow Emergency Medical Service officers ended up on a grim detail of combing through the dust and debris to recover and catalogue the body parts.

"It was find it, put it in the red bag and put in the container, write it up," he said. He carried a clean American flag on his cart every day in case he found one of the 141 friends he had lost.

"I'm not gonna put them under a dirty flag," he said.

That sense of loyalty and patriotism is what drove him in those days. He doesn't think Whitman gave it back.

"We just went in there to do our jobs, and we didn't ask too many questions," Gleason said. "You rely on the people above to watch your back, and they didn't."

Still, if he could, he'd rush to Ground Zero again, knowing the risks. "I would," he said. "But I'd protect myself."

mmcauliff@nydailynews.com

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Retirees go to Washington DC to tell the Senate our Story:

On March 21, 2007 The FDNY EMS Retirees Association and the Uniformed FDNY EMS Officers Union Local 3621 went to Washington DC with some of our members to tell the US Senate Committee on Health Education Labor and Pensions about our experiences.  We submitted additional testimony, and you can read that here.

                    Testimony in PDF                      EMT Stephen Hess' Testimony                        LT. William Gleason Testimony

 

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A battle for meds to keep breathing

 

Marianne Pizzitola of FDNY EMS Retirees Association with ex-Emergency Medical Service worker William Dahl, who says city won't pay for lung scans.
EMS workers Ray Simons and William Dahl spent countless hours at the World Trade Center site - and their bodies prove it.

Their lungs are scarred and pocked with nodules. Both men rely on devices and medicines to help them breathe every day.

But even though the city agrees that Simons, 56, and Dahl, 42, are too sick to keep working, they say it's been a constant battle to get the city to pay for treatment as simple as a CAT scan or tissue biopsy.

"This is the city's responsibility to its employees, and they are not doing it," said Dahl, who lives in Seaford, L.I., with his wife and two children.

Simons said he was hours away from surgery last month when it had to be canceled because the city had not signed off on the procedure to remove a piece of his damaged left lung.

"It's ridiculous. It's like the sword of Damocles hanging over," said Simons, a 24-year veteran who lives on Long Island. "It's not an operation I want in the first place - it's scary."

Dahl said he can't get approval for regular scans to check the increase in nodules on his lungs.

Advocates say the plight of the two men shows that some 9/11 rescue workers still have trouble getting help even though their illnesses can be directly traced to the terrorist attacks.

Unlike police and fire employees whose cases are handled by their departments, Emergency Medical Service workers must go to the city's Law Department to get treatment approved. "Weeks and months go by, and these guys are getting sicker and sicker," said Marianne Pizzitola, president of the FDNY EMS Retirees Association. "It shouldn't take this long to get authorization or clearance. Anything related to 9/11 seems to be a fight for these people."

The Law Department insists it is not trying to cheat injured workers.

"The only time we object to medical treatment is if we have a medical expert who believes it's not warranted," said John Sweeney, the Law Department's workers' compensation division chief.

"Doctors disagree on treatment. We have lots of workers' compensation board hearings. We try to do the right thing on each case."

After calls were made by the Daily News, Simons' surgery was approved.

Law Department officials said the surgery had not been approved because it was still being reviewed, a process that can take several weeks. They said similar surgeries are scheduled months in advance.

Even though Dahl said he spoke with department personnel about treatment requests, officials said last week there was no record of requests for procedures from Dahl's doctors. They did promise to review any future requests.

"My experience has been a fight since day one," Dahl said.

Originally published on February 5, 2007

 

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Retro Checks In Limbo for 300 Ex-EMS Staff
1/26/07
By GINGER ADAMS OTIS

Approximately 300 retroactive paychecks for former Emergency Medical Service workers are being held by the city because recipients haven't stepped forward to claim them, THE CHIEF-LEADER has learned.

 

CAN'T COLLECT WHAT'S DUE: Paramedic David Reeve, shown here in happier times with daughter Elizabeth, son Mark, and his deceased wife Deborah, learned last week that a paycheck in Deborah's name worth $10,000 that should have been sent to him last July now has to be reissued - after he again submits paperwork to the city proving her death.
The checks are owed to EMS members under a contract deal reached with the city in June 2006 that granted retroactive wage hikes stretching back to 2002.  

