Surgical Career Toast Due to Dermatitis

[synesthesia56]

Hi, and Thanks for this Wonderful Site,

I'm a 54 year old surgical technologist who has developed chronic/recurring dermatitis on my hands from all the surgical scrubs my job requires me to do. I'm still working on modified duty, but I believe they are going to try to bump me into a lower paying position as every time my dermatitis clears up and I return to scrubbing my dermatitis comes back.

I believe retraining is an option, but I wish to avoid this, as at my age, in this economy, I fear my employment options will be limited. I understand if you choose retraining this is the end of the road at your previous job, and you are on your own once training is complete.

I have NO college (surgical technology is a vocational certification), and I fear the only jobs they may offer me is stocking shelves or patient transport etc. which pay about half what I make now.

An interesting side note... My surgical unit has adopted an unusual practice the last few years in which they require us to scrub in and out, then back into the same case every time; effectively doubling the number of surgical scrubs we are required to do in a day. This practice greatly increases the potential for "occupational irritant dermatitis" and several other nurses and surgical technicians have developed dermatitis similar to mine in our unit.

The nurse practitioner I see in employee health has requested a review of this cluster injury in our unit by the safety officer at work. My supervisor is scrambling like mad to cover up this anomaly in our unit with plausible deniability regarding the unusual amount of scrubbing we are required to do, and I believe they will decide the remarkable dermatitis rate in our unit is not unusual, even though it is.

The nurses who developed dermatitis simply move into a role that does not involve scrubbing, and the surg techs with dermatitis are working through their injuries with sores and bandages on their hand and arms, trying to avoid modified duty and/or an end to their careers. A sort of "don't ask, don't tell" and you can keep your job situation. My supervisor will claim any dermatitis that has occurred in the past has been resolved, and I am the only one claiming to have a problem now.

I am not allowed to scrub with my dermatitis, as since the cluster injury has been reported they are following me closely as a potential troublemaker. I am being isolated as the lone employee who's dermatitis has failed to resolve, and expect to be scooted out of the unit into a substantially lower paid position to resolve their problem.

I don't really want to sue anybody, but it looks like my career is toast due to the excessive scrubbing demand my supervisor has placed on the staff in hopes of increasing productivity.

What I need to know is... What are my rights regarding being forced into a position that may only pay half what I'm making now?

Thanks for any input you might have.

[Alice Dodd]

Have you filed for worker's comp? Are you being treated by a worker's comp doctor?

[synesthesia56]

Hi Ms Dodd, I filled out an accident report and was contacted by the work comp carrier which requested a 10 year medical history for their discovery process.

I haven't missed any work, so I haven't filed a claim for hours. The hospital I work for has a very aggressive work comp manager and he's made sure there is modified duty work available to me.

I've only been seen by the employer nurse practitioner, but I believe she will send me for a dermatology consult when I see her tomorrow, as this is the process all the other employees with dermatitis have said they have been through.

The work comp dermatologist waits for our skin to clear and then returns us to work without followup. At that point we realize if we go back to employee health with another outbreak, we will be referred for re-assignment, retraining, or settlement.

We all want to keep working, and this causes the don't ask don't tell policy to develop. Our supervisor can then say the dermatitis is resolved when in fact it is not.

My dermatitis is a bit worse than my co-workers, and is concentrated in "nummular" lesions which are more noticeable than the disseminated dermatitis of my coworkers.

Thanks for your help with this!

[CatBert]

Have they given you any reason to think this is going to happen? It seems to be a lot of speculation.

[synesthesia56]

The other technicians who have been through the process told me that they were told if their condition was chronic and did not improve after several modified duty attempts they would need to plan on reassignment or settlement.

I was on modified duty for a month while my dermatitis resolved. After only 4 days back scrubbing, my dermatitis is back, worse than ever. I will see employee health tomorrow for a second round of modified duty, and I assume, a referral to a dermatologist, much as those who have gone before me have described.

This really has me worried... How swiftly it comes back... I was trying to be very careful.

Thanks again for your help CatBert

[CAIW]

In reviewing your posts I see you are in California.

In nearly all states, including Calif, filing a claim for benefits under your employER's plan for industrial injury/illness is the exclusive remedy. Therefore, in all but the rarest circumstance, you cannot sue your ER in civil/tort action.