'Actives' Updated in July

The city's 3,000 active EMS members got their back pay tacked on to regular payroll checks last July. But a group of retired EMS workers - curious why their payments hadn't materialized - discovered many were being held by the FDNY.

According to Marianne Pizzitola, a retired Emergency Medical Technician who formed the Uniformed FDNY EMS Retirees' Association, FDNY officials initially attributed the backlog of checks to former workers who moved and didn't provide forwarding addresses or were otherwise untraceable.

FDNY Deputy Commissioner Francis X. Gribbon during a Jan. 19 interview stated that a good-faith effort was being made to get payments out. The first priority was active members, he stressed, who had all been paid. The only checks still in FDNY possession were those sent back by the Postal Service due to changes in address, he said.

'They'll Get Their Money'

"We are not trying to keep people from being paid," he insisted. "Anyone who is owed will get their money."

Ms. Pizzitola succeeded in getting a list of 439 names of persons with unclaimed checks from the Office of Labor Relations last fall, and realized most of the money being held belonged to EMS workers who retired, died or were fired after 2002.

Through a word-of-mouth campaign and Internet searches, her organization succeeded in locating 84 people on the OLR list - all of whom said they had never been contacted by the city or the FDNY about a retro check.

Wife Was Due $10G

Among them was David Reeve, an active Paramedic whose wife, Deborah, died in March 2006 from mesothelioma, a deadly cancer her friends and family believe was contracted during her time at Ground Zero.

I got a call from a colleague in EMS who said I should check to see if my wife was owed money," said Mr. Reeve, who now holds two jobs to provide for his children, Elizabeth and Mark.

After a round of calls in late August and early September, Mr. Reeve learned that the city was holding a check totaling just under $10,000 in his wife's name.

Despite having filed numerous pieces of paperwork with several city agencies declaring himself and his children her beneficiaries - and receiving regular line-of-duty death benefit payments into his account - he was told the check couldn't be released to him.

Put Through the System

"They said they'd take it back and cut it again and then send it along, but it took two months for supervisors to approve that," Mr. Reeve said.

The Reeve family has lived at the same Bronx address for the past 12 years, and Mr. Reeve said he never received written or verbal notification that his wife's funds were waiting to be claimed.

Busy with the demands of single-parenting and work, Mr. Reeve waited several months before contacting the city again.

Last week he reached someone in the Office of Payroll Management, who confirmed to him that a check was waiting, but it was still in his wife's name.

"It's just sitting where it was four months ago, and nothing has changed," he said during a phone interview Jan. 18. "They told me to send in the same stuff I've sent to the city several times before - proof of death, spousal proof, kids information, Social Security numbers and bank accounts, and when that's processed, I can have my wife's retro pay in 30 to 60 days."

Strange Omission

Several other retired or terminated EMS members contacted by this paper shared similar stories. Former EMS Lieut. Peter Escalera, who retired a few years ago and moved to New London, Conn., said he gets regular mailings from the FDNY, but never knew he was owed a check.

"I don't know how much it's for, but if it's over $50, I want it," said Mr. Escalera, who suffers from lung disease related to 9/11.

While his retro payment hasn't appeared in the mail, he gets semi-annual orders from the FDNY's Bureau of Health Services to come into the city for medical check-ups as part of the WTC registry.

"I just got one the other day telling me to go to NYU Hospital for a lung scan to see if the scarring I've developed has gotten worse," he said. "I get all my retirement benefits and departmental mailings at this address, so I gotta figure the FDNY knows where I live."

Mr. Gribbon, when asked about Lieutenant Escalera's situation, said it was possible some individuals who moved could receive pension payouts from the city or FDNY health updates but not their retro checks because "those are completely different databases." But he reiterated that "every effort is being made to get people paid."

 

Abusing The Disabled

December 29, 2006

To the Editor:

After reading "City Tries to Limit Disabled Doctor Visits" (Dec. 19 issue), I feel compelled to correct the comments of EMS Local 2507 President Patrick Bahnken. Mr. Bahnken stated he "encouraged retired and active EMS workers to arbitrate any problems they had with the Workers' Compensation system." He said the city had the right to challenge any invoice it felt was unauthorized.

To clarify, no arbitration procedure exists for the injured workers to fight for treatment. Currently, the only arbitration procedure is for medical providers - when they are not being paid by the city - to arbitrate their bills or take a reduced settlement. All of our disputes must be resolved in a Workers' Compensation hearing before an Administrative Law Judge.

This is not a matter of "unauthorized treatment." Our treatment has already been authorized by the state. We should not have to fight for treatment that has already been approved. The city is trying to limit treatment and withholding payment for services for treatments they have already authorized. As disabled workers, we have already been found permanently disabled by the NYS Workers' Comp Board and were all granted symptomatic treatment at our hearings before an Administrative Law Judge. Under the law, we are entitled to treatment of our symptoms, whether it be twice a month or twice a week.

State officials advised that when they look at the treatment over a long period of time, they look to see peaks and valleys, and said that the Law Department is not correct in its actions in limiting care to 1-2 times per month. In my conversations with the State Comp Board attorney, I was advised the city has free rein to do as it wants and the state has no recourse. The state has advised the Law Department on numerous occasions that its interpretation of the state law is erroneous, yet the city acts without consideration for the state's position. This is an egregious failure on the part of the state and abuse of power on the part of the Law Department that has gone unchecked.

The Law Department is not just violating the law but the rights of these injured workers. The system needs help, and if our people are forced to fight a system that our unions know is not working, we as leaders should be compelled to change that system, and hold the carriers responsible so the system does not further add to these workers' troubles. The unions have an even greater impetus to force the city to follow the Comp Law as written and interpreted by the state; if they do not advocate for the Law Department to pay for our treatment as ordered, it has been shown that most people will resort to using their union health benefits to pay for their care.

MARIANNE PIZZITOLA, President, Uniformed FDNY EMS Retirees' Association, Inc.

 

 

 

12/22/06

Violating 'Comp' Policy?
City Tries to Limit Disabled Doctor Visits


By GINGER ADAMS OTIS


More than a dozen retired Emergency Medical Service employees who receive Workers' Compensation benefits from the city have gotten letters from the Law Department limiting the number of doctors' visits they can make each month.

 

The letters authorize the EMS workers, all of whom retired after suffering debilitating on-the-job injuries - two of them on Sept. 11 - to seek "symptomatic treatment (1-2 times per month)."  

Broader Definition

But according to the definition provided by the state Workers' Compensation Board, symptomatic treatment is defined as medical care "as needed" to treat symptoms.

Jon Sullivan, a spokesman for the state board, urged any workers who felt they were being denied medical care that they were owed as part of their Workers' Compensation settlement to contact his agency's Worker Advocacy hotline.

He stopped short of saying that the city was breaking the law by setting a monthly cap on medical visits.

"At times insurance carriers seek to limit treatments to keep costs down," he said. "The board does not share their interpretation of their ability to do so."

 

CAUGHT IN THE SYSTEM: Richard McAllan (left) and William Dahl are among the former Emergency Medical Service workers who take issue with the city's attempt to restrict them to no more than two visits a month for treatment of their disabilities. Mr. Dahl asked, 'What am I supposed to do for the rest of the month - choke?'
Workers can appeal treatment denials to an Administrative Law Judge at a Workers' Compensation hearing, he said, but results are specific to the instances being grieved. The judge has no ability to compel a change in policy, meaning workers would have to grieve their claim for treatment every time they feel it's wrongly denied.  

City Not Talking

Because of medical privacy regulations, the Law Department declined to comment on the letters it sent to the EMS workers. A spokeswoman also declined to speak generally about its policy regarding symptomatic treatment.

But statements made by a Law Department official at a court hearing involving retired Paramedic Richard McAllan revealed details of the department's approach.

Mr. McAllan, who has sued the city for infringing on his First Amendment rights, alleged that the city was denying him medical treatment that he was legally entitled to by his Workers' Compensation award in retaliation for his previous suits.