The condition you describe may or may not be industrial...it's probably a CT/Cumulative Trauma claim though. There may also be underlying cause of your dermatitis, but this would still be a compensable claim as aggravation to a pre existing condition or prior injury would be a valid 'injury/illness' in the workplace.

If your ER is legally self insured, it would be appropriate that there would be one person, CA/claims adjuster handling the injury/illness claims for the ER.
If there is a WC carrier then they would handle the claim, and ER not be involved but for light duty/modified job or RTW consideration at MMI.

Whether self insured, or covered under a liability policy, under Calif statute, you must have a ''doctor'' ...PTP/Primary Treating Physician to diagnose and develop a treatment plan. PA/phy asst, or NP/nurse practitioner may assist and write Rx were appropriate, but it takes a PTP to certify an IW for all benefits, whether wage replacement/TTD/TPD, or medical care.

Some of this isn't clear based on the info you have provided.

I filled out an accident report and was contacted by the work comp carrier which requested a 10 year medical history for their discovery process.

That makes this sound like there is a insurance company providing the benefits in your claim. Therefore, your ER employEE's should not be involved in your care or treatment plan. Even though there may be a 'nurse' or supervisors have nothing to do with any claim determinations. Whether they are ''medical professionals'' or not.

So... based on the info here...
1) You should be sure there has been a DWC-1 First Report of Injury filed with your ER. They must in turn file a claim with their WC carrier. (then step aside completely and let the CA investigate your claim)
2) You must have a PTP/Dr to diagnose and treat your claimed injury.
3) As you apparently have not been provided notice of the PTP approach, you are free to treat with a Dr of your choice, does not have to be in the carriers MPN/network. And if you are working in a hospital, or surgical center, your PTP should probably not be a co worker.

The other technicians who have been through the process told me that they were told if their condition was chronic and did not improve after several modified duty attempts they would need to plan on reassignment or settlement.

Try not to make comparisons of your injury/illness and claim with what other EE's may have been though, or what they "think" is the next step or ''guess'' to what the final outcome may be. Few EE's are actually fully versed in the WC system, or how/what benefits are provided.

As to your return to work/job/career issues.
Once you have been diagnosed/treated/recovered to a point of MMI/max med improvement, you will be evaluated and rated for PD/WPI (permanent disability/whole person impairment). At that time, your ER must make the decision to offer you a job that fits within any restrictions you may have. That job must be for a period of one year or more, and pay not less than 85% of your pre injury AWW/Average Weekly Wage.
If you suffer any residual PD/impairment, or reduced capacity to compete in the open labor market, there would be indemnity due, based on the PD/WPI rating you receive once you are determined to have reached MMI.

Keep in mind, being MMI does NOT mean you won't be eligible for additional treatment. Once you have a accepted claim, the ER/IC is responsible for treatment to your injury/illness "for life", or until you cash out the medical in your claim. (yet another reason for there to be an actual claim filed and process under the WC rules/statutes.)

You may or may not be eligible for TPD/Temp Partial Disability if you have wage loss prior to MMI.

I will see employee health tomorrow for a second round of modified duty, and I assume, a referral to a dermatologist, much as those who have gone before me have described.

OK...IMHO. Stop seeing the EE health care person. GET a PTP to diagnose/treat your injury.
Let the WC carrier CA/claims adjuster handle this claim, and step away from other EE's where you work. All they are doing is attempting to delay/deny benefits and the WC process. Be SURE a formal claim has been filed. If not, DO it immediately, or you could forfeit benefits by delaying.

Fact Sheets for Injured Workers are here http://www.dir.ca.gov/dwc/InjuredWorker.htm
If you have difficulty with your ER/IC or claim, you can talk to an Information and Assistance officer at the WCAB, or an attorney, specializing in WC claims.

So far, it appears your ER is attempting to avoid a formal Workers Compensation claim... that is illegal in Calif. The law requires any injury/illness that requires more than basic first aid to be reported and a claim filed with the ER WC carrier.
Your ''agressive'' WC person is not playing by the rules here.

[synesthesia56]

OK, this answers a lot of my questions...

Many thanks CAIW!

I'll get the ball rolling today.

Thanks to you all for your wonderful help.