He brought his argument to U.S. District Court in Manhattan this summer (a decision is pending).

Mr. McAllan, as part of a Feb. 17, 2005 decision from the state Workers' Compensation Board that his on-the-job back injury was a "permanent partial disability," was granted permission to seek "symptomatic treatment."

According to court documents submitted by Mr. McAllan, the city refused to pay his chiropractor for treatments given to him on March 7, 12, 14, 19 and 23, April 9, 11, and 16, and May 14, 18 and 24 last year.

'Questioned the Need'

The Law Department sent his chiropractor a letter stating that the dates of service were denied "because we questioned the need and frequency of the treatment."

It continued, "Please be advised that Mr. McAllan was authorized for symptomatic treatment per hearing held 12/17/05. Symptomatic treatment is not an authorization for treatment twice a week. ... Dates of service that were denied must be referred to the New York Workers' Compensation Board for arbitration." During those hearings Mindy Roller, Deputy Chief of the Law Department's Workers' Compensation Division, offered a statement to the judge about how the department viewed symptomatic treatment.

After reiterating the facts of Mr. McAllan's case, including his Workers' Compensation award and permission to seek symptomatic treatment, Ms. Roller pointed out that "there is no specific frequency of treatment ordered in the WCB decision. However, the term 'symptomatic treatment' is a term of art frequently utilized in WCB decisions. ... [It] is generally understood by judges, attorneys and medical providers ... to mean medical treatment once or twice a month."

Challenge If More

She said that "in the ordinary course of business, the Workers' Compensation Division will challenge any claims for symptomatic treatment that occur more than one or two times a month."

Ms. Roller also stated that "the general policy of the Workers' Compensation Division is to question excessive treatment by medical providers where only symptomatic treatment has been authorized by the WCB. The city's decision ... was in complete compliance with the WCB's determination."

Leonard Schwade, a retired EMS worker who moved to South Carolina in August 2005, said he's had problems getting treatment from doctors who fear they won't get paid by the city. Although he had not sought symptomatic treatment for his disability - a nerve disorder known as Reflex Sympathetic Dystrophy - for several weeks, he too got a letter from the Law Department telling him he was only authorized for one or two visits a month.

While his symptoms have been in abeyance recently, he worries about the future.

Worst Kind of Side-Effect

RSD, a known potential side-effect of some surgeries, involves the body's mechanism for pain recognition. It upsets perception down the damaged nerve, setting off intractable pain that's often worse than the original injury. Over time RSD can spread as other nerves in the body's "sympathetic" central nervous system get affected.

Mr. Schwade had an electronic sensor similar to a pacemaker implanted in the vertebrae of his neck - it sends pulses through his arm that block the pain signals being sent to his brain.

The doctor that provides his regular medical care - not symptomatic treatment - is in New York and Mr. Schwade travels to see him. After eight surgeries and a bout of meningitis that almost killed him, his condition is fairly stable, but he has two doctors in South Carolina.

"The only problem is the city hasn't paid them since last year. I complained to the state, they got involved and I sent them all the bills," Mr. Schwade said. "The city said it had paid them, and now they just won't answer my queries. So doctors don't want to treat me, because they know they aren't going to get paid."

Trouble Being Seen

He goes to the chiropractor a few times a month and has a pain management specialist who refused at first to see him without approval from the city. Mr. Schwade got it, but because the city hasn't paid the doctor's bills, he has difficulty getting appointments.

"I worry about what would happen if I needed another implant, or the pain increased or some of the worse symptoms return," he said. "If I can't get treatment for something that's approved because doctors don't get paid, they certainly aren't going to give me symptomatic treatment the city has said it won't approve."

Retired EMS worker William Dahl, who was approved for a 9/11-related Workers' Compensation disability after developing severe respiratory problems in the wake of the disaster, has been waiting since Oct. 21 for approval of a scan to see if the nodes on his lungs have grown in the past year.

'City Won't Respond'

"It's fairly routine; my doctor told me, 'It's time for another lung scan to see what's going on,' and I can't get them to respond to his authorization request," said Mr. Dahl. He also got a letter telling him any symptomatic treatments would have to be limited to two times a month.

"I haven't needed that yet - I'm more worried about getting my regular medical care approved right now," he said.

But if his breathing were to worsen, for example, and he needed to see a pulmonologist to address the flare-up, Mr. Dahl worried that twice a month wouldn't be enough. "What am I supposed to do for the rest of the month - choke?" he asked.

Mr. Dahl learned last week that clearance for his lung scan had been denied. "The supervisor told me, it was a diagnostic test, and I was only authorized by the comp judge for symptomatic treatment," he said.

May Hold Hearing

City Councilman Joseph P. Addabbo Jr., who chairs the Civil Service and Labor Committee, said he was considering holding a hearing on the issue of symptomatic treatment.

DC 37 Local 2507 President Patrick V. Bahnken, who represents EMTs and Paramedics, encouraged retired and active EMS workers to arbitrate any problems they had with the Workers' Compensation system. He said the city had the right to challenge any invoice it felt was unauthorized, but said it would "lose a lot of money" if workers challenged them in return.

At the same time, he noted, the byzantine Workers' Compensation system was often too much for injured or ill people to tackle.

"I have no doubt that the Law Department can find the legal logic it needs to make sick people crawl across the grass on their hands and knees," he commented. "That doesn't mean it's not morally reprehensible."

 

May 30, 2006

FOR THE RECORD

The Fire Department's Emergency Medical Service Bureau may soon have its first retirees' association.

A group of retired EMS officers and rank-and-file members met May 22 to set up a fraternal organization to address the practical and emotional needs of EMS personnel after they leave active service.

"We're trying to get it off the ground. I think we're a special group of people and I think we have special concerns that other folks don't really have," said Peter Hosey, a retired EMS Chief. "That's one part of it - the other is to continue the mutual friendships that we've developed over many years on the job."

Because the unions representing EMS workers - Local 2507 for Emergency Medical Technicians and Paramedics and Local 3621 for EMS Officers - fall under the umbrella of District Council 37, the bureau's retired members are expected to join DC 37's Retirees' Association, headed by Stu Leibowitz.

"Stu does such wonderful work for his members. We're not trying to undercut his organization," said Marianne Pizzitola, a retired member of Local 2507 and pension coordinator for Local 3621.

But she noted that many EMS workers who go on disability retirement are considerably younger - sometimes in their 30s and 40s - than the members of DC 37's Retirees' Association, and that the pension concerns of many EMS workers don't match those of the majority of DC 37 members.

Mr. Leibowitz said several locals have set up retiree organizations for members while remaining active participants in the DC 37 Retirees' Association that he heads. "I'm from Local 371 and am very familiar with its group. Local 375 has one too," he said. "I don't have any problem with locals setting up individual associations. God bless 'em."

The yet-to-be-named EMS group had about 20 members at its inaugural gathering, which was also attended by Local 3621 President Thomas Eppinger.

"I wanted to show them my support and see if there was any way we could help them get started. An organization like this could be really important, especially for educating newly-retired members and as a source of support for others as they try to adjust and work through the paperwork of drawing benefits and all that," the union leader said. "As we all know, information can fall through the cracks, so this kind of network is a crucial resource."

Retired EMS Chief Hosey said one issue members were eager to discuss related to the cost of living adjustments awarded to EMS retirees.

"I just got my COLA check in the mail and it was approximately 1 percent of $18,000 - that is not a big check," he said. But it was standard for EMS retirees who are bound to the DC 37 terms of COLA payouts, which peg the increase to a percentage of $18,000 regardless of how much a retiree is actually drawing. For most EMS workers, it's more than $25,000.

Many retirees were also surprised to learn that they had no say on the four-year contract recently reached between the Bloomberg administration and their union leaders. Since only dues-paying members in good standing can participate in ratification votes, retirees were effectively disenfranchised, even though those who retired after 2003 are eligible for the retroactive pay raises agreed upon in the deal.

"It behooves the unions to pay attention to our needs - this is just one example," said Chief Hosey. "We are retired, sure, but like I tell the union presidents, you're gonna be retired too one day. Won't you want to know what's going on?"

